Patients and family members (N = 671) were surveyed in five Mid-Atlantic U.S. hospitals to ascertain the number and kinds of ethical concerns they are presently experiencing or have previously experienced while being sick or receiving medical care. Seventy percent of participants had at least one (range 0–14) type of ethical concern or question. The most commonly experienced concerns pertained to being unsure how to plan ahead or complete an advance directive (29.4%), being unsure whether someone in the family was (...) able to make their own decisions (29.2%), deciding about limiting life-sustaining treatments (28.6%), wondering about disclosing personal medical information to others in the family (26.4%) and not being sure whether to undergo treatment because of cost (26.2%). Most were interested to some degree in getting help from ethics consultants in the future (76.6%). Given this prevalence, common concerns might usefully be addressed systematically, rather than exclusively on a case-by-case basis. (shrink)

1. Yŏn'gyŏngjae Sŏng Hae-ŭng. "Yŏn'gyŏngjae chŏnjip", innŭn sasil ŭl kŭdaero kirok hada -- 2. P'ungsŏk Sŏ Yu-gu. "Imwŏn kyŏngjeji", hŭlkuk kwa chongittŏk in hangmun ŭn anŭrira -- 3. Oju Yi Kyu-gyŏng. "Ojuyŏn munjang chŏnsan'go", pakhak kwa kojŭnghak ŭro modŭn kŏt ŭl pyŏnjŭng hara -- 4. Tasan Chŏng Yag-yong. "Mongmin simsŏ", sidae rŭl ap'ahago paeksŏngdŭl ŭi pich'am han sam e punno haeya handa -- 5. Ch'ujae Cho Su-sam. "Ch'ujae chip", nara ka mangharyŏmyŏn pandŭsi yomul i naonda -- 6. Nakhasaeng Yi Hak-kyu. (...) "Yŏngnam akpu", mal hanŭn cha nŭn choe ka ŏpta -- 7. Kuhwajae Hong Sŏng-mo. "Tongguk sesigi", sot e kadŭkhan kuk ŭl han sutkal ro mat poda -- 8. Hosan Cho Hŭi-ryong. "Sŏgu mangnyŏllok", hanŭl arae kajang t'ongk'wae han il ida -- 9. Sŏp'a Yu Hŭi. "Munt'ong", ilsaeng ŭl nŭl sibi sok esŏ saranne -- 10. Hyegang Ch'oe Han-gi. "Kihak", taedong ilt'ong ŭi isang segye rŭl kuhyŏn hada -- 11. Kosanja Kim Chŏng-ho. "Taedong yŏjido", chido ro ch'ŏnha ŭi hyŏngse rŭl salp'il su itta -- 12. Paegun Sim Tae-yun. "Pongni chŏnsŏ", mani ilgŭlsurok pongni ka tŏuk manajinda -- 13. Suun Ch'oe Che-u. "Tonggyŏng taejŏn", hangmun ŭro marhajamyŏn 'tonghak' irago haeya handa -- 14. Tongmu Yi Che-ma. "Kyŏkch'igo", i ch'aek i ch'ŏllima ka toeji ank'ennŭn'ga? (shrink)

E n est e a r tícul o e l auto r s e pr e gunt a s i l a teorí a socia l de l derech o pued e apo r tar un a contribució n especí f ic a a u n concept o d e justici a via b l e h o y e n día , frent e a l o que sobr e ell a pued e deci r l a f ilosofí (...) a moral , polític a y jurídica . E n s u opinión , lo s conceptos d e autopoiesi s y deconst r ucció n (Luhman n y De r rida ) tiene n e l potencia l su f icient e para act iv a r ta l contribució n e n do s direccione s diferentes : reconst r ucció n d e un a geneal o gía d e l a justici a y obse r v ació n d e la s paradoja s decisionale s de l derech o mode r no . E l planteamient o genealógic o intent a descubri r la s con e xione s oculta s entr e l a semántic a d e la justici a y l a est r uctur a socia l (l o cual , po r otr o lado , pued e desemboca r e n l a refo r mulació n d e u n concept o plausi b l e d e justici a e n la s condicione s actuales) . U n procedimiento deconst r uct ivo pe r mite , a s u v ez , obse r v a r e l hiat o e xistent e entr e la s est r uctura s jurídicas y la s decisiones , u n hiat o qu e pr o v oc a impo r tante s paradoja s e n lo s proceso s d e tom a de decisione s jurídicas . Mediant e ta l obse r v ació n e s posi b l e alcanza r un a comprensió n más profund a d e l a justicia , qu e e l auto r inte r preta , e n últim a instancia , com o u n proces o de autodescripció n de l derech o qu e soc a va e l carácte r recurs ivo d e la s operacione s jurídicas y qu e fuerz a a l derech o a s u autotrascendencia , per o qu e s e sabote a a s í mism o po r qu e en s u realizació n cre a siempr e un a nu eva injusticia : un a e xperienci a cuy a elaboració n literaria anticip ó Heinric h v o n Kleis t e n s u n o v el a Mi c hae l K ohlhaas. (shrink)

