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Opinions of the students of the South Bohemia university about selected ethical problems of the health care
RAZIMOVÁ, Pavlína
This Bachelor thesis is focused on ethical issues in medicine, namely in communication between physician and patient, further on euthanasia, interruption and transplantation. This work is divided into two parts. The theoretical part introduces the theme of the thesis. It provides the basic information about ethics, about the relationship between physician and patient and their communication, about patient´s rights, about euthanasia, interruption and transplantation, too. The practical part reflects opinions of the students of the South Bohemia university in České Budějovice of these ethical matters. The analysis is based on quantitative research, which was performed by anonymous questionnaire in electronic form. The obtained data are processed in tabular and graphic forms.
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Patient's status and rights during emergency medical services
ZRŮSTOVÁ, Simona
It is necessary to consider each patient to be a unique entity and respect his or her rights. This position requires an individual approach of paramedics. They should give the client a sense of security, certainty of assistance and take into account the fact that the patient is exposed to stress, which can change his behaviour. The paramedic must cope with these facts, he cannot be influenced, he must know how to prevent conflicts and behave according to the rules of medical ethics. The aims of this thesis was to map out the level of knowledge of patients in the area of their rights, and to find out their views on the attitude and behaviour of the paramedics during an intervention of a medical rescue service. The third part of this bachelor thesis deals with the knowledge of paramedics in the area of the patients' rights and their observance of these rights. Three research questions were set up. Whether the legal awareness among patients regarding the intervention of medical rescue services is sufficient and how patients evaluate the attitude and behaviour of paramedics during the intervention. A research question was also set up for the third aim of this thesis: what is the point of view of paramedics on respecting the patients' rights during pre-hospital emergency care. In the theoretical part I focused on explaining of the basic concepts of the medical ethics issues, its history and development. The most important part of the thesis is the ethic of emergency medicine and the issues of the rights of patients during prehospital emergency care. The thesis also discusses the ethical dilemmas that paramedics deals with during their responses and an equally important area is focused on different patients' rights, including legal standards that modify them. The research part consists of interviews with two groups of respondents: eight paramedics of the Ambulance Service of Pardubice Region and eight patients who used their services. The research showed that the legal awareness of patients is inadequate. At first glance, all patients were satisfied with the intervention of the medical rescue service and had no objections. After targeted questions targeted on the compliance of individual patient's rights, I concluded that in some cases the right to privacy and dignity of the patient was not respected. The patients were not sufficiently informed about their health and procedures that paramedics performed. None of the interviewed paramedics complied the patient's right to know the name of the medical staff member who treated him. The paramedics themselves commented on the issue of the rights of patients during the pre-hospital emergency care in the sense that they try to comply these rights, but they had problems with is not always possible. They are aware of the ethical code of the rights of patients, but they had problems with telling its content. The most frequent reason for non-compliance of the rights of patients was reported in connection with responses to people under the influence of alcohol, drugs or to patients with disorders of consciousness. The surprising result of the research was the finding that half of the responding paramedics have used violence against a patient during their practice. Among the groups of patients, to whom the responding paramedics do not like to drive, are mostly Romani people, homeless people and repeatedly calling patients. This bachelor thesis will contribute to a better awareness of paramedics and the general public about the respecting the rights of patients. Paramedics can use the observations of patients and by that remove the deficiencies they have been committing during their responses.
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An ethical duty of the Hippocratic oath today
PETRŮ, Martina
The Hippocratic Oath probably comes from the 4th - 5th century BC. It is traditionally attributed to ancient physician Hippocrates or one of his disciples. It was created as a moral guide to behavior of physicians and it describes fundamental ethical principles of their profession in relation to the surroundings, family, teachers and the patient. In its time it represented a revolutionary rule.Text of the Hippocratic Oath has functioned as an oath sworn by inchoative physicians for centuries. Today it is replaced by a medical oath, which, in its different variants, is based on ethical Hippocratic requirements related to quality of contact between the physician and the patient. Changes in the Hippocratic Oath are mainly related to the development of surgery, transplantation, euthanasia, etc. The Hippocratic Oath refuses surgical interventions, because in times when it was created, these principles were in conflict with beneficence and intactness.This is the reason why it also rejects euthanasia and abortion.Nowadays, these interventions are already legalised in some countries to a certain extent and are applied according to relevant principles. Target of this Bachelor´s thesis was to find out what significance is attached to the Hippocratic Oath today. The thesis was conceived as a theoretical and historical comparative study aimed at the interpretation of content of the Hippocratic Oath, its further historical development and its today's validity or applicability. It was examined whether its text can compete in present times and which parts are still valid and which have been overcome. For this purpose, there was used a comparison of interpretation of content of the Hippocratic Oath with present moral codes in medicine, specifically with the Czech Medical Chamber Code and the Nurse Code of Ethics.In the introductory chapter of my Bachelor´s thesis, there are defined basic concepts related to the Hippocratic Oath, such as ethics, morality, medical ethics, relations between ethics and the law and basic medical principles. The next chapter deals with the author of the Oath, his teachings, times and circumstances of creation of the Hippocratic Oath, development of changes in the text of medical sponzes connected to changes in the society. The third chapter is dedicated to history of medicine from death of Hippocrates to present days.The last section is dedicated to the text analysis of the Hippocratic Oath in connection with current status of the medical field, and at the same time there was carried out a comparison of its text with applicable codes mentioned above. Aim of this thesis, in addition to interpretation and validity findings of the Hippocratic Oath, is to reveal identical and different elements referring to its text in the codes. Mutual comparison revealed that ethical issues of both codes are in accordance with the Hippocratic Oath. General ethical principles like decency, thoughtfulness and mutual respect are concepts, which have effect even today. I would say that in some points the Hippocratic Oath is obsolete and does not have anything to offer today. However, the opposite is true. Nowadays, medicine develops at an incredible pace and good relations between the physician and the patient slowly fade away. The patient is increasingly becoming some kind of material substance. Physicians often carry out their work under pressure of environment, insurance companies, pharmaceutical and other companies. Decency, empathy and good manners are disappearing. Nowadays, the Hippocratic Oath cannot fully encompass all complicated relationships and problems physicians face during their performance of their occupation, and according to these problems they should choose actual ethical practices. Despite its age, however, it is still accepted by laical and professional public for its unquestionable moral legacy.
