Changing the Question

Brudney, Daniel

doi:10.1002/hast.988

Cited by 3 publications

(11 citation statements)

References 14 publications

(12 reference statements)

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“…Source: Derived and adapted from Ricoeur 64 , Brudney, 55 Phillips, 30 de Groot and van Hoek 79 and Brudney. 47 …”

Section: Discussionmentioning

confidence: 99%

“…48 Furthermore, the question of substituted judgement is sometimes not sufficiently connected to the moral value on which it is supposed to be based. 47 As a result, the moral responsibility of surrogates could be downplayed. 32 So substituted judgement standard is often unhelpful.…”

Section: Principlistic Approachmentioning

confidence: 99%

“…The ‘ good life ’ approach: Among his or her interests, a person also has an interest in leading a life that is good. 55 According to Williams 60 and Brudney, 47 a good life is a life that is led in accordance with one’s reflected upon and endorsed commitments – that are motivations, ambitions, thoughtful goals, endorsed responsibilities giving long-term structure and meaning to the person’s life. What is at stake among the person’s best interests is to advance her good, that is, the continuation of the pursuit of a good life.…”

Section: Narrative Approachesmentioning

confidence: 99%

“…The appropriate question for relatives is, then, what could the patient choose, given her values and commitments? 47 This question refocuses the relatives’ reflection on the goodness of the different options – that is, on moral psychology. 47 The person’s previous reflections on values, goodness and commitments need not have necessarily been conscious and explicit; sometimes they can only be read in the person’s history.…”

Section: Narrative Approachesmentioning

confidence: 99%

“…47 This question refocuses the relatives’ reflection on the goodness of the different options – that is, on moral psychology. 47 The person’s previous reflections on values, goodness and commitments need not have necessarily been conscious and explicit; sometimes they can only be read in the person’s history. 32 But the question of the relevance and validity of a normative view of a good life for human beings remains when no particular clues are available in the life of the now dead or dying person.…”

Section: Narrative Approachesmentioning

confidence: 99%

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Ethical reflection support for potential organ donors' relatives: A narrative review

et al. 2022

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Background: Even in countries with an opt-out or presumed consent system, relatives have a considerable influence on the post-mortem organ harvesting decision. However, their reflection capacity may be compromised by grief, and they are, therefore, often prone to choose refusal as default option. Quite often, it results in late remorse and dissatisfaction. So, a high-quality reflection support seems critical to enable them to gain a stable position and a long-term peace of mind, and also avoid undue loss of potential grafts. In practice, recent studies have shown that the ethical aspects of reflection are rarely and often poorly discussed with relatives and that no or incomplete guidance is offered. No review of the literature is available to date, although it could be of value to improve the quality of the daily practice. Objectives: The objective was to review and synthesize the main concepts and approaches, theories and practices of ethical reflection support of the relatives or surrogates of potential post-mortem organ donors. Research design: A narrative review was performed in the medical, psychological and ethical fields using PubMed, PsycArticles and Web of Science databases (1980–2020). Results: Out of 150 papers, 25 were finally retained. Four themes were drawn: the moral status of the potential post-mortem organ donor, the principlistic approach with its limits and critics, the narrative approach and the transcendental approach. Discussion: This review suggests an extension of psychological support towards ethical reflection support. The process of helping relatives in their ethical exploration of post-mortem organ donation is psychologically and morally characterized. The need for specialized professionals educated and experienced both in clinical psychology and in health ethics to carry out this task is discussed. Practical impact: This review could contribute to optimize the quality of the ethical reflection support by initiating an evolution from an empirical, partial and individual-dependent support to a more systematized, professionalized and exhaustive support.

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“…Source: Derived and adapted from Ricoeur 64 , Brudney, 55 Phillips, 30 de Groot and van Hoek 79 and Brudney. 47 …”

Section: Discussionmentioning

confidence: 99%

Section: Principlistic Approachmentioning

confidence: 99%

Section: Narrative Approachesmentioning

confidence: 99%

Section: Narrative Approachesmentioning

confidence: 99%

Section: Narrative Approachesmentioning

confidence: 99%

See 3 more Smart Citations

Ethical reflection support for potential organ donors' relatives: A narrative review

et al. 2022

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Promoting the Values for Surrogate Decision-making

Wendler

2022

JAMA

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The process of making medical decisions used to be straightforward. Clinicians selected the treatment course they determined would best promote the patient's interests. More recently, in response to increased emphasis on individual autonomy, it is the patient, in consultation with their clinicians and loved ones, who makes medical decisions. This approach respects patients who are able to make their own treatment decisions. However, it poses a challenge for the many adult patients who are unable to understand the information relevant to the decision in question, reason in light of this information and their own values, make a voluntary decision on this basis, or communicate their decision.To respect these patients who lack decisionmaking capacity, current practice directs patientdesignated and next-of-kin surrogates to make medical decisions based on the patient's documented preferences (eg, as described in an advance directive). 1 When a patient does not document their preferences, surrogates are instructed to use substituted judgment, trying to make the decision the patient would have made for themselves. When this is unclear, surrogates attempt to promote the patient's best interests. 1 Current implementation of this approach is subject to several important shortcomings. 2 First, many patients do not complete an advance directive or otherwise document their preferences prospectively. 3

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Non-Psychiatric Treatment Refusal in Patients with Depression: How Should Surrogate Decision-Makers Represent the Patient’s Authentic Wishes?

Berkowitz,

Trevick

2024

HEC Forum

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Changing the Question

Cited by 3 publications

References 14 publications

Ethical reflection support for potential organ donors' relatives: A narrative review

Ethical reflection support for potential organ donors' relatives: A narrative review

Promoting the Values for Surrogate Decision-making

Non-Psychiatric Treatment Refusal in Patients with Depression: How Should Surrogate Decision-Makers Represent the Patient’s Authentic Wishes?

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