Pursuing concordance: moving away from paternalism

McKinnon, John

doi:10.12968/bjon.2014.23.12.677

Cited by 10 publications

(9 citation statements)

References 25 publications

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“…Ultimately, the concept of shared decision making will only be successful if health care professionals acknowledge and accept that while patients often make decisions thought to be the "right" ones, they also have the right to make decisions that health care professionals may view as the "wrong" ones. 18,19 Nevertheless, as Lennard 15 notes, it can be a stressful time for health care professionals when patients make unwise choices that carry a potential risk of significant harm to well-being.…”

Section: Assessmentmentioning

confidence: 99%

“…However, if possible, it is imperative for health care professionals to gather life stories and experiences from patients, this will provide a valuable insight in making decisions in order to inform the aspect of any past and present wishes, which may need to be considered. 18 Nursing: Research and Reviews downloaded from https://www. If there have been no advance plans created, health care professionals such as nurses may be considered as the decision maker if a person is unable to make a decision at the time it needs to be made, while keeping the patient at the center of the process.…”

Section: Advance Planningmentioning

confidence: 99%

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The Mental Capacity Act: 10 years on – the key learning areas for healthcare professionals

Marshall¹,

Sprung²

2018

NRR

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The Mental Capacity Act (MCA) became statute law in England and Wales from October 2007 and was described as a visionary piece of legislation for its time, which had the potential to give people a voice and an opportunity to be heard. However, 10 years on, the Act is not being utilized in the UK as was intended. A scrutiny report published by the House of Lords in 2014 1 identified that the MCA was not embedded into the everyday practice of health care professionals due to the lack of knowledge, understanding, and confidence in the application of the basic principles of the MCA in clinical settings. The Department of Health produced a response document, which placed improvements in the implementation of the MCA at the forefront of the political agenda in order to empower and safeguard those deemed the most vulnerable in society. It is envisaged that this response will require a shift in the culture of health care professionals to view the MCA as a mandatory part of clinical practice and not an option. With the prevalence of people with impairment of mind or brain set to rise in the coming years, it is of vital importance that the MCA is used proactively in order to provide a protection for both patients and practitioners.

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Section: Assessmentmentioning

confidence: 99%

Section: Advance Planningmentioning

confidence: 99%

The Mental Capacity Act: 10 years on – the key learning areas for healthcare professionals

Marshall¹,

Sprung²

2018

NRR

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“…The terms person and patient‐centred care both appear the most within the records included. Six records use person‐centredness or person‐centred care (Cranley et al, 2020; Holmberg et al, 2020; McKinnon, 2014; Nicholson, 2017). Five records use patient‐centred care (de Angst et al, 2019; Doekhie et al, 2020; Eloranta et al, 2014; Hallock, 2014; Siouta et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

Sharing decision‐making between the older person and the nurse: A scoping review

Marriott‐Statham

Dickson

Hardiman

2022

Int J Older People Nursing

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Background: Sharing decision-making is globally recognised as an important concept in healthcare research, policy, education and practice which enhances person-centred care. However, it is becoming increasingly evident shared decision-making has not been successfully translated into everyday healthcare practice. Sharing decisionmaking has strong links with person-centred practice. Core to person-centredness and shared decision making, is the need to recognise that as we age, greater reliance is placed on emotion and life experience to inform decision making processes. With the world's ageing population, older persons facing more complex decisions and transitions of care, it is more important than ever it is understood how shared decisionmaking occurs.Objectives: This scoping literature review aims to find out how sharing decision making between nurses and older persons in healthcare settings is understood and presented in published literature. Methods: This scoping review utilised the Arksey and O'Malley methodological framework, advanced by Levac et al. Electronic databases and grey literature were searched, returning 362 records which were examined against defined inclusion criteria. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).Results: Twenty-two records met inclusion criteria for the review. Results indicate while shared decision-making is included in research, education and policy literature, it has not been effectively translated to inform practice and the relationship between a nurse and an older person. The records lack definitions of shared decision-making and theoretical or philosophical underpinnings. There is also no consideration of emotion and life experience in decision-making and how nurses 'do' shared decisionmaking with older persons.

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“…According to some studies[ 28 ], a culture of domination prevails among the North American and European professionals in the clinical setting, trying to generate a type of patients that follow the medical paradigm. Some investigations[ 29 - 32 ] raise different cultural conceptions on the patient’s informed consent and the family’s part in decision-making.…”

Section: Qualitative Approach To Foucauldian Ethicsmentioning

confidence: 99%

Grounded theory qualitative approach from Foucault's ethical perspective: Deconstruction of patient self-determination in the clinical setting

Molina-Mula

2021

WJCC

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This paper aims to explain the construction of the autonomous subject from Foucault's ethical perspective for the qualitative analysis of interprofessional relationships, patient-professional relationships, and moral ethics critique. Foucault tried to break loose from the self, which is merely the result of a biopolitical subjectivation and constituted an interpersonal level. From this, different elements involved in the decision-making capacity of patients in a clinical setting were analysed. Firstly, the context in which decision-making occurs has been explained, distinguishing between traditional practices involved in self-care and the more modern conceptions that make certain possible transformations. Secondly, an attempt is made to explain the formation of the medicalisation of society using the transformations of what Foucault called "techniques of the self". Finally, the ethical framework for a subject's "self-creation", insisting more on the exercises of self-subjectivation, reinforcing the ethics of the self by itself, the "care of the self", has been explained. The role of the patient is understood as an autonomous subject to the extent that the clinical institution and the professionals involved comprehend how the patient’s autonomy in the clinical environment is constituted. All these elements could generate grounded theory on the qualitative methodology of this phenomenon. The current ethical model based on universal principles is not useful to provide a capacity for patients decision-making, relegating to the background their opinions and beliefs. Consequently, a new ethical perspective emerges that aims to return the patient to the fundamental axis of attention.

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Pursuing concordance: moving away from paternalism

Cited by 10 publications

References 25 publications

The Mental Capacity Act: 10 years on – the key learning areas for healthcare professionals

The Mental Capacity Act: 10 years on – the key learning areas for healthcare professionals

Sharing decision‐making between the older person and the nurse: A scoping review

Grounded theory qualitative approach from Foucault's ethical perspective: Deconstruction of patient self-determination in the clinical setting

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Pursuing concordance: moving away from paternalism

Cited by 10 publications

References 25 publications

The Mental Capacity Act: 10 years on &ndash; the key learning areas for healthcare professionals

The Mental Capacity Act: 10 years on &ndash; the key learning areas for healthcare professionals

Sharing decision‐making between the older person and the nurse: A scoping review

Grounded theory qualitative approach from Foucault's ethical perspective: Deconstruction of patient self-determination in the clinical setting

Contact Info

Product

Resources

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The Mental Capacity Act: 10 years on – the key learning areas for healthcare professionals

The Mental Capacity Act: 10 years on – the key learning areas for healthcare professionals