&lt;p&gt;Modeling Lay People’s Ethical Attitudes to Organ Donation: A Q-Methodology Study&lt;/p&gt;

Hammami, Muhammad M.; Aboushaar, Reem

doi:10.2147/ppa.s230286

Cited by 5 publications

(4 citation statements)

References 53 publications

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“…On the other hand, patient's preference-related determinants were strongly embraced in only 3 models and strongly discounted in 5. The results are in general agreement with a related US study that used a different design and mainly recruited white educated women 6 and with studies on laypeople's attitude to organ donation 29 and placebos, 28 showing predominance of consequences over autonomy. The results are also consistent with the current preference thesis that takes into account only experiential interests and believes that interests do not survive loss of mental capacity, 7,8 they and provide some empirical evidence against the prospective/extended autonomy concept and substituted judgment standard, where surrogate decision making is based on stated or predicted wishes of the patient.…”

Section: Predominance Of Patient's Healthsupporting

confidence: 89%

“…Family-centric determinants and surrogate's interestrelated determinants were strongly embraced in 8 EA models compared to 1 ME model. This suggests that EA men may be more family focused than ME men and is consistent with the prevalence of familism in East Asia, 16,17,36 studies showing a stronger familism orientation in Christian/Philippines-educated than Muslim/ Saudi Arabia-educated respondents in relation to organ donation, 29 and studies showing culture dependency of end-of-life preferences. 21,22,37 However, although Q-methodology identified relatively familism-influenced models in all EA viewpoints, there were also a relatively familism-influenced model in the ME S-viewpoint and a relatively family burden-influenced model in the ME Pviewpoint.…”

Section: Comparing Middle Eastern and East Asian Mensupporting

confidence: 56%

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Importance Hierarchy of Surrogate Medical Decision Making Determinants: A Q-Methodology Study in Middle Eastern and East Asian Men

2020

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Background Factors other than patient’s preference may influence surrogate medical decision making in a culture- and viewpoint-dependent way. We explored the importance hierarchy of potential surrogate medical decision making determinants to Middle-Eastern (ME) and East-Asian (EA) men according to their norm-perception (N-viewpoint), preference as patients (P-viewpoint), and preference as surrogate decision-makers (S-viewpoint). Methods Each respondent (120 ME, 120 EA) sorted 28 items reflecting potential determinants into a fixed distribution of importance hierarchy according to the three viewpoints. Latent decision making models were explored by by-person factor analysis (Q-methodology). Results Six models were identified for each ME and EA viewpoint (total 36). Patient’s health-related, patient’s preference-related, and society’s interests-related determinants were strongly embraced in 34, 3, and zero models and strongly discounted in 2, 5, and 21 models, respectively. Patient’s religious/spiritual belief was strongly embraced in 6 EA models compared to 2 ME models and strongly discounted in 2 EA models compared to 5 ME models. Further, family-centric and surrogate’s interest-related determinants were strongly embraced in 8 EA models compared to 1 ME model. They were also strongly embraced in 5 P-viewpoint compared to 2 S-viewpoint models and strongly discounted in 4 P-viewpoint compared to 11 S-viewpoint models. Despite the overall predominance of patient’s health-related determinants and culture- and viewpoint-dependent differences, Q-methodology analysis identified relatively patient’s preference-influenced, religious/spiritual beliefs–influenced, emotion-influenced, and familism-influenced models and showed notable overlap in models. Conclusions Patient’s health was more important than other potential medical surrogate decision making determinants, including patient’s preference, for both ME and EA men and in all viewpoints. The relative importance of some determinants was culture- and viewpoint- dependent and allowed description of different albeit overlapping models.

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Section: Predominance Of Patient's Healthsupporting

confidence: 89%

Section: Comparing Middle Eastern and East Asian Mensupporting

confidence: 56%

Importance Hierarchy of Surrogate Medical Decision Making Determinants: A Q-Methodology Study in Middle Eastern and East Asian Men

2020

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“…Consistently, a previous study using simple rating and dichotomization showed that 78% of surrogates (mostly white educated US women) focused more on patient's well-being than patient's preferences [6]. A predominance of consequentialist attitude over autonomy-based attitude was also observed in lay people approach to medical use of placebos [34] and organ donation, [35] providing support to the concept that "good" may be more fundamental than "right" and to the importance of "harm/care" as one of the psychological foundations of morality [36].…”

