Toward a framework for levels of robot autonomy in human-robot interaction

PubMed Central

Beer, Jenay M.; Fisk, Arthur D.; Rogers, Wendy A.

2017-01-01

A critical construct related to human-robot interaction (HRI) is autonomy, which varies widely across robot platforms. Levels of robot autonomy (LORA), ranging from teleoperation to fully autonomous systems, influence the way in which humans and robots may interact with one another. Thus, there is a need to understand HRI by identifying variables that influence – and are influenced by – robot autonomy. Our overarching goal is to develop a framework for levels of robot autonomy in HRI. To reach this goal, the framework draws links between HRI and human-automation interaction, a field with a long history of studying and understanding human-related variables. The construct of autonomy is reviewed and redefined within the context of HRI. Additionally, the framework proposes a process for determining a robot’s autonomy level, by categorizing autonomy along a 10-point taxonomy. The framework is intended to be treated as guidelines to determine autonomy, categorize the LORA along a qualitative taxonomy, and consider which HRI variables (e.g., acceptance, situation awareness, reliability) may be influenced by the LORA. PMID:29082107

Work autonomy of certified nursing assistants in long-term care facilities: discrepant perceptions between nursing supervisors and certified nursing assistants.

PubMed

Liu, Li-Fan; Liu, Wei-Pei; Wang, Jong-Yi

2011-09-01

Despite increasing demand of certified nursing assistants (CNAs) in long-term care (LTC) facilities, their work autonomy delegated by nursing supervisors remains ambiguous and varied. This study investigates the CNAs' role in LTC facilities by examining the degrees of work autonomy of CNAs from the perspectives of nursing supervisors and CNAs. Whether the characteristics of institutions including ownership of facilities, bed size, staffing levels, and the occupancy rate affected the CNAs' work autonomy and delegations was also examined. A stratified random sampling method was used to sample LTC facilities in Taiwan. A self-administered structured questionnaire was answered by a senior nursing supervisor and CNA in each sampled institution for their perception of work autonomy in the 5 main aspects of CNAs' job contents: personal care, affiliated nursing care, auxiliary medical service, social care, and administration services. Student t test and general linear models (GLM) were used to test the mean differences of CNAs' work autonomy and their relationship with the institutions' characteristics. Nursing supervisors and CNAs both rated the highest scores of work autonomy in the aspect of personal care, and the lowest scores in the aspect of affiliated nursing care. However, the nursing supervisors expected higher work autonomy of CNAs on the work items particularly in affiliated nursing care and auxiliary medical services than did the CNAs (P < .05). The institutional-level factors were significantly associated with perceptions of nursing supervisors toward CNAs' work autonomy. The ownership (hospital-based or freestanding homes), sizes (capacity), occupancy rates, CNA staff numbers of the long-term care facilities, and resident numbers were related to the CNAs' work autonomy as perceived by their nursing supervisors. No difference between the aspects of administration activities and social care was seen. There are discordance views towards CNAs' work autonomy both in nursing supervisors and CNAs across different settings in LTC institutions. The characteristics of institutions influence perceptions of CNAs' work autonomy as perceived by nursing supervisors. Clear and mandated regulation of CNA job contents is needed for their work identity and autonomy to improve the quality of care in LTC facilities. Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

Ethics consultation and autonomy.

PubMed

Varelius, Jukka

2008-03-01

Services of ethics consultants are nowadays commonly used in such various spheres of life as engineering, public administration, business, law, health care, journalism, and scientific research. It has however been maintained that use of ethics consultants is incompatible with personal autonomy; in moral matters individuals should be allowed to make their own decisions. The problem this criticism refers to can be conceived of as a conflict between the professional autonomy of ethics experts and the autonomy of the persons they serve. This paper addresses this conflict and maintains that when the nature of both ethics consultation and individual autonomy is properly understood, the professional autonomy of ethics experts is compatible with the autonomy of the persons they assist.

20 Years of Autonomy and Technology: How Far Have We Come and Where to Next?

ERIC Educational Resources Information Center

Reinders, Hayo; White, Cynthia

2016-01-01

Learner autonomy has become an assumed goal of language education in many parts of the world. In the 20 years since the launch of "Language Learning & Technology," the relationship among computer-assisted language learning research and practice and autonomy has become both more complex and more promising. This article traces how the…

Autonomy-Supportive Teaching and Its Antecedents: Differences between Teachers and Teaching Assistants and the Predictive Role of Perceived Competence

ERIC Educational Resources Information Center

Bennett, Marcus; Ng-Knight, Terry; Hayes, Ben

2017-01-01

Research predicated on self-determination theory (SDT) has established a positive relationship between autonomy-supportive teaching and a range of desired student outcomes. Therefore, the enhancement of autonomy-supportive teaching is a legitimate focus of efforts to improve student outcomes. In this study, we compared self-reported levels of…

Using WebQuests as Idea Banks for Fostering Autonomy in Online Language Courses

ERIC Educational Resources Information Center

Sadaghian, Shirin; Marandi, S. Susan

2016-01-01

The concept of language learner autonomy has influenced Computer-Assisted Language Learning (CALL) to the extent that Schwienhorst (2012) informs us of a paradigm change in CALL design in the light of learner autonomy. CALL is not considered a tool anymore, but a learner environment available to language learners anywhere in the world. Based on a…

[Autonomy and health needs in the systematization of nursing assistance under the optics of the primary care].

PubMed

Barros, Débora Gomes; Chiesa, Anna Maria

2007-12-01

Given recent changes in the organization of the primary health care in Brazil, it is necessary to reflect on the contributions of nursing care. This article aims to review the concepts of autonomy and health needs and its applications in different proposals for the systematization of the nursing care. It is a literature review on systematization of the nursing assistance, autonomy and health needs in databases LILACS and BDENF. The most relevant results indicate that autonomy incorporates aspects professional and patient's that are sustained by their respective categories. About needs we found that tracks biological needs and social needs, which intersect with the psychological to cover biopsychosocial needs. It was found that the application of the concepts was not present in classification systems of nursing. However, they were more related to International Classification of Nursing Practice (ICNP) and International Classification of Nursing Practice in Collective Heath (ICNPCH) projects.

Understanding Sexual Freedom and Autonomy in Assisted Living: Discourse of Residents' Rights Among Staff and Administrators.

PubMed

Barmon, Christina; Burgess, Elisabeth O; Bender, Alexis A; Moorhead, James R

2017-05-01

In contrast to nursing homes, assisted living (AL) facilities emphasize independence and autonomy as part of their mission. However, we do not know to what extent this extends to sexual freedom and autonomy. Using grounded theory methodology and symbolic interactionism, we examine how staff and administrators in AL facilities discuss residents' rights to sexual freedom and how this influences the environment of AL. Staff and administrators engage in a contradictory discourse of residents' rights that simultaneously affirms the philosophy of AL while behaving in ways that create an environment of surveillance and undermine those rights. A discourse of residents' rights masks a significant conflict between autonomy and protection in regards to sexual freedom in AL. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

An undignified side of death with dignity legislation.

PubMed

Plaisted, Dennis

2013-09-01

The primary justification for Death with Dignity legislation has been the principle of respect for autonomy. However, some have objected that if respect for autonomy is the reason for allowing physician-assisted suicide, then why not allow it for people with longer than six months to live? Defenders of the laws have responded that respect for autonomy must be balanced against the state's interest in the lives of its citizens. Persons with less than six months remaining have virtually no life left to protect; persons with more time have a meaningfully long segment of life remaining. The state can therefore overrule their autonomy interests to preserve their lives. This paper will argue that this response constitutes an ironic affront to the dignity of people with less than six months to live, for it implies that their lives are not worth enough for the state to prevent them from committing physician-assisted suicide.

Intention, autonomy, and brain events.

PubMed

Gillett, Grant

2009-07-01

Informed consent is the practical expression of the doctrine of autonomy. But the very idea of autonomy and conscious free choice is undercut by the view that human beings react as their unconscious brain centres dictate, depending on factors that may or may not be under rational control and reflection. This worry is, however, based on a faulty model of human autonomy and consciousness and needs close neurophilosophical scrutiny. A critique of the ethics implied by the model takes us towards a 'care of the self' view of autonomy and the subject's attunement to the truth as the crux of reasoning rather than the inner mental/neural state views of autonomy and human choice on offer at present.

[Is autonomy ground of human dignity?].

PubMed

Gordillo Alvarez-Valdés, Lourdes

2008-01-01

This paper considers the conditions of autonomy if this is to be the foundation of human dignity. Since Kant Modernity has dissociated nature from morality and has tried to support autonomy in its purely formal aspect. To forget nature has voluntarist consequences that affect the way in which autonomy is understand. But autonomy does not consist of not having links, but of knowing how to assume one's own links freely and to be conscious of one's own limits. Autonomy and liberty are the very thing of the rational being, capable of discerning good and bad, and this must direct our actions. Reason directs as and distances us from reality to recognize the advisable thing in the human being.

Intuitive adaptive orientation control of assistive robots for people living with upper limb disabilities.

PubMed

Vu, Dinh-Son; Allard, Ulysse Cote; Gosselin, Clement; Routhier, Francois; Gosselin, Benoit; Campeau-Lecours, Alexandre

2017-07-01

Robotic assistive devices enhance the autonomy of individuals living with physical disabilities in their day-to-day life. Although the first priority for such devices is safety, they must also be intuitive and efficient from an engineering point of view in order to be adopted by a broad range of users. This is especially true for assistive robotic arms, as they are used for the complex control tasks of daily living. One challenge in the control of such assistive robots is the management of the end-effector orientation which is not always intuitive for the human operator, especially for neophytes. This paper presents a novel orientation control algorithm designed for robotic arms in the context of human-robot interaction. This work aims at making the control of the robot's orientation easier and more intuitive for the user, in particular, individuals living with upper limb disabilities. The performance and intuitiveness of the proposed orientation control algorithm is assessed through two experiments with 25 able-bodied subjects and shown to significantly improve on both aspects.

Workload Measurement in Human Autonomy Teaming: How and Why?

NASA Technical Reports Server (NTRS)

Shively, Jay

2016-01-01

This is an invited talk on autonomy and workload for an AFRL Blue Sky workshop sponsored by the Florida Institute for Human Machine Studies. The presentation reviews various metrics of workload and how to move forward with measuring workload in a human-autonomy teaming environment.

Stories of Human Autonomy, Law, and Technology

ERIC Educational Resources Information Center

Tranter, Kieran

2010-01-01

Considering the relationship between human autonomy, law and technology has deep origins. Both technology studies and legal theory tell origin stories about human autonomy as the prize from either a foundational technological or jurisprudential event. In these narratives either law is considered a second order consequence of technology or…

Visitors and Resident Autonomy: Spoken and Unspoken Rules in Assisted Living.

PubMed

Bennett, Colleen R; Frankowski, Ann Christine; Rubinstein, Robert L; Peeples, Amanda D; Perez, Rosa; Nemec, Mary; Tucker, Gretchen G

2017-04-01

This article explores resident autonomy in assisted living (AL) and the effects that visitors and visiting the AL have on that autonomy. We examine formal and informal policies that govern visiting in AL, stakeholders' views and enforcement of these policies, and the complex arrangements that visiting often entails in everyday life in the setting. Data are drawn from a multiyear ethnographic study of autonomy in AL. Research from multiple sites included participant observation, informal and in-depth, open-ended interviews of various stakeholders, and the writing of field notes. Research team biweekly discussions and the Atlas.ti software program facilitated coding and analysis of interview transcripts and fieldnotes. Our ethnographic data highlight complicated factors related to visitors and visiting in AL. We discuss two important aspects of visiting: (a) formal and informal policies at each setting; and (b) how resident autonomy is expressed or suppressed through rules about visiting in AL. Our data underscore the importance of resident autonomy and quality of care in relation to visitors and visiting, especially how this relationship is affected by inconsistent and confusing formal and informal visiting policies in AL. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Advancing Robotic Control for Space Exploration Using Robonaut 2

NASA Technical Reports Server (NTRS)

Badger, Julia; Diftler, Myron; Hart, Stephen; Joyce, Charles

2012-01-01

Robonaut 2, or R2, arrived on the International Space Station (ISS) in February 2011 and is currently being tested in preparation for its role initially as an Intra-Vehicular Activity (IVA) tool and eventually as a robot that performs Extra-Vehicular Activities (EVA). Robonaut 2, is a state of the art dexterous anthropomorphic robotic torso designed for assisting astronauts. R2 features increased force sensing, greater range of motion, higher bandwidth, and improved dexterity over its predecessor. Robonaut 2 is unique in its ability to safely allow humans in its workspace and to perform significant tasks in a workspace designed for humans. The current operational paradigm involves either the crew or the ground control team running semi-autonomous scripts on the robot as both the astronaut and the ground team monitor R2 and the data it produces. While this is appropriate for the check-out phase of operations, the future plans for R2 will stress the current operational framework. The approach described here will outline a suite of operational modes that will be developed for Robonaut 2. These operational modes include teleoperation, shared control, directed autonomy, and supervised autonomy, and they cover a spectrum of human involvement in controlling R2.

From Here to Autonomy.

PubMed

Endsley, Mica R

2017-02-01

As autonomous and semiautonomous systems are developed for automotive, aviation, cyber, robotics and other applications, the ability of human operators to effectively oversee and interact with them when needed poses a significant challenge. An automation conundrum exists in which as more autonomy is added to a system, and its reliability and robustness increase, the lower the situation awareness of human operators and the less likely that they will be able to take over manual control when needed. The human-autonomy systems oversight model integrates several decades of relevant autonomy research on operator situation awareness, out-of-the-loop performance problems, monitoring, and trust, which are all major challenges underlying the automation conundrum. Key design interventions for improving human performance in interacting with autonomous systems are integrated in the model, including human-automation interface features and central automation interaction paradigms comprising levels of automation, adaptive automation, and granularity of control approaches. Recommendations for the design of human-autonomy interfaces are presented and directions for future research discussed.

Inclusive and relevant language: the use of the concepts of autonomy, dignity and vulnerability in different contexts.

PubMed

Haugen, Hans Morten

2010-08-01

The article analyses the three terms autonomy, dignity and vulnerability. The relevance and practical application of the terms is tested in two spheres. First, as guiding principles in the area of ethics of medicines and science. Second, as human rights principles, serving to guide the conduct of public policies for an effective realization of human rights. The article argues that all human beings have the same dignity, but that the autonomy--and therefore vulnerability--differs considerably. Simply said, with reduced autonomy comes increased vulnerability, implying extra attention to the protective dimensions. The article finds that the three terms approach the protection of human beings in different ways and that all are relevant and applicable in both spheres, but that an isolated notion of autonomy and a 'group-based' notion of vulnerability are not adequate.

Relational Autonomy in Assisted Living: A Focus on Diverse Care Settings for Older Adults

PubMed Central

Perkins, Molly M.; Ball, Mary M.; Whittington, Frank J.; Hollingsworth, Carole

2012-01-01

Consistent with Western cultural values, the traditional liberal theory of autonomy, which places emphasis on self-determination, liberty of choice, and freedom from interference by others, has been a leading principle in health care discourse for several decades. In context to aging, chronic illness, disability, and long-term care, increasingly there has been a call for a relational conception of autonomy that acknowledges issues of dependency, interdependence, and care relationships. Although autonomy is a core philosophy of assisted living (AL) and a growing number of studies focus on this issue, theory development in this area is lagging and little research has considered race, class, or cultural differences, despite the growing diversity of AL. We present a conceptual model of autonomy in AL based on over a decade of research conducted in diverse facility settings. This relational model provides an important conceptual lens for understanding the dynamic linkages between varieties of factors at multiple levels of social structure that shape residents' ability to maintain a sense of autonomy in this often socially challenging care environment. Social and institutional change, which is ongoing, as well as the multiple and ever-changing cultural contexts within which residents are embedded, are important factors that shape residents' experiences over time and impact resident-facility fit and residents' ability to age in place. PMID:22707852

Toward a gender-sensitive assisted reproduction policy.

PubMed

Donchin, Anne

2009-01-01

The recent case of the UK woman who lost her legal struggle to be impregnated with her own frozen embryos, raises critical issues about the meaning of reproductive autonomy and the scope of regulatory practices. I revisit this case within the context of contemporary debate about the moral and legal dimensions of assisted reproduction. I argue that the gender neutral context that frames discussion of regulatory practices is unjust unless it gives appropriate consideration to the different positions women and men occupy in relation to reproductive processes and their options for autonomous choice. First, I consider relevant legal rulings, media debate, and scholarly commentary. Then I discuss the concept of reproductive autonomy imbedded in this debate. I argue that this concept conflates informed consent and reproductive autonomy, thereby providing an excessively narrow reading of autonomy that fails to give due regard to relations among individuals or the social, political and economic environment that shapes their options. I contrast this notion of autonomy with feminist formulations that seek to preserve respect for the agency of individuals without severing them from the conditions of their embodiment, their surrounding social relationships, or the political contexts that shape their options. Taking these considerations into account I weigh the advantages of regulation over the commercial market arrangement that prevails in some countries and suggest general guidelines for a regulatory policy that would more equitably resolve conflicting claims to reproductive autonomy.

Mobile-Assisted Language Learning and Language Learner Autonomy

ERIC Educational Resources Information Center

Lyddon, Paul

2016-01-01

In the modern age of exponential knowledge growth and accelerating technological development, the need to engage in lifelong learning is becoming increasingly urgent. Successful lifelong learning, in turn, requires learner autonomy, or "the capacity to take control of one's own learning" (Benson, 2011, p. 58), including all relevant…

Ethical Issues Relative to Autonomy and Personal Control in Independent and Cognitively Impaired Elders.

ERIC Educational Resources Information Center

Rice, Virginia Hill; And Others

1997-01-01

Discusses ethical issues surrounding health care for independent elders, those in long-term care, and those with cognitive impairments, as well as death, dying, euthanasia, and assisted suicide. Suggests that nurses should focus on older adults' choice, autonomy, and personal control. (SK)

Learner Autonomy in a Task-Based 3D World and Production

ERIC Educational Resources Information Center

Collentine, Karina

2011-01-01

This study contributes to the research on learner autonomy by examining the relationship between Little's (1991) notions of "independent action" and "decision-making", input, and L2 production in computer-assisted language learning (CALL). Operationalizing "independent action" and "decision-making" with Dam's (1995) definition that focuses on…

Maximizing Autonomy: Reforming Personal Support Laws in Sweden and the United States.

ERIC Educational Resources Information Center

Herr, Stanley S.

1995-01-01

Forms of guardianship for U.S. individuals with disabilities are reviewed, and Swedish legal and public policy innovations that replace guardianship with personal support services, such as mentors and personal assistants, are considered. The impact of Sweden's reforms on autonomy, independence, and integration is addressed. (Author/SW)

Paradox of choice and the illusion of autonomy: The construction of ethical subjects in right-to-die activism.

PubMed

Gandsman, Ari

2018-01-01

The right to die is an issue is predicated on larger cultural understandings of autonomy. Autonomy, in turn, is centered around assumptions of choice, that individuals are able to make health-related decisions based on a rational calculation. In such a way, a medically assisted death is differentiated from suicide. Through an ethnographic study of right-to-die activists in North America and Australia and how they understand ideals of "good deaths," this article will complicate this view by examining the ethical subject constructed by such activism that reveals autonomy to be a useful guiding fiction that mask larger ethical relationships.

Health equality, social justice and the poverty of autonomy.

PubMed

Newdick, Christopher

2017-10-01

How does the concept of autonomy assist public responses to 'lifestyle' diseases? Autonomy is fundamental to bioethics, but its emphasis on self-determination and individuality hardly supports public health policies to eat and drink less and take more exercise. Autonomy rejects a 'nanny' state. Yet, the cost of non-communicable diseases is increasing to individuals personally and to public health systems generally. Health care systems are under mounting and unsustainable pressure. What is the proper responsibility of individuals, governments and corporate interests working within a global trading environment? When public health care resources are unlikely to increase, we cannot afford to be so diffident to the cost of avoidable diseases.

Autonomy and dignity of patients with dementia: Perceptions of multicultural caretakers.

PubMed

Bentwich, Miriam Ethel; Dickman, Nomy; Oberman, Amitai

2018-02-01

A key message in the World Health Organization's report on dementia emphasizes the need to improve public and professional attitudes to dementia and its understanding, while acknowledging the fact that the workforce in dementia care is becoming increasingly diverse culturally. To explore possible differences among formal caretakers from varied cultural background in their attitudes toward the autonomy and human dignity of patients with dementia. Semi-structured interviews and content analysis, utilizing two fictional vignettes for eliciting caretakers' attitudes toward dignity and autonomy of their patients. Participants and context: A total of 20 formal caretakers of patients with dementia from three different cultural groups in Israel ("Sabras," "Arabs," and "Russians"), working in nursing homes and a hospital. Ethical consideration: Approvals of relevant research ethics committees were obtained and followed. In comparison with the other groups, most Arab caretakers offer markedly richer perceptions of human dignity and autonomy. Their human dignity's conceptualization emphasizes "person-centered approach," and their perception of patients' autonomy includes provision of explanations and preservation and encouragement of independence. The differences found in the attitudes toward the meaning of autonomy and human dignity between the Arab caretakers and the other caretakers stand in contrast to previous studies regarding human dignity, emphasizing the common nature of these attitudes. Offering a linkage (theoretical and empirical) between the Arab perceptions of dignity and autonomy, the study strengthen and further the importance attributed in existing literature to person-centered care in enhancing the quality of care for patients with dementia. The conceptualization of human dignity may vary among different cultural groups. It may also influence the extent to which the caretaker holds a full-fledged perception of the patients' autonomy.

The Establishment of Autonomy: Assisting Late Adolescents with Positive Management of Separation Issues.

ERIC Educational Resources Information Center

de St. Aubin, Therese; And Others

This manual presents a developmentally focused group intervention, ("But Mom (Dad) - I'm an Adult Now") developed by the Student Counseling Center at Illinois State University for college students who are having difficulty establishing autonomy from their family of origin. The group uses a condition of didactic presentations,…

Computer-Mediated Communication as an Autonomy-Enhancement Tool for Advanced Learners of English

ERIC Educational Resources Information Center

Wach, Aleksandra

2012-01-01

This article examines the relevance of modern technology for the development of learner autonomy in the process of learning English as a foreign language. Computer-assisted language learning and computer-mediated communication (CMC) appear to be particularly conducive to fostering autonomous learning, as they naturally incorporate many elements of…

[Is autonomy a universal value principle? The study of concrete clinical cases in perinatology].

PubMed

Tilmans-Cabiax, Chantal

2007-09-01

Certain perinatalogy situations make one confront cultural differences and, in particular, the relative importance of the value of female autonomy. This leads to the following question: should autonomy have as much weight everywhere as it is given in Western health ethics? The passionate, philosophical and historical work by J.B. Schneewind, The Invention of Autonomy: A History of Modern Moral Philosophy, is used to assist in the understanding of the important cultural evolutions which have interacted to support the idea of moral autonomy in the West. This return to our roots brings us, not to question moral autonomy through its claim to universality, but to dare to relativize the modalities according to cultural contexts. And especially to rehabilitate other values--for example caring for one another--prominent in other more community orientated societies in which the West can be inspired.

'It's my life': autonomy and people with intellectual disabilities.

PubMed

Björnsdóttir, Kristín; Stefánsdóttir, Guðrún V; Stefánsdóttir, Ástríður

2015-03-01

This article discusses autonomy in the lives of adults with intellectual disabilities. The article draws on inclusive research in Iceland with 25 women and 16 men and employs ideas of relational autonomy from the perspectives of the Nordic relational approach to disability. In this article, we examine autonomy in relation to private life, that is, homes and daily activities. The article demonstrates how practices have improved with time and seem less paternalistic. However, the article also demonstrates that the assistance people with intellectual disabilities receive in their homes often has institutional qualities, and they are often met with belittling perspectives from staff and family members. Furthermore, many did not have access to important information needed to develop individual autonomy and independence, including making their own choices. The research findings suggest that people with intellectual disabilities can with appropriate support develop individual autonomy and make their own choices. © The Author(s) 2014.

An Intelligent Agent-Controlled and Robot-Based Disassembly Assistant

NASA Astrophysics Data System (ADS)

Jungbluth, Jan; Gerke, Wolfgang; Plapper, Peter

2017-09-01

One key for successful and fluent human-robot-collaboration in disassembly processes is equipping the robot system with higher autonomy and intelligence. In this paper, we present an informed software agent that controls the robot behavior to form an intelligent robot assistant for disassembly purposes. While the disassembly process first depends on the product structure, we inform the agent using a generic approach through product models. The product model is then transformed to a directed graph and used to build, share and define a coarse disassembly plan. To refine the workflow, we formulate “the problem of loosening a connection and the distribution of the work” as a search problem. The created detailed plan consists of a sequence of actions that are used to call, parametrize and execute robot programs for the fulfillment of the assistance. The aim of this research is to equip robot systems with knowledge and skills to allow them to be autonomous in the performance of their assistance to finally improve the ergonomics of disassembly workstations.

Autonomy Support as an Interpersonal Motivating Style: Is It Teachable?

PubMed

Reeve

1998-07-01

Students benefit when teachers support their autonomy. Recognizing this, the present study examined the motivating styles of beginning preservice teachers by asking two questions: (1) Do personality characteristics orient preservice teachers toward either an autonomy-supportive or controlling motivating style? and (2) Is the autonomy-supportive style teachable to preservice teachers? Study 1, which addressed the first question, relied on self-determination theory to identify and confirm causality orientation as one personality characteristic related to motivating style. Study 2, which addressed the second question, randomly assigned preservice teachers to receive training in either autonomy-supportive, controlling, or neutral instructional strategies. Results showed that the autonomy-supportive style was teachable. Autonomy-oriented preservice teachers (as measured by causality orientation) assimilated the information rather easily, while control-oriented preservice teachers accommodated the information only in proportion to the extent that they perceived it to be highly plausible and classroom applicable. The discussion relies on self-determination theory and the conceptual change literature to recommend how teacher certification programs can assist teachers-in-training develop an autonomy-supportive motivating style. Copyright 1998 Academic Press.

[Nurses' autonomy and vulnerability in the Nursing Assistance Systematization practice].

PubMed

Menezes, Silvia Regina Tamae; Priel, Margareth Rose; Pereira, Luciane Lucio

2011-08-01

The objective of this study was to recognize the autonomy and vulnerability of nurses in the implementation of the Sistema da Assistência de Enfermagem (SAE) Nursing Care System through an integrative literature review, using content analysis. A survey was conducted, and 40 articles published between 1998 and 2008 were selected based on their relevance. Results showed two main categories of meaning: Benefits associated to the SAE practice (to patients, to the profession and to the institution) and Determinants for the Implementation of SAE (nurse's competence, training and education, record-instruments, infrastructure and collective sharing-construction). From the integration of the two categories, the highlights were the autonomy in acting with freedom and responsibility, science-based decision-making, and being valued for their social work, as well as the vulnerability expressed by interpersonal relationships, the wear generated by professional stress and the risk inherent to the service.

75 FR 13735 - Office of Innovation and Improvement; Overview Information; Charter Schools Program (CSP): State...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-23

... financial assistance for the planning, program design, and initial implementation of charter schools, and to... process for the denial of an application for a charter school. Priority 4--High Degree of Autonomy (10 points). The State ensures that each charter school has a high degree of autonomy over the charter school...

An intercultural nursing perspective on autonomy.

PubMed

Hanssen, Ingrid

2004-01-01

This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients' possibly harmful choices is discussed, the focus is on 'forced' autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively participate neither in the treatment offered nor in making choices regarding that treatment. Nurses' demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person's autonomy is also respect for the person, one's respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second-order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why.

Euthanasia, assisted suicide, and the philosophical anthropology of Karol Wojtyla.

PubMed

Fernandes, Ashley K

2001-12-01

The lack of consensus in American society regarding the permissibility of assisted suicide and euthanasia is due in large part to a failure to address the nature of the human person involved in the ethical act itself. For Karol Wojtyla, philosopher and Pope, ethical action finds meaning only in an authentic understanding of the person; but it is through acting (actus humanus) alone that the human person reveals himself. Knowing what the person ought to be cannot be divorced from what he ought to do; for Wojtyla, the structure of the ethical "do"--the act itself--comes first. The current paper will focus on four arguments used to justify assisted suicide and euthanasia: (1) the argument from autonomy, (2) the argument from compassion, (3) the argument from the evil of suffering, and (4) the argument from the loss of dignity. It will seek to answer each claim from the perspective of Karol Wojtyla's philosophical anthropology. Much of this will come from his defining work in pure philosophy, The Acting Person (1969). The final part of the paper will suggest some positive solutions to the stalemate over the euthanasia debate, again drawn from Wojtyla's idea of human fufillment through participation with the other, and with the community itself.

Integrating autonomous distributed control into a human-centric C4ISR environment

NASA Astrophysics Data System (ADS)

Straub, Jeremy

2017-05-01

This paper considers incorporating autonomy into human-centric Command, Control, Communications, Computers, Intelligence, Surveillance and Reconnaissance (C4ISR) environments. Specifically, it focuses on identifying ways that current autonomy technologies can augment human control and the challenges presented by additive autonomy. Three approaches to this challenge are considered, stemming from prior work in two converging areas. In the first, the problem is approached as augmenting what humans currently do with automation. In the alternate approach, the problem is approached as treating humans as actors within a cyber-physical system-of-systems (stemming from robotic distributed computing). A third approach, combines elements of both of the aforementioned.

Toward increased autonomy in the surgical OR: needs, requests, and expectations.

PubMed

Kranzfelder, Michael; Staub, Christoph; Fiolka, Adam; Schneider, Armin; Gillen, Sonja; Wilhelm, Dirk; Friess, Helmut; Knoll, Alois; Feussner, Hubertus

2013-05-01

The current trend in surgery toward further trauma reduction inevitably leads to increased technological complexity. It must be assumed that this situation will not stay under the sole control of surgeons; mechanical systems will assist them. Certain segments of the work flow will likely have to be taken over by a machine in an automatized or autonomous mode. In addition to the analysis of our own surgical practice, a literature search of the Medline database was performed to identify important aspects, methods, and technologies for increased operating room (OR) autonomy. Robotic surgical systems can help to increase OR autonomy by camera control, application of intelligent instruments, and even accomplishment of automated surgical procedures. However, the important step from simple task execution to autonomous decision making is difficult to realize. Another important aspect is the adaption of the general technical OR environment. This includes adaptive OR setting and context-adaptive interfaces, automated tool arrangement, and optimal visualization. Finally, integration of peri- and intraoperative data consisting of electronic patient record, OR documentation and logistics, medical imaging, and patient surveillance data could increase autonomy. To gain autonomy in the OR, a variety of assistance systems and methodologies need to be incorporated that endorse the surgeon autonomously as a first step toward the vision of cognitive surgery. Thus, we require establishment of model-based surgery and integration of procedural tasks. Structured knowledge is therefore indispensable.

Understanding Human Autonomy Teaming Through Applications

NASA Technical Reports Server (NTRS)

Aponso, B.; Stallmann, Summer; Lachter, Joel; Shively, Jay; Benton, J.; Kaneshige, John; Mumaw, Randy; Feary, Michael

2017-01-01

This presentation describes the development and demonstration of human autonomy teaming technologies for improving aviation safety and efficiency during nominal and off-nominal operations by developing and validating increasingly autonomous systems concepts, technologies, and procedures.

Bi-Directional Communication: A Critical Component of HAT

NASA Technical Reports Server (NTRS)

Shively, Robert J.

2016-01-01

Known problems with automation include lack of mode awareness, automation brittleness, and risk of miscalibrated trust. Human-Autonomy Teaming (HAT) is essential for improving these problems. This presentation outlines critical components for Human-Autonomy Teaming.

An ecologically-controlled exoskeleton can improve balance recovery after slippage

NASA Astrophysics Data System (ADS)

Monaco, V.; Tropea, P.; Aprigliano, F.; Martelli, D.; Parri, A.; Cortese, M.; Molino-Lova, R.; Vitiello, N.; Micera, S.

2017-05-01

The evolution to bipedalism forced humans to develop suitable strategies for dynamically controlling their balance, ensuring stability, and preventing falling. The natural aging process and traumatic events such as lower-limb loss can alter the human ability to control stability significantly increasing the risk of fall and reducing the overall autonomy. Accordingly, there is an urgent need, from both end-users and society, for novel solutions that can counteract the lack of balance, thus preventing falls among older and fragile citizens. In this study, we show a novel ecological approach relying on a wearable robotic device (the Active Pelvis Orthosis, APO) aimed at facilitating balance recovery after unexpected slippages. Specifically, if the APO detects signs of balance loss, then it supplies counteracting torques at the hips to assist balance recovery. Experimental tests conducted on eight elderly persons and two transfemoral amputees revealed that stability against falls improved due to the “assisting when needed” behavior of the APO. Interestingly, our approach required a very limited personalization for each subject, and this makes it promising for real-life applications. Our findings demonstrate the potential of closed-loop controlled wearable robots to assist elderly and disabled subjects and to improve their quality of life.

