This research aims to examine access to medical treatment during the COVID-19 pandemic for people living with disabilities. During the COVID-19 pandemic, the practical and ethical problems of allocating limited medical resources such as intensive care unit beds and ventilators became critical. Although different countries have proposed different guidelines to manage this emergency, these proposed criteria do not sufficiently consider people living with disabilities. People living with disabilities are therefore at a higher risk of exclusion from medical treatments as physicians (...) tend to assume they have poor quality of life, whereas access to medical treatment should be based on several parameters, including clinical data and prognosis. However, the COVID-19 pandemic shifts the medical paradigm from person-centred medicine to community-centred medicine, challenging the main ethical theories. We reviewed the main guidelines and recommendations for resources allocation and examined their position toward persons with disabilities. Based on our findings, we propose criteria for not discriminating against people with disabilities in allocating resources. The shift from person-centred to community-centred medicine offers opportunities but also risks sacrificing the most vulnerable people. The principle of reasonable accommodation must always be considered to guarantee the rights of persons with disabilities. (shrink)

Healthcare robots enable practices that seemed far-fetched in the past. Robots might be the solution to bridge the loneliness that the elderly often experience; they may help wheelchair users walk again, or may help navigate the blind. European Institutions, however, acknowledge that human contact is an essential aspect of personal care and that the insertion of robots could dehumanize caring practices. Such instances of human–robot interactions raise the question to what extent the use and development of robots for healthcare applications (...) can challenge the dignity of users. In this article, therefore, we explore how different robot applications in the healthcare domain support individuals in achieving ‘dignity’ or pressure it. We argue that since healthcare robot applications are novel, their associated risks and impacts may be unprecedented and unknown, thus triggering the need for a conceptual instrument that is binding and remains flexible at the same time. In this respect, as safety rules and data protection are often criticized to lack flexibility, and technology ethics to lack enforceability, we suggest human dignity as the overarching governance instrument for robotics, which is the inviolable value upon which all fundamental rights are grounded. (shrink)

This volume-"Selected Contemporary Challenges of Aging Policy"-is the most international of all published monographs from the series "Czech-Polish-Slovak Studies in Andragogy and Social Gerontology." Among the scholars trying to grasp the nuances and trends of social policy, there are diverse perspectives, resulting not only from the extensive knowledge of the authors on the systematic approach to the issue of supporting older people but also from the grounds of the represented social gerontology schools. In the texts of Volume VII interesting are (...) both distinct and coherent elements presenting the role of local, regional and global policies in the prism of the countries from which the authors originate: the Czech Republic, Slovenia, Lithuania, Latvia, Poland, Slovakia, Italy, Turkey, and the United States. The chapters show a wealth of methodological approaches to the perception of social policy and its tools. In the texts there are issues related to the idea of active ageing, discrimination against older people in the workplace, comparability of solutions friendly to employment of older adults in the Czech Republic, Poland, and Slovakia as well as focused on the importance of educational forms determining an active life in old age. This monograph also attempted to answer the question regarding how to transfer the idea of intergenerational learning into the realm of practice. This issue complements the chapter on the implementation of intergenerational programs in institutions providing long-term care support. The book also outlines a public policy on ageing in the perspective of the changes over the last few decades and the case demonstrating solutions to accelerate self-reliance as a key to active ageing. We hope that seventh volume of our series will be an intellectual stimulus for further international research on change in social policy and will contribute to the dissemination of best practices as well as contribute to positive social change. (shrink)

Ziel des vorliegenden Beitrags ist es, den Inklusionsbegriff aus einer sozialphilosophischen Perspektive systematisch zu erschließen. Im Hintergrund meiner Überlegungen steht dabei die Überzeugung, dass ›Inklusion‹ eine sozialtheoretische Schlüsselkategorie für ein analytisch aufschlussreiches Verständnis und eine sachlich angemessene Kritik zwischenmenschlicher Beziehungen darstellt.

