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Journal articles on the topic 'Moral and ethical aspects of Suicide'
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Tulsky, James A., Ann Alpers, and Bernard Lo. "A Middle Ground on Physician-Assisted Suicide." Cambridge Quarterly of Healthcare Ethics 5, no. 1 (1996): 33–43. http://dx.doi.org/10.1017/s0963180100006708.
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“[A] murder prosecution is a poor way to design an ethical and moral code for doctors,” observed the California Court of Appeal in 1983. Yet, physicians who have chosen to help terminally ill patients to commit suicide have trespassed on illegal ground. When skilled medical care fails to relieve the pain of terminally ill patients, some people believe that physicians may assist in these suicides. Others reject any kind of physician involvement. The debate on assisted suiczide and active euthanasia has focused on whether these acts can ever be acceptable. We propose to shift the debate to a less divisive issue: whether a caring physician who provides a suffering and ill patient with a prescription for a lethal dose of medication should be prosecuted as a felon. Even assisted suicide's opponents may object to such criminal prosecution. We propose to modify existing criminal laws to give physicians who assist their terminally ill patients in suicide, under carefully defined circumstances, a legal defense against criminal charges.
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Polozhy, B. "The ethno-cultural peculiarities of suicidal behavior in multinational Russia." European Psychiatry 41, S1 (2017): s891. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1811.
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IntroductionAccording to the data of 2015, suicide rate in Russia was 17.1 cases per 100,000 population. However, many aspects of the problem of suicidal behavior are not studied. This prevents the organization of the system of effective suicide prevention. In this regard, special attention deserves ethno-cultural factors, since they are essential to the moral and ethical attitude to the possibility of suicide and to potential willingness to formation of suicidal behavior.ObjectiveStudy of the rate of suicide among different nations of Russia.MethodsStatistical analysis of suicide rate in constituent entities of the Russian federation from 2010 to 2015.ResultsThe specificity of suicide situation in Russia is that suicide rates in different ethnic groups of the population has the distinction of reaching 21: from 2.8 per 100,000 in the Republic of North Ossetia to 59.7 per 100,000 in the Altai Republic. This is due to cultural peculiarities of different ethnic groups, including the historically established their relationship to suicide. Taking in consideration these factors were elaborated the differential programs for suicide prevention. That has allowed to lower suicidal rate in Russia in 1.4 times for the last 5 years. That indicates the possible beneficial effects of the ethno-cultural approach in suicide prevention strategies.ConclusionIn planning programs suicide prevention in multinational countries should take into account the ethno-cultural characteristics of the residing peoples.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
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Warrender, Dan. "Borderline personality disorder and the ethics of risk management: The action/consequence model." Nursing Ethics 25, no. 7 (2017): 918–27. http://dx.doi.org/10.1177/0969733016679467.
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Patients with borderline personality disorder are frequent users of inpatient mental health units, with inpatient crisis intervention often used based on the risk of suicide. However, this can present an ethical dilemma for nursing and medical staff, with these clinician responses shifting between the moral principles of beneficence and non-maleficence, dependent on the outcomes of the actions of containing or tolerating risk. This article examines the use of crisis intervention through moral duties, intentions and consequences, culminating in an action/consequence model of risk management, used to explore potential outcomes. This model may be useful in measuring adherence and violation of the principles of beneficence and non-maleficence and therefore an aid to clinical decision making.
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Pesut, Barbara, Madeleine Greig, Sally Thorne, et al. "Nursing and euthanasia: A narrative review of the nursing ethics literature." Nursing Ethics 27, no. 1 (2019): 152–67. http://dx.doi.org/10.1177/0969733019845127.
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Background: Medical Assistance in Dying, also known as euthanasia or assisted suicide, is expanding internationally. Canada is the first country to permit Nurse Practitioners to provide euthanasia. These developments highlight the need for nurses to reflect upon the moral and ethical issues that euthanasia presents for nursing practice. Purpose: The purpose of this article is to provide a narrative review of the ethical arguments surrounding euthanasia in relationship to nursing practice. Methods: Systematic search and narrative review. Nine electronic databases were searched using vocabulary developed from a stage 1 search of Medline and CINAHL. Articles that analysed a focused ethical question related to euthanasia in the context of nursing practice were included. Articles were synthesized to provide an overview of the literature of nursing ethics and euthanasia. Ethical Considerations: This review was conducted as per established scientific guidelines. We have tried to be fair and respectful to the authors discussed. Findings: Forty-three articles were identified and arranged inductively into four themes: arguments from the nature of nursing; arguments from ethical principles, concepts and theories; arguments for moral consistency; and arguments from the nature of the social good. Key considerations included nursing’s moral ontology, the nurse–patient relationship, potential impact on the profession, ethical principles and theories, moral culpability for acts versus omissions, the role of intention and the nature of the society in which euthanasia would be enacted. In many cases, the same assumptions, values, principles and theories were used to argue both for and against euthanasia. Discussion: The review identified a relative paucity of literature in light of the expansion of euthanasia internationally. However, the literature provided a fulsome range of positions for nurses to consider as they reflect on their own participation in euthanasia. Many of the arguments reviewed were not nursing-specific, but rather are relevant across healthcare disciplines. Arguments explicitly grounded within the nature of nursing and nurse–patient relationships warrant further exploration.
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Muis, Quita, Inge Sieben, Tim Reeskens, and Loek Halman. "Seksueel-ethische permissiviteit: trends in Nederland 1981-2017." Mens en maatschappij 94, no. 4 (2019): 429–58. http://dx.doi.org/10.5117/mem2019.4.004.muis.
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Abstract In this study, we explore trends in sexual-ethical permissiveness in the Netherlands during the last decades. Using Dutch data from the European Values Study (1981-2017), we show that tolerance towards homosexuality, abortion, divorce, euthanasia, and suicide increased in this period. About a third of this trend can be explained by cohort replacement: because younger, more permissive cohorts slowly replace older, less permissive cohorts, the moral climate in society changes. In turn, the differences in sexual-ethical permissiveness between cohorts can be explained by differences in level of education, church attendance and religious socialization. At the same time, the results of the counterfactual analyses show that all groups in Dutch society, including the lower educated and churchgoers, have become more permissive about sexual-ethical aspects of life. Apparently, a moral progressive consensus is present in the Netherlands. Finally, our results show that the youngest cohort, born between 1990 and 1999, appears somewhat less permissive than older cohorts. If these more conservative moral convictions persist in the future and are present in new generations as well, there may be a cultural backlash.