Paternalism and partial autonomy.

PubMed Central

O'Neill, O

1984-01-01

A contrast is often drawn between standard adult capacities for autonomy, which allow informed consent to be given or withheld, and patients' reduced capacities, which demand paternalistic treatment. But patients may not be radically different from the rest of us, in that all human capacities for autonomous action are limited. An adequate account of paternalism and the role that consent and respect for persons can play in medical and other practice has to be developed within an ethical theory that does not impose an idealised picture of unlimited autonomy but allows for the variable and partial character of actual human autonomy. PMID:6520849

Making Good Choices: How Autonomy Support Influences the Behavior Change and Motivation of Troubled and Troubling Youth

ERIC Educational Resources Information Center

Harper, Elaine

2007-01-01

Autonomy is a basic human need having influence on motivation. Facilitating student autonomy is an essential ingredient of effective programs for maximizing internalized change and increasing motivation in troubled and troubling youth. This article examines the theoretical concepts of autonomy and control related to choices and considers their…

Methods for Determining the Level of Autonomy to Design into a Human Spaceflight Vehicle: A Function Specific Approach

NASA Technical Reports Server (NTRS)

Proud, Ryan W.; Hart, Jeremy J.; Mrozinski, Richard B.

2003-01-01

The next-generation human spaceflight vehicle is in a unique position to realize the benefits of more than thirty years of technological advancements since the Space Shuttle was designed. Computer enhancements, the emergence of highly reliable decision-making algorithms, and an emphasis on efficiency make an increased use of autonomous systems highly likely. NASA is in a position to take advantage of these advances and apply them to the human spaceflight environment. One of the key paradigm shifts will be the shift, where appropriate, of monitoring, option development, decision-making, and execution responsibility from humans to an Autonomous Flight Management (AFM) system. As an effort to reduce risk for development of an AFM system, NASA engineers are developing a prototype to prove the utility of previously untested autonomy concepts. This prototype, called SMART (Spacecraft Mission Assessment and Replanning Tool), is a functionally decomposed flight management system with an appropriate level of autonomy for each of its functions. As the development of SMART began, the most important and most often asked question was, How autonomous should an AFM system be? A thorough study of the literature through 2002 surrounding autonomous systems has not yielded a standard method for designing a level of autonomy into either a crewed vehicle or an uncrewed vehicle. The current focus in the literature on defining autonomy is centered on developing IQ tests for built systems. The literature that was analyzed assumes that the goal of all systems is to strive for complete autonomy from human intervention, rather than identifying how autonomous each function within the system should have been. In contrast, the SMART team developed a method for determining the appropriate level of autonomy to be designed into each function within a system. This paper summarizes the development of the Level of Autonomy Assessment Tool and its application to the SMART project.

Perceived Parenting and Adolescent Cyber-Bullying: Examining the Intervening Role of Autonomy and Relatedness Need Satisfaction, Empathic Concern and Recognition of Humanness.

PubMed

Fousiani, Kyriaki; Dimitropoulou, Panagiota; Michaelides, Michalis P; Van Petegem, Stijn

Due to the progress in information technology, cyber-bullying is becoming one of the most common forms of interpersonal harm, especially among teenagers. The present study ( N  = 548) aimed to investigate the relation between perceived parenting style (in terms of autonomy support and psychological control) and cyber-bullying in adolescence. Thereby, the study tested for the intervening role of adolescent need satisfaction (i.e., autonomy and relatedness), empathic concern towards others, and adolescents' recognition of full humanness to cyber-bullying offenders and victims. Findings revealed both a direct and an indirect relation between parenting and cyber-bullying. More specifically, parental psychological control directly predicted cyber-bullying, whereas parental autonomy support related to less cyber-bullying indirectly, as it was associated with the satisfaction of adolescents' need for autonomy, which predicted more empathic concern towards others, which in turn differentially related to recognition of humanness to victims and bullies. The discussion focuses on the implications of the current findings.

Overview of Robotic Devices for Nursing Care Project.

PubMed

Hirukawa, Hirohisa

2017-01-01

METI/AMED are conducting a project on the development and deployment of robotic devices for nursing care to enhance the autonomy of elderly persons and assist care givers. An evaluation protocol is presented and the devices developed in the project are introduced. The devices consist of transfer assist devices (wearable/non-wearable), walking assist devices (outdoor/indoor), safety surveillance sensors (nursing home/private home), bath lift and toilet assist.

Why Virtual, Why Environments? Implementing Virtual Reality Concepts in Computer-Assisted Language Learning.

ERIC Educational Resources Information Center

Schwienhorst, Klaus

2002-01-01

Discussion of computer-assisted language learning focuses on the benefits of virtual reality environments, particularly for foreign language contexts. Topics include three approaches to learner autonomy; supporting reflection, including self-awareness; supporting interaction, including collaboration; and supporting experimentation, including…

From 'automation' to 'autonomy': the importance of trust repair in human-machine interaction.

PubMed

de Visser, Ewart J; Pak, Richard; Shaw, Tyler H

2018-04-09

Modern interactions with technology are increasingly moving away from simple human use of computers as tools to the establishment of human relationships with autonomous entities that carry out actions on our behalf. In a recent commentary, Peter Hancock issued a stark warning to the field of human factors that attention must be focused on the appropriate design of a new class of technology: highly autonomous systems. In this article, we heed the warning and propose a human-centred approach directly aimed at ensuring that future human-autonomy interactions remain focused on the user's needs and preferences. By adapting literature from industrial psychology, we propose a framework to infuse a unique human-like ability, building and actively repairing trust, into autonomous systems. We conclude by proposing a model to guide the design of future autonomy and a research agenda to explore current challenges in repairing trust between humans and autonomous systems. Practitioner Summary: This paper is a call to practitioners to re-cast our connection to technology as akin to a relationship between two humans rather than between a human and their tools. To that end, designing autonomy with trust repair abilities will ensure future technology maintains and repairs relationships with their human partners.

Home-care nursing staff in self-directed teams are more satisfied with their job and feel they have more autonomy over patient care: a nationwide survey.

PubMed

Maurits, Erica E M; de Veer, Anke J E; Groenewegen, Peter P; Francke, Anneke L

2017-10-01

The aims of this study were: (1) To examine whether working in a self-directed team is related to home-care nursing staff's job satisfaction; (2) To assess the mediating effect of self-perceived autonomy over patient care; (3) To investigate the moderating effect of educational level on the association between autonomy over patient care and job satisfaction. Self-directed teams are being introduced in home care in several countries. It is unknown whether working in a self-directed team is related to nursing staff's job satisfaction. It is important to gain insight into this association since self-directed teams may help in retaining nursing staff. A cross-sectional study based on two questionnaire surveys in 2014 and 2015. The study involved 191 certified nursing assistants and registered nurses employed in Dutch home-care organizations (mean age of 50). These were members of the Dutch Nursing Staff Panel, a nationwide panel of nursing staff working in various healthcare settings. Self-direction is positively related to nursing staff's job satisfaction. This relationship is partly mediated by autonomy over patient care. For certified nursing assistants and registered nurses with a bachelor's degree, a greater sense of autonomy over patient care in self-directed teams is positively related to job satisfaction. No significant association was found between autonomy over patient care and job satisfaction for registered nurses with an associate degree. This study suggests that home-care organizations should consider the use of self-directed teams as this increases nursing staff's job satisfaction and may therefore help to retain nursing staff in home care. © 2017 John Wiley & Sons Ltd.

Assisted suicide laws create discriminatory double standard for who gets suicide prevention and who gets suicide assistance: Not Dead Yet responds to Autonomy, Inc.

PubMed

Coleman, Diane

2010-01-01

Not Dead Yet is a national disability rights organization formed in 1996 to articulate and organize the disability rights opposition to legalization of assisted suicide. In the first half of 2009, Not Dead Yet and four other national disability organizations joined in an amicus brief filed in Baxter v. State of Montana, an assisted suicide case on appeal to the state Supreme Court. Autonomy, Inc., another disability organization, filed an amicus brief in favor of a constitutional right to assisted suicide. The author reviews the lower court opinion and the key arguments in these amicus briefs from the perspective of Not Dead Yet. The Montana District Court concluded that the privacy and dignity provisions of the Montana Constitution establish a constitutional right to physician assisted suicide for terminally ill people, and that potential abuses of that right could be regulated by state statute. The author addresses the question, "What does disability have to do with it?" The author uses a combination of clinical research, legal analysis and the Oregon Reports on assisted suicide to examine the claim that abuses can be prevented by restricting assisted suicide to competent people who are terminally ill and choose it voluntarily. Autonomy, Inc.'s arguments explicitly depend on the medical profession's ability to reliably predict terminal status, and the capacity of society and the law to implement a double standard of suicide prevention and suicide assistance based on terminal status. Not Dead Yet's central argument is that such a double standard based on health status constitutes unlawful discrimination under the Americans With Disabilities Act. The author highlights data from the Oregon Reports demonstrating that lethal prescriptions were issued to people who were not terminally ill under the law's definition, and examines various problems of implementation and enforcement under the Oregon and Washington assisted suicide statutes. Particular attention is given to the problems associated with the role of physicians as gatekeepers under the statutes, providing examples of physicians pressuring people to forego life-sustaining treatment and involuntarily withholding life-sustaining treatment. Copyright © 2010 Elsevier Inc. All rights reserved.

Perspectives on autonomy.

PubMed

Keys, Yolanda

2009-09-01

This department, sponsored by the AONE, presents information to assist nurse leaders in shaping the future of healthcare through creative and innovative leadership. The strategic priorities of AONE anchor the editorial content. They reflect contemporary healthcare and nursing practice issues that challenge nurse executives as they strive to meet the needs of patients. This article describes how 9 Magnet-hospital, chief nursing officers perceive their autonomy and its importance in accomplishing their work.

[What role for the family carers of elderly people losing their autonomy?].

PubMed

Le Bihan, Blanche; Campéon, Arnaud

2016-03-01

The qualitative analysis of the role of family carers shows that supporting a family member losing their autonomy not only involves providing physical assistance and care but also, increasingly, adopting a role of coordinator. These activities can be a source of stress or they can be rewarding, depending on the shared history of the carer-patient relationship. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Patient autonomy and choice in healthcare: self-testing devices as a case in point.

PubMed

Greaney, Anna-Marie; O'Mathúna, Dónal P; Scott, P Anne

2012-11-01

This paper aims to critique the phenomenon of advanced patient autonomy and choice in healthcare within the specific context of self-testing devices. A growing number of self-testing medical devices are currently available for home use. The premise underpinning many of these devices is that they assist individuals to be more autonomous in the assessment and management of their health. Increased patient autonomy is assumed to be a good thing. We take issue with this assumption and argue that self-testing provides a specific example how increased patient autonomy and choice within healthcare might not best serve the patient population. We propose that current interpretations of autonomy in healthcare are based on negative accounts of liberty to the detriment of a more relational understanding. We also propose that Kantian philosophy is often applied to the healthcare arena in an inappropriate manner. We draw on the philosophical literature and examples from the self-testing process to support these claims. We conclude by offering an alternative account of autonomy based on the interrelated concepts of relationality, care and responsibility.

Harm as the price of liberty? Pre-implantation diagnosis and reproductive freedom.

PubMed

Haker, Hille

2003-01-01

Reproductive autonomy is often used as an argument to offer assisted reproduction services to women and to continue research into improving this service. What is often overlooked, however, is the gendered and normative background of parenthood, especially of motherhood. In this paper, I attempt to make women visible and to listen to their voices. Turning to the women's stories, the ethical perspective might be reversed: the so-called 'side-effects' of the overall successful assisted reproduction with or without genetic diagnosis, are to be considered the 'main effects' of assisted reproduction--true for the majority of couples and women. Autonomy, then, must be reformulated as concept of moral agency in the context of divergent social contexts and cultures of parenthood, of socially shaped images of disability, and in the context of scientific visions of technology which do not necessarily match with the medical practice.

The struggle for dignity by people with severe functional disabilities.

PubMed

Wadensten, Barbro; Ahlström, Gerd

2009-07-01

The purpose of this study was to investigate what strategies people with severe functional disabilities who receive personal assistance in their homes use in their daily life to achieve autonomy, integrity, influence and participation. Qualitative interviews were carried out and subjected to qualitative latent content analysis. The main finding was expressed in terms of six subthemes: trying to keep a private sphere; striving to communicate; searching for possibilities; taking the initiative; striving to gain insight; and using one's temperament. These generated the overall theme: maintaining dignity in close relationships. This study contributes an understanding of the strategies used by people who are dependent on personal assistance. Future efforts in nursing must focus on supporting personal assistants with ethical knowledge and guidance in order that people with severe functional disabilities are empowered to achieve autonomy, integrity, influence and participation in their daily lives.

Euthanasia or physician-assisted suicide? A survey from the Netherlands.

PubMed

Kouwenhoven, Pauline S C; van Thiel, Ghislaine J M W; Raijmakers, Natasja J H; Rietjens, Judith A C; van der Heide, Agnes; van Delden, Johannes J M

2014-03-01

Legalizing euthanasia or physician-assisted suicide (PAS) is a current topic of debate in many countries. The Netherlands is the only country where legislation covers both. To study physicians' experiences and attitudes concerning the choice between euthanasia and PAS. A questionnaire including vignettes was sent to a random sample of 1955 Dutch general practitioners, elderly care physicians and medical specialists. In total, 793 physicians (41%) participated. There was no clear preference for euthanasia (36%) or PAS (34%). Two thirds of physicians thought that PAS underlines the autonomy and responsibility of the patient and considered this a reason to choose PAS. Reasons for not choosing PAS were expected practical problems. A minority (22%) discussed the possibility of PAS with their patient in case of a request for assistance in dying. Patients receiving PAS more often experienced psychosocial suffering in comparison with patients receiving euthanasia. In vignettes of patients with a request for assistance in dying due to psychosocial suffering, physicians agreed more often with the performance of PAS than with euthanasia. Dutch physicians perceive a difference between euthanasia and PAS. Although they believe PAS underlines patient autonomy and responsibility, the option of PAS is rarely discussed with the patient. The more psychosocial in nature the patient's suffering, the more physicians choose PAS. In these cases, PAS seems to fulfil physicians' preferences to emphasize patient autonomy and responsibility. Expected technical problems and unfamiliarity with PAS also play a role. Paradoxically, the choice for PAS is predominantly a physician's one.

[Autonomy: to what extent is the concept relevant in psychiatry?].

PubMed

de Wit, F A

2012-01-01

Autonomy is an important concept in psychiatry, but because it is a somewhat abstract and ambiguous notion, it is not applicable in its entirety in a psychiatric context. This becomes obvious in situations where patients are receiving long term care and treatment. To modify the concept of autonomy in such a way that it acquires an extra dimension that renders it applicable to daily psychiatric practice. The literature was reviewed in order to find articles that reveal the tensions that arise between autonomy and dependence in psychiatry and that reflect the human characteristics that are concealed behind the modern concepts of autonomy, freedom and respect for autonomy. Concepts such as person, identity, acknowledgement, dialogical ethics and life histories are used as an addition to the concepts of autonomy of Kant and Mill. A phenomenological and a context sensitive conception of autonomy is needed within the perspective of dialogical ethics. A dialogical perspective requires from psychiatric professionals a susceptibility for what the patient as a human being really has to say. On the basis of a dialogue where there is space and attention for life histories, backgrounds and the potentials of patients, a new perspective can be developed that is shared by the persons involved. In psychiatry, statements about real autonomy and genuine respect for autonomy are only truly meaningful within the context of doctors, nurses and patients. A hermeneutic approach to patients which involves dialogue creates new opportunities in the field of staff-patient relations.

[Ethics and handicap].

PubMed

Schmitt, J; Arthuis, M; Huriet, C; Joubert, F R; Rebillon, M

1994-11-01

The deprivation of numerous possibilities suffered by the severely-handicapped on account of their somato-psychic deficiency extends to many areas: mobility, relationships, autonomy in their everyday life, dependency, psychological or even mental consequences. The most elementary ethics would require to take all these deprivations into account, not just in the choice of accommodation structures but also in the behaviour of relatives and friends, or of qualified members of staff, in their approach to the handicapped. The range of application of these ethical rules must therefore extend from the quality of life and assistance, and the concern for efficiency of interventions, to the problems of security and securization, the assessment and the prevention of risks deriving from the handicap or its consequences, through the information of the patients regarding their elementary or specific rights, the introduction of the most favourable basis in order to make sure that they enjoy the dignity due to any human being, whatever his condition. Such a vast program requires a great many means of action, which all imply the recourse to the appropriate material and human assistance.

[Carers and the policy for autonomy].

PubMed

Naiditch, Michel

2016-03-01

Long-time invisible, the role of informal carers in providing assistance to elderly patients losing their autonomy is gaining recognition. A policy in favour of carers coordinated with that aimed at the people being cared for is necessary, but it is struggling to establish itself in France. Some progress can however be seen with the French bill on adapting society to the ageing of the population. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Effects of a caregiver-inclusive assistive technology intervention: a randomized controlled trial.

PubMed

Ben Mortenson, W; Demers, Louise; Fuhrer, Marcus J; Jutai, Jeffrey W; Bilkey, Jessica; Plante, Michelle; DeRuyter, Frank

2018-04-18

The principal aim of this study was to investigate whether a caregiver-inclusive assistive technology intervention improved older care recipients' functional autonomy and decreased the perceived burden of their family caregivers compared to customary care. The study was a single-blind, mixed-methods, randomized controlled trial with baseline data collection and follow-ups at 6-, 22-, and 58-weeks after baseline evaluation, which was prospectively registered ( ClinicalTrials.gov Identifier: NCT01640470. Registered 11/21/2011). Dyads comprising a care recipient and family caregiver were randomly assigned to either a caregiver-inclusive experimental group (N = 44) or a customary-care comparison group (N = 46). Eligible care recipients were aged ≥55 years and had one or more limitations with mobility or daily activities, and family caregivers provided at least four hours per week of assistance. Outcome measures were administered to both groups at baseline and at the three follow-up time points. The data collectors were blinded regarding participants' intervention group. The primary outcome measures were the Functional Autonomy Measurement System to assess care recipients' functional performance, and the Caregiver Assistive Technology Outcome Measure to assess caregivers' burden. Qualitative interviews examined participants' perceptions of the caregiver-inclusive and customary care interventions. The experimental intervention addressed significantly more dyad-identified problematic activities, but caregiver involvement was evident in both groups and outcomes were not significantly different over time. In both groups, care recipients' functional autonomy declined significantly (P < .01), and caregivers' activity-specific and overall burden decreased significantly (P < .01). Given the unintended congruence between the caregiver-inclusive and customary care interventions, the overall findings lend support for the provision of assistive technology to reduce caregiver burden.

ARMD Strategic Thrust 6: Assured Autonomy for Aviation Transformation

NASA Technical Reports Server (NTRS)

Ballin, Mark; Holbrook, Jon; Sharma, Shivanjli

2016-01-01

In collaboration with the external community and other government agencies, NASA will develop enabling technologies, standards, and design guidelines to support cost-effective applications of automation and limited autonomy for individual components of aviation systems. NASA will also provide foundational knowledge and methods to support the next epoch. Research will address issues of verification and validation, operational evaluation, national policy, and societal cost-benefit. Two research and development approaches to aviation autonomy will advance in parallel. The Increasing Autonomy (IA) approach will seek to advance knowledge and technology through incremental increases in machine-based support of existing human-centered tasks, leading to long-term reallocation of functions between humans and machines. The Autonomy as a New Technology (ANT) approach seeks advances by developing technology to achieve goals that are not currently possible using human-centered concepts of operation. IA applications are mission-enhancing, and their selection will be based on benefits achievable relative to existing operations. ANT applications are mission-enabling, and their value will be assessed based on societal benefit resulting from a new capability. The expected demand for small autonomous unmanned aircraft systems (UAS) provides an opportunity for development of ANT applications. Supervisory autonomy may be implemented as an expansion of the number of functions or systems that may be controlled by an individual human operator. Convergent technology approaches, such as the use of electronic flight bags and existing network servers, will be leveraged to the maximum extent possible.

Self-Determination Theory: The Importance of Autonomy to Well-Being across Cultures

ERIC Educational Resources Information Center

Wichmann, Sonia Secher

2011-01-01

According to proponents of self-determination theory, autonomous regulation is a universal psychological human need. Researchers have found autonomy (defined as acting in accordance with one's values) related to well-being across cultures. Encouraging client autonomy is therefore fundamental to the practice of humanistic counseling.

Cutting the Cord: Discrimination and Command Responsibility in Autonomous Lethal Weapons

DTIC Science & Technology

2014-02-13

machine responses to identical stimuli, and it was the job of a third party human “witness” to determine which participant was man and which was...machines may be error free, but there are potential benefits to be gained through autonomy if machines can meet or exceed human performance in...lieu of human operators and reap the benefits that autonomy provides. Human and Machine Error It would be foolish to assert that either humans

Knowing when to assist: developmental issues in lifelong assistive robotics.

PubMed

Demiris, Yiannis

2009-01-01

Children and adults with sensorimotor disabilities can significantly increase their autonomy through the use of assistive robots. As the field progresses from short-term, task-specific solutions to long-term, adaptive ones, new challenges are emerging. In this paper a lifelong methodological approach is presented, that attempts to balance the immediate context-specific needs of the user, with the long-term effects that the robot's assistance can potentially have on the user's developmental trajectory.

Desire for hastened death: exploring the emotions and the ethics.

PubMed

Branigan, Monica

2015-03-01

As we approach the end of our lives, many of us will have a desire for hastened death (DHD). Fortunately, our ability to respond to suffering at the end of life is improving. At the same time, in many jurisdictions, changes are underway to legislate physician-assisted death. This compels us as clinicians to explore DHD in a compassionate way - to reduce suffering and reduce premature death. This challenge is becoming more compelling as a large cohort of individuals, who value autonomy and control, age and experience illness. Studies confirm that DHD is not always a request to die. Clarifying the intention behind the desire and exploring the individual factors and underlying reasons behind the wish have been described. Another theme questions our basic assumptions about these statements - a normal part of a human experience or an indicator of disease. This tension is also manifested in the appropriate balance between patient autonomy and preventing harm. We have a professional responsibility to mindfully explore with the patient the suffering that can be relieved and the suffering that remains.

Autonomy and the principle of respect for autonomy.

PubMed

Gillon, R

1985-06-15

Autonomy is defined as the capacity to think, decide, and act freely and independently on the basis of such thought and decisions. Three types of autonomy are distinguished: autonomy of thought, which embraces the wide range of human intellectual activities called "thinking for oneself"; autonomy of will, or the capacity to decide to do things on the basis of one's deliberations; and autonomy of action, the absence of which is illustrated by the situation of a patient whose voluntary muscles are paralyzed by curariform drugs and who thus cannot tell the surgeon that the anesthetist has forgotten the nitrous oxide. Autonomy is viewed as a prerequisite for all the virtues, rather than as a virtue in its own right. The arguments of Immanuel Kant and John Stuart Mill concerning the principle of respect for autonomy are summarized as exemplars respectively of the deontological and utilitarian philosophical approaches.

Parental Mathematics Homework Involvement of Low-Income Families with Middle School Students

ERIC Educational Resources Information Center

O'Sullivan, Robyn Hackford; Chen, Yung-Chi; Fish, Marian C.

2014-01-01

This study explores the relationships between methods of parental assistance (i.e., provision of structure, direct assistance, and autonomy support) with mathematics homework for high-achieving and low-achieving students and children's achievement in mathematics in low-income families and examines the impact of parental efficacy on these…

[The nurse-healthcare assistant partnership: a learning tool?].

PubMed

Martin, Yolaine; Chauzy, Sébastien; Pasticcio, Denise; Blivet, Annie

2015-02-01

In intensive care, working in a nurse-healthcare assistant partnership is essential. It facilitates the way they receive the patient, organise and work together in performing technical procedures, provide personal care and comfort and compensate for a decrease in or loss of autonomy. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Creating Space: Maximising the Potential of the Graduate Teaching Assistant Role

ERIC Educational Resources Information Center

Fairbrother, Hannah

2012-01-01

Creating space for Graduate Teaching Assistants (GTAs) to work as active members of the department and take ownership of certain learning and teaching activities has many potential benefits. Allowing GTAs the autonomy to pursue personal projects and share their enthusiasm for their subjects could help GTAs to develop a sense of professional…

Humans and Autonomy: Implications of Shared Decision Making for Military Operations

DTIC Science & Technology

2017-01-01

and machine learning transparency are identified as future research opportunities. 15. SUBJECT TERMS autonomy, human factors, intelligent agents...network as either the mission changes or an agent becomes disabled (DSB 2012). Fig. 2 Control structures for human agent teams. Robots without tools... learning (ML) algorithms monitor progress. However, operators have final executive authority; they are able to tweak the plan or choose an option

Human dignity and autonomy in the care for patients with dementia: differences among formal caretakers from various cultural backgrounds.

PubMed

Bentwich, Miriam Ethel; Dickman, Nomy; Oberman, Amitai

2018-02-01

To explore whether gaps exist between caretakers from different ethno-cultural groups (Israeli-born Jews [Sabras], Israeli Arabs [Arabs], and migrants from Russia [Russians]) regarding their perceptions of autonomy and human dignity of patients with dementia. A mixed-methods research scheme was used, comprised of qualitative and quantitative methods, utilizing semi-structured interviews and self-reported questionnaires. Twenty formal caretakers participated in the qualitative portion, and approximately 200 caretakers were included in the quantitative portion. All participants were recruited from three nursing homes and one hospital in the Galilee region (Israel). The qualitative portion of the study yielded eight themes encapsulated in the concept of autonomy and ten themes entailed within human dignity, in the context of care for patients with dementia. By utilizing these themes in the quantitative portion, substantial differences in nursing homes were found in the attitudes to autonomy and dignity of patients with dementia between Russian and Arab as well as Sabra caretakers (index score for autonomy: 2.97, 4.07, and 4, respectively; index score for dignity: 3.17, 4.1, and 4.07). A multi-variable regression, focusing on caretakers from nursing homes, showed the most significant influencing variables on the indexes of autonomy and dignity were ethno-culture Arab/Russian (0.84, 0.62) and the patient's family (0.29, 0.30). Regarding the autonomy index, being a female caretaker also had a significant influence (0.24). In the hospital, no influence emerged for the ethno-culture variables, and neither type of institution showed any influence of religion or religiousness as well as societal or community norms. Contrary to past research, in nursing homes, significant differences were found between certain ethno-cultural groups (Arabs and Russians) regarding their stance toward the dignity and autonomy of patients with dementia. Arab caretakers' fostering of more encompassing conceptions of dignity and autonomy, irrespective of institutional setting, provides better grounds for person-centered care.

Investigation of human-robot interface performance in household environments

NASA Astrophysics Data System (ADS)

Cremer, Sven; Mirza, Fahad; Tuladhar, Yathartha; Alonzo, Rommel; Hingeley, Anthony; Popa, Dan O.

2016-05-01

Today, assistive robots are being introduced into human environments at an increasing rate. Human environments are highly cluttered and dynamic, making it difficult to foresee all necessary capabilities and pre-program all desirable future skills of the robot. One approach to increase robot performance is semi-autonomous operation, allowing users to intervene and guide the robot through difficult tasks. To this end, robots need intuitive Human-Machine Interfaces (HMIs) that support fine motion control without overwhelming the operator. In this study we evaluate the performance of several interfaces that balance autonomy and teleoperation of a mobile manipulator for accomplishing several household tasks. Our proposed HMI framework includes teleoperation devices such as a tablet, as well as physical interfaces in the form of piezoresistive pressure sensor arrays. Mobile manipulation experiments were performed with a sensorized KUKA youBot, an omnidirectional platform with a 5 degrees of freedom (DOF) arm. The pick and place tasks involved navigation and manipulation of objects in household environments. Performance metrics included time for task completion and position accuracy.

Proactive human-computer collaboration for information discovery

NASA Astrophysics Data System (ADS)

DiBona, Phil; Shilliday, Andrew; Barry, Kevin

2016-05-01

Lockheed Martin Advanced Technology Laboratories (LM ATL) is researching methods, representations, and processes for human/autonomy collaboration to scale analysis and hypotheses substantiation for intelligence analysts. This research establishes a machinereadable hypothesis representation that is commonsensical to the human analyst. The representation unifies context between the human and computer, enabling autonomy in the form of analytic software, to support the analyst through proactively acquiring, assessing, and organizing high-value information that is needed to inform and substantiate hypotheses.

Animal-assisted interventions in internal and rehabilitation medicine: a review of the recent literature.

PubMed

Muñoz Lasa, S; Ferriero, G; Brigatti, E; Valero, R; Franchignoni, F

2011-06-01

While conventional wisdom has always affirmed the value of animals in promoting human well-being, only recently has their therapeutic role in medicine become the focus of dedicated research. Therapeutic modalities that use animals as a tool for improving the physical, emotional, cognitive and/or social functioning of humans are called animal-assisted interventions (AAI), and are classified into: animal-assisted activities (AAA); animal-assisted therapy (AAT); and service animal programs (SAP). The aim of this review is to analyze the papers published between 2001 and 2010 in the most influential medical journals dealing with AAI, and discuss their findings in the light of what may be of interest for internal medicine and rehabilitation. A total of 35 articles met the strict inclusion criteria for this review: 18 papers dealing with AAA, 8 with AAT, and 9 with SAP. The therapeutic outcomes associated with AAA are: enhancement of socialization; reduction of stress, anxiety and loneliness; improvement in mood and general well-being; and development of leisure/recreation skills. Regarding AAT, horses are often used as a complementary strategy to facilitate the normalization of muscle tone and improve motor skills in children with cerebral palsy and persons with lower limb spasticity. Finally, most SAP utilize dogs, that assist people with various disabilities in performing everyday activities, thus reducing their dependence on other persons. Further studies are needed to better define the fields and programs for the therapeutic use of animals and to increase their utilization in medicine, as a promising, complementary and natural means to improve both functional autonomy and quality of life.

Resourcifying human bodies--Kant and bioethics.

PubMed

Miyasaka, Michio

2005-01-01

This essay roughly sketches two major conceptions of autonomy in contemporary bioethics that promote the resourcification of human body parts: (1) a narrow conception of autonomy as self-determination; and (2) the conception of autonomy as dissociated from human dignity. In this paper I will argue that, on the one hand, these two conceptions are very different from that found in the modern European tradition of philosophical inquiry, because bioethics has concentrated on an external account of patient's self-determination and on dissociating dignity from internal human nature. However, on the other hand, they are consistent with more recent European philosophy. In this more recent tradition, human dignity has gradually been dissociated from contextual values, and human subjectivity has been dissociated from objectivity and absolutized as never to be objectified. In the concluding part, I will give a speculative sketch in which Kant's internal inquiry of maxim of ends, causality and end, and dignity as iirreplaceability is recombined with bioethics' externalized one and used to support an extended human resourcification.

Nursing Assistants' Job Commitment: Effect of Nursing Home Organizational Factors and Impact on Resident Well-Being

ERIC Educational Resources Information Center

Bishop, Christine E.; Weinberg, Dana Beth; Leutz, Walter; Dossa, Almas; Pfefferle, Susan G.; Zincavage, Rebekah M.

2008-01-01

Purpose: The purpose of this study was to investigate (a) whether certified nursing assistants (CNAs) are more committed to nursing home jobs when they perceive their jobs as enhanced (greater autonomy, use of knowledge, teamwork), and (b) whether CNA job commitment affects resident satisfaction. Design and Methods: A qualitative exploration of…

Autonomy and why you can "Never Let Me Go".

PubMed

Bowyer, Lynne

2014-06-01

Kazuo Ishiguro's book Never Let Me Go is a thoughtful and provocative exploration of what it means to be human. Drawing on insights from the hermeneutic-phenomenology of Martin Heidegger, I argue that the movement of Ishiguro's story can be understood in terms of actualising the human potential for autonomous action. Liberal theories take autonomy to be concerned with analytically and ethically isolatable social units directing their lives in accordance with self-interested preferences, arrived at by means of rational calculation. However, I argue that such theories are simplistic abstractions from our human-life world, distorting the fundamental embodied, embedded, and relational nature of autonomy. When we attend closely to our concrete, lived existence we see instead that autonomy is about responding appropriately to others with whom we share a world. As we follow the path of Ishiguro's central character Kathy H., we are shown how an awareness and acceptance of our existential finitude as precarious and fallible creatures is necessary for guiding such appropriate interactions. As Kathy grows and is affirmed into her life-world, which grounds and supports her Being, she moves from heteronomy to autonomy; from being moved by external laws to embodying those laws, thereby becoming autonomous. This is exemplified by her appropriation of the carer role, through which she responds in a fitting way to those with whom she shares her world, bearing the weight of and dwelling responsibly within our human condition.

