Subject(s)
Conflict of Interest , Gift Giving/ethics , Practice Patterns, Physicians'/ethics , Professional Practice/ethics , Psychiatry/ethics , Drug Industry/ethics , Ethics, Institutional , Ethics, Medical , Humans , Organizational Affiliation/ethics , Patient Admission , Patient Selection/ethics , Politics , South AfricaSubject(s)
Authorship/standards , Biomedical Research/economics , Organizational Affiliation/economics , Biomedical Research/ethics , Biomedical Research/standards , Guidelines as Topic , Humans , Norway , Organizational Affiliation/ethics , Organizational Affiliation/standards , Research Support as TopicABSTRACT
No disponible
Subject(s)
Humans , /ethics , Public Health Administration/ethics , Organizational Affiliation/ethics , /methods , /organization & administration , /statistics & numerical data , /standards , /trends , Public Health Administration/legislation & jurisprudence , Organizational Affiliation/legislation & jurisprudence , Organizational Affiliation/organization & administrationABSTRACT
OBJECTIVE: To describe the form and content of ethics policies on euthanasia in Flemish hospitals and the possible influence of religious affiliation on policy content. METHODS: Content analysis of policy documents. RESULTS: Forty-two documents were analyzed. All policies contained procedures; 57% included the position paper on which the hospital's stance on euthanasia was based. All policies described their hospital's stance on euthanasia in competent terminally ill patients (n=42); 10 and 4 policies, respectively, did not describe their stance in incompetent terminally and non-terminally ill patients. Catholic hospitals restrictively applied the euthanasia law with palliative procedures and interdisciplinary deliberations. The policies described several phases of the euthanasia care process--confrontation with euthanasia request (93%), decision-making process (95%), care process in cases of no-euthanasia decision (38%), preparation and performance of euthanasia (79%), and aftercare (81%)--as well as involvement of caregivers, patients, and relatives; ethical issues; support for caregivers; reporting; and practical examples of professional attitudes and communication skills. CONCLUSION: Euthanasia policies go beyond summarizing the euthanasia law by addressing the importance of the euthanasia care process, in which palliative care and interdisciplinary cooperation are important factors. PRACTICE IMPLICATIONS: Euthanasia policies provide tangible guidance for physicians and nurses on handling euthanasia requests.
Subject(s)
Euthanasia , Hospitals, General/organization & administration , Hospitals, Religious/organization & administration , Hospitals, Special/organization & administration , Patient Acceptance of Health Care , Terminal Care/organization & administration , Belgium , Catholicism , Chi-Square Distribution , Decision Making, Organizational , Documentation , Euthanasia/ethics , Euthanasia/legislation & jurisprudence , Euthanasia/psychology , Guidelines as Topic , Health Services Research , Hospital Bed Capacity/statistics & numerical data , Hospitals, General/ethics , Hospitals, Religious/ethics , Hospitals, Special/ethics , Humans , Mental Competency , Organizational Affiliation/ethics , Organizational Affiliation/organization & administration , Organizational Policy , Ownership , Patient Acceptance of Health Care/psychology , Patient Care Team/organization & administration , Religion and Psychology , Terminal Care/ethics , Terminal Care/psychologySubject(s)
Ethics Committees, Research/organization & administration , Health Services Research/ethics , Organizational Affiliation/ethics , Research Personnel/ethics , Alberta , Conflict of Interest , Evidence-Based Medicine/ethics , Humans , Organizational Culture , Peer Review, Research/methods , Personnel Staffing and Scheduling/organization & administration , Program Evaluation , Quality Assurance, Health Care/ethics , Total Quality Management/ethicsABSTRACT
If a dam springs several leaks, there are various ways to respond. One could assiduously plug the holes, for instance. Or one could correct the underlying weaknesses, a more sensible approach. When it comes to corporate governance, for too long we have relied on the first approach. But the causes of many governance problems lie well below the surface--specifically, in critical relationships that are not structured to support the players involved. In other words, the very foundation of the system is flawed. And unless we correct the structural problems, surface changes are unlikely to have a lasting impact. When shareholders, management, and the board of directors work together as a system, they provide a powerful set of checks and balances. But the relationship between shareholders and directors is fraught with weaknesses, undermining the entire system's equilibrium. As the authors explain, the exchange of information between these two players is poor. Directors, though elected by shareholders to serve as their agents, aren't individually accountable to the investors. And shareholders--for a variety of reasons--have failed to exert much influence over boards. In the end, directors are left with the Herculean task of faithfully representing shareholders whose preferences are unclear, and shareholders have little say about who represents them and few mechanisms through which to create change. The authors suggest several ways to improve the relationship between shareholders and directors: Increase board accountability by recording individual directors' votes on key corporate resolutions; separate the positions of chairman and CEO; reinvigorate shareholders; and give boards funding to pay for outside experts who can provide perspective on crucial issues.