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Andersson, Petra Lilja, Åsa Petersén, Caroline Graff, and Anna-Karin Edberg. "Ethical aspects of a predictive test for Huntington’s Disease." Nursing Ethics 23, no. 5 (2016): 565–75. http://dx.doi.org/10.1177/0969733015576356.
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Background: A predictive genetic test for Huntington’s disease can be used before any symptoms are apparent, but there is only sparse knowledge about the long-term consequences of a positive test result. Such knowledge is important in order to gain a deeper understanding of families’ experiences. Objectives: The aim of the study was to describe a young couple’s long-term experiences and the consequences of a predictive test for Huntington’s disease. Research design: A descriptive case study design was used with a longitudinal narrative life history approach. Participants and research context: The study was based on 18 interviews with a young couple, covering a period of 2.5 years; starting 6 months after the disclosure of the test results showing the woman to be a carrier of the gene causing Huntington’s disease. Ethical considerations: Even though the study was extremely sensitive, where potential harm constantly had to be balanced against the benefits, the couple had a strong wish to contribute to increased knowledge about people in their situation. The study was approved by the ethics committee. Findings: The results show that the long-term consequences were devastating for the family. This 3-year period was characterized by anxiety, repeated suicide attempts, financial difficulties and eventually divorce. Discussion: By offering a predictive test, the healthcare system has an ethical and moral responsibility. Once the test result is disclosed, the individual and the family cannot live without the knowledge it brings. Support is needed in a long-term perspective and should involve counselling concerning the families’ everyday life involving important decision-making, reorientation towards a new outlook of the future and the meaning of life. Conclusion: As health professionals, our ethical and moral responsibility thus embraces not only the phase in direct connection to the actual genetic test but also a commitment to provide support to help the family deal with the long-term consequences of the test.
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Post, Stephen G. "Dementia in Our Midst: The Moral Community." Cambridge Quarterly of Healthcare Ethics 4, no. 2 (1995): 142–47. http://dx.doi.org/10.1017/s0963180100005818.
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This article focuses on the elderly patient with a progressive and irreversible dementia, most often of the Alzheimer type. However dementia, the decline in mental function from a previous state, can occur in all ages. For example, if Alzheimer's disease (AD) is the dementia of the elderly, increasingly AIDS is the dementia of many who are relatively young. I will not present the major ethical issues relating to dementia care following the progression of disease from the mild to the severe stages, for I have done this elsewhere. Among the issues included are: presymptomatic testing, both psychological and genetic; responsible diag- nostic disclosure and use of support groups; restrictions on driving and other activities; preemptive assisted suicide; advance directives for research and treatment; quality of life in relation to the use of life-extending technologies; and euthanasia.
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Jansen, Trine-Lise, Marit Helene Hem, Lars Johan Dambolt, and Ingrid Hanssen. "Moral distress in acute psychiatric nursing: Multifaceted dilemmas and demands." Nursing Ethics 27, no. 5 (2019): 1315–26. http://dx.doi.org/10.1177/0969733019877526.
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Background In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored. Research design A qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke’s six analytic phases were used. Ethical considerations Approval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary. Findings Based on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral doubt are included. Coercive administration of medicines, coercion that might be avoided and resistance to the use of coercion are all morally stressful situations. Insufficient resources, mentally poorer patients and quicker discharges lead to superficial treatment. Few staff on evening shifts/weekends make nurses worry when follow-up of the most ill patients, often suicidal, in need of seclusion or with heightened risk of violence, must be done by untrained personnel. Provision of good care when exposed to violence is morally challenging. Feelings of inadequacy, being squeezed between ideals and clinical reality, and failing the patients create moral distress. Moral distress causes bad conscience and feelings of guilt, frustration, anger, sadness, inadequacy, mental tiredness, emotional numbness and being fragmented. Others feel emotionally ‘flat’, cold and empty, and develop high blood pressure and problems sleeping. Even so, some nurses find that moral stress hones their ethical awareness. Conclusion Moral distress in acute psychiatric care may be caused by multiple reasons and cause a variety of reactions. Multifaceted ethical dilemmas, incompatible demands and proximity to patients’ suffering make nurses exposed to moral distress. Moral distress may lead to reduced quality care, which again may lead to bad conscience and cause moral distress. It is particularly problematic if moral distress results in nurses distancing and disconnecting themselves from the patients and their inner selves.
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Franke, I. "Pad in forensic psychiatry." European Psychiatry 64, S1 (2021): S33. http://dx.doi.org/10.1192/j.eurpsy.2021.115.
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IntroductionA recent court decision in Germany defined assisted suicide as a basic human right. Consequently, the discussion regarding PAD needs to be extended to people who are in forensic/secure psychiatric hospitals or prisons, sometimes without any prospects of release. Several studies have shown that long-term hospitalization and detention are associated with feelings of hopelessness, depression and suicidal ideations. Moreover, the resources for adequate therapy are often rare. This results in complex moral challenges for mental health care.ObjectivesTo review current practices in countries that allow PAD and to discuss ethical conflicts.MethodsLiterature review; international comparison of current regulations.ResultsA majority of the literature on PAD in detention refers to prisoners with terminal medical conditions. Single case reports of PAD-requests of mentally disordered offenders aroused great public interest. The resulting ethical conflicts are similar to those issues regarding PAD and mental disorder in general. However, in secure treatment settings and detention additional aspects such as adverse living conditions and inadequate access to mental health care need to be taken into account.ConclusionsIf unbearable pain is not a precondition for assisted suicide, then mentally disordered and healthy offenders have a right to request PAD, provided they have medical decision-making capacity. Considering the common insufficient mental health care for people in detention, policy and law makers need to ensure that access to PAD will not replace therapy. Professionals involved in PAD evaluations need support by specific guidelines.DisclosureNo significant relationships.
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Sugarman, Jeremy. "The Future of Empirical Research in Bioethics." Journal of Law, Medicine & Ethics 32, no. 2 (2004): 226–31. http://dx.doi.org/10.1111/j.1748-720x.2004.tb00469.x.