Supervised Remote Robot with Guided Autonomy and Teleoperation (SURROGATE): A Framework for Whole-Body Manipulation

NASA Technical Reports Server (NTRS)

Hebert, Paul; Ma, Jeremy; Borders, James; Aydemir, Alper; Bajracharya, Max; Hudson, Nicolas; Shankar, Krishna; Karumanchi, Sisir; Douillard, Bertrand; Burdick, Joel

2015-01-01

The use of the cognitive capabilties of humans to help guide the autonomy of robotics platforms in what is typically called "supervised-autonomy" is becoming more commonplace in robotics research. The work discussed in this paper presents an approach to a human-in-the-loop mode of robot operation that integrates high level human cognition and commanding with the intelligence and processing power of autonomous systems. Our framework for a "Supervised Remote Robot with Guided Autonomy and Teleoperation" (SURROGATE) is demonstrated on a robotic platform consisting of a pan-tilt perception head, two 7-DOF arms connected by a single 7-DOF torso, mounted on a tracked-wheel base. We present an architecture that allows high-level supervisory commands and intents to be specified by a user that are then interpreted by the robotic system to perform whole body manipulation tasks autonomously. We use a concept of "behaviors" to chain together sequences of "actions" for the robot to perform which is then executed real time.

Designing Autonomy: Opportunities for New Wildness in the Anthropocene.

PubMed

Cantrell, Bradley; Martin, Laura J; Ellis, Erle C

2017-03-01

Maintaining wild places increasingly involves intensive human interventions. Several recent projects use semi-automated mediating technologies to enact conservation and restoration actions, including re-seeding and invasive species eradication. Could a deep-learning system sustain the autonomy of nonhuman ecological processes at designated sites without direct human interventions? We explore here the prospects for automated curation of wild places, as well as the technical and ethical questions that such co-creation poses for ecologists, conservationists, and designers. Our goal is to foster innovative approaches to creating and maintaining the autonomy of evolving ecological systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

"Science Discovers, Genius Invents, Industry Applies, and Man Adapts Himself...": Some Thoughts on Human Autonomy, Law, and Technology

ERIC Educational Resources Information Center

Chandler, Jennifer

2010-01-01

This short note considers the relationships between human autonomy, both individual and collective, and technology. At the collective level, numerous writers have observed the profound effects on society of technological discoveries--leading to the suggestion that societal mechanisms through which we might seek to make deliberate choices about…

Principals and Self-Determination Theory (SDT): What Trends Are Seen in Levels of Autonomy, Competence, and Relatedness?

ERIC Educational Resources Information Center

Roundy-Harter, Anne

2010-01-01

This study builds upon Deci and Ryan's (1985) Self-Determination Theory (SDT) which states that humans must meet three basic psychological needs for optimal well-being: autonomy, competence, and relatedness. The purpose of this qualitative study was to explore trends in principals' experiences in the areas of autonomy, competence, and relatedness.…

Defining the doula's role: fostering relational autonomy.

PubMed

Meadow, Sandra L

2015-12-01

Training organizations as well as academic and popular literature provide ambiguous or ethically contentious characterizations of the role of the birth doula, a non-clinical role assisting women in pregnancy and birth with information and physical and emotional support. Doulas have been criticized for attempting to impose their own agendas on their clients and for interfering with the relationship between women and their medical caregivers. To develop a theoretically grounded model of the birth doula's role to guide constructive practice and refute some training organizations' and doulas' adoption of an active 'advocacy' role with clients that can lead to inappropriate practices. Apply the theoretical framework of relational autonomy to the components of the work that doulas perform with their clients. The conceptual framework of relational autonomy recognizes the social context in which women make choices about their care in pregnancy and birth, instead of assuming that autonomy is exercised in isolation. To support this understanding of autonomy, a relational model emphasizes women's skills development, self-confidence and recognition of the social context for decisions. Highlighting these aspects of exercising autonomy reduces the potential for the doula to seek to influence her client. The doula's role is reframed as one of facilitating patient engagement and shared decision-making. © 2014 John Wiley & Sons Ltd.

DoD Autonomy Roadmap: Autonomy Community of Interest

DTIC Science & Technology

2015-03-24

Initiative 27  Exploiting Priming Effects Team (Navy)  Develop machine perception relatable to the manner in which a human perceives the ...and trust among the team members; understanding of each member’s tasks, intentions, capabilities, and progress; and ensuring effective and timely...learning capabilities to greatly reduce the need for human interventions, while enabling effective teaming with the warfighter Machine Perception

System Analysis Applied to Autonomy: Application to Human-Rated Lunar/Mars Landers

NASA Technical Reports Server (NTRS)

Young, Larry A.

2006-01-01

System analysis is an essential technical discipline for the modern design of spacecraft and their associated missions. Specifically, system analysis is a powerful aid in identifying and prioritizing the required technologies needed for mission and/or vehicle development efforts. Maturation of intelligent systems technologies, and their incorporation into spacecraft systems, are dictating the development of new analysis tools, and incorporation of such tools into existing system analysis methodologies, in order to fully capture the trade-offs of autonomy on vehicle and mission success. A "system analysis of autonomy" methodology will be outlined and applied to a set of notional human-rated lunar/Mars lander missions toward answering these questions: 1. what is the optimum level of vehicle autonomy and intelligence required? and 2. what are the specific attributes of an autonomous system implementation essential for a given surface lander mission/application in order to maximize mission success? Future human-rated lunar/Mars landers, though nominally under the control of their crew, will, nonetheless, be highly automated systems. These automated systems will range from mission/flight control functions, to vehicle health monitoring and prognostication, to life-support and other "housekeeping" functions. The optimum degree of autonomy afforded to these spacecraft systems/functions has profound implications from an exploration system architecture standpoint.

Patients as Rights Holders.

PubMed

Brännmark, Johan

2017-07-01

Autonomy and consent have been central values in Western moral and political thought for centuries. One way of understanding the bioethical models that started to develop, especially in the 1970s, is that they were about the fusion of a long-standing professional ethics with the core values underpinning modern political institutions. That there was a need for this kind of fusion is difficult to dispute, especially since the provision of health care has in most developed countries become an ever more important concern of our political institutions, with governments playing a significant role in regulating and facilitating the provision of health care and in many countries even largely organizing it. There is, nevertheless, still room for dispute about how best to achieve this fusion and how to best think about autonomy and consent in a biomedical context. The simplest model we can have is probably about how being a person is largely about having the capacity of autonomous choice and that the main mode through which we exercise autonomy is by providing informed consent. Yet, liberal democracy's core idea that human beings have a high and equal value is also found in other accounts of the person. The human-rights framework provides an alternative model for thinking about personhood and about patient care. The human-rights approach is grounded, not in an account of autonomy (although it has something to say about autonomy), but in an account of the moral and political personhood that people possess merely by being human beings. In this approach, values like dignity and integrity, both highly relevant in a bioethical context, are identified as distinct values rather than being derived from and therefore reduced to respect for autonomous choice. The human-rights approach can supplement the problematic notion of autonomy that has been central to bioethics by placing this notion in a broader, strongly pluralistic framework. © 2017 The Hastings Center.

Psychological autonomy and hierarchical relatedness as organizers of developmental pathways

PubMed Central

Keller, Heidi

2016-01-01

The definition of self and others can be regarded as embodying the two dimensions of autonomy and relatedness. Autonomy and relatedness are two basic human needs and cultural constructs at the same time. This implies that they may be differently defined yet remain equally important. The respective understanding of autonomy and relatedness is socialized during the everyday experiences of daily life routines from birth on. In this paper, two developmental pathways are portrayed that emphasize different conceptions of autonomy and relatedness that are adaptive in two different environmental contexts with very different affordances and constraints. Western middle-class children are socialized towards psychological autonomy, i.e. the primacy of own intentions, wishes, individual preferences and emotions affording a definition of relatedness as psychological negotiable construct. Non-Western subsistence farmer children are socialized towards hierarchical relatedness, i.e. positioning oneself into the hierarchical structure of a communal system affording a definition of autonomy as action oriented, based on responsibility and obligations. Infancy can be regarded as a cultural lens through which to study the different socialization agendas. Parenting strategies that aim at supporting these different socialization goals in German and Euro-American parents on the one hand and Nso farmers from North Western Cameroon on the other hand are described. It is concluded that different pathways need to be considered in order to understand human psychology from a global perspective. PMID:26644589

Psychological autonomy and hierarchical relatedness as organizers of developmental pathways.

PubMed

Keller, Heidi

2016-01-19

The definition of self and others can be regarded as embodying the two dimensions of autonomy and relatedness. Autonomy and relatedness are two basic human needs and cultural constructs at the same time. This implies that they may be differently defined yet remain equally important. The respective understanding of autonomy and relatedness is socialized during the everyday experiences of daily life routines from birth on. In this paper, two developmental pathways are portrayed that emphasize different conceptions of autonomy and relatedness that are adaptive in two different environmental contexts with very different affordances and constraints. Western middle-class children are socialized towards psychological autonomy, i.e. the primacy of own intentions, wishes, individual preferences and emotions affording a definition of relatedness as psychological negotiable construct. Non-Western subsistence farmer children are socialized towards hierarchical relatedness, i.e. positioning oneself into the hierarchical structure of a communal system affording a definition of autonomy as action oriented, based on responsibility and obligations. Infancy can be regarded as a cultural lens through which to study the different socialization agendas. Parenting strategies that aim at supporting these different socialization goals in German and Euro-American parents on the one hand and Nso farmers from North Western Cameroon on the other hand are described. It is concluded that different pathways need to be considered in order to understand human psychology from a global perspective. © 2015 The Author(s).

Is frailty associated with life-space mobility and perceived autonomy in participation outdoors? A longitudinal study.

PubMed

Portegijs, Erja; Rantakokko, Merja; Viljanen, Anne; Sipilä, Sarianna; Rantanen, Taina

2016-07-01

essential aspects of independence in community mobility among older people concern the control over where, when and how to participate (perceived autonomy), and actual mobility (life-space mobility; frequency, distance and need of assistance). We studied relationships between frailty and life-space mobility and perceived autonomy in participation outdoors among community-dwelling 75-90 years old people. longitudinal analyses of the 'Life-space mobility in old age' cohort study (n = 753). Life-space mobility (Life-Space Assessment, range 0-120) and perceived autonomy in participation outdoors (Impact on Participation and Autonomy subscale 'autonomy outdoors', range 0-20) were assessed at baseline and 2 years later. Baseline frailty indicators were unintentional weight loss (self-report), weakness (5 times chair rise), exhaustion (self-report), slowness (2.44 m walk) and low physical activity (self-report). in total, 53% had no frailty, 43% pre-frailty (1-2 frailty indicators) and 4% frailty (≥3 indicators). Generalised estimation equation models showed that life-space mobility was lower among those with frailty and pre-frailty compared with those without frailty and, in addition, declined at a faster pace. Perceived autonomy in participation outdoors was more restricted among those with frailty and pre-frailty compared with those without frailty, but the rate of decline did not differ. frailty was associated with more restricted life-space mobility and poorer perceived autonomy in the decision-making concerning community mobility. Over the follow-up, frailty predicted a steeper decline in life-space mobility but not in perceived autonomy. Further study is warranted to determine whether compensation strategies or changes in the valuation of activities underlie this discrepancy. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Human-Autonomy Teaming Approach for a Flight-Following Task

NASA Technical Reports Server (NTRS)

Brandt, Summer L.; Lachter, Joel; Russell, Ricky; Shively, R. Jay

2017-01-01

Human involvement with increasingly autonomous systems must adjust to allow for a more dynamic relationship involving cooperation and teamwork. As part of an ongoing project to develop a framework for human autonomy teaming (HAT) in aviation, a study was conducted to evaluate proposed tenets of HAT. Participants performed a flight-following task at a ground station both with and without HAT features enabled. Overall, participants preferred the ground station with HAT features enabled over the station without the HAT features. Participants reported that the HAT displays and automation were preferred for keeping up with operationally important issues. Additionally, participants reported that the HAT displays and automation provided enough situation awareness to complete the task, reduced the necessary workload and were efficient. Overall, there was general agreement that HAT features supported teaming with the automation. These results will be used to refine and expand our proposed framework for human-autonomy teaming.

Death with "dignity": the wedge that divides the disability rights movement from the right to die movement.

PubMed

Behuniak, Susan M

2011-01-01

Much of the American debate over physician assisted death (PAD) is framed as an ideological split between conservatives and liberals, pro life and pro choice advocates, and those who emphasize morality versus personal autonomy. Less examined, but no less relevant, is a split within the ranks of progressives--one that divides those supporting a right to die in the name of human rights from disability rights activists who invoke human rights to vehemently oppose euthanasia. This paper reviews how "dignity" serves both as a divisive wedge in this debate but also as a value that can span the divide between groups and open the way to productive discourse. Supporters of legalized euthanasia use "dignity" to express their position that some deaths might indeed be accelerated. At the same time, opponents adopt the concept to argue that physician assisted suicide stigmatizes life with a disability. To bridge this divide, the worldviews of two groups, Compassion & Choices and Not Dead Yet, are studied. The analysis concludes that the two organizations are more parallel than contrary--a finding that offers opportunities for dialogue and perhaps even advances in public policy.

Situation awareness-based agent transparency for human-autonomy teaming effectiveness

NASA Astrophysics Data System (ADS)

Chen, Jessie Y. C.; Barnes, Michael J.; Wright, Julia L.; Stowers, Kimberly; Lakhmani, Shan G.

2017-05-01

We developed the Situation awareness-based Agent Transparency (SAT) model to support human operators' situation awareness of the mission environment through teaming with intelligent agents. The model includes the agent's current actions and plans (Level 1), its reasoning process (Level 2), and its projection of future outcomes (Level 3). Human-inthe-loop simulation experiments have been conducted (Autonomous Squad Member and IMPACT) to illustrate the utility of the model for human-autonomy team interface designs. Across studies, the results consistently showed that human operators' task performance improved as the agents became more transparent. They also perceived transparent agents as more trustworthy.

The origins and consequences of patient autonomy: a 25-year retrospective.

PubMed

Rothman, D J

2001-01-01

This essay explores the evolution of the tension between the principles of autonomy and beneficence in American health care over the past several decades. In retrospect it is clear that the social movements of the 1960s and 70s set the tone and the goals for the emergence of a new emphasis on patient autonomy. Indeed, the impact of civil liberties-minded lawyers on the promotion of a commitment to autonomy is far more vital than the term "bioethics" commonly suggests. Tracing the impact of this principle on clinical encounters over the past 25 years makes apparent that consumers have extended their influence over a wide range of treatment decisions. This influence is now being reinforced by an extraordinary information revolution, which includes the computer, the web, the dot.coms, the search engines, and such novel practices as Direct-to-Consumer advertising by pharmaceutical companies. The impact of these developments may be seen in such diverse issues as physician-assisted suicide and the failure of national health insurance initiatives.

Robotic-assisted laparoscopic radical nephrectomy using the Da Vinci Si system: how to improve surgeon autonomy. Our step-by-step technique.

PubMed

Davila, Hugo H; Storey, Raul E; Rose, Marc C

2016-09-01

Herein, we describe several steps to improve surgeon autonomy during a Left Robotic-Assisted Laparoscopic Radical Nephrectomy (RALRN), using the Da Vinci Si system. Our kidney cancer program is based on 2 community hospitals. We use the Da Vinci Si system. Access is obtained with the following trocars: Two 8 mm robotic, one 8 mm robotic, bariatric length (arm 3), 15 mm for the assistant and 12 mm for the camera. We use curved monopolar scissors in robotic arm 1, Bipolar Maryland in arm 2, Prograsp Forceps in arm 3, and we alternate throughout the surgery with EndoWrist clip appliers and the vessel sealer. Here, we described three steps and the use of 3 robotic instruments to improve surgeon autonomy. Step 1: the lower pole of the kidney was dissected and this was retracted upwards and laterally. This maneuver was performed using the 3rd robotic arm with the Prograsp Forceps. Step 2: the monopolar scissors was replaced (robotic arm 1) with the robotic EndoWrist clip applier, 10 mm Hem-o-Lok. The renal artery and vein were controlled and transected by the main surgeon. Step 3: the superior, posterolateral dissection and all bleeders were carefully coagulated by the surgeon with the EndoWrist one vessel sealer. We have now performed 15 RALRN following these steps. Our results were: blood loss 300 cc, console time 140 min, operating room time 200 min, anesthesia time 180 min, hospital stay 2.5 days, 1 incisional hernia, pathology: (13) RCC clear cell, (1) chromophobe and (1) papillary type 1. Tumor Stage: (5) T1b, (8) T2a, (2) T2b. We provide a concise, step-by-step technique for radical nephrectomy (RN) using the Da Vinci Si robotic system that may provide more autonomy to the surgeon, while maintaining surgical outcome equivalent to standard laparoscopic RN.

Autonomous technology - sources of confusion: a model for explanation and prediction of conceptual shifts.

PubMed

Stensson, Patrik; Jansson, Anders

2014-01-01

Today, autonomous is often used for technology with a more intelligent self-management capability than common automation. This concept usage is maladaptive, ignoring both the distinction between autonomy and heteronomy according to Kant's categorical imperative and that the meaning of autonomy implies qualities technology cannot have. Being autonomous is about having the right to be wrong, a right justified by accountability and insightful understanding of real-life values, and it is about being externally uncontrollable. The contemporary use of autonomy as well as similar concepts is discussed and a model is presented showing how six sources of confusion interact in a vicious circle that impede human authority and autonomy. Our goal is to sort out these confusions and contribute to a development in which the different roles of machines and people, and human responsibilities, are explicated rather than blurred, which should facilitate the forming of truly beneficial and complementary systems.

Making a difference: incorporating theories of autonomy into models of informed consent.

PubMed

Delany, C

2008-09-01

Obtaining patients' informed consent is an ethical and legal obligation in healthcare practice. Whilst the law provides prescriptive rules and guidelines, ethical theories of autonomy provide moral foundations. Models of practice of consent, have been developed in the bioethical literature to assist in understanding and integrating the ethical theory of autonomy and legal obligations into the clinical process of obtaining a patient's informed consent to treatment. To review four models of consent and analyse the way each model incorporates the ethical meaning of autonomy and how, as a consequence, they might change the actual communicative process of obtaining informed consent within clinical contexts. An iceberg framework of consent is used to conceptualise how ethical theories of autonomy are positioned and underpin the above surface, and visible clinical communication, including associated legal guidelines and ethical rules. Each model of consent is critically reviewed from the perspective of how it might shape the process of informed consent. All four models would alter the process of obtaining consent. Two models provide structure and guidelines for the content and timing of obtaining patients' consent. The two other models rely on an attitudinal shift in clinicians. They provide ideas for consent by focusing on underlying values, attitudes and meaning associated with the ethical meaning of autonomy. The paper concludes that models of practice that explicitly incorporate the underlying ethical meaning of autonomy as their basis, provide less prescriptive, but more theoretically rich guidance for healthcare communicative practices.

Towards "DRONE-BORNE" Disaster Management: Future Application Scenarios

NASA Astrophysics Data System (ADS)

Tanzi, Tullio Joseph; Chandra, Madhu; Isnard, Jean; Camara, Daniel; Sebastien, Olivier; Harivelo, Fanilo

2016-06-01

Information plays a key role in crisis management and relief efforts for natural disaster scenarios. Given their flight properties, UAVs (Unmanned Aerial Vehicles) provide new and interesting perspectives on the data gathering for disaster management. A new generation of UAVs may help to improve situational awareness and information assessment. Among the advantages UAVs may bring to the disaster management field, we can highlight the gain in terms of time and human resources, as they can free rescue teams from time-consuming data collection tasks and assist research operations with more insightful and precise guidance thanks to advanced sensing capabilities. However, in order to be useful, UAVs need to overcome two main challenges. The first one is to achieve a sufficient autonomy level, both in terms of navigation and interpretation of the data sensed. The second major challenge relates to the reliability of the UAV, with respect to accidental (safety) or malicious (security) risks. This paper first discusses the potential of UAV in assisting in different humanitarian relief scenarios, as well as possible issues in such situations. Based on recent experiments, we discuss the inherent advantages of autonomous flight operations, both lone flights and formation flights. The question of autonomy is then addressed and a secure embedded architecture and its specific hardware capabilities is sketched out. We finally present a typical use case based on the new detection and observation abilities that UAVs can bring to rescue teams. Although this approach still has limits that have to be addressed, technically speaking as well as operationally speaking, it seems to be a very promising one to enhance disaster management efforts activities.

Exploitation, autonomy, and the case for organ sales.

PubMed

Hughes, P M

1998-01-01

A recent argument in favor of a free market in human organs claims that such a market enhances personal autonomy. I argue here that such a market would, on the contrary, actually compromise the autonomy of those most likely to sell their organs, namely, the least well off members of society. A Marxian-inspired notion of exploitation is deployed to show how, and in what sense, this is the case.

Human/autonomy collaboration for the automated generation of intelligence products

NASA Astrophysics Data System (ADS)

DiBona, Phil; Schlachter, Jason; Kuter, Ugur; Goldman, Robert

2017-05-01

Intelligence Analysis remains a manual process despite trends toward autonomy in information processing. Analysts need agile decision-­-support tools that can adapt to the evolving information needs of the mission, allowing the analyst to pose novel analytic questions. Our research enables the analysts to only provide a constrained English specification of what the intelligence product should be. Using HTN planning, the autonomy discovers, decides, and generates a workflow of algorithms to create the intelligence product. Therefore, the analyst can quickly and naturally communicate to the autonomy what information product is needed, rather than how to create it.

Autonomy: Life and Being

NASA Astrophysics Data System (ADS)

Williams, Mary-Anne

This paper uses robot experience to explore key concepts of autonomy, life and being. Unfortunately, there are no widely accepted definitions of autonomy, life or being. Using a new cognitive agent architecture we argue that autonomy is a key ingredient for both life and being, and set about exploring autonomy as a concept and a capability. Some schools of thought regard autonomy as the key characteristic that distinguishes a system from an agent; agents are systems with autonomy, but rarely is a definition of autonomy provided. Living entities are autonomous systems, and autonomy is vital to life. Intelligence presupposes autonomy too; what would it mean for a system to be intelligent but not exhibit any form of genuine autonomy. Our philosophical, scientific and legal understanding of autonomy and its implications is immature and as a result progress towards designing, building, managing, exploiting and regulating autonomous systems is retarded. In response we put forward a framework for exploring autonomy as a concept and capability based on a new cognitive architecture. Using this architecture tools and benchmarks can be developed to analyze and study autonomy in its own right as a means to further our understanding of autonomous systems, life and being. This endeavor would lead to important practical benefits for autonomous systems design and help determine the legal status of autonomous systems. It is only with a new enabling understanding of autonomy that the dream of Artificial Intelligence and Artificial Life can be realized. We argue that designing systems with genuine autonomy capabilities can be achieved by focusing on agent experiences of being rather than attempting to encode human experiences as symbolic knowledge and know-how in the artificial agents we build.

The question of autonomy in maternal health in Africa: a rights-based consideration.

PubMed

Amzat, Jimoh

2015-06-01

Maternal mortality is still very high in Africa, despite progress in control efforts at the global level. One elemental link is the question of autonomy in maternal health, especially at the household level where intrinsic human rights are undermined. A rights-based consideration in bioethics is an approach that holds the centrality of the human person, with a compelling reference to the fundamental human rights of every person. A philosophical and sociological engagement of gender and the notion of autonomy within the household reveals some fundamental rights-based perplexities for bioethical considerations in maternal health. The right to self-determination is undermined, and therefore women's dignity, freedom and autonomy, capacities, and choices are easily defiled. This study applies a rights-based approach to maternal health and demonstrates how rights concerns are associated with negative outcomes in maternal health in Africa. The discussion is situated at the household level, which is the starting point in health care. The paper submits that beyond legal and political rights within the context of the state, rights-based issues manifest at the household level. Many of those rights issues, especially relating to women's autonomy, are detrimental to maternal health in Africa. Therefore, a rights-based approach in the social construction of maternal health realities will contribute to alleviating the burden of maternal mortality in Africa.

Provider satisfaction in army primary care clinics.

PubMed

Byers, V L; Mays, M Z; Mark, D D

1999-02-01

The job satisfaction of physicians, nurse practitioners, and physician assistants was assessed during the course of a multicenter study of Army primary care clinics. All providers in nine clinics at three medical centers who were engaged in adult or family care were invited to participate in the study. Questionnaires on job satisfaction and other practice style variables were completed by 26 physicians, 19 nurse practitioners, and 13 physician assistants (46, 76, and 41% of eligible providers, respectively). Analysis revealed a broad range of job satisfaction in the sample. However, average levels of job satisfaction were not significantly different across the three groups of primary care providers. Autonomy and collaboration were significant predictors of job satisfaction. It is clear that changes in health care systems that reduce, or appear to reduce, the primary care provider's autonomy in clinical matters are likely to reduce provider satisfaction as well.

Physical activity counseling intervention at a federally qualified health center: improves autonomy-supportiveness, but not patients' perceived competence.

PubMed

Carroll, Jennifer K; Fiscella, Kevin; Epstein, Ronald M; Sanders, Mechelle R; Winters, Paul C; Moorhead, S Anne; van Osch, Liesbeth; Williams, Geoffrey C

2013-09-01

To assess the effect of a pilot intervention to promote clinician-patient communication about physical activity on patient ratings of their perceived competence for physical activity and their clinicians' autonomy-supportiveness. Family medicine clinicians (n=13) at two urban community health centers were randomized to early or delayed (8 months later) communication training groups. The goal of the training was to teach the 5As (Ask, Advise, Agree, Assist, Arrange) for physical activity counseling. Outcome measures were changes in patient perceptions of autonomy support (modified Health Care Climate Questionnaire, mHCCQ) and perceived competence (Perceived Competence Scale for physical activity, PCS) completed via surveys at baseline, post-intervention and six-month follow-up. Patients (n=326) were mostly female (70%) and low income. Using a generalized estimating equations model (GEE) with patients nested within clinician, patient perceived autonomy support increased at post-intervention compared to baseline (mean HCCQ scores 3.68-4.06, p=0.03). There was no significant change in patient perceived competence for physical activity. A clinician-directed intervention increased patient perceptions of clinician autonomy support but not patient perceived competence for physical activity. Clinicians working with underserved populations can be taught to improve their autonomy supportiveness, according to patient assessments of their clinicians. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Are there limits to respect for autonomy in bioethics?

PubMed

de Roubaix, Malcolm

2008-06-01

I discuss the significance of respect for personal autonomy in bioethics with reference to its practical expression: rational informed patient choice. The question is whether, given the apparent practical limitations to this notion, bioethical autonomy should be seen as an absolute. After a historical review of informed consent and its development, I discuss the requirements for informed consent. Some inherent tensions are evaluated, as is the applicability of the notion that in order to be legitimate, autonomy should do some ethical work. Limits to the notion of informed consent are explored with reference to six examples: the right of women to reproductive autonomy; the autonomy of legally minor Jehovah's Witnesses; autonomy in cosmetic surgery; inappropriate treatment; autonomy and human medical research, and euthanasia and other end-of-life options. The discussion is within a South African framework with reference to other jurisdictions and decisions where appropriate. I conclude that whilst some unusual instances of limitation of bioethical informed consent might be ethically justifiable, the arguments presented point to the opposite: the unfounded limitation of informed consent.

Are the Motivational Effects of Autonomy-Supportive Conditions Universal? Contrasting Results Among Indians and Americans.

PubMed

Tripathi, Ritu; Cervone, Daniel; Savani, Krishna

2018-04-01

In Western theories of motivation, autonomy is conceived as a universal motivator of human action; enhancing autonomy is expected to increase motivation panculturally. Using a novel online experimental paradigm that afforded a behavioral measure of motivation, we found that, contrary to this prevailing view, autonomy cues affect motivation differently among American and Indian corporate professionals. Autonomy-supportive instructions increased motivation among Americans but decreased motivation among Indians. The motivational Cue × Culture interaction was extraordinarily large; the populations exhibited little statistical overlap. A second study suggested that this interaction reflects culturally specific norms that are widely understood by members of the given culture. When evaluating messages to motivate workers, Indians, far more than Americans, preferred a message invoking obligations to one invoking autonomous personal choice norms. Results cast doubt on the claim, made regularly in both basic and applied psychology, that enhancing autonomy is a universally preferred method for boosting motivation.

Finding common ground by unifying autonomy indices to understand needed capabilities

NASA Astrophysics Data System (ADS)

Bihl, Trevor; Cox, Chadwick; Jenkins, Todd

2018-05-01

Autonomous machines promise to reduce the workload of human operators by replacing some or all cognitive functions with intelligent software. However, development is retarded by disagreement among researchers at very basic levels, including what is meant by autonomy and how to achieve it. Clear definitions are few and no one has successfully bridged the gap between philosophical notions and engineering methods. A variety of autonomy measures are reviewed, highlighting their strengths and weaknesses. Various researchers have developed these autonomy measures to facilitate discussions of capabilities. These measures are also a means of comparing and contrasting autonomy approaches. We contend that any properly structured set of measures are not only useful for these functions, but it provides both a philosophical and practical justification, it outlines developmental steps, it suggests schematic constraints, and it implies requirements for tests. As such, we make recommendations for the further developments of autonomy measures.

Self-regulation and the problem of human autonomy: does psychology need choice, self-determination, and will?

PubMed

Ryan, Richard M; Deci, Edward L

2006-12-01

The term autonomy literally refers to regulation by the self. Its opposite, heteronomy, refers to controlled regulation, or regulation that occurs without self-endorsement. At a time when philosophers and economists are increasingly detailing the nature of autonomy and recognizing its social and practical significance, many psychologists are questioning the reality and import of autonomy and closely related phenomena such as will, choice, and freedom. Using the framework of self-determination theory (Ryan & Deci, 2000), we review research concerning the benefits of autonomous versus controlled regulation for goal performance, persistence, affective experience, quality of relationships, and well-being across domains and cultures. We also address some of the controversies and terminological issues surrounding the construct of autonomy, including critiques of autonomy by biological reductionists, cultural relativists, and behaviorists. We conclude that there is a universal and cross-developmental value to autonomous regulation when the construct is understood in an exacting way.

[Tools for assisting diagnosis].

PubMed

Roux, Magali; Asset, Sonya; Medjebar, Samir

2017-11-01

Connected objects are revolutionising practices, fulfil patients' needs for autonomy and the need to deploy healthcare provision beyond healthcare facilities. This article illustrates how these tools can be used in the case of epilepsy. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Demonstration of Human-Autonomy Teaming Principles

NASA Technical Reports Server (NTRS)

Shively, Robert Jay

2016-01-01

Known problems with automation include lack of mode awareness, automation brittleness, and risk of miscalibrated trust. Human-Autonomy Teaming (HAT) is essential for improving these problems. We have identified some critical components of HAT and ran a part-task study to introduce these components to a ground station that supports flight following of multiple aircraft. Our goal was to demonstrate, evaluate, and refine HAT principles. This presentation provides a brief summary of the study and initial findings.

Autonomous System Technologies for Resilient Airspace Operations

NASA Technical Reports Server (NTRS)

Houston, Vincent E.; Le Vie, Lisa R.

2017-01-01

Increasing autonomous systems within the aircraft cockpit begins with an effort to understand what autonomy is and developing the technology that encompasses it. Autonomy allows an agent, human or machine, to act independently within a circumscribed set of goals; delegating responsibility to the agent(s) to achieve overall system objective(s). Increasingly Autonomous Systems (IAS) are the highly sophisticated progression of current automated systems toward full autonomy. Working in concert with humans, these types of technologies are expected to improve the safety, reliability, costs, and operational efficiency of aviation. IAS implementation is imminent, which makes the development and the proper performance of such technologies, with respect to cockpit operation efficiency, the management of air traffic and data communication information, vital. A prototype IAS agent that attempts to optimize the identification and distribution of "relevant" air traffic data to be utilized by human crews during complex airspace operations has been developed.

