Care Obligations Research Articles

Philosophical Values for Children's Legal Rules in the Positive Law of Islam Indonesia

Abstract The obligation to provide for a child is prioritized by a father, but if it is not capable, then the mother will take it. Ages earn a living from 0 to 21 years or get married. If a civil servant then the child salary is 1/3. The philosophy of child care obligations in Islamic UUP, if viewed from the axiological aspect of the benefit of the law, then the livelihood of children is a medium to achieve people's welfare, with the fulfillment of children's livelihood means that they have prepared quality human resources in the future, because in their livelihood three children aspects of fulfilling basic needs of children, namely primary needs, children's spiritual (psychological) needs and children's intellectual needs. From the axiological aspect of legal justice, the fulfillment of children's livelihood is full of the values of theological justice, social justice and gender justice. Whereas from the axiological aspect of legal certainty, the existence of legal sanctions on family law legislation serves as social control as a preventive measure to prevent acts of neglect of the child and repressive (forcing) parents to provide for the child by paying them later, as guarantee of child rights (child rights).

Intimate Lives in the Global Bioeconomy: Reproductive Biographies of Mexican Egg Donors

Research on cross-border reproductive care has shown how the geographical, historical, economic and political contexts in which egg donation takes place shape this transnational practice. As many women offer their oocytes due to their precarious conditions, they become seen as ‘bioavailable bodies’. The presence of these bioavailable bodies is key to the emergence of global egg donation hotspots. We argue that feminist research needs to go beyond the conceptualization of egg donors as bioavailable bodies. We suggest the analysis of ‘reproductive biographies’ as an innovative way to understand the entanglements of the global bioeconomy with intimate experiences of reproduction. We suggest advancing current feminist discussions around clinical labour by (1) studying the entanglements between the global bioeconomy, a neoliberalized healthcare system, systematic feminicide and women’s reproductive biographies, and by (2) revealing how women’s decision to donate results from gendered dependencies, obligations of care and coercive moments in egg donors’ reproductive biographies.

Constructing authentic decisions: proxy decision making for research involving adults who lack capacity to consent

Research involving adults who lack capacity to consent relies on proxy (or surrogate) decision making. Proxy decisions about participation are ethically complex, with a disparity between normative accounts and empirical...

Evidence of Exacerbated Gender Inequality in Child Care Obligations in Canada and Australia during the COVID-19 Pandemic

AbstractHouseholds in Canada and Australia have exhibited similar trends in the gendered allocation of additional child care responsibilities resulting from policy responses to the COVID-19 pandemic. In this article, we employ survey data to analyze the extent to which policy interventions related to COVID-19 have exacerbated gender disparities in child care obligations. We find that existing asymmetrical distributions of child care obligations in Canada and Australia have been amplified during the pandemic, resulting in a disproportionate burden on women. During the pandemic we also find that, in households with children, women tend to report experiencing poorer mental health than men.

What guidance does HIPAA offer to providers considering familial risk notification and cascade genetic testing?

BackgroundIt is unclear how the Health Insurance Portability and Accountability Act (HIPAA) should be interpreted in the context of sharing of genomic information between family members.MethodsThe authors analyzed the HIPAA Privacy Rule, reviewed the literature and constructed a clinical scenario to inform how HIPAA can be interpreted for multiple forms of patient- and provider-mediated genetic risk notification.ResultsUnder HIPAA, healthcare providers can lawfully notify relatives to recommend genetic risk assessment using multiple approaches, including supporting the patient telling their own relatives, contacting relatives directly with the patient’s authorization, or contacting a relative’s provider directly.ConclusionsMultiple forms of patient- or provider-mediated contact of relatives are already legally permissible under HIPAA, are consistent with ethical obligations of care to patients and their families, and could result in improved population health through identification of clinically actionable disease risk. Unanswered questions remain about implementation and impacts of provider-mediated programs.

Conflicts of interest in the context of end of life care for potential organ donors in Australia.

