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  1. Personal Autonomy in Society.Marina Oshana - 2006 - Routledge.
    Challenging many of the currently accepted conceptions of autonomy and of how it is valued, Oshana develops a social-relational account of autonomy that is constituted by a person's relations with others and by the absence of certain social relations. She denies that command over one's motives and the freedom to realize one's will are sufficient to secure the kind of command over one's life that autonomy requires, and argues against psychological, procedural, and content neutral accounts of autonomy.
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  • Understanding patient needs without understanding the patient: the need for complementary use of professional interpreters in end-of-life care.Demi Krystallidou, Ignaas Devisch, Dominique Van de Velde & Peter Pype - 2017 - Medicine, Health Care and Philosophy 20 (4):477-481.
    High-quality doctor-patient communication in end-of-life care results in better quality of life for patients. In linguistically and culturally diverse societies, language discordant consultations become daily practice, leading to difficulties in eliciting patient preferences toward end-of-life care. Although family members invariably act as informal interpreters, this may cause some ethical dilemmas. We present a case of a palliative patient whose son acted as an interpreter. This case generated a triple- layered ethical dilemma: how to safeguard patient autonomy against paternalistic interventions by (...)
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  • Limits to relational autonomy—The Singaporean experience.L. K. R. Krishna, D. S. Watkinson & N. L. Beng - 2015 - Nursing Ethics 22 (3):331-340.
    Recognition that the Principle of Respect for Autonomy fails to work in family-centric societies such as Singapore has recently led to the promotion of relational autonomy as a suitable framework within which to place healthcare decision making. However, empirical data, relating to patient and family opinions and the practices of healthcare professionals in Confucian-inspired Singapore, demonstrate clear limitations on the ability of a relational autonomy framework to provide the anticipated compromise between prevailing family decision-making norms and adopted Western led atomistic (...)
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  • Systematic Reviews in Bioethics: Types, Challenges, and Value.R. Mcdougall - 2014 - Journal of Medicine and Philosophy 39 (1):89-97.
    There has recently been interest in applying the techniques of systematic review to bioethics literature. In this paper, I identify the three models of systematic review proposed to date in bioethics: systematic reviews of empirical bioethics research, systematic reviews of normative bioethics literature, and systematic reviews of reasons. I argue that all three types yield information useful to scholarship in bioethics, yet they also face significant challenges particularly in relation to terminology and time. Drawing on my recent experience conducting a (...)
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  • Autonomy and the Role of the Family in Making Decisions at the End of Life.Jonathan M. Breslin - 2005 - Journal of Clinical Ethics 16 (1):11-19.
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  • The Diversity of Responsibility: The Value of Explication and Pluralization.Silke Schicktanz & Mark Schweda - 2012 - Medicine Studies 3 (3):131-145.
    Purpose Although the term “responsibility” plays a central role in bioethics and public health, its meaning and implications are often unclear. This paper defends the importance of a more systematic conception of responsibility to improve moral philosophical as well as descriptive analysis. Methods We start with a formal analysis of the relational conception of responsibility and its meta-ethical presuppositions. In a brief historical overview, we compare global-collective, professional, personal, and social responsibility. The value of our analytical matrix is illustrated by (...)
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  • Autonomy, liberalism and advance care planning.S. Ikonomidis & P. A. Singer - 1999 - Journal of Medical Ethics 25 (6):522-527.
    The justification for advance directives is grounded in the notion that they extend patient autonomy into future states of incompetency through patient participation in decision making about end-of-life care. Four objections challenge the necessity and sufficiency of individual autonomy, perceived to be a defining feature of liberal philosophical theory, as a basis of advance care planning. These objections are that the liberal concept of autonomy (i) implies a misconception of the individual self, (ii) entails the denial of values of social (...)
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  • Personal Autonomy and Society.Marina A. L. Oshana - 1998 - Journal of Social Philosophy 29 (1):81-102.
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  • (5 other versions)Principles of biomedical ethics.Tom L. Beauchamp - 1989 - New York: Oxford University Press. Edited by James F. Childress.
    Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...)
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  • Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self.Catriona Mackenzie & Natalie Stoljar (eds.) - 2000 - New York: Oxford University Press.
