Illusion Of Choice Research Articles

The law's response to reproductive genetic testing: questioning assumptions about choice, causation and control.

The law's response to reproductive genetic testing depends on a number of assumptions about choice, causation and control which need to be questioned. From the preconception stage forward, the illusion of choice may raise such fundamental questions as the woman's choice not to be tested, limits on genetic information, and the availability of reproductive options. In turn, assumptions about choice raise questions about the responsibility for results and the connection between choice and causation in the context of wrongful birth and life actions. Assumptions made about control over reproductive choice and over causing 'harm', will impact on the development of future law.

The negotiation of death: Clinical decision making at the end of life

The ability of medical science to prolong biological life through the use of technology raises the question of how far physicians should go in treating the terminally ill patient. In clinical decision making involving the dying patient, physicians, patients and families bring various perceptions and interpretations to the situation. These different realities must be negotiated in order to define the meaning of the situation and the meaning of various medical technologies. The patient's demise becomes a negotiated death, a bargaining over how far medical technology should go in prolonging life or in prolonging death. A case study of the process of ethical decision making in the forgoing of life-supporting therapy in an intensive care setting is presented and analyzed. The decision making process in this case follows a ‘cascade’ pattern rather than a controlled, reflective model. While ethicists view the withholding and withdrawing of life-supporting treatment as morally equivalent, physicians tend to make a distinction based on the perceived locus of moral responsibility for the patient's death. In the author's interpretation the moral responsibility for the patient's death by withdrawing treatment is shared with family members, while the moral responsibility for the patient's death by withholding treatment is displaced to the patient. The author suggests that an illusion of choice in medical decision making, as offered by the physician, begins a negotiation of meanings that allows a sharing of moral responsibility for medical failure and its eventual acceptance by patient, family and physician alike.

The Role of the Nurse on Hospital Ethics Committees

Sound decisions are characterized by assurance of adequate information, multiple perspectives, sufficiently deliberate thought, emotional support for all decision makers, and legal acceptability. Each of these features can be enhanced by appropriate involvement of the nurse on an ethics committee. As a result, the nurse will be helping to assure patient, family, and professional participants that they have done their best under difficult constraints. Serving as a member of a hospital ethics committee is time consuming and challenging. Yet, it is one of the most important ways nurses can function in the role of patient advocate. The ethics committee can be the answer to the frustration that nurses confront every day when faced with increased technology, legislative inaction, and medical paternalism. Even competent patients are often manipulated when they want to refuse treatment. Patients and families frequently have the illusion of choice but no real choice at all. If an ethics committee can provide some meaningful avenue for the exercise of patients' and families' rights, then they are worth the effort.

The Illusion of Choice: Defense and Welfare in Advanced Industrial Democracies, 1948-1978

Research on the tendency of governments to trade off welfare spending for defense has generated diverse and often contradictory findings. This study attempts to clarify the issue of trade-offs by examining expenditure patterns since 1948 for the four major NA TO allies: United States, United Kingdom, Federal Republic of Germany, and France. When viewed from the perspective of long-term trends in shares of outlays, trade-offs are evident. When short-term changes in expenditure, which are more germane to the potential for one spending category to benefit at the expense of the other are studied, no pattern of trade-off can be detected. A three-equation model is estimated to control for the variety of possible determining factors of public resource allocation. In none of the four nations does a pattern of trade-off emerge, except in periods of wartime or postwar reconstruction. These findings are consistent with the ability of governments to finance new spending through either increased taxes or larger budget deficits. The growing disinclination to use these methods, however, suggests that the potential for trade-offs has perhaps reappeared in the 1980s.

The Illusion of Choice in Ethnic Bilingual Education

The Illusion of Choice in Ethnic Bilingual Education