RESUMO
PURPOSE: This scoping review explores how virtue and care ethics are incorporated into health professions education and how these factors may relate to the development of humanistic patient care. METHOD: Our team identified citations in the literature emphasizing virtue ethics and care ethics (in PubMed, NLM Catalog, WorldCat, EthicsShare, EthxWeb, Globethics.net , Philosopher's Index, and ProQuest Central) lending themselves to constructs of humanism curricula. Our exclusion criteria consisted of non-English articles, those not addressing virtue and care ethics and humanism in medical pedagogy, and those not addressing aspects of character in health ethics. We examined in a stepwise fashion whether citations: 1) Contained definitions of virtue and care ethics; 2) Implemented virtue and care ethics in health care curricula; and 3) Evidenced patient-directed caregiver humanism. RESULTS: Eight hundred eleven citations were identified, 88 intensively reviewed, and the final 25 analyzed in-depth. We identified multiple key themes with relevant metaphors associated with virtue/care ethics, curricula, and humanism education. CONCLUSIONS: This research sought to better understand how virtue and care ethics can potentially promote humanism and identified themes that facilitate and impede this mission.
Assuntos
Educação Médica , Humanismo , Currículo , Atenção à Saúde , Ética Médica , Humanos , VirtudesRESUMO
Our society's professions, including the health professions, have long overlooked the possibility that one might learn something valuable about one's own profession's ethics by studying the ethics of other professions. Reflecting on the preceding article by Ritwik, Patterson, and Alfonzo-Echeverri, one can identify important similarities between dentistry's professional ethics and the ethics of the other health professions. But there are also important differences between these professions' ethics that should prompt reflection on the reasons for these differences, perhaps challenge something that has been taken for granted in one's own profession, and in any case facilitate better mutual understanding and more effective inter-professional collaboration.
Assuntos
Ética Profissional , HumanosRESUMO
Unrepresented patients are hospital patients who lack decision-making capacity but have no advance directive and no one to serve as a legally authorized surrogate. An important first step in efforts to change the law and develop organizational policies that help respond to these patients' needs is determining which patients should be considered unrepresented and which aspects of hospital care should receive attention. This article proposes working definitions of unrepresented patient and important medical decisions based on the work of one statewide initiative, the Unrepresented Patients Project for Illinois.
Assuntos
Tomada de Decisões/ética , Hospitalização , Pacientes Internados , Defesa do Paciente/legislação & jurisprudência , Papel do Médico , Consentimento do Representante Legal/ética , Consentimento do Representante Legal/legislação & jurisprudência , Humanos , Terminologia como Assunto , Estados UnidosRESUMO
A vision is presented of six ethical skills that every practicing dentist should ideally possess. To achieve this vision will require substantial strengthening in the ethics curricula in dental schools and development of a well-trained cadre of ethics teachers. Ethics leaders must also be developed and programs made available to reach practicing dentists. Finally, the body of scholarship in dental ethics must be fortified. Such a long-range and far-reaching project will require leadership, recruitment and training, and sustained funding.
Assuntos
Odontólogos/ética , Ética Odontológica , Financiamento de Capital , Competência Clínica , Currículo , Educação em Odontologia/economia , Ética Odontológica/educação , Docentes de Odontologia , Apoio Financeiro , Previsões , Humanos , Liderança , Seleção de Pessoal , Desenvolvimento de Programas , EditoraçãoRESUMO
There are two very different ways of understanding access and care that are at work in contemporary American society. One of these is the understanding that our society's health professions have about access and care as they consider their ethical commitment to respond to patients' oral health needs. The other is how these matters are understood within America's public culture. In this view, needs--including health care needs--are no different in kind or ethical significance from unmet desires of any sort. This article will spell out the differences between these two ways of understanding care and access. Comprehending the distance that separates the health professions' perspective from much of mainstream American thinking on these matters is essential to a careful discussion of the ethics of access to oral health care.
Assuntos
Assistência Odontológica/ética , Acessibilidade aos Serviços de Saúde/ética , Necessidades e Demandas de Serviços de Saúde/ética , Atitude do Pessoal de Saúde , Cultura , Humanos , Opinião Pública , Estados UnidosRESUMO
Is there a way to support a special ethical status for unmet oral health needs within our pluralistic, liberty-loving American society? Some people in American society, perhaps many people, believe that some kinds of human needs have special ethical importance. But very few people outside the oral health professions have ever considered that unmet oral health needs might belong to this category. This article will examine why some kinds of needs are thought to have special ethical importance and propose that certain categories of oral health care are needs that fit this description. Without thinking these issues through, we who argue for improved access to oral health care will remain unable to provide an adequate answer to a very legitimate question, namely: improved access to what? When this task has been completed, the article will consider some of the implications of such a view for our society.