The development and use of advanced and innovative neuroscience, neurotechnology and some forms of artificial intelligence have exposed potential threats to the human condition, including human rights. As a result, reconceptualizing or creating human rights (i.e. neurorights) has been proposed to address specific brain and mind issues like free will, personal identity and cognitive liberty. However, perceptions, interpretations and meanings of these issues—and of neurorights—may vary between countries, contexts and cultures, all relevant for an international-consensus definition and implementation of neurorights. (...) Thus, we encourage reflecting on the proactive inclusion of transnational, cross-cultural and contextual considerations and concerns to contribute to the global discourse. This inclusion does not mean endorsing ethical relativism but rather a call to foster a universal understanding of key concepts and concerns. Including contextual and cultural perspectives may truly anticipate global concerns which could be addressed while developing and implementing neurorights. Consequently, any ethical and/or legal regulatory framework(s) for the translational and transnational use of advanced neuroscience, neurotechnology and some forms of artificial intelligence intended to protect and safeguard human dignity should be contextually and culturally mindful, responsible, respectful and inclusive of not only human rights and fundamental freedoms but also of neurocognitive cultural diversity. (shrink)

The harm usually associated with psychopathy requires therapeutically, legally, and ethically satisfactory solutions. Scholars from different fields have, thus, examined whether empirical evidence shows that individuals with psychopathic traits satisfy concepts, such as responsibility, mental disorder, or disability, that have specific legal or ethical implications. The present paper considers the less discussed issue of whether psychopathy is a disability. As it has been shown for the cases of the responsibility and mental disorder status of psychopathic individuals, we argue that it (...) is undecided whether psychopathy is a disability. Nonetheless, based on insights from disability studies and legislations, we propose that interventions to directly modify the propensities of individuals with psychopathic tendencies should be balanced with modifications of the social and physical environments to accommodate their peculiarities. We also suggest how this social approach in some practical contexts that involve non-offender populations might be effective in addressing some of the negative effects of psychopathy. (shrink)

Growing evidence in recent years has led to an agreement on the importance and benefits that inclusive education has for students with special educational needs (SEN). However, the extension and universalization of an inclusive approach will also be enhanced with more evidence on the benefits that inclusion has for all students, including those without SEN. Based on the existing knowledge that learning interactions among diverse students are a key component of educational inclusion, the aim of this study is to identify (...) the impact on students without SEN of being educated with students with SEN in shared, inclusive, interactive learning environments. Data were collected in three schools using a qualitative approach with a communicative orientation. Semistructured interviews were held with teachers as well as community volunteers participating in the schools. Further, focus groups were conducted with students and teachers. The results show that students without SEN benefit from participating in interactive learning activities with peers with SEN in different ways: (1) they learn to respect others, accept differences, and acknowledge different abilities, thereby creating opportunities for new friendships to develop; (2) they learn about abilities related to helping others participate and learn, to be patient and to gain the satisfaction in helping others learn and behave better; and (3) they benefit from the cognitive effort required to explain themselves and from the contributions of peers with SEN from which they can learn. (shrink)

Violence suffered by children is a violation of human rights and a global health problem. Children with disabilities are especially vulnerable to violence in the school environment, which has a negative impact on their well-being and health. Students with disabilities educated in special schools have, in addition, more reduced experiences of interaction that may reduce both their opportunities for learning and for building protective social networks of support. This study analyses the transference of evidence-based actions to prevent violence in schools (...) – the dialogic model of prevention and resolution of conflicts (DMPRC) – in the context of a special school, and its impact on the reduction of violence, the creation of egalitarian relationships, and the prevention of bullying. A case study with a communicative approach was conducted including in-depth interviews and communicative focus groups with the diverse participants to analyze the process of transformation carried out in the school and the main actions that give students a voice in the management and creation of egalitarian non-violent relationships. The results show that the inclusion of the students’ voices in the resolution and prevention of conflicts reduces violence, empowers special education students, strengthens friendship relationships, caring behavior, and active positioning among the community. The positive impact of the transference of the DMPRC to special schools contributes to students’ well-being and healthy development by offering safe and protective educational spaces and quality emotional education, also contributing to the achievement of the Sustainable Development Goals related to the elimination of all forms of violence in childhood. (shrink)

