Take your health into your own hands

Take your health into your own hands

Take your health into your own hands

On the patient’s side: the basic principles and rights of the patient

The basic principles accepted in our cultural tradition are: respect for the person, the principle of beneficence, the principle of non-maleficence, fairness and justice.

Respect for the person

Respect for the individual encompasses at least two fundamental ethical beliefs: first, that individuals should be treated as autonomous agents; second, that people whose autonomy is diminished have a right to be protected. The principle of respecting people, is thus divided into two distinct moral demands: recognizing autonomy and protecting those whose autonomy is diminished. An autonomous person is an individual capable of reflecting on his or her personal goals. Respecting autonomy means giving weight to the opinions and deliberate choices of autonomous people, refraining from obstructing their actions. To disrespect an autonomous person is to deny value to thoughtful judgments, to deny him or her individual freedom to act, or to refuse to provide him or her with the information necessary to make a judgment. However, not all human beings are capable of self-determination. Some people, lose this ability completely or partially, as we saw earlier, due to illness or mental incapacity.
Respect for the immature and incapacitated demands that we protect them throughout the maturation process and as long as they remain in a state of incapacity.

The principle of beneficence

To treat people morally, one must not only respect their decisions and protect them against harm, but also strive to ensure their well-being. However, the cause of harm must be known if it is to be avoided; and in seeking this cause people may be exposed to the risk of receiving some harm.

The principle of non-maleficence

This principle is expressed in not intentionally doing harm. But, like all others, this principle does not have absolute validity, so it is not necessarily connected with the defense of life, but it is also compatible with judgments around the quality of life, however problematic and ambiguous this notion may be.

Equity and justice

What is everyone’s due?
Injustice occurs when a benefit to which a person is entitled is denied to him or her without a valid reason. This principle relates back to the right to informed consent. The assisted person has the right to receive adequate information in advance regarding the purpose and nature of the intervention, as well as its consequences and risks. The person concerned may freely withdraw his or her consent at any time. Only the informed patient knows what is good for him.

Charter of the rights of the premature infant

On September 22, 2010, UN Secretary-General Ban Ki-moon, presented the Global Strategy for Women’s and Children’s Health to the UN General Assembly at which he urged the need for joint efforts.
Italy was the first to respond to this call with the presentation, on December 21, 2010, in the Senate of the “Manifesto of the Rights of the Premature Child,” the result of the efforts of a multidisciplinary team composed of neonatologists, gynecologists and parents’ associations.
The Manifesto contains the “Charter of Rights of the Child Born Preterm,” promoted by Vivere
Onlus, the national coordination of neonatology associations. This decalogue represents an important legal landing place for all children and for the rights of the person, as well as for the rights of the premature infant. It is the result of associationism, between public and private institutions as well as at the family level.
Here, we might consider its enactment, the fruit of social justice advocacy efforts. In fact, this charter was born out of the need to protect silent people, such as premature infants. This phrase is intended to mean an infant at high perinatal risk because he or she was born before the completion of the 37th week of gestation. Preterm birth prevents many organs from reaching the physiological maturation necessary to cope with the extra uterine environment.
This charter stems from the need to have institutions recognize the priority right of premature infants, to benefit in the immediate and future from the highest level of care congruent with their condition. What is stipulated in that charter, also concerns the rights of the newborn with illnesses requiring hospitalization.

Art. 1 states, “The infant born prematurely must, by positive law, be considered a person.” The premature infant is not a patient or subject but fully a person and therefore “in relationship,” and it is no coincidence that the Charter places great emphasis on relationships. The premature baby, even if in the incubator, attached to tubes and whatnot, is and should be considered a “person.”

Art. 2 states, “All children have the right to be born within a system of care that ensures their safety and well-being, particularly in conditions that pose a risk of preterm pregnancy/delivery/birth, feto-neonatal distress, and/or postnatal onset malformations.” This article is about all children and is a warning to all of today’s society, which offers welfare but can hardly offer safety.

Art. 3 states, “The premature infant has the right to all support and treatment congruent with his or her state of health and to therapies aimed at pain relief. In particular, he has the right to compassionate care and to the presence and affection of his parents even in the terminal phase.” We would like to emphasize the multidimensional perception of pain and the person, which is evident from the use of the expressions “pain relief” and “compassionate care.” The concluding expression, “even in the terminal phase,” is indicative of the protection of life until its end.

