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  1. Family experiences with non-therapeutic research on dying patients in the intensive care unit.Amanda van Beinum, Nick Murphy, Charles Weijer, Vanessa Gruben, Aimee Sarti, Laura Hornby, Sonny Dhanani & Jennifer Chandler - 2022 - Journal of Medical Ethics 48 (11):845-851.
    Experiences of substitute decision-makers with requests for consent to non-therapeutic research participation during the dying process, including to what degree such requests are perceived as burdensome, have not been well described. In this study, we explored the lived experiences of family members who consented to non-therapeutic research participation on behalf of an imminently dying patient. We interviewed 33 family members involved in surrogate research consent decisions for dying patients in intensive care. Non-therapeutic research involved continuous physiological monitoring of dying patients (...)
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  • The theorisation of ‘best interests’ in bioethical accounts of decision-making.Giles Birchley - 2021 - BMC Medical Ethics 22 (1):1-18.
    Background Best interests is a ubiquitous principle in medical policy and practice, informing the treatment of both children and adults. Yet theory underlying the concept of best interests is unclear and rarely articulated. This paper examines bioethical literature for theoretical accounts of best interests to gain a better sense of the meanings and underlying philosophy that structure understandings. Methods A scoping review of was undertaken. Following a literature search, 57 sources were selected and analysed using the thematic method. Results Three (...)
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  • Deciding Together? Best Interests and Shared Decision-Making in Paediatric Intensive Care.Giles Birchley - 2014 - Health Care Analysis 22 (3):203-222.
    In the western healthcare, shared decision making has become the orthodox approach to making healthcare choices as a way of promoting patient autonomy. Despite the fact that the autonomy paradigm is poorly suited to paediatric decision making, such an approach is enshrined in English common law. When reaching moral decisions, for instance when it is unclear whether treatment or non-treatment will serve a child’s best interests, shared decision making is particularly questionable because agreement does not ensure moral validity. With reference (...)
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  • The Substituted Judgment Approach: Its Difficulties and Paradoxes in Mental Health Settings.Thomas G. Gutheil & Paul S. Appelbaum - 1985 - Journal of Law, Medicine and Ethics 13 (2):61-64.
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  • Paternalism modernised.G. B. Weiss - 1985 - Journal of Medical Ethics 11 (4):184-187.
    The practice of paternalism has changed along with developments in medicine, philosophy, law, sociology and psychology. Physicians have learned that a patient's values are a factor in determining what is best for that patient. Modern paternalism continues to be guided by the principle that the physician decides what is best for the patient and pursues that course of action, taking into account the values and interests of the patient. In the autonomy model of the doctor-patient relationship, patient values are decisive. (...)
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  • Clarifying substituted judgement: the endorsed life approach: Table 1.John Phillips & David Wendler - 2015 - Journal of Medical Ethics 41 (9):723-730.
    A primary goal of clinical practice is to respect patient autonomy. To promote this goal for patients who have lost the ability to make their own decisions, commentators recommend that surrogates make their treatment decisions based on the substituted judgment standard. This standard is commonly interpreted as directing surrogates to make the decision the patient would have made in the circumstances, if the patient were competent. However, recent commentators have argued that this approach—attempting to make the decision the patient would (...)
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  • Incompetent Persons as Research Subjects and the Ethics of Minimal Risk.Kathleen Cranley Glass & Marc Speyer-Ofenberg - 1996 - Cambridge Quarterly of Healthcare Ethics 5 (3):362.
    The voluntary and informed consent of subjects has been the central focus of concern in research reviews, overshadowing the importance of all other considerations. The Nuremberg Code, with its rights-based protection of the subject's autonomy above all else, made it difficult to justify research with no intended benefit when subjects are incompetent to make a valid informed choice to participate. Subsequent codes providing for research with incompetent subjects followed the lead of Nuremberg, substituting the informed authorization of a proxy for (...)
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  • Must ethics be theological? A critique of the new pragmatists.Richard Sherlock - 2009 - Journal of Religious Ethics 37 (4):631-649.
    In the last decade there has been a pragmatic turn in the work of those doing Christian ethics, especially as represented by the work of Jeffrey Stout and Franklin Gamwell. The pragmatic turn represents a critique of the highly influential work of Stanley Hauerwas and Alasdair MacIntyre, which argues for a strongly intra-church ethics. The pragmatists are correct in arguing that Christian ethics must engage the public sphere. However, I argue that they are deeply mistaken in their claim that this (...)
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  • Blood ties and trust: a comparative history of policy on family consent in Japan and the United States.Hiroyuki Nagai - 2017 - Monash Bioethics Review 34 (3-4):226-238.
    Informed consent honors the autonomous decisions of patients, and family consent places importance on decisions made by their families. However, there is little understanding of the relationship between these two medical decision-making approaches. Both approaches exist in Japan as part of its truth disclosure policy. What is the status of family consent in the United States, from which Japan introduced informed consent? This paper compares the situation in the United States with that in Japan, where family consent has been combined (...)
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