Assuntos
Assistência Odontológica/ética , Ética Odontológica , Prioridades em Saúde/ética , Acessibilidade aos Serviços de Saúde/ética , Necessidades e Demandas de Serviços de Saúde/ética , Alocação de Recursos para a Atenção à Saúde , Humanos , Papel Profissional , Recuperação de Função Fisiológica , Odontalgia/prevenção & controle , Estados UnidosRESUMO
Though "good people' are important for the life of any organization, it is a myth to think that enough good people will make for a good organization. To break free of this myth, a health care organization, which is made up of numerous persons and groups, ought to be regarded as a single, unitary actor in society. When seen as a single actor, the organization's systems for carrying out its mission can be better assessed and improved if necessary. If the organization's systems are not functioning as they should, then even good people will be hindered in their efforts. It can be said, therefore, that organizational ethics takes seriously the idea that every Catholic health care organization is a moral actor needing to reflect carefully on what it does in relation to its employees, leaders, and the outside community. In an environment where the organization's actions are reflected upon, and its character is carefully and continually shaped according to its mission, individual persons in that organization will be better equipped for making and carrying out good decisions that are aligned with that same regard for the mission.
Assuntos
Catolicismo , Relações Comunidade-Instituição , Ética Institucional , Hospitais Religiosos/ética , Marketing de Serviços de Saúde/ética , Objetivos Organizacionais , Valores Sociais , Estados UnidosRESUMO
Conflicts of interest are unavoidable in dentistry. A set of five questions is offered to help sort through such conflicts. The potential harm and the likelihood of such harm caused by secondary interests (the potentially conflicting ones) must be considered against the potential harm and the likelihood of damage caused by withholding services in which secondary interests are present. The use of these questions is illustrated with an example of a researcher who has a commercial interest in the product under study and of dentists who have secondary interests in services provided to patients.
Assuntos
Conflito de Interesses , Assistência Odontológica/ética , Pesquisa em Odontologia/ética , Ética Odontológica , Códigos de Ética , Humanos , Viés de Publicação , Gestão de RiscosRESUMO
Although the number of incidents is unknown, professional quality-oriented renal organizations have become aware of an increased number of complaints regarding nephrologists who approach patients with the purpose of influencing patients to change nephrologists or dialysis facilities (hereinafter referred to as patient solicitation). This development prompted the Forum of ESRD Networks and the Renal Physicians Association to publish a policy statement on professionalism and ethics in medical practice as these concepts relate to patient solicitation. Also common but not new is the practice of nephrologists trying to recruit their own patients to a new dialysis unit in which they have a financial interest. This paper presents two illustrative cases and provides an ethical framework for analyzing patient solicitation and physician conflict of interest. This work concludes that, in the absence of objective data that medical treatment is better elsewhere, nephrologists who attempt to influence patients to change nephrologists or dialysis facilities fall short of accepted ethical standards pertaining to professional conduct, particularly with regard to the physician-patient relationship, informed consent, continuity of care, and conflict of interest.
Assuntos
Diálise/ética , Ética Médica , Nefrologia/ética , Médicos/ética , Má Conduta Profissional/ética , Conflito de Interesses , Continuidade da Assistência ao Paciente/ética , Diálise/economia , Humanos , Consentimento Livre e Esclarecido/ética , Marketing de Serviços de Saúde/ética , Nefrologia/economia , Relações Médico-Paciente/ética , Médicos/economiaRESUMO
KIE: An "Exchange Theory of Justice" is advanced to argue for a universal right to basic health care in any society able to provide such services. The theory assumes that a just exchange is not possible if one party lacks goods necessary for survival while a second party holds an abundance of those goods. The responsibility to equitably distribute health care lies with the society as a whole. Health professionals are morally obligated only to the extent that they are responsible as members of society for endeavoring to achieve a just social policy.^ieng
Assuntos
Atenção à Saúde , Direitos Humanos , Justiça Social , Responsabilidade Social , Alocação de Recursos para a Atenção à Saúde , Humanos , Obrigações Morais , Alocação de RecursosRESUMO
... Because institutional ethics has been neglected, there is a tendency in our institutional life to apply moral principles with which we are familiar from our personal life. However, principles from individual ethics often distort institutional ethics. Ethical problems in the hospital are not exactly the same as ethical problems that arise when individual doctors treat individual patients. And when the problems are similar, the ethical principles by which we should resolve them are likely to be quite different. To begin to make a case for taking hospital ethics seriously, I briefly examine two familiar principles of individual doctor-patient ethics that look different, or should look different, in the setting of a hospital. I then discuss ethics committees -- one of the most important ways in which hospital ethics is put into practice.