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The meaning of the dead donor rule in current transplantion ethics
Rusinová, Kateřina ; Šimek, Jiří (advisor) ; Kieslichová, Eva (referee) ; Hříbek, Tomáš (referee)
The thesis presents current understanding of the concept of death and criteria for diagno- sis of death in the context of organ donation. We will argue that 1) the dead donor rule should not be the necessary condition for retrieving organs for transplantation and 2) it should be permissible to retrieve organs from patients that are imminently dying (not dead yet), with respect to the principle of autonomy and non-maleficence. We will first present the impossibility and current inconsistencies in determining the exact "moment of death" and we will then demonstrate that current organ donors do not fulfill biological criteria for death and that the dead donor rule is not respected in clinical practice. We suggest that in the context of recent major technological advances in the field of critical care medicine the dead donor rule becomes irrelevant and does not contribute to the transplantation ethics. The legal concept of death and the biological phenomenon of death become more and more distant. We argue that declaring death is not necessary for ethically justified policy in transplantation. Both the societal trust and the protection of vulnerable individuals can be ensured by different ethical principles (i.e. the principle of autonomy and the principle of non- maleficence). The sound ethical...
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Philosophical aspects of health care decision making at the end of life
Heřmanová, Jana ; Šimek, Jiří (advisor) ; Prudil, Lukáš (referee) ; Umlauf, Václav (referee)
Introduction: The relationship of the doctor and his patient is based on informed consent about proposed treatment and care. Informed consent is derived from the principle of respect to patient's autonomy and the right patient for self-determination. Decision making at the end of life is complicated by the fact that in some situations the patient is not able to state his preferences and sign the legal document of informed consent. Thesis: Proper implementation of advance directives using hermeneutics as a method of text interpretation represents application of an informed consent at the end of life in a patient who at that time is not able to sign the legal document. Aim and methods: The aim is to describe and analyze the situation of patients at the end of life and point to some ethical dilemmas in the work of healthcare workers and family carers. Other aim was to search for a way how to manage the care of a seriously ill incompetent patient that would be in accord with his previous wishes and value preferences. Review of the relevant literature was used to analyse the philosophical nature of advance directives and their implementation in future concrete situation. The possibility of interpretation of advance directives by hermeneutic method was also addressed. Results: A patient who writes...
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Self-care as a Sign of Autonomy in the Health Care Process
Halmo, Renata ; Šimek, Jiří (advisor) ; Ivanová, Kateřina (referee) ; Dolista, Josef (referee)
Thesis: The main contribution of D. Orem's self-care theory is that, using adequate methods, it leads the nurses to respect patients' own conception of self-care. Key words: Patient - nurse relationships, Self-Care Deficit Nursing Theory, D. E. Orem, human actions, respect for autonomy, NANDA taxonomy, non-compliance, responsibility. This dissertation thesis deals with the issues of a relationship between a patient and a healthcare worker, or more precisely a nurse, all from the point of view of patient self-care in the sense of deliberate action that is conducted by the patient for the purpose of sustaining their health and realizing their life plans. Ethical aspects of Orem's Self-Care Deficit Theory consist in the approach to a person that emphasizes the human nature of a human being that develops within the community - among other people, that becomes unique and that cares about their own being. Self-care deficit nursing theory is compared to NANDA taxonomy II with respect to a patient's autonomy. Both approaches to nursing care are studied from the point of view of their assumptions, theoretical basis, the diagnostic process, communication, personal competence of nurses and the aims of health care. Attention is also paid to the situations when a patient is not willing to take part in the...
