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Advance Directives: Declarations by patients, made in advance of a situation in which they may be incompetent to decide about their own care, stating their treatment preferences or authorizing a third party to make decisions for them. (Bioethics Thesaurus)Advance Directive Adherence: Compliance by health personnel or proxies with the stipulations of ADVANCE DIRECTIVES (or similar directives such as RESUSCITATION ORDERS) when patients are unable to direct their own care.Living Wills: Written, witnessed declarations in which persons request that if they become disabled beyond reasonable expectation of recovery, they be allowed to die rather than be kept alive by extraordinary means. (Bioethics Thesaurus)Advance Care Planning: Discussions with patients and/or their representatives about the goals and desired direction of the patient's care, particularly end-of-life care, in the event that the patient is or becomes incompetent to make decisions.Life Support Care: Care provided patients requiring extraordinary therapeutic measures in order to sustain and prolong life.Proxy: A person authorized to decide or act for another person, for example, a person having durable power of attorney.Withholding Treatment: Withholding or withdrawal of a particular treatment or treatments, often (but not necessarily) life-prolonging treatment, from a patient or from a research subject as part of a research protocol. The concept is differentiated from REFUSAL TO TREAT, where the emphasis is on the health professional's or health facility's refusal to treat a patient or group of patients when the patient or the patient's representative requests treatment. Withholding of life-prolonging treatment is usually indexed only with EUTHANASIA, PASSIVE, unless the distinction between withholding and withdrawing treatment, or the issue of withholding palliative rather than curative treatment, is discussed.Legal Guardians: A legal concept for individuals who are designated to act on behalf of persons who are considered incapable of acting in their own behalf, e.g., minors and persons found to be not mentally competent.Mental Competency: The ability to understand the nature and effect of the act in which the individual is engaged. (From Black's Law Dictionary, 6th ed).Resuscitation Orders: Instructions issued by a physician pertaining to the institution, continuation, or withdrawal of life support measures. The concept includes policies, laws, statutes, decisions, guidelines, and discussions that may affect the issuance of such orders.Personal Autonomy: Self-directing freedom and especially moral independence. An ethical principle holds that the autonomy of persons ought to be respected. (Bioethics Thesaurus)Terminal Care: Medical and nursing care of patients in the terminal stage of an illness.Judicial Role: The kind of action or activity proper to the judiciary, particularly its responsibility for decision making.Patient Self-Determination Act: The purpose of this 1990 federal act is to assure that individuals receiving health care services will be given an opportunity to participate in and direct health care decisions affecting themselves. Under this act, hospitals, health care agencies, and health maintenance organizations are responsible for developing patient information for distribution. The information must include patients' rights, advance directives, living wills, ethics committees' consultation and education functions, limited medical treatment (support/comfort care only), mental health treatment, resuscitation, restraints, surrogate decision making and transfer of care. (from JCAHO, Lexicon, 1994)Right to Die: The right of the patient or the patient's representative to make decisions with regard to the patient's dying.Medical Futility: The absence of a useful purpose or useful result in a diagnostic procedure or therapeutic intervention. The situation of a patient whose condition will not be improved by treatment or instances in which treatment preserves permanent unconsciousness or cannot end dependence on intensive medical care. (From Ann Intern Med 1990 Jun 15;112(12):949)Ethics, Medical: The principles of professional conduct concerning the rights and duties of the physician, relations with patients and fellow practitioners, as well as actions of the physician in patient care and interpersonal relations with patient families.Euthanasia: The act or practice of killing or allowing death from natural causes, for reasons of mercy, i.e., in order to release a person from incurable disease, intolerable suffering, or undignified death. (from Beauchamp and Walters, Contemporary Issues in Bioethics, 5th ed)Personhood: The state or condition of being a human individual accorded moral and/or legal rights. Criteria to be used to determine this status are subject to debate, and range from the requirement of simply being a human organism to such requirements as that the individual be self-aware and capable of rational thought and moral agency.Patient Rights: Fundamental claims of patients, as expressed in statutes, declarations, or generally accepted moral principles. (Bioethics Thesaurus) The term is used for discussions of patient rights as a group of many rights, as in a hospital's posting of a list of patient rights.Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.Third-Party Consent: Informed consent given by someone other than the patient or research subject.Attitude to Death: Conceptual response of the person to the various aspects of death, which are based on individual psychosocial and cultural experience.Euthanasia, Passive: Failing to prevent death from natural causes, for reasons of mercy by the withdrawal or withholding of life-prolonging treatment.Persistent Vegetative State: Vegetative state refers to the neurocognitive status of individuals with severe brain damage, in whom physiologic functions (sleep-wake cycles, autonomic control, and breathing) persist, but awareness (including all cognitive function and emotion) is abolished.European Union: The collective designation of three organizations with common membership: the European Economic Community (Common Market), the European Coal and Steel Community, and the European Atomic Energy Community (Euratom). It was known as the European Community until 1994. It is primarily an economic union with the principal objectives of free movement of goods, capital, and labor. Professional services, social, medical and paramedical, are subsumed under labor. The constituent countries are Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden, and the United Kingdom. (The World Almanac and Book of Facts 1997, p842)Patient Preference: Individual's expression of desirability or value of one course of action, outcome, or selection in contrast to others.Double Effect Principle: Guideline for determining when it is morally permissible to