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dissertation (2)


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2014 (2)

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Dissertation
Ethical issues in using robots for elderly care: a review of argument-based ethics literature
Authors: --- ---
Year: 2014 Publisher: Leuven : K.U. Leuven. Faculteit Geneeskunde

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Abstract

Background: In recent years, there has been a rapid trend in the aging of the population. Shortage of nursing and caregiving workforce, together with recent technological advances, makes the use of robots in elderly care increasingly likely. Robots have been developed for elderly care in three main ways including assisting in daily care, providing companionship, and monitoring. Despite the possible benefits, using robots for elderly care raises new ethical challenges. The overall objective of this review was to address ethical arguments about the use of robots in elderly care as reported in the argument-based research literature. Methods: we conducted a systematic search on existing literature on the use of robots in aged-care. Based on the inclusion criteria 18 argument-based ethics articles were included. Results: The thematic analysis of the literature revealed the argument-based ethics literature are mostly influenced by two important approaches in ethical argumentation including care-oriented approach and principles-oriented approach. Ethical arguments on the use of robots in elderly care were mostly guided by the principles of beneficence and nonmaleficence. Care-oriented arguments had been subjected to less attention in the literature. Conclusions: Introducing robots in aged-care should be discussed in a more conceptualized way, considering all the related values.

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Dissertation
Physicians' Attitudes towards Artificial Food or Fluid Administration in Patients with Advanced Dementia and in Terminally Ill Patients: A Review of the Literature
Authors: --- ---
Year: 2014 Publisher: Leuven : K.U. Leuven. Faculteit Geneeskunde

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Objective: The physicians’ attitudes toward artificial nutrition and hydration make much of a concern about the application of this type of management for terminally ill or markedly demented patients. The aim of this study was to examine and analyze the physicians’ attitudes and their justification of these attitudes, by means of a literature review.Methods:An extensive search was conducted for the electronic databases including; PubMed, ScienceDirect, The Cochrane Library, Cinahl, FRANCIS, PsycINFO, Philosopher's Index, and Social Sciences Citation Index for articles published between January 1990 and December 2013.Findings:The number of found studies was thirteen with huge diversity in the research question. Physicians arguments were grouped in three categories; ethical-legal, clinical and socio-cultural. There were slight differences in the arguments used to support or reject the use of artificial nutrition and hydration in the two studied patient populations. The ethical-legal issues were the most prominent arguments used in both populations either to support or to oppose this type of therapy. The value of communication with the patient and his family was stressed. The impact of professional guidelines was overruled by other social, cultural and religious factors in taking decisions for both categories of patients.Conclusion:Attitudes of physicians in taking decisions regarding providing, withholding or withdrawing artificial nutrition and hydration were a real reflection of this critical and sensitive perspective. The arguments provided by the physicians to defend their attitudes were ethically valid, but almost all of them stressed the value of honest clear informative communication with the patient and his family and how much this would facilitate the decision making process regarding artificial nutrition and hydration especially in the presence of advance directives.

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