The objective of this article is to shed light on some challenging questions regarding public health and medical ethics that the Turkish healthcare system has recently been forced to confront. In recent years, terrorists in eastern Turkey have launched increasingly destructive attacks, including numerous attempts to undermine the social order by targeting not only government agencies but also the healthcare system. In this study, 54 terrorist incidents specifically targeting the Turkish healthcare system and healthcare professionals were analyzed and divided into (...) 6 categories according to the type of attack. Each category was evaluated in terms of the relevant ethical issues, with regard to both public health and medical ethics. This study shows that terrorist activity may lead to numerous breaches of public health and clinical ethics rules. Therefore, healthcare policy must involve special precautions to minimize breaches of public health and medical ethics in the face of terrorist attacks. (shrink)

Wearable robots and exoskeletons are relatively new technologies designed for assisting and augmenting human motor functions. Due to their different possible design applications and their intimate connection to the human body, they come with specific ethical, legal, and social issues, which have not been much explored in the recent ELS literature. This paper draws on expert consultations and a literature review to provide a taxonomy of the most important ethical, legal, and social issues of wearable robots. These issues are categorized (...) in wearable robots and the self, wearable robots and the other, and wearable robots in society. (shrink)

PurposeInternational organizations are working on an unprecedented number of development initiatives relevant to people with disabilities. This makes it essential for the global disability community to be able to participate effectively in the decision-making processes associated with these programs. In light of this, this study aims to explore whether information technologies can help create a more inclusive global governance, forming the basis for equitable development for people with disabilities.Design/methodology/approachThe results of a global survey of disabled people’s organizations’ leaders are discussed. (...) This asked disability rights advocates about their experiences with accessibility and barriers to effective participation, low-cost accessible technological solutions for remote participation and freely available “off-the-shelf” online technologies – in particular social media platforms – to bridge the gap between the disability community and global governance processes.FindingsAlthough only a small number of international conferences offer accessible virtual participation through web conferencing and other tools, responses from DPO advocates suggest that there is a strong demand for this technology and provide evidence of its potential for improving accessibility in global governance. Furthermore, disability organizations all over the world have embraced social media platforms to liaise with their grassroots and enable them to part-take in policy-making processes.Originality/valueThis study highlights community-backed technological solutions to persisting barriers that systematically exclude people with disabilities from fundamental global governance processes, illuminating the nexus of disability, accessibility, and participation. (shrink)

Euthanasia and assisted suicide have been legally possible in the Netherlands since 2001, provided that statutory due care criteria are met, including: voluntary and well-considered request; unbearable suffering without prospect of improvement; informing the patient; lack of a reasonable alternative; independent second physician’s opinion. ‘Unbearable suffering’ must have a medical basis, either somatic or psychiatric, but there is no requirement of limited life expectancy. All EAS cases must be reported and are scrutinised by regional review committees. The purpose of this (...) study was to investigate whether any particular difficulties arise when the EAS due care criteria are applied to patients with an intellectual disability and/or autism spectrum disorder. The 416 case summaries available on the RTE website were searched for intellectual disability and autism spectrum disorder. Direct content analysis was used on these nine cases. Assessment of decisional capacity was mentioned in eight cases, but few details given; in two cases, there had been uncertainty or disagreement about capacity. Two patients had progressive somatic conditions. For most, suffering was due to an inability to cope with changing circumstances or increasing dependency; in several cases, suffering was described in terms of characteristics of living with an autism spectrum disorder, rather than an acquired medical condition. Some physicians struggled to understand the patient’s perspective. Treatment refusal was a common theme, leading physicians to conclude that EAS was the only remaining option. There was a lack of detail on social circumstances and how patients were informed about their prognosis. Autonomy and decisional capacity are highly complex for patients with intellectual disabilities and difficult to assess; capacity tests in these cases did not appear sufficiently stringent. Assessment of suffering is particularly difficult for patients who have experienced life-long disability. The sometimes brief time frames and limited number of physician-patient meetings may not be sufficient to make a decision as serious as EAS. The Dutch EAS due care criteria are not easily applied to people with intellectual disabilities and/or autism spectrum disorder, and do not appear to act as adequate safeguards. (shrink)

