Movatterモバイル変換


[0]ホーム

URL:


PhilPapersPhilPeoplePhilArchivePhilEventsPhilJobs
Order:

1 filter applied
Disambiguations
Laura Guidry-Grimes [28]Laura K. Guidry-Grimes [4]
  1.  802
    Disability Rights as a Necessary Framework for Crisis Standards of Care and the Future of Health Care.Laura Guidry-Grimes,Katie Savin,Joseph A. Stramondo,Joel Michael Reynolds,Marina Tsaplina,Teresa Blankmeyer Burke,Angela Ballantyne,Eva Feder Kittay,Devan Stahl,Jackie Leach Scully,Rosemarie Garland-Thomson,Anita Tarzian,Doron Dorfman &Joseph J. Fins -2020 -Hastings Center Report 50 (3):28-32.
    In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...) distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)
    Direct download(3 more)  
     
    Export citation  
     
    Bookmark   13 citations  
  2.  958
    Against Personal Ventilator Reallocation.Joel Michael Reynolds,Laura Guidry-Grimes &Katie Savin -2020 -Cambridge Quarterly of Healthcare Ethics 30 (2):272-284.
    The COVID-19 (Coronavirus disease of 2019) pandemic has led to intense conversations about ventilator allocation and reallocation during a crisis standard of care. Multiple voices in the media and multiple state guidelines mention reallocation as a possibility. Drawing upon a range of neuroscientific, phenomenological, ethical, and sociopolitical considerations, the authors argue that taking away someone’s personal ventilator is a direct assault on their bodily and social integrity. They conclude that personal ventilators should not be part of reallocation pools and that (...) triage protocols should be immediately clarified to explicitly state that personal ventilators will be protected in all cases. (shrink)
    Direct download(4 more)  
     
    Export citation  
     
    Bookmark   6 citations  
  3.  54
    Moral Expertise: New Essays from Theoretical and Clinical Bioethics.Jamie Carlin Watson &Laura K. Guidry-Grimes (eds.) -2018 - Springer International Publishing.
    This collection addresses whether ethicists, like authorities in other fields, can speak as experts in their subject matter. Though ethics consultation is a growing practice in medical contexts, there remain difficult questions about the role of ethicists in professional decision-making. Contributors examine the nature and plausibility of moral expertise, the relationship between character and expertise, the nature and limits of moral authority, how one might become a moral expert, and the trustworthiness of moral testimony. This volume engages with the growing (...) literature in these debates and offers new perspectives from both academics and practitioners. The readings will be of particular interest to bioethicists, clinicians, ethics committees, and students of social epistemology. These new essays promise to advance discussions in the professionalization and accreditation of ethics consultation. (shrink)
    No categories
    Direct download(3 more)  
     
    Export citation  
     
    Bookmark   9 citations  
  4.  48
    Vulnerability in practice: Peeling back the layers, avoiding triggers, and preventing cascading effects.Elizabeth Victor,Florencia Luna,Laura Guidry-Grimes &Alison Reiheld -2022 -Bioethics 36 (5):587-596.
    The concept of vulnerability is widely used in bioethics, particularly in research ethics and public health ethics. The traditional approach construes vulnerability as inherent in individuals or the groups to which they belong and views vulnerability as requiring special protections. Florencia Luna and other bioethicists continue to challenge traditional ways of conceptualizing and applying the term. Luna began proposing a layered approach to this concept and recently extended this proposal to offer two new concepts to analyze the concept of vulnerability, (...) namely understanding external conditions that trigger vulnerability and layers of vulnerability with cascading effects. Luna's conception of vulnerability is useful, which we demonstrate by applying her layered view and the new analyses in multiple contexts. We begin by outlining Luna's view and we use vignettes from healthcare involving transgender patients, the care of patients in psychiatric contexts, and research involving prisoners to illustrate how each part of Luna's concept elucidates important moral issues. (shrink)
    Direct download(4 more)  
     
