Differentiating Between Rights-Based and Relational Ethical Approaches

Trobec, Irena; Herbst, Majda; Žvanut, Boštjan

doi:10.1177/0969733009102689

Cited by 6 publications

(9 citation statements)

References 5 publications

(10 reference statements)

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“…Relational ethics [ 38 ] builds on traditional bioethical principles of autonomy, justice, beneficence, non-maleficence [ 39 ], and shifts attention to relationships as the source of ethical action [ 40 ]. As greater emphasis is placed on how patients and HCPs negotiate communications and shared decision-making, a relational lens [ 41 , 42 ] provides contextual and relationship insights into health care practices [ 43 ]; this is particularly pertinent in chronic illness care [ 44 ] and patient-centered care [ 32 , 45 ]. Core elements of relational ethics are mutuality, engagement, respect, trust, vulnerability, uncertainty, and an interdependent environment [ 40 ] applicable to everyday experiences, practices, and interactions.…”

Section: Introductionmentioning

confidence: 99%

eHealth, Participatory Medicine, and Ethical Care: A Focus Group Study of Patients’ and Health Care Providers’ Use of Health-Related Internet Information

Townsend¹,

Leese²,

Adam³

et al. 2015

J Med Internet Res

122

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BackgroundThe rapid explosion in online digital health resources is seen as transformational, accelerating the shift from traditionally passive patients to patients as partners and altering the patient–health care professional (HCP) relationship. Patients with chronic conditions are increasingly engaged, enabled, and empowered to be partners in their care and encouraged to take responsibility for managing their conditions with HCP support.ObjectiveIn this paper, we focus on patients’ and HCPs’ use of health-related Internet information and how it influences the patient-HCP relationship. In particular, we examine the challenges emerging in medical encounters as roles and relationships shift and apply a conceptual framework of relational ethics to examine explicit and nuanced ethical dimensions emerging in patient-HCP interactions as both parties make increased use of health-related Internet information.MethodsWe purposively sampled patients and HCPs in British Columbia, Canada, to participate in focus groups. To be eligible, patients self-reported a diagnosis of arthritis and at least one other chronic health condition; HCPs reported a caseload with >25% of patients with arthritis and multimorbidity. We used a semistructured, but flexible, discussion guide. All discussions were audiotaped and transcribed verbatim. Elements of grounded theory guided our constant comparison thematic analytic approach. Analysis was iterative. A relational ethics conceptual lens was applied to the data.ResultsWe recruited 32 participants (18 patients, 14 HCPs). They attended seven focus groups: four with patients and three with rehabilitation professionals and physicians. Predominant themes to emerge were how use of health-related Internet information fostered (1) changing roles, (2) patient-HCP partnerships, and (3) tensions and burdens for patients and HCPs.ConclusionsRelational aspects such as mutual trust, uncertainty, and vulnerability are illuminated in patient-HCP interactions around health-related Internet information and the negotiated space of clinical encounters. New roles and associated responsibilities have key ethical dimensions that make clear the changes are fundamental and important to understand in ethical care. When faced with tensions and burdens around incorporating health-related Internet information as a resource in clinical encounters, participants described a particular ambivalence illustrating the fundamental changes being negotiated by both patients and HCPs.

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Section: Introductionmentioning

confidence: 99%

eHealth, Participatory Medicine, and Ethical Care: A Focus Group Study of Patients’ and Health Care Providers’ Use of Health-Related Internet Information

Townsend¹,

Leese²,

Adam³

et al. 2015

J Med Internet Res

122

View full text Add to dashboard Cite

show abstract

“…Regarding involuntary treatment, some articles argue that health professionals should resort to certain ethical guidelines, namely dominant rights and ethics of care, such as relational ethics [44,48,51,52]. The rights-based ethical approach assumes people are autonomous, where everyone's personality and humanity have exactly the same intrinsic value, and it also defines acts that infringe upon a person's autonomy and the criteria for considering a patient incompetent and/or dangerous [52].…”

Section: Ethical Foundations That Guide Clinical Decision-makingmentioning

confidence: 99%

Ethical Issues in Clinical Decision-Making about Involuntary Psychiatric Treatment: A Scoping Review