In recent years inclusion has become one of the most dominant values and objectives in education. However, there is still considerable disagreement concerning the theoretical concept of inclusion and its normative implications. This article suggests an understanding of inclusion that first differentiates analytically between societal and communal forms of inclusion, and second, situates the value of inclusion in the debate around recognition and freedom. Furthermore, it connects the discussion to some dilemmas and difficulties we might face in education. The overall (...) approach and goal of the article is to contribute to the on-going debate on the nature and value of inclusion and inclusive education. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

The article raises the issue of ‘the right to be ill’, formulated by Tadeusz Kielanowski, a Polish physician and humanist. According to him, the right to health should be supplemented by the principle which would serve the protection of people with diseases or disabilities. One-sided interpretation of ‘the right to health’ may result in various forms of intolerance and discrimination. This paper presents what dangers Kielanowski recognized and explains why his approach was considered to be a novelty; what the idea (...) of ‘the right to be ill’ is, how the need for it is substantiated. This idea is considered in the context of human rights and it constitutes a starting point for the reflection on social phenomena connected with medicine. Taking into account the changes in medical ethics and culture which have taken place in the recent decades the question has been asked—is it worth talking about the right to be ill these days? Giving positive answers to this question, the spheres and issues that have been presented can be analyzed and assessed from the perspective of the right to be ill. (shrink)

Human rights have recently impacted on current conceptualisations of the rights and obligations owed to individuals with impairments, culminating in the UN Convention for the Rights of Persons with Disabilities. Particularly significant is Article 12, where interpretations have heralded a “will and preferences” paradigm which rejects substituted decision-making mechanisms, even in situations where an individual should make personally harmful or unwise decisions about their treatment, care, or relationships. This paper explores problems with “strict” and “flexible” interpretations of Article 12, focusing (...) specifically on safeguarding issues in cases of relational abuse, exploitation, and coercion. Drawing analogies with feminist arguments opposing violence against women in the domestic sphere, I challenge the private/public and individualistic account of autonomy which is implicit in interpretations of the “will and preferences” paradigm, and suggest that proponents of Article 12 should consider the possible justifiability of expanded protectionist measures in cases of abuse involving individuals with impairments. (shrink)

People with disabilities face inequalities in mental wellbeing, for which social exclusion is a contributing factor. Musical activities offer a promising but complex intervention, making impacts on a population with highly varied characteristics and needs challenging to capture. This paper reports on a mixed methods, person-centered study investigating a community music intervention for such a population. Three groups of adult service users with varied disabilities (either physical, learning, or both), took part in weekly music workshops in different locations. Music staff, (...) housing and resource center staff, as well as participants and members of their families, took part in semi-structured interviews. A quantitative measure administered by service staff was used to rate service users’ social development. Two lay researchers, both individuals with a disability contributed to all aspects of the study. Interviews were analyzed through thematic analysis. Improvements in individuals’ self-expression, confidence, mood, and social skills were consistent with previous findings. Differences in effect between centers included: Group 1, some of whom had previous experience of workshops, showed an improvement in musical skills; Group 2 showed a mixed response, some participated with enthusiasm but others chose art activities over music workshops; Group 3 had lasting positive impact, this group had very limited opportunities for music due to their rural location. Quantitative analysis showed significant increase over all groups in communication, interaction with others, and joint attention. The intervention was beneficial for participants in separate locations in similar ways, but also highlighted that context and prior experience mediated effects in distinct ways. The lay researchers enhanced the qualitative analysis by emphasizing (1) the importance of recognizing participants’ self-expression in non-verbal modes of communication and (2) the importance of having music staff with a disability to provide a positive role model. This paper proposes that mixed methods person-centered research is the most suitable approach to capture and understand the multiple and varied effects of this complex intervention for a diverse group of participants. (shrink)

