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5.
Tidsskr Nor Laegeforen ; 139(17)2019 Nov 19.
Artigo em Norueguês, Inglês | MEDLINE | ID: mdl-31746156
7.
Z Gerontol Geriatr ; 52(Suppl 4): 243-248, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31602507

RESUMO

The use of freedom-depriving measures (physical and medicinal restraints) in people with cognitive impairment or dementia in clinical care settings is of ongoing importance. At the same time, these coercive measures are not only heavily debated but also in most cases ethically questionable from the perspective of the ethics of human dignity. Usually, the ethical evaluation of freedom-depriving measures follows classical paradigms of medical ethics, such as the Principles of Biomedical Ethics by Beauchamp and Childress. To enrich the debate at this point, the ethical category of embodiment ("Leiblichkeit" ) is introduced and discussed after a short summary of the ethical problem at hand. The phenomenon of the living body that has received increasingly more attention in several sciences since the proclaimed "corporeal turn" enables new perspectives towards human dignity, freedom and deprivation of freedom: freedom-depriving measures do not take place in an invisible realm of ideas but are directly applied to the psychophysical unity that is the living body of a person. Thus, freedom-depriving measures are an intervention into the bodily autonomy of the human being and the personal freedom that is manifested in the living body. The concept of the living body ("Leib") that is applied here, signifies more than just a physical object and is especially apt to capture the (inter)subjective dimension that has to be taken into account here. Finally, it will have to be investigated whether the use of medicinal restraints represents an especially serious interference into the sphere of human embodiment. Once introduced into the debate on freedom-depriving measures in clinical care, the category of embodiment can warrant decisive new emphases.


Assuntos
Cuidados Críticos/ética , Demência/terapia , Liberdade , Direitos do Paciente/ética , Autonomia Pessoal , Respeito , Cuidados Críticos/psicologia , Tomada de Decisões , Ética Médica , Humanos
10.
Perspect Biol Med ; 62(3): 489-502, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31495793

RESUMO

While mainstream, establishment medical journals have published opinion pieces condemning conscientious refusals in medical care, American law has consistently and repeatedly supported a right to such refusals. Law has not relied on a particular philosophical basis for health care. Indeed, legal precedents reject any monolithic model, whether based on consumerism or on professional obligations. Law focuses on the coexistence of diverse understandings, motivations, and delivery models. Scholarly approaches tend to ignore the fact that, fundamentally, conscientious objection involves a minority telling the majority that the objector(s) cannot ethically participate according to the majority's preferred model or set of rules. Religious liberty is protected in the US by applying strict scrutiny. Any governmental burden on religious liberty must further a compelling governmental interest and be implemented using the least restrictive means reasonably available. After years of scholarly controversy, strict scrutiny continues to be the law. The moral basis for the legal right of conscientious objection has been affirmed and expanded by Hobby Lobby in 2014, outlined in an Attorney General Memorandum in 2017, and codified in a Final Conscience Rule by the Department of Health and Human Services in May 2019.


Assuntos
Recusa Consciente em Tratar-se/ética , Liberdade , Relações Médico-Paciente/ética , Aborto Induzido , Recusa Consciente em Tratar-se/legislação & jurisprudência , Acesso aos Serviços de Saúde/ética , Acesso aos Serviços de Saúde/legislação & jurisprudência , Humanos , Obrigações Morais , Estados Unidos
11.
Am J Bioeth ; 19(10): W9-W13, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31557098
12.
BMC Public Health ; 19(1): 1082, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399049

RESUMO

BACKGROUND: Active transportation (AT), independent mobility (IM), and outdoor time are promising ways to increase children's physical activity. However, in order to create interventions to increase those forms of physical activity, it is important to understand the relationships between area-level socioeconomic status (SES) and type of urbanization with AT, IM, outdoor time, and physical activity, and this was the aim of the study. METHODS: One thousand six hundred ninety-nine children in grades 4 to 6 (mean age: 10.2 ± 1.0 years) from three Canadian regions participated. AT, IM, and outdoor time were assessed using questionnaires and physical activity was measured using the SC-StepRX pedometer. Area-level SES was assessed using the median household income of the census tract in which the school was located and type of urbanization was determined for each school using standardized procedures. Generalized linear and general linear mixed models were used to examine the relationships. RESULTS: Area-level SES and the type of urbanization were generally not related to AT, IM, or physical activity for either gender. However, we observed that both boys and girls living in lower SES areas had decreased odds of spending > 2 h outdoors on weekend days compared to their peers from higher SES areas. Girls living in suburban or rural areas were more likely to spend > 2 h outdoors on weekdays compared to their urban counterparts. CONCLUSIONS: AT, IM, and physical activity are generally not associated with area-level SES or the type of urbanization in this sample of Canadian children. The finding regarding outdoor time showing that both boys and girls of lower SES areas had decreased odds of spending > 2 h outdoors on weekends compared to their peers from higher SES areas suggest that additional efforts should be implemented to offer outdoor play opportunities in lower SES areas.