Art. 4 states, “The premature infant has the right to immediate and continuous contact with his or her family, by whom he or she must be cared for. To this end, the active presence of the parent next to the child must be supported in the care pathway, avoiding any dispersion among family members.” This article emphasizes, the role of the family unit in its entirety, not relegating only to the mother a significant role in the growth and care given to her child. This means that crucial, not only for the premature infant but for every child, are the parental couple and their relationships. Each parent’s role and function in family balance should be accentuated. This article also refers to the concept of “contact,” understood as physical and psychological, and the concept of continuity, which is also etymologically related to the concept of “containment” or holding.

Art. 5 states, “Every premature infant has the right to enjoy the benefits of breast milk throughout his or her hospital stay, and as soon as possible, to be breastfed at his or her mother’s breast. Any other nutrient shall be subject to individual prescription as complementary and subsidiary food.” This article draws attention to the extreme heterogeneity of the hospital situation in Italy, in that there are hospitals that practice “marsupiotherapy” (so called because the infant is placed on the mother’s chest) and other hospitals where, on the other hand, parents are only allowed to approach the incubator for a couple of hours a day.

Art. 6 states, “The hospitalized premature infant has the right to have parents properly informed in an understandable, comprehensive and continuous manner about the development of his or her condition and treatment choices.” This article emphasizes the consideration of the infant as a person by posing as a contrast to the depersonalization of the sick person.

Art. 7 states, “The premature infant has the right to have parents supported in acquiring their special and new parenting skills.” This article highlights the difference between generativity and parenting, emphasizing that parenting is the result of a conscious choice, with a time dimension
continuous and not just the expression of one’s own desire or need, limited in time.

Art. 8 states, “the premature infant has the right to continuity of care after hospitalization, pursued through an explicit personal care plan shared with the parents, involving expertise in the territory and which, in particular, provides, after discharge, for the implementation over time of an appropriate multidisciplinary follow-up, coordinated by the team that received and cared for the infant at birth and/or that is following the infant.” This article highlights the shift from “caring” medicine to “taking care.”

Art. 9 states, “In the case of outcomes involving disabilities of any kind and degree, the newborn child has the right to receive rehabilitative care as necessary and benefit from the appropriate integrated social, psychological and economic supports.” This article refers to the duty of solidarity as enshrined in Article 2 of our Constitution.

Art. 10 states, “Every family of a premature infant has the right to have its special needs met, including through collaboration between institutions and entities belonging to the Third Sector.” In this article we focus on the effectiveness of the interventions that are delivered.

Source: ” Mediserve‘s Intrapartum Care Models,” by Vittorio Artiola, Simona Novi, Salvatore Paribello, Ferdinando Pellegrino, Giuseppina Piacente, Andrea Vettori

Patient empowerment

Nothing about me, without me”

“Nothing I don’t know, not without me ”

This is the phrase that best expresses the concept of patient empowerment in the terms of the
Patient’s right and ability to make choices and take responsibility for the consequences of their choices…..

The Self-empowerment health education model originated in university research in multiple countries , which followed the Chronic Disease Self-Management Program developed by Stanford University’s Patient Education Research Center.

Source :
http://www.selfmanagementresource.com/

“Patient empowerment is a process that helps people gain control, through initiative, problem solving, and decision making, which can be applied in various settings in health and social care. But it is also the patient’s right and ability to make choices and take responsibility for the consequences of their choices.

“Patient empowerment─who empowers whom?” This is the title of a recent Lancet editorial[1] reporting on the first European Conference on Patient Empowerment, held in Copenhagen, Denmark, and organized by the European Network of the same name (ENOPE 2012).

Source: http://www.saluteinternazionale.info/2012/07/nothing-about-me-without-me/

The British Medical Journal also reports on the conference in its News section[2]. One definition of patient empowerment given by the conference organizers is: “a process that helps people gain control, through initiative, problem solving, and decision making, which can be applied in various contexts in health and social care.”

