The principle of respect for autonomy often dominates the bioethical discourse. Yet despite its prominence, the exact contours are not always well defined. Widespread disagreement about the nature of autonomy has led some to conclude that autonomy is hopelessly vague and therefore ought to be abandoned in contemporary bioethics. Despite calls to move beyond it, autonomy remains at the center of bioethical reflection. The challenge, then, if autonomy is to function as a bedrock of contemporary bioethics, is to define more (...) clearly the shape of autonomy, to mark more precisely its conceptual boundaries, and to delineate more carefully how best autonomy is put into practice in medical ethics. In this article, I raise questions about the ways autonomy is used in theory, as well as the ways that it is operationalized in practice. (shrink)

This study sought to determine cardiologists’ degrees of ethical awareness and preferred courses of action for ethical dilemmas frequently encountered in clinical settings. For this evaluation, an online survey was created and sent to cardiologists affiliated with various academic posts in Ankara, Turkey. The survey included ten cases with various ethical considerations selected from our book, “Clinic Ethics with Cases from Cardiology.” Four possible action choices were defined for each case. Participants were asked to choose one or more of these (...) preferences. In addition, a fictional change was made in each case’s context without changing the original ethical issue, and participants were asked whether an attitude different from the first chosen one was preferred. The participation ratio was 49/185 (26%), consent ratio 47/185 (25,4%), and completion ratio 44/185 (23,7%). Nine of the ten scenario changes did not change participants’ preferred action. For most questions, action preferences were concentrated between the two options. Although legal regulations did not reduce ethical dilemmas, they clarified physicians’ action preferences. Similarly, as an obscure moral issue gained prominence, physicians were forced to draw clearer lines in their actions. External factors such as healthcare emergencies can change physicians’ ethical dilemma-solving attitudes. (shrink)

Interpersonal respect can be differentiated into two kinds: horizontal respect, i.e. treating someone with dignity; and vertical respect, i.e. genuinely honoring someone’s merits. With the present research, we draw on motivation theory to explore their interplay in leadership relations. Specifically, we argue for a moderated mediation hypothesis in that leaders’ horizontal respect for their subordinates fundamentally speaks to subordinates’ self-determination and that the message of respectful leadership is enhanced by the vertical respect subordinates have for their leaders. As a result, (...) subordinates are more satisfied with their jobs, which should also show in a decreased willingness to leave. The proposed model was supported in two survey studies and an experimental scenario study —thus suggesting that perceived leader behavior needs to be complemented by leader standing. (shrink)

Background: The theoretical framework of Jϋrgen Habermas suggests that effective communication requires competent participants with an objective attitude that complies with the rules and worlds designated as objective, social and subjective. This situation determines communicative action, which stimulates the search for mutual understanding and results in a process of interaction that promotes self-determination. Objectives: In this study, the discharge letters of patients with myocardial infarction were explored regarding the provision of information. The patient’s right to information and the duty of (...) informing were analysed according to the perspective of Jϋrgen Habermas. Research design: This was a cross-sectional analysis (from a broader longitudinal study) of all discharge letters that were directly related to nursing interventions regarding the provision of information to 106 patients. In this major study, the difficulties faced by patients who experienced a myocardial infarction and the changes in their lifestyles were analysed based on the type of information received. Ethical considerations: The hospital Ethics Committee approved the study, which complied with ethical principles and required informed consent. Findings: In the nursing letters, interventions related to the provision of information were conducted at an average of 3.59 interventions per patient. For 8.5% of the patients, however, no interventions related to the provision of information were performed. The most common area of information during hospitalisation was related to the management of signs and symptoms and applied to 90.6% patients. Discussion: The nursing interventions did not cover patient education, transition processes or awareness of the disease. Thus, the right to information can be questioned. Conclusion: Information is a right, and communication is extremely important. Health professionals should be aware of this importance regarding both care management and the satisfaction guarantee. The sharing of information by health professionals based on their competency is essential for patients to exercise their right to self-determination and decision-making. (shrink)

The American Journal of Bioethics, Volume 12, Issue 3, Page 37-39, March 2012.