Autonomy Software: V&V Challenges and Characteristics

NASA Technical Reports Server (NTRS)

Schumann, Johann; Visser, Willem

2006-01-01

The successful operation of unmanned air vehicles requires software with a high degree of autonomy. Only if high level functions can be carried out without human control and intervention, complex missions in a changing and potentially unknown environment can be carried out successfully. Autonomy software is highly mission and safety critical: failures, caused by flaws in the software cannot only jeopardize the mission, but could also endanger human life (e.g., a crash of an UAV in a densely populated area). Due to its large size, high complexity, and use of specialized algorithms (planner, constraint-solver, etc.), autonomy software poses specific challenges for its verification, validation, and certification. -- - we have carried out a survey among researchers aid scientists at NASA to study these issues. In this paper, we will present major results of this study, discussing the broad spectrum. of notions and characteristics of autonomy software and its challenges for design and development. A main focus of this survey was to evaluate verification and validation (V&V) issues and challenges, compared to the development of "traditional" safety-critical software. We will discuss important issues in V&V of autonomous software and advanced V&V tools which can help to mitigate software risks. Results of this survey will help to identify and understand safety concerns in autonomy software and will lead to improved strategies for mitigation of these risks.

Commercial surrogacy and the human right to autonomy.

PubMed

Sifris, Ronli

2015-12-01

Arguments against commercial surrogacy frequently focus on the rights of the surrogate. For-example, those opposed to commercial surrogacy often argue that surrogacy arrangements amount to the exploitation of women and the commodification of their wombs. Phrased in the language of rights, such arguments draw on the right to be free from degrading treatment and the right to be free from discrimination. In contrast, those who support commercial surrogacy refute the arguments relating to exploitation and commodification and cite the right to work and more commonly the right to privacy/autonomy as the key rights in question. This article focuses on the human right to autonomy and interrogates whether prohibitions on commercial surrogacy violate the right of a woman to choose to be a surrogate.

An investigation of the relationship between autonomy, childbirth practices, and obstetric fistula among women in rural Lilongwe District, Malawi.

PubMed

Kaplan, Julika Ayla; Kandodo, Jonathan; Sclafani, Joseph; Raine, Susan; Blumenthal-Barby, Jennifer; Norris, Alison; Norris-Turner, Abigail; Chemey, Elly; Beckham, John Michael; Khan, Zara; Chunda, Reginald

2017-06-19

Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households. We hypothesize that women's limited autonomy may play a role in reinforcing childbirth practices that increase the risk of obstetric fistula in this setting by hindering access to emergency care and further prolonging obstructed labor. A medical student at Baylor College of Medicine partnered with a Malawian research assistant in July 2015 to conduct in-depth qualitative interviews in Chichewa with 25 women living within the McGuire Wellness Centre's catchment area (rural Central Lilongwe District) who had received obstetric fistula repair surgery. This study assessed whether women's limited autonomy in rural Malawi reinforces childbearing practices that increase risk of obstetric fistula. We considered four dimensions of autonomy: sexual and reproductive decision-making, decision-making related to healthcare utilization, freedom of movement, and discretion over earned income. We found that participants had limited autonomy in these domains. For example, many women felt pressured by their husbands, families, and communities to become pregnant within three months of marriage; women often needed to seek permission from their husbands before leaving their homes to visit the clinic; and women were frequently prevented from delivering at the hospital by older women in the community. Many of the obstetric fistula patients in our sample had limited autonomy in several or all of the aforementioned domains, and their limited autonomy often led both directly and indirectly to an increased risk of prolonged labor and fistula. Reducing the prevalence of fistula in Malawi requires a broad understanding of the causes of fistula, so we recommend that the relationship between women's autonomy and fistula risk undergo further investigation.

Application of Human-Autonomy Teaming (HAT) Patterns to Reduce Crew Operations (RCO)

NASA Technical Reports Server (NTRS)

Shively, R. Jay; Brandt, Summer L.; Lachter, Joel; Matessa, Mike; Sadler, Garrett; Battiste, Henri

2011-01-01

Unmanned aerial systems, advanced cockpits, and air traffic management are all seeing dramatic increases in automation. However, while automation may take on some tasks previously performed by humans, humans will still be required to remain in the system for the foreseeable future. The collaboration between humans and these increasingly autonomous systems will begin to resemble cooperation between teammates, rather than simple task allocation. It is critical to understand this human-autonomy teaming (HAT) to optimize these systems in the future. One methodology to understand HAT is by identifying recurring patterns of HAT that have similar characteristics and solutions. This paper applies a methodology for identifying HAT patterns to an advanced cockpit project.

Relational autonomy in informed consent (RAIC) as an ethics of care approach to the concept of informed consent.

PubMed

Osuji, Peter I

2018-03-01

The perspectives of the dominant Western ethical theories, have dominated the concepts of autonomy and informed consent for many years. Recently this dominant understanding has been challenged by ethics of care which, although, also emanates from the West presents a more nuanced concept: relational autonomy, which is more faithful to our human experience. By paying particular attention to relational autonomy, particularity and Process approach to ethical deliberations in ethics of care, this paper seeks to construct a concept of informed consent from the perspective of ethics of care which is here called relational autonomy-in-informed consent (RAIC). Thus, providing a broader theoretical basis for informed consent beyond the usual theoretical perspectives that are particularly Western. Care ethics provides such a broader basis because it appeals to a global perspective that encompasses lessons from other cultures, and this will help to enrich the current ideas of bioethics principles of autonomy and informed consent. This objective will be achieved by exploring the ethics of care emphasis on relationships based on a universal experience of caring; and by contrasting its concept of autonomy as relational with the understanding of autonomy in the approaches of the dominant moral theories that reflect rational, individualistic, and rights-oriented autonomy of the American liberalism.

State Governance Action Report, September 2011

ERIC Educational Resources Information Center

Toutsi, Cristin; Novak, Richard

2011-01-01

This report represents the latest State Governance Action Report (SGAR) covering current or just recently completed legislative sessions. Among the most important issues being considered are management autonomy, such as relaxed rules for purchasing, procurement, and human resources, and greater fiscal autonomy measures such as carry-over budgeting…

Access to assisted reproductive technologies in France: the emergence of the patients' voice.

PubMed

Fournier, Véronique; Berthiau, Denis; d'Haussy, Julie; Bataille, Philippe

2013-02-01

Is there any ethical justification for limiting the reproductive autonomy and not make assisted reproductive technologies available to certain prospective parents? We present and discuss the results of an interdisciplinary clinical ethics study concerning access to assisted reproductive technologies (ART) in situations which are considered as ethically problematic in France (overage or sick parents, surrogate motherhood). The study focused on the arguments that people in these situations put forward when requesting access to ART. It shows that requester's arguments are based on sound ethical values, and that their legitimacy is at least as strong as that of those used by doctors to question access to ART. Results reveal that the three implicit normative arguments that founded the law in 1994, which are still in force after the bioethics law revision in July 2011-the welfare of the child, the illegitimacy of a "right to a child," and the defense of the so called "social order"-are challenged on several grounds by requesters as reasons for limiting their reproductive autonomy. Although these results are limited to exceptional situations, they are of special interest insofar as they give voice to the requesters' own ethical concerns in the ongoing political debate over access to ART.

78 FR 67925 - Transfer of Real Property at Defense Nuclear Facilities for Economic Development

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... that may affect family well-being. This rule would not have any impact on the autonomy or integrity of... enter into and fufill the obligations of a DOE financial assistance agreement.'' 0 b. Adding in the...

77 FR 43410 - Data Collection Available for Public Comments and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-24

... the collections, to Sandra Johnston, Program Analyst, Office of Financial Assistance, Small Business... Premier Certified Lenders Program (PCLP) transfers considerable authority and autonomy to Premier...) that are held in account at financial institutions and about SBIC borrowings from financial...

Amyotrophic lateral sclerosis and assisted ventilation: how patients decide.

PubMed

Lemoignan, Josée; Ells, Carolyn

2010-06-01

Throughout the course of their illness, people with amyotrophic lateral sclerosis (ALS) must make many treatment decisions; however, none has such a significant impact on quality of life and survival as decisions about assisted ventilation. The purpose of this study was to better understand the experience of decision-making about assisted ventilation for ALS patients. Using qualitative phenomenology methodology, 10 semi-structured interviews were conducted with persons with ALS and their caregivers to elicit factors that are pertinent to their decision-making process about assisted ventilation. Six main themes emerged from the interviews. (1) the meaning of the intervention - participants made a sharp distinction between non-invasive ventilation, which they viewed as a means to relieve symptoms of respiratory failure, and invasive ventilation, which they viewed as taking over their breathing and thereby saving their life when they otherwise would die, (2) the importance of context - including functional status, available supports, and financial implications, (3) the importance of values - with respect to communication, relationships, autonomy, life, and quality of life, (4) the effect of fears - particularly respiratory distress, chocking, running out of air, and the process of death itself, (5) the need for information - how use of assisted ventilation would impact daily life, how death from respiratory failure would occur, how caregivers and persons with ALS differ in their information needs and common misconceptions, and (6) adaptation to or acceptance of the intervention - a lengthy process that involved gradual familiarization with the equipment and its benefits. People with ALS and caregivers value autonomy in decision-making about assisted ventilation. Their decision-making process is neither wholly rational nor self-interested, and includes factors that health professionals should anticipate and address. Discussions about assisted ventilation and timing should be tailored to each individual and undertaken periodically.

Application of Human-Autonomy Teaming (HAT) Patterns to Reduce Crew Operations (RCO)

NASA Technical Reports Server (NTRS)

Shively, R. Jay; Brandt, Summer L.; Lachter, Joel; Matessa, Mike; Sadler, Garrett; Battiste, Henri

2016-01-01

Unmanned aerial systems, robotics, advanced cockpits, and air traffic management are all examples of domains that are seeing dramatic increases in automation. While automation may take on some tasks previously performed by humans, humans will still be required, for the foreseeable future, to remain in the system. The collaboration with humans and these increasingly autonomous systems will begin to resemble cooperation between teammates, rather than simple task allocation. It is critical to understand this human-autonomy teaming (HAT) to optimize these systems in the future. One methodology to understand HAT is by identifying recurring patterns of HAT that have similar characteristics and solutions. This paper applies a methodology for identifying HAT patterns to an advanced cockpit project.

Progress in medicine: autonomy, oughtonomy and nudging.

PubMed

Devisch, Ignaas

2011-10-01

In this article, I argue that we need a new perspective in the debate on autonomy in medicine, to understand many of the problems we face today - dilemmas that are situated at the intersection of autonomy and heteronomy, such as why well informed and autonomous people make unhealthy lifestyle choices. If people do not choose what they want, this is not simply caused by their lack of character or capability, but also by the fact that absolute autonomy is impossible; autonomous individuals are 'contaminated' by heteronymous aspects, by influences from 'outside'. Consequently, there are many good reasons to question the widely accepted hierarchical opposition of autonomy (progress) versus heteronomy (paternalism) in medicine. In an earlier article an analysis is made of the neologism 'oughtonomy' to support the thesis that when it comes down to human existence, autonomy and heteronomy are intertwined, rather than being merely opposites. In this article, I reflect upon how social conditions might improve our 'choice architecture', what Thaler & Sunstein have called 'nudging': how to change individual health choices without being paternalistic? I explore the extent to which both oughtonomy and nudging are able to challenge the question of autonomy in today's medicine. Autonomy may and should be a shared target in today's medicine, but we should never forget that it is always intertwined with heteronomy. Starting from this perspective, progress in medicine demands far more than the increase of autonomy. © 2011 Blackwell Publishing Ltd.

How self-determination theory can assist our understanding of the teaching and learning processes in medical education. AMEE guide No. 59.

PubMed

Ten Cate, Th J; Kusurkar, Rashmi A; Williams, Geoffrey C

2011-01-01

Self-determination Theory (SDT), designed by Edward Deci and Richard Ryan, serves among the current major motivational theories in psychology. SDT research has been conducted in many areas, among which are education and health care, but its applications in medical education are rare. The potential of SDT to help understand processes in medical education justifies this Guide. SDT is explained in seven principles, one of which is the distinction of three innate psychological needs of human beings: for competence, for autonomy and for relatedness. Further, SDT elaborates how humans tend to internalise regulation of behaviour that initially has been external, in order to develop autonomous, self-determined behaviour. Implications of SDT for medical education are discussed with reference to preparation and selection, curriculum structure, classroom teaching, assessments and examinations, self-directed learning, clinical teaching, students as teachers and researchers, continuing professional development, faculty development and stress among trainees.

Whose life is it anyway? A study in respect for autonomy.

PubMed Central

Norden, M

1995-01-01

Brian Clark's drama, Whose Life Is It Anyway?, explores the difficulties of applying the principle of respect for autonomy to real-life circumstances. In the play a permanently disabled patient, who wishes to be allowed to die, raises moral questions about the adequacy of the autonomous agent, respect for the autonomy of others, the authority of the law, the allocation of society's resources, and the intrinsic value of human life. After a brief review of the story and definition of respect for autonomy, this paper cites passages from the play that dramatize the tension between respect for autonomy and these other moral concerns. There follows a review of relevant commentary from the classicists Kant and Mill and the modernists Childress and Gillon. The study concludes that although classical and contemporary philosophers have clarified and elaborated upon the relationship between ethical principles, they have not provided definitive guidelines. PMID:7674285

The Porosity of Autonomy: Social and Biological Constitution of the Patient in Biomedicine.

PubMed

Beever, Jonathan; Morar, Nicolae

2016-01-01

The nature and role of the patient in biomedicine comprise issues central to bioethical inquiry. Given its developmental history grounded firmly in a backlash against 20th-century cases of egregious human subjects abuse, contemporary medical bioethics has come to rely on a fundamental assumption: the unit of care (and the unit of value) is the autonomous self-directing patient. In this article we examine first the structure of the feminist social critique of autonomy. Then we show that a parallel argument can be made against relational autonomy as well, demonstrating how this second concept of autonomy fails to take sufficiently into account an array of biological determinants, particularly those from microbial biology. Finally, in light of this biological critique, we question whether or to what extent any relevant and meaningful view of autonomy can be recovered in the contemporary landscape of bioethics.

Dilemmas of Autonomy and Happiness: Harry Brighouse on Subjective Wellbeing and Education

ERIC Educational Resources Information Center

Warnick, Bryan R.

2009-01-01

Harry Brighouse has advanced an intriguing set of arguments about the place of human flourishing in liberal educational theory. In his book "On Education", Brighouse argues that autonomy can be justified instrumentally because it promotes flourishing. He links flourishing to the psychological concept of "subjective wellbeing" and he spells out the…

Individual Autonomy, Law, and Technology: Should Soft Determinism Guide Legal Analysis?

ERIC Educational Resources Information Center

Cockfield, Arthur J.

2010-01-01

How one thinks about the relationship between individual autonomy (sometimes referred to as individual willpower or human agency) and technology can influence the way legal thinkers develop policy at the intersection of law and technology. Perspectives that fall toward the "machines control us" end of the spectrum may support more interventionist…

Autonomy and its vulnerability: Ricoeur's view on justice as a contribution to care ethics.

PubMed

Hettema, Theo L

2014-11-01

We examine an article of Paul Ricoeur on autonomy and vulnerability. Ricoeur presents the two notions in the field of justice as intricately woven into each other. He analyzes their interdependence on three levels of human agency. Ricoeur's exposition has a focus on judicial judgment. After presenting Ricoeur's argument and an analysis of his main points, the author argues that Ricoeur's reflection lines up with some essential intentions of care ethics. Ricoeur's contribution to care ethics is given in a delicate balance of autonomy and its vulnerability.

Medical Systems Engineering to Support Mars Mission Crew Autonomy

NASA Technical Reports Server (NTRS)

Antonsen, Erik; Mindock, Jennifer

2017-01-01

Human spaceflight missions to Mars face exceptionally challenging resource limitations that far exceed those faced before. Increasing transit times, decreasing opportunity for resupply, communications challenges, and extended time to evacuate a crew to definitive medical care dictate a level of crew autonomy in medical care that is beyond the current medical model. To approach this challenge, a medical systems engineering approach is proposed that relies on a clearly articulated Concept of Operations and risk analysis tools that are in development at NASA. This paper proposes an operational clinical model with key terminology and concepts translated to a controls theory paradigm to frame a common language between clinical and engineering teams. This common language will be used for design and validation of an exploration medical system that is fully integrated into a Mars transit vehicle. This approach merges medical simulation, human factors evaluation techniques, and human-in-the-loop testing in ground based analogs to tie medical hardware and software subsystem performance and overall medical system functionality to metrics of operational medical autonomy. Merging increases in operational clinical autonomy with a more restricted vehicle system resource scenario in interplanetary spaceflight will require an unprecedented level of medical and engineering integration. Full integration of medical capabilities into a Mars vehicle system may require a new approach to integrating medical system design and operations into the vehicle Program structure. Prior to the standing-up of a Mars Mission Program, proof of concept is proposed through the Human Research Program.

[The Hypertrophy of Autonomy in the Bioethical Debate].

PubMed

Martínez Otero, Juan María

2017-01-01

In the current bioethical debate personal autonomy is frequently used as an argument to justify the legalization of new options for the subject. This is the case, for instance, of the controversies around surrogated motherhood, organ free market, euthanasia or egg freezing in order to postpone motherhood. This paper aims to show how legalizing certain options can be harmful to people, and would justify and perpetuate situations of domination of some human beings over others. In this regard, the importance of recognizing the unavailability of certain goods and human rights is underlined.

Nature and autonomy: an organizational view of social and neurobiological aspects of self-regulation in behavior and development.

PubMed

Ryan, R M; Kuhl, J; Deci, E L

1997-01-01

The concepts of self-regulation and autonomy are examined within an organizational framework. We begin by retracing the historical origins of the organizational viewpoint in early debates within the field of biology between vitalists and reductionists, from which the construct of self-regulation emerged. We then consider human autonomy as an evolved behavioral, developmental, and experiential phenomenon that operates at both neurobiological and psychological levels and requires very specific supports within higher order social organizations. We contrast autonomy or true self-regulation with controlling regulation (a nonautonomous form of intentional behavior) in phenomenological and functional terms, and we relate the forms of regulation to the developmental processes of intrinsic motivation and internalization. Subsequently, we describe how self-regulation versus control may be characterized by distinct neurobiological underpinnings, and we speculate about some of the adaptive advantages that may underlie the evolution of autonomy. Throughout, we argue that disturbances of autonomy, which have both biological and psychological etiologies, are central to many forms of psychopathology and social alienation.

Do Children's Executive Functions Account for Associations between Early Autonomy-Supportive Parenting and Achievement through High School?

ERIC Educational Resources Information Center

Bindman, Samantha W.; Pomerantz, Eva M.; Roisman, Glenn I.

2015-01-01

This study evaluated whether the positive association between early autonomy-supportive parenting and children's subsequent achievement is mediated by children's executive functions. Using observations of mothers' parenting from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (N…

Mothers' and Fathers' Support for Child Autonomy and Early School Achievement

ERIC Educational Resources Information Center

Developmental Psychology, 2008

2008-01-01

Data were analyzed from 641 children and their families in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development to test the hypotheses that in the early school years, mothers' and fathers' sensitive support for autonomy in observed parent-child interactions would each make unique predictions…

Learner Autonomy via Asynchronous Online Interactions: A Malaysian Perspective

ERIC Educational Resources Information Center

Kaur, Ranjit; Sidhu, Gurnam Kaur

2010-01-01

The integration of information and communication technologies (ICT) in course offerings in institutions of higher learning (IHLs) is the catalyst towards empowering learners to become autonomous lifelong learners. In an effort to produce quality and independent learners, Learning Management Systems (LMS) are seen as a means to assist educators in…

The Cognitive Value of College Women's Friendships.

ERIC Educational Resources Information Center

Martinez Aleman, Ana M.

The cognitive nature, power, and educational value of college women's friendships were studied. As a means for dissolving the boundaries between the academic and intellectual, and as a place where autonomy and interdependence are in dynamic exercise, female friendships can provide a model for peer-assisted learning in higher education. Data were…

Physician-assisted suicide of patients with dementia. A medical ethical analysis with a special focus on patient autonomy.

PubMed

Gather, Jakov; Vollmann, Jochen

2013-01-01

For many years there has been a controversial international debate on physician-assisted suicide (PAS). While proponents of PAS regularly refer to the unbearable suffering and the right of self-determination of incurably ill patients, critics often warn about the diverse risks of abuse. In our article, we aim to present ethical arguments for and against PAS for patients in an early stage of dementia. Our focus shall be on ethical questions of autonomy, conceptual and empirical findings on competence and the assessment of mental capacity to make health care decisions. While the capacity to make health care decisions represents an ethically significant precondition for PAS, it becomes more and more impaired in the course of the dementia process. We present conditions that should be met in order to ethically justify PAS for patients with dementia. From both a psychiatric and an ethical perspective, a thorough differential diagnosis and an adequate medical and psychosocial support for patients with dementia considering PAS and their relatives should be guaranteed. If, after due deliberation, the patient still wishes assistance with suicide, a transparent and documented assessment of competence should be conducted by a professional psychiatrist. Copyright © 2013 Elsevier Ltd. All rights reserved.

TDAS: The Thermal Expert System (TEXSYS) data acquisition system

NASA Technical Reports Server (NTRS)

Hack, Edmund C.; Healey, Kathleen J.

1987-01-01

As part of the NASA Systems Autonomy Demonstration Project, a thermal expert system (TEXSYS) is being developed. TEXSYS combines a fast real time control system, a sophisticated human interface for the user and several distinct artificial intelligence techniques in one system. TEXSYS is to provide real time control, operations advice and fault detection, isolation and recovery capabilities for the space station Thermal Test Bed (TTB). TEXSYS will be integrated with the TTB and act as an intelligent assistant to thermal engineers conducting TTB tests and experiments. The results are presented from connecting the real time controller to the knowledge based system thereby creating an integrated system. Special attention will be paid to the problem of filtering and interpreting the raw, real time data and placing the important values into the knowledge base of the expert system.

Delivery and Receipt of a Self-Determination-Theory-Based Extracurricular Physical Activity Intervention: Exploring Theoretical Fidelity in Action 3:30.

PubMed

Sebire, Simon J; Edwards, Mark J; Fox, Kenneth R; Davies, Ben; Banfield, Kathryn; Wood, Lesley; Jago, Russell

2016-08-01

The implementation, fidelity, and receipt of a self-determination-theory-based after-school physical activity intervention (Action 3:30) delivered by teaching assistants (TAs) was examined using a mixed-methods process evaluation. Physical activity motivation and need satisfaction were reported by 539 participants at baseline, the end of intervention, and 4-month follow-up. Pupil- and TA-reported autonomy-support and teaching efficacy were collected alongside interviews with 18 TAs and focus groups with 60 participants. Among intervention boys there were small increases in identified, introjected, and external motivation and no differences in need satisfaction. Among girls, intrinsic and identified motivation and autonomy and relatedness were lower in the intervention group. Qualitative evidence for fidelity was moderate, and boys reported greater need satisfaction than girls. TAs provided greater structure than involvement or autonomy-support and felt least efficacious when facing school-based challenges. The findings highlight the refinements needed to enhance theoretical fidelity and intervention effectiveness for boys and girls.

Autonomy and manual operation in a small robotic system for under-vehicle inspections at security checkpoints

NASA Astrophysics Data System (ADS)

Smuda, William; Muench, Paul L.; Gerhart, Grant R.; Moore, Kevin L.

2002-07-01

Unmanned ground vehicle (UGV) technology can be used in a number of ways to assist in counter-terrorism activities. In addition to the conventional uses of tele-operated robots for unexploded ordinance handling and disposal, water cannons and other crowd control devices, robots can also be employed for a host of terrorism deterrence and detection applications. In previous research USU developed a completely autonomous prototype robot for performing under- vehicle inspections in parking areas (ODIS). Testing of this prototype and discussions with the user community indicated that neither the technology nor the users are ready for complete autonomy. In this paper we present a robotic system based on ODIS that balances the users' desire/need for tele- operation with a limited level of autonomy that enhances the performance of the robot. The system can be used by both civilian law enforcement and military police to replace the traditional mirror on a stick system of looking under cars for bombs and contraband.

Vulnerability and resilience: a critical nexus.

PubMed

Lotz, Mianna

2016-02-01

Not all forms of human fragility or vulnerability are unavoidable. Sometimes we knowingly and intentionally impose conditions of vulnerability on others; and sometimes we knowingly and intentionally enter into and assume conditions of vulnerability for ourselves (for example, when we decide to trust or forgive, enter into intimate relationships with others, become a parent, become a subject of medical or psychotherapeutic treatment, and the like). In this article, I propose a presently overlooked basis on which one might evaluate whether the imposition or assumption of vulnerability is acceptable, and on which one might ground a significant class of vulnerability-related obligations. Distinct from existing accounts of the importance of promoting autonomy in conditions of vulnerability, this article offers a preliminary exploration of the nature, role, and importance of resilience promotion, its relationship to autonomy promotion, and its prospects for improving human wellbeing in autonomy inhibiting conditions.

Human Value, Dignity, and the Presence of Others.

PubMed

Hernandez, Jill Graper

2015-09-01

In the health care professions, the meaning of--and implications for--'dignity' and 'value' are progressively more important, as scholars and practitioners increasingly have to make value judgments when making care decisions. This paper looks at the various arguments for competing sources of human value that medical professionals can consider--human rights, autonomy, and a higher-order moral value--and settles upon a foundational model that is related to (though distinct from) the Kantian model that is popular within the medical community: human value is foundational; human dignity, autonomy, and rights derive from the relational quality of human dignity. Moral dignity is expressed though the relationships we cultivate, the communal ends we pursue, and the rights we enjoy. Correlatively, human dignity is inseparable from its ground (i.e., morality), and the relationship between these two is best represented for Kant in the humanities formulation. The foundational model of dignity ensures that human value is non-circularly derived, but is ultimately tied to expressions of individual human dignity that comes from the dignity of morality. Linking Kant's dignity of humanity to the dignity of morality affords a unique and efficacious response to the discussion of human value. In one sense, dignity is amplificatory, since its worth is inextricable with that of autonomy and the rights afforded to the autonomous. But that isn't to say that the worth of dignity is merely amplificatory. Rather, human dignity indicates the absolute inner value (MM 6:435) found in each individual in virtue of being human (MM 6:435, 462). That inner worth engenders certain universal rights--derivable from the dignity and fundamental rational appeal of morality--just as it provides for the possibility for a community of beings to seek to live the moral life.

Application of Human-Autonomy Teaming (HAT) Patterns to Reduced Crew Operations (RCO)

NASA Technical Reports Server (NTRS)

Shively, R. Jay; Brandt, Summer L.; Lachter, Joel; Matessa, Mike; Sadler, Garrett; Battiste, Henri

2016-01-01

As part of the Air Force - NASA Bi-Annual Research Council Meeting, slides will be presented on recent Reduced Crew Operations (RCO) work. Unmanned aerial systems, robotics, advanced cockpits, and air traffic management are all examples of domains that are seeing dramatic increases in automation. While automation may take on some tasks previously performed by humans, humans will still be required, for the foreseeable future, to remain in the system. The collaboration with humans and these increasingly autonomous systems will begin to resemble cooperation between teammates, rather than simple task allocation. It is critical to understand this human-autonomy teaming (HAT) to optimize these systems in the future. One methodology to understand HAT is by identifying recurring patterns of HAT that have similar characteristics and solutions. A methodology for identifying HAT patterns to an advanced cockpit project is discussed.

Capturing Requirements for Autonomous Spacecraft with Autonomy Requirements Engineering

NASA Astrophysics Data System (ADS)

Vassev, Emil; Hinchey, Mike

2014-08-01

The Autonomy Requirements Engineering (ARE) approach has been developed by Lero - the Irish Software Engineering Research Center within the mandate of a joint project with ESA, the European Space Agency. The approach is intended to help engineers develop missions for unmanned exploration, often with limited or no human control. Such robotics space missions rely on the most recent advances in automation and robotic technologies where autonomy and autonomic computing principles drive the design and implementation of unmanned spacecraft [1]. To tackle the integration and promotion of autonomy in software-intensive systems, ARE combines generic autonomy requirements (GAR) with goal-oriented requirements engineering (GORE). Using this approach, software engineers can determine what autonomic features to develop for a particular system (e.g., a space mission) as well as what artifacts that process might generate (e.g., goals models, requirements specification, etc.). The inputs required by this approach are the mission goals and the domain-specific GAR reflecting specifics of the mission class (e.g., interplanetary missions).

Safe delivery care practices in western Nepal: Does women's autonomy influence the utilization of skilled care at birth?

PubMed

Bhandari, Tulsi Ram; Kutty, V Raman; Sarma, P Sankara; Dangal, Ganesh

2017-01-01

Despite various efforts to increase the utilization of skilled birth attendants (SBA), nearly two-thirds of deliveries take place at home without the assistance of SBAs in Nepal. We hypothesized that the ability of women to take decisions about their own lives-women's autonomy-plays an important part in birth choices. To know this, we conducted a community-based cross-sectional study for assessing women's autonomy and utilization of safe delivery care service in Kapilvastu district of Nepal from June to October 2014. We used multivariate modeling to associate socioeconomic factors and women's autonomy with the utilization of safe delivery care services. Just over one-third of women sought institutional delivery care during the birth of their last child. Out of the total deliveries at health facilities, nearly 58% women visited health facility for self-reported emergency obstructive care. Only 6.2% home deliveries were handled by health workers and 14.7% women used the safe delivery kit for home delivery care. Higher levels of women's education had a strong positive association (odds ratio = 24.11, CI = 9.43-61.64) with institutional delivery care. Stratified analysis showed that when the husband is educated, women's education seems to work partly through their autonomy in decision making. Educational status of women emerged as one of the key predictors of the utilization of delivery care services in Kapilvastu district. Economic status of household and husband's education are other dominant predictors of the utilization of safe delivery care services. Improving the economic and educational status may be the way out for improving the proportion of institutional deliveries. Women's autonomy may be an important mediating factor in this pathway.

Some Internet Applications for Language Teaching: A Web-Assisted Course of English for Construction.

ERIC Educational Resources Information Center

Fernandez, Jose Maria Perez

2001-01-01

Describes how the Internet was used in an English class for architecture and construction students at the University of Granada (Spain). Discusses course organization; links to construction company Web sites; active learning; group work; student presentations; student autonomy and student motivation; and problems with plagiarism. (LRW)

Redesigning the Role of Deputy Heads in Norwegian Schools--Tensions between Control and Autonomy?

ERIC Educational Resources Information Center

Abrahamsen, Hedvig

2018-01-01

A substantial body of research emphasises school leadership as a major influence on quality improvement in schools. Although numerous studies have identified the importance of the principal, fewer studies have examined the middle management level within schools, the deputy heads and assistant principals. Influenced by international trends, local…

[Maintaining patients' autonomy at home].

PubMed

Niang, Bénédicte; Coudre, Jean Pierre

2015-01-01

To maintain the flow of hospital discharges, the patient's return home with support from a home nursing service is important. If any difficulties are identified, there are various programmes or good practices which can be put into place. The future law on adapting society to ageing also comprises a scheme combining home assistance and nursing care.

[The law of March 5, 2007 and the care of persons placed under guardianship].

PubMed

Modot, Matthieu; Rougé-Maillart, Clotilde

2018-04-01

The care of persons placed under guardianship has changed considerably since the law of March 5, 2007, as greater autonomy is granted to them. By advocating greater autonomy of protected adults, the French Civil Code is in opposition with the French Public Health Code since the latter states that the systematic consent of the guardian is required in addition to that of the protected adult for so-called general care. In cases of serious injury to bodily integrity, the guardianship judge's opinion must be sought by the guardian. For some specific medical procedures (medically assisted procreation, abortion, etc.), the consent of the guardian does not seem necessary. A protected adult can now, if he/she is able to understand the information, with the agreement of the guardianship judge or the family council, appoint a trusted person and draft advance directives without possible representation by the guardian. The legislator promotes greater autonomy while not neglecting their protection. It also helps relieve the guardian, who is generally trained in asset management, of sometimes difficult medical decisions. Harmony between the Civil Code and the Public Health Code seems essential so as to move towards greater autonomy of the person under guardianship in the care relationship. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Autonomy in chimpanzees.

PubMed

Beauchamp, Tom L; Wobber, Victoria

2014-04-01

Literature on the mental capacities and cognitive mechanisms of the great apes has been silent about whether they can act autonomously. This paper provides a philosophical theory of autonomy supported by psychological studies of the cognitive mechanisms that underlie chimpanzee behavior to argue that chimpanzees can act autonomously even though their psychological mechanisms differ from those of humans. Chimpanzees satisfy the two basic conditions of autonomy: (1) liberty (the absence of controlling influences) and (2) agency (self-initiated intentional action), each of which is specified here in terms of conditions of understanding, intention, and self-control. In this account, chimpanzees make knowledge-based choices reflecting a richly information-based and socially sophisticated understanding of the world. Finally, two major theories of autonomy (Kantian theory and two-level theory) are rejected as too narrow to adequately address these issues, necessitating the modifications made in the present approach.

Dignity and autonomy in the care for patients with dementia: Differences among formal caretakers of varied cultural backgrounds and their meaning.

