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- Hagelin, J, et al.
(författare)
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Surveys on attitudes towards legalisation of euthanasia: importance of question phrasing
- 2004
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Ingår i: Journal of Medical Ethics. - : BMJ. - 1473-4257 .- 0306-6800. ; 30:6, s. 521-523
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore whether the phrasing of the questions and the response alternatives would influence the answers to questions about legalisation of euthanasia. Methods: Results were compared from two different surveys in populations with similar characteristics. The alternatives "positive'', "negative'', and "don't know'' (first questionnaire) were replaced with an explanatory text, "no legal sanction'', four types of legal sanctions, and no possibility to answer "don't know'' (second questionnaire). Four undergraduate student groups (engineering, law, medicine, and nursing) answered. Results: In the first questionnaire (n = 684) 43% accepted euthanasia (range 28-50%), 14% (8-33%) did not, and 43% (39-59%) answered "don't know''. Two per cent of the respondents declined to answer. In comparison with previous surveys on attitudes to euthanasia the proportion of "don't know'' was large. The results of the second questionnaire (n = 639), showed that 38% favoured "no legal prosecution'' (26-50%). However, 62% (50-74%) opted for different kinds of legal sanctions, and two of four groups expressed significantly different views in the two surveys. A proportion of 10% declined to answer the second questionnaire. Conclusion: An introduction of an explanatory text and a wider range of response alternatives produced differences between the results of the two surveys conducted.
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- Lundin, Susanne, et al.
(författare)
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Attitudes of Swedes to marginal donors and xenotransplantation
- 2003
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Ingår i: Journal of Medical Ethics. - : BMJ. - 1473-4257 .- 0306-6800. ; 29:3, s. 186-192
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Tidskriftsartikel (refereegranskat)abstract
- The aim of our survey was to capture the attitudes of Swedes to marginal donors and xenotransplantation. Modern biotechnology makes it possible to replace non-functioning organs, cells, and genes. Nonetheless, people may have reservations and fears about such treatments. With the survey, Attitudes of the General Public to Transplants, we have sought to expose the ambivalence that arises when medical possibilities are juxtaposed with ideas of risk. The design of the questionnaire originates from the interdisciplinary cooperation between ethnologists, medical scientists, and geneticists. By combining qualitative and quantitative methods, it is possible to illustrate the complexity that characterises peoples view of modern biomedicine. Peoples reflections are based on a personal and situation bound morality, which does not necessarily coincide with what they generally consider as ethically justifiable
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- Löfmark, R, et al.
(författare)
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Conditions and consequences of medical futility - from a literature review to a clinical model
- 2002
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Ingår i: Journal of Medical Ethics. - : BMJ. - 1473-4257 .- 0306-6800. ; 28:2, s. 115-119
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To present an analysis of futility that is useful in the clinical setting. Design: Literature review. Material and methods: According to Medline more than 750 articles have been published about medical futility. Three criteria (language, time period, and the authors expressed their own opinions) singled out 43 of them. The authors opinions about futility were analysed using the scheme: If certain conditions are satisfied, then a particular measure is futile and If a particular measure is futile, then certain moral consequences are implied. Results: Regarding conditions, most authors stated that judgments about futility should be made by physicians. The measure was usually some kind of medical treatment, and the goals related to quality of life, physiological improvement, or prolongation of life. The probability of success in reaching the goal was in most cases described in semiquantitative terms. Regarding consequences, the authors stated that health care professionals may (sometimes ought or should) withhold or withdraw a futile measure, most often after a dialogue with the patient (29 articles), but sometimes without informing the patient (nine articles), or with one-way information (four articles). Over time more and more articles recommend that the patient should be involved in joint decision making. Based on this literature review a clinical model was developed. Conclusions: The model, requiring that conditions and consequences should be made explicit, may, in futility situations, facilitate both the collection of the necessary information and make the moral implications visible. It also makes communication about measures considered to be futile possible without using such ambiguous terms as futile.
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- Nilstun, Tore, et al.
(författare)
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Teaching medical ethics to experienced staff: participants, teachers and method
- 2001
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Ingår i: Journal of Medical Ethics. - : BMJ. - 1473-4257 .- 0306-6800. ; 27:6, s. 409-412
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Tidskriftsartikel (refereegranskat)abstract
- Almost all articles on education in medical ethics present proposals for or describe experiences of teaching students in different health professions. Since experienced staff also need such education, the purpose of this paper is to exemplify and discuss educational approaches that may be used after graduation. As an example we describe the experiences with a five-day European residential course on ethics for neonatal intensive care personnel. In this multidisciplinary course, using a case-based approach, the aim was to enhance the participants understanding of ethical principles and their relevance to clinical and research activities. Our conclusion is that working with realistic cases encourages practising nurses and physicians to apply their previous knowledge and new concepts learnt in the course, thus helping them to bridge the gap between theory and practice.
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- Ridderstolpe, Lisa, et al.
(författare)
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Priority setting in cardiac surgery : A survey of decision making and ethical issues
- 2003
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Ingår i: Journal of Medical Ethics. - : BMJ Journals. - 0306-6800 .- 1473-4257. ; 29:6, s. 353-358
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Forskningsöversikt (refereegranskat)abstract
- Objectives: The aim of this study was to examine priority setting for coronary artery bypass surgery, and to provide an overview of decisions and rationales used in clinical practice.Method: Questionnaires were sent to all permanently employed cardiologists, cardiothoracic surgeons, and anaesthesiologists at nine Swedish hospitals performing adult cardiothoracic surgery.Results: A total of 208 physicians responded (a 44% return rate). There was considerable agreement concerning the criteria that should be used to set priorities for coronary artery bypass interventions (clusters of factors in synthesis). However, there was a lack of accord regarding the use of national guidelines for priority setting and risk indexes.Conclusions: Basic training and the strong support of ethical principles in priority setting are lacking. The respondents indicated a need for clearer guidelines and an open dialogue or discussion. The lack of generally acknowledged plans and guidelines for priority setting may result in unequal, conditional, and unfair treatment.
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