perform an action to pursue a good end with knowledge that the action will also bring about bad results. It generally states that, in cases where a contemplated action has such double effect, the action is permissible only if: it is not wrong in itself; the bad result is not intended; the good result is not a direct causal result of the bad result; and the good result is "proportionate to" the bad result. (from Solomon, "Double Effect," in Becker, The Encyclopedia of Ethics, 1992)Judaism: The religion of the Jews characterized by belief in one God and in the mission of the Jews to teach the Fatherhood of God as revealed in the Hebrew Scriptures. (Webster, 3d ed)Nontherapeutic Human Experimentation: Human experimentation that is not intended to benefit the subjects on whom it is performed. Phase I drug studies (CLINICAL TRIALS, PHASE I AS TOPIC) and research involving healthy volunteers are examples of nontherapeutic human experimentation.Religion: A set of beliefs concerning the nature, cause, and purpose of the universe, especially when considered as the creation of a superhuman agency. It usually involves devotional and ritual observances and often a moral code for the conduct of human affairs. (Random House Collegiate Dictionary, rev. ed.)Hospice Care: Specialized health care, supportive in nature, provided to a dying person. A holistic approach is often taken, providing patients and their families with legal, financial, emotional, or spiritual counseling in addition to meeting patients' immediate physical needs. Care may be provided in the home, in the hospital, in specialized facilities (HOSPICES), or in specially designated areas of long-term care facilities. The concept also includes bereavement care for the family. (From Dictionary of Health Services Management, 2d ed)Hospitals, Religious: Private hospitals that are owned or sponsored by religious organizations.Dissent and Disputes: Differences of opinion or disagreements that may arise, for example, between health professionals and patients or their families, or against a political regime.Forensic Psychiatry: Psychiatry in its legal aspects. This includes criminology, penology, commitment of mentally ill, the psychiatrist's role in compensation cases, the problems of releasing information to the court, and of expert testimony.Palliative Care: Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)Physician-Patient Relations: The interactions between physician and patient.Nursing Homes: Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization.Family: A social group consisting of parents or parent substitutes and children.Mentally Ill Persons: Persons with psychiatric illnesses or diseases, particularly psychotic and severe mood disorders.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Patient Advocacy: Promotion and protection of the rights of patients, frequently through a legal process.Beneficence: The state or quality of being kind, charitable, or beneficial. (from American Heritage Dictionary of the English Language, 4th ed). The ethical principle of BENEFICENCE requires producing net benefit over harm. (Bioethics Thesaurus)Physician's Role: The expected function of a member of the medical profession.Forms and Records Control: A management function in which standards and guidelines are developed for the development, maintenance, and handling of forms and records.Terminally Ill: Persons with an incurable or irreversible illness at the end stage that will result in death within a short time. (From O'Leary et al., Lexikon: Dictionary of Health Care Terms, Organizations, and Acronyms for the Era of Reform, 1994, p780)Legislation, Medical: Laws and regulations, pertaining to the field of medicine, proposed for enactment or enacted by a legislative body.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Attitude: An enduring, learned predisposition to behave in a consistent way toward a given class of objects, or a persistent mental and/or neural state of readiness to react to a certain class of objects, not as they are but as they are conceived to be.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Informed Consent: Voluntary authorization, by a patient or research subject, with full comprehension of the risks involved, for diagnostic or investigative procedures, and for medical and surgical treatment.Communication Barriers: Those factors, such as language or sociocultural relationships, which interfere in the meaningful interpretation and transmission of ideas between individuals or groups.Hospitals, Military: Hospitals which provide care for the military personnel and usually for their dependents.Treatment Refusal: Patient or client refusal of or resistance to medical, psychological, or psychiatric treatment. (APA, Thesaurus of Psychological Index Terms, 8th ed.)Patient Education as Topic: The teaching or training of patients concerning their own health needs.Patient Participation: Patient involvement in the decision-making process in matters pertaining to health.Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders.Cultural Diversity: Coexistence of numerous distinct ethnic, racial, religious, or cultural groups within one social unit, organization, or population. (From American Heritage Dictionary, 2d college ed., 1982, p955)Comprehension: The act or fact of grasping the meaning, nature, or importance of; understanding. (American Heritage Dictionary, 4th ed) Includes understanding by a patient or research subject of information disclosed orally or in writing.Assisted Living Facilities: A housing and health care alternative combining independence with personal care. It provides a combination of housing, personalized supportive services and health care designed to meet the needs, both scheduled and unscheduled, of those who need help with activities of daily living. (www.alfa.org)GermanyHomes for the Aged: Geriatric long-term care facilities which provide supervision and assistance in activities of daily living with medical and nursing services when required.Communication: The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.Public Opinion: The attitude of a significant portion of a population toward any given proposition, based upon a measurable amount of factual evidence, and involving some degree of reflection, analysis, and reasoning.Medical Staff, Hospital: Professional medical personnel approved to provide care to patients in a hospital.Physicians: Individuals licensed to practice medicine.MarylandHealth Knowledge, Attitudes, Practice: Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).Truth Disclosure: Truthful revelation of information, specifically when the information disclosed is likely to be psychologically painful ("bad news") to the recipient (e.g., revelation to a patient or a patient's family of the patient's DIAGNOSIS or PROGNOSIS) or embarrassing to the teller (e.g., revelation of medical errors).United States