It is widely accepted among medical ethicists that competence is a necessary condition for informed consent. In this view, if a patient is incompetent to make a particular treatment decision, the decision must be based on an advance directive or made by a substitute decision-maker on behalf of the patient. We call this the competence model. According to a recent report of the United Nations (UN) High Commissioner for Human Rights, article 12 of the UN Convention on the Rights of (...) Persons with Disabilities (CRPD) presents a wholesale rejection of the competence model. The High Commissioner here adopts the interpretation of article 12 proposed by the Committee on the Rights of Persons with Disabilities. On this interpretation, CRPD article 12 renders it impermissible to deny persons with mental disabilities the right to make treatment decisions on the basis of impaired decision-making capacity and demands the replacement of all regimes of substitute decision-making by supported decision-making. In this paper, we explicate six adverse consequences of CRPD article 12 for persons with mental disabilities and propose an alternative way forward. The proposed model combines the strengths of the competence model and supported decision-making. (shrink)

The application of human right frameworks is an increasingly important part of efforts to accelerate progress in global mental health. Much of this has been driven by several influential legal and policy instruments, most notably the United Nations’ Convention on the Rights of Persons with Disabilities, as well as the World Health Organization’s QualityRights Tool Kit and Mental Health Action Plan. Despite these significant developments, however, much more needs to be done to prevent human rights violations. This chapter focuses on (...) a critical component of this broader challenge, which is the question of how best to regulate and reduce the use of coercive measures. The recent literature on coercion in psychiatry – which addresses involuntary commitment, seclusion, restraint, and forced medication – represents a useful resource that can help guide tractable solutions in global mental health. These issues are evaluated from the perspective of global health governance, and several general recommendations are made in order to improve monitoring and enforcement, provide guidance for domestic legislative reform, and strengthen health systems. (shrink)

This article argues that deafness as disability from a medical view does not rest on the scientific aspect of medicine. Rather there are ideological biases and prejudices that are masked under the medical view of deafness as disability. The article reveals these and counters them.

An ageing population is a global phenomenon that takes place in Latvia, too. The active ageing policy is a social response to social challenges caused by demographic changes. Growing generational gap is a challenge to all “greying societies‘ in Europe and Latvia in particular. The active ageing policy is oriented to provide possibilities for older adults to live independently. However, long-term care institutions remain necessary, especially for those who live alone and have serious health problems. LTCIs are mostly orientated to (...) provide primary needs and health care. People regardless of their age also need a social and cultural life, but for older people who live in LTCIs, it is insufficient. The study shows those who are residing in LTCIs settings are subject to everyday routine. LTCIs care provision is very much dependent on the authorities of the institution. The insufficient level of interaction between older people and the more active part of society prevents the finding of effective ways of achieving that the care in LTCIs is in accordance with the active ageing policy. The study aims to find out ways how intergenerational cultural programs of professional and amateur activities are implemented in LTCIs. The study uses a qualitative approach to explore how LTCIs intergenerational cultural programs are helping to keep our youngest and oldest generations connected. (shrink)

This paper critiques current arguments advancing the potential for transhumanism and a range of biological and pharmacological enhancements to better human flourishing. It does so from a historical perspective weighing the individualistic and competitive evolutionary theories of Darwin with the cooperative and communal theories of Prince Peter Kropotkin a generation later. In doing so it proposes the transhumanist and enhancement enthusiasts operate within a paradigm similar to Darwin’s, one that is atomist and individualistic. The critique, which considers the status of (...) those with cognitive, sensory and physical limits, advances a vision of society as a cooperative and communal rather than individualistic and competitive. Within this framework the argument is not one of either/or but on the lexicographical superiority of the communal and social over the individualistic and competitive ethos underlying both Darwin and most contemporary transhumanist literature. This reordering of priorities, it is argued, reflects advances in contemporary biology and evolutionary thinking. (shrink)

One of the most consequential advances in sciences and technology is the increasing generation of bodily enhancement products that enable a culture of, demand for, and acceptance of improving and modifying the human body (structure, function, abilities) beyond its species-typical boundaries. A lively discourse exists around the rights and wrongs of human genetic and other forms of enhancement. Many treat the species-typical human body as an obsolescent technology in need of serious improvements. This raises various questions. This paper addresses the (...) following questions: a) can one refuse the upgrade, b) who has access to the upgrade, c) is there a way to revert to the obsolescent state after the upgrade, and d) what is the impact of perceiving oneself as obsolescent. (shrink)