Recent literature, provides other definitions that, in addition to the process, take into account the goal, describing patientempowerment in terms of the
patient’s right and ability to make choices and take responsibility for the consequences of their choices
[3]. In general, the guiding principle is that of self-determination (“nothing about me, without me”)

Even in Europe, as evidenced by the Copenhagen Conference the use of this Program and the focus on patient empowerment is growing. There are now 11 European countries in which the Program is being adopted on a larger or smaller scale and with a systematic dissemination initiative ( as in the United Kingdom and Denmark ) or in a patchwork manner .In Italy , for example, it has been used by the Primary Care of many ASLs in several regions ( e.g., Tuscany, Emilia Romagna, Lombardy )

The Program and related studies have shown that informing and enhancing patient empowerment allows patients to positively influence nonfunctional disease-related behaviors.

Stanford University Stanford Patient Education Research Center Stanford University School of Medicine 1000 Welch Road, Suite 204 Palo Alto CA 94304 (650) 723-7935 voice – (650) 725-9422 fax http://patienteducation.stanford.edu [email protected]

Initial assessment and patient management: initial care

A physician grappling with a poisoning does not have a battery of antidotes available, and their use in medical practice is the exception.

Compared with other medical emergencies, acute poisoning is difficult to diagnose. Depressed subjects are often found unconscious with a letter and an empty tablet case next to them. Or a child is found gnawing and chewing on something inedible. Initially perhaps poisoning is not suspected, and only after the patient is resuscitated can the true cause of the condition be understood.

Examination of the patient

The physician must pay attention only to the patient and not to the inconsistent explanations of those who accompanied the victim. In the absence of critical symptomatology , a complete examination should be done by evaluating: level of consciousness, respiration, circulatory status, presence of seizures, pupil diameter, injection marks, body temperature, skin condition, and lesions.

Emergency treatment

Emergency treatment consists of resuscitative measures. If the patient is able to breathe spontaneously, you need to put him on his side, remove any obvious obstruction and intubate him.

If the patient, on the other hand, is unconscious, lateral decubitus is important, preferably with the head slightly down and avoiding tongue drop.

If the pulse is not regular, it is necessary to elevate the feet about 20° to promote venous return to the heart.

If the patient has seizures , intravenous injections of 5-10 mg dizepam should be given immediately. If, on the other hand, he has inhaled toxic gases or vapors, it is necessary to remove him from the polluted environment and ensure adequate ventilation.

Finally, if the patient has eyes, skin and clothes contaminated with toxic material, it is necessary to immediately flush the eyes with saline solution, remove the clothes and wash the contaminated skin, immediately covering it with a clean blanket.

Source: Roy Goulding’s Vademecum of Poisoning Therapy.

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MEDICINES AND MEDICAL DEVICES
 
PARENTING
 
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MIND AND BRAIN
 
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WAYS OF BEING
 
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HEALTHCARE AND PATIENTS
 
SEXUALITY
 
OLDER AGE
 
CANCERS
 
EMERGENCIES
 
NUTRITION AND DIET
 
NATURE, SPORTS, PLACES
 
CULTIVATING HEALTH
 
MENOPAUSE
 
MOM IN SHAPE
 
TRADITIONAL CHINESE MEDICINE
 
HEART SURGERY
 
MEDICINES AND MEDICAL DEVICES
 
PARENTING
 
THE CULTURE OF HEALTH
 
HEALTH UTILITIES
 
GENERAL MEDICINE
 
NATURAL MEDICINE, THERMAL
 
MIND AND BRAIN
 
NEUROVEGETATIVE DYSTONIA
 
WAYS OF BEING
 
HEALTH AND SOCIETY
 
HEALTHCARE AND PATIENTS
 
SEXUALITY
 
OLDER AGE
 
CANCERS
 
EMERGENCIES
 
DIGESTIVE SYSTEM
 
RESPIRATORY SYSTEM
 
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HEART AND CIRCULATION
 
SKIN
 
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BONES AND LIGAMENTS
 
ENDOCRINE SYSTEM
 
NERVOUS SYSTEM
 
DIGESTIVE SYSTEM
 
RESPIRATORY SYSTEM
 
UROGENITAL SYSTEM
 
HEART AND CIRCULATION
 
SKIN
 
INFECTIOUS DISEASES
 
EYES
 
EARS, NOSE, AND THROAT
 
BONES AND LIGAMENTS
 
ENDOCRINE SYSTEM
 
NERVOUS SYSTEM
 

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