End-of-life (EOL) care has become an integral part of intensive care medicine and includes the exploration of possibilities for deceased organ and tissue donation. Donation physicians are specialist doctors with expertise in EOL processes encompassing organ and tissue donation, who contribute significantly to improvements in organ and tissue donation services in many countries around the world. Donation physicians are usually also intensive care physicians, and thus they may be faced with the dual obligation of caring for dying patients and their families in the intensive care unit (ICU), whilst at the same time ensuring organ and tissue donation is considered according to best practice. This dual obligation poses specific ethical challenges that need to be carefully understood by clinicians, institutions and health care networks. These obligations are complementary and provide a unique skillset to care for dying patients and their families in the ICU. In this paper we review current controversies around EOL care in the ICU, including the use of palliative analgesia and sedation specifically with regards to withdrawal of cardiorespiratory support, the usefulness of the so-called doctrine of double effect to guide ethical decision-making, and the management of potential or perceived conflicts of interest in the context of dual professional roles.

Introduction to the Special Issue: “Transnational Family Care ‘On Hold’? Intergenerational Relationships and Obligations in the Context of Immobility Regimes”

This special issue explores how members of transnational families manage their intergenerational care obligations in the context of increasing restrictions to cross–border mobility. We ask: How do ...

History Matters: Racialized Motherhoods and Neoliberalism.

Neoliberal political reasoning is remaking the state's democratic character and its governing rules to reflect those of the market. The most prominent legislative example, Temporary Assistance for Needy Families, dictates work requirements, time limits, and monitoring and sanctioning of clients. Through such policies, the primary aims of government assistance changed from aiding needy citizens to transforming individuals into paid workers, regardless of continued poverty or care obligations. Although scholarship of related policy and governance tools has grown, less study has centered on understanding the historic events and ways in which race-based, gendered, and poverty narratives facilitated adoption of such austere policies. This article compares circumstances of African American and White mothers in the United States from the Revolutionary War to the postwelfare era. It describes what neoliberalism is, discusses the role of ideological discourses in policy and governance, presents the history and historical racialized portrayals of White and African American motherhood during this period, and analyzes the differential impact of ideological discourses using a lens of intersectionality. The conclusion discusses how discriminatory discourses subvert a democratic ethos for all and suggests ways for social workers to contest the impacts of neoliberalism.

Demarcated pens and dependent pets: Conservation livelihoods in an indigenous Amazonian protected area

ABSTRACTAnthropological discussions of indigenous participation in (or exclusion from) conservation projects tend to emphasize contrasting socio‐environmental relations and power asymmetries. By tracing Waiwai interpretations of a protected area partnership in southern Guyana, the article describes how indigenous ideas about land and boundaries have implications beyond enacting the “environment.” Waiwai emphases on an obligation of care implied through enclosure, framed in terms of pets and pens, speak to the practical and political importance of building relationships with powerful outsiders for contemporary Amazonian livelihoods. Despite the value placed on self‐sufficiency in environmentalist discourse, the ability to make claims on others—including from a position of dependency—matters for obtaining land rights, development outcomes, and money. These outcomes, which deepen relations to governments, NGOs, and market economies, are important to how Waiwai people think of sustaining their lives. This article suggests that relations of strategic dependency are an important, though potentially fraught, form of indigenous agency in Amazonia. [agency, dependency, environmental conservation, development, Guyana, Amazonia, Waiwai]

<p>Community Health Care Workers’ Experiences on Enacting Policy on Technology with Citizens with Mild Cognitive Impairment and Dementia</p>

PurposeAssistive technologies and digitalization of services are promoted through health policy as key means to manage community care obligations efficiently, and to enable older community care recipients with mild cognitive impairment (MCI) and dementia (D) to remain at home for longer. The overall aim of this paper is to explore how community health care workers enacted current policy on technology with home-dwelling citizens with MCI/D.Participants and MethodsTwenty-four community health care workers participated in one of five focus group discussions that explored their experiences and current practices with technologies for citizens with MCI/D. Five researchers took part in the focus groups, while six researchers collaboratively conducted an inductive, thematic analysis according to Braun & Clarke.ResultsTwo main themes with sub-themes were identified: 1) Current and future potentials of technology; i) frequently used technology, ii) cost-effectiveness and iii) “be there” for social contact and 2) Barriers to implement technologies; i) unsystematic approaches and contested responsibility, ii) knowledge and training and iii) technology in relation to user-friendliness and citizen capacities.ConclusionThis study revealed the complexity of implementing policy aims regarding technology provision for citizens with MCI/D. By use of Lipsky’s theory on street-level bureaucracy, we shed light on how community health care workers were situated between policies and the everyday lives of citizens with MCI/D, and how their perceived lack of knowledge and practical experiences influenced their exercise of professional discretion in enacting policy on technology in community health care services. Overall, addressing systematic technology approaches was not part of routine care, which may contribute to inequities in provision of technologies to enhance occupational possibilities and meaningful activities in everyday lives of citizens with MCI/D.Trial registrationNSD project number 47996.