PubMed

Bentwich, Miriam Ethel; Dickman, Nomy; Oberman, Amitai

A key message in the World Health Organization report on dementia (2012) emphasizes this disease as a top priority in public health and the need to improve professional attitudes to patients with dementia, while acknowledging that the workforce in dementia care is becoming increasingly diverse culturally. To trace whether there are substantial gaps between formal caretakers from different cultural groups (Israeli born Jews [Sabras], Israeli Arabs [Arabs] and migrants from Russia [Russians]) regarding their stances on the human dignity and autonomy of patients with dementia, as well as understand the meaning of these gaps. quantitative analysis utilizing questionnaires that were filled-out by approximately 200 caretakers from the different cultural groups, working in a nursing home or a hospital. In nursing homes, substantial differences were found in the attitudes to human dignity and autonomy of patients with dementia between Russian and Arab as well as Sabra caretakers. In the hospital, there was no influence for the ethno-culture variable on dignity or autonomy. Contrary to past research, in nursing homes, significant differences were found between certain ethno-cultural groups (Arabs and Russians) regarding their stance towards the dignity of patients with dementia. Arab caretakers hold a conception of dignity and autonomy that resonates strongly with person-centered care and outweighs institutional settings as well as may be related to the fostering of virtues. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Health smart home: towards an assistant tool for automatic assessment of the dependence of elders.

PubMed

Le, Xuan Hoa Binh; Di Mascolo, Maria; Gouin, Alexia; Noury, Norbert

2007-01-01

In order to help elders living alone to age in place independently and safely, it can be useful to have an assistant tool that can automatically assess their dependence and issue an alert if there is any loss of autonomy. The dependence can be assessed by the degree of performance, by the elders, of activities of daily living. This article presents an approach enabling the activity recognition for an elder living alone in a Health Smart Home equipped with noninvasive sensors.

'Aid-in-dying' and the taking of human life.

PubMed Central

Campbell, C S

1992-01-01

In several US states, the legalisation of euthanasia has become a question for voters to decide in public referenda. This democratic approach in politics is consistent with notions of personal autonomy in medicine, but the right of choice does not mean all choices are morally equal. A presumption against the taking of human life is embedded in the formative moral traditions of society; human life does not have absolute value, but we do and should impose a strict burden of justification for exceptions to the presumption, as exemplified by the moral criteria invoked to justify self-defence, capital punishment, or just war. These criteria can illuminate whether another exception should be carved out for doctor-assisted suicide or active euthanasia. It does not seem, in the United States at any rate, that all possible alternatives to affirm the control and dignity of the dying patient and to relieve pain and suffering, short of taking life, have been exhausted. Moreover, the procedural safeguards built into many proposals for legalised euthanasia would likely be undone by the sorry state of the US health care system, with its lack of universal access to care, chronic cost-containment ills, a litigious climate, and socioeconomic barriers to care. There remains, however, common ground in the quest for humane care of the dying. PMID:1404279

[Clarifying the implementation of nursing care systematization].

PubMed

Hermida, Patricia Madalena Vieira

2004-01-01

This study has reviewed the national literature regarding nursing assistance systematization (NAS), with the aim of identifying the difficulties implementing this practice and the factors that interfere with and harm its implementation. The MEDLINE, LILACS, and BDENF databases have been utilized and six studies published in nursing periodicals in the last five years have been surveyed. The results indicate several difficulties implementing the NAS and several factors that interfere negatively with its implementation. Considering the importance of this assistance methodology for valuing professional nursing, it is necessary to reflect on/discuss its practical difficulties so that we can overcome them, making it a pleasurable activity capable of providing nurses with autonomy and providing patients with quality assistance.

Personhood status of the human zygote, embryo, fetus.

PubMed

Miklavcic, John Janez; Flaman, Paul

2017-05-01

The fields of biology, medicine, and embryology have described the developmental milestones of humans throughout gestation in great detail. It is less clear as to when humans are recognized as people, persons, or beings with rights that are protected by legislation. The practice of law is irrevocably intertwined with that of ethical conduct; and the time at which a human life is considered a person has implications that extend to health care, legislation on abortion, and autonomy of individuals. This article reviews the economical position that fertilization is the moment that personhood of the conceptus begins. Alternate positions proposing that personhood begins at other possible times after fertilization are presented and contrasted to the economical hypothesis. Summary : This article is an original work critically analyzing the various arguments for human personhood at fertilization and thereafter. The various positions on human personhood are compared and contrasted herein. The time of the human lifespan at which personhood is conferred has important implications for health care, legislation, and personal autonomy.

Ethical dilemmas related to predictions and warnings of impending natural disaster.

PubMed

Phua, Kai-Lit; Hue, J W

2013-01-01

Scientists and policy makers issuing predictions and warnings of impending natural disaster are faced with two major challenges, that is, failure to warn and issuing a false alarm. The consequences of failure to warn can be serious for society overall, for example, significant economic losses, heavy infrastructure and environmental damage, large number of human casualties, and social disruption. Failure to warn can also have serious for specific individuals, for example, legal proceedings against disaster research scientists, as in the L'Aquila earthquake affair. The consequences of false alarms may be less serious. Nevertheless, false alarms may violate the principle of nonmaleficence (do no harm), affect individual autonomy (eg, mandatory evacuations), and may result in the "cry wolf" effect. Other ethical issues associated with natural disasters include the promotion of global justice through international predisaster technical assistance and postdisaster aid. Social justice within a particular country is promoted through greater postdisaster aid allocation to the less privileged.

Visual privacy by context: proposal and evaluation of a level-based visualisation scheme.

PubMed

Padilla-López, José Ramón; Chaaraoui, Alexandros Andre; Gu, Feng; Flórez-Revuelta, Francisco

2015-06-04

Privacy in image and video data has become an important subject since cameras are being installed in an increasing number of public and private spaces. Specifically, in assisted living, intelligent monitoring based on computer vision can allow one to provide risk detection and support services that increase people's autonomy at home. In the present work, a level-based visualisation scheme is proposed to provide visual privacy when human intervention is necessary, such as at telerehabilitation and safety assessment applications. Visualisation levels are dynamically selected based on the previously modelled context. In this way, different levels of protection can be provided, maintaining the necessary intelligibility required for the applications. Furthermore, a case study of a living room, where a top-view camera is installed, is presented. Finally, the performed survey-based evaluation indicates the degree of protection provided by the different visualisation models, as well as the personal privacy preferences and valuations of the users.

Supplemental Security Income for the Aged, Blind and Disabled (SSI) program demonstration project; treatment of cash received and conserved to pay for medical or social services--SSA. Notice.

PubMed

1998-11-02

The Commissioner of Social Security will conduct a demonstration project to test how certain altered resources counting rules might apply in the SSI program. The SSI program is authorized by title XVI of the Social Security Act (the Act). The rules which will be tested are those that apply to the treatment of cash received and conserved to pay for medical or social services. Cash which is received for the purposes of payment for medical or social services is not counted as income to the beneficiary when received. If cash received for medical or social services which is not a reimbursement for these services already paid for by the beneficiary is conserved, it is not counted as a resource for the calendar month following the month of receipt, so long as it remains separately identifiable from other resources of the individual. Beginning with the second calendar month following the month of receipt, cash received for the payment of medical or social services becomes a countable resource used in the determination of SSI eligibility. The Health Care Financing Administration of the Department of Health and Human Services (DHHS) is collaborating with the States of Arkansas, Florida, New Jersey and New York and with the National Program Office at the University of Maryland's Center on Aging, the Robert Wood Johnson Foundation, the Office of the Assistant Secretary for Planning and Evaluation of the DHHS, the National Council on Aging and Mathematica Policy Research (the evaluator) on a demonstration project to provide greater autonomy to the consumers of personal assistance services. Personal assistance services are help with the basic activities of daily living, including bathing, dressing, transferring, toileting, and eating, and/or instrumental activities of daily living such as housekeeping, meal preparation, shopping, laundry, money management and medication management. Consumers of personal assistance services who participate in this demonstration will be empowered by purchasing the services they require (including medical and social services) to perform the activities of daily living. In order to accomplish the objective of the demonstration project, cash allowances and information services will be provided directly to persons with disabilities to enable them to choose and purchase services from providers which they feel would best meet their needs. Medicaid is the predominant source of public financing for personal assistance services programs for the aged, blind and disabled. The demonstration which will permit the States of Arkansas, Florida, New Jersey and New York to waive certain requirements under title XIX of the Act to participate in this "Cash and Counseling" demonstration is within the authority granted to the Secretary of Health and Human Services (HHS) by section 1115 of the Act. Medicaid beneficiaries who participate in this demonstration will be given cash to purchase the services they need from traditional and nontraditional providers as they deem appropriate. Counseling will be available for these beneficiaries to assist them in effective use of funds allotted for personal assistance services. Many of the Medicaid beneficiaries who participate in the Cash and Counseling demonstration will be SSI beneficiaries or belong to coverage groups using eligibility methodologies related to those of the SSI program under title XIX of the Act. The Commissioner of Social Security wishes to test the appropriateness of current SSI rules which require counting cash received for the purchase of medical or social services as resources if retained for more than one month after the month of receipt. The test will also be used to assist the Secretary of HHS in testing the possibility of providing greater autonomy to the consumers of personal assistance services by empowering them to purchase the services they require (including medical and social services) to perform their activities of daily living. (ABSTRACT TRUNCATED)

Goal Tracking in a Natural Language Interface: Towards Achieving Adjustable Autonomy

DTIC Science & Technology

1999-01-01

communication , we believe that human/machine interfaces that share some of the characteristics of human- human communication can be friendlier and easier...natural means of communicating with a mobile robot. Although we are not claiming that communication with robotic agents must be patterned after human

Language and Character

ERIC Educational Resources Information Center

Barrow, Robin

2004-01-01

Recent empirical research into the brain, while reinforcing the view that we are extensively "programmed", does not refute the idea of a distinctive human mind. The human mind is primarily a product of the human capacity for a distinctive kind of language. Human language is thus what gives us our consciousness, reasoning capacity and autonomy. To…

A cybernetic theory of morality and moral autonomy.

PubMed

Chambers, J

2001-04-01

Human morality may be thought of as a negative feedback control system in which moral rules are reference values, and moral disapproval, blame, and punishment are forms of negative feedback given for violations of the moral rules. In such a system, if moral agents held each other accountable, moral norms would be enforced effectively. However, even a properly functioning social negative feedback system could not explain acts in which individual agents uphold moral rules in the face of contrary social pressure. Dr. Frances Kelsey, who withheld FDA approval for thalidomide against intense social pressure, is an example of the degree of individual moral autonomy possible in a hostile environment. Such extreme moral autonomy is possible only if there is internal, psychological negative feedback, in addition to external, social feedback. Such a cybernetic model of morality and moral autonomy is consistent with certain aspects of classical ethical theories.

[Home automation for elderly people in the process of losing their autonomy].

PubMed

Muller, Philippe

2012-01-01

The safety of elderly people, particularly dependent at night, is a major factor in preventingthem from remaining in their own home. An experiment in Corrèze using domotics and advanced remote assistance services and involving around one hundred elderly people living at home, took place from summer 2009 to autumn 2010.

Expanding the Evaluation Department Role in a Restructuring District: A Technical Assistance Model.

ERIC Educational Resources Information Center

Borton, William M.

Although San Diego City Schools is entering its fourth year of restructuring efforts, many schools are still reluctant to assume the autonomy offered to them. If school restructuring is stalling, it is because district offices have not yet restructured, research on what is known about implementing changes has been ignored, and no clear methodology…

Enhancing Competence and Autonomy in Computer-Based Instruction Using a Skill-Challenge Balancing Strategy

ERIC Educational Resources Information Center

Kim, Jieun; Ryu, Hokyoung; Katuk, Norliza; Wang, Ruili; Choi, Gyunghyun

2014-01-01

The present study aims to show if a skill-challenge balancing (SCB) instruction strategy can assist learners to motivationally engage in computer-based learning. Csikszentmihalyi's flow theory (self-control, curiosity, focus of attention, and intrinsic interest) was applied to an account of the optimal learning experience in SCB-based learning…

From Autonomy to Relationships: Productive Engagement with Uncertainty

ERIC Educational Resources Information Center

Clegg, J.; Lansdall-Welfare, R.

2010-01-01

This paper argues that we are at a point of change in ID services, that new ideas and different frames of reference are required to take services forward in the 21st century. We describe how contemporary thinking in architecture, philosophy and organisational theory can assist in generating service principles for specialist services that allow us…

The Role of Computer-Assisted Language Learning (CALL) in Promoting Learner Autonomy

ERIC Educational Resources Information Center

Mutlu, Arzu; Eroz-Tuga, Betil

2013-01-01

Problem Statement: Teaching a language with the help of computers and the Internet has attracted the attention of many practitioners and researchers in the last 20 years, so the number of studies that investigate whether computers and the Internet promote language learning continues to increase. These studies have focused on exploring the beliefs…

A Triangular Approach to Motivation in Computer Assisted Autonomous Language Learning (CAALL)

ERIC Educational Resources Information Center

Raby, Francoise

2007-01-01

This study was carried out in a language centre, in French higher education. Teachers and researchers had contrived a pedagogical system labeled guided autonomy which combined class attendance in groups and self-study in the self-study room. This kind of autonomous and technologically enhanced learning system will be referred to as CAALL (Computer…

What Middle School Educators Should Know about Assistive Technology and Universal Design for Learning

ERIC Educational Resources Information Center

Zascavage, Victoria; Winterman, Kathleen G.

2009-01-01

In the new millennium, the No Child Left Behind Act (2001) and the Individuals with Disabilities Education Improvement Act (IDEIA) (2004) ask educators to maximize opportunities for students with disabilities to succeed in inclusive classrooms. To make autonomy and integration seamless, many students with special needs will need to make use of…

Long-term culture change related to rapid response system implementation.

PubMed

Stevens, Jennifer; Johansson, Anna; Lennes, Inga; Hsu, Douglas; Tess, Anjala; Howell, Michael

2014-12-01

Increasing attention to patient safety in training hospitals may come at the expense of trainee autonomy and professional growth. This study sought to examine changes in medical trainees' self-reported behaviour after the institution-wide implementation of a rapid response system. We conducted a two-point cross-sectional survey of medical trainees in 2006, during the implementation of a rapid response system, and in 2010, in a single academic medical centre. A novel instrument was used to measure trainee likelihood of calling for supervisory assistance, perception of autonomy, and comfort in managing decompensating patients. Non-parametric tests to assess for change were used and year of training was evaluated as an effect modifier. Response rates were 38% in 2006 and 70% in 2010. After 5 years of the full implementation of the rapid response system, residents were significantly more likely to report calling their attending physicians for assistance (rising from 40% to 65% of relevant situations; p < 0.0001). Year of training was a significant effect modifier. Interns felt significantly more comfortable in managing acutely ill patients; juniors and seniors felt significantly less concerned about their autonomy at 5 years after the implementation of the rapid response system. These changes were mirrored in the actual use of the rapid response system, which increased by 41% during the 5-year period after adjustment for patient volume (p < 0.0001). A primary team-focused implementation of a rapid response system was associated with durable changes in resident physicians' reported behaviour, including increased comfort with involving more experienced physicians and managing unstable patients. © 2014 John Wiley & Sons Ltd.

Architectures and Evaluation for Adjustable Control Autonomy for Space-Based Life Support Systems

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Schreckenghost, Debra K.

2001-01-01

In the past five years, a number of automation applications for control of crew life support systems have been developed and evaluated in the Adjustable Autonomy Testbed at NASA's Johnson Space Center. This paper surveys progress on an adjustable autonomous control architecture for situations where software and human operators work together to manage anomalies and other system problems. When problems occur, the level of control autonomy can be adjusted, so that operators and software agents can work together on diagnosis and recovery. In 1997 adjustable autonomy software was developed to manage gas transfer and storage in a closed life support test. Four crewmembers lived and worked in a chamber for 91 days, with both air and water recycling. CO2 was converted to O2 by gas processing systems and wheat crops. With the automation software, significantly fewer hours were spent monitoring operations. System-level validation testing of the software by interactive hybrid simulation revealed problems both in software requirements and implementation. Since that time, we have been developing multi-agent approaches for automation software and human operators, to cooperatively control systems and manage problems. Each new capability has been tested and demonstrated in realistic dynamic anomaly scenarios, using the hybrid simulation tool.

The Use of Assistive Technology to Promote Care of the Self and Social Inclusion in Patients with Sequels of Leprosy.

PubMed

Maia, Fátima Beatriz; Teixeira, Enéas Rangel; Silva, Gislaine Valeria; Gomes, Maria Katia

2016-04-01

This study is about the contribution of occupational therapy inside a rehabilitation group, and we focus on the autonomy of patients with disabilities due to leprosy. There are few studies on the use of assistive technology by leprosy patients; to our knowledge, none of them aim to have a subjective approach of care. Our purpose was to analyze the repercussions of assistive technology on autonomy of care of the self in patients with sequels of leprosy. A qualitative, descriptive exploratory study with a semi-structured interview and a field observation as a research method was conducted between November 2014 and February 2015 at a University Hospital in Rio de Janeiro. Eight patients from the service of Occupational Therapy were interviewed, and 44 hours of observation were performed. Interviews followed a semi-structured script and a field journal was used to take notes. Analysis was conducted by the hermeneutic approach. Costs were obtained after a global cost analysis of the fixed and variable expenses and direct and indirect costs to the manufactured products with an amount of 100 dollars. Results were grouped according to the following categories: contribution of the adapted devices for the care of the self and feelings and sensations provoked by the use of self-help devices. The reports revealed feelings, perceptions and meaningful contents about the social, familiar and individual dimensions, also the stigma coupled with leprosy. However, forms of re-signification were elaborated. Assistive technology empowers the subject to perform care of the self and promotes social inclusion.

The Use of Assistive Technology to Promote Care of the Self and Social Inclusion in Patients with Sequels of Leprosy

PubMed Central

2016-01-01

Background This study is about the contribution of occupational therapy inside a rehabilitation group, and we focus on the autonomy of patients with disabilities due to leprosy. There are few studies on the use of assistive technology by leprosy patients; to our knowledge, none of them aim to have a subjective approach of care. Our purpose was to analyze the repercussions of assistive technology on autonomy of care of the self in patients with sequels of leprosy. Methods A qualitative, descriptive exploratory study with a semi-structured interview and a field observation as a research method was conducted between November 2014 and February 2015 at a University Hospital in Rio de Janeiro. Findings Eight patients from the service of Occupational Therapy were interviewed, and 44 hours of observation were performed. Interviews followed a semi-structured script and a field journal was used to take notes. Analysis was conducted by the hermeneutic approach. Costs were obtained after a global cost analysis of the fixed and variable expenses and direct and indirect costs to the manufactured products with an amount of 100 dollars. Results were grouped according to the following categories: contribution of the adapted devices for the care of the self and feelings and sensations provoked by the use of self-help devices. The reports revealed feelings, perceptions and meaningful contents about the social, familiar and individual dimensions, also the stigma coupled with leprosy. However, forms of re-signification were elaborated. Conclusions Assistive technology empowers the subject to perform care of the self and promotes social inclusion. PMID:27124408

Mothers' and fathers' support for child autonomy and early school achievement.

PubMed

2008-07-01

Data were analyzed from 641 children and their families in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development to test the hypotheses that in the early school years, mothers' and fathers' sensitive support for autonomy in observed parent-child interactions would each make unique predictions to children's reading and math achievement at Grade 3 (controlling for demographic variables), children's reading and math abilities at 54 months, and children's level of effortful control at 54 months and that these associations would be mediated by the level of and changes over time in children's observed self-reliance in the classroom from Grades 1 through 3. The authors found that mothers' and fathers' support for autonomy were significantly and uniquely associated with children's Grade 3 reading and math achievement with the above controls, but only for boys. For boys, the effect of mothers' support for child autonomy was mediated by higher self-reliance at Grade 1 and of fathers' support for child autonomy by greater increases in self-reliance from Grades 1 through 3.

Methodology for Prototyping Increased Levels of Automation for Spacecraft Rendezvous Functions

NASA Technical Reports Server (NTRS)

Hart, Jeremy J.; Valasek, John

2007-01-01

The Crew Exploration Vehicle necessitates higher levels of automation than previous NASA vehicles, due to program requirements for automation, including Automated Rendezvous and Docking. Studies of spacecraft development often point to the locus of decision-making authority between humans and computers (i.e. automation) as a prime driver for cost, safety, and mission success. Therefore, a critical component in the Crew Exploration Vehicle development is the determination of the correct level of automation. To identify the appropriate levels of automation and autonomy to design into a human space flight vehicle, NASA has created the Function-specific Level of Autonomy and Automation Tool. This paper develops a methodology for prototyping increased levels of automation for spacecraft rendezvous functions. This methodology is used to evaluate the accuracy of the Function-specific Level of Autonomy and Automation Tool specified levels of automation, via prototyping. Spacecraft rendezvous planning tasks are selected and then prototyped in Matlab using Fuzzy Logic techniques and existing Space Shuttle rendezvous trajectory algorithms.

Intrinsic and Extrinsic Motivations: Classic Definitions and New Directions.

PubMed

Ryan; Deci

2000-01-01

Intrinsic and extrinsic types of motivation have been widely studied, and the distinction between them has shed important light on both developmental and educational practices. In this review we revisit the classic definitions of intrinsic and extrinsic motivation in light of contemporary research and theory. Intrinsic motivation remains an important construct, reflecting the natural human propensity to learn and assimilate. However, extrinsic motivation is argued to vary considerably in its relative autonomy and thus can either reflect external control or true self-regulation. The relations of both classes of motives to basic human needs for autonomy, competence and relatedness are discussed. Copyright 2000 Academic Press.

Family support in the transition to adulthood in Portugal--its effects on identity capital development, uncertainty management and psychological well-being.

PubMed

Oliveira, José Egídio; Mendonça, Marina; Coimbra, Susana; Fontaine, Anne Marie

2014-12-01

In a familistic southern European society such as the Portuguese, the family has historically played a prominent role in supporting the negotiation of transition pathways into adulthood. The present study aimed at capturing (1) the relative weight of parental financial support and autonomy support in contributing to the youngsters' psychological well-being (PWB), and (2) the mediating role of identity capital and uncertainty management in this relationship. A total of 620 participants completed measures of parental support, identity capital, uncertainty management and PWB. Autonomy support was found to be the strongest predictor of PWB, both directly and indirectly through its effects on identity capital and the use of target focused uncertainty management strategies. Conversely, financial support evidenced only a minor indirect impact through the mediation of tangible identity capital. Autonomy stimulation may constitute one of the most developmentally determinant family challenges in assisting the process of coming of age in Portugal. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Laboratory testing of candidate robotic applications for space

NASA Technical Reports Server (NTRS)

Purves, R. B.

1987-01-01

Robots have potential for increasing the value of man's presence in space. Some categories with potential benefit are: (1) performing extravehicular tasks like satellite and station servicing, (2) supporting the science mission of the station by manipulating experiment tasks, and (3) performing intravehicular activities which would be boring, tedious, exacting, or otherwise unpleasant for astronauts. An important issue in space robotics is selection of an appropriate level of autonomy. In broad terms three levels of autonomy can be defined: (1) teleoperated - an operator explicitly controls robot movement; (2) telerobotic - an operator controls the robot directly, but by high-level commands, without, for example, detailed control of trajectories; and (3) autonomous - an operator supplies a single high-level command, the robot does all necessary task sequencing and planning to satisfy the command. Researchers chose three projects for their exploration of technology and implementation issues in space robots, one each of the three application areas, each with a different level of autonomy. The projects were: (1) satellite servicing - teleoperated; (2) laboratory assistant - telerobotic; and (3) on-orbit inventory manager - autonomous. These projects are described and some results of testing are summarized.

Application of Human-Autonomy Teaming to an Advanced Ground Station for Reduced Crew Operations

NASA Technical Reports Server (NTRS)

Ho, Nhut; Johnson, Walter; Panesar, Karanvir; Wakeland, Kenny; Sadler, Garrett; Wilson, Nathan; Nguyen, Bao; Lachter, Joel; Stallmann, Summer

2017-01-01

Within human factors there is burgeoning interest in the "human-autonomy teaming" (HAT) concept as a way to address the challenges of interacting with complex, increasingly autonomous systems. The HAT concept comes out of an aspiration to interact with increasingly autonomous systems as a team member, rather than simply use automation as a tool. The authors, and others, have proposed core tenets for HAT that include bi-directional communication, automation and system transparency, and advanced coordination between human and automated teammates via predefined, dynamic task sequences known as "plays." It is believed that, with proper implementation, HAT should foster appropriate teamwork, thus increasing trust and reliance on the system, which in turn will reduce workload, increase situation awareness, and improve performance. To this end, HAT has been demonstrated and/or studied in multiple applications including search and rescue operations, healthcare and medicine, autonomous vehicles, photography, and aviation. The current paper presents one such effort to apply HAT. It details the design of a HAT agent, developed by Human Automation Teaming Solutions, Inc., to facilitate teamwork between the automation and the human operator of an advanced ground dispatch station. This dispatch station was developed to support a NASA project investigating a concept called Reduced Crew Operations (RCO); consequently, we have named the agent R-HATS. Part of the RCO concept involves a ground operator providing enhanced support to a large number of aircraft with a single pilot on the flight deck. When assisted by R-HATS, operators can monitor and support or manage a large number of aircraft and use plays to respond in real-time to complicated, workload-intensive events (e.g., an airport closure). A play is a plan that encapsulates goals, tasks, and a task allocation strategy appropriate for a particular situation. In the current implementation, when a play is initiated by a user, R-HATS determines what tasks need to be completed and has the ability to autonomously execute them (e.g., determining diversion options and uplinking new routes to aircraft) when it is safe and appropriate. R-HATS has been designed to both support end users and researchers in RCO and HAT. Additionally, R-HATS and its underlying architecture were developed with generalizability in mind as a modular software applicable outside of RCO/aviation domains. This paper will also discuss future further development and testing of RHATS.

Biases and Heuristics in Decision Making and Their Impact on Autonomy.

PubMed

Blumenthal-Barby, J S

2016-05-01

Cognitive scientists have identified a wide range of biases and heuristics in human decision making over the past few decades. Only recently have bioethicists begun to think seriously about the implications of these findings for topics such as agency, autonomy, and consent. This article aims to provide an overview of biases and heuristics that have been identified and a framework in which to think comprehensively about the impact of them on the exercise of autonomous decision making. I analyze the impact that these biases and heuristics have on the following dimensions of autonomy: understanding, intentionality, absence of alienating or controlling influence, and match between formally autonomous preferences or decisions and actual choices or actions.

The many faces of autonomy.

PubMed

Gracia, Diego

2012-02-01

What does autonomy mean from a moral point of view? Throughout Western history, autonomy has had no less than four different meanings. The first is political: the capacity of old cities and modern states to give themselves their own laws. The second is metaphysical, and was introduced by Kant in the second half of the 18th century. In this meaning, autonomy is understood as an intrinsic characteristic of all rational beings. Opposed to this is the legal meaning, in which actions are called autonomous when performed with due information and competency and without coercion. This last meaning, the most frequently used in bioethics, is primarily legal instead of moral. Is there a proper moral meaning of the word autonomy? If so, this would be a fourth meaning. Acts can only be called moral when they are postconventional (using the terminology coined by Lawrence Kohlberg), inner-directed (as expressed by David Riesman), and responsible (according to Hannah Arendt). Such acts are autonomous in this new, fourth, and to my mind, the only one proper, moral meaning. The goal of ethics cannot be other than forming human beings capable of making autonomous and responsible decisions, and doing so because they think this is their duty and not because of any other nonmoral motivation, like comfort, convenience, or satisfaction. The goal of ethics is to promote postconventional and mature human beings. This was what Socrates tried to do with the young people of Athens. And it is also the objective of every course of ethics and of any process of training.

Cochlear Implantation, Enhancements, Transhumanism and Posthumanism: Some Human Questions.

PubMed

Lee, Joseph

2016-02-01

Biomedical engineering technologies such as brain-machine interfaces and neuroprosthetics are advancements which assist human beings in varied ways. There are exciting yet speculative visions of how the neurosciences and bioengineering may influence human nature. However, these could be preparing a possible pathway towards an enhanced and even posthuman future. This article seeks to investigate several ethical themes and wider questions of enhancement, transhumanism and posthumanism. Four themes of interest are: autonomy, identity, futures, and community. Three larger questions can be asked: will everyone be enhanced? Will we be "human" if we are not, one day, transhuman? Should we be enhanced or not? The article proceeds by concentrating on a widespread and sometimes controversial application: the cochlear implant, an auditory prosthesis implanted into Deaf patients. Cochlear implantation and its reception in both the deaf and hearing communities have a distinctive moral discourse, which can offer surprising insights. The paper begins with several points about the enhancement of human beings, transhumanism's reach beyond the human, and posthuman aspirations. Next it focuses on cochlear implants on two sides. Firstly, a shorter consideration of what technologies may do to humans in a transhumanist world. Secondly, a deeper analysis of cochlear implantation's unique socio-political movement, its ethical explanations and cultural experiences linked with pediatric cochlear implantation-and how those wary of being thrust towards posthumanism could marshal such ideas by analogy. As transhumanism approaches, the issues and questions merit continuing intense analysis.

Beyond the Humanism/Posthumanism Debate: The Educational Implications of Said's Critical, Humane Praxis

ERIC Educational Resources Information Center

Chatelier, Stephen

2017-01-01

The late Edward Said sought to place critique and, indeed, self-critique at the heart of humanism. While the posthuman critiques surrounding the (im)possibility of humanism in postmodern times tend to focus on human autonomy, rationality, and essentialism, Stephen Chatelier here explores the idea that Said's writing on humanism could help us shift…

Identification of the human factors contributing to maintenance failures in a petroleum operation.

PubMed

Antonovsky, Ari; Pollock, Clare; Straker, Leon

2014-03-01

This research aimed to identify the most frequently occurring human factors contributing to maintenance-related failures within a petroleum industry organization. Commonality between failures will assist in understanding reliability in maintenance processes, thereby preventing accidents in high-hazard domains. Methods exist for understanding the human factors contributing to accidents. Their application in a maintenance context mainly has been advanced in aviation and nuclear power. Maintenance in the petroleum industry provides a different context for investigating the role that human factors play in influencing outcomes. It is therefore worth investigating the contributing human factors to improve our understanding of both human factors in reliability and the factors specific to this domain. Detailed analyses were conducted of maintenance-related failures (N = 38) in a petroleum company using structured interviews with maintenance technicians. The interview structure was based on the Human Factor Investigation Tool (HFIT), which in turn was based on Rasmussen's model of human malfunction. A mean of 9.5 factors per incident was identified across the cases investigated.The three most frequent human factors contributing to the maintenance failures were found to be assumption (79% of cases), design and maintenance (71%), and communication (66%). HFIT proved to be a useful instrument for identifying the pattern of human factors that recurred most frequently in maintenance-related failures. The high frequency of failures attributed to assumptions and communication demonstrated the importance of problem-solving abilities and organizational communication in a domain where maintenance personnel have a high degree of autonomy and a wide geographical distribution.

[Implementation of functional autonomy measurement system: barriers and facilitators in PISE-Dordogne project].

PubMed

Gervais, Pauline; Hébert, Réjean; Lamontagne, Julie; Tousignant, Michel

2011-12-01

The objectives of the study were to identify the adjustments made during the implantation and the conditions favouring or limiting the SMAF utilisation. A multiqualitative quote was developed. The Functional autonomy measurement system (SMAF) was implanted in 11 French medico-social establishments. Analyses were made with the mixed type thematic method from Miles and Huberman. Principal adjustments that have been made during implantation concern the informatics assistance and clinical support. Strategic, organizational and individual factors explained adhesion level of actors and the subsequent flow of implantation. Establishment of SMAF and of the software eSMAF® in the medico-social establishments rests on a certain number of conditions which could be identified during the study. These conditions made it possible to work out structured recommendations for future implementations.

76 FR 67622 - Modification of Regulatory Provisions Requiring Credit Rating or Assessments in Accordance With...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-02

... requirements to provide a credit rating or other credit assessment as part of an application for financial... that may affect family well-being. This rule would not have any impact on the autonomy or integrity of... rating or other credit assessment as part of an application for financial assistance or an application to...

GATE: Energy Efficient Vehicles for Sustainable Mobility-Project TI022- FinalReport

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rizzoni, Giorgio

Unique opportunity for industry to engage in original, highly leveraged precompetitive research in automotive and transportation systems, with focus on advanced propulsion systems; fuel economy; vehicle safety, connectivity and autonomy; and advanced driver assistance systems Additional benefits: prepare graduate students for future careers in automotive industry, reaching undergraduate students through capstone design and other project activities, focused recruitment events

Autonomous home-care nursing staff are more engaged in their work and less likely to consider leaving the healthcare sector: a questionnaire survey.