    Export citation  
     
    Bookmark   3 citations  
  5.  33
    Clarifying a Clinical Ethics Service’s Value, the Visible and the Hidden.Jane Jankowski,Marycon Chin Jiro,Thomas May,Arlene M. Davis,Kaarkuzhali Babu Krishnamurthy,Kelly Kent,Hannah I. Lipman,Marika Warren &Laura Guidry-Grimes -2019 -Journal of Clinical Ethics 30 (3):251-261.
    Our aim in this article is to define the difficulties that clinical ethics services encounter when they are asked to demonstrate the value a clinical ethics service (CES) could and should have for an institution and those it serves. The topic emerged out of numerous related presentations at the Un- Conference hosted by the Cleveland Clinic in August 2018 that identified challenges of articulating the value of clinical ethics work for hospital administrators. After a review these talks, it was apparent (...) that the field of clinical ethics may be at a crisis of sorts due to increased pressure to provide explicit measures to healthcare institutions to concretely demonstrate that CESs make a valuable difference in healthcare delivery. In this article, we grapple with how to satisfy the need for demonstrable value in a field in which metrics alone may not capture the scope of clinical ethics practice. We suggest that capturing the value of a CES has been difficult because the benefits of ethics consultation may be overt or attributable to the CES, but are often hidden due to the systems-level and process-oriented nature of clinical ethics work. Part of the difficulty in demonstrating the value of CESs is capturing and conveying all of the ways the integration of a CES throughout an institution positively affects patients, families, visitors, healthcare professionals, administrators, and the institution itself. Our aim is to (1) elucidate the multifaceted value added by a CES, including value that tends to be hidden and (2) suggest how to demonstrate value to others in a way that is not simplistic or reductionistic. (shrink)
    No categories
    Direct download  
     
    Export citation  
     
    Bookmark   5 citations  
  6.  58
    Relational autonomy in action: Rethinking dementia and sexuality in care facilities.Elizabeth Victor &Laura Guidry-Grimes -2019 -Nursing Ethics 26 (6):1654-1664.
    Background: Caregivers and administrators in long-term facilities have fragile moral work in caring for residents with dementia. Residents are susceptible to barriers and vulnerabilities associated with the most intimate aspects of their lives, including how they express themselves sexually. The conditions for sexual agency are directly affected by caregivers’ perceptions and attitudes, as well as facility policies. Objective: This article aims to clarify how to approach capacity determinations as it relates to sexual activity, propose how to theorize about patient autonomy (...) in this context, and suggest some considerations for finding an ethically responsible and practically feasible way to respect the sexual rights of this population. Research Design: The focus is on residents with early to moderate dementia in states of daily dependency on professional caregivers. The article critically examines existing empirical research on sexuality among persons with dementia, caregivers’ attitudes, and institutional roadblocks to enabling residents’ sexuality. A relational lens and insights from disability studies are used in the philosophical analysis. Participants and Research Context: No research participants were part of this analysis. Ethical Considerations: This article offers a conceptual analysis and normative framework only. Findings: The analysis highlights the delicate balance that capacity assessments for sexual activity have to strike; while caregivers should protect those who cannot give adequate consent, the denial of sexuality among residents can cause deep, long-ranging harms. Sexual agency features into an ongoing sense of self for many individuals with dementia, and the imposition of inappropriate standards and expectations for sexual autonomy can lead to unwarranted obstacles to sexual activity. Discussion: Recommendations include developing clear and inclusive institutional policies and practices of care, providing education for caregivers on how to discuss and document residents’ sexual preferences over time, and taking advantage of ethics consultation services. Conclusion: This analysis establishes the need for more research and discussion on this sensitive topic. Future research should investigate the specific responsibilities of caregivers in furthering the sexual interests of residents, how exactly to modify existing capacity instruments, and how best to support historically marginalized patients in their sexual identities. (shrink)
    Direct download(2 more)  
     
    Export citation  
     
    Bookmark   5 citations  
  7.  62
    Applying Nonideal Theory to Bioethics: Living and Dying in a Nonideal World.Elizabeth Victor &Laura K. Guidry-Grimes (eds.) -2021 - New York: Springer.
    This book offers new essays exploring concepts and applications of nonideal theory in bioethics. Nonideal theory refers to an analytic approach to moral and political philosophy (especially in relation to justice), according to which we should not assume that there will be perfect compliance with principles, that there will be favorable circumstances for just institutions and right action, or that reasoners are capable of being impartial. Nonideal theory takes the world as it actually is, in all of its imperfections. Bioethicists (...) have called for greater attention to how nonideal theory can serve as a guide in the messy realities they face daily. Although many bioethicists implicitly assume nonideal theory in their work, there is the need for more explicit engagement with this theoretical outlook. A nonideal approach to bioethics would start by examining the sociopolitical realities of healthcare and the embeddedness of moral actors in those realities. How are bioethicists to navigate systemic injustices when completing research, giving guidance for patient care, and contributing to medical and public health policies? When there are no good options and when moral agents are enmeshed in their sociopolitical viewpoints, how should moral theorizing proceed? What do bioethical issues and principles look like from the perspective of historically marginalized persons? These are just a few of the questions that motivate nonideal theory within bioethics. This book begins in Part I with an overview of the foundational tenets of nonideal theory, what nonideal theory can offer bioethics, and why it may be preferable to ideal theory in addressing moral dilemmas in the clinic and beyond. In Part II, authors discuss applications of nonideal theory in many areas of bioethics, including reflections on environmental harms, racism and minority health, healthcare injustices during incarceration and detention, and other vulnerabilities experienced by patients from clinical and public health perspectives. The chapters within each section demonstrate the breadth in scope that nonideal theory encompasses, bringing together diverse theorists and approaches into one collection. (shrink)
    Direct download(3 more)  
     
    Export citation  
     
    Bookmark   2 citations  
  8.  87
    Inhospitable Healthcare Spaces: Why Diversity Training on LGBTQIA Issues Is Not Enough.Megan A. Dean,Elizabeth Victor &Laura Guidry-Grimes -2016 -Journal of Bioethical Inquiry 13 (4):557-570.
    In an effort to address healthcare disparities in lesbian, gay, bisexual, transgender, and queer populations, many hospitals and clinics institute diversity training meant to increase providers’ awareness of and sensitivity to this patient population. Despite these efforts, many healthcare spaces remain inhospitable to LGBTQ patients and their loved ones. Even in the absence of overt forms of discrimination, LGBTQ patients report feeling anxious, unwelcome, ashamed, and distrustful in healthcare encounters. We argue that these negative experiences are produced by a variety (...) of subtle, ostensibly insignificant features of healthcare spaces and interpersonal interactions called microaggressions. Healthcare spaces and providers often convey heteronormative microaggressions, which communicate to LGBTQ—and, we suggest, intersex and asexual —people that their identities, experiences, and relationships are abnormal, pathological, unexpected, unwelcome, or shameful. We identify heteronormative microaggressions common to healthcare settings and specify how they negatively impact LGBTQIA patients. We argue that standard diversity training cannot sufficiently address heteronormative microaggressions. Despite these challenges, healthcare institutions and providers must take responsibility for heteronormative microaggressions and take steps to reduce their frequency and mitigate their effects on LGBTQIA care. We conclude by offering strategies for problem-solving at the level of medical education, institutional culture and policy, and individual awareness. (shrink)
    Direct download(2 more)  
     
    Export citation  
     
    Bookmark   6 citations  
  9.  49
    Ethical complexities in assessing patients’ insight.Laura Guidry-Grimes -2019 -Journal of Medical Ethics 45 (3):178-182.
    The question of whether a patient has insight is among the first to be considered in psychiatric contexts. There are several competing conceptions of clinical insight, which broadly refers to a patient’s awareness of their mental illness. When a patient is described as lacking insight, there are significant implications for patient care and to what extent the patient is trusted as a knower. Insight is currently viewed as a multidimensional and continuous construct, but competing conceptions of insight still lack consensus (...) on the specifics. Studies also give contradictory evidence regarding the frequency and consequences of poor insight. A number of crucial questions remain unanswered. After outlining some of the key theoretical disagreements about what insight means, I highlight ethical issues that have not received much attention in the literature. Given the conceptual ambiguities and the absence of standardised bedside tools, there are significant ethical concerns about insight assessments. I highlight two main ethical concerns, specifically that these assessments risk: (1) marginalising patients by setting unattainable ideals for self-knowledge and (2) minimising the patient’s own perspective on their mental health. I close with recommendations for documenting and responding to concerns about poor insight, so patients who are vulnerable to losing epistemic trust are better supported in their therapeutic relationships. (shrink)
    Direct download(5 more)  
     
    Export citation  
     
    Bookmark   3 citations  
  10.  41
    Expectation and Suffering With LVAD Deactivation.Laura Guidry-Grimes &Nneka Sederstrom -2015 -American Journal of Bioethics 15 (7):74-76.
  11.  34
    Disability bioethics and the commitment to equality.Laura Guidry-Grimes -2022 -Theoretical Medicine and Bioethics 43 (4):209-220.
    Robert Veatch’s The Foundations of Justice: Why the Retarded and the Rest of Us Have Claims to Equality delves into deep questions of justice through the case of a child with disabilities. I describe what is basically right about this vision, as well as what is problematic from the standpoint of contemporary disability bioethics. From there, I dive into the notion of vulnerability that is at play in his work. He describes disability as necessarily a condition of weakness, lesser-than existence, (...) and neediness. When disability is viewed in this way as an inherently vulnerable state of being, the essential sociopolitical dimensions of disability receive inadequate attention, which, in turn, makes it impossible to identify injustices correctly. I connect these points to concrete challenges faced by disability communities during the COVID-19 pandemic, which have raised profound questions about the just use of scarce critical care resources. Any case drawn from the pandemic is a very different kind of case than that of the child in Veatch’s book, but a commonality is the question of who should get what limited resources when needs and urgency vary. (shrink)
    Direct download(3 more)  
     
    Export citation  
     
    Bookmark   1 citation  
  12.  110
    Vulnerabilities Compounded by Social Institutions.Laura Guidry-Grimes &Elizabeth Victor -2012 -International Journal of Feminist Approaches to Bioethics 5 (2):126-146.
    How can social institutions complicate and worsen vulnerabilities of particular individuals or groups? We begin by explicating how certain diagnoses within mental health and medicine operate as interactive kinds of labels and how such labels can create institutional barriers that hinder one's capacity to achieve wellbeing. Interactive-kind modeling is a conceptual tool that elucidates the ways in which labeling can signal to others how the labeled person ought to be treated, how such labeling comes about and is perceived, and how (...) it compounds vulnerabilities. We argue that this shift in standpoint helps us recognize and mitigate compounded vulnerabilities. (shrink)
    Direct download(10 more)  
     
    Export citation  
     
    Bookmark   4 citations  
  13.  43
    In the Balance: Weighing Preferences of Decisionally Incapacitated Patients.Laura Guidry-Grimes -2018 -Hastings Center Report 48 (3):41-42.
    In this issue of the Hastings Center Report, Jason Wasserman and Mark Navin argue that patients without decisional capacity can still have relatively stable wishes or inclinations toward one treatment option over another and that these preferences are “not devoid of moral weight and might therefore guide or at least influence treatment decisions when they cannot be defeated by other considerations.” This position is not controversial among most bioethicists. The hard work comes in sussing out the details of this position. (...) How much moral weight do these preferences have? When should preferences be defeated by other considerations? How should we identify actual preferences, and how should preferences be differentiated and weighed against one another? (shrink)
    Direct download(2 more)  
     
    Export citation  
     
    Bookmark   2 citations  
  14.  70
    Covert administration of medication in food: a worthwhile moral gamble?Laura Guidry-Grimes,Megan Dean &Elizabeth Kaye Victor -2021 -Journal of Medical Ethics 47 (6):389-393.
    The covert administration of medication occurs with incapacitated patients without their knowledge, involving some form of deliberate deception in disguising or hiding the medication. Covert medication in food is a relatively common practice globally, including in institutional and homecare contexts. Until recently, it has received little attention in the bioethics literature, and there are few laws or rules governing the practice. In this paper, we discuss significant, but often overlooked, ethical issues related to covert medication in food. We emphasise the (...) variety of ways in which eating has ethical importance, highlighting what is at risk if covert administration of medication in food is discovered. For example, losing trust in feeders and food due to covert medication may risk important opportunities for identity maintenance in contexts where identity is already unstable. Since therapeutic relationships may be jeopardised by a patient’s discovery that caregivers had secretly put medications in their food, this practice can result in an ongoing deception loop. While there may be circumstances in which covert medication is ethically justified, given a lack of suitable alternatives, we argue that in any particular case this practice should be continually re-evaluated in light of the building moral costs to the relational agent over time. (shrink)
    Direct download(4 more)  
     
    Export citation  
     
    Bookmark   1 citation  
  15.  32
    Against Personal Ventilator Reallocation—ADDENDUM.Joel Michael Reynolds,Laura Guidry-Grimes &Katie Savin -2021 -Cambridge Quarterly of Healthcare Ethics 30 (2):403-403.
  16.  24
    Introduction to Nonideal Theory and Its Contribution to Bioethics.Elizabeth Victor &Laura K. Guidry-Grimes -2021 - In Elizabeth Victor & Laura K. Guidry-Grimes,Applying Nonideal Theory to Bioethics: Living and Dying in a Nonideal World. New York: Springer. pp. 3-15.
    At its core, nonideal theory is an attempt not only to address issues of justice, but it also provides us a lens through which we can articulate our limitations as knowers and reasoners, the ways in which we are relational in our autonomy needs, and the ways in which we are deeply dependent upon institutions and social supports for our agency and identities. Bringing this lens into bioethics means shifting our orientation in our scholarship and our practice. This shift will (...) have implications in how bioethical evaluations are taken up and played out in policies, institutional structures that inform the clinical encounter, and avenues for protection and redress for marginalized and vulnerable populations. It will also allow theorists and researchers to interrogate the status quo, revealing how many standard policies and practices are embedded in social and institutional arrangements that privilege the few or are built on exclusionary norms. The path forward, and the aim of this volume, is to extend the scholarship of nonideal approaches to bioethics. The volume is divided into two main parts. The first is focused on philosophically unpacking nonideal theory as an approach in bioethics. The second offers applications of nonideal theory in environmental ethics, healthcare ethics, public heath ethics, and genetic ethics. Our collective aim is to expand what has been considered nonideal bioethics. The history of nonideal theory has as its point of reference a turn away from Rawlsian justice, but the future of nonideal theory is ripe with possibilities. (shrink)
    Direct download  
     
    Export citation  
     
    Bookmark   1 citation  
  17.  23
    Navigating Contested Harms and Competing Metaphysics: Humility and Ethics Consultation.Laura Guidry-Grimes &Jamie Carlin Watson -2021 -American Journal of Bioethics 21 (6):34-36.
    Baby A1 was born prematurely with severe encephalopathy, injured brainstem, and a potentially injured spinal cord. He had no response to pain or other external stimuli. The neonatal team unanimousl...
    No categories
    Direct download(2 more)  
     
    Export citation  
     
    Bookmark   1 citation  
  18.  786
    Louisiana's “Medically Futile” Unborn Child List: Ethical Lessons at the Post-Dobbs Intersection of Reproductive and Disability Justice.Laura Guidry-Grimes,Devan Stahl &Joel Michael Reynolds -2023 -Hastings Center Report 53 (1):3-6.
    Ableist attitudes and structures regarding disability are increasingly recognized across all sectors of healthcare delivery. After Dobbs, novel questions arose in the USA concerning how to protect reproductive autonomy while avoiding discrimination against and devaluation of disabled persons. As a case study, we examine the Louisiana’s Department of Public Health August 1st Emergency Declaration, “List of Conditions that shall deem an Unborn Child ‘Medically Futile.’” We raise a number of medical, ethical, and public health concerns that lead us to argue (...) the declaration should be rescinded. The ethically objectionable declaration provides valuable lessons concerning how to uphold both reproductive and disability justice in a post-Dobbs landscape. (shrink)
    Direct download(3 more)  
     
    Export citation  
     
    Bookmark  
  19.  73
    The persistence of agency through social institutions and caring for future generations.Elizabeth Victor &Laura Guidry-Grimes -2014 -International Journal of Feminist Approaches to Bioethics 7 (1):122-141.
    We argue that we have obligations to future people that are similar in kind to obligations we have to current people. Modifying Michael Bratman’s account, we argue that as planning agents we must plan for the future to act practically in the present. Because our autonomy and selfhood are relational by nature, those plans will involve building affiliative bonds and caring for others. We conclude by grounding responsibility to future others by the way we plan through our social institutions. Our (...) account fills out the story of responsibility to future generations by referring only to ourselves, our practical identities, and practical reason. (shrink)
    Direct download(7 more)  
     
    Export citation  
     
    Bookmark   2 citations  
  20.  20
    Posthumous HIV Disclosure and Relational Rupture.D. Micah Hester &Laura K. Guidry-Grimes -2018 -Journal of Clinical Ethics 29 (3):196-200.
    In response to Anne L. Dalle Ave and David M. Shaw, we agree with their general argument but emphasize a moral risk of HIV disclosure in deceased donation cases: the risk of relational rupture. Because of the importance that close relationships have to our sense of self and our life plans, this kind of rupture can have long-ranging implications for surviving loved ones. Moreover, the now-deceased individual cannot participate in any relational mending. Our analysis reveals the hefty moral costs that (...) disclosure can bring, which should influence what information is given to wouldbe donors and how organ procurement coordinators approach these conversations. (shrink)
    No categories
    Direct download  
     
    Export citation  
     
    Bookmark   1 citation  
  21.  42
    Smuggled Doughnuts and Forbidden Fried Chicken: Addressing Tensions around Family and Food Restrictions in Hospitals.Megan A. Dean &Laura Guidry-Grimes -2023 -Hastings Center Report 53 (4):10-15.
    It is a common practice for family members to bring food to hospitalized loved ones. However, in some cases, this food contravenes a patient's dietary plan. Such situations can create significant tension and distrust between health care professionals and families and may lead the former to doubt a family's willingness or ability to support patient recovery. This case‐study essay offers an ethical analysis of these situations. We draw on Hilde Lindemann's work to argue that providing food to family members is (...) an important way that families discharge their moral functions of caring for their members and holding them in their identities. When family members are hospitalized, other means of performing these functions are limited. Acknowledging the ethical importance of feeding family members alongside the medical need for dietary restrictions, we offer strategies for creative problem‐solving that center diet as a subject for shared decision‐making and regular, ongoing communication among health care professionals, patients, and families. (shrink)
    Direct download(2 more)  
     
    Export citation  
     
    Bookmark  
  22.  4
    State-Mandated Ethics Oversight Is Inappropriate for Gender-Affirming Care.Hilary Mabel,Laura Guidry-Grimes &Lauren R. Sankary -2024 -Journal of Law, Medicine and Ethics 52 (4):950-952.
    A proposed state administrative rule would have required medical ethicists to approve certain aspects of gender-affirming care. The authors argue the proposed rule lacked appropriate justification compared to other instances of state-mandated ethics oversight and would undermine trust, raise practical challenges, and send harmful messages to society, patients, and providers.
    Direct download(2 more)  
     
    Export citation  
     
    Bookmark  
  23.  18
    Ethical Bargaining and Parental Exclusion: A Clinical Case Analysis.Elizabeth Victor &Laura Guidry-Grimes -2015 -Journal of Clinical Ethics 26 (3):250-259.
    Although there has been significant attention in clinical ethics to when physicians should follow a parent’s wishes, there has been much less discussion of the obligation to solicit viewpoints and decisions from all caregivers who have equal moral and legal standing in relation to a pediatric patient. How should healthcare professionals respond when one caregiver dominates decision making? We present a case that highlights how these problems played out in an ethical bargain. Ethical bargaining occurs when the parties involved choose (...) not to pursue a morally preferable option for the sake of coming to a resolution. This case is not one of parental disagreement; rather, the medical team agreed to exclude the patient’s mother from decision making if the patient’s father promised to bring their son back to the hospital for necessary medical tests. We argue that there is an obligation to notice and acknowledge power asymmetries in the family unit, which, in this case, was manifested as the marginalization of the female decision maker by the male decision maker. In these scenarios, clinicians should be careful to avoid treating parents as one homogenous unit, and they should take action to enable caregivers’ autonomy and voice. While there are moral and practical limits to how and when physicians should intervene in family dynamics, we discuss the steps that the medical team should have taken in this case to avoid undermining the parental authority of the mother. We conclude by offering recommendations to address and enable caregivers’ autonomy at an institutional level, and we discuss the importance of tracking and responding to damaging family dynamics to prevent ethically impermissible bargaining. (shrink)
    No categories
    Direct download  
     