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Empirical research in bioethics can be defined as the application of research methods in the social sciences (such as anthropology, epidemiology, psychology, and sociology) to the direct examination of issues in [bioethics]. As such, empirical work is a form of descriptive ethics, focused on describing a particular state of affairs that has some moral or ethical relevance. For example, empirical research can help to describe cultural beliefs about the appropriateness of providing health-related information, such as the diagnosis of a life-threatening illness, which informs deliberations about the extent to which it is morally important for clinicians to provide comprehensive information to patients in different cultural contexts. Similarly, empirical research can delineate popular attitudes and experiences related to contentious issues such as abortion, cloning, stem-cell research, and physician-assisted suicide to enlighten discussions and policy formulations regarding them.
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Kious, Brent M., and Margaret (Peggy) Battin. "Physician Aid-in-Dying and Suicide Prevention in Psychiatry: A Moral Crisis?" American Journal of Bioethics 19, no. 10 (2019): 29–39. http://dx.doi.org/10.1080/15265161.2019.1653397.
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Pellegrino, Edmund D. "Physician-Assisted Suicide and Euthanasia: Rebuttals of Rebuttals The Moral Prohibition Remains." Journal of Medicine and Philosophy 26, no. 1 (2001): 93–100. http://dx.doi.org/10.1076/jmep.26.1.93.3034.
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Quill, Timothy E., and Gerrit Kimsma. "End-of-Life Care in the Netherlands and the United States: A Comparison of Values, Justifications, and Practices." Cambridge Quarterly of Healthcare Ethics 6, no. 2 (1997): 189–204. http://dx.doi.org/10.1017/s0963180100007805.
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Voluntary active euthanasia (VAE) and physician-assisted suicide (PAS) remain technically illegal in the Netherlands, but the practices are openly tolerated provided that physicians adhere to carefully constructed guidelines. Harsh criticism of the Dutch practice by authors in the United States and Great Britain has made achieving a balanced understanding of its clinical, moral, and policy implications very difficult. Similar practice patterns probably exist in the United States, but they are conducted in secret because of a more uncertain legal and ethical climate. In this manuscript, we plan to compare end-of-life care in the United States and the Netherlands with regard to underlying values, justifications, and practices. We will explore the risks and benefits of each system for a real patient who was faced with a common end-of-life clinical dilemma, and close with challenges for public policies in both countries.
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Cooley, Dennis R. "A Kantian Moral Duty for the Soon-to-be Demented to Commit Suicide." American Journal of Bioethics 7, no. 6 (2007): 37–44. http://dx.doi.org/10.1080/15265160701347478.
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Grigoriou, Markella, Rachel Upthegrove, and Lisa Bortolotti. "Instrumental rationality and suicide in schizophrenia: a case for rational suicide?" Journal of Medical Ethics 45, no. 12 (2019): 802–5. http://dx.doi.org/10.1136/medethics-2019-105454.
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It is estimated that up to 7500 people develop schizophrenia each year in the UK. Schizophrenia has significant consequences, with 28% of the excess mortality in schizophrenia being attributed to suicide. Previous research suggests that suicide in schizophrenia may be more related to affective factors such as depression and hopelessness, rather than psychotic symptoms themselves. Considering suicide in schizophrenia within this framework enables us to develop a novel philosophical approach, in which suicide may not be related to loss of self-consciousness, thought processing dysfunctions or perception disturbances. The action of suicide may be due neither to persistent hallucinations nor other psychotic symptoms, such as delusional beliefs, but to other underexamined, perhaps rational reasons, such as extreme social isolation, severe depression or emotional withdrawal. This paper does not examine the moral character of suicide. Instead, it argues that we should conceive the action of suicide in schizophrenia as an act that is not necessarily irrational. People with schizophrenia might end their life based on reasons if suicide is the best means to achieve their ends. However, the paper does not support assisted suicide. It aims to provide a better understanding of the reasons why people take their own lives and suggests that understanding can inform effective interventions to reduce high rates of suicide.
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Calkins, Bethany C., and Keith M. Swetz. "Physician Aid-in-Dying and Suicide Prevention in Psychiatry: A Moral Imperative Over a Crisis." American Journal of Bioethics 19, no. 10 (2019): 68–70. http://dx.doi.org/10.1080/15265161.2019.1653398.
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Struc, Aleksy Tarasenko. "Do Suicide Attempters Have a Right Not to Be Stabilized in an Emergency?" Hastings Center Report 54, no. 2 (2024): 22–33. http://dx.doi.org/10.1002/hast.1576.
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AbstractThe standard of care in the United States favors stabilizing any adult who arrives in an emergency department after a failed suicide attempt, even if he appears decisionally capacitated and refuses life‐sustaining treatment. I challenge this ubiquitous practice. Emergency clinicians generally have a moral obligation to err on the side of stabilizing even suicide attempters who refuse such interventions. This obligation reflects the fact that it is typically infeasible to determine these patients’ level of decisional capacitation—among other relevant information—in this unique setting. Nevertheless, I argue, stabilizing suicide attempters over their objection sometimes violates a basic yet insufficiently appreciated right of theirs—the right against bodily invasion. In such cases, it is at least prima facie wrong to stabilize a patient who wants to die even if they lack a contrary advance directive or medical order and suffer from no terminal physical illness.
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Vong, G. "In defence of Kant's moral prohibition on suicide solely to avoid suffering." Journal of Medical Ethics 34, no. 9 (2008): 655–57. http://dx.doi.org/10.1136/jme.2007.021410.
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Johnson, Sandra H. "Setting Limits on Death: A View From the United States." Cambridge Quarterly of Healthcare Ethics 5, no. 1 (1996): 24–32. http://dx.doi.org/10.1017/s0963180100006691.
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Assisted suicide is a tragic issue, one of those for which the tools of mere logic are inadequate and in which the power of the individual case is compelling and seductive but not necessarily clarifying. Meaningful dialogue is difficult. Persuasion is limited because the resolution of the issue, on a moral level, must be founded upon fundamental notions of what it means to be human, especially in the midst of suffering or disability or at the point of death.
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Cooley, Dennis R. "Response to Open Peer Commentaries on “A Kantian Moral Duty for the Soon to Be Demented to Commit Suicide”." American Journal of Bioethics 7, no. 6 (2007): W1—W3. http://dx.doi.org/10.1080/15265160701429607.