A large proportion of nursing home residents in developed countries come from ethnic minority groups. Unmet care needs and poor quality of care for this resident population have been widely reported. This systematic review aimed to explore social conditions affecting ethnic minority residents' ability to exercise their autonomy in communication and care while in nursing homes. In total, 19 studies were included in the review. Findings revealed that ethno‐specific nursing homes create the ideal social condition for residents to express their (...) care needs and preferences in a language of choice. In nonethno‐specific nursing homes, staff cultural competence and nursing home commitment to culturally safe care are crucial social conditions that enable this group of residents to fulfil their autonomy in communicating and in participating in their care. In contrast, social conditions that undermine residents' ability to express their care needs and preferences include low levels of staff cultural awareness and cultural desire, negative attitudes towards residents and limited organisational support for staff to improve culturally responsive and culturally safe care. In conclusion, it is important to optimise the social conditions to support ethnic minority residents to communicate their care needs and preferences. (shrink)

Person‐centred care, with its central focus on the patient in partnership with healthcare practitioners, is considered to be the contemporary gold standard of care. This type of care implies effective communication from and by both the patient and the healthcare practitioner. This is often problematic in the case of the paediatric population, because of the many communicative challenges that may arise due to the child's developmental level, illness and distress, linguistic competency and disabilities. The principle of universal design put forth (...) in conventions and legislation means that the design of products and services should be usable by all people, to the greatest extent possible. Augmentative and alternative communication encompasses strategies, for example pictures and apps, that are typically used with people with communication disability. In this position paper, we argue for the universal use of augmentative and alternative communication to support person‐centred communication and care for children, regardless of age or potential disability. Clinical examples are shared from three different paediatric care settings where pictorial supports were applied universally. Interviews were conducted with children and adolescents (with and without disabilities), parents and healthcare practitioners, and the principles of universal design were used as a framework to demonstrate how person‐centred communication is supported in paediatric care. (shrink)

Well-being is an important policy concept including in discussions around the use of artificial intelligence, machine learning and robotics. Disabled people experience challenges in their well-being. Therefore, the aim of our scoping review study of academic abstracts employing Scopus, IEEE Xplore, Compendex and the 70 databases from EBSCO-HOST as sources was to better understand how academic literature focusing on AI/ML/robotics engages with well-being in relation to disabled people. Our objective was to answer the following research question: how and to what (...) extent does the AI/ML/robot literature we covered include well-being in relation to disabled people? We found 2071 academic abstracts covering AI/ML and well-being, and 1055 covering robotics and well-being. Within these abstracts, only 39 covered AI/ML and 48 robotics and well-being in relation to disabled people. The tone of the coverage was techno-positive and techno-optimistic arguing that AI/ML/robotics could improve the well-being of disabled people in general or improve well-being by helping disabled people overcome their ‘disability’ or make tasks easier. No negative effects that AI/ML/robotics could have or has had on the well-being of disabled people were mentioned. Disabled people were portrayed only within patient, client, or user roles but not in their roles as stakeholders in the governance of AI/ML/robotics discussions. This biased and limited coverage of the impact of AI/ML/robotics on the well-being of disabled people disempowers disabled people. (shrink)

Since the advent of accessible online computing, the digital divide existed, it exists today and it will exist tomorrow. It means that almost every aspect of life will be affected, particularly for those who are most vulnerable for whatever reason. It is important that research-informed action addresses this unacceptable state. In this special issue, a number of perspectives are taken to consider different aspects of the digital divide. In total, they illustrate the synergistic value of crossing disciplinary boundaries and adopting (...) a plethora of research methods and philosophies. Thus, the guest editors and authors of this special issue have created a notable contribution to the fight against the digital divide. (shrink)

