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1.
James Lindemann Nelson 《Theoretical medicine and bioethics》1992,13(4):319-328
Mary Anne Warren's claim that there is room for only one person with full and equal rights inside a single human skin ([1], p. 63) calls attention to the vast range of moral conflict engendered by assigning full basic moral rights to fetuses. Thereby, it serves as a goad to thinking about conflicts between pregnant women and their fetuses in a way that emphasizes relationships rather than rights. I sketch out what a care orientation might suggest about resolving gestational conflicts. I also argue that the care orientation, with its commitment to the significance of the partial and the particular, cannot be absorbed within standard, impartialist moral theory. 相似文献
2.
Deborah E. Bender 《Theoretical medicine and bioethics》1989,10(3):239-249
The challenge of excellence in community health services has been taken up by medical educators in Colombia. Confronted with a nation where the primary indicators of disease mortality and morbidity (cardiovascular disease and infant mortality) were characteristic of First and Third World patterns, respectively, the Ministry of Health and La Asociacion Colombiana de Facultades de Medicina (ASCOFAME), representatives of institutions of medical education, have collaborated to conduct a needs assessment of the country's health needs and devised an implementation plan designed to better address the needs of the majority of that nation's people.As a model, the Colombian reorganization of medical education is an example which could be emulated by the U.S. where policy makers are struggling with troublesome questions of cost, equity and quality. 相似文献
3.
Yolanda van Beek David Hessen Lisa Levelt Daniëla Beijer Corine Rijnberk Athanasios Maras Mathilde M. Overbeek 《Journal of Family Therapy》2023,45(3):271-290
The effectiveness of intense specialised multi-family therapy (ISMFT) for 111 multi-stressed families, and the therapeutic alliance as a possible predictor of outcome, were examined. A repeated measures design was used, where changes in all ISMFT phases (preparation, multi-family therapy and follow-up) were assessed and compared for both mothers and fathers. Evidence was found for improved family functioning after the therapy period, which was maintained at 3 months follow-up, although the multi-stressed families still functioned in the problematic range. The therapy did however not decrease parenting stress, or did so only temporarily. Observations of the therapeutic alliance with the System for Observing Family Therapy Alliances (SOFTA) scales indicated that high therapist engagement was related to positive therapy outcomes, both at the start of therapy and later. High family engagement also predicted therapy effectiveness, but only at the start of therapy. The present study shows that solution-focused multi-family therapy at least seems to provide the first step in alleviating problems in multi-stressed families. 相似文献
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Peter D. Mott 《Theoretical medicine and bioethics》1990,11(2):95-102
The issues involved in decision making about the aggressiveness of future medical care for older persons are explored. They are related to population trends, the heterogeneity of older persons and a variety of factors involved in individual preferences. Case studies are presented to illustrate these points, as well as a review of pertinent literature. The argument is offered that, considering these many factors, a system of flexible, individualized care by informed patient preference, is more rational than the rationing of technological services by age. 相似文献
8.
Carol Taylor 《Theoretical medicine and bioethics》1990,11(2):111-124
In this paper a case is used to demonstrate how ethical analysis enables health care professionals, patients and family members to make treatment decisions which ensure that medical technologies are used in the overall best interests of the patient. The claim is made and defended that ethical analysis can secure four beneficial outcomes when medical technologies are employed: (1) not allowing any medical technologies to be employed until the appropriate decision makers are identified and consulted; (2) insisting that medical technologies be employed not merely to promote the medical interests of the patient but rather on the basis of their ability to contribute to the overall well-being of the patient; (3) challenging caregivers to reflect on the dynamic interplay between their conscious and unconscious values and consequent determinations of what is in the patient's best interests; and (4) providing a justification for selected interventions which makes possible rational dialogue between caregivers espousing different viewpoints about treatment options. 相似文献
9.
Jack W. Finney Kathryn M. Miller Stuart P. Adler 《Journal of applied behavior analysis》1993,26(4):471-472
Child-to-parent transmission of cytomegalovirus may be reduced by increasing protective behaviors (handwashing and glove use) and decreasing risky behaviors (intimate contact between child and parent). This study showed that an educational intervention resulted in increases in reported and objective measures of protective behaviors and decreases in reported risky behaviors. Further study must determine if changes in protective and risky behavior are maintained and prevent cytomegalovirus transmission. 相似文献
10.
Kristofer J. Hagglund Mary Nack Robert G. Frank 《Journal of clinical psychology in medical settings》1997,4(2):243-253
State Medicaid programs are rapidly converting fee-for-service health delivery systems to managed care for people with disabilities. In theory, managed care models of health delivery will substantially improve the quality of care for people with disabilities, but in reality, few successful models exist. This period of transition holds both opportunities and challenges for psychologists in medical settings. Because Medicaid reforms for people with disabilities may herald similar reforms for both the public and the private sectors, psychology's response will determine its role in the future of health care delivery for this population. Changes in training and increased attention to outcomes research, innovations in practice, and advocacy will be the keys to success. 相似文献