Violence and aggression in hospitals-what if the personnel need help?

In view of the increasing violence and aggression against medical personnel in healthcare facilities, there are considerations by the legislature to punish violent offenders in hospitals more severely. Hospital and emergency room staff are increasingly confronted by physically and psychologically violent patients or their relatives. Sometimes medical treatment in ahospital or emergency room is an exceptional physical or mental situation for many patients and their relatives. In addition, the consumption of alcohol and drugs, long waiting times, psychiatric illnesses and dissatisfaction with medical care or communication problems are considered to be the cause of violence against medical personnel in healthcare facilities. In addition to the physical consequences for the affected employees, the psychological consequences, such as job dissatisfaction, fear of work and posttraumatic stress disorder also pose major challenges for the employer. In order to fulfil the obligation of care towards employees, the latter should provide concepts for protection against violence as part of the company health management. Structural, organizational and personal measures as well as concepts for dealing with aggressive patients are the cornerstones of employee protection. Professional training courses on de-escalation, self-protection and self-defense can also contribute to the protection of employees and are gladly accepted by the staff. Even in the extreme case of a rampage situation, hospital deployment and alarm plans have to be developed and established.

The Impact of School Closure for COVID-19 on the US Healthcare Workforce and the Net Mortality Effects

Background: COVID-19 is leading to the implementation of social distancing policies around the world and in the United States, including school closures. The evidence that mandatory school closures reduce cases and ultimately mortality mostly comes from experience with influenza or from models that do not include the impact of school closure on the healthcare labor supply or the role of the healthcare labor force in reducing the per infection mortality from the pathogen. There is considerable uncertainty of the incremental effect of school closures on transmission and lives saved from school closures. The likely, but uncertain, benefits from school closure need to be weighed against uncertain, and seldom quantified, costs of healthcare worker absenteeism associated with additional child care obligations. Methods: We analyze data from the US Current Population Survey to measure the potential child care obligations for US healthcare workers that will need to be addressed if school closures are employed as a social distancing measure. We account for the occupation within the healthcare sector, state, and household structure to identify the segments of the healthcare labor force that are most exposed to child care obligations from school closures. We use these estimates to identify the critical level for the importance of healthcare labor supply in increasing a patient’s COVID-19 survival probability that would undo the benefits of school closures and ultimately increase cumulative mortality. Findings: The US healthcare sector has some of the highest child care obligations in the United States. 29% of healthcare provider households must provide care for children 3-12. Assuming non-working adults or a sibling 13 years old or older can provide child care, leaves 15% of healthcare provider households in need of childcare during a school closure, while 7% of healthcare households are single-parent households. We document the substantial variation within the healthcare system. For example, 35% of medical assistants and 31% of nursing, psychiatric, and home health aide households have child care obligations, while only 24% of emergency medical personnel have childcare obligations. Child care obligations can vary between states by over 10 percentage points. A 15% decline in the healthcare labor force, combined with reasonable parameters for COVID-19 such as a 15% case reduction from school closings and 2% baseline mortality rate implies that a 15% loss in the healthcare labor force must decrease the survival probability per percent healthcare worker lost by 17.6% for a school closure to increase cumulative mortality. This means that the per infection mortality rate cannot increase from 2% to 2.35% when the healthcare workforce declines by 15%; otherwise, school closures will lead to a greater number of deaths than they prevent. For school closures to unambiguously provide a net reduction in COVID-19 mortality with these parameters, the school closures must reduce cases by over 25%. Conclusion: School closures come with many tradeoffs. Setting aside economic costs, school closures implemented to reduce COVID-19 spread create unintended childcare obligations, which are particularly large in healthcare occupations. Detailed data are provided to help public health officials make informed decisions about the tradeoffs associated with closing schools. The results suggest that it is unclear if the potential contagion prevention from school closures justifies the potential loss of healthcare workers from the standpoint of reducing cummulative mortality. Funding Statement: No external funding.Declaration of Interests: The authors declare no competing interests.