Section: Importance Of Patient's Healthsupporting

confidence: 70%

Factors underlying surrogate medical decision-making in middle eastern and east Asian women: a Q-methodology study

et al. 2020

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Background: It is not clear how lay people prioritize the various, sometimes conflicting, interests when they make surrogate medical decisions, especially in non-Western cultures. The extent such decisions are perspective-related is also not well documented. Methods: We explored the relative importance of 28 surrogate decision-making factors to 120 Middle-Eastern (ME) and 120 East-Asian (EA) women from three perspectives, norm-perception (N), preference as patient (P), and preference as surrogate decision-maker (S). Each respondent force-ranked (one to nine) 28 opinion-items according to each perspective. Items' ranks were analyzed by averaging-analysis and Q-methodology. Results: Respondents' mean (SD) age was 33.2 (7.9) years; all ME were Muslims, 83% of EA were Christians. "Trying everything possible to save patient," "Improving patient health," "Patient pain and suffering," and/or "What is in the best interests of patient" were the three most-important items, whereas "Effect of caring for patient on all patients in society," "Effect of caring for patient on patients with same disease," and/or "Cost to society from caring for patient" were among the three least-important items, in each ME and EA perspectives. P-perspective assigned higher mean ranks to family and surrogate's needs and burdens-related items, and lower mean rank to "Fear of loss" than S-perspective (p<0.001). ME assigned higher mean ranks to "Medical facts" and "Surrogate own wishes for patient" and lower mean rank to "Family needs" in all perspectives (p<0.001). Q-methodology identified models that were relatively patient's preference-, patient's religious/spiritual beliefs-, or emotion-dependent (all perspectives); medical facts-dependent (N-and S-perspectives), financial needs-dependent (P-and S-perspectives), and family needs-dependent (P-perspective). Conclusions: 1) Patient's health was more important than patient's preference to ME and EA women; society interest was least important. 2) Family and surrogate's needs/ burdens were more important, whereas fear of loss was less important to respondents as patients than as surrogate decision-makers. 3) Family needs were more important to EA than ME respondents, the opposite was true for medical facts and surrogate's wishes for patient. 4) Q-methodology models that relatively emphasized various surrogate decision-making factors overlapped the ME and EA women' three perspectives.

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“…Q-methodology is a quali-quantitative methodology that originated in the field of psychology (Brown, 1980) but is now used in a wide array of fields to understand the range of stakeholder perceptions in reference to contested issues [e.g., education (Rodl et al, 2020), medicine (Hammami et al, 2020), and environment (Moros et al, 2020)]. Q-methodology combines statistical analysis in the form of a data-reduction technique applied to pseudo-ranking data with the analysis of qualitative data obtained during the ranking exercise to reveal core perceptions.…”

Section: Q-methodologymentioning

confidence: 99%

Recognising Stakeholder Conflict and Encouraging Consensus of ‘Science-Based Management’ Approaches for Marine Biodiversity Beyond National Jurisdiction (BBNJ)

et al. 2020

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Areas beyond national jurisdiction (ABNJ) encompass the seabed, subsoil and water column beyond coastal State jurisdiction and marine biodiversity beyond national jurisdiction (BBNJ) is rich and varied. From providing sustenance and supporting livelihoods, to absorbing anthropogenic carbon dioxide emissions, ABNJ ecosystems are vital to the wellbeing of humankind. However, an enhanced understanding of BBNJ and its significance has not equated to its successful conservation and sustainable use. Negotiations for a new international legally binding instrument for the conservation and sustainable use of BBNJ have scoped applicable principles for a future agreement, including the use of best available science and science-based approaches. But there remains a lack of convergence on what science-based approaches would look like, or how they would be operationalised. In order to negotiate and implement a meaningful BBNJ treaty that can meet conservation and sustainable use objectives, stakeholder perceptions must be identified, and areas of divergence must be overcome. This study uses Q-methodology to reveal and analyse the diversity of perceptions that exist amongst key stakeholders regarding what it means to operationalise sciencebased approaches for the conservation and sustainable use of BBNJ. The Q-study features 25 stakeholder interviews and 30 Q-study participants revealing four different perceptions, each of which represent a different interpretation of what science-based management means in the context of BBNJ. Across these perceptions, there were areas of stakeholder consensus (e.g., regarding the benefits of integrative management, the application of precautionary approaches when data are insufficient, and the issues pertaining to the trustworthiness and credibility of science) and areas of stakeholder conflict (e.g., regarding the definition, function and authority of science within current and future BBNJ governance processes). Key implications of this study include the evidencing of fundamental tensions between differing perceptions of the authority of science and between conservation and sustainable use objectives, that may be fueling stakeholder conflict, and the subsequent proposal of integrative and highly participatory management approaches to operationalise science-based management of BBNJ.

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<p>Modeling Lay People’s Ethical Attitudes to Organ Donation: A Q-Methodology Study</p>

Cited by 5 publications

References 53 publications

Importance Hierarchy of Surrogate Medical Decision Making Determinants: A Q-Methodology Study in Middle Eastern and East Asian Men

Importance Hierarchy of Surrogate Medical Decision Making Determinants: A Q-Methodology Study in Middle Eastern and East Asian Men

Factors underlying surrogate medical decision-making in middle eastern and east Asian women: a Q-methodology study

Recognising Stakeholder Conflict and Encouraging Consensus of ‘Science-Based Management’ Approaches for Marine Biodiversity Beyond National Jurisdiction (BBNJ)

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