In recent years, several studies have advocated the need to expand the concept of patient autonomy beyond the capacity to deliberate and make decisions regarding a specific medical intervention or treatment (decision-making or decisional autonomy). Arguing along the same lines, this paper proposes a multidimensional concept of patient autonomy (decisional, executive, functional, informative and narrative) and argues that determining the specific aspect of autonomy affected is the first step towards protecting or promoting (and respecting) patient autonomy. These different manifestations of (...) autonomy are not mutually dependent; there may be patients who have problems in one dimension, while at the same time being fully autonomous in others. Nevertheless, a close interaction has been observed between the various dimensions and indeed, a phenomenological analysis shows that damage to or a reduction in one aspect of people’s capacity for self-government generally affects other aspects of their autonomy, which in turn disrupts their identity and the way in which they see themselves and are seen by others. In this paper, I shall examine some of these interactions and show how they may lie at the heart of the problem of poor treatment adherence (where adherence is defined as being the extent to which a patient’s behavior over time coincides with the recommendations made by and agreed with their health professional). One example given is that of psoriasis, a chronic skin disease with a very poor adherence record. In Spain, it is calculated that 85% of patients diagnosed with mild to moderate psoriasis fail to comply properly with their treatment, and figures from other parts of the world are similar. Although there are many possible causes for non-adherence among psoriasis patients, assessing their decisional, executive and narrative capacities and taking appropriate action based on the results may help increase adherence rates. (shrink)

There are only a few ethical regulations that deal explicitly with robots, in contrast to a vast number of regulations, which may be applied. We will focus on ethical issues with regard to “responsibility and autonomous robots”, “machines as a replacement for humans”, and “tele-presence”. Furthermore we will examine examples from special fields of application (medicine and healthcare, armed forces, and entertainment). We do not claim to present a complete list of ethical issue nor of regulations in the field of (...) robotics, but we will demonstrate that there are legal challenges with regard to these issues. (shrink)

Part of the standard protection of decisionally incapacitated research subjects is a prohibition against enrolling them unless surrogate decision makers authorize it. A common view is that surrogates primarily ought to make their decisions based on what the decisionally incapacitated subject would have wanted regarding research participation. However, empirical studies indicate that surrogate predictions about such preferences are not very accurate. The focus of this article is the significance of surrogate accuracy in the context of research that is not expected (...) to benefit the research subject. We identify three morally relevant asymmetries between being enrolled and not being enrolled in such non-beneficial research, and conclude that when there is a non-negligible probability that surrogates’ predictions are wrong, it will generally be better to err on the side of not authorizing enrollment. (shrink)

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n (...) = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (shrink)

In this commentary, we criticize the argument that allowing euthanasia for people with disabilities is ableist. We analyze the distinction between facts and values in medical assistance in dying, the expressivist objection, and the problem of crypwashing.

The United Nations Convention on the Rights of Persons with Disabilities urges and requires changes to how signatories discharge their duties to people with intellectual disabilities, in the direction of their greater recognition as legal persons with expanded decision-making rights. Australian jurisdictions are currently undertaking inquiries and pilot projects that explore how these imperatives should be implemented. One of the important changes advocated is to move from guardianship models to supported or assisted models of decision-making. A driving force behind these (...) developments is a strong allegiance to the social model of disability, in the formulation of the Convention, in inquiries and pilot projects, in implementation and in the related academic literature. Many of these instances suffer from confusing and misleading statements and conceptual misinterpretations of certain elements such as legal capacity, decision-making capacity, and support for decision-making. This paper analyses some of these confusions and their possible negative implications for supported decision-making instruments and those whose interests these instruments would serve, and advises a more incremental development of existing guardianship regimes. This provides a more realistic balance between neglecting the real limits of those with mental disabilities and thereby ignoring their identity and particularity, and continuing to bring them equally and fully into society. (shrink)

Zusammenfassung Special Olympics ist die größte Sportorganisation für Menschen mit geistiger Behinderung. Bei den Special Olympics World Games 2019 war Special Olympics Deutschland mit zwei Handballteams vertreten, einem Frauen Traditional-Team und einem Unified-Team (bestehend aus Menschen mit und ohne Behinderung). Die Mitglieder beider Teams wurden aus mehreren Bewerber*innen bei Sichtungslehrgängen ausgewählt und bereiteten sich anschließend in Trainingslagern auf die World Games vor. Diese Prozesse wurden mithilfe von teilnehmenden Beobachtungen und Leitfaden gestützten Interviews mit den Spieler*innen und Trainer*innen wissenschaftlich begleitet und (...) evaluiert. Die Ergebnisse offenbaren ein Spannungsfeld zwischen sportlichem Erfolgswunsch und sozialer Unterstützung, in dem sich die Teilnehmer*innen bewegen. (shrink)