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Goodwin, Michele. "Vulnerable Subjects: Why Does Informed Consent Matter?" Journal of Law, Medicine & Ethics 44, no. 3 (2016): 371–80. http://dx.doi.org/10.1177/1073110516667935.
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This special issue of the Journal Law, Medicine & Ethics takes up the concern of informed consent, particularly in times of controversy. The dominant moral dilemmas that frame traditional bioethical concerns address medical experimentation on vulnerable subjects; physicians assisting their patients in suicide or euthanasia; scarce resource allocation and medical futility; human trials to develop drugs; organ and tissue donation; cloning; xenotransplantation; abortion; human enhancement; mandatory vaccination; and much more. The term “bioethics” provides a lens, language, and guideposts to the study of medical ethics. It is worth noting, however, that medical experimentation is neither new nor exclusive to one country. Authors in this issue address thorny subjects that span borders and patients: from matters dealing with children and vaccination to the language and perception of consent.
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Pestaner, Joseph P. "End-of-Life Care: Forensic Medicine v. Palliative Medicine." Journal of Law, Medicine & Ethics 31, no. 3 (2003): 365–76. http://dx.doi.org/10.1111/j.1748-720x.2003.tb00100.x.
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The increasing life expectancy of terminally-ill people has raised many public policy concerns about end-of-life care. Due to increased longevity and the lack of cures for illnesses like cancer and heart disease, palliative care, particularly pain management, has become an important mode OF medical therapy. Palliative care providers feel that “[h]ealth care professionals have a moral duty to provide adequate palliative care and pain relief, even if such care shortens the patient’s life.” Practitioners of forensic medicine grapple with determining when to classify the death of a person formerly receiving palliative care as a non-natural death. Such classification may be paramount in the enforcement of new statutes that aim at preventing assisted suicide or monitoring the quality of health care, but it potentially places forensic medicine and palliative medicine in adversarial roles.
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Miller, Franklin G. "A Communitarian Approach to Physician-Assisted Death." Cambridge Quarterly of Healthcare Ethics 6, no. 1 (1997): 78–87. http://dx.doi.org/10.1017/s0963180100007635.
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The standard argument in favor of the practice of voluntary physician-assisted death, by means of assisted suicide or active euthanasia, rests on liberal, individualistic grounds. It appeals to two moral considerations: (1) personal self-determination—the right to choose the circumstances and timing of death with medical assistance; and (2) individual well-being—relief of intolerable suffering in the face of terminal or incurable, severely debilitating illness. One of the strongest challenges to this argument has been advanced by Daniel Callahan. Callahan has vigorously attacked the practice of physician-assisted death and the goal of legalization as deep affronts to values of community: “By assuming that the relief of suffering is a goal important enough to legitimate killing as a way of achieving it, we corrupt the idea of such relief as a social goal and duty. We cease helping to bear one another's suffering, but eliminate altogether the person who suffers. We thereby jeopardize both the future of self-determination and the kind of community that furthers its members' capacity to bear one another's suffering. Why bear what can be eliminated altogether?” In another passage Callahan remarks, “For there is a deep sense in which suicide and euthanasia are likely to represent, at least in part, a failure of the community, whether that of the intimate community of family and friends, or the larger civic community, to respond to the needs of another.”
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Cavanagh, Denis. "Right to Life in the American Medical System." Medicina e Morale 45, no. 6 (1996): 1151–61. http://dx.doi.org/10.4081/mem.1996.895.
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The article deals with the impact of the so called “culture of death” on medical practice in United States (US). In fact, in America, while the pretence is being kept up on the importance of the Hippocratic oath and the evangelic benevolence of the Good Samaritan, the strategy of the secular humanists is to try to make these irrelevant in the twin interests of social convenience and fiscal security. This campaign has been quietly waged in the media, in the courts, in public schools and universities. According this strategy, the threats to human life are, namely, two: abortion and euthanasia.
On the first issue, in US the situation is discouraging because the US Supreme Court rulings Roe v. Wade and Doe v. Bolton in 1973, that have made abortion a woman’s choice for any reason in the first and second trimester and available with medical consultation for almost any reason in the third trimester of pregnancy.
Regarding the euthanasia, the campaign strategy is following the same pattern as that used to legalize abortion: the Euthanasia Lobby is claiming that millions of people in America are suffering unbearable pain because of terminal illness and so ought to have the right to end their pain with physician- assisted suicide.
On the contrary, the author assert that there is no right to destroy any human life or participate in its destruction and there is no good moral reason for abortion or euthanasia, including the physician-assisted suicide. Finally, the author think that it is vital that Catholic activists, allied with Christian church-going brethren, should resist with all the power they can muster to the “culture of death”.
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Kopelman, Loretta M. "On Pellegrino and Thomasma’s Admission of a Dilemma and Inconsistency." Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 44, no. 6 (2019): 677–97. http://dx.doi.org/10.1093/jmp/jhz027.
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Abstract Edmund Pellegrino and David Thomasma’s writings have had a worldwide impact on discourse about the philosophy of medicine, professionalism, bioethics, healthcare ethics, and patients’ rights. Given their works’ importance, it is surprising that commentators have ignored their admission of an unresolved and troubling dilemma and inconsistency in their theory. The purpose of this article is to identify and state what problems worried them and to consider possible solutions. It is argued that their dilemma stems from their concerns about how to justify professional rules restricting colleagues from performing acts they view as direct, active, and formal (intentional) killings, such as physician-assisted suicide, mercy killing, and abortion. It is further argued that their inconsistency is that they both assert and deny that professional colleagues should not use their moral or theological values to impose professional restrictions on other colleagues without adequate philosophical grounds. At risk are their arguments about the nature of an internal morality for medicine, a secular and multicultural basis for medical ethics, and a nonarbitrary way to determine what acts fall outside the ends of medicine. These are arguments they claim also apply to other healthcare professions. The article begins with a brief overview of their key positions to provide the context in which they make their admission.
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Vorobev, Vladimir, Vladimir Beloborodov, Igor Golub, et al. "Urinary System Iatrogenic Injuries: Problem Review." Urologia Internationalis 105, no. 5-6 (2021): 460–69. http://dx.doi.org/10.1159/000512882.
