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3.
Narrat Inq Bioeth ; 9(2): 163-171, 2019.
Article in English | MEDLINE | ID: mdl-31447454

ABSTRACT

Ethics consultants can apply a narrative ethics approach to address ethical challenges that arise in critical situations. This approach recognizes how those involved in the narrative make sense of, keep faith with, and try on new identities and new understanding of their stories. This case study explores the ways in which the stories of patient, provider, and clinical ethics consultant intersect, and considers how the organic nature of the narrative ethics approach allows ethics consultants to navigate the stories of multiple stakeholders as they grapple with complex health care decisions. This essay also suggests that clinical ethics consultants applying the lens of narrative ethics have an obligation to approach consultations with courage, professional humility, intellectual curiosity, and an appreciation for the narratives of as many of the stakeholders as possible (including one's own).


Subject(s)
Physician-Patient Relations/ethics , Cardiopulmonary Resuscitation/ethics , Ethicists , Ethics Consultation , Female , Heart Arrest/therapy , Humans , Narration , Patient Advocacy/ethics , Patient Discharge , Young Adult
4.
J Clin Ethics ; 29(2): 102-13, 2018.
Article in English | MEDLINE | ID: mdl-30129735

ABSTRACT

The broad use of social networking and user-generated content has increased the online footprint of many individuals. A generation of healthcare professionals have grown up with online search activities as part of their everyday lives. Sites like Facebook, Twitter, and Instagram have given the public new ways to share intimate details about their public and private lives and the lives of their friends and families. As a result, careproviders have the ability to find out more about their patients with just the tap of a key or the click of a mouse. This type of online searching for patient information is known as patient-targeted googling or PTG. This article provides an overview of the emergence of PTG, identifies the potential benefits and possible pitfalls of engaging in PTG, and explores current ethical frameworks that guide decisions about PTG. The article describes the development of a critical thinking tool developed by the Behavioral Health Ethics Committee at CHI Health, that can serve as a best-practice model for other hospitals and health systems. Called TTaPP (Together Take a Pause and Ponder), this tool is designed to help healthcare professionals across settings practice collaborative critical thinking skills as they consider the ethical questions of whether or not to engage in PTG. Finally, this article suggests areas for further study, including ways to prompt collaboration and appropriate documentation by maximizing electronic medical records systems, exploring the effectiveness of the TTaPP tool as a way to promote a culture of collaborative critical thinking practices, and the attitudes of patients and the public regarding PTG.


Subject(s)
Decision Making/ethics , Information Seeking Behavior/ethics , Physician-Patient Relations/ethics , Psychotherapeutic Processes , Social Media/statistics & numerical data , Thinking , Humans , Privacy
5.
J Clin Ethics ; 29(1): 102-113, 2018.
Article in English | MEDLINE | ID: mdl-29916827

ABSTRACT

The broad use of social networking and user-generated content has increased the online footprint of many individuals. A generation of healthcare professionals have grown up with online search activities as part of their everyday lives. Sites like Facebook, Twitter, and Instagram have given the public new ways to share intimate details about their public and private lives and the lives of their friends and families. As a result, careproviders have the ability to find out more about their patients with just the tap of a key or the click of a mouse. This type of online searching for patient information is known as patient-targeted googling or PTG. This article provides an overview of the emergence of PTG, identifies the potential benefits and possible pitfalls of engaging in PTG, and explores current ethical frameworks that guide decisions about PTG. The article describes the development of a critical thinking tool developed by the Behavioral Health Ethics Committee at CHI Health, that can serve as a best-practice model for other hospitals and health systems. Called TTaPP (Together Take a Pause and Ponder), this tool is designed to help healthcare professionals across settings practice collaborative critical thinking skills as they consider the ethical questions of whether or not to engage in PTG. Finally, this article suggests areas for further study, including ways to prompt collaboration and appropriate documentation by maximizing electronic medical records systems, exploring the effectiveness of the TTaPP tool as a way to promote a culture of collaborative critical thinking practices, and the attitudes of patients and the public regarding PTG.


Subject(s)
Psychiatry , Thinking , Animals , Health Personnel , Humans , Mice , Patients
6.
Am J Hosp Palliat Care ; 25(5): 347-53, 2008.
Article in English | MEDLINE | ID: mdl-18812620

ABSTRACT

Although the 1990 Patient Self-determination Act was enacted to insure that patients' wishes regarding advance directives were known and respected, it has had little impact in quality or aggressiveness of care for patients nearing death. The purpose of this descriptive study was to explore staff attitudes related to Advance Directives. A short survey was distributed to 650 hospital, home care, hospice, assisted living, and long term professional and staff members. Analysis was completed on 413 surveys (return rate 63.3%). Findings suggest that although staff members believe that Advance Directives are an important tool, they have found both logistical and process challenges to following them. The results provide needed information for improving processes for completion and utilization of Advance Directives.


Subject(s)
Advance Care Planning , Attitude of Health Personnel , Health Knowledge, Attitudes, Practice , Adult , Advance Care Planning/organization & administration , Advance Directive Adherence/legislation & jurisprudence , Advance Directive Adherence/psychology , Advance Directive Adherence/statistics & numerical data , Aged , Communication , Decision Making , Dissent and Disputes , Female , Health Services Needs and Demand , Humans , Interprofessional Relations , Male , Middle Aged , Midwestern United States , Nursing Methodology Research , Prognosis , Surveys and Questionnaires , Time Factors , Total Quality Management/organization & administration
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