Family Obligation Attitudes, Gender, and Migration

This study focuses on attitudes related to fulfilling family obligations and their relationships to migration behavior. We hypothesize that men who highly value fulfilling family obligations will be more likely to migrate in order to fulfill material obligations while women who highly value fulfilling family obligations will be less likely to migrate in order to fulfill care obligations. The empirical analysis examines data from the Chitwan Valley Family Study, located in south-central Nepal. We test whether variation in how much individuals value putting family needs before individual needs and caring for their adult parents matter for whether they migrate at all and if so, to which specific destinations. Our results provide only moderate support for these hypotheses but uncover patterns in how these attitudes toward family obligations are related to migration destinations. Men with strong attitudes toward family obligations are more likely to migrate internationally but especially to nearby India, sacrificing some level of economic returns for proximity. For women, the effect of attitudes is consistent: putting family needs first is negatively related to migration, while caring for adult parents is positively related to migration to India but not domestic or other international destinations. The findings suggest that our conventional typology of gendered labor and gender expectations for masculine breadwinning and feminine care might too strictly dichotomize the reality of how people actually care and provide for their families, obfuscating how they negotiate these competing demands.

Ethical reflections on the Measures Taken in Nursing Homes During Pandemic

The crisis in the health system caused by COVID-19 has left some important humanitarian deficits on how to care for the sick in their last days of life. The humanization of the dying process has been affected in three fundamental aspects, each of which constitutes a medical and ethical duty necessary. In this study, I analyze why dying accompanied, with the possibility of saying goodbye and receiving spiritual assistance, constitutes a specific triad of care and natural obligations that should not be overlooked - even in times of health crisis - if we do not want to see human dignity violated and violated some fundamental rights derived from it.

Humanize Death in a Time of Sanitary Crisis: Accompanied Die, Farewell and Receive Spiritual Care

The crisis in the health system caused by COVID-19 has left some important humanitarian deficits on how to care for the sick in their last days of life. The humanization of the dying process has been affected in three fundamental aspects, each of which constitutes a medical and ethical duty necessary. In this study, I analyze why dying accompanied, with the possibility of saying goodbye and receiving spiritual assistance, constitutes a specific triad of care and natural obligations that should not be overlooked - even in times of health crisis - if we do not want to see human dignity violated and violated some fundamental rights derived from it.

Reciprocity between older adults and their care-givers in emigrant households of Kerala, India

AbstractThe felt obligation to return a benefit, termedreciprocity, has been identified as motivating care exchanges between older adults and their younger family members. Within the context of large-scale emigration of young adults from the Indian state of Kerala, this study examines how left-behind older adults and their family care-givers recognise, interpret and give meaning to reciprocal exchanges, expectations and obligations in their care relationship. Employing a social exchange perspective, we qualitatively explore the norm of reciprocity through in-depth interviews of 48 participants (older adults and their care-givers) from emigrant households. Older adults and their care-givers identified reciprocal notions in their care exchange relationship that provided an interpretive framework for describing expectations, motivations, obligations and experiences across care-giving relationships. Spousal care-givers derived reciprocal motives and mutual care obligations through the institution of marriage. Adult children recognised filial duties and responsibilities and were in principle prepared to provide care to their parents. Reciprocating the support received and the likelihood of intergenerational transfers motivated care exchanges from adult children to their older parents. Daughters-in-law executed transferred filial roles from their emigrant husbands and bore a larger burden of care. Primary adult care-givers relied on the ‘demonstration effect’, hoping that children observe the care-giving process and emulate it later. Imbalances and non-reciprocity in the care exchange led to frustrations and threatened the care relationships.