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<b><i>Introduction:</i></b> From May to December 2019, a literature review of the urinary system iatrogenic injury problem was performed. The most cited, representative articles in PubMed, Scopus, and WoS databases dedicated to this problem were selected. Urinary system iatrogenic injuries include ureter, bladder, urethra, and kidney traumas. It is widely thought that the main causes of such injuries are urological, obstetric, gynecological, and surgical operations on the retroperitoneal space, pelvis, or perineum. <b><i>Methods:</i></b> The purpose of the study is to describe all aspects of the iatrogenic injure problem, under the established scheme and for each of the most damaged organs: the urethra, bladder, kidney, and ureter. The treatment of confirmed iatrogenic injuries largely depends on the period of its detection. Modern medical procedures provide conservative or minimally invasive treatment. An untimely diagnosis worsens the treatment prognosis. “Overlooked” urinary system trauma is a serious threat to society and a particular patient. Thus, incorrect or traumatic catheterization can lead to infection (RR 95%) and urethral stricture (RR ≥11–36%), and percutaneous puncture nephrostomy can cause the risk of functional renal parenchyma loss (median 5%), urinary congestion (7%), or sepsis (0.6–1.5%). <b><i>Results:</i></b> Lost gain, profits, long-term and expensive, possibly multistage treatment, stress and depression, and the risks of suicide put a heavy financial, moral, and ethical burden on a person and society. Also, iatrogenic injury might have legal consequences. <b><i>Discussion/Conclusion:</i></b> Thus, the significant problem of urinary tract iatrogenic injuries is still difficult to solve. There is a need to implement mandatory examining algorithms for patients at risk, as well as the multidisciplinary principle for all pelvic surgery.
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Lukyanchenko, E. A. "Human Capital: Moral and Ethical Aspects." MGIMO Review of International Relations, no. 3(30) (June 28, 2013): 142–43. http://dx.doi.org/10.24833/2071-8160-2013-3-30-142-143.
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Oyebode, Femi. "Choosing death: the moral status of suicide." Psychiatric Bulletin 20, no. 2 (1996): 85–89. http://dx.doi.org/10.1192/pb.20.2.85.
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Our moral conception of suicide is examined. It is argued that a neutral definition of suicide is difficult to achieve and that how we treat the Question of suicide shows what value we place on the sanctity of Me or on life as a means to other ends. The case is made that autonomy, the principle of self-governance, has acquired special importance in the modem world to me detriment of other ethical principles such as beneficence.
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Best, Ernest E. "Suicide: Ethical and Moral Issues from a Theological Perspective." Canadian Journal of Psychiatry 31, no. 2 (1986): 97–100. http://dx.doi.org/10.1177/070674378603100203.
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A historical review of the Jewish, Christian, Islamic, Hindu and Buddist attitudes of suicide. The evolution to the contemporary Christian perspective is discussed citing contributions of Aristotle, Augustine, Aquinas and Donne. Issues raised by life-extension technology are discussed.
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Scanlon, C., and CH Rushton. "Assisted suicide: clinical realities and ethical challenges." American Journal of Critical Care 5, no. 6 (1996): 397–403. http://dx.doi.org/10.4037/ajcc1996.5.6.397.
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The increasing attention to assisted suicide, as evidenced by recent legislation, initiatives, court decisions, and research, propels the issue to a new level of importance and urgency within society and the health professions. Nurses cannot help but be confronted by and struggle with the complex moral and professional quandaries related to assisted suicide. Critical care nurses must continue to evaluate the implications of the possible legalization of assisted suicide and to define the boundaries of morally acceptable professional practice. The challenges to the roles and responsibilities of critical care nurses that might occur if assisted suicide were legalized must be thoughtfully and responsibly explored.
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Steffen, Lloyd. "Physician Assistance in Dying: An Option for Christians?" Christian bioethics: Non-Ecumenical Studies in Medical Morality 27, no. 3 (2021): 228–49. http://dx.doi.org/10.1093/cb/cbab012.
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Abstract Opposition to physician-assisted suicide is widespread in Christian ethics. However, on a topic as controversial as physician-assisted suicide, no one can reasonably speak for “the Christian” perspective. Natural-law and, specifically, just-war thinking are claimed in the Christian tradition, yet the natural-law contribution to a Christian ethical analysis of physician-assisted suicide requires explanation and defense. Natural-law ethical theory affirms the central role of reason in moral thinking and provides a theoretical resource in contemporary ethics to assist in analyzing specific moral issues, problems, and conflicts. This essay seeks to demonstrate how just-war thinking, derived from natural-law tradition, allows movement from the theoretical world of natural-law theory to the practical world of normative ethics. Here the case is made that the just-war model of ethics helps elucidate the moral problematic involved in physician-assisted suicide while clarifying direction on this particularly thorny and controversial problem.
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Sychev, A. A., E. V. Zaytseva, and P. S. Tolkachev. "MORAL-ETHICAL ASPECTS OF THE DIGITAL ECONOMY." Vestnik Universiteta, no. 1 (March 23, 2020): 36–42. http://dx.doi.org/10.26425/1816-4277-2020-1-36-42.
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At the present stage, the digital (information) economy is playing an increasingly important role in the world economy and national economies. Using rapid exchange of information benefits allows economic agents at all levels (from ordinary consumers to large corporations and state bodies, regulating economic relations) to make more accurate decisions in various economic issues. It is obvious, that the creation of the Russian information system will be able to increase the efficiency of our national economy (including the objectives of its state regulation) and at the same time raise the level of the country’s security. However, the effective use of the digital economy does not only depend on the level of development of the technical base of the information system. Only the moral state of society can send the information received for the benefit of all its members.
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Benedict, Susan, Anne Griswold Pierce, and Sharon Sweeney. "Historical, ethical, and legal aspects of assisted suicide." Journal of the Association of Nurses in AIDS Care 9, no. 2 (1998): 34–44. http://dx.doi.org/10.1016/s1055-3290(98)80059-9.
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Piasta, Ruslan. "The problem of suicide in the teachings of the Catholic Church." Good Parson: scientific bulletin of Ivano-Frankivsk Academy of John Chrysostom. Theology. Philosophy. History, no. 17 (May 30, 2022): 70–86. http://dx.doi.org/10.52761/2522-1558.2022.17.7.
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The article studies the problem of the suicide in the moral and ethical teachings of the Catholic Church and the statistics of this phenomenon in Ukraine. A number of problems of socio-ethical nature related to this issue are also highlighted. The problem of the suicide and the question of the relationship between freedom and human responsibility are analyzed in the light of the biblical commandment «Thou shalt not kill».
