Helping Surrogate Decision-Makers Through Difficult Conversations

Difficult conversations in the ICU are often seen as ones of getting a surrogate decision-maker to make an end-of-life decision. However, allowing the surrogate decision-maker to become a narrator can alleviate the daunting task lying ahead

Review of: Magnussen H. (2017) The Moral Work of Nursing – Asking and Living with the Questions

A narrative description of personal moral challenges of a nurse serving diverse communities

Let\u27s Talk About Death: Use of Euphemistic Language in the Medical Context

https://openworks.mdanderson.org/sumexp23/1031/thumbnail.jp

Emily Hobhouse’s Psychosocial Developmental Trajectory as Anti-War Campaigner: A Levinsonian Psychobiography

The aim of this psychobiography was to uncover, reconstruct and illustrate significant trajectories of psychosocial development and historical events over the lifespan of Emily Hobhouse (1860-1926). The British-born Hobhouse later became an anti-war campaigner and social activist who exposed the appalling conditions of the British concentration camps during the Anglo-Boer War (1899-1902), as evidenced by primary and secondary historical data. Purposive sampling was used to select Hobhouse as a significant and exemplary subject. Levinson’s four eras or seasons of lifespan development served as the theoretical psychological approach. The study was undertaken against the background of Merleau-Ponty’s ontological philosophy that elucidates a human science phenomenology where the individual cannot be separated from her social world. Alexander’s model of identifying salient biographical themes was utilized and a conceptual psycho-historical framework, based on both the life cycle theory of Levinson and significant historical periods throughout Hobhouse’s life, was employed to assist with data gathering, categorisation, and analyses. The findings highlight significant psychosocial and historical events in the life of Hobhouse that shaped her development as an anti-war campaigner. These include: The role of her strong-willed and determined mother; the denial of an opportunity to study and pursue a formal education; her management of painful feelings of abandonment and grief; the care of her father during his illness and his eventual death; the abrupt ending of her failed romantic relationship; her networking capacity; and her open-mindedness and capacity for independent humanitarian thought. Against the philosophical background of Merleau-Ponty’s phenomenological ontology, Levinson’s theory and eras proved valuable in identifying these particular psychosocial life experiences and historical events as having shaped Emily Hobhouse into an antiwar campaigner

Professional consequence for dentists involved in unethical decision-making

ABSTRACT The previously gullible and apathetic South African public, generally speaking, is lately becoming increasingly rights-based sophisticated. Patients are no longer accepting inferior quality work and have become more knowledgeable especially regarding the expected skills and professional conduct of dentists. The present study examined archival material as published between 2007 and 2013 of penalties against ethical misconduct. It was found that the majority of ethical transgressions took place in urban settings and the most predominant transgression was charging for services not performed and submitting these claims to medical aids as well as performing sub-optimal interventions. Legally a practitioner who performs such acts may be held liable for the damage or injury suffered by the patient as a consequence of these acts, on the basis of negligence. Penalties imposed by the Health Professions Council of South Africa vary between 5,000 Rand and 15,000 Rand, as well as suspensions of between 9 to 12 months. It is doubtful that transgressors would change their behaviour in the light of the present Continuous Professional Development programmes where attendance is really the only prerequisite and not moral reflection. This study recommends that the Health Professions Council of South Africa need to re-evaluate the effectiveness of their ethical training programmes and adapt the model to incorporate more inclusive learning

When hanging on at all costs is the only option

Having hope that a terminally ill patient may recover is not an unfamiliar sight in intensive care units across the globe. However, cultural heritage may make it even tougher. This fictional case study, which is a collection of years of experience, addresses decision-making within the Chinese Immigrant culture and focusses on how this may influence the care team. A new initiative, the Goals of Care (GOC) team, is also described

Christian hermeneutics in South Africa

Hermeneutics remains a divisive and polarizing topic within scholarly and ecclesiastical communities in South Africa. These tensions are not limited to theoretical differences but often crystallize on a grassroots level when local churches and church assemblies have to make important decisions on controversial ethical topics such as ordaining women in church offices, assessing the ethics of gay marriages, and taking a stance on the land debate in South Africa. This book makes a unique contribution in two ways: firstly, it focuses on the uniquely South African hermeneutical landscape; secondly, it relates theories to practical ethical application. The unique scholarly contribution of this consists in it relating hermeneutics to ethics within the South African landscape. A diverse group of scholars have been invited to partake in the project and the views expressed are often quite diverse. This allows readers to develop an understanding and sensitivity of the various angles employed and the interests at stake in addressing difficult societal problems

Christian hermeneutics in South Africa

Hermeneutics remains a divisive and polarizing topic within scholarly and ecclesiastical communities in South Africa. These tensions are not limited to theoretical differences but often crystallize on a grassroots level when local churches and church assemblies have to make important decisions on controversial ethical topics such as ordaining women in church offices, assessing the ethics of gay marriages, and taking a stance on the land debate in South Africa. This book makes a unique contribution in two ways: firstly, it focuses on the uniquely South African hermeneutical landscape; secondly, it relates theories to practical ethical application. The unique scholarly contribution of this consists in it relating hermeneutics to ethics within the South African landscape. A diverse group of scholars have been invited to partake in the project and the views expressed are often quite diverse. This allows readers to develop an understanding and sensitivity of the various angles employed and the interests at stake in addressing difficult societal problems

The hidden curriculum and integrating cure- and care-based approaches to medicine

Although current literature about the “cure versus care” issue tends to promote a patient-centered approach, the disease-centered approach remains the prevailing model in practice. The perceived dichotomy between the two approaches has created a barrier that could make it difficult for medical students and physicians to integrate psychosocial aspects of patient care into the prevailing disease-based model. This article examines the influence of the formal and hidden curricula on the perception of these two approaches and finds that the hidden curriculum perpetuates the notion that “cure” and “care” based approaches are dichotomous despite significant changes in formal curricula that promote a more integrated approach. The authors argue that it is detrimental for clinicians to view the two approaches as oppositional rather than complementary and attempt to give recommendations on how the influence of the hidden curriculum can be reduced to get a both-cure-and-care-approach, rather than an either-cure-or-care-approach

Review of: Magnussen H. (2017) The Moral Work of Nursing – Asking and Living with the Questions

A narrative description of personal moral challenges of a nurse serving diverse communities