Fieldwork Interrupted: Considering Implications of the COVID-19 Pandemic for Qualitative Family Policy Research

The Covid-19 pandemic has had significant implications for the feasibility of field research across academic disciplines. Graduate students in particular can find themselves in the challenging situation of having to re-think their research methods and research design more broadly. This essay outlines some of the implications of the Covid-19 pandemic for qualitative field research as a PhD candidate. In particular, the essay focuses on how a shift in research methods, namely from in-person to online interviews, can have an impact on methodology, i.e. on a theory-based research design. In addition, I consider how the pandemic may have an effect on substantive research results, especially in family sociology and family policy research. The challenge of managing care work during the pandemic and gendered impacts on care obligations have become a topic of political discussion in the past few months. This essay discusses some of the potential consequences of the current crisis for recent parents. Finally, I reflect on intersectionality and the importance of considering demographics of research participants and women in academia when discussing the effects of the pandemic, as Covid-19 has disproportionately impacted BIPOC communities, individuals with low SES and those with care responsibilities.

SEC Regulation Best Interest: A Practical Guide for Broker-Dealers and Investment Advisers

On June 30, 2020 registered securities broker-dealers must begin their compliance with new SEC Regulation Best Interest and Form CRS Relationship Summary/Form ADV Part 3, which were announced by the Securities and Exchange Commission on June 5, 2019. These new regulations were promulgated under authority given to the SEC by the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010. Regulation Best Interest has four components: (1) the disclosure obligation; (2) the care obligation; (3) the conflict of interest obligation; and (4) the compliance obligation. The Form CRS Relationship Summary/Form ADV Part 3 imposes an obligation on both broker-dealers and investment advisers to provide a Customer Relationship Summary to retail investors. For broker-dealers this form is called Form CRS. For investment advisers this form is Form ADV Part 3. This article will provide some basic preliminary guidance on how broker-dealers and investment advisers can prepare for the June 30 compliance date.

Duty or safety? Exploring emergency service personnel's perceptions of risk and decision-making when driving through floodwater

Vehicle-related flood fatalities and rescues due to driving through floodwater are a significant emergency management issue for emergency services. To reduce fatalities, injuries, and costs associated with this risky driving behaviour it is essential to develop strategies to stop or reduce the incidence of people driving through floodwater. In Australia, people are told not to enter floodwater – on foot or in vehicles – with the phrase ‘If it's flooded, forget it’ widely used in official messaging. As first responders responsible for floods, storms and tsunamis, Australian State Emergency Service (SES) personnel are working in flood conditions regularly and are considered an occupationally ‘at-risk’ group for driving through floodwater. Although SES agencies across states and territories in Australia are independently led, they typically promote policies of not entering floodwater to their personnel. Such policies are important for meeting duty of care obligations to employees, for protection of assets (vehicles and equipment), and for upholding organisational reputation (leading by example). This study was undertaken to explore the behaviour of driving through floodwater by SES personnel. The study explored the characteristics of those who have and have not driven through floodwater, and then used detailed situations in which SES personnel entered floodwater in vehicles to analyse their perception of risks, the conditions and contexts in which they entered floodwater, and to identify what influenced their decision to enter.Following an earlier systematic literature review, a detailed online questionnaire was developed and administered to SES personnel from a single agency. Data from 670 respondents indicated that 54.8% had driven through floodwater in the previous two years, and a number of differences in the profile of those who had/had not driven through floodwater were identified. Those more likely to have driven through floodwater included males, volunteer personnel with longer lengths of service, those doing more driving hours per week, those deployed to work in flood conditions, and those with current flood rescue qualifications. The location type, water depth, and water velocity were conditions that contributed more to perception of risk at the time personnel drove through the floodwater. Detailed information about an experience of entering floodwater was obtained from 201 respondents who had driven through floodwater in SES vehicles, and six factors relating to the decision to drive through floodwater were extracted. ‘Organisational training and safety’, ‘External locus of control’ and ‘Absence of risk signals’ were identified as having the greatest influence on risk perception leading to decisions to drive through floodwater. The findings of the study have a number of practical implications for the improvement of occupational safety management; such as upgrading risk assessments strategies, reviewing workplace health and safety policies, enhancing training, increasing skills and knowledge of emergency services personnel about floodwater hazard situations, and improving internal flood risk communication.

Imperfect by design: the problematic ethics of surgical training

There exists in academic medicine a core ethical issue that is seldom pursued: trainees are frequently not the best person in the operating room at a given intervention being performed,...