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Wasserman, D. "ECP05-03 - Treatment of suicidal patients: Legal and ethical aspects." European Psychiatry 26, S2 (2011): 1801. http://dx.doi.org/10.1016/s0924-9338(11)73505-2.
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According to WHO estimates, 1.5 million people worldwide will complete suicide in the year 2020 and approximately 10-20 times this number will attempt suicide. Given that suicide still remains the most serious outcome of mental disease, it is essential that psychiatrists are specifically trained regarding legal and ethical aspects related to the treatment of suicidal psychiatric patients.Clinical decisions guided by evidence based knowledge and ethical judgments according to the principles of beneficence, non-maleficence and autonomy intimately interact when a psychiatrist performs suicide risk assessment, recommends treatment and follow- up rehabilitation measures. Ethical dilemmas of respecting acute suicidal or chronic suicidal patient's autonomy when she/he is unable to control self-destructive impulses, confidentiality, Do Not Resuscitate (DNR) orders and involuntary confinement for the institutional ward will be discussed.Existing research indicates that suicide risk is higher in the immediate aftermath of discharge from the hospital and when patients are transferred to outpatient care without securing the follow- up visit. Psychiatrists are sometimes under considerable pressure, due to economical downsizing of the psychiatric care, to discharge suicidal patients from inpatient care, which can lead to serious legal and ethical repercussions. Following evidence-based procedures is crucial, as well as maintaining a high standard of documentation for all processes and decisions taken.Continuous education of health care staff, scrutiny of existing routines and knowledge about own attitudes towards suicidal patients are needed in order to prevent suicide.
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Tsopelas, C. "Moral Obligation to Acknowledge and Prevent Suicide in Life Sentence Incarcerated Inmates." European Psychiatry 33, S1 (2016): S457. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1662.
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IntroductionFor an inmate incarcerated for life we could acknowledge factors contributing to the desire to commit suicide, as social isolation, insensitive discipline, lack of privacy, constant threat of violence, fear, guilt, hopelessness, and depression are prominent in the life imprisonment.AimsTo discuss the ethical issues of prevention suicide in inmates incarcerated for life.MethodsWe performed thorough research of the main medical databases, and web search engines for relevant studies, articles and opinions and reviewed them independently.ResultsPrevalence of mental illness is high among inmates and several common stressors typically herald an inmate's suicide. Suicide is often the single most common cause of death in correctional settings. Even though some suicide victims have consulted a mental health service-provider before their suicide, the majority of suicide victims were not mentally ill. The paradox, particularly for life sentence inmates is that we are trying to persuade an inmate to live within a disciplinary environment, which has as side effect the increase of suicidality of the inmates.ConclusionsPrisons’ inability to protect the health and safety of inmates could raise ethical issues. We have obligation to adequate suicide prevention for all inmates, and we should be more broad minded as the will to die in mentally healthy individuals is beside an free will expression, a sign of serious lack of support and humane living conditions. We should be vigilant not to use the prevention of suicide programs as another way to increase punishment of life long imprisonment.Disclosure of interestThe author has not supplied his declaration of competing interest.
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Dašić, Dejan, Gruja Kostadinović, and Milan Stanković. "Ethical Aspects of Science and Technological Innovations." International Journal of Cognitive Research in Science, Engineering and Education (IJCRSEE) 11, no. 2 (2023): 343–50. http://dx.doi.org/10.23947/2334-8496-2023-11-2-343-350.
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The progress of civilization depends on both science and ethics, on two different ideas. Unlike ethics, which deals with moral principles and ideals that guide human behavior, science is based on logical argumentation, empirical data, and methodical testing. However, as science develops, it often raises ethical questions that must be addressed. As a result, science and ethics are intertwined and both are essential for the moral and long-term advancement of science. This research examines the results of two interconnected processes: the quick development of science and technology and its moral ramifications, or the harm it does to people’s lives all around the world. The writers highlight the need for a qualitative shift in attitudes toward nature and society as a whole in order to address environmental challenges and remove the threat of a global ecological disaster by analyzing the substance and impact of these processes.
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Abou Hashish, Ebtsam Aly, and Nadia Hassan Ali Awad. "Relationship between ethical ideology and moral judgment: Academic nurse educators’ perception." Nursing Ethics 26, no. 3 (2017): 845–58. http://dx.doi.org/10.1177/0969733017722825.
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Background: Ascertaining the relationship between ethical ideology, moral judgment, and ethical decision among academic nurse educators at work appears to be a challenge particularly in situations when they are faced with a need to solve an ethical problem and make a moral decision. Purpose: This study aims to investigate the relationship between ethical ideology, moral judgment, and ethical decision as perceived by academic nurse educators. Methods: A descriptive correlational research design was conducted at Faculty of Nursing, Alexandria University. All academic nurse educators were included in the study (N = 220). Ethical Position Questionnaire and Questionnaire of Moral Judgment and Ethical Decisions were proved reliable to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects’ informed consent. Findings: This study reveals a significant positive moderate correlation between idealism construct of ethical ideology and moral judgment in terms of recognition of the behavior as an ethical issue and the magnitude of emotional consequences of the ethical situation (p < 0.001; p = 0.031) respectively. Also, there is a positive significant moderate correlation between relativism construct of ethical ideology and overall moral judgment (p = 0.010). Approximately 3.5% of the explained variance of overall moral judgment is predicted by idealism together with relativism. Discussion: The findings suggest that variations in ethical position and ideology are associated with moral judgment and ethical decision. Conclusion: Organizations of academic nursing education should provide a supportive work environment to help their academic staff to develop their self-awareness and knowledge of their ethical position and promoting their ethical ideologies and, in turn, enhance their moral judgment as well as develop ethical reasoning and decision-making capability of nursing students. More emphasis in nursing curricula is needed on ethical concepts for developing nursing competencies.
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Parent, Bea. "Moral, ethical, and legal aspects of infection control." American Journal of Infection Control 13, no. 6 (1985): 278–80. http://dx.doi.org/10.1016/0196-6553(85)90030-6.
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Corley, Mary C., Ptlene Minick, R. K. Elswick, and Mary Jacobs. "Nurse Moral Distress and Ethical Work Environment." Nursing Ethics 12, no. 4 (2005): 381–90. http://dx.doi.org/10.1191/0969733005ne809oa.
