Browsing by Subject "Respect"

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    Respect and shared decision making in the clinical encounter, A Video-Reflexive Ethnography
    (2017-05) McLeod, Heidi
    Background: Shared decision making (SDM) is key for improving the quality of healthcare delivery. Respecting patients’ preferences and values is integral to SDM, so it is intuitive that respect is also important for SDM. Yet, there is room for further studies on respect. This study describes what respect means to patients and clinicians and how respect is related to SDM in primary care clinical encounters. Methods: A Video-Reflexive Ethnography (VRE) with 40 hours of video recordings from 15 primary care clinical encounters and 27 video-reflexivity sessions. Clinicians (14), patients (13) and caregivers (3) were invited to share their perspectives on respect and decision making in individual reflexivity sessions. The video-reflexivity sessions were video-recorded and transcribed. A grounded theory analysis was conducted. Results: This study extends current descriptions of respect to include respect for both ‘patients and clinicians as persons’ in the clinical encounter. It also highlights an affective and emotional aspect of respect. Respect is described as ‘valuing individuality’ (patients and clinicians as persons in a broader social context), ‘valuing agency’ (patients’ ability to influence the encounter and future care) and ‘valuing feeling comfortable’ (at-ease and open). Respect is relevant in all types of decision making in primary care clinical encounters (clinician-led, patient-led and shared). SDM in primary care should be seen as a process, carried out over time. Regardless of who makes the decision, participants described attributes of respect that enabled them to accept the process and the decision. Throughout the clinical encounter, clinicians highlighted institutional factors that influenced the extent to which respect was evident. Both patients and clinicians described respect as being co-created by them interacting in the encounter in ways that involved additional work and effort. Conclusion: Respect is valued by both patients and clinicians, but it is not always easy to practice. Training and re-structuring the institutional constraints that clinicians face may facilitate respectful encounters. Respect may influence patients wanting to see their clinician again improving continuity of care; may encourage both clinicians and patients to open up in ways that strengthen the relationship; and may lead to partnership in treatment planning affecting adherence.
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    Shame, Respect and Well-Being: What Can We Learn from Early Chinese Philosophy?
    (2023-05) Li, Qiannan
    My dissertation aims to bring insights from early Chinese Philosophy into constructive dialogue with Western thought to enrich our philosophical understanding of two significant philosophical questions. First, what is the moral value of the feelings of respect and shame? Second, what are the necessary constituents of a well-lived life? I compare the predominant accounts of respect, shame, and well-being in the Western tradition with the Confucian and Daoist traditions on these topics. I show that a mutual understanding of both perspectives yields a more comprehensive picture of moral emotions and well-being. First, I propose an account of well-being inspired by an early Daoist philosopher Zhuangzi and compare it with the predominant accounts of well-being in Western philosophy. The comparison aims to demonstrate the prudential value of a good process of cultivating well-being, which tends to be ignored in Western theories that focus on achievements. On the moral value of shame, I provide a Confucian analysis of shame and compare it with the Aristotelian account. This comparison aims to challenge the view that shame feelings reflect a person’s damaged self-esteem. Instead, by borrowing insights from the early Confucians, we can see that the disposition to feel shame has moral value in itself and is constitutive of our need to value ourselves in order to feel worthwhile. On the moral value of respect, I compare the Confucian account of respect with the Kantian account. For early Confucians, the notion of respect not only refers to intentional feelings (feelings directed at specific objects) but more frequently refers to a respectful frame of mind. I argue that a Confucian notion of respectfulness helps to extend Kantian respect beyond Kant’s own target of rational agency to respect the elderly and people with mental illness whose rational capacities have been impaired.