setting, are warranted. This article details a descriptive study in which patients were interviewed, during hospital stays, about their beliefs and understanding of advanced directions, as well as the processes used in completing them. The study was undertaken in a community hospital located in a rural area in the Midwest. Findings show that many patients were able to clearly articulate what an AD means in terms of making their choices known. However, misconceptions were found in patients' understanding of ADs and (...) only 46% reported discussing their ADs with a physician. Strategies for effective implementation of education programs related to ADs are detailed here. © 1999 Lippincott Williams & Wilkins, Inc.... (shrink)

Based on extensive questionnaire data, this paper focuses on parents’ views about children’s right to decide about participation in research. The data originates from 4000 families participating in a longitudinal prospective screening as 1997. Although current regulations and recommendations underline that children should have influence over their participation, many parents in this study disagree. Most (66%) were positive providing information to the child about relevant aspects of the study. However, responding parents were split about whether or not children should at (...) some point be allowed decisional authority when participating in research: 41.6% of the parents reported being against or unsure. Those who responded positively believed that children should be allowed to decide about blood-sampling procedures (70%), but to a less extent about participation (48.5%), analyses of samples (19.7%) and biological bank storage (15.4%). That as many as possible should remain in the study, and that children do not have the competence to understand the consequences for research was strongly stressed by respondents who do not think children should have a right to decide. When asked what interests they consider most important in paediatric research, child autonomy and decision-making was ranked lowest. We discuss the implications of these findings. (shrink)

Based on extensive clinical questionnaire data, this paper explores the relation between research subjects’ self-assessed understanding and actual knowledge of a large-scale predictive screening study, and its implications for the proper handling of information and consent routines in longitudinal studies. The intitial data show that low self-assessed understanding among participants was correlated with limited knowledge, concern over participation and collected samples, less satisfaction with information, and feeling passive or negative towards the study. Among those reporting high understanding, a non-negligible number (...) displayed a lack of knowledge regarding central aspects of the study. Regarding high assessed understanding, the multivariate analysis identified the main predictor variables to be knowledge, having a positive attitude towards participation and the study itself, being satisfied with information, having a stable psychosocial background and feeling calm regarding the handling of samples. These findings indicate that to evaluate participants' understanding through self-assessment may not be reliable method. Self-assessed understanding may rather be a good indicator of general attitudes than a tool for analysing content. The data also show that actual understanding varies considerably among participants, suggesting that more effort needs to be put into adjusting the information to the needs of different subgroups. It is argued that when doing this, researchers in longitudinal studies must be careful not to exhaust participants with excessive information that they do not want and that may cause them to drop out. The ethical relevance of obtaining repeated consents in longitudinal research is discussed. (shrink)

This book presents a new view point on some problems of semantics within the framework of the Meaning - Text model introduced to linguistics by I. A. Mel'čuk, A. K. Zolkovskij and Ju. D. Apresjan. In addition to some new formalisms and concepts it provides a great number of specific informal semantic analyses and thus gives a good idea of Apresjan's approach to semantics. Zsfassung in engl. Sprache: Types of information for the surface- semantic component of the 'meaning - text' (...) model. Zsfassung in engl. Sprache: Types of information for the surface- semantic component of the 'meaning - text' model. (shrink)

This article will explore pediatric consent through the analysis of a clinical case study using the principles of biomedical ethics approach. Application of the principles of autonomy, nonmaleficence, beneficence, and justice will be dissected in order to attempt to establish resolution of the ethical dilemma. The main conflict in this case study deals with whether the wishes of an adolescent for end-of-life care should be followed or should the desire of his parents outweigh this request. In terminal cancer, the hope (...) of early palliative care and dignity in dying serve as priorities in therapy. Application of the moral principles to both sides of the dilemma aided in providing an objective resolution to uphold pediatric consent. (shrink)