Science and technology, including nanoscale science and technology, influences and is influenced by various discourses and areas of action. Ableism is one concept and ability expectation is one dynamic that impacts the direction, vision, and application of nanoscale science and technology and vice versa. At the same time, policy documents that involve or relate to disabled people exhibit ability expectations of disabled people. The authors present ability expectations exhibited within two science and technology direction documents from Asia, as well as (...) in two policy documents generated and influenced by disabled people from Asia. As well, the authors discuss the impact of the ability expectations exhibited in these four documents with respect to the relationship between science and technology and disabled people. (shrink)

Providing an inclusive and quality education for all contributes toward the Sustainable Development Goals of the United Nations. High-quality learning environments based on what works in education benefit all students and can be particularly beneficial for children with disabilities. This article contributes to advance knowledge to enhance the quality of education of students with disabilities that are educated in special schools. This research analyses in which ways, if any, interactive learning environments can be developed in special schools and create better (...) learning opportunities for children with disabilities. A case study was conducted with students with disabilities (N = 36) and teaching staff in a special school, involving interviews and focus groups. We argue that rethinking the learning context by introducing instruction models based on interaction benefit children with disabilities and provide high-quality learning and safe and supportive relationships for these students, thereby promoting their educational and social inclusion. (shrink)

Purpose In 2006, the United Nations established the convention on the rights of persons with disabilities. Simultaneously, the UN has adopted the sustainable development goals in 2015 and the 17 goals must be achieved by member states by 2030. Regionally, countries within the Caribbean community have formulated the Kingston Accord and the Declaration of Petion Ville. Both of these two instruments outlined a regional framework on the issue of persons with disabilities. The media, therefore, have axiological roles to play in (...) educating and informing all the stakeholders of these programmes, policies and legislation. It is within this context that this researcher did a qualitative assessment of how the media within Caribbean societies have been aiding the process of developmental transformation for PWDs. The main purpose of this paper therefore; is to show that if the varied programmes and policies relating to PWDs within the Anglophone Caribbean are to be successfully implemented, digital and traditional media will have to play a lead role through their social and ethical responsibilities in changing attitudes of non-disabled individuals towards the members of this vulnerable group. The main purpose of this paper therefore; is to show that if the varied programmes and policies relating to PWDs within the Anglophone Caribbean are to be successfully implemented, digital and traditional media will have to play a lead role through their social and ethical responsibilities in changing attitudes of non-disabled individuals towards the members of this vulnerable group. Design/methodology/approach The central argument guiding this paper is that if the varied programmes and policies relating to PWDs within the Caribbean are to be successfully implemented, the media, in all its forms, will have to play a lead role through their social and ethical responsibilities in changing attitudes of non-disabled individuals towards the members of this vulnerable group. The unequivocal questions that have been answered are how and what are the media doing to aid in the transformation of the lives of PWDs in the Caribbean? Are they fulfiling their social and ethical responsibilities? Findings The major finding is that the media in the Anglophone Caribbean has significant work to do to fulfil one of its social and ethical responsibilities in aiding the developmental transformation of PWDs in the region. Research limitations/implications The research is limited by the fact that there is serious data scarcity on the population of PWDs in the region. Serious research on the population is just emerging and this will change significantly over the next few years. Practical implications The practical implication of this study is that it will bring to the forefront of the media in the Caribbean, the importance of placing issues relating to PWDs on the development agenda in a consistent manner. Social implications PWDs will be brought in the mainstream of Caribbean society over time. Originality/value This is an original study and will undoubtedly contribute to a greater understanding of the media and PWDs in the Caribbean. (shrink)

Volume 20, Issue 8, August 2020, Page 88-90.