Assuntos
Exercício/fisiologia , Liberdade , Áreas de Pobreza , Transportes/estatística & dados numéricos , Urbanização , Adolescente , Canadá , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários , Fatores de Tempo
13.
J Int Bioethique Ethique Sci ; Vol. 30(2): 169-180, 2019 07 02.
Artigo em Francês | MEDLINE | ID: mdl-31460734

RESUMO

Faced with complex situations, caregivers test one of the oldest philosophical questions: how to prove the freedom of a decision? In the care, it is a question of determining if the patient has understood the situation, evaluated the consequences of his choice and if his decision is taken in the absence of any constraint. In other words, is the patient's decision an autonomous decision? But what are the tools that make it possible to evaluate this autonomy precisely and objectively? And also, how to promote a greater autonomy?


Assuntos
Tomada de Decisões , Metafísica , Autonomia Pessoal , Relações Médico-Paciente/ética , Comportamento de Escolha , Liberdade , Humanos
15.
Soins Psychiatr ; 40(322): 41-43, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31229146

RESUMO

The desire to modernise the approach to psychiatric care aims to confirm the patient's place as subject and to reposition him or her in a context of empowerment. This article describes the contextualisation of the mental health dimension, through the democratic impetus given by an 'emancipatory' form of psychiatry.


Assuntos
Transtornos Mentais/terapia , França , Liberdade , Humanos , Política , Psiquiatria/tendências
16.
BMC Public Health ; 19(1): 725, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182064

RESUMO

BACKGROUND: Depression, the world's leading cause of disability, disproportionately affects women. Women in India, one of the most gender unequal countries worldwide, face systemic gender disadvantage that significantly increases the risk of common mental disorders. This study's objective was to examine the factors influencing women's participation in psychosocial support groups, within an approach where community members work together to collectively strengthen their community's mental health. METHODS: This community-based qualitative study was conducted from May to July 2016, across three peri-urban sites in Dehradun district, Uttarakhand, Northern India. Set within an NGO-run mental health project, data were collected through focus group discussions with individuals involved in psychosocial support groups including women with psychosocial disabilities as well as caregivers (N = 10, representing 59 women), and key informant interviews (N = 8) with community members and mental health professionals. Data were analyzed using a thematic analysis approach. RESULTS: The principal barrier to participating in psychosocial support groups was restrictions on women's freedom of movement. Women in the community are not normally permitted to leave home, unless going to market or work, making it difficult for women to leave their home to participate in the groups. The restrictions emanated from the overall community's attitude toward gender relations, the women's own internalized gender expectations, and most significantly, the decision-making power of husbands and mothers-in-law. Other factors including employment and education shaped women's ability to participate in psychosocial support groups; however, the role of these additional factors must be understood in connection to a gender order limiting women's freedom of movement. CONCLUSIONS: Mental health access and gender inequality are inseparable in the context of Northern India, and women's mental health cannot be addressed without first addressing underlying gender relations. Community-based mental health programs are an effective tool and can be used to strengthen communities collectively; however, attention towards the gender constraints that restrict women's freedom of movement and their ability to access care is required. To our knowledge, this is the first study to clearly document and analyze the connection between access to community mental health services in South Asia and women's freedom of movement.


Assuntos
Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Liberdade , Relações Interpessoais , Participação do Paciente/psicologia , Participação Social/psicologia , Adulto , Ásia , Atitude , Tomada de Decisões , Depressão/psicologia , Emprego/psicologia , Família , Feminino , Grupos Focais , Identidade de Gênero , Humanos , Índia , Transtornos Mentais/psicologia , Saúde Mental , Pesquisa Qualitativa , Grupos de Autoajuda , Cônjuges , Saúde da Mulher
18.
Am J Bioeth ; 19(7): 1-5, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31237501
20.
Community Dent Health ; 36(2): 169-174, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31046203

RESUMO

This paper explores the range of approaches that might be adopted in order to take seriously the challenge that Transnational Corporations (TNCs) pose to inequalities in oral health. The challenge we must face together is the challenge of promoting freedom from disease and enabling all humans to flourish. The paper examines how the goals of the new public health might be better realised through consideration of the 'corporate determinants of health'. It is argued that in order to meaningfully engage with the challenge posed by TNCs in oral health we have to recognise that not all TNCs are evil. Indeed some TNCs have played a central role in the improvements in the oral health of populations over the last fifty or so years. The paper goes on to outline how an awareness of different professional strategies can be used to frame an interdisciplinary programme of work looking at the role of TNCs in oral health. These strategies involve a professional focus on data collection and analysis, a focus on policy, being critical, being publicly involved, and acting with foresight. The paper goes on to provide an outline of how these strategies might be pursued to engage TNCs in a programme of research around inequalities in oral health. It is proposed that we form a broad collaboration between appropriate TNCs, academics and funders. This paper provides a very brief sketch about how such a program might be envisaged.


Assuntos
Saúde Bucal , Autonomia Pessoal , Saúde Pública , Liberdade , Humanos , Condições Sociais
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