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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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- Krantz, Ingela, et al.
(författare)
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Ethics and vaccination.
- 2004
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Ingår i: Scand J Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 32:3, s. 172-8
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Tidskriftsartikel (refereegranskat)
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- Lundqvist, Anita, et al.
(författare)
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Both empowered and powerless: mothers' experiences of professional care when their newborn dies.
- 2002
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Ingår i: Birth. - 0730-7659. ; 29:3, s. 192-199
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Tidskriftsartikel (refereegranskat)abstract
- The death of a newborn is a complex and tragic situation, the uncertain and stressful nature of which places emotional burdens on the parents. The aim of this study was to examine and illuminate mothers' experiences and perceptions of the care given to them at neonatal clinics while facing the threat and the reality of losing their baby. METHOD: Interviews were performed, in the form of conversations, with 16 mothers approximately 2 years after the death of their newborns. The interviews were analyzed using a hermeneutic phenomenological method. RESULTS: The primary themes identified were feeling empowered and feeling powerless. Three related themes to feeling empowered were a sense of nearness-supporting confidence; a sense of encouragement-supporting self-esteem; and a sense of empathy-supporting comfort. Three related themes to feeling powerless were a sense of distance-leading to strength or adjustment; a sense of violation-leading to helplessness and despondency; and a sense of disconnection-leading to insecurity and discouragement. All mothers felt both empowered and powerless. When experiencing empowering care, they had a feeling of encountering benevolence, with respect to their individual desires. Experiencing competent care without humane treatment madethemfeel powerless, and they were neither respected as a mother nor a person. CONCLUSIONS: Feelings of empowerment emerged when the health care professionals not only saw the mother as an individual but also "saw through the mothers' eyes" and "felt with the mother's feelings".Feelings of powerlessness emerged when the similarity in the lifeworld (i.e., the world of lived experiences) differed, and the perspectives of the mothers and the health care professionals did not correspond. (BIRTH 29:3 September 2002)
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- Lundqvist, Anita, et al.
(författare)
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Experiencing neonatal death: an ambivalent transition into motherhood
- 2002
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Ingår i: Pediatric nursing. - 0097-9805. ; 28:6, s. 621-625
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To illuminate the lived experience of women facing the threat of lossing their newborn child and then experiencing the reality of their infant's death. STUDY DESIGN: Sixteen women were interviewed approximately 2 years after the death of their infant using a hermeneutic phenomenological approach. FINDINGS: The main theme was ambivalent transition into motherhood. The women went through the whole life-span of their infant during a very short time. The women's narratives were interpreted as broken expectations, total confusion, reality awareness, consciously leave-taking, and elusive grief. CONCLUSIONS: Women need the opportunity to evolve their own patterns and rhythms in the ambivalent transition from expected motherhood to experiencing neonatal dying and death. Knowledge about the individuality of this process may assist nurses in improving the quality of care.
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| 11. |
- Lundqvist, Anita, et al.
(författare)
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Neonatal end-of-life care in Sweden.
- 2003
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Ingår i: Nursing in critical care. - : Wiley. - 1478-5153 .- 1362-1017. ; 8:5, s. 197-202
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Tidskriftsartikel (refereegranskat)abstract
- A survey was carried out of Swedish neonatal end-of-life regarding practice before birth, at birth, during dying and after death using a descriptive questionnaire with close-ended questions and individual comments The practice in 32 of 38 neonatal units, as described by the head nurse or the registered nurses, was largely similar. Respectful treatment of both the neonate and the parents during neonatal end-of-life care was indicated Differences were found in pre-natal care concerning the information about the risks of pre-term birth, the opportunity for parents to view a pre-term neonate and meet its family, as well as a social worker Practice directly after birth was also different. A little less than half of the units answered that they gave a description of the seriously ill neonate to the parents before the first visit to the ward Practice during dying indicated that only a few units permitted the neonate to die at home
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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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| 18. |
- van der Heide, A, et al.
(författare)
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End-of-life decision-making in six European countries: descriptive study
- 2003
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Ingår i: The Lancet. - 1474-547X. ; 362:9381, s. 345-350
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Tidskriftsartikel (refereegranskat)abstract
- Background Empirical data about end-of-life decision-making practices are scarce. We aimed to investigate frequency and characteristics of end-of-life decision-making practices in six European countries: Belgium, Denmark, Italy, the Netherlands, Sweden, and Switzerland. Methods In all participating countries, deaths reported to death registries were stratified for cause (apart from in Switzerland), and samples were drawn from every stratum. Reporting doctors received a mailed questionnaire about the medical decision-making that had preceded the death of the patient. The data-collection procedure precluded identification of any of the doctors or patients. All deaths arose between June, 2001, and February, 2002. We weighted data to correct for stratification and to make results representative for all deaths: results were presented as weighted percentages. Findings The questionnaire response rate was 75% for the Netherlands, 67% for Switzerland, 62% for Denmark, 61% for Sweden, 59% for Belgium, and 44% for Italy. Total number of deaths studied was 20 480. Death happened suddenly and unexpectedly in about a third of cases in all countries. The proportion of deaths that were preceded by any end-of-life decision ranged between 23% (Italy) and 51% (Switzerland). Administration of drugs with the explicit intention of hastening death varied between countries: about 1% or less in Denmark, Italy, Sweden, and Switzerland, 1.82% in Belgium, and 3.40% in the Netherlands. Large variations were recorded in the extent to which decisions were discussed with patients, relatives, and other caregivers. Interpretation Medical end-of-life decisions frequently precede dying in all participating countries. Patients and relatives are generally involved in decision-making in countries in which the frequency of making these decisions is high.
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