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This study examined the relationship between moral distress intensity, moral distress frequency and the ethical work environment, and explored the relationship of demographic characteristics to moral distress intensity and frequency. A group of 106 nurses from two large medical centers reported moderate levels of moral distress intensity, low levels of moral distress frequency, and a moderately positive ethical work environment. Moral distress intensity and ethical work environment were correlated with moral distress frequency. Age was negatively correlated with moral distress intensity, whereas being African American was related to higher levels of moral distress intensity. The ethical work environment predicted moral distress intensity. These results reveal a difference between moral distress intensity and frequency and the importance of the environment to moral distress intensity.
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Rostotskaya, Marianna Albertovna. "Moral Aspects of Russian PreRevolutionary Cinema." Journal of Flm Arts and Film Studies 3, no. 4 (2011): 8–17. http://dx.doi.org/10.17816/vgik348-17.
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Yevgeniy Bauer was an outstanding exponent of the refined mass culture that began to penetrate into spiritual life at the beginning of the 20th century. The article investigates the moral conflicts and patterns that lay behind Bauer’s films and reflected the ethical guidelines of the mass audience in Pre-Revolutionary Russia
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Băcilă, C., C. Anghel, and D. Vulea. "Ethical aspects in the management of postpartum depression." Sæculum 47, no. 1 (2019): 227–31. http://dx.doi.org/10.2478/saec-2019-0022.
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AbstractPostpartum depression is a relatively frequent psychiatric pathology that involves some challenges in the management and treatment of the case due to the increased risk of suicide and infanticide. Having a relatively early postpartum onset within 4-12 weeks, this pathology may have psychological, social and family repercussions in the long term, both on mother and father, but especially on the child. Postpartum depression is a relatively frequent psychiatric pathology involving some challenges in managing and treating the case due to the increased risk of suicide and infanticide. Having a relatively early postpartum onset within 4-12 weeks, this pathology may have psychological, social and family repercussions in the long term, both on the mother and father, but especially on the child.Postpartum depression manifests with symptoms typical of all depressive episodes, such as depressed mood, irritability, low tolerance to frustration, anxiety, hypersomnia, but also more specific symptoms such as feelings and guilty thoughts about correct child development, lack of empathy, lack of maternal behavior. Emotional, socio-cultural and physiological factors play an important role in the onset of this symptomatology.Postpartum depression raises ethical concerns about the proper conduct of the doctor. In this article we will address both deontological aspects such as doctor-patient confidentiality, suicide and infanticide, as well as the legal aspects that may occur in such situations. Thus, postpartum depression is a therapeutic challenge because of the multiple social, family and legal interferences it presents.
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Liégeois, Axel, and Marc Eneman. "Ethical Aspects of the Prevention of Suicide in Psychiatry." Ethical Human Psychology and Psychiatry 14, no. 2 (2012): 140.2–149. http://dx.doi.org/10.1891/1559-4343.14.2.140.
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From an ethical perspective, three values are at stake in the prevention of suicide—the inviolability of life, the autonomy of the client, and the care relationship between caregivers and client. These values can be integrated in the following way. The best prevention consists of a good care relationship involving intensive counseling of the client regarding existential questions. In this way, caregivers can increase the client’s autonomy and responsibility. Sometimes, however, caregivers need to intervene with protective measures to safeguard the inviolability of the client’s life. Caregivers strive for a reasonable balance between autonomy and inviolability by means of the integrating value of the relationship.
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Beech, Ian. "Suicide and Voluntary Active Euthanasia: Why the Difference in Attitude?" Nursing Ethics 2, no. 2 (1995): 161–70. http://dx.doi.org/10.1177/096973309500200208.
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It appears that the attitudes of health professionals differ towards suicide and voluntary active euthanasia. An acceptance of, if not an agreement with, voluntary active eutha nasia exists, while there is a general consensus that suicide should be prevented. This paper searches for a working definition of suicide, to discover ethical reasons for the negative value that suicide assumes, and also to provide a term of reference when comparing suicide with euthanasia. On arriving at a working definition of suicide, it is compared with voluntary active euthanasia. An analysis of utilitarian and deontological considerations is provided and proves to be inconclusive with respect to the ethical principles informing the attitudes of professionals. Therefore, a search for other influences is attempted; this indicates that psychological influences inform attitudes to a greater degree than ethical principles.
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Atabay, Gülem, Burcu Güneri Çangarli, and Şebnem Penbek. "Impact of ethical climate on moral distress revisited." Nursing Ethics 22, no. 1 (2014): 103–16. http://dx.doi.org/10.1177/0969733014542674.
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Background: Moral distress is a major problem in nursing profession. Researchers identified that the stronger the ethical basis of the organization, the less moral distress is reported. However, different ethical climates may have different impacts on moral distress. Moreover, conceptualization of moral distress and ethical climate as well as their relationship may change according to the cultural context. Objectives: The main aim of the study is to investigate the relationship between different types of ethical climate as described in Victor and Cullen’s framework, and moral distress intensity among nurses in Turkish healthcare settings. Research design: An online survey was administrated to collect data. Questionnaires included moral distress and ethical climate scales in addition to demographic questions. Participants and research context: Data were collected from registered nurses in Turkey. In all, 201 of 279 nurses completed questionnaires, resulting in a response rate of 72%. Ethical considerations: Ethical approval was obtained from the university to which the authors were affiliated, after a detailed investigation of the content and data collection method. Findings: Factor analyses showed that moral distress had three dimensions, namely, organizational constraints, misinformed and over-treated patients, and lack of time and resources, while ethical climate had four types, namely, rules, well-being of stakeholders, individualism, and organizational interests. Positive correlations were identified between certain types of ethical climate (rules, individualism, or organizational interests) and moral distress intensity. Discussion: Factor distribution of the scales shows some commonalities with the findings of previous research. However, context-specific dimensions and types were also detected. No particular ethical climate type was found to have a negative correlation with moral distress. Conclusion: Recommendations were made for reducing the negative impact of ethical climate on moral distress. These include solving the nursing-shortage problem, increasing autonomy, and improving physical conditions.
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Fida, Roberta, Carlo Tramontano, Marinella Paciello, et al. "Nurse moral disengagement." Nursing Ethics 23, no. 5 (2016): 547–64. http://dx.doi.org/10.1177/0969733015574924.