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Moral arguments in consideration of courts when applying law
Šimek, Jiří ; Wintr, Jan (advisor) ; Maršálek, Pavel (referee)
This thesis deals with relationship of law and morals from the perspective of a judge applying the law. It starts by defining morals as a normative system which determines what is good and what is bad. Bad morals are punished by social sanction. The relationship of content of morals and law can be described as an intersection. There are three possible relationships of the area of law and morals regarding their respective application: (i) area which should be regulated only by moral rules; (ii) area which should be regulated only by law; and (iii) common area for both normative systems. Morals can penetrate reasoning of a judge applying the law at least in three ways: Firstly, Legislator can order the judge to drag a moral norm into his consideration. Such an order is called boni mores (dobré mravy) in Czech legal system (used in Section 3 or Section 39 of Czech Civil Code). Secondly, the school of phenomenology hermeneutics claims that any interpretation, thus interpretation of law as well, is conditioned by existence of so called pre-structures. We cannot get rid of these structures, they create necessary interpretative frame of interpreting individual. Moral feelings or moral attitudes are parts of these pre-structures. Morals can project to the decision-making of judge knowingly or unknowingly through...
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The Role of Physical Impairment in a Partnership (Medical Anthropology)
Kovářová, Eva ; Šimek, Jiří (advisor) ; Klepal, Jaroslav (referee)
Couples of a physically disabled person and an able bodied one are being considered odd and exceptional by many people and furthermore associated with many prejudices and myths. The most common is probably the assumption of this relationship as an unequal and being rather a kind of carer and cared. The aim of this thesis has been to uncover the world of a couple of a person with acquired physical disability and his/her able bodied partner and to determine the impact of a physical disability and physical limitations stemming from the impairment on the inner life of the couple, a character of this relationship and the impact of the physical impairment on the social roles of the physically disabled person as a partner or potentially a parent. Acquired physical disability as a consequence of a spinal cord injury or a disease is a sudden and essential change in all three areas of a human being - physical, mental and social. In case of pre-injury/illness relationships I have been interested in the impact of this fundamental and unchangeable turnaround of existing conditions and life style on the couple. The theoretical phrame for this thesis has been phenomenological philosophy for its concern in the subjective experience regarded as a basis for further investigation and analysis and for its concept of...
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Informed consent
Roiková, Kateřina ; Šimek, Jiří (advisor)
Informed consent is one of the most important institutes of medical law and medical ethics. Any medical procedure may be performed only with the free consent of the patient and the patient must be appropriately doctor informed about all circumstances procedure which should subsequently based on the diagnosis undergo. The patient has the right to withdraw your consent at any time
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Women's Free Will in the Caesarean Section Indication
Křepelka, Petr ; Payne, Jan (advisor) ; Šimek, Jiří (referee) ; Calda, Pavel (referee)
Currently, Caesarean section is the most commonly indicated procedure. The proportion of caesarean deliveries continues to rise and the spectrum of surgical indications has broadened dramatically. This contemplation focuses on the ethical dilemmas arising during the indication of a Caesarean section: a refusal of a Caesarean section by a pregnant woman when there is a rationally-empirical indication and an enforced Caesarean section. The importance of the woman free will in the process of operating indication closely relates to the issue of the Caesarean section upon request. The assessment of the ethical acceptability of the individual surgical indications is performed on the grounds of confrontation of the pregnant woman's dignity and the dignity of human fetus and subsequently by reflections on theoretical duties and resulting parental responsibilities on the one hand and the right to self-determination of a pregnant women on the other. The fetal dignity is given by its value, attributed to it by the pregnant woman and by the human society. It has always been inferior to the dignity of a pregnant woman. Determining of specific positive duties a pregnant woman has towards the fetus is a very controversial issue and it is impossible to codify them legally despite the unquestionable social character of a...
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Home care: its role in prevention of seniors're-hospitalization
Staňa, Jiří ; Šimek, Jiří (advisor)
V Praze 10. 6. 2016 Oznámení Na základě opatření rektora č. 6/2010 Zpřístupnění elektronické databáze závěrečných prací a Opatření děkana č. 12/2010, kterým se stanovují Pravidla pro evidenci, odevzdávání a zveřejňování závěrečných prací, probíhá na 3. lékařské fakultě Univerzity Karlovy v Praze doplňování elektronických verzí u starších prací obhájených v období od 1. 1. 2006 do 28. 9. 2010 do Studijního systému informačního systému UK. Omlouváme se, tento dokument není dostupný pro zpětnou digitalizaci. MUDr. David Marx, Ph.D. proděkan pro studium a výuku 3. LF UK
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