Laureano,

Laranjeira,

Querido

et al. 2024

Healthcare

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In mental health and psychiatric care, the use of involuntary psychiatric treatment for people with mental disorders is still a central and contentious issue. The main objective of this scoping review was to map and systematize the literature on ethical issues in clinical decision-making about involuntary psychiatric treatment. Five databases (Embase, PsycINFO, CINAHL, Medline, and Scopus) were searched for articles on this topic. Out of a total of 342 articles found, 35 studies from 14 countries were included based on the selection criteria. The articles were analyzed using the inductive content analysis approach. The following main categories were identified: (1) ethical foundations that guide clinical decision-making; (2) criteria for involuntary psychiatric treatment; (3) gaps, barriers, and risks associated with involuntary psychiatric treatment; (4) strategies used to reduce, replace, and improve the negative impact of involuntary treatment; and (5) evidence-based recommendations. Most of the selected articles discuss the logic underlying involuntary treatment of the mentally ill, exploring ethical principles such as autonomy, beneficence, non-maleficence, or justice, as well as how these should be properly balanced. During the process of involuntary psychiatric admission, there was a notable absence of effective communication and a significant power imbalance that disenfranchised those seeking services. This disparity was further intensified by professionals who often use coercive measures without a clear decision-making rationale and by family members who strongly depend on hospital admission. Due to the pluralistic and polarized nature of opinions regarding legal capacity and the complexity and nuance of involuntary admission, further studies should be context-specific and based on co-production and participatory research.

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“…As highlighted in the story, ethics approval was helpful only partially when the researcher character tried to follow the ethics review document to the letter. If the researcher character were to mentor Nicole, the character would have been forced to ''distort the situation to fit predetermined criteria'' (Trobec et al, 2009). Current institutional ethics review procedure in many universities are guided by the so-called principle-based ethics or a regulatory approach-one that guides researchers to make ethical decisions based on a compliance with systemized ethical principles and guidelines (Banks et al, 2013).…”

Section: Story 2: Helicopter-in and -Out At The Blurry Boundariesmentioning

confidence: 99%

Working at the Margin: Lessons Learned from School-Based Participatory Research

Lee

Jin

2021

Asia-Pacific Edu Res

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School-based participatory research (SBPR) studies-that is, school-situated and action-oriented collaborative inquiries in which those researched are involved in research processes as participants, decision-makers, or co-researchers-aim at producing and translating knowledge with the potential to offer transformative, relevant, and viable solutions to specific school-based matters. While several studies have provided recommendations for ethical conducts of engaging in SBPR, there has been a lack of examinations on the lived experiences of education researchers, who face uncertain and complex interactions within SBPR contexts. Using autobiographical narrative inquiry, this study thus (1) explores the lived experiences of education researchers engaging in SBPR with underserved students and their school communities and (2) identifies challenges they face and opportunities they become aware of in building and maintaining reciprocal and positive relationships in their research processes. Three SBPR researchers in the field of physical and health education present their lived experiences through fictionalized stories and subsequent reflections on those stories. This study thus critically unpacks some of the challenging ethical questions and internal dilemmas faced by SBPR researchers. Narrative findings revealed that SBPR researchers must understand themselves while relationally understanding others' opinions about their research projects. Therefore, concepts of reflexivity, relationship, and sustainability were further discussed via researchers' selfreflective narratives. This study may offer other education researchers a set of conceptual or methodological tools for reflecting critically on their own experiences of engaging in SBPR, thereby contributing to the enhancement of ethical conducts in SBPR studies.

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Differentiating Between Rights-Based and Relational Ethical Approaches

Cited by 6 publications

References 5 publications

eHealth, Participatory Medicine, and Ethical Care: A Focus Group Study of Patients’ and Health Care Providers’ Use of Health-Related Internet Information

eHealth, Participatory Medicine, and Ethical Care: A Focus Group Study of Patients’ and Health Care Providers’ Use of Health-Related Internet Information

Ethical Issues in Clinical Decision-Making about Involuntary Psychiatric Treatment: A Scoping Review

Working at the Margin: Lessons Learned from School-Based Participatory Research

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