    This collection of original essays explores the social and relational dimensions of individual autonomy. Rejecting the feminist charge that autonomy is inherently masculinist, the contributors draw on feminist critiques of autonomy to challenge and enrich contemporary philosophical debates about agency, identity, and moral responsibility. The essays analyze the complex ways in which oppression can impair an agent's capacity for autonomy, and investigate connections, neglected by standard accounts, between autonomy and other aspects of the agent, including self-conception, self-worth, memory, and the (...)
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  • The individualist model of autonomy and the challenge of disability.Anita Ho - 2008 - Journal of Bioethical Inquiry 5 (2-3):193-207.
    In recent decades, the intertwining ideas of self-determination and well-being have received tremendous support in bioethics. Discussions regarding self-determination, or autonomy, often focus on two dimensions—the capacity of the patient and the freedom from external coercion. The practice of obtaining informed consent, for example, has become a standard procedure in therapeutic and research medicine. On the surface, it appears that patients now have more opportunities to exercise their self-determination than ever. Nonetheless, discussions of patient autonomy in the bioethics literature, which (...)
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  • Principles of Biomedical Ethics.Ezekiel J. Emanuel, Tom L. Beauchamp & James F. Childress - 1995 - Hastings Center Report 25 (4):37.
    Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.
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  • “I just think that we should be informed” a qualitative study of family involvement in advance care planning in nursing homes.Lisbeth Thoresen & Lillian Lillemoen - 2016 - BMC Medical Ethics 17 (1):72.
    BackgroundAs part of the research project “End-of-life Communication in Nursing Homes. Patient Preferences and Participation”, we have studied how Advance Care Planning is carried out in eight Norwegian nursing homes. The concept of ACP is a process for improving patient autonomy and communication in the context of progressive illness, anticipated deterioration and end-of-life care. While an individualistic autonomy based attitude is at the fore in most studies on ACP, there is a lack of empirical studies on how family members’ participation (...)
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  • Die Autonomiekonzeption in Patientenverfügungen – Die Rolle von Persönlichkeit und sozialen Beziehungen.Susanne Brauer - 2008 - Ethik in der Medizin 20 (3):230-239.
    Sowohl in der klinischen und rechtlichen Praxis als auch in der Medizinethik besteht Uneinigkeit darüber, was die (moralische) Verbindlichkeit von Patientenverfügungen begründet und wie mit ihnen in der Praxis zu verfahren ist. Dieser Artikel versucht, die ethisch-normative Basis von Patientenverfügungen näher zu beleuchten. Eine Bestimmung erfolgt in drei Schritten. Erstens wird analysiert, welche Autonomiekonzeption Patientenverfügungen zugrunde liegt. Patientenverfügungen, so meine These, sind Ausdruck eines relationalen, um den Aspekt der Persönlichkeit angereicherten Autonomiebegriffs. Eine moralische Verbindlichkeit ist mit dieser Analyse noch nicht (...)
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  • Authenticity and autonomy in deep-brain stimulation.Alistair Wardrope - 2014 - Journal of Medical Ethics 40 (8):563-566.
    Felicitas Kraemer draws on the experiences of patients undergoing deep-brain stimulation to propose two distinct and potentially conflicting principles of respect: for an individual's autonomy , and for their authenticity. I argue instead that, according to commonly-invoked justifications of respect for autonomy, authenticity is itself in part constitutive of an analysis of autonomy worthy of respect; Kraemer's argument thus highlights the shortcomings of practical applications of respect for autonomy that emphasise competence while neglecting other important dimensions of autonomy such as (...)
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  • The “We” in the “Me”: Solidarity and Health Care in the Era of Personalized Medicine.Barbara Prainsack - 2018 - Science, Technology, and Human Values 43 (1):21-44.
    This article challenges a key tacit assumption underpinning legal and ethical instruments in health care, namely, that people are ideally bounded, independent, and often also strategically rational individuals. Such an understanding of personhood has been criticized within feminist and other critical scholarship as being unfit to capture the deeply relational nature of human beings. In the field of medicine, however, it also causes tangible problems. I propose that a solidarity-based perspective entails a relational approach and as such helps to formulate (...)
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  • A personalist approach to care ethics.Linus Vanlaere & Chris Gastmans - 2011 - Nursing Ethics 18 (2):161-173.
    Notwithstanding the fact that care ethics has received increased attention, it has also faced much criticism. One of the focal points of critics is the normativity of care. Only when the objective normative basis of care is sufficiently clarified can care practices be evaluated and optimized from an ethical point of view. We emphasize that two levels of normativity can be identified: the context level and the foundational anthropology level. The personalist approach to care ethics is normatively stronger, at least (...)