PubMed

Maurits, Erica E M; de Veer, Anke J E; van der Hoek, Lucas S; Francke, Anneke L

2015-12-01

The need for home care is rising in many Western European countries, due to the ageing population and governmental policies to substitute institutional care with home care. At the same time, a general shortage of qualified home-care staff exists or is expected in many countries. It is important to retain existing nursing staff in the healthcare sector to ensure a stable home-care workforce for the future. However, to date there has been little research about the job factors in home care that affect whether staff are considering leaving the healthcare sector. The main purpose of the study was to examine how home-care nursing staff's self-perceived autonomy relates to whether they have considered leaving the healthcare sector and to assess the possible mediating effect of work engagement. The questionnaire-based, cross-sectional study involved 262 registered nurses and certified nursing assistants employed in Dutch home-care organisations (mean age of 51; 97% female). The respondents were members of the Dutch Nursing Staff Panel, a nationwide group of nursing staff members in various healthcare settings (67% response rate). The questionnaire included validated scales concerning self-perceived autonomy and work engagement and a measure for considering pursuing an occupation outside the healthcare sector. Logistic regression and mediation analyses were conducted to test associations between self-perceived autonomy, work engagement and considering leaving the healthcare sector. Nursing staff members in home care who perceive more autonomy are more engaged in their work and less likely to have considered leaving the healthcare sector. The positive association between self-perceived autonomy and considering leaving, found among nursing staff members regardless of their level of education, is mediated by work engagement. In developing strategies for retaining nursing staff in home care, employers and policy makers should target their efforts at enhancing nursing staff's autonomy, thereby improving their work engagement. Copyright © 2015 Elsevier Ltd. All rights reserved.

Human Science for Human Freedom? Piaget's Developmental Research and Foucault's Ethical Truth Games

ERIC Educational Resources Information Center

Zhao, Guoping

2012-01-01

The construction of the modern subject and the pursuit of human freedom and autonomy, as well as the practice of human science has been pivotal in the development of modern education. But for Foucault, the subject is only the effect of discourses and power-knowledge arrangements, and modern human science is part of the very arrangement that has…

ASEAN’s Path to Regional Autonomy: Lessons Learned from the European Union

DTIC Science & Technology

2016-04-04

Soviet Union, as well as China and Japan, in the region.”37 ASEAN has since expanded to include Brunei, Cambodia, Laos, Myanmar , and Vietnam. The...ASEAN. ASEAN’s Path to Regional Autonomy 12 Both the 1997 Asian Financial Crisis and ASEAN expansion to Myanmar made it clear that something...international legitimacy if something were not done about human rights violations in Myanmar . An example of a change that resulted is that prior

Safeguarding donors' personal rights and biobank autonomy in biobank networks: the CRIP privacy regime.

PubMed

Schröder, Christina; Heidtke, Karsten R; Zacherl, Nikolaus; Zatloukal, Kurt; Taupitz, Jochen

2011-08-01

Governance, underlying general ICT (Information and Communication Technology) architecture, and workflow of the Central Research Infrastructure for molecular Pathology (CRIP) are discussed as a model enabling biobank networks to form operational "meta biobanks" whilst respecting the donors' privacy, biobank autonomy and confidentiality, and the researchers' needs for appropriate biospecimens and information, as well as confidentiality. Tailored to these needs, CRIP efficiently accelerates and facilitates research with human biospecimens and data.

Advance directives: the consecration of autonomy and dignity of the human being.

PubMed

Chaves, Marianna

2013-12-01

Advance directives emerge in the doctor-patient relationship as a way to ensure that the autonomy of the patient is observed, prior to a potential state of incapacity. Thus, autonomy can be exercised ensuring patient's dignity and self-determination. Advance directives yet have the power to drive the medical practitioner and his staff so that it is given the treatment and care previously chosen by the patient. The main purpose of this paper is to show the lack of legislation on the matter in Brazil versus the recognition of Advance Directives by the Brazilian Federal Council of Medicine. Can a mere resolution of the Council transform directives into enforceable wishes? This is an answer we intend to offer throughout the text.

Safe delivery care practices in western Nepal: Does women’s autonomy influence the utilization of skilled care at birth?

PubMed Central

Kutty, V. Raman; Sarma, P. Sankara; Dangal, Ganesh

2017-01-01

Despite various efforts to increase the utilization of skilled birth attendants (SBA), nearly two-thirds of deliveries take place at home without the assistance of SBAs in Nepal. We hypothesized that the ability of women to take decisions about their own lives—women’s autonomy—plays an important part in birth choices. To know this, we conducted a community-based cross-sectional study for assessing women’s autonomy and utilization of safe delivery care service in Kapilvastu district of Nepal from June to October 2014. We used multivariate modeling to associate socioeconomic factors and women’s autonomy with the utilization of safe delivery care services. Just over one-third of women sought institutional delivery care during the birth of their last child. Out of the total deliveries at health facilities, nearly 58% women visited health facility for self-reported emergency obstructive care. Only 6.2% home deliveries were handled by health workers and 14.7% women used the safe delivery kit for home delivery care. Higher levels of women’s education had a strong positive association (odds ratio = 24.11, CI = 9.43–61.64) with institutional delivery care. Stratified analysis showed that when the husband is educated, women’s education seems to work partly through their autonomy in decision making. Educational status of women emerged as one of the key predictors of the utilization of delivery care services in Kapilvastu district. Economic status of household and husband’s education are other dominant predictors of the utilization of safe delivery care services. Improving the economic and educational status may be the way out for improving the proportion of institutional deliveries. Women’s autonomy may be an important mediating factor in this pathway. PMID:28771579

In Defense of Pharmaceutically Enhancing Human Morality.

PubMed

Protopapadakis, Evangelos D

2017-01-01

I will discuss the prospect of pharmaceutically enhancing human morality and decision making in such a way as to eliminate morally unjustifiable choices and promote desirable ones. Our species in the relatively short period since it has emerged has enormously advanced in knowledge, science, and technical progress. When it comes to moral development, the distance it has covered is almost negligible. What if we could medically accelerate our moral development? What if we could once and for all render our species totally immune to certain vices? I will examine whether pharmaceutically intervening in human morality would compromise the autonomy of moral agents. I will argue that the argument from the autonomy of the moral agent is neither stable nor convincing. In the light of Kantian ethics we might consider moral enhancement by pharmaceutical means to be a perfect duty for moral agents.

Negotiated autonomy in diabetes self-management: the experiences of adults with intellectual disability and their support workers.

PubMed

Whitehead, L C; Trip, H T; Hale, L A; Conder, J

2016-02-02

The basic human right of autonomy is underpinned by the ability to practice decision-making. The rights of people with disabilities to engage in autonomous decision-making are promoted as best practice and includes decisions around health and self-care. Little is known about autonomy in the field of long-term condition management. This paper explores how people with intellectual disabilities (ID) and their support workers experience and practice autonomy in relation to the management of diabetes. Semi-structured interviews were completed in residential and independent living settings with people living with an ID and type 1 (N = 8) or type 2 (N = 6) diabetes and their support workers (N = 17). The participant with ID's support worker was present as requested; however, the interviews were run separately with each participant rather than jointly. Thematic analysis was undertaken, and a constructivist lens informed both data collection and analysis. The analysis revealed a strong process of negotiated autonomy between people with ID and their support workers in relation to the daily management of diabetes. During times of transition, roles in relation to diabetes management were renegotiated, and the promotion of autonomy was prefaced within the context of risk and client safety. Goals to increase independence were drivers for negotiating greater autonomy. The successful negotiation of autonomy in relation to diabetes illustrates the potential for people with ID to play a key role in the management of long-term health conditions. The study highlights the primacy of developing decision-making skills among people with ID. Promoting opportunities for decision-making and an ethos of supported decision-making through person-centred planning are all vital in working towards enhancing autonomy. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Nursing and human freedom.

PubMed

Risjord, Mark

2014-01-01

Debates over how to conceptualize the nursing role were prominent in the nursing literature during the latter part of the twentieth century. There were, broadly, two schools of thought. Writers like Henderson and Orem used the idea of a self-care deficit to understand the nurse as doing for the patient what he or she could not do alone. Later writers found this paternalistic and emphasized the importance of the patient's free will. This essay uses the ideas of positive and negative freedom to explore the differing conceptions of autonomy which are implicit in this debate. The notion of positive freedom has often been criticized as paternalistic, and the criticisms of self-care in the nursing literature echo criticisms from political philosophy. Recent work on relational autonomy and on the relationship between autonomy and identity are used to address these objections. This essay argues for a more nuanced conception of the obligation to support autonomy that includes both positive (freedom to) and negative (freedom from) dimensions. This conception of autonomy provides a moral foundation for conceptualizing nursing in something like Henderson's terms: as involving the duty to expand the patient's capacities. The essay concludes by generalizing the lesson. Respect for autonomy on the part of any health care provider requires both respect for the patient's choices and a commitment to expand the patient's ability to actualize their choices. © 2013 John Wiley & Sons Ltd.

Autonomy and dignity: a discussion on contingency and dominance.

PubMed

Van Brussel, Leen

2014-06-01

With dying increasingly becoming a medicalised experience in old age, we are witnessing a shift from concern over death itself to an interest in dying 'well'. Fierce discussions about end-of-life decision making and the permissibility of medical intervention in dying, discursively structured around the notion of a 'good' death, are evidence of this shift. This article focuses on 'autonomy' and 'dignity' as key signifiers in these discussions. Rather than being fully fixed and stable, both signifiers are contingent and carry a variety of meanings within different discursive projects. The article aims to distinguish the varieties of these signifiers by elaborating existing theoretical perspectives on autonomy and dignity, and also, starting from a perspective on mass media as sites of meaning production and contestation, to study the contingency of autonomy and dignity in Belgian newspaper coverage of four prominent euthanasia cases. By means of a discourse-theoretical textual analysis, this study exposes a dominant--yet contested--articulation of rational-personal autonomy and of dignity in external terms as something that can be obtained, retained or lost, rather than in terms of intrinsic human integrity. These logics of representation reflect a more general late modern dominance of liberal autonomy and of dignity as being closely connected to self-identity, but at the same time result in limited visibility of alternative ways of experiencing an autonomous and dignified death.

Autonomy is a Right, Not a Feat: How Theoretical Misconceptions have Muddled the Debate on Dynamic Consent to Biobank Research.

PubMed

Johnsson, Linus; Eriksson, Stefan

2016-09-01

Should people be involved as active participants in longitudinal medical research, as opposed to remaining passive providers of data and material? We argue in this article that misconceptions of 'autonomy' as a kind of feat rather than a right are to blame for much of the confusion surrounding the debate of dynamic versus broad consent. Keeping in mind two foundational facts of human life, freedom and dignity, we elaborate three moral principles - those of autonomy, integrity and authority - to better see what is at stake. Respect for autonomy is to recognize the other's right to decide in matters that are important to them. Respect for integrity is to meet, in one's relationship with the other, their need to navigate the intersection between private and social life. Respect for authority is to empower the other - to help them to cultivate their responsibility as citizens. On our account, to force information onto someone who does not want it is not to respect that person's autonomy, but to violate integrity in the name of empowerment. Empowerment, not respect for autonomy, is the aim that sets patient-centred initiatives employing a dynamic consent model apart from other consent models. Whether this is ultimately morally justified depends on whether empowerment ought to be a goal of medical research, which is questionable. © 2016 John Wiley & Sons Ltd.

Optimization of shared autonomy vehicle control architectures for swarm operations.

PubMed

Sengstacken, Aaron J; DeLaurentis, Daniel A; Akbarzadeh-T, Mohammad R

2010-08-01

The need for greater capacity in automotive transportation (in the midst of constrained resources) and the convergence of key technologies from multiple domains may eventually produce the emergence of a "swarm" concept of operations. The swarm, which is a collection of vehicles traveling at high speeds and in close proximity, will require technology and management techniques to ensure safe, efficient, and reliable vehicle interactions. We propose a shared autonomy control approach, in which the strengths of both human drivers and machines are employed in concert for this management. Building from a fuzzy logic control implementation, optimal architectures for shared autonomy addressing differing classes of drivers (represented by the driver's response time) are developed through a genetic-algorithm-based search for preferred fuzzy rules. Additionally, a form of "phase transition" from a safe to an unsafe swarm architecture as the amount of sensor capability is varied uncovers key insights on the required technology to enable successful shared autonomy for swarm operations.

Does Remuneration for Plasma Compromise Autonomy?

PubMed

White, Lucie

2015-12-01

In accordance with a recent statement released by the World Health Organization, the Canadian province of Ontario is moving to ban payment for plasma donation. This is partially based on contentions that remuneration for blood and blood products undermines autonomy and personal dignity. This paper is dedicated to evaluating this claim. I suggest that traditional autonomy-based arguments against commodification of human body parts and substances are less compelling in the context of plasma donation in Canada, but that there is another autonomy-based objection to paid plasma donation that has not received sufficient attention. Namely, the stigma that surrounds exchanging plasma for payment makes it difficult to make an autonomous decision to engage in this activity. I suggest that this problem can be overcome in one of two ways; by banning payment for plasma, or by reducing the stigma surrounding this practice. I provide an indication of how we might work to achieve the latter, contending that this possibility should be taken seriously, due to the difficulties in achieving a sufficient supply of plasma without remuneration.

Reproductive cloning, genetic engineering and the autonomy of the child: the moral agent and the open future.

PubMed

Mameli, M

2007-02-01

Some authors have argued that the human use of reproductive cloning and genetic engineering should be prohibited because these biotechnologies would undermine the autonomy of the resulting child. In this paper, two versions of this view are discussed. According to the first version, the autonomy of cloned and genetically engineered people would be undermined because knowledge of the method by which these people have been conceived would make them unable to assume full responsibility for their actions. According to the second version, these biotechnologies would undermine autonomy by violating these people's right to an open future. There is no evidence to show that people conceived through cloning and genetic engineering would inevitably or even in general be unable to assume responsibility for their actions; there is also no evidence for the claim that cloning and genetic engineering would inevitably or even in general rob the child of the possibility to choose from a sufficiently large array of life plans.

Reproductive cloning, genetic engineering and the autonomy of the child: the moral agent and the open future

PubMed Central

Mameli, M

2007-01-01

Some authors have argued that the human use of reproductive cloning and genetic engineering should be prohibited because these biotechnologies would undermine the autonomy of the resulting child. In this paper, two versions of this view are discussed. According to the first version, the autonomy of cloned and genetically engineered people would be undermined because knowledge of the method by which these people have been conceived would make them unable to assume full responsibility for their actions. According to the second version, these biotechnologies would undermine autonomy by violating these people's right to an open future. There is no evidence to show that people conceived through cloning and genetic engineering would inevitably or even in general be unable to assume responsibility for their actions; there is also no evidence for the claim that cloning and genetic engineering would inevitably or even in general rob the child of the possibility to choose from a sufficiently large array of life plans. PMID:17264194

Teaching ethics: when respect for autonomy and cultural sensitivity collide.

PubMed

Minkoff, Howard

2014-04-01

Respect for autonomy is a key ethical principle. However, in some cultures other moral domains such as community (emphasizing the importance of family roles) and sanctity (emphasizing the sacred and the spiritual side of human nature) hold equal value. Thus, an American physician may sometimes perceive a conflict between the desire to practice ethically and the wish to be sensitive to the mores of other cultures. For example, a woman may appear to be making what the physician thinks is a bad clinical choice because her spouse is speaking on her behalf. That physician may find it difficult to reconcile the sense that the patient had not exercised freely her autonomy with the desire to be culturally sensitive. In this article, the means by which a physician can reconcile respect for other cultures with respect for autonomy is explored. The question of whether physicians must always defer to patients' requests solely because they are couched in the language of cultural sensitivity is also addressed. Copyright © 2014 Mosby, Inc. All rights reserved.

Good physicians from the perspective of their patients

PubMed Central

Schattner, Ami; Rudin, Dan; Jellin, Navah

2004-01-01

Background It is not currently known what is the patient's viewpoint of a "good" physician. We set out to define patient's priorities regarding different physician's attributes in 3 domains important in medical care. Methods Patients hospitalized or attending clinics at a large teaching hospital selected the 4 attributes that they considered most important out of 21 listed arbitrarily in a questionnaire. The questionnaire included 7 items each in the domains of patient autonomy, professional expertise and humanism. Results Participating patients (n = 445, mean age 57.5 ± 16 years) selected professional expertise (50%), physician's patience and attentiveness (38% and 30%, respectively), and informing the patient, representing the patient's interests, being truthful and respecting patient's preferences (25–36% each) as the most essential attributes. Patient's selections were not significantly influenced by different demographic or clinical background. Selections of attributes in the domain of patient's autonomy were significantly more frequent and this was the preferred domain for 31% and as important as another domain for 16% – significantly more than the domain of professional expertise (P = 0.008), and much more than the domain of humanism and support (P < 0.0005). Conclusions Patients studied want their physicians to be highly professional and expert clinicians and show humaneness and support, but their first priority is for the physician to respect their autonomy. PMID:15361255

Human-Autonomy Teaming in a Flight Following Task

NASA Technical Reports Server (NTRS)

Shively, Robert J.

2017-01-01

The NATO HFM-247 Working Group is creating a summary report of the group's activities on human-autonomy teaming. This chapter is a summary of our at NASA Ames work toward developing a framework for human-autonomy teaming (HAT) in aviation. The purpose of this project was to demonstrate and evaluate proposed tenets of HAT. The HAT features were derived from three tenets and were built into an automated recommender system on a ground station. These tenets include bi-directional communication, automation transparency, and operator directed interface. This study focused primarily on interactions with one piece of automation, the Autonomous Constrained Flight Planner (ACFP). The ACFP is designed to support rapid diversion decisions for commercial pilots in off-nominal situations. Much effort has gone into enhancing this tool not only in capability but also in transparency. In this study, participants used the ACFP at a ground station designed to aid dispatchers in a flight following role to reroute aircraft in situations such as inclement weather, system failures and medical emergencies. Participants performed this task both with HAT features enabled and without and provided feedback. We examined subjective and behavioral indicators of HAT collaborations using a proof-of-concept demonstration of HAT tenets. The data collected suggest potential advantages and disadvantages of HAT.

Towards Human-Friendly Efficient Control of Multi-Robot Teams

NASA Technical Reports Server (NTRS)

Stoica, Adrian; Theodoridis, Theodoros; Barrero, David F.; Hu, Huosheng; McDonald-Maiers, Klaus

2013-01-01

This paper explores means to increase efficiency in performing tasks with multi-robot teams, in the context of natural Human-Multi-Robot Interfaces (HMRI) for command and control. The motivating scenario is an emergency evacuation by a transport convoy of unmanned ground vehicles (UGVs) that have to traverse, in shortest time, an unknown terrain. In the experiments the operator commands, in minimal time, a group of rovers through a maze. The efficiency of performing such tasks depends on both, the levels of robots' autonomy, and the ability of the operator to command and control the team. The paper extends the classic framework of levels of autonomy (LOA), to levels/hierarchy of autonomy characteristic of Groups (G-LOA), and uses it to determine new strategies for control. An UGVoriented command language (UGVL) is defined, and a mapping is performed from the human-friendly gesture-based HMRI into the UGVL. The UGVL is used to control a team of 3 robots, exploring the efficiency of different G-LOA; specifically, by (a) controlling each robot individually through the maze, (b) controlling a leader and cloning its controls to followers, and (c) controlling the entire group. Not surprisingly, commands at increased G-LOA lead to a faster traverse, yet a number of aspects are worth discussing in this context.

A Vision-Based System for Intelligent Monitoring: Human Behaviour Analysis and Privacy by Context

PubMed Central

Chaaraoui, Alexandros Andre; Padilla-López, José Ramón; Ferrández-Pastor, Francisco Javier; Nieto-Hidalgo, Mario; Flórez-Revuelta, Francisco

2014-01-01

Due to progress and demographic change, society is facing a crucial challenge related to increased life expectancy and a higher number of people in situations of dependency. As a consequence, there exists a significant demand for support systems for personal autonomy. This article outlines the vision@home project, whose goal is to extend independent living at home for elderly and impaired people, providing care and safety services by means of vision-based monitoring. Different kinds of ambient-assisted living services are supported, from the detection of home accidents, to telecare services. In this contribution, the specification of the system is presented, and novel contributions are made regarding human behaviour analysis and privacy protection. By means of a multi-view setup of cameras, people's behaviour is recognised based on human action recognition. For this purpose, a weighted feature fusion scheme is proposed to learn from multiple views. In order to protect the right to privacy of the inhabitants when a remote connection occurs, a privacy-by-context method is proposed. The experimental results of the behaviour recognition method show an outstanding performance, as well as support for multi-view scenarios and real-time execution, which are required in order to provide the proposed services. PMID:24854209

Nursing challenges for universal health coverage: a systematic review1

PubMed Central

Schveitzer, Mariana Cabral; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida Maria da Silva

2016-01-01

Objectives to identify nursing challenges for universal health coverage, based on the findings of a systematic review focused on the health workforce' understanding of the role of humanization practices in Primary Health Care. Method systematic review and meta-synthesis, from the following information sources: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS and Proquest, using the keyword Primary Health Care associated, separately, with the following keywords: humanization of assistance, holistic care/health, patient centred care, user embracement, personal autonomy, holism, attitude of health personnel. Results thirty studies between 1999-2011. Primary Health Care work processes are complex and present difficulties for conducting integrative care, especially for nursing, but humanizing practices have showed an important role towards the development of positive work environments, quality of care and people-centered care by promoting access and universal health coverage. Conclusions nursing challenges for universal health coverage are related to education and training, to better working conditions and clear definition of nursing role in primary health care. It is necessary to overcome difficulties such as fragmented concepts of health and care and invest in multidisciplinary teamwork, community empowerment, professional-patient bond, user embracement, soft technologies, to promote quality of life, holistic care and universal health coverage. PMID:27143536

A vision-based system for intelligent monitoring: human behaviour analysis and privacy by context.

PubMed

Chaaraoui, Alexandros Andre; Padilla-López, José Ramón; Ferrández-Pastor, Francisco Javier; Nieto-Hidalgo, Mario; Flórez-Revuelta, Francisco

2014-05-20

Due to progress and demographic change, society is facing a crucial challenge related to increased life expectancy and a higher number of people in situations of dependency. As a consequence, there exists a significant demand for support systems for personal autonomy. This article outlines the vision@home project, whose goal is to extend independent living at home for elderly and impaired people, providing care and safety services by means of vision-based monitoring. Different kinds of ambient-assisted living services are supported, from the detection of home accidents, to telecare services. In this contribution, the specification of the system is presented, and novel contributions are made regarding human behaviour analysis and privacy protection. By means of a multi-view setup of cameras, people's behaviour is recognised based on human action recognition. For this purpose, a weighted feature fusion scheme is proposed to learn from multiple views. In order to protect the right to privacy of the inhabitants when a remote connection occurs, a privacy-by-context method is proposed. The experimental results of the behaviour recognition method show an outstanding performance, as well as support for multi-view scenarios and real-time execution, which are required in order to provide the proposed services.

Semantic Likelihood Models for Bayesian Inference in Human-Robot Interaction

NASA Astrophysics Data System (ADS)

Sweet, Nicholas

Autonomous systems, particularly unmanned aerial systems (UAS), remain limited in au- tonomous capabilities largely due to a poor understanding of their environment. Current sensors simply do not match human perceptive capabilities, impeding progress towards full autonomy. Recent work has shown the value of humans as sources of information within a human-robot team; in target applications, communicating human-generated 'soft data' to autonomous systems enables higher levels of autonomy through large, efficient information gains. This requires development of a 'human sensor model' that allows soft data fusion through Bayesian inference to update the probabilistic belief representations maintained by autonomous systems. Current human sensor models that capture linguistic inputs as semantic information are limited in their ability to generalize likelihood functions for semantic statements: they may be learned from dense data; they do not exploit the contextual information embedded within groundings; and they often limit human input to restrictive and simplistic interfaces. This work provides mechanisms to synthesize human sensor models from constraints based on easily attainable a priori knowledge, develops compression techniques to capture information-dense semantics, and investigates the problem of capturing and fusing semantic information contained within unstructured natural language. A robotic experimental testbed is also developed to validate the above contributions.

Wetware, Hardware, or Software Incapacitation: Observational Methods to Determine When Autonomy Should Assume Control

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.; Gregory, Irene M.

2014-01-01

Control-theoretic modeling of human operator's dynamic behavior in manual control tasks has a long, rich history. There has been significant work on techniques used to identify the pilot model of a given structure. This research attempts to go beyond pilot identification based on experimental data to develop a predictor of pilot behavior. Two methods for pre-dicting pilot stick input during changing aircraft dynamics and deducing changes in pilot behavior are presented This approach may also have the capability to detect a change in a subject due to workload, engagement, etc., or the effects of changes in vehicle dynamics on the pilot. With this ability to detect changes in piloting behavior, the possibility now exists to mediate human adverse behaviors, hardware failures, and software anomalies with autono-my that may ameliorate these undesirable effects. However, appropriate timing of when au-tonomy should assume control is dependent on criticality of actions to safety, sensitivity of methods to accurately detect these adverse changes, and effects of changes in levels of auto-mation of the system as a whole.

Assisted Dying & Disability.

PubMed

Riddle, Christopher A

2017-07-01

This article explores at least two dominant critiques of assisted dying from a disability rights perspective. In spite of these critiques, I conclude that assisted dying ought to be permissible. I arrive at the conclusion that if we respect and value people with disabilities, we ought to permit assisted dying. I do so in the following manner. First, I examine recent changes in legislation that have occurred since the Royal Society of Canada Expert Panel on End-of-Life Decision-Making report, published in this journal. I suggest that these changes are likely to only strengthen opposition to assisted dying from disability rights activists and people with disabilities. Second, I focus on respect for people with disabilities and in particular, respect for their autonomy and decision-making abilities. Third, I explore the opposition to assisted dying that focuses on risk and the vulnerability of people with disabilities. Here I suggest that this risk ought not to be of special concern. Ultimately, I conclude that upholding respect for the disabled requires the legalization of assisted dying, rather than the denial of access in a misguided effort to protect people with disabilities. © 2017 John Wiley & Sons Ltd.

Expanding the Writing Center: A Theoretical and Practical Toolkit for Starting an Online Writing Lab

ERIC Educational Resources Information Center

Paiz, Joshua M.

2018-01-01

As the disciplinary focus on learner agency and autonomy increases, a space for online writing labs (OWLs) is reemerging. OWL services represent an opportunity for writing centers to expand their reach both on and off campus, assisting student writers where they are at and in a way that allows them to take increased agency over their compositional…

Between Saddam and the American Occupation: Iraq's Academic Community Struggles for Autonomy

ERIC Educational Resources Information Center

Watenpaugh, Keith

2004-01-01

In June 2003, shortly after the fall of the Baathist regime, and after the United States declared an end to major combat, Keith Watenpaugh, assistant professor of Islamic and Middle Eastern history at Le Moyne College and associate director of peace and global studies, re-turned to Baghdad and al-Mutanabbi Street as the leader of a group of …

Country of origin and racio-ethnicity: are there differences in perceived organizational cultural competency and job satisfaction among nursing assistants in long-term care?

PubMed

Allensworth-Davies, Donald; Leigh, Jennifer; Pukstas, Kim; Geron, Scott Miyake; Hardt, Eric; Brandeis, Gary; Engle, Ryann L; Parker, Victoria A

2007-01-01

Long-term care facilities nationwide are finding it difficult to train and retain sufficient numbers of nursing assistants, resulting in a dire staffing situation. Researchers, managers, and practitioners alike have been trying to determine the correlates of job satisfaction to address this increasingly untenable situation. One factor that has received little empirical attention in the long-term care literature is cultural competence. Cultural competence is defined as a set of skills, attitudes, behaviors, and policies that enable organizations and staff to work effectively in cross-cultural situations. To examine organizational cultural competence as perceived by nursing assistants and determine if this was related to differences in job satisfaction across countries of origin and racio-ethnic groups. Primary data collected from a cross-section of 135 nursing assistants at four New England nursing homes. Demographics, perceptions of organizational cultural competence, and ratings of job satisfaction were collected. A multivariate, generalized linear model was used to assess predictors of job satisfaction. A secondary analysis was then conducted to identify the most important components of organizational cultural competency. Perception of organizational cultural competence (p = .0005) and autonomy (p = .001) were the strongest predictors of job satisfaction among nursing assistants; as these increase, job satisfaction also increases. Neither country of origin nor racio-ethnicity was associated with job satisfaction, but racio-ethnicity was associated with perceived organizational cultural competence (p = .05). A comfortable work environment for employees of different races/cultures emerged as the strongest organizational cultural competency factor (p = .04). Developing and maintaining organizational cultural competency and employee autonomy are important managerial strategies for increasing job satisfaction and improving staff retention. Toward this end, creating a comfortable work environment for employees of different races/cultures is an integral part of the process. Managerial recommendations are discussed.

Integration into What? Reflections on Development Planning for Women.

ERIC Educational Resources Information Center

Boulding, Elise

1980-01-01

Integration of women into the existing international economic and technological order promises only further loss of autonomy and increased marginalization. Women's groups should explore human-centered development which will generate new social structures and new approaches to human productivity and welfare. (SK)

[The correlation between motivation, emotions land learning].

PubMed

Holm, Ellen; Jørsboe, Hanne Blæhr; Holm, Kirsten; Sørensen, Jette Led

2017-07-03

This article explores the importance of emotions as conditional for motivation in medical education. The main principles in self-determination theory and in control-value theory are outlined, and practical consequences which may be drawn from these theories are discussed. Based on the literature we hypothesize that human need for autonomy and competence may be violated by strict regulations and detailed plans for medical education, and that constructive feedback may modify these potential negative effects and support feelings of competence and autonomy.

Adolescent mothers leaving multigenerational households.

PubMed

Oberlander, Sarah E; Shebl, Fatma M; Magder, Laurence S; Black, Maureen M

2009-01-01

This study examined how the developmental processes of autonomy and relatedness are related to changes in the residential status of 181 first-time, adolescent, urban, low-income, African American mothers over the first 24 months postpartum. Although adolescent mothers were eager to live independently, few made a clear transition out of the multigenerational household; 56% lived in the household of origin continuously (IN), 21% left and never returned (OUT), and 23% had multiple moves in and out of the household (IN/OUT). Older adolescent maternal age, less supportive adolescent mother-grandmother relations, and high household density were associated with leaving the household of origin. The IN/OUT group had difficulty adopting the roles of adult and parent. Helping adolescent mothers and grandmothers negotiate roles to reduce conflict may promote autonomy and relatedness, allowing mothers to learn parenting skills, qualify for public assistance, and continue their education.

Legal harmonization and reproductive tourism in Europe.

PubMed

Pennings, Guido

2004-12-01

Legislation of ethical issues illustrates the uneasy mix of ethics and politics. Although the majority has the political right to express its moral views in the law, a number of important ethical values like autonomy, tolerance and respect for other people's opinions urge the majority to take the minorities' position into account. Ignoring pluralism in society will inevitably lead to reproductive tourism. Although European legislation and harmonization in the domain of medically assisted reproduction is presented as a partial solution to this phenomenon, it is argued that European legislation should be avoided as much as possible. Regulation of these private ethical matters should be left to the national parliaments. A soft or compromise legislation will keep reproductive travelling to a minimum. Reproductive tourism is a safety valve that reduces moral conflict and expresses minimal recognition of the others' moral autonomy.

Experiences with HIV Testing, Entry, and Engagement in Care by HIV-Infected Women of Color, and the Need for Autonomy, Competency, and Relatedness

PubMed Central

Messer, Lynne C.; Adimora, Adaora A.; Roytburd, Katya; Bowditch, Natasha; Parnell, Heather; Seay, Julia; Bell, Lynda; Pierce, Jonah K.

2013-01-01

Abstract Self-determination theory examines the needs of people adopting new behaviors but has not been applied to the adoption of HIV healthcare behaviors. The current study applied self-determination theory to descriptions of healthcare behaviors adopted by ethnic minority women after an HIV diagnosis. Women of color were asked to describe their experiences with HIV testing, entry, and engagement-in-care in qualitative interviews and focus groups. Participants were mostly African-American (88%), over 40 years old (70%), had been diagnosed for more than 6 years (87%) and had disclosed their HIV infection to more than 3 people (73%). Women described unmet self-determination needs at different time points along the HIV Continuum of Care. Women experienced a significant loss of autonomy at the time of HIV diagnosis. Meeting competency and relatedness needs assisted women in entry and engagement-in-care. However, re-establishing autonomy was a key element for long-term engagement-in-care. Interventions that satisfy these needs at the optimal time point in care could improve diagnosis, entry-to-care, and retention-in-care for women living with HIV. PMID:23829331

Experiences with HIV testing, entry, and engagement in care by HIV-infected women of color, and the need for autonomy, competency, and relatedness.