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Background: Ethics is a founding component of the nursing profession; however, nurses sometimes find it difficult to constantly adhere to the required ethical standards. There is limited knowledge about the factors that cause a committed nurse to violate standards; moral disengagement, originally developed by Bandura, is an essential variable to consider. Research objectives: This study aimed at developing and validating a nursing moral disengagement scale and investigated how moral disengagement is associated with counterproductive and citizenship behaviour at work. Research design: The research comprised a qualitative study and a quantitative study, combining a cross-validation approach and a structural equation model. Participants and research context: A total of 60 Italian nurses (63% female) involved in clinical work and enrolled as students in a postgraduate master’s programme took part in the qualitative study. In 2012, the researchers recruited 434 nurses (76% female) from different Italian hospitals using a convenience sampling method to take part in the quantitative study. Ethical considerations: All the organisations involved and the university gave ethical approval; all respondents participated on a voluntary basis and did not receive any form of compensation. Findings: The nursing moral disengagement scale comprised a total of 22 items. Results attested the mono-dimensionality of the scale and its good psychometric properties. In addition, results highlighted a significant association between moral disengagement and both counterproductive and citizenship behaviours. Discussion: Results showed that nurses sometimes resort to moral disengagement in their daily practice, bypassing moral and ethical codes that would normally prevent them from enacting behaviours that violate their norms and protocols. Conclusion: The nursing moral disengagement scale can complement personnel monitoring and assessment procedures already in place and provide additional information to nursing management for designing interventions aimed at increasing compliance with ethical codes by improving the quality of the nurses’ work environment.
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Oelhafen, Stephan, Settimio Monteverde, and Eva Cignacco. "Exploring moral problems and moral competences in midwifery: A qualitative study." Nursing Ethics 26, no. 5 (2018): 1373–86. http://dx.doi.org/10.1177/0969733018761174.
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Background: Most undergraduate midwifery curricula comprise ethics courses to strengthen the moral competences of future midwives. By contrast, surprisingly little is known about the specific moral competences considered to be relevant for midwifery practice. Describing these competences not only depends on generic assumptions about the moral nature of midwifery practice but also reflects which issues practitioners themselves classify as moral. Objective: The goal of this study was to gain insight into the ethical issues midwives encounter in their daily work, the key competences and resources they consider indispensable to understand and deal with them, and to assess phenomena linked to moral distress. Methods: We conducted individual semi-structured interviews with eight midwives and two other health professionals, varying in terms of years of experience and work setting. Interview transcripts were analyzed in an interdisciplinary research group, following thematic analysis. Ethical considerations: This study was not subject to approval according to the Swiss Law on Research with Humans. Participants were informed about the study goals and gave written informed consent prior to participation. Results: External constraints limiting the midwife’s and the patient’s autonomy and resulting interpersonal conflicts were found to be the most relevant ethical issues encountered in clinical practice and were most often associated with moral distress. These conflicts often arise in the context of medical interventions midwives consider as not appropriate and situations in which less experienced midwives in particular observe a lack of both interprofessional communication and trust in their professional competence. Ethical issues related to late abortions or prenatal diagnostics and selective abortions were also frequently addressed, but many midwives involved had learned to cope with them. Discussion: In the light of the ethical issues and factors contributing to phenomena of moral distress, an empirically grounded profile of moral competences is drafted. Curricular implications in the light of possible adaptations within undergraduate midwifery education are critically discussed.
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Lucia, Irccs S. "Ethical Aspects of Brain Research." European Journal of Health Law 1, no. 4 (1994): 427–29. http://dx.doi.org/10.1163/157180994x00105.
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AbstractTheme I: Health and Human Rights. Health and human rights in relation to children and other vulnerable groups - for example, ethnic minorities and migrants; the role of health professionals in promoting respect for human rights; discrimination on the basis of health status. Theme II: The Death Debates. Cross-cultural and comparative religion perspectives on dying; euthanasia; nurse-assisted and physician-assisted suicide; the futility debate; advance directives; transplantation ; procuring organs from heart-beating donors or anencephalic infants. Theme III: Genetics and Reproductive Technology. The nature of human identity; genome mapping; genetic manipulation and counselling ; embryo research; preimplantation and prenatal diagnosis; the legal status of embryos, fetuses, infants, and families created by assisted reproduction; fetal tissue transplants; eugenics; population ethics. Theme IV: Health, Ecology, Persons and Planet. The connections between human health and ecological health, including how concepts developed in medicine, ethics, and law might be applicable in the promotion of ecological health, and vice versa. These include resource allocation; justice (including intergenerational justice) in health care; open and closed legal systems; and concepts of trust, covenant, and quality of life.
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Amantova-Salmane, Liene. "ETHICAL ASPECTS OF REGIONAL ECONOMY." Latgale National Economy Research 1, no. 3 (2011): 18. http://dx.doi.org/10.17770/lner2011vol1.3.1803.
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In the beginning of economic history, economics as a social science was closely related to ethics and had a moral dimension. The works of Aristotle and Adam Smith show that the science of economics has evolved taking into consideration the ethical stand. However, during the twentieth century, ethics was not considered in the economic analysis, but this situation transformed and ethics became a part of economics. Removing ethics from economics also removes social responsibility and critical awareness. This research analyzes the ethical aspects of regional economy. Regional economy has an ethical dimension because its main goal is to reduce the disparities between regions. There is carried out a brief reference to the relationship between ethics and economy. In the following article there are analysed ethical aspects of regional policy.
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Hunt, Geoffrey. "Moral Crisis, Professionals and Ethical Education." Nursing Ethics 4, no. 1 (1997): 29–38. http://dx.doi.org/10.1177/096973309700400104.
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Western civilization has probably reached an impasse, expressed as a crisis on all fronts: economic, technological, environmental and political. This is experienced on the cultural level as a moral crisis or an ethical deficit. Somehow, the means we have always assumed as being adequate to the task of achieving human welfare, health and peace, are failing us. Have we lost sight of the primacy of human ends? Governments still push for economic growth and technological advances, but many are now asking: economic growth for what, technology for what? Health care and nursing are caught up in the same inversion of human priorities. Professionals, such as nurses and midwives, need to take on social responsibilities and a collective civic voice, and play their part in a moral regeneration of society. This involves carrying civic rights and duties into the workplace.