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  • From Birth to Death? A Personalist Approach to End-of-Life Care of Severely Ill Newborns.Chris Gastmans, Gunnar Naulaers, Chris Vanhole & Yvonne Denier - 2013 - Christian Bioethics 19 (1):7-24.
    In this paper, a personalist ethical perspective on end-of-life care of severely ill newborns is presented by posing two questions. (1) Is it ethically justified to decide not to start or to withdraw life-sustaining treatment in severely ill newborns? (2) Is it ethically justified, in exceptional cases, to actively terminate the life of severely ill newborns? Based on five values—respect for life and for the dignity of the human person, quality of life, respect for the process of dying, relational autonomy, (...)
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  • Examining American Bioethics: Its Problems and Prospects.Renée C. Fox & Judith P. Swazey - 2005 - Cambridge Quarterly of Healthcare Ethics 14 (4):361-373.
    In 1986, philosopher-bioethicist Samuel Gorovitz published an essay entitled “Baiting Bioethics,” in which he reported on various criticisms of bioethics that were “in print, or voiced in and around … the field” at that time, and set forth his assessment of their legitimacy. He gave detailed attention to what he judged to be the particularly fierce and “irresponsible attacks” on “the moral integrity” and soundness of bioethics contained in two papers: “Getting Ethics” by philosopher William Bennett and “Medical Morality Is (...)
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  • How to Deal with Euthanasia Requests: A Palliative Filter Procedure.Paul Schotsmans & Chris Gastmans - 2009 - Cambridge Quarterly of Healthcare Ethics 18 (4):420.
    On September 23, 2002, the Belgian law on euthanasia came into force. This makes Belgium the second country in the world to have an act on euthanasia. Even though there is currently a legal regulation of euthanasia in Belgium, very little is known about how this legal regulation could be translated into care for patients who request euthanasia. Although euthanasia-related mortality rates in Belgium are low, ranging from 0.30% to 1.20%, it can be expected that caregivers will increasingly be confronted (...)
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  • Beyond individualism: Is there a place for relational autonomy in clinical practice and research?Edward S. Dove, Susan E. Kelly, Federica Lucivero, Mavis Machirori, Sandi Dheensa & Barbara Prainsack - 2017 - Clinical Ethics 12 (3):150-165.
    The dominant, individualistic understanding of autonomy that features in clinical practice and research is underpinned by the idea that people are, in their ideal form, independent, self-interested and rational gain-maximising decision-makers. In recent decades, this paradigm has been challenged from various disciplinary and intellectual directions. Proponents of ‘relational autonomy’ in particular have argued that people’s identities, needs, interests – and indeed autonomy – are always also shaped by their relations to others. Yet, despite the pronounced and nuanced critique directed at (...)
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  • Beyond a Western Bioethics in Asia and Its Implication on Autonomy.Mark Tan Kiak Min - 2017 - The New Bioethics 23 (2):154-164.
    Despite flourishing as a multidisciplinary subject, the predominant view in bioethics today is based on Anglo-American thought. This has serious implications for a global bioethics that needs to be contextualized to local cultures and circumstances in order to be relevant. Being the largest continent on the earth, Asia is home to a variety of cultures, religions and countries of different economic statuses. While the practice of medicine in the East and West may be similar, its ethical practices do differ. Thus, (...)
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  • The role of ‘accompagnement’ in the end-of-life debate in France: from solidarity to autonomy.Marie Gaille & Ruth Horn - 2016 - Theoretical Medicine and Bioethics 37 (6):473-487.
    This article traces the way autonomy has become a recognised value in health care in France. In a country that based its social fundamentals on the very idea of solidarity for many years, autonomy has long been considered a foreign ‘Anglo-American principle’. Taking the example of the end-of-life debate, the article shows, however, how the use of the French term ‘accompagnement’ allowed autonomy to be redefined and to be associated with the concept of solidarity. Exploring the arguments used over the (...)
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  • Solidarity in Healthcare – the Challenge of Dementia.Aleksandra Małgorzata Głos - 2016 - Diametros 49:1-26.
    Dementia will soon be ranked as the world’s largest economy. At present, it ranges from the 16th to 18th place, with countries such as Indonesia, the Netherlands, and Turkey. Dementia is not only a financial challenge, but also a philosophical one. It provokes a paradigm shift in the traditional view of healthcare and expands the classic concepts of human personhood and autonomy. A promising response to these challenges is the idea of cooperative solidarity. Cooperative solidarity, contrary to its ‘humanitarian’ version, (...)