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Transplatantion and ethics - general awareness (preliminary survey)
FARKAŠOVÁ, Markéta
This bachelor's thesis deals with the ethical issues of transplantation and its awareness by the general public. The theoretical part of the thesis is focused on the description of the most common ethical issues of transplantation. In modern era the transplantation of tissues and organs is generally seen as positive and emphasized clinical method, but still there are some certain ethical dilemmas. The very problem is the fact that this topic is only few communicated in the public and the citizens, speaking about the specific situation in the Czech Republic, have in certain parts the mistaken awareness of the function of the transplantation system "Opting out" which presumes the posthumous agreement with taking of tissues and organs after the death of the patient. The aim of the bachelor's thesis is to find out first what ethical aspects of transplantations are identified by the experts and whether according to their awareness the general publics have the interest in transplantations. Subsequently, the pre-research survey questions collect whether the answers from the citizens correspond with the answers of the expert representatives and also whether the respondents consider the current system in the Czech Republic as functional and ethically acceptable. Based on the described objectives the primarily qualitative research was chosen, managed by interviewing technique and semi-structured interviews with medical transplantologist, medical lawyer and bioethicist. From these interviews the important ethical aspects were analyzed from which further survey questions that have been tested on a sample of 130 respondents were prepared. The processed survey is the result of the bachelor's thesis and serves only as a pre-research of the pilot study. The results of interviews point to an existence of certain ethical issues connected with transplantations. Subsequently created and validated survey reflects the awareness of Czech Republic citizens of selected topic. Despite the fact that collected data from survey answers are considered as a guide and in fact indicative, some of the registered data is surprising. Among these belongs also e.g. the absolute majority of most respondent conviction of the possibility of illegal trade with organs in the Czech Republic. Other points of interest include the slightest awareness of such citizens who do not want to be donors upon their death. The positive result can be the fact that most of the surveyed respondents wish and agree with posthumous collection of their tissues and organs. Immediately we do learn that about the half of respondents is not well familiarized with currently working system of transplantations in the Czech Republic that assumes the agreement with posthumous collection of tissues and organs. Based on these findings, this created survey with specific slight changes, can be used in the future for quantitative more detailed investigation focused on the mentioned respondents according to pre-research results.