PubMed

Quinlivan, E Byrd; Messer, Lynne C; Adimora, Adaora A; Roytburd, Katya; Bowditch, Natasha; Parnell, Heather; Seay, Julia; Bell, Lynda; Pierce, Jonah K

2013-07-01

Self-determination theory examines the needs of people adopting new behaviors but has not been applied to the adoption of HIV healthcare behaviors. The current study applied self-determination theory to descriptions of healthcare behaviors adopted by ethnic minority women after an HIV diagnosis. Women of color were asked to describe their experiences with HIV testing, entry, and engagement-in-care in qualitative interviews and focus groups. Participants were mostly African-American (88%), over 40 years old (70%), had been diagnosed for more than 6 years (87%) and had disclosed their HIV infection to more than 3 people (73%). Women described unmet self-determination needs at different time points along the HIV Continuum of Care. Women experienced a significant loss of autonomy at the time of HIV diagnosis. Meeting competency and relatedness needs assisted women in entry and engagement-in-care. However, re-establishing autonomy was a key element for long-term engagement-in-care. Interventions that satisfy these needs at the optimal time point in care could improve diagnosis, entry-to-care, and retention-in-care for women living with HIV.

Assistance System for Disabled People: A Robot Controlled by Blinking and Wireless Link

NASA Astrophysics Data System (ADS)

Del Val, Lara; Jiménez, María I.; Alonso, Alonso; de La Rosa, Ramón; Izquierdo, Alberto; Carrera, Albano

Disabled people already profit from a lot of technical assistance that improves their quality of life. This article presents a system which will allow interaction between a physically disabled person and his environment. This system is controlled by voluntary muscular movements, particularly those of face muscles. These movements will be translated into machine-understandable instructions, and they will be sent by means of a wireless link to a mobile robot that will execute them. Robot includes a video camera, in order to show the user the environment of the route that the robot follows. This system gives a greater personal autonomy to people with reduced mobility.

NASA Intelligent Systems Project: Results, Accomplishments and Impact on Science Missions.

NASA Astrophysics Data System (ADS)

Coughlan, J. C.

2005-12-01

The Intelligent Systems Project was responsible for much of NASA's programmatic investment in artificial intelligence and advanced information technologies. IS has completed three major project milestones which demonstrated increased capabilities in autonomy, human centered computing, and intelligent data understanding. Autonomy involves the ability of a robot to place an instrument on a remote surface with a single command cycle, human centered computing supported a collaborative, mission centric data and planning system for the Mars Exploration Rovers and data understanding has produced key components of a terrestrial satellite observation system with automated modeling and data analysis capabilities. This paper summarizes the technology demonstrations and metrics which quantify and summarize these new technologies which are now available for future NASA missions.

NASA Intelligent Systems Project: Results, Accomplishments and Impact on Science Missions

NASA Technical Reports Server (NTRS)

Coughlan, Joseph C.

2005-01-01

The Intelligent Systems Project was responsible for much of NASA's programmatic investment in artificial intelligence and advanced information technologies. IS has completed three major project milestones which demonstrated increased capabilities in autonomy, human centered computing, and intelligent data understanding. Autonomy involves the ability of a robot to place an instrument on a remote surface with a single command cycle. Human centered computing supported a collaborative, mission centric data and planning system for the Mars Exploration Rovers and data understanding has produced key components of a terrestrial satellite observation system with automated modeling and data analysis capabilities. This paper summarizes the technology demonstrations and metrics which quantify and summarize these new technologies which are now available for future Nasa missions.

The tension between self governance and absolute inner worth in Kant's moral philosophy.

PubMed

Häyry, M

2005-11-01

The concepts of autonomy as the self governance of individuals and dignity as the inner worth of human beings play an important role in contemporary bioethics. Since both notions are crucial to Immanuel Kant's moral theory, it would be tempting to think that Kantian ethics could ease the friction between the two concepts. It is argued in this paper, however, that this line of thought cannot be supported by Kant's original ideas. While he did make a conscious effort to bring autonomy and dignity together, his emphasis on the absolute inner worth of our collective humanity made it impossible for him to embrace fully the personal self determination of individuals, as it is usually understood in today's liberal thinking.

In vitro gametogenesis: just another way to have a baby?

PubMed Central

Suter, Sonia M.

2015-01-01

Advances in science have made possible the derivation of reproductively viable gametes in vitro from mice. The research on human cells suggests that in vitro gametogenesis (“IVG”) with reproductive potential may one day be possible with humans. This technology would allow same-sex couples to have children who are biologically related to both of them; allow single individuals to procreate without the genetic contribution of another individual; and facilitate “multiplex” parenting, where groups of more than two individuals procreate together, producing children who are the genetic progeny of them all. IVG could also make prenatal selection a much more refined and comprehensive process than it is today, allowing for the selection of embryos on the basis of multiple factors. Evaluating IVG under a relational autonomy framework, this article argues that the potential benefits or harms of IVG depend on the social, scientific, and legal context in which it is situated and how it is used. It concludes that IVG is preferable to some forms of assisted reproductive technologies in certain instances and substantially more problematic in others. Finally, it suggests that its capacity to “perfect” prenatal selection in many ways exacerbates the problematic aspects of increasingly expansive prenatal selection. PMID:27774234

RFID: A key technology for Humanity

NASA Astrophysics Data System (ADS)

Duroc, Yvan; Tedjini, Smail

2018-01-01

The RFID (Radio Frequency IDentification) technology is a well-known wireless application for traceability, logistics, and access control. It became ubiquitous in industry and our daily life (ticketing, payment, passports, car keys, etc.). RFID is nowadays a standardized technology; its inherent advantages, which are unitary, identification, wireless communication, and low cost of tags, provide it with decisive practical benefits that drive new developments in terms of concepts and applications. This trend is largely confirmed by the market forecast, but also by its implementation in the area of health (smart hospital), assistance to persons, anti-counterfeiting, as well as by its perspective in terms of new paradigms for distributed ambient intelligence and the Internet of Things. The first part of this paper briefly reviews the fundamental concepts of the RFID technology, and shows its link with the radio science. A state of the art including the presentation of current performance and developments is also summarized. The second part illustrates the impact of RFID to the service of our society with a focus of applications in the field of autonomy and handicap. Finally, the last part highlights a panorama of perspectives and the future directions of RFID applications dedicated to the service of Humanity. xml:lang="fr"

Man Cannot Change His Nature.

ERIC Educational Resources Information Center

Tsipko, Aleksandr Sergeevich

1990-01-01

Considers perestroika's implications for Soviet recognition of sources of human motivation. Critically examines how the collectivist ideology endemic to twentieth-century Russian history failed to consider human nature. Attributes Soviet economic problems to a disregard of the need for individual autonomy and dignity. Calls for a reconsideration…

Sexuality and human rights in europe.

PubMed

Graupner, Helmut

2005-01-01

Written human rights law in Europe is as scanty as in the rest of the world. Case-law however provides considerable protection of sexual rights. It guarantees comprehensive protection of autonomy in sexual life, also for minors, and provides protection against discrimination based on sexual orientation. Negative attitudes of a majority may not justify interferences with the sexual rights of a minority and society could be expected to tolerate a certain inconvenience to enable individuals to live in dignity and worth in accordance with the sexual identity chosen by them. Compensation for interference with sexual autonomy and freedom is awarded. This high-level protection (as compared to other parts of the world) is however limited. It seems to be granted only in areas where it corresponds with public attitudes and social developments. And it is seldom secured on the national level but nearly exclusively by the European Court of Human Rights, whose case-law is often weakened by inconsistency.

Interculturalism and Informed Consent: Respecting Cultural Differences without Breaching Human Rights.

PubMed

Ekmekci, Perihan Elif; Arda, Berna

2017-01-01

Interventions in medicine require multicenter clinical trials on a large rather than limited number of subjects from various genetic and cultural backgrounds. International guidelines to protect the rights and well-being of human subjects involved in clinical trials are criticized for the priority they place on Western cultural values. These discussions become manifest especially with regard to the content and methodology of the informed consent procedure. The ethical dilemma emerges from the argument that there are fundamental differences about the concept of respect for the autonomy of individuals in different cultures and religions. Some communities prioritize the consent of community leaders or the head of family - usually men - over the voluntary and free consent of the individual. The aim of this work is to discuss this ethical dilemma to determine a base for a consensus that satisfies the sensibilities of different cultures without damaging the rights and autonomy of human subjects.

Interculturalism and Informed Consent: Respecting Cultural Differences without Breaching Human Rights

PubMed Central

Ekmekci, Perihan Elif; Arda, Berna

2018-01-01

Interventions in medicine require multicenter clinical trials on a large rather than limited number of subjects from various genetic and cultural backgrounds. International guidelines to protect the rights and well-being of human subjects involved in clinical trials are criticized for the priority they place on Western cultural values. These discussions become manifest especially with regard to the content and methodology of the informed consent procedure. The ethical dilemma emerges from the argument that there are fundamental differences about the concept of respect for the autonomy of individuals in different cultures and religions. Some communities prioritize the consent of community leaders or the head of family – usually men – over the voluntary and free consent of the individual. The aim of this work is to discuss this ethical dilemma to determine a base for a consensus that satisfies the sensibilities of different cultures without damaging the rights and autonomy of human subjects. PMID:29645014

Marketing human organs: the autonomy paradox.

PubMed

Marshall, P A; Thomasma, D C; Daar, A S

1996-03-01

The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a "gift of life" and a "commodity exchange." The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources.

[How free is free will? Neuro-scientific and philosophical aspects of motivation and decision-making].

PubMed

Hinterhuber, Hartmann

2012-01-01

The question concerning the postulated freedom of will continues to occupy the neuro-sciences, psychiatry, law and neuro-philosophy. Do current research results really show that freedom and responsibility were only illusions, since previously supposed free decisions were only accompanying features of long held neuronal activations? Did Julien de La Mettrie have a great vision, when, already in the Eighteenth Century, he expected a "monsieur Machine"?This article attempts to summarize and evaluate findings that are currently available. The autonomy of human action is not only founded in a subjectively perceived act of will but far more in the ability of the human being to act according to an inner drive which is steered consciously and rationally. The autonomy of human action is not only restricted to the perceived ego, but comprises body and soul, brain and spirit and consequently the whole human being with all their characteristics, values and aims. Modern science thereby supports the old philosophical theory of a conditional freedom of will.

Recentralization within decentralization: County hospital autonomy under devolution in Kenya

PubMed Central

Manyara, Anthony M.; Molyneux, Sassy; Tsofa, Benjamin

2017-01-01

Background In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. Methods We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya. We collected data by in-depth interviews of county health managers and hospital managers in the case study hospitals (n = 21). We adopted the framework proposed by Chawla et al (1995) to examine the autonomy that hospitals had over five management domains (strategic management, finance, procurement, human resource, and administration), and how these influenced hospital functioning. Findings Devolution had resulted in a substantial reduction in the autonomy of county hospitals over the five key functions examined. This resulted in weakened hospital management and leadership, reduced community participation in hospital affairs, compromised quality of services, reduced motivation among hospital staff, non-alignment of county and hospital priorities, staff insubordination, and compromised quality of care. Conclusion Increasing the autonomy of county hospitals in Kenya will improve their functioning. County governments should develop legislation that give hospitals greater control over resources and key management functions. PMID:28771558

Applying self-determination theory to the blood donation context: The blood donor competence, autonomy, and relatedness enhancement (Blood Donor CARE) trial.

PubMed

France, Christopher R; France, Janis L; Carlson, Bruce W; Frye, Victoria; Duffy, Louisa; Kessler, Debra A; Rebosa, Mark; Shaz, Beth H

2017-02-01

The Blood Donor Competency, Autonomy, and Relatedness Enhancement (Blood Donor CARE) project was designed as a practical application of self-determination theory to encourage retention of first-time donors. Self-determination theory proposes that people are more likely to persist with behaviors that are internally-motivated, and that externally-motivated behavior can evolve and become internalized given the appropriate socio-environmental conditions. According to self-determination theory, motivation to engage in blood donation may become increasingly self-determined if the behavior satisfies fundamental human needs for competence (a sense of self-efficacy to achieve specific goals), autonomy (a sense of volitional control over one's behavior), and relatedness (a sense of connection to a larger group). The primary aim of this randomized controlled trial is to examine the effect of competence, autonomy, and/or relatedness interventions on donor retention. Using a full factorial design, first-time donors will be assigned to a control condition or one of seven intervention conditions. Donation competence, autonomy, and relatedness, along with additional constructs associated with return donation, will be assessed before and after the intervention using online surveys, and donation attempts will be tracked for one-year using blood center donor databases. We hypothesize that, compared to the control condition, the interventions will increase the likelihood of a subsequent donation attempt. We will also examine intervention-specific increases in competence, autonomy, and relatedness as potential mediators of enhanced donor retention. By promoting first-time donor competence, autonomy, and relatedness our goal is to enhance internal motivation for giving and in so doing increase the likelihood of future donation. Copyright © 2016 Elsevier Inc. All rights reserved.

Applying self-determination theory to the blood donation context: The blood donor competence, autonomy, and relatedness enhancement (Blood Donor CARE) trial

PubMed Central

France, Christopher R.; France, Janis L.; Carlson, Bruce W.; Frye, Victoria; Duffy, Louisa; Kessler, Debra A.; Rebosa, Mark; Shaz, Beth H.

2016-01-01

The Blood Donor Competency, Autonomy, and Relatedness Enhancement (Blood Donor CARE) project was designed as a practical application of self-determination theory to encourage retention of first-time donors. Self-determination theory proposes that people are more likely to persist with behaviors that are internally-motivated, and that externally-motivated behavior can evolve and become internalized given the appropriate socio-environmental conditions. According to self-determination theory, motivation to engage in blood donation may become increasingly self-determined if the behavior satisfies fundamental human needs for competence (a sense of self-efficacy to achieve specific goals), autonomy (a sense of volitional control over one’s behavior), and relatedness (a sense of connection to a larger group). The primary aim of this randomized controlled trial is to examine the effect of competence, autonomy, and/or relatedness interventions on donor retention. Using a full factorial design, first-time donors will be assigned to a control condition or one of seven intervention conditions. Donation competence, autonomy, and relatedness, along with additional constructs associated with return donation, will be assessed before and after the intervention using online surveys, and donation attempts will be tracked for one-year using blood center donor databases. We hypothesize that, compared to the control condition, the interventions will increase the likelihood of a subsequent donation attempt. We will also examine intervention-specific increases in competence, autonomy, and relatedness as potential mediators of enhanced donor retention. By promoting first-time donor competence, autonomy, and relatedness our goal is to enhance internal motivation for giving and in so doing increase the likelihood of future donation. PMID:27979752

Determining access to assisted reproductive technology: reactions of clinic directors to ethically complex case scenarios.

PubMed

Stern, J E; Cramer, C P; Green, R M; Garrod, A; DeVries, K O

2003-06-01

Our aim was to increase understanding of how patient selection is handled by assisted reproductive technology (ART) clinicians. Ethically complex case scenarios were evaluated by the directors of USA ART clinics. Scenarios included using a son as sperm donor for his father, sex selection without associated disease, treatment of morally irresponsible couples, and a dispute over embryo disposition. Respondents reviewed eight scenarios and gave their opinions on whether to offer treatment. Reasons given for these decisions were placed into one of 13 categories. Survey response rate was 57%. Between 3 and 50% of respondents would treat in each case. Of reasons given, 'conditional' responses (requiring counselling, blood tests or agreement to other 'conditions') were common (31.4%). Non-maleficence (risk) accounted for 29.4% of responses, philosophy of medicine 18.9%, respect for patient autonomy 5.9% and legal concerns 4.6%. Discrimination and threats were each significant in one case. Reasons evoking absolutist beliefs, personal discomfort, commitment to justice, religion and ethical relativism were rare. Clinicians felt conflict between a desire to respect patient autonomy and their discomfort over the risk associated with the procedure. They raised concerns about misuse of medical technology. Attempts to resolve complex issues through negotiation and compromise were common.

Physician-Assisted Suicide: Why Neutrality by Organized Medicine Is Neither Neutral Nor Appropriate.

PubMed

Sulmasy, Daniel P; Finlay, Ilora; Fitzgerald, Faith; Foley, Kathleen; Payne, Richard; Siegler, Mark

2018-05-02

It has been proposed that medical organizations adopt neutrality with respect to physician-assisted suicide (PAS), given that the practice is legal in some jurisdictions and that membership is divided. We review developments in end-of-life care and the role of medical organizations with respect to the legalization of PAS since the 1990s. We argue that moving from opposition to neutrality is not ethically neutral, but a substantive shift from prohibited to optional. We argue that medical organizations already oppose many practices that are legal in many jurisdictions, and that unanimity among membership has not been required for any other clinical or ethical policy positions. Moreover, on an issue so central to the meaning of medical professionalism, it seems important for organized medicine to take a stand. We subsequently review the arguments in favor of PAS (arguments from autonomy and mercy, and against the distinction between killing and allowing to die (K/ATD)) and the arguments against legalization (the limits of autonomy, effects on the patient-physician relationship, the meaning of healing, the validity of the K/ATD distinction, the social nature of suicide, the availability of alternatives, the propensity for incremental extension, and the meaning of control). We conclude that organized medicine should continue its opposition to PAS.

Challenges in managing elderly people with diabetes in primary care settings in Norway

PubMed Central

2013-01-01

Abstract Objective To explore the experiences and clinical challenges that nurses and nursing assistants face when providing high-quality diabetes-specific management and care for elderly people with diabetes in primary care settings. Design Focus-group interviews. Subjects and setting Sixteen health care professionals: 12 registered nurses and four nursing assistants from nursing homes (10), district nursing service (5), and a service unit (1) were recruited by municipal managers who had local knowledge and knew the workforce. All the participants were women aged 32–59 years with clinical experience ranging from 1.5 to 38 years. Results Content analysis revealed a discrepancy between the level of expertise which the participants described as important to delivering high-quality care and their capacity to deliver such care. The discrepancy was due to lack of availability and access to current information, limited ongoing support, lack of cohesion among health care professionals, and limited confidence and autonomy. Challenges to delivering high-quality care included complex, difficult patient situations and lack of confidence to make decisions founded on evidence-based guidelines. Conclusion Participants lacked confidence and autonomy to manage elderly people with diabetes in municipal care settings. Lack of information, support, and professional cohesion made the role challenging. PMID:24205973

SmARTest regulation? Comparing the regulatory structures for ART in the UK and Australia.

PubMed

Petersen, Kerry; Johnson, Martin H

2007-08-01

Assisted reproductive technologies are regulated in both the UK and Australia, thereby curtailing both reproductive and professional autonomy. Different regulatory models have developed in each jurisdiction, despite the similar legal, scientific and cultural histories of the two jurisdictions. In the UK the regulatory structures are under review, largely in the absence of empirical research on the costs and benefits of regulation. The regulatory structures in each jurisdiction are compared and some key differences identified. The UK regulatory structure governing assisted reproductive technologies is currently simpler, more accountable and more transparent than that in Australia. On the other hand, despite administrative and legislative restrictions (particularly in Victoria), the medical scientists and clinicians in Australia generally have more control than their British counterparts over the technical aspects of their work in the provision of IVF and other treatment services, and to a lesser extent in embryo research. Recent proposals appear to move the UK regulatory structure towards a less accountable and less transparent model, but with no evident increase in reproductive or professional autonomy. It is suggested that this change is not in the interests of patients, doctors and the public, and a different model is outlined for devolution of both authority and accountability to the professions.

Rethinking What Motivates and Inspires Students

ERIC Educational Resources Information Center

Bowman, Richard

2011-01-01

Drawing on four decades of scientific research on human motivation, contemporary behavioral scientists contend that exceptional educators provide students with a contextual sense of their intrinsic worth by creating academic environments that engage three overarching human needs: "autonomy," the freedom to make choices and determine one's future;…

Autonomy of the child in the South African context: is a 12 year old of sufficient maturity to consent to medical treatment?

PubMed

Ganya, Wandile; Kling, Sharon; Moodley, Keymanthri

2016-11-02

A child is a developing person with evolving capacities that include autonomy, mental (decisional) capacity and capacity to assume responsibility. Hence, children are entitled to participatory (autonomy) rights in South Africa as observed in the Children's Act 38 of 2005. According to section 129 of the Act a child may consent to his or her own medical treatment provided that he or she is over the age of 12 years and is of sufficient maturity and decisional capacity to understand the various implications of the treatment including the risks and benefits thereof. However, the Act does not provide a definition for what qualifies as 'sufficient maturity' nor does it stipulate how health professionals ought to assess the decisional capacity of a child. In addition, South Africa is a culturally diverse country. The Western liberal notion of autonomy may not necessarily find equal prominence in the mores of people with a different worldview. Hence we demonstrate a few salient comparisons between legal liberal moral theory and African communitarianism as pertinent to the autonomy of the child. Children are rights-holders by virtue of their humanity. Their dignity as individual human persons affords them the entitlement to human rights as contemplated under the Constitution of the Republic of South Africa. However, contrary to the traditional Western notion of individual autonomous persons African societies hold a communalistic notion of person hence there is less regard for individual autonomy and rights with more emphasis on the communal good and maintaining the continuity of relationships and interdependencies shared within a community. A child considered in this view is not regarded as a full person. This implies that decisions concerning the child, including consent to medical treatment are discussed and determined by the community to which the child belongs. Lastly, in this article, we draw on the notion of capacity for responsibility to produce a pragmatic definition of sufficient maturity. It seems reasonable to suggest a move away from a general legal age of consent for medical treatment toward more individualised, context-specific approaches in determining the maturity of a child patient to consent to medical treatment. Perhaps, decision-making with respect to consent to the medical treatment of a child belonging to a traditional African community where the notion of a person is embedded in communitarianism ought to involve the child's parents/guardians/caregivers where possible provided that the best interests of the child are awarded priority.

Visual Privacy by Context: Proposal and Evaluation of a Level-Based Visualisation Scheme

PubMed Central

Padilla-López, José Ramón; Chaaraoui, Alexandros Andre; Gu, Feng; Flórez-Revuelta, Francisco

2015-01-01

Privacy in image and video data has become an important subject since cameras are being installed in an increasing number of public and private spaces. Specifically, in assisted living, intelligent monitoring based on computer vision can allow one to provide risk detection and support services that increase people's autonomy at home. In the present work, a level-based visualisation scheme is proposed to provide visual privacy when human intervention is necessary, such as at telerehabilitation and safety assessment applications. Visualisation levels are dynamically selected based on the previously modelled context. In this way, different levels of protection can be provided, maintaining the necessary intelligibility required for the applications. Furthermore, a case study of a living room, where a top-view camera is installed, is presented. Finally, the performed survey-based evaluation indicates the degree of protection provided by the different visualisation models, as well as the personal privacy preferences and valuations of the users. PMID:26053746

'In a twilight world'? Judging the value of life for the minimally conscious patient.

PubMed

Huxtable, Richard

2013-09-01

The recent ruling from England on the case of M is one of very few worldwide to consider whether life-sustaining treatment, in the form of clinically assisted nutrition and hydration, should continue to be provided to a patient in a minimally conscious state. Formally concerned with the English law pertaining to precedent autonomy (specifically advance decision-making) and the best interests of the incapacitated patient, the judgment issued in M's case implicitly engages with three different accounts of the value of human life, which respectively emphasise its self-determined, intrinsic and instrumental value. The judge appeared to be most persuaded by the intrinsic value of life and he concluded that treatment ought to continue. Assessing whether his approach or conclusion were ethically appropriate involves significant substantive and evidential questions regarding where the burden of proof should lie and what standard of proof should be required when decisions are to be made about the fates of patients inhabiting 'twilight worlds'.

[Fundamental principles of social work--(also) a contribution to public health ethics].

PubMed

Lob-Hüdepohl, A

2009-05-01

Social work and public health are different but mutually connected. Both are professions with their own ethical foundations. Despite all differences, they have the same goal: to protect and to enhance the well-being of people. This is, in part, why the fundamental ethical principles of social work are salient for developing public health ethics. As a human rights profession, social work respects the personal autonomy of clients, supports solidarity-based relationships in families, groups or communities, and attempts to uphold social justice in society. Social workers need to adopt special professional attitudes: sensibility for the vulnerabilities of clients, care and attentiveness for their resources and strengths, assistance instead of paternalistic care and advocacy in decision making for clients' well-being when clients are not able to decide for themselves. These fundamental ethical principles are the basis for discussion of special topics of social work ethics as public health ethics, for example, in justifying intervention in individual lifestyles by public services without the participation or consent of the affected persons.

The ethics of uterus transplantation.

PubMed

Catsanos, Ruby; Rogers, Wendy; Lotz, Mianna

2013-02-01

Human uterus transplantation (UTx) is currently under investigation as a treatment for uterine infertility. Without a uterus transplant, the options available to women with uterine infertility are adoption or surrogacy; only the latter has the potential for a genetically related child. UTx will offer recipients the chance of having their own pregnancy. This procedure occurs at the intersection of two ethically contentious areas: assisted reproductive technologies (ART) and organ transplantation. In relation to organ transplantation, UTx lies with composite tissue transplants such as face and limb grafts, and shares some of the ethical concerns raised by these non-life saving procedures. In relation to ART, UTx represents one more avenue by which a woman may seek to meet her reproductive goals, and as with other ART procedures, raises questions about the limits of reproductive autonomy. This paper explores the ethical issues raised by UTx with a focus on the potential gap between women's desires and aspirations about pregnancy and the likely functional outcomes of successful UTx. © 2011 Blackwell Publishing Ltd.

Can ethics survive the onslaught of science?

PubMed

Lupton, Michael

2013-09-01

The issue on which I will attempt to cast some light is certainly not novel. It has been ongoing for many years but the pace of scientific progress is gathering and the retreat of ethical barriers is relentless. I will illustrate my thesis by using examples of legal decisions from the realm of assisted human procreation and the posthumous conception of children from the sperm of deceased fathers e.g., the cases of Diane Blood, Parpalaix and Nikolas Coltan Evans. I will also highlight the recent case of Ashley X, a nine year old girl whose parents authorised radical medical treatment to arrest her development. I will argue that the law is being driven to roll back the ethical standards derived from our legacy of Natural Law by the imperatives of human rights e.g., the right to found a family, and the quest for patient autonomy. These are both admirable goals but fulfilling these goals comes at a cost to cherished ethical values e.g., that children are conceived by living fathers and that indulging the personal desires of every individual cannot forever be encompassed. As our legislators and courts chip away at our core network of ethical values, are they replacing them with equivalent values or do their decisions amount to a hollowing out of the core ethical values e.g., Thou shalt not kill and that human life is sacrosanct? Yet abortion is legal in many countries as is euthanasia. Paradoxically there is legislative protection for embryos by limiting experimentation on these clusters of cells. How do you construct a rational ethical framework with such blatant legal inconsistencies in the protection of human life? The sanctity of human life constitutes one of the fundamental pillars of ethical values which, in turn, support much more of the structure of ethics. Is a society that permits freezing the development of a nine year old child not a society whose ethics are so compromised that it is doomed to defend an ever diminishing mass of ethical values? Is there a core of ethics which is sacrosanct or is every ethical frontier fair game for invasion? Are the Ethics Committees, which approve and monitor research in the field of bioethics in Universities. Hospitals and laboratories failing in their duty as gatekeepers? They are after all the first line of defence for the survival of crucial ethical values. Can we continue to indulge the whims and needs of every individual under the guise of human rights or patient autonomy? Can a civilised society endure as such with an ever diminishing mass of ethical values?

Physician Assistant Job Satisfaction: A Narrative Review of Empirical Research.

PubMed

Hooker, Roderick S; Kuilman, Luppo; Everett, Christine M

2015-12-01

To examine physician assistant (PA) job satisfaction and identify factors predicting job satisfaction and identify areas of needed research. With a global PA movement underway and a half-century in development, the empirical basis for informing employers of approaches to improve job satisfaction has not received a careful review. A narrative review of empirical research was undertaken to inform stakeholders about PA employment with a goal of improved management. The a priori criteria included published studies that asked PAs about job satisfaction. Articles addressing PA job satisfaction, written in English, were reviewed and categorized according to the Job Characteristics Model. Of 68 publications reviewed, 29 met criteria and were categorized in a Job Characteristics Model. Most studies report a high degree of job satisfaction when autonomy, income, patient responsibility, physician support, and career advancement opportunities are surveyed. Age, sex, specialty, and occupational background are needed to understand the effect on job satisfaction. Quality of studies varies widely. Employers may want to examine their relationships with PAs periodically. The factors of job satisfaction may assist policymakers and health administrators in creating welcoming professional employment environments. The main limitation: no study comprehensively evaluated all the antecedents of job satisfaction. PAs seem to experience job satisfaction supported by low attrition rates and competitive wages. Contributing factors are autonomy, experienced responsibility, pay, and supportive supervising physician. A number of intrinsic rewards derived from the performance of the job within the social environment, along with extrinsic rewards, may contribute to overall job satisfaction. PA job satisfaction research is underdeveloped; investigations should include longitudinal studies, cohort analyses, and economic determinants.

[Frequency of dementia and pre-dementia in elderly people requesting an Autonomy Adapted Assistance grant in the department of Nièvre].

PubMed

Carrin-Maudet, C; Abidh, L; Ganier, M H; Schulz, T; Refait, D

2005-06-01

This study was carried out in the French county of Nièvre after the establishment of a new state funded grant for elderly people called the Autonomy Adapted Allocation. The study looks at the medical evaluations conducted in the homes of elderly people aged 60 and over who have submitted a request for this new grant (a total of 2388 requests were received). The study points to a high level of dependence within the target population of those who are "susceptible to dementia". It also demonstrated that the current scale used for identifying those who are susceptible to dementia is insufficient for its purpose in this case, and unfortunately it lacks the ability to include a portion of the population who should be considered as recipients of these funds. This gap corroborates the difficulty in fully appreciating and understanding the functional repercussions of dementia.

Forced to be free? Increasing patient autonomy by constraining it

PubMed Central

2014-01-01

It is universally accepted in bioethics that doctors and other medical professionals have an obligation to procure the informed consent of their patients. Informed consent is required because patients have the moral right to autonomy in furthering the pursuit of their most important goals. In the present work, it is argued that evidence from psychology shows that human beings are subject to a number of biases and limitations as reasoners, which can be expected to lower the quality of their decisions and which therefore make it more difficult for them to pursue their most important goals by giving informed consent. It is further argued that patient autonomy is best promoted by constraining the informed consent procedure. By limiting the degree of freedom patients have to choose, the good that informed consent is supposed to protect can be promoted. PMID:22318413

Forced to be free? Increasing patient autonomy by constraining it.

PubMed

Levy, Neil

2014-05-01

It is universally accepted in bioethics that doctors and other medical professionals have an obligation to procure the informed consent of their patients. Informed consent is required because patients have the moral right to autonomy in furthering the pursuit of their most important goals. In the present work, it is argued that evidence from psychology shows that human beings are subject to a number of biases and limitations as reasoners, which can be expected to lower the quality of their decisions and which therefore make it more difficult for them to pursue their most important goals by giving informed consent. It is further argued that patient autonomy is best promoted by constraining the informed consent procedure. By limiting the degree of freedom patients have to choose, the good that informed consent is supposed to protect can be promoted.

Virtual HR: The Impact of Information Technology on the Human Resource Professional.

ERIC Educational Resources Information Center

Gardner, Sharyn D.; Lepak, David P.; Bartol, Kathyrn M.

2003-01-01

Responses from 357 complete pairs of human resources executives and professionals from the same company showed that information technology has increased autonomy, the responsiveness of their information dissemination, and networking with other professionals; they spend more time in technology support activities. Organizational climate moderated…

Respect-Due and Respect-Earned: Negotiating Student-Teacher Relationships

ERIC Educational Resources Information Center

Goodman, Joan F.

2009-01-01

Respect is a cardinal virtue in schools and foundational to our common ethical beliefs, yet its meaning is muddled. For philosophers Kant, Mill, and Rawls, whose influential theories span three centuries, respect includes appreciation of universal human dignity, equality, and autonomy. In their view children, possessors of human dignity, but…

Constraint, consent, and well-being in human kidney sales.

PubMed

Hughes, Paul M

2009-12-01

This paper canvasses recent arguments in favor of commercial markets in human transplant kidneys, raising objections to those arguments on grounds of the role of injustice, exploitation, and coercion in compromising the autonomy of those most likely to sell a kidney, namely, the least well off members of society.

[Democratic management and new craft: concepts to rethink integration between autonomy and responsibility in health work].