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  • Artificial insemination (donor).P. Bloom - forthcoming - The Eugenics Review.
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  • The Role of Relational Knowing in Advance Care Planning.Victoria Palmer, Paul Komesaroff, Marilys Guillemen, Kelsey Hegarty & Kate Robins-Browne - 2017 - Journal of Clinical Ethics 28 (2):122-134.
    Medical decision making when a patient cannot participate is complicated by the question of whose voice should be heard. The most common answer to this question is that “autonomy” is paramount, and therefore it is the voice of the unwell person that should be given priority. Advance care planning processes and practices seek to capture this sentiment and to allow treatment preferences to be documented and decision makers to be nominated. Despite good intentions, advance care planning is often deficient because (...)
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  • Binding consent or element of presumed consent? – Conceptualization and legal relevance of advance health care directives in the context of multicultural bioethics.Martino Mona - 2008 - Ethik in der Medizin 20 (3):248-257.
    Erleichtert die Konzeptualisierung der Patientenverfügung als bloßes Indiz für den mutmaßlichen Willen die notwendige Einbeziehung eines relationalen Autonomieverständnisses in eine zunehmend kulturübergreifende Bioethik? Ich lege dar, dass die Berücksichtigung relationaler Autonomiekonzepte kein überzeugendes Argument für die Bestimmung der Patientenverfügung als bloßes Indiz für den mutmaßlichen Willen ist, sondern vielmehr – neben einer Reihe anderer Argumente – für die Patientenverfügung als verbindliche Willensbekundung spricht. Diese erweist sich als flexibel genug, um unterschiedlichen Formen von Autonomie gerecht zu werden.
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  • Human nature: a foundation for palliative care.Beverly J. B. Whelton - 2008 - Nursing Philosophy 9 (2):77-88.
    The Aristotelian‐Thomist philosopher holds that human intellectual knowledge is possible because of the order in the world and natural human capacities. It is the position of this paper that there is a shared human form or nature that unites all humanity as members of the same kind. Moral treatment is due to every human being because they are human, and is not based upon expression of abilities. Humans have substantial dynamic existence in the world, an existence which overflows in expressive (...)
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  • Autonomy, interdependence, and assisted suicide: Respecting boundaries/crossing lines.Anne Donchin - 2000 - Bioethics 14 (3):187–204.
    Western philosophy has been powerfully influenced by a paradigm of personal agency that is linked to an individualistic conception of autonomy. This essay contrasts this conception with an alternative understanding that recognizes a social component built into the very meaning of autonomy. After reviewing feminist critiques of the dominant conception of autonomy, I develop the broad outlines of a relational view and apply this reconceptualization to a concrete situation in order to show how this altered view reconfigures understanding of the (...)
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  • Competent Patients' Refusal of Nursing Care.Denise M. Dudzinski & Sarah E. Shannon - 2006 - Nursing Ethics 13 (6):608-621.
    Competent patients’ refusals of nursing care do not yet have the legal or ethical standing of refusals of life-sustaining medical therapies such as mechanical ventilation or blood products. The case of a woman who refused turning and incontinence management owing to pain prompted us to examine these situations. We noted several special features: lack of paradigm cases, social taboo around unmanaged incontinence, the distinction between ordinary versus extraordinary care, and the moral distress experienced by nurses. We examined this case on (...)
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  • Concepts of personhood and autonomy as they apply to end-of-life decisions in intensive care.Paul Walker & Terence Lovat - 2015 - Medicine, Health Care and Philosophy 18 (3):309-315.
    Amongst traditionally-available frameworks within which end-of-life decisions in Intensive Care Units (ICU) are situated, we favour Ordinary versus Extra-ordinary care distinctions as the most helpful. Predicated on this framework, we revisit the concepts of personhood and autonomy. We argue that a full account of personhood locates its foundation in relationships with others, rather than merely in “rationality”. A full account of autonomy also recognises relationships with others, as well as the actual reality of the patient’s situation-in-the-world. The fact that, when (...)
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  • Deciding on death: Conventions and contestations in the context of disability. [REVIEW]Margrit Shildrick - 2008 - Journal of Bioethical Inquiry 5 (2-3):209-219.
