Perspective Of Autonomy Research Articles

Patient Perspectives of Dignity, Autonomy and Control at the End of Life: Systematic Review and Meta-Ethnography.

BackgroundResearch in the end-of-life context has explored the sense of dignity experienced by patients with advanced disease, examining the factors associated with it. Whereas certain perspectives regard dignity as an intrinsic quality, independent of external factors, in the clinical setting it is generally equated with the person’s sense of autonomy and control, and it appears to be related to patients’ quality of life. This study aims to explore the relationship between perceived dignity, autonomy and sense of control in patients at the end of life.MethodsWe conducted a systematic review and meta-ethnography using reciprocal translation and line-of-argument synthesis. The search strategy used MeSH terms in combination with free-text searching of the Pubmed, Web of Science, CINAHL, PsycINFO and Cochrane databases, from their inception until 2015. This identified 186 articles, after excluding duplicates. The inclusion criterion was primary qualitative studies in which dignity, autonomy and control at the end of life were explored. Studies were evaluated using the CASP guidelines.ResultsTwenty-one studies recording the experiences of 400 participants were identified. Three themes emerged: a) dignity mediated by the loss of functionality, linked to the loss of control; b) dignity as identity; and c) autonomy as a determining factor of perceived dignity, understood as the desire for control over the dying process and the desire for self-determination. We propose an explanatory model which highlights that those patients with an intrinsic sense of dignity maintained a positive view of themselves in the face of their illness.ConclusionThis synthesis illustrates how dignity and autonomy are intertwined and can be perceived as a multidimensional concept, one that is close to the notion of personal identity. The ability to regard dignity as an intrinsic quality has a positive impact on patients, and the design of care strategies should take this into account.

Liberal eugenics: moral justification of practice

This paper considers the question of justification of liberal eugenics as a mean to change human nature that is formed by evolution. The paper present an idea of liberal eugenics, and position of its proponent Nicholas Agar and its opponent Francis Fukuyama. The question of moral justification of liberal eugenics will be predominantly examined from the perspective of autonomy. It will be argued that the respect for human nature, formed by evolution, is secondary to the question of moral obligation to respect human dignity and as such, the practice of liberal eugenics can be morally justified.

Ethical Perspectives on the Middle East Respiratory Syndrome Coronavirus Epidemic in Korea.

Ethical considerations are essential in planning for and responding to outbreaks of infectious diseases. During the outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the Republic of Korea in 2015, serious challenges emerged regarding important ethical issues, such as transparency and the protection of privacy. The development of bioethics in Korea has been influenced by individualistic perspectives applied in clinical contexts, leading to a paucity of ethical perspectives relevant to population-level phenomena such as outbreaks. Alternative theories of public health ethics include the perspectives of relational autonomy and the patient as victim and vector. Public health actions need to incorporate clear and systematic procedures founded upon ethical principles. The MERS-CoV epidemic in Korea created significant public support for more aggressive early interventions in future outbreaks. This trend makes it all the more imperative for ethical principles and procedures to be implemented in future planning and responses to outbreaks in order to promote perceptions of legitimacy and civic participation.

Work-to-family enrichment: Influences of work resources, work engagement and satisfaction among employees within the South African context

The aim of this study was to investigate the relationship of work resources, work-to-family enrichment, engagement and job satisfaction among employees in the South African context. Data were collected from 627 participants (females=67%, Afrikaans or English speakers=81.8%). The analysis utilised multiple regression analysis to predict work resources and work-to-family enrichment dimensions from work engagement dimensions, job satisfaction and career satisfaction. In the multiple regression analyses, work-related development opportunities, work autonomy and work-family affect were significant predictors of work vigour. Furthermore, work-related development opportunities, work autonomy, work-family affect and work-family perspectives were significant predictors of work dedication, job satisfaction and career satisfaction. Results support the idea that participation in one role may enrich the quality of life in the other role and provides a more comprehensive understanding of the positive side of the work/family interface.

National assessment meets teacher autonomy: national assessment of learning outcomes in music in Finnish basic education

ABSTRACT In Finland, teachers’ have extensive autonomy, that is freedom from control by others over their professional actions in the classroom, and it is considered a strength of Finnish education. At the same time, national assessment of learning outcomes has been constructed to examine the learner's progress and achievements in relation to the criteria of the Finnish National Core Curriculum for Basic Education in effect at the time. The national assessment of learning outcomes in music was conducted for the first time in 2011. In this article, the implementation and the main results of this National Assessment of Learning Outcomes in Music, in the ninth-grade of Finnish Basic Education are explored, and the whole process is examined critically from the perspective of teacher autonomy. The article discusses how, in the assessment, the ideals of teacher autonomy challenged assignment construction and the findings and conclusions of the national assessment. The article concludes that both teacher autonomy and national assessment are essential to compulsory education but must be balanced in a meaningful way.