PubMed

Campos, Gastão Wagner de Sousa

2010-08-01

This article analyses tensions between the dominant management rationality and health work. By means of philosophical concepts and bibliography revision it was found that clinical and public health practices are structured as praxis, a term defined by Aristotle. It does not work automatically, depending on a human being to reflect and decide in most situations, making mediation between established knowledge and singular context. So, it is recommended the adoption of a management model that enables and favors the combination of professional autonomy and sanitary responsibility.

Ethical issues in research.

PubMed

Artal, Raul; Rubenfeld, Sheldon

2017-08-01

Biomedical research is currently guided by ethical standards that have evolved over many centuries. Historical and political events, social and legal considerations, and continuous medical and technological advances have led to the prevailing research ethics and practice. Currently, patients and research subjects have complete autonomy while under medical care or when volunteering as research subjects. Enrolling volunteers in human subjects research includes a detailed and meaningful informed consent process that follows the cardinal principles of ethics: autonomy, beneficence, nonmaleficence, and justice. These principles were gradually adopted after World War II, primarily in response to the unethical behavior of German physicians and scientists during the Third Reich. This review emphasizes the importance of historical milestones and the essential role that ethics has in contemporary medical research. Research protocols should achieve maximum benefits for the society, have clinical and scientific value, be subject to independent review, respect human dignity, and follow the principles of informed consent, and most importantly, subjects should have complete autonomy. However, current principles and regulations cannot cover every conceivable situation, particularly in view of the new advances in science and technology. New and evolving medical technology, genetic research, therapeutic interventions, and innovations challenge society to maintain the highest moral and ethical principles. Copyright © 2017. Published by Elsevier Ltd.

Dependence and a Kantian conception of dignity as a value.

PubMed

Byers, Philippa

2016-02-01

Kantian moral concepts concerning respect for human dignity have played a central role in articulating ethical guidelines for medical practice and research, and for articulating some central positions within bioethical debates more generally. The most common of these Kantian moral concepts is the obligation to respect the dignity of patients and of human research subjects as autonomous, self-determining individuals. This article describes Kant's conceptual distinction between dignity and autonomy as values, and draws on the work of several contemporary Kantian philosophers who employ the distinction to make sense of some common moral intuitions, feelings, and norms. Drawing on this work, the article argues that the conceptual distinction between dignity and autonomy as values is indispensable in the context of considering our obligations to those who are dependent and vulnerable.

Single-trial EEG RSVP classification using convolutional neural networks

NASA Astrophysics Data System (ADS)

Shamwell, Jared; Lee, Hyungtae; Kwon, Heesung; Marathe, Amar R.; Lawhern, Vernon; Nothwang, William

2016-05-01

Traditionally, Brain-Computer Interfaces (BCI) have been explored as a means to return function to paralyzed or otherwise debilitated individuals. An emerging use for BCIs is in human-autonomy sensor fusion where physiological data from healthy subjects is combined with machine-generated information to enhance the capabilities of artificial systems. While human-autonomy fusion of physiological data and computer vision have been shown to improve classification during visual search tasks, to date these approaches have relied on separately trained classification models for each modality. We aim to improve human-autonomy classification performance by developing a single framework that builds codependent models of human electroencephalograph (EEG) and image data to generate fused target estimates. As a first step, we developed a novel convolutional neural network (CNN) architecture and applied it to EEG recordings of subjects classifying target and non-target image presentations during a rapid serial visual presentation (RSVP) image triage task. The low signal-to-noise ratio (SNR) of EEG inherently limits the accuracy of single-trial classification and when combined with the high dimensionality of EEG recordings, extremely large training sets are needed to prevent overfitting and achieve accurate classification from raw EEG data. This paper explores a new deep CNN architecture for generalized multi-class, single-trial EEG classification across subjects. We compare classification performance from the generalized CNN architecture trained across all subjects to the individualized XDAWN, HDCA, and CSP neural classifiers which are trained and tested on single subjects. Preliminary results show that our CNN meets and slightly exceeds the performance of the other classifiers despite being trained across subjects.

Two Ingredients for My Dinner with R2D2: Integration and Adjustable Autonomy

DTIC Science & Technology

2000-01-01

communication theory (Grice 1957) is felicity. He includes it in one of his postulates attempting to explain how human communication is possible...Basically, human communication is effective when it embodies, among other characteristics, felicity, which he characterizes as the aptness and ease of...expression incorporated in human communication . It seems only logical, therefore, that if we are extending human communication to incorporate humanoid

Whose Death Is It Anyway? Perspectives on End-of-Life in Canada.

PubMed

Taylor, Maureen; Martin, Sandra

2014-01-01

People die every minute in Canada, but how they die has become increasingly contentious as the demand for physician-assisted death and euthanasia has become louder and more widespread. Several events have propelled the debate around choice in end-of-life care, including the posthumous release of a video in which infectious disease expert Dr. Donald Low expressed his frustrations over his inability to control the manner of his death, the passing of Bill 52 in Quebec and the Supreme Court's decision to hear the Carter case challenging the constitutionality of the law against assisted suicide. Baby boomers are demanding more autonomy and choice in dying. Is the medical profession listening?

Shifting the autonomy debate to theory as ideology.

PubMed

Ells, C

2001-08-01

Some feminists have been critical about the dominant conception of autonomy, questioning, for example, its conception of persons and ideal of personhood. Tom Beauchamp and James Childress (B&C), the major proponents of the dominant conception of autonomy, believe that these feminists have misunderstood their theory and, moreover, that their theory is immune to feminist attack. Their response to feminist critics, however, has been dismissive and does nothing to assuage these critics' concerns. In this paper I briefly review the state of play in this debate about autonomy, showing that B&C are not without positive rejoinders to objections raised by feminist critics. These rejoinders rest on the notion that feminist concerns are a matter of what is logically entailed by B&C's theory of autonomy and attempt to show that feminist commitments are logically consistent with that theory. However, these rejoinders are less than convincing for reasons illuminated by Cheshire Calhoun. Calhoun reminds us that feminists are sensitive to ways in which the shape of discourse is influenced by non-epistemic considerations. In particular, Calhoun draws our attention to the cumulative effect of a whole tradition of moral reasoning that focuses on too narrow a range of moral problems and too narrow an understanding of people and the human condition. B&C's conception of autonomy relies on and reinforces ideologies of the moral life created in just this way. Following Calhoun, I show that criticism of their theory as ideology is not criticism of its logical implications, but something far more damaging, something without available rejoinders.

A Survey of Expectations About the Role of Robots in Robot-Assisted Therapy for Children with ASD: Ethical Acceptability, Trust, Sociability, Appearance, and Attachment.

PubMed

Coeckelbergh, Mark; Pop, Cristina; Simut, Ramona; Peca, Andreea; Pintea, Sebastian; David, Daniel; Vanderborght, Bram

2016-02-01

The use of robots in therapy for children with autism spectrum disorder (ASD) raises issues concerning the ethical and social acceptability of this technology and, more generally, about human-robot interaction. However, usually philosophical papers on the ethics of human-robot-interaction do not take into account stakeholders' views; yet it is important to involve stakeholders in order to render the research responsive to concerns within the autism and autism therapy community. To support responsible research and innovation in this field, this paper identifies a range of ethical, social and therapeutic concerns, and presents and discusses the results of an exploratory survey that investigated these issues and explored stakeholders' expectations about this kind of therapy. We conclude that although in general stakeholders approve of using robots in therapy for children with ASD, it is wise to avoid replacing therapists by robots and to develop and use robots that have what we call supervised autonomy. This is likely to create more trust among stakeholders and improve the quality of the therapy. Moreover, our research suggests that issues concerning the appearance of the robot need to be adequately dealt with by the researchers and therapists. For instance, our survey suggests that zoomorphic robots may be less problematic than robots that look too much like humans.

Important medical decisions: Using brief motivational interviewing to enhance patients' autonomous decision-making.

PubMed

Pantalon, Michael V; Sledge, William H; Bauer, Stephen F; Brodsky, Beth; Giannandrea, Stephanie; Kay, Jerald; Lazar, Susan G; Mellman, Lisa A; Offenkrantz, William C; Oldham, John; Plakun, Eric M; Rockland, Lawrence H

2013-03-01

The use of motivational interviewing (MI) when the goals of patient and physician are not aligned is examined. A clinical example is presented of a patient who, partly due to anxiety and fear, wants to opt out of further evaluation of his hematuria while the physician believes that the patient must follow up on the finding of hematuria. As patients struggle in making decisions about their medical care, physician interactions can become strained and medical care may become compromised. Physicians sometimes rely on their authority within the doctor-patient relationship to assist patients in making decisions. These methods may be ineffective when there is a conflict in motivations or goals, such as with patient ambivalence and resistance. Furthermore, the values of patient autonomy may conflict with the values of beneficence. A patient simulation exercise is used to demonstrate the value of MI in addressing the motivations of a medical patient when autonomy is difficult to realize because of a high level of resistance to change due to fear. The salience of MI in supporting the value of patient autonomy without giving up the value of beneficence is discussed by providing a method of evaluating the patient's best interests by psychotherapeutically addressing his anxious, fear-based ambivalence.

Patients who challenge.

PubMed

Ward, Michael; Savulescu, Julian

2006-12-01

Individuals have different values. They seek to express their individuality even when receiving medical care. It is a part of modern medical practice and respect for patient autonomy to show respect for different values. We give an account of what it means to respect different values and challenging patients in medical practice. Challenging choices are often choices which are perceived by many to be either irrational or against a person's interests, such as engaging in harmful or excessively risky activities. When the medical profession is involved in such choices, the basic medical principle of acting in a person's best interests is challenged. Often doctors refuse to respect controversial choices on paternalistic grounds. We should all respect and facilitate the controversial choices of competent individuals, subject to resource limitations, our own and others well-being and autonomy, and the public interest. But more importantly, sometimes such choices make for a better, more autonomous life. Sometimes, such choices reflect considerations of global well-being or altruism, or idiosyncratic attitudes to risk. Sometimes, they reflect unusual values. However, in some other cases, controversial choices are irrational and are not expressions of our autonomy. Doctors should assist patients to make rational if individual choices. The patient also bears the responsibility for bringing his beliefs to the attention of the clinician.

Dignity reevaluated: A theological examination of human dignity and the role of the Church in bioethics and end-of-life care.

PubMed

Genuis, Quentin I T

2016-02-01

Predominant among the terminological ambiguities that plague contemporary bioethics is confusion attending the meaning of the term "human dignity," particularly as it applies to so-called end-of-life discussions. This study surveys current trends in treatment of the concept of dignity, examining relevant thinkers who see dignity as redundant or as capability-dependent. These inadequate views are contrasted with an attitude, based theologically in Mark 5, that understands human dignity to represent an absolute characteristic that is donated graciously to all bearers of imago Dei . Human dignity must thus be affirmed as inviolable and independent of autonomy, rationality, or capability. A specific task of the Christian Church is to faithfully recognize and proclaim this dignity. This investigation is particularly relevant in the face of contemporary discussions regarding euthanasia and physician-assisted death. Lay Summary: Much of the polarization within the contemporary bioethical discussion proceeds out of confusion regarding how we ought to define the terms of the debate. If we may take the existing debates regarding euthanasia and physician-assisted death as an example, we may understand the vital need for a sensible definition of the term that stands at the heart of the arguments of both sides of the debate: "human dignity." As such, this study seeks to define dignity in a logical, theological, deeply personal, and highly practical fashion, and to outline the critical role of the Church within such an understanding. Sometimes, when I walk into the room, he ignores me. Sometimes he thinks I am someone else. Most often he is asleep, subjugated by drugs designed to prevent agitation, although "agitation" is the sterilized hospital word for what I would call unbridled panic, total disorientation. The night he had the stroke, they had to tie him to the bed just to keep him in the hospital. And they wouldn't let me see him because he had been calling my name. Very dramatic, but most of his suffering, and our grief, is not dramatic. It is just the mundane process of one man slowly fading, becoming, every day, more of a stranger to himself and to those he loves.

Academic Freedom 3: Education and Human Rights.

ERIC Educational Resources Information Center

Daniel, John, Ed.; And Others

This collection of reports gives a picture of educational systems from a human rights perspective, monitoring academic freedom in the context of freedom of thought and freedom of opinion and expression. The World University Service's Lima Declaration on Academic Freedom and Autonomy of Institutions of Higher Education of 1988 is used as the…

Information sciences and human factors overview

NASA Technical Reports Server (NTRS)

Holcomb, Lee B.

1988-01-01

An overview of program objectives of the Information Sciences and Human Factors Division of NASA's Office of Aeronautics and Space Technology is given in viewgraph form. Information is given on the organizational structure, goals, the research and technology base, telerobotics, systems autonomy in space operations, space sensors, humans in space, space communications, space data systems, transportation vehicle guidance and control, spacecraft control, and major program directions in space.

Principlism, medical individualism, and health promotion in resource-poor countries: can autonomy-based bioethics promote social justice and population health?

PubMed Central

2010-01-01

Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy. PMID:20082703

Principlism, medical individualism, and health promotion in resource-poor countries: can autonomy-based bioethics promote social justice and population health?

PubMed

Azétsop, Jacquineau; Rennie, Stuart

2010-01-18

Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy.

Interactive autonomy and robotic skills

NASA Technical Reports Server (NTRS)

Kellner, A.; Maediger, B.

1994-01-01

Current concepts of robot-supported operations for space laboratories (payload servicing, inspection, repair, and ORU exchange) are mainly based on the concept of 'interactive autonomy' which implies autonomous behavior of the robot according to predefined timelines, predefined sequences of elementary robot operations and within predefined world models supplying geometrical and other information for parameter instantiation on the one hand, and the ability to override and change the predefined course of activities by human intervention on the other hand. Although in principle a very powerful and useful concept, in practice the confinement of the robot to the abstract world models and predefined activities appears to reduce the robot's stability within real world uncertainties and its applicability to non-predefined parts of the world, calling for frequent corrective interaction by the operator, which in itself may be tedious and time-consuming. Methods are presented to improve this situation by incorporating 'robotic skills' into the concept of interactive autonomy.

[ETHICS, MORALS AND SOCIETY IN PERSONALIZED MEDICINE].

PubMed

Flugelman, Anath

2015-09-01

Following the completion of the human genome project, genomic medicine including personalized medicine, widely based on pharmacogenetics and pharmacogenomics, is rapidly developing. This breakthrough should benefit humankind thanks to tailoring the most appropriate prevention, interventions and therapies to each individual, minimizing adverse side effects, based on inter-personal genetic variety and polymorphism. Yet wide spectrum ethical, legal and social issues carry significant implications regarding individuals, families, society and public health. The main issues concern genomic information and autonomy, justice and equity, resources allocation and solidarity, challenging the traditional role of medicine and dealing with unlimited boundaries of knowledge. Those issues are not new nor exceptional to genomic medicine, yet their wide unlimited scope and implications on many aspects of life renders them crucial. These aspects will be discussed in light of Beauchamp and Childress' four principles: non-maleficence, beneficence, autonomy and justice, and main moral philosophies, Kant's autonomy, Utilitarianism which promotes the common good, and Rawls' Theory of Justice.

EVALUATING ROBOT TECHNOLOGIES AS TOOLS TO EXPLORE RADIOLOGICAL AND OTHER HAZARDOUS ENVIRONMENTS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Curtis W. Nielsen; David I. Gertman; David J. Bruemmer

2008-03-01

There is a general consensus that robots could be beneficial in performing tasks within hazardous radiological environments. Most control of robots in hazardous environments involves master-slave or teleoperation relationships between the human and the robot. While teleoperation-based solutions keep humans out of harms way, they also change the training requirements to accomplish a task. In this paper we present a research methodology that allowed scientists at Idaho National Laboratory to identify, develop, and prove a semi-autonomous robot solution for search and characterization tasks within a hazardous environment. Two experiments are summarized that validated the use of semi-autonomy and show thatmore » robot autonomy can help mitigate some of the performance differences between operators who have different levels of robot experience, and can improve performance over teleoperated systems.« less

Assisted or Hastened Death: The Healthcare Practitioner’s Dilemma

PubMed Central

MacLeod, Rod D; Wilson, Donna M; Malpas, Phillipa

2012-01-01

Assisting or hastening death is a dilemma with many ethical as well as practical issues facing healthcare practitioners in most countries worldwide now. Various arguments for and against assisted dying have been made over time but the call from the public for the legalisation of euthanasia and assisted suicide has never been stronger. While some studies have documented the reluctance of medical and other healthcare professionals to be involved in the practice of assisted dying or euthanasia, there is still much open debate in the public domain. Those who have the most experience of palliative care are strongest in their opposition to hastening death. This paper explores salient practical and ethical considerations for healthcare practitioners associated with assisting death, including a focus on examining the concepts of autonomy for patients and healthcare practitioners. The role of the healthcare practitioner has clearly and undoubtedly changed over time with advances in healthcare practices but the duty of care has not changed. The dilemmas for healthcare practitioners thus who have competent patients requesting hastened death extends far beyond acting within a country’s laws as they go to the very heart of the relationship between the practitioner and patient. PMID:23121745

Space and Ground Trades for Human Exploration and Wearable Computing

NASA Technical Reports Server (NTRS)

Lupisella, Mark; Donohue, John; Mandl, Dan; Ly, Vuong; Graves, Corey; Heimerdinger, Dan; Studor, George; Saiz, John; DeLaune, Paul; Clancey, William

2006-01-01

Human exploration of the Moon and Mars will present unique trade study challenges as ground system elements shift to planetary bodies and perhaps eventually to the bodies of human explorers in the form of wearable computing technologies. This presentation will highlight some of the key space and ground trade issues that will face the Exploration Initiative as NASA begins designing systems for the sustained human exploration of the Moon and Mars, with an emphasis on wearable computing. We will present some preliminary test results and scenarios that demonstrate how wearable computing might affect the trade space noted below. We will first present some background on wearable computing and its utility to NASA's Exploration Initiative. Next, we will discuss three broad architectural themes, some key ground and space trade issues within those themes and how they relate to wearable computing. Lastly, we will present some preliminary test results and suggest guidance for proceeding in the assessment and creation of a value-added role for wearable computing in the Exploration Initiative. The three broad ground-space architectural trade themes we will discuss are: 1. Functional Shift and Distribution: To what extent, if any, should traditional ground system functionality be shifted to, and distributed among, the Earth, Moon/Mars, and the human. explorer? 2. Situational Awareness and Autonomy: How much situational awareness (e.g. environmental conditions, biometrics, etc.) and autonomy is required and desired, and where should these capabilities reside? 3. Functional Redundancy: What functions (e.g. command, control, analysis) should exist simultaneously on Earth, the Moon/Mars, and the human explorer? These three themes can serve as the axes of a three-dimensional trade space, within which architectural solutions reside. We will show how wearable computers can fit into this trade space and what the possible implications could be for the rest of the ground and space architecture(s). We intend this to be an example of explorer-centric thinking in a fully integrated explorer paradigm, where integrated explorer refers to a human explorer having instant access to all relevant data, knowledge of the environment, science models, health and safety-related events, and other tools and information via wearable computing technologies. The trade study approach will include involvement from the relevant stakeholders (Constellation Systems, CCCI, EVA Project Office, Astronaut office, Mission Operations, Space Life Sciences, etc.) to develop operations concepts (and/or operations scenarios) from which a basic high-level set of requirements could be extracted. This set of requirements could serve as a foundation (along with stakeholder buy-in) that would help define the trade space and assist in identifying candidate technologies for further study and evolution to higher-level technology readiness levels.

Negotiated Identities: Male Migration and Left-Behind Wives in India

PubMed Central

Desai, Sonalde; Banerji, Manjistha

2009-01-01

This paper examines the impact of husbands’ migration on the lives of women left behind. Using data from the India Human Development Survey 2005, we focus on two dimensions of women’s lives: women’s autonomy and control over their lives; and women’s labour force participation. Results suggest that household structure forms the key mediating factor through which husbands’ absence affects women. Women not residing in extended families are faced with both higher levels of responsibilities and greater autonomy, while women who live in extended households do not experience these demands or benefits. PMID:20694050

Vaccination refusal. Autonomy and permitted coercion.

PubMed

Grzybowski, Andrzej; Patryn, Rafał K; Sak, Jarosław; Zagaja, Anna

2017-06-01

The article presents vaccination obligation in relation to the existing or newly enacted legislation. Mass vaccinations and a wave of criticism they cause, forces us to reflect on the limits of medical intervention in the human body and the boundaries granted to individual's freedom and autonomy. This problem is universal and exists mainly in countries without mandatory vaccinations. Analyzing recent years, it must be underlined that a process in some legislatures has been introduced to enforce various forms of vaccination coercion. Although, refusing vaccinations has been treated liberally, the last wave of epidemics in the United States and Europe forced the creation of a different approach. Gradually in the USA, a duty (not a 'coercion') of vaccination is being enforced. Occurring epidemics, (e.g. measles) and dangers resulting from them, force authorities to violate the principle of autonomy and restrict individuals' freedoms regarding their own body. The article presents legal solutions relating to vaccinations in the United States and Europe i.e. administrative decisions imposing vaccinations, solutions conditioning social existence and financial penalties for not complying with this obligation and proposes a solution based on financial liability that will balance out patients' autonomy and public security.

Vaccination refusal. Autonomy and permitted coercion

PubMed Central

Grzybowski, Andrzej; Patryn, Rafał K.; Sak, Jarosław

2017-01-01

The article presents vaccination obligation in relation to the existing or newly enacted legislation. Mass vaccinations and a wave of criticism they cause, forces us to reflect on the limits of medical intervention in the human body and the boundaries granted to individual’s freedom and autonomy. This problem is universal and exists mainly in countries without mandatory vaccinations. Analyzing recent years, it must be underlined that a process in some legislatures has been introduced to enforce various forms of vaccination coercion. Although, refusing vaccinations has been treated liberally, the last wave of epidemics in the United States and Europe forced the creation of a different approach. Gradually in the USA, a duty (not a ‘coercion’) of vaccination is being enforced. Occurring epidemics, (e.g. measles) and dangers resulting from them, force authorities to violate the principle of autonomy and restrict individuals’ freedoms regarding their own body. The article presents legal solutions relating to vaccinations in the United States and Europe i.e. administrative decisions imposing vaccinations, solutions conditioning social existence and financial penalties for not complying with this obligation and proposes a solution based on financial liability that will balance out patients’ autonomy and public security. PMID:28486849

In the beginning: role of autonomy support on the motivation, mental health and intentions of participants entering an exercise referral scheme.

PubMed

Rouse, Peter C; Ntoumanis, Nikos; Duda, Joan L; Jolly, Kate; Williams, Geoffrey C

2011-06-01

Self-determination theory (Deci & Ryan, 2000, Intrinsic motivation and self-determination in human behaviour. New York: Plenum Publishing) highlights the impact autonomy supportive environments can have on exercise motivation and positive health outcomes. Yet little is known about whether differential effects occur as a function of which significant other is providing this support. Further, no research has examined the relationship between motivation and the social environment with participants' mental health and intentions to be physically active before entering an exercise intervention. Study participants were 347 British adults who were about to start an exercise referral scheme. Regression analyses revealed that the effects of autonomy support on mental health and physical activity intentions differed as a function of who provided the support (offspring, partner or physician), with the offspring having the weakest effects. A structural model was supported, indicating that autonomy support and more autonomous regulations led to more positive mental health outcomes and stronger intentions to be physically active. Knowledge of the social environmental and personal motivation of those about to commence an exercise programme can provide important insights for professionals supporting such efforts. © 2011 Taylor & Francis

Patient experiences of autonomy and coercion while receiving legal leverage in forensic assertive community treatment.

PubMed

Lamberti, J Steven; Russ, Ann; Cerulli, Catherine; Weisman, Robert L; Jacobowitz, David; Williams, Geoffrey C

2014-01-01

Legal leverage is broadly defined as the use of legal authority to promote treatment adherence. It is widely utilized within mental health courts, drug courts, mandated outpatient treatment programs, and other intervention strategies for individuals with mental illness or chemical dependency who have contact with the criminal justice system. Nonetheless, the ethics of using legal authority to promote treatment adherence remains a hotly debated issue within public and professional circles alike. While critics characterize legal leverage as a coercive form of social control that undermines personal autonomy, advocates contend that it supports autonomy because treatment strategies using legal leverage are designed to promote health and independence. Despite the controversy, there is little evidence regarding the impact of legal leverage on patient autonomy as experienced and expressed by patients themselves. This report presents findings from a qualitative study involving six focus groups with severely mentally ill outpatients who received legal leverage through three forensic assertive community treatment (FACT) programs in Northeastern, Midwestern, and West Coast cities. Findings are discussed in the context of the self-determination theory of human motivation, and practical implications for the use of legal leverage are considered.

Autonomy and couples' joint decision-making in healthcare.

PubMed

Osamor, Pauline E; Grady, Christine

2018-01-11

Respect for autonomy is a key principle in bioethics. However, respecting autonomy in practice is complex because most people define themselves and make decisions influenced by a complex network of social relationships. The extent to which individual autonomy operates for each partner within the context of decision-making within marital or similar relationships is largely unexplored. This paper explores issues related to decision-making by couples (couples' joint decision-making) for health care and the circumstances under which such a practice should be respected as compatible with autonomous decision-making. We discuss the concept of autonomy as it applies to persons and to actions, human interdependency and gender roles in decision-making, the dynamics and outcomes of couples' joint decision-making, and the ethics of couples' joint decision-making. We believe that the extent to which couples' joint decision-making might be deemed ethically acceptable will vary depending on the context. Given that in many traditional marriages the woman is the less dominant partner, we consider a spectrum of scenarios of couples' joint decision-making about a woman's own health care that move from those that are acceptably autonomous to those that are not consistent with respecting the woman's autonomous decision-making. To the extent that there is evidence that both members of a couple understand a decision, intend it, and that neither completely controls the other, couples' joint decision-making should be viewed as consistent with the principle of respect for the woman's autonomy. At the other end of the spectrum are decisions made by the man without the woman's input, representing domination of one partner by the other. We recommend viewing the dynamics of couples' joint decision-making as existing on a continuum of degrees of autonomy. This continuum-based perspective implies that couples' joint decision-making should not be taken at face value but should be assessed against the specific cultural, ethnic, and religious backgrounds and personal circumstances of the individuals in question.

Euthanasia—a dialogue

PubMed Central

Berry, P.

2000-01-01

A terminally ill man requests that his life be brought to a peaceful end by the doctor overseeing his care. The doctor, an atheist, regretfully declines. The patient, unsatisfied by the answer and increasingly desperate for relief, presses the doctor for an explanation. During the ensuing dialogue the philosophical, ethical and emotional arguments brought to bear by both the doctor and the patient are dissected. Key Words: Euthanasia • physician-assisted suicide • autonomy • empathy • end of life PMID:11055041

Enabling Advanced Automation in Spacecraft Operations with the Spacecraft Emergency Response System

NASA Technical Reports Server (NTRS)

Breed, Julie; Fox, Jeffrey A.; Powers, Edward I. (Technical Monitor)

2001-01-01

True autonomy is the Holy Grail of spacecraft mission operations. The goal of launching a satellite and letting it manage itself throughout its useful life is a worthy one. With true autonomy, the cost of mission operations would be reduced to a negligible amount. Under full autonomy, any problems (no matter the severity or type) that may arise with the spacecraft would be handled without any human intervention via some combination of smart sensors, on-board intelligence, and/or smart automated ground system. Until the day that complete autonomy is practical and affordable to deploy, incremental steps of deploying ever-increasing levels of automation (computerization of once manual tasks) on the ground and on the spacecraft are gradually decreasing the cost of mission operations. For example, NASA's Goddard Space Flight Center (NASA-GSFC) has been flying spacecraft with low cost operations for several years. NASA-GSFC's SMEX (Small Explorer) and MIDEX (Middle Explorer) missions have effectively deployed significant amounts of automation to enable the missions to fly predominately in 'light-out' mode. Under light-out operations the ground system is run without human intervention. Various tools perform many of the tasks previously performed by the human operators. One of the major issues in reducing human staff in favor of automation is the perceived increased in risk of losing data, or even losing a spacecraft, because of anomalous conditions that may occur when there is no one in the control center. When things go wrong, missions deploying advanced automation need to be sure that anomalous conditions are detected and that key personal are notified in a timely manner so that on-call team members can react to those conditions. To ensure the health and safety of its lights-out missions, NASA-GSFC's Advanced Automation and Autonomy branch (Code 588) developed the Spacecraft Emergency Response System (SERS). The SERS is a Web-based collaborative environment that enables secure distributed fault and resource management. The SERS incorporates the use of intelligent agents, threaded discussions, workflow, database connectivity, and links to a variety of communications devices (e.g., two-way paging, PDA's, and Internet phones) via commercial gateways. When the SERS detects a problem, it notifies on-call team members, who then can remotely take any necessary actions to resolve the anomalies.The SERS goes well beyond a simple '911' system that sends out an error code to everyone with a pager. Instead, SERS' software agents send detailed data (i.e., notifications) to the most appropriate team members based on the type and severity of the anomaly and the skills of the on-call team members. The SERS also allows the team members to respond to the notifications from their wireless devices. This unique capability ensures rapid response since the team members no longer have to go to a PC or the control center for every anomalous event. Most importantly, the SERS enables safe experimentation with various techniques for increasing levels of automation, leading to robust autonomy. For the MIDEX missions at NASA GSFC, the SERS is used to provide 'human-in-the-loop' automation. During lights-out operations, as greater control is given to the MIDEX automated systems, the SERS can be configured to page remote personnel and keep them informed regarding actions taking place in the control center. Remote off-duty operators can even be given the option of enabling or inhibiting a specific automated response in near real time via their two-way pagers. The SERS facilitates insertion of new technology to increase automation, while maintaining the safety and security of mission resources. This paper will focus on SERS' overall functionality and how SERS has been designed to handle the monitoring and emergency response for missions with varying levels of automation. The paper will also convey some of the key lessons learned from SERS' deployment across of variety of missions, highlighting this incremental approach to achieving 'robust autonomy'.

The role of mental health professionals in gender reassignment surgeries: unjust discrimination or responsible care?

PubMed

Selvaggi, Gennaro; Giordano, Simona

2014-12-01

Recent literature has raised an important ethical concern relating to the way in which surgeons approach people with gender dysphoria (GD): it has been suggested that referring transsexual patients to mental assessment can constitute a form of unjust discrimination. The aim of this paper is to examine some of the ethical issues concerning the role of the mental health professional in gender reassignment surgeries (GRS). The role of the mental health professional in GRS is analyzed by presenting the Standards of Care by the World Professional Association of Transgender Health, and discussing the principles of autonomy and non-discrimination. Purposes of psychotherapy are exploring gender identity; addressing the negative impact of GD on mental health; alleviating internalized transphobia; enhancing social and peer support; improving body image; promoting resilience; and assisting the surgeons with the preparation prior to the surgery and the patient's follow-up. Offering or requesting psychological assistance is in no way a form of negative discrimination or an attack to the patient's autonomy. Contrarily, it might improve transsexual patients' care, and thus at the most may represent a form of positive discrimination. To treat people as equal does not mean that they should be treated in the same way, but with the same concern and respect, so that their unique needs and goals can be achieved. Offering or requesting psychological assistance to individuals with GD is a form of responsible care, and not unjust discrimination. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Developing a General Framework for Human Autonomy Teaming

NASA Technical Reports Server (NTRS)

Lachter, Joel; Brandt, Summer; Shively, Jay

2017-01-01

Automation has entered nearly every aspect of our lives, but it often remains hard to understand. Why is this? Automation is often brittle, requiring constant human oversight to assure it operates as intended. This oversight has become harder as automation has become more complicated. To resolve this problem, Human-Autonomy Teaming (HAT) has been proposed. HAT looks to make automation act as more of a teammate, by having it communicate with human operators in a more human, goal-directed, manner which provides transparency into the reasoning behind automated recommendations and actions. This, in turn, permits more trust in the automation when it is appropriate, and less when it is not, allowing a more targeted supervision of automated functions. This paper proposes a framework for HAT, incorporating two key tenets: bi-directional communication, and operator directed authority. We have successfully applied these tenets to integrating the autonomous constrained flight planner (an aide for planning diverts) into a dispatch station. We propose the development of general design patterns that may allow these results to be generalized to domains such as photography and automotive navigation. While these domains are very different, we find application of our HAT tenets provides a number of opportunities for improving interaction between human operators and automation.

Collaborative autonomous sensing with Bayesians in the loop

NASA Astrophysics Data System (ADS)

Ahmed, Nisar

2016-10-01

There is a strong push to develop intelligent unmanned autonomy that complements human reasoning for applications as diverse as wilderness search and rescue, military surveillance, and robotic space exploration. More than just replacing humans for `dull, dirty and dangerous' work, autonomous agents are expected to cope with a whole host of uncertainties while working closely together with humans in new situations. The robotics revolution firmly established the primacy of Bayesian algorithms for tackling challenging perception, learning and decision-making problems. Since the next frontier of autonomy demