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American Journal of Bioethics最新文献

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Coercion, Power Relations, and the Expectations Patients Bring to Mental Health Treatment. 胁迫、权力关系以及患者对心理健康治疗的期望。
IF 17 1区 哲学 Q1 ETHICS
American Journal of Bioethics
Pub Date : 2024-12-01 Epub Date: 2024-11-20 DOI: 10.1080/15265161.2024.2420560
Brendan Saloner, Jennifer Blumenthal-Barby
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引用次数: 0
Systems, Stress, and Embodied Inequality in Community Health. 社区健康中的系统、压力和体现的不平等。
IF 17 1区 哲学 Q1 ETHICS
American Journal of Bioethics
Pub Date : 2024-12-01 Epub Date: 2024-11-20 DOI: 10.1080/15265161.2024.2416127
Johanna T Crane, Carolyn P Neuhaus
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引用次数: 0
Moral Stress, Distress, and Injury: Clarifications Using the ADC Model of Moral Judgment. 道德压力、苦恼和伤害：使用道德判断的 ADC 模型进行澄清。
IF 17 1区 哲学 Q1 ETHICS
American Journal of Bioethics
Pub Date : 2024-12-01 Epub Date: 2024-11-20 DOI: 10.1080/15265161.2024.2416141
Shaun Respess, Veljko Dubljević
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引用次数: 0
You Say Potato, I Say Potahto: Should We Call the Whole Thing Off? 你说土豆，我说波塔赫托：我们应该取消整件事吗？
IF 17 1区 哲学 Q1 ETHICS
American Journal of Bioethics
Pub Date : 2024-12-01 Epub Date: 2024-11-20 DOI: 10.1080/15265161.2024.2416119
Connie M Ulrich, Anessa Foxwell, Christine Grady, Georgina Morley, Carol Taylor
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引用次数: 0
Examining Moral Stress and Moral Distress Through the Lens of Non-Human Animal Clinicians: Understanding Challenges in Animal Healthcare Systems. 通过非人类动物临床医生的视角审视道德压力和道德困扰：了解动物医疗保健系统面临的挑战。
IF 17 1区 哲学 Q1 ETHICS
American Journal of Bioethics
Pub Date : 2024-12-01 Epub Date: 2024-11-20 DOI: 10.1080/15265161.2024.2416168
Kate M Millar, Raymond Anthony
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引用次数: 0
Moral Distress and Moral Stress Among Nurses Facing Challenges in a Health Care System Under Pressure. 在面临压力的医疗保健系统中，面临挑战的护士的道德困扰和道德压力》（Moral Distress and Moral Stress Among Nurses Facing Challenges in a Health Care System Under Pressure）。
IF 17 1区 哲学 Q1 ETHICS
American Journal of Bioethics
Pub Date : 2024-12-01 Epub Date: 2024-11-20 DOI: 10.1080/15265161.2024.2417992
Belinda Mandrell, Jacklyn Boggs, Jami Gattuso, Mary Caples, Kimberly E Sawyer, Arshia Madni, Liza-Marie Johnson
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引用次数: 0
Moral Reflection and the Feeling of Powerlessness. 道德反思与无力感。
IF 17 1区 哲学 Q1 ETHICS
American Journal of Bioethics
Pub Date : 2024-12-01 Epub Date: 2024-11-20 DOI: 10.1080/15265161.2024.2416136
Weian Zhong
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引用次数: 0
When Treatment Pressures Become Coercive: A Context-Sensitive Model of Informal Coercion in Mental Healthcare. 当治疗压力变成胁迫时：心理保健中非正式胁迫的情境敏感模型》（A Context-Sensitive Model of Informal Coercion in Mental Healthcare）。
IF 17 1区 哲学 Q1 ETHICS
American Journal of Bioethics
Pub Date : 2024-12-01 Epub Date: 2023-07-28 DOI: 10.1080/15265161.2023.2232754
Christin Hempeler, Esther Braun, Sarah Potthoff, Jakov Gather, Matthé Scholten

Treatment pressures are communicative strategies that mental health professionals use to influence the decision-making of mental health service users and improve their adherence to recommended treatment. Szmukler and Appelbaum describe a spectrum of treatment pressures, which encompasses persuasion, interpersonal leverage, offers and threats, arguing that only a particular type of threat amounts to informal coercion. We contend that this account of informal coercion is insufficiently sensitive to context and fails to recognize the fundamental power imbalance in mental healthcare. Based on a set of counterexamples, we argue that what makes a proposal coercive is not whether service users will actually be made worse off if they reject the proposal, but rather whether they have the justified belief that this is the case. Whether this belief is justified depends on the presence of certain contextual factors, such as strong dependency on professionals and the salient possibility of formal coercion.

治疗压力是心理健康专业人员用来影响心理健康服务使用者的决策并提高他们对建议治疗的依从性的沟通策略。Szmukler 和 Appelbaum 描述了一系列治疗压力，其中包括说服、人际杠杆、提议和威胁，并认为只有特定类型的威胁才构成非正式强迫。我们认为，这种对非正式胁迫的解释对背景不够敏感，也没有认识到精神医疗中根本的权力不平衡。基于一系列反例，我们认为，使一项建议具有胁迫性的原因并不在于服务使用者如果拒绝该建议，他们的境况是否会变得更糟，而在于他们是否有理由相信情况会如此。这种信念是否合理，取决于是否存在某些背景因素，如对专业人员的强烈依赖和正式胁迫的显著可能性。
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引用次数: 0
Moral Stress and Moral Distress: Confronting Challenges in Healthcare Systems under Pressure. 道德压力与道德困扰：面对压力下医疗系统的挑战》。
IF 17 1区 哲学 Q1 ETHICS
American Journal of Bioethics
Pub Date : 2024-12-01 Epub Date: 2023-06-22 DOI: 10.1080/15265161.2023.2224270
Mara Buchbinder, Alyssa Browne, Nancy Berlinger, Tania Jenkins, Liza Buchbinder

Stresses on healthcare systems and moral distress among clinicians are urgent, intertwined bioethical problems in contemporary healthcare. Yet conceptualizations of moral distress in bioethical inquiry often overlook a range of routine threats to professional integrity in healthcare work. Using examples from our research on frontline physicians working during the COVID-19 pandemic, this article clarifies conceptual distinctions between moral distress, moral injury, and moral stress and illustrates how these concepts operate together in healthcare work. Drawing from the philosophy of healthcare, we explain how moral stress results from the normal operations of overstressed systems; unlike moral distress and moral injury, it may not involve a sense of powerlessness concerning patient care. The analysis of moral stress directs attention beyond the individual, to stress-generating systemic factors. We conclude by reflecting on how and why this conceptual clarity matters for improving clinicians' professional wellbeing, and offer preliminary pathways for intervention.

医疗保健系统的压力和临床医生的道德困扰是当代医疗保健领域紧迫而又相互交织的生物伦理问题。然而，生物伦理探究中的道德困扰概念往往忽视了医疗保健工作中对职业操守的一系列常规威胁。本文通过我们对 COVID-19 大流行期间工作在一线的医生的研究实例，澄清了道德困扰、道德伤害和道德压力之间的概念区别，并说明了这些概念在医疗保健工作中是如何共同发挥作用的。我们从医疗保健哲学出发，解释了道德压力如何产生于过度紧张的系统的正常运行；与道德困扰和道德伤害不同，道德压力可能不涉及对患者护理的无力感。对道德压力的分析将注意力从个人引向了产生压力的系统因素。最后，我们反思了这一概念的明确性对改善临床医生职业福祉的重要性和原因，并提供了初步的干预途径。
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引用次数: 0
Psychiatry's Unruly Practices and Their Implications for the Ethics of Psychiatry. 精神病学的不规范行为及其对精神病学伦理的影响》（Psychiatry's Unruly Practices and Their Implications for the Ethics of Psychiatry）。
IF 17 1区 哲学 Q1 ETHICS
American Journal of Bioethics
Pub Date : 2024-12-01 Epub Date: 2024-11-20 DOI: 10.1080/15265161.2024.2416124
Thomas Schramme
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引用次数: 0
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