Синергетический подход к формированию языковой и информационной самостоятельности студентов

This paper presents the process of learning a foreign language from the perspective of learner autonomy. The authors focus on the role of synergetic approach in the formation of language and information autonomy of students in higher education institutions of the Republic of Kazakhstan. Synergetic approach as the direction of interdisciplinary research in the formation of anguage and information autonomy of students reveals the general requirements, conditions and regularities of the learning process of students to a foreign language. All elements of the system interact consistently and lead to the process of self-organization. The process of learning a foreign language is integrated, systematic learning, with a student being self-governing, self-organizing and self- learning system. The role of synergy has not been fully defined in the system of scientific knowledge. Synergetics is interpreted as a picture of worldview, scientific paradigm, or a separate discipline. Synergetics applied to interdisciplinary knowledge is a new phenomenon that makes us think that traditional disciplinary structure of scientific knowledge becomes unacceptable. Synergetics as a model of self-organization brings new opportunities of strategies and stylistics of thinking, giving non-traditional approaches to multiple problems. Synergy sets a more general and wider problem of studying the emergence of self-organization as it occurs in natural processes.

A Study of Teacher Satisfaction on the Use of Educational Activities from an Autonomy Perspective: Focused on Busan Metropolitan City Elementary‧Middle‧High School Teachers

A Study of Teacher Satisfaction on the Use of Educational Activities from an Autonomy Perspective: Focused on Busan Metropolitan City Elementary‧Middle‧High School Teachers

Effective Judicial Protection in Consumer Protection in the ECJ's Case Law

The aim of my paper is to examine the effective control that ECJ exercises on national law applying the right for citizens to benefit from effective judicial protection, particularly in the matter of consumer protection. As we know, when there is not a regulation in EU law, Member States possess a procedural autonomy. However, this called procedural autonomy must respect and guarantee the exercise of UE fundamental rights. ECJ developed a relevant jurisprudence in this matter that is very interesting. In this sense, I study the cases Unibet (C-432/05), Pannon GSM (243-08), Penzugyi (C-137/08), Dominguez (C-282/10), Banco Espanol de Credito (C-618/10), and Aziz (415/11). And finally I highline the recent case Sanchez Morcillo (C-169/14). Thanks to this study we will be able to understand better actual perspectives of procedural autonomy and the right for citizens to benefit from effective judicial protection in the matter of consumer protection as a limit to this EU law principle.

The transplantation of solid organs from HIV-positive donors to HIV-negative recipients: ethical implications

HIV-positive individuals have traditionally been barred from donating organs due to transmission concerns, but this barrier may soon be lifted in the USA in limited settings when recipients are also...

Autonomy and foreign language learning in a virtual learning environment

1. Paradox and Promise: autonomy, foreign language learning and technology 2. Understanding Autonomy: an overview 3. Technology: Virtual Promise or Virtual Reality - the pedagogical challenge 4. Shadow Dancing: autonomy in action 5. Learner Reflections about Learning English as a Foreign Language and the role of technology 6. Perceptions and Reality 1: Students' response to using a VLE in computer-room lessons 7. Perceptions and Reality 2: Students' free-time use of the VLE 8. An Ecological Perspective of Autonomy, Foreign Language Learning and Technology 9. Looking Back, Thinking Forwards Bibliography Index

Problematising autonomy and advocacy in nursing

Customarily patient advocacy is argued to be an essential part of nursing, and this is reinforced in contemporary nursing codes of conduct, as well as codes of ethics and competency standards governing practice. However, the role of the nurse as an advocate is not clearly understood. Autonomy is a key concept in understanding advocacy, but traditional views of individual autonomy can be argued as being outdated and misguided in nursing. Instead, the feminist perspective of relational autonomy is arguably more relevant within the context of advocacy and nurses' work in clinical healthcare settings. This article serves to highlight and problematise some of the assumptions and influences around the perceived role of the nurse as an advocate for patients in contemporary Western healthcare systems by focusing on key assumptions concerning autonomy inherent in the role of the advocate.

