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  • 1.
    Bremer, Anders
    Högskolan i Borås, Institutionen för Vårdvetenskap. Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Etiska frågeställningar vid drunkning2014Konferansepaper (Annet vitenskapelig)
    Abstract [sv]

    WHO uppskattar att 450 000 människor årligen avlider i världen till följd av drunkning, varav majoriteten är barn. Hjärtstopp och plötslig död som orsakas av drunkning är betydligt vanligare i låginkomstländer. Detta innebär att många liv går förlorade till följd av drunkningsolyckor, samtidigt som fattiga länder drabbas särskilt hårt. Mot bakgrund av detta framträder den etiska frågan: Hur kan fler liv räddas? Även rättviseprincipen blir viktig och bör rimligen föranleda åtgärder för att förhindra drunkning och rädda drunkningsoffer i särskilt utsatta delar av världen. Vilket ansvar har vi i Sverige för detta arbete?

    Etiker använder ofta drunkning som exempel för att tydliggöra den moraliska plikten att rädda liv. Vid ett drunkningstillbud kräver denna plikt specifika förmågor, mod och självuppoffring. Ett fullgörande av plikten kan å ena sidan riskera egna förluster och ytterst det egna livet, och å andra sidan ge belöning i form av självaktning och framför allt minskat lidande och död för andra. Plikten att göra allt för patientens bästa grundas i godhetsprincipen som innebär att främja nyttan för den drabbade, samtidigt som riskerna med fortsatta återupplivningsförsök övervägs i ett senare skede. Här framträder den etiska frågan: Hur kan liv räddas, samtidigt som överlevnad till ett ovärdigt liv minimeras?

  • 2.
    Bremer, Anders
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Etiska värderingar inom spansk och svensk ambulanssjukvård2015Konferansepaper (Annet vitenskapelig)
  • 3.
    Bremer, Anders
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Sandboge, Samuel
    Rosengren, Ewa
    Etiska ”knäckfrågor” inom HLR2016Konferansepaper (Annet (populærvitenskap, debatt, mm))
  • 4.
    Heidenreich, Kaja
    et al.
    Örebro University.
    Bremer, Anders
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd. Linnaeus University.
    Materstvedt, Lars Johan
    Norwegian University of Science and Technology.
    Tidefelt, Ulf
    Norwegian University of Science and Technology.
    Svantesson, Mia
    University of Glasgow.
    Relational autonomy in the care of the vulnerable: Health care professionals' reasoning in Moral Case Deliberation (MCD)2017Inngår i: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In Moral Case Deliberation (MCD), healthcare professionals discuss ethically di cult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical re ection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals’ moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis. The moral reasoning centred on how to strike the balance between personal convictions about what constitutes good care, and the perceived dissonant care preferences held by the patient. The healthcare professionals deliberated about good care in relation to demands considered to be unrealistic, justi cations for in uencing the patient, the incapacitated patient’s nebulous interests, and coping with the con ict between using coercion to achieve good while pro- tecting human dignity. Furthermore, as a basis for the reasoning, the healthcare professionals re ected on how to establish a responsible relationship with the vulnerable person. This comprised acknowledging the patient as a susceptible human being, protecting dignity and integrity, de ning their own moral responsibility, and having patience to give the patient and family time to come to terms with illness and declining health. The profound struggle to respect the patient’s autonomy in clinical practice can be understood through the concept of relational autonomy, to try to secure both patients’ in uence and at the same time take responsibility for their needs as vulnerable humans. 

  • 5.
    Heidenreich, Kaja
    et al.
    Faculty of Health and Medicine, University Health Care Research Center, Örebro University.
    Bremer, Anders
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Materstvedt, Lars Johan
    Department of Philosophy and Religious Studies, Faculty of Humanities, Norwegian University of Science and Technology (NTNU).
    Tidefelt, Ulf
    Faculty of Health and Medicine, University Health Care Research Center, Örebro University.
    Svantesson, Mia
    Faculty of Health and Medicine, University Health Care Research Center, Örebro University.
    Relational autonomy in the care of the vulnerable: Health care professionals' reasoning in Moral Case Deliberation (MCD)2017Inngår i: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 35, s. 37-42Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In Moral Case Deliberation (MCD), healthcare professionals discuss ethically difficult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical reflection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals’ moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis. The moral reasoning centred on how to strike the balance between personal convictions about what constitutes good care, and the perceived dissonant care preferences held by the patient. The healthcare professionals deliberated about good care in relation to demands considered to be unrealistic, justifications for influencing the patient, the incapacitated patient’s nebulous interests, and coping with the conflict between using coercion to achieve good while pro- tecting human dignity. Furthermore, as a basis for the reasoning, the healthcare professionals reflected on how to establish a responsible relationship with the vulnerable person. This comprised acknowledging the patient as a susceptible human being, protecting dignity and integrity, defining their own moral responsibility, and having patience to give the patient and family time to come to terms with illness and declining health. The profound struggle to respect the patient’s autonomy in clinical practice can be understood through the concept of relational autonomy, to try to secure both patients’ influence and at the same time take responsibility for their needs as vulnerable humans.

  • 6. Nord, Anette
    et al.
    Lundgren, Johan
    Bremer, Anders
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Carlsson, Jörg
    Israelsson, Johan
    Apropå! – HLR och rätten till en värdig död2016Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 20Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 7.
    Sandman, Lars
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Bremer, Anders
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Etik inom ambulanssjukvården2016Inngår i: Prehospital akutsjukvård / [ed] Björn-Ove Suserud & Lars Lundberg, Stockholm: Liber , 2016, 2, s. 26-39Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 8.
    Ågård, Anders
    et al.
    Sahlgrenska University Hospital.
    Bremer, Anders
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Sallin, Karl
    Uppsala University.
    Engström, Ingemar
    Örebro University.
    Ethical controversies when formulating new national guidelines on cardiopulmonary resuscitation in Sweden2017Inngår i: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101XArtikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The Delegation for Medical Ethics within the Swedish Society of Medicine has taken the initiative to create national ethical guidelines on cardiopulmonary resuscitation. The reasons behind this initiative were indications of differences in the way decisions about cardiopulmonary resuscitation were made and documented and requests expressed by health- care professionals for new national ethical guidelines. During the process of creating the guidelines, a number of work- shops were held with representatives from the delegation and clinical experts from various branches of medicine. Several versions of the working document were sent to consultation bodies with requests for comments. We therefore believe that the final guidelines are well supported by the medical profession in Sweden. The purpose of this article is to present ethical issues on which it was difficult to reach consensus due to divergent opinions expressed by the people and organisations involved. The arguments for and against a particular point of view or wording in the text are presented. The main controversies were related to the following six issues; Determining whether or not cardiopulmonary resus- citation is beneficial for the patient – The presence of close loved ones during cardiopulmonary resuscitation – Performing cardiopulmonary resuscitation for the benefit of people other than the patient – Ambulance personnel’s mandate to decide not to initiate and to terminate cardiopulmonary resuscitation outside hospital – Limiting the length and content of cardiopulmonary resuscitation – Whether or not to specify a week of gestation before which cardio- pulmonary resuscitation should not be started. 

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