/library/oar/handle/123456789/101442 2025-11-15T00:40:37Z 2025-11-15T00:40:37Z /library/oar/handle/123456789/107932 2023-03-30T05:54:40Z 2022-01-01T00:00:00Z

Title: Autonomy vs duty of care : ethical considerations in the management of gender dysphoria and gender reassignment surgery Abstract: The management of gender dysphoria and gender reassignment surgery is typically centred around the principle of autonomy. This dissertation compares autonomy and duty of care perspectives in addressing these issues. Specifically, it investigates whether the predominantly autonomous stance currently underpinning transgender healthcare, legislation and politics serves the best interests of transgender populations or whether advocating a duty of care imperative is a preferrable alternative to transgender care. To test the hypothesis that a duty of care standard produces superior transgender health and wellbeing outcomes over an autonomy-based approach, a literature review that included a broad range of data on the subject was conducted. Special consideration was given to transgender healthcare, legislative and political contexts, and their engagement with autonomy and duty of care philosophies. The findings demonstrated that upholding a duty of care imperative in the confrontation of transgender issues is more conducive to the attainment of diligent transgender personal and socio-familial quality of life and welfare goals. These results imply that existing transgender healthcare, legislative and political practices are inadequately targeting transgender difficulties. On this basis, a radical transformation of pertaining policies reflecting duty of care precepts is solicited and specific actions for change are proposed. Description: M.A. Bioethics(Melit.)

2022-01-01T00:00:00Z /library/oar/handle/123456789/101850 2022-09-20T06:18:53Z 2022-01-01T00:00:00Z

Title: The role of the general practitioner in advance directives Abstract: Patients have a right to self-determination, however, patients lacking mental capacity are not able to make autonomous decisions. Their right to self-determination can be preserved through the use of advance directives. Advance directives allow patients to make their preferences on future treatments in advance, just in case they lose the capacity to make the same decisions in the future. In spite of their commendable purpose, it is often argued that problems related to the creation and implementation of advance directives nullify their usefulness. A greater involvement of the general practitioner in the process of advance care planning is believed to be the answer. Obstacles to the creation of advance directives are generally attributable to problems affecting advance care discussions between patients and doctors. Primarily these include a lack of sufficient time for such discussions, doctor’s lack of training, and a fear of quashing the patient’s hope. Barriers attributable to the patient include lack of trust in the health provider, a lack of knowledge on the subject, and fear of creating familial conflict. Problems related to the implementation of advance directives affect one or more of three essential criteria: existence, applicability and validity. Uncertainties relating to any of the three criteria may preclude the use of advance directives. The attributes of general practice, such as continuity of care, patient-centredness and family orientation, and ease of accessibility, are all factors which position the general practitioner as the best answer to most of these problems. For advance directives to be effective they need legal-backing. Laws regulating advance directives are widespread, and while many include provisions that try to ensure the patient’s rights are protected, the general practitioner’s potential role is largely disregarded. An argument is made that giving greater importance to the general practitioner’s facilitating role within advance directive legislation can improve their successful creation and implementation. Description: M.A. Bioethics(Melit.)

2022-01-01T00:00:00Z /library/oar/handle/123456789/101847 2022-09-20T06:18:21Z 2022-01-01T00:00:00Z

Title: Allocating vaccines in a pandemic : strategic and ethical aspects Abstract: The issue around the allocation and distribution of COVID-19 vaccines and who deserves priority on a local and global level is a question of justice, best addressed by keeping the entire population's health as the primary objective. The benefits of vaccination during a pandemic extend beyond preventing mortality and morbidity since it effectively protects and promotes health within populations by eradicating and eliminating diseases. Moreover, globally it directly impacts public welfare, health and the economy whilst extending life expectancy. A comparative analysis of the three most prominent strategies recommended by the World Health Organisation, the Centers for Disease Control and Prevention and the European Commission will be discussed and analysed. The study briefly outlines the underlying ethical aspects of the respective strategies before comparing the frameworks. However, as observed during the pandemic, whether the allocation and distribution of vaccines are done justly is a point of contention, often due to conflicting interests. In an unprecedented effort to tackle the global crisis, governments, international institutions, and pharmaceutical companies created a milieu to develop safe and effective COVID-19 vaccines. Nevertheless, instead of making the vaccines available to everyone on a fair and equal basis, vaccine nationalism was prominent, where rich countries stockpiled vaccines instead of redistributing them to undeveloped countries. Hence, it is argued that if vaccines are allocated and distributed justly, with the common good in mind, then viral transmission is curbed more effectively. Consequently, the health and quality of life within any given population would improve significantly. Description: M.A. Bioethics(Melit.)

2022-01-01T00:00:00Z /library/oar/handle/123456789/101846 2022-09-20T06:16:52Z 2022-01-01T00:00:00Z

Title: Dying at home : retrieving a hospice palliative care practice through care ethics Abstract: This work will discuss dying at home as a practice which is being replaced by dying in a clinical setting thus giving rise to several end of life bioethical dilemmas. The combination of shifting death to the hospital and medical advances, paved the way to new bioethical issues pertaining to end of life care. A paradoxical situation in which on one hand life was being prolonged and on the other hand hastened, started to emerge. The emergence of hospice palliative care was a result of the dissatisfaction with how dying men and women were being cared for, and an attempt to offer an alternative, dignified care to the dying. The philosophy of hospice palliative care is considered to share common features with care ethics, and thus, a care ethics framework is deemed to be the most suitable in solving hospice palliative care ethical dilemmas. Considering caring for the dying from a care ethics approach gives a new meaning to the dying process as it is through care that humans connect, value each other, and respond to each other’s needs, values which are synonymous with hospice palliative care. The everchanging demographics wherein people suffering from a life-limiting disease are living longer, will result in an increased demand for hospice palliative care. This requires more support in terms of research, legislation, funding, awareness, and equitable access. The reinforcement and promotion of hospice palliative care as a form of care ethics might be the answer that counteracts end of life bioethical issues, only if society would learn to place more emphasis on caring rather than curing. Description: M.A. Bioethics(Melit.)

2022-01-01T00:00:00Z