Book review: Autonomy: Capitalism, Class and Politics, by David Eden

David Eden Autonomy: Capitalism, Class and Politics, Ashgate: Farnham, 2012; 283 pp: 1409411741, 60 [pounds sterling] (hbk) Early on in this highly impressive survey of contemporary autonomist thought, David Eden makes the claim that anarchism has come to function as 'the hegemonic ideology of anti-capitalism in the North', with communism--equated with state control--commonly perceived to be 'covered in blood and filth' (p. 7). Around 2011, this claim certainly seemed to be true, with Occupy's non-hierarchical and prefigurative model the spectacularly dominant form of organization, and David Graeber coming to rival Slavoj Zizek as the mainstream media's go-to leftist of choice. Fast-forward a couple of years, however, and the landscape seems to have changed somewhat. Now, the term 'communism' has accrued a viral power in anticapitalist circles--as evidenced quite gloriously by an enormous banner at the anti-privatisation protests at the University of Sussex, demanding (or perhaps announcing) 'COMMUNISM'; and by the memetic power of the phrase 'FULL COMMUNISM' in certain corners of the internet. As Huw Lemmey has pointed out, however, communism-as-meme 'is essentially contentless ... To actually begin to define the ambition would cause the fragmentation of the community' (2012, online at ). Yet defining ambitions is precisely the task facing those who seek communism, and this fragmentation can easily be seen in the differing paths taken by those mobilising around the term. On one hand, thinkers such as Zizek (2009) and Jodi Dean (2012) argue that communism must entail a return to vanguardism and the primacy of the party as organisational form (initially, at least, retaining the link with state control). For many others, communist practice should maintain a critical distance from the state-and hierarchical organisation more broadly. Situated firmly within the latter approach, Eden's book offers a useful commentary on three dominant 'tendencies' within what he calls 'the perspective of autonomy' (p. 1): those of Antonio Negri and Paolo Virno; the Midnight Notes Collective (MNC); and John Holloway. It offers no easy answers, but aptly demonstrates why engaging with class, capitalism and attendant concepts central to Marxian analysis is a necessity for those on the radical left. Building on Marx and Engels's famous claim that communism constitutes 'the real movement which abolishes the present state of things' (p. 8), Eden's central thesis is that this immanent movement functions differently in the three tendencies of autonomy he outlines. For Negri and Virno, it is a movement beyond capitalism; for the MNC it is a movement outside capitalism; whilst for Holloway, it is a movement against capitalism. Bound up with these understandings are differing visions on the nature and agency of the proletariat. To explicate these differences further, Eden affords each of the tendencies three chapters: one in which to outline the theory, one to consider how it might function in practice, and one for sympathetic (but rigorous) critique. The theory chapters are commendably well researched, with lesser-known and coauthored texts drawn upon extensively alongside each author's better-known texts. Concepts such as 'multitude' and 'commons' are explicated, as are the ways in which Negri, Virno, MNC and Holloway (re)think more traditional Marxist concepts such as subsumption, primitive accumulation and value. Though Eden's explanations are largely clear, the scarcity of examples means that the book may be a struggle for readers lacking previous engagement with the autonomist tradition. Eden also engages with autonomism's non-Marxist influences--Spinoza, Deleuze, Foucault and St. Francis of Assisi all feature--though the focus remains firmly in the tradition of Marxist critique of political economy. Seasoned readers will undoubtedly find minor areas with which to take issue --I would like to see more on Virno's relative pessimism vis-a-vis Negri, and I feel that Eden takes the MNC member p. …

Conditions of care: Migration, vulnerability, and individual autonomy

This paper investigates the specific conditions of female migrant workers who come to Canada as caregivers for the very young or the very old. Most of Canada’s live-in caregivers come into the country under the auspices of the Live-in Caregiver program. I assess this program from the perspective of individual autonomy and vulnerability. I argue that such programs allow for the realization of individual migration projects; however, they also generate specific vulnerabilities for female care workers that restrict and disable their capacity for autonomy. Insofar as programs can be modified to avoid these vulnerabilities while still allowing for migration, they need to be changed.

Rational versus unreasonable persuasion in doctor–patient communication: A normative account

ObjectivePersuasion plays a critical role in doctor–patient communication. The relevant literature tends to equate persuasion to manipulation as a suboptimal form of interaction. The objective of this paper is to distinguish among different types of persuasion processes and to highlight when their use can be beneficial or risky from the perspective of the patient's autonomy. MethodsThis paper presents a conceptual analysis of persuasion based on the analytical and normative frameworks of argumentation theory. ResultsPersuasion is a generic term that refers to at least four main forms of persuasion: rational persuasion, unintentional unreasonable persuasion, intentional (without deception) unreasonable persuasion and intentional (with deception) unreasonable persuasion (i.e., manipulation). ConclusionRational persuasion can be a process of value for the medical encounter. The other forms of persuasion can negatively impact patients’ decision making. They are suboptimal for different reasons that are partly due to the quality of communication, and partly due to ethics of the medical conduct. Practice implicationsThis paper offers a basis for developing training opportunities that foster deeper understanding of different forms and uses of persuasion. Also, it can inspire the development of educational material for patients targeted to the enhancement of their critical health literacy.