    Conflicts between bioethicists and disability theorists often arise over the permissibility of euthanasia and physician assisted suicide. Where mainstream bioethicists propose universalist guidelines that will direct action across a range of effectively disembodied situations, and take for granted that moral agency requires autonomy, feminist bioethicists demand a contextualisation of the circumstances under which moral decision making is conducted, and stress a more relational view of autonomy that does not require strict standards of independent agency. Nonetheless, neither traditional nor feminist perspectives (...)
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  • Physician responsibility towards palliative care patients in regard to the new customer orientation paradigm.Katharina Seibel, Franziska Krause & Gerhild Becker - 2014 - Ethik in der Medizin 26 (1):47-58.
    Ein gelungenes Arzt-Patient-Verhältnis, das auf gegenseitigem Vertrauen und ärztlicher Verantwortung basiert, ist ein zentraler Bestandteil des Ideals der ärztlichen Profession. Aktuell wird vielfach von einem neuen „ökonomischen Paradigma“ in der Medizin gesprochen, das dieses Verhältnis vermeintlich unterminiert. Als ein wichtiges Merkmal dieses Paradigmas gilt das Verständnis vom Patienten als Kunden, der charakterisiert ist durch seine Selbstbestimmung bzw. Autonomie. Wie stellt sich die Kundenrolle nun aber bei vulnerablen Patientengruppen dar, die in ihrer Autonomie eingeschränkt sind, und was bedeutet dies wiederum für (...)
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  • Sharing death and dying: Advance directives, autonomy and the family.Ho Mun Chan - 2004 - Bioethics 18 (2):87–103.
    ABSTRACT This paper critically examines the liberal model of decision making for the terminally ill and contrasts it with the familial model that can be found in some Asian cultures. The contrast between the two models shows that the liberal model is excessively patient‐centred, and misconceives and marginalises the role of the family in the decision making process. The paper argues that the familial model is correct in conceiving the last journey of one's life as a sharing process rather than (...)
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  • Relational Responsibility, and Not Only Stewardship. A Roman Catholic View on Voluntary Euthanasia for Dying and Non-Dying Patients.Paul T. Schotsmans - 2003 - Christian Bioethics 9 (2-3):285-298.
    The Roman Catholic theological approach to euthanasia is radically prohibitive. The main theological argument for this prohibition is the so-called “stewardship argument”: Christians cannot escape accounting to God for stewardship of the bodies given them on earth. This contribution presents an alternative approach based on European existentialist and philosophical traditions. The suggestion is that exploring the fullness of our relational responsibility is more apt for a pluralist – and even secular – debate on the legitimacy of euthanasia.
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  • Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self.Sue Campbell - 2002 - Hypatia 17 (2):165-168.
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  • Models for Ethical Medicine in a Revolutionary Age.Robert M. Veatch - 1972 - Hastings Center Report 2 (3):5-7.
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  • Advancing a Welfare-Based Model in Medical Decision.Lalit K. R. Krishna, Jason Te Tay, Deborah S. Watkinson & Alethea Chung Pheng Yee - 2015 - Asian Bioethics Review 7 (3):306-320.
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  • A critical analysis of health promotion and ‘empowerment’ in the context of palliative family care-giving.Kelli Stajduhar, Laura Funk, Eva Jakobsson & Joakim Öhlén - 2010 - Nursing Inquiry 17 (3):221-230.
    STAJDUHAR K, FUNK L, JAKOBSSON E and ÖHLÉN J. Nursing Inquiry 2010; 17: 221–230A critical analysis of health promotion and ‘empowerment’ in the context of palliative family care-givingTraditionally viewed as in opposition to palliative care, newer ideas about ‘health-promoting palliative care’ increasingly infuse the practices and philosophies of healthcare professionals, often invoking ideals of empowerment and participation in care and decision-making. The general tendency is to assume that empowerment, participation, and self-care are universally beneficial for and welcomed by all individuals. (...)
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  • Ethical Challenges Facing Adcance Care Planning.Shahla Siddiqui - 2016 - Asian Bioethics Review 8 (1):53-65.
    Advance Care Planning was introduced as a means of empowering individuals to make informed decisions regarding their health and end-of-life care. It is a way for individuals to contemplate their own personal values and to exercise autonomy. However, there is reason to believe that ACP may not be widely taken up and when adopted, may not be applied as intended. The ethical challenges facing ACP need careful study. This essay focuses on two problematic ethical aspects of ACP: 1. a strict (...)
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