    Export citation  
     
    Bookmark   1 citation  
  24.  25
    An Open Discussion of the Impact of OpenNotes on Clinical Ethics: A Justification for Harm-Based Exclusions from Clinical Ethics Documentation.Savitri Fedson,Joey Elizabeth Burke,Claire Horner,Adira Hulkower,Parker Crutchfield,Laura Guidry-Grimes &Holland Kaplan -2022 -Journal of Clinical Ethics 33 (4):303-313.
    The OpenNotes (ON) mandate in the 21st Century Cures Act requires that patients or their legally authorized representatives be able to access their medical information in their electronic medical record (EMR) in real time. Ethics notes fall under the domain of this policy. We argue that ethics notes are unique from other clinical documentation in a number of ways: they lack best-practice guidelines, are written in the context of common misconceptions surrounding the purpose of ethics consultation, and often answer questions (...) of a different nature than other documentation. Thus, we believe the clinical ethics community would benefit from clarification on when the withholding of ethics notes is justified. We provide recommendations for excluding information from ethics documentation based on the likelihood and magnitude of harm that may occur with particular disclosures and suggest approaches to decrease the potential harms that may occur. We define and explain six types of reasons to exclude information from ethics notes based on significant harms that are not addressed in the ON policy: (1) harmful revelations from a protected chart note; (2) negative emotional effects on patients or families; (3) the purpose of the consultation is undermined by harmful consequences; (4) avoidable negative impact on interpersonal dynamics; (5) inappropriate labeling or disclosure of medical, social, or financial information; and (6) inclusion of biasing or otherwise unfair information. We also suggest approaches to mitigate harm when excluding, including, reframing, or delaying release of information that is perceived to be relevant to an ethics case. Overall, we hope our analysis and recommendations will initiate a much-needed discussion about the impact of the ON mandate on clinical ethics documentation. (shrink)
    No categories
    Direct download  
     
    Export citation  
     
    Bookmark  
  25.  21
    The Case of Ms D: A Family’s Request for Posthumous Procurement of Ovaries.Laura Guidry-Grimes -2016 -Journal of Clinical Ethics 27 (1):51-58.
    The MedStar Washington Hospital Center clinical ethics team became involved in a case when the family requested the posthumous removal of a patient’s ovaries for future reproductive use. This case presents a novel question for clinical ethicists, since the technology for posthumous female reproduction is still in development. In the bioethics literature, the standard position is to refuse to comply with such a request, unless there is explicit consent or evidence of explicit conversations that demonstrate the deceased would have wanted (...) this option pursued. Ms D’s case, we suggest, offers an exception to this default position; complying with the family’s request could have been ethically permissible in this case, had it been medically feasible. (shrink)
    No categories
    Direct download  
     
    Export citation  
     
    Bookmark  
  26.  42
    Erratum to: Inhospitable Healthcare Spaces: Why Diversity Training on LGBTQIA Issues Is Not Enough.Megan A. Dean,Elizabeth Victor &Laura Guidry-Grimes -2018 -Journal of Bioethical Inquiry 15 (1):173-173.
    Direct download(3 more)  
     