Autonomy, Local Voices and Conflict Resolution: Lessons from East Timor

The civil society in East Timor – today The Democratic Republic of Timor-Leste – developed knowledge and views about different constitutional structures during some critical years before the country’s independence in 2002. “Autonomy” proved to be an effective generic concept for this purpose in dialogues and seminars, organised inside and outside East Timor, on the issue of the territory’s future international status. While a certain political autonomy structure, alongside with independence, were the two options in the 1999 UN-led referendum on East Timor’s final status, the concept of “autonomy” was used as a point of reference for the analysis of principally different structural options for small territories – from typical independence, via forms of limited independence and associated state arrangements, to autonomy and levels of integration. Naturally, existing autonomy arrangments are studied when relevant in peace processes, but the concept of “autonomy”, with its need for local adaptation and recognition of difference, brings also compromise and therefore creativity into a process of political wrangling. In addition, an autonomy perspective in peace processes raises the issue of human rights protection on national level – can it protect on the level of an autonomy? The autonomy concept provides, finally, a framework for its own legitimacy, in relation to human rights and other measures in defense of human dignity. To identify a potential autonomy, thus, means assessing the characteristics of difference in such a framework, a process that local voices in East Timor needed to pursue.

Conditions of care: Migration, vulnerability, and individual autonomy

This paper investigates the specific conditions of female migrant workers who come to Canada as caregivers for the very young or the very old. Most of Canada’s live-in caregivers come into the country under the auspices of the Live-in Caregiver program. I assess this program from the perspective of individual autonomy and vulnerability. I argue that such programs allow for the realization of individual migration projects; however, they also generate specific vulnerabilities for female care workers that restrict and disable their capacity for autonomy. Insofar as programs can be modified to avoid these vulnerabilities while still allowing for migration, they need to be changed.

The State, Civil Society and Religious Freedom

How is the legal principle of religious freedom supposed to regulate the relationship between state and religion, especially in cases where state and religion seem to make competing claims? This article argues that, in order to fully appreciate this complex relationship, we need to reflect on the proper place of the state within society. In both the Catholic and the Reformed lines of thought it has traditionally been emphasized that society doesn’t consist merely of individuals and a state. There are also a variety of institutions (eg families and civil society organizations) providing different, yet equally necessary, goods. Applying this way of thinking about the state in a theory on religious freedom, provides a distinctive and promising theoretical point of view and is more likely to guarantee adequate protection in a range of current religious freedom cases in both Europe and the United States than the dominant individual autonomy perspective.

Editorial

Welcome to the special issue of SiSAL Journal on strategies and self-regulation in self-access learning. Learner strategy and self-regulation theory have been in a state of flux in recent years, and I believe it is an exciting time to share new ideas, conceptualizations and models of research in order to move the field forward. Therefore, I was eager to pursue a special issue where emerging voices in these fields could be heard, and these new ideas could be shared. In addition, I was also impressed by the number of learner strategy-related papers presented at this year’s Independent Learning Association conference in Wellington, New Zealand. The representation of strategic learning in the ILA conference is indicative of a growing trend in the field to move towards a self-access and learner autonomy perspective. I, for one, feel the potential to share knowledge between these fields is immense.

Influence of strength training on variables related to elderly autonomy

The process of aging results in several changes in the organisms, thus, is necessary to search for ways to mitigate the negative effects of this involution process, for this, knowing that the strength improvement represents a greater availability for everyday activities, this study searched at strength training, evidence of possible improvements in variables related to elderly autonomy. Before and after 12 weeks of training, we performed a pre and post-assessment respectively, in which were measured anthropometric variables as body weight, height, body mass index, waist and hip circumference, waist-hip ratio and fat. We also performed a strength test with hand-held and lower-limb dynamometers, besides functional capacity tests as climbing stairs and self-perception performance in activities of daily living. The sample consisted of 12 elderly females without any type of strength training. The results showed a significant improvement in strength and functional capacity, there was also significant reduction of fat, and increase of lean body mass. Concluding, elderly people can enjoy the benefits provided by strength training, especially in autonomy perspective.

Self-Recognition and Self-Regulation: The Relationship with Socialization Trajectories and Children's Sex

The initial process of self development involves interaction with others and the establishment of relationships taking different paths depending on the socio-cultural context. Self-recognition and self-regulation are considered manifestations of this development between 18 and 24 months of age. This study aimed at analyzing the relationship between these two aspects, maternal beliefs about autonomy and relatedness, as well as identifying differences between boys and girls in this developmental stage. Participants were 94 mothers of different educational levels and their children of 17-22 months of age in two Brazilian cities. Socialization Goals Inventory and Parental Practices in the First Year Inventory were used to collect data on mothers' beliefs. Children performed tasks related to self-recognition (the mirror test) and self-regulation (compliance to requests). The group of mothers studied valued both autonomy and interdependence. Children's responses are consistent with a perspective of relational autonomy, which value both independence and interdependence. Differences were found in relation to sex in both self-recognition and self-regulation, and baby girls showed superior performance than boys in both tasks.