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Consent in hospital - theory and practice
SÝKOROVÁ, Marta
The diploma thesis is divided into a theoretical and a practical part. The first part describes the current state of the issue of informed consent in a general context and related topics. To obtain the data, I used the qualitative research, the method of questioning, and the data collection technique of a semi-structures interview. The research sample group consisted of 11 patients and two doctors. The objective of the thesis was to identify and describe the differences between the theory and the practice of informed consent in the hospital, and to find out whether there has been any shift in the mistakes and errors associated with informed consent as stated by Haškovcová (2007). The research results have shown that the interviewed patients are not familiar with the concept of informed consent. The knowledge of the informed consent concept was more accurate by doctors as presumed. On the issue of viewed benefits of informed consent, it is clear from respondents? answers that informed consent is viewed primarily as doctors? legal protection against any complaints or lawsuits made by the patients in the performance of their profession by making the patient familiar with any complications that may occur during the performance. This benefit is perceived by both patients and doctors. Doctors see its benefit also as the protection of patients. Another benefit viewed by doctors is the written informed consent form. Six of the interviewed patients stated that informed consent was submitted to them to sign by the nurse/male nurse without proper instructions. Furthermore, doctors? answers show that the timing of instructions depends on the nature of the surgery, whether it is planned or acute. However, some patients said that they were not even instructed with the sufficient time after giving informed consent even when related to a planned procedure. The most stated form was the combination of written and oral instructions, so the patient was first instructed orally and then he was also handed a detailed description of the particular procedure in the written form. There was no uniformity about the question of the amount of submitted information among the interviewed patients as well as doctors ? some of them prefer just basic information, some of them want to know all the information. One of the interviewed doctors favored just the adequate informed consent and saw the detailed informed consent as problematic, another doctor preferred introduction of all the details, although in the written form, mainly because of legal protection. In terms of quality of the provided information, it is clear from the statements of the patients that two most important facts for them are that the performance is in their benefit and the duration of hospitalization. All patients have agreed on the fact that it is very good that they are informed about the procedure which will be performed on them. However, they were not united regarding the issue of participation in the decision ? two patients stated that not even the properly informed patient should participate in the decision about their treatment. Only one doctor expressed his stance to the patient?s participation in the decision stating that he tries to persuade his patients that his proposed solution is the optimal. The standard for the patients is to ask questions when they are concerned about something or interested in it. However, the statements showed that they do not always get the answer they are satisfied with. When the patients stated that they do not ask their doctors about anything, their reasons were enough information, lack of staff and a feeling of unwillingness on the part of doctors. If the patients did not receive enough information from the medical staff, they looked for it in other sources of information. This thesis points to the broader psychosocial context of informed consent, so its results may help during the training of staff in the assisting professions.
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Ethical Aspects of Organ Transplantations
ČANDOVÁ, Jana
In the introduction the theses deals with change of medicine paradigma and shows development and changes of transplantation method. Then is discussed the classification of transplantation and presents general conditions and biological positions, which are connected with medical ethics of organ transplantations. There are presented (and discused) important ethical aspects of cadaveric transplantation, problems of live organ donors and question of xenotransplantation. Relevant International ethical codes and legislation in the Czech Republic is also mentioned. The analysis at the end shows the urgency to engage in the problems of extended posibilities and the need of taking some limits. It is also necessary to educate professional, responsible and empathic physicians.
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A NEW CONCEPT OF HEALTH CARE IN THE CZECH REPUBLIC IN RELATION TO PUBLIC ADMINISTRATION
Bouša, Ladislav ; Loužek, Marek (advisor) ; Krebs, Vojtěch (referee)
Thesis "A NEW CONCEPT OF HEALTH CARE IN THE CZECH REPUBLIC IN RELATION TO PUBLIC ADMINISTRATION "deals with health care in the Czech Republic. In the most economically developed countries health care is becoming a part of their health care policy. The diploma thesis reflects the health reform efforts in recent years of economic reality in the Czech Republic. The state acts as a guarantor, whose task is to regulate health care, establish legal and economic rules and thereby to ensure availability. Focus of the thesis is analytical and descriptive. The introductory chapter describes the health systems, the second focuses on the legal framework and then the third on the demographic and health status of the population. The focus of the work is in the fourth chapter, this chapter describes the economics of health policy, financing of individual groups, the fifth drug policy. Consistency of health care associated with the Czech Republic's accession to the EU, its principals and strategies are presented in the final chapter
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Ethical aspects of prenatal diagnosis
ŠIROKÁ, Barbora
The thesis deals with the applications of ethical principles in prenatal diagnosis. The introduction is devoted to the phenomenon of life and its aspects. The professional medical part characterises the preimplantation and prenatal diagnosis and methods used during the care of pregnant. The ethical part of the thesis describes the origin, the approaches and concepts of bioethics. Further it defines each of bioethical principles which are based on bioethics. At the end of the third chapter various aspects and problems of medical ethics are shown. The aim of the last chapter of this thesis is the ethical reflection in which the different diagnostic methods are examined in terms of bioethical principles. It´s followed by analyzing the current situation ethics of prenatal diagnosis in the Czech Republic. Comparison of different opinions from professionals in this field is interesting and surprising. The fourth chapter is concluded with specific case studies of pregnant women. Conclusions include evaluation and comparison of available information and express my own view on the issue.
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The Medical Ethics Of Terminal Care
KYLBERGEROVÁ, Radka
The main subject of this thesis is a reflection issue of the terminal care ethics. The structure of the thesis consists of four thematic units. The first part is the introduction to the concept of medical ethics: the description of the subject, the historical development and its principles. The second block of the thesis focuses on the biggest existential event of human life ? death, and the human approach to death and dying. The search for the meaning of life and for the meaning of suffering be
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Ethical aspects of conventional and alternative medicine
KRČÁL, Petr
The Bachelor Thesis deals with an analysis of ethical aspects of conventional and alternative medicine, particularly with ethical dilemmas resulting from application of alternative and scientific medicine and with an insight into possible correspondences and differences between both the treatment methods. The theoretical part contains description of the current problems of the topic, particularly the ethical sources, modern philosophical schools, basic principles of ethical behaviour, explanation of the term alternative medicine and types of alternative treatment methods.
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