    Export citation  
     
    Bookmark  
  27.  41
    Another Roadblock to Including Women in Research.Laura Guidry-Grimes &Elizabeth Victor -2012 -Hastings Center Report 42 (5):inside back cover-inside back co.
    Scientists, clinicians, and bioethicists are worried about how so‐called personhood measures would limit access to certain types of contraception, research involving stem cells, and access to fertility treatments. While these measures have been struck down in Colorado, South Dakota, California, and Mississippi, the bill signed into law in Oklahoma in February deserves critical scrutiny, particularly into the ways these legal measures influence eligibility for clinical research. Oklahoma's bill states that the laws of the state “shall be interpreted and construed to (...) acknowledge on behalf of the unborn child at every stage of development all the rights, privileges, and immunities available to other persons, citizens, and residents of this state.”. (shrink)
    Direct download(2 more)  
     
    Export citation  
     
    Bookmark  
  28.  15
    Covert Consciousness and Covert Ethics.Laura Guidry-Grimes -2020 -Perspectives in Biology and Medicine 63 (3):553-569.
    Clinical and ethical reasoning often follows the grooves, the forks, the paths of decision trees. Health-care professionals and clinical ethicists can come to rely on them, especially in intricate cases with complex problems that need to be broken down into analyzable steps. Despite their usefulness, decision trees can lead everyone astray if they are rooted in outdated medicine. In his 2015 book, Rights Come to Mind: Brain Injury, Ethics, and the Struggle for Consciousness, Joseph Fins illuminates the errors of common (...) medical and ethical understandings of disorders of consciousness, especially vegetative states and minimally conscious states.1 Fins weaves together over 50 in-depth interviews with patients... (shrink)
    Direct download(2 more)  
     
    Export citation  
     
    Bookmark  
  29.  32
    Homeless, Ill, and Psychiatrically Complex: The Grueling Carousel of Cassandra Lee.Laura Guidry-Grimes -2019 -Hastings Center Report 49 (4):8-13.
    Ask any clinical ethics consultant, and they can tell you about their transformative cases. Some stick with us because all roads led nowhere. Cassandra Lee had a history of pulling out lines and tubes and a distaste of warming blankets. Her admission marked her thirtieth over the past year. Many of the challenges facing the hospital caring for her were not unique: significant psychiatric issues, prolonged nonadherence to medical advice, and end‐of‐life decision‐making combined to create an ethically dense and vexing (...) situation. Ms. Lee, like so many patients, was suffering because of system failures. (shrink)
    Direct download(2 more)  
     
    Export citation  
     
    Bookmark  
  30. Introduction.Laura Guidry-Grimes &Jamie Watson -2018 - In Jamie Carlin Watson & Laura K. Guidry-Grimes,Moral Expertise: New Essays from Theoretical and Clinical Bioethics. Springer International Publishing.
    No categories
     
    Export citation  
     
    Bookmark  
  31.  28
    Knickknacks.Laura Guidry-Grimes -2021 -Journal of Medical Humanities 42 (2):303-305.
    Direct download(3 more)  
     
    Export citation  
     
    Bookmark  
  32.  19
    Reimagining Commitments to Patients and the Public in Professional Oaths.Laura Guidry-Grimes -2022 -Kennedy Institute of Ethics Journal 32 (3):261-296.
    ABSTRACT:Robert Veatch argues that physician oaths should not be valued as substantive moral commitments, transformational rituals, or symbolic acts. Further, he insists that oath recitation in medical schools is immoral. I respond to Veatch's criticisms and argue that, with alterations to their content and practice, oaths can have value for articulating moral commitments and building a sense of moral community within the profession. I break down Veatch's multitude of objections to oaths over his career, and I suggest how medical schools (...) can avoid the pitfalls identified by Veatch. A promising and innovative path forward is to integrate a commitment to diversity, equity, and inclusion—though with an understanding that a few lines in an oath are far from sufficient for institutional culture, faculty accountability, or students' education. (shrink)
    Direct download(2 more)  
     
    Export citation  
     
    Bookmark  
Export
Limit to items.
Filters





Configure languageshere.Sign in to use this feature.

Viewing options


Open Category Editor
Off-campus access
Using PhilPapers from home?

Create an account to enable off-campus access through your institution's proxy server or OpenAthens.


[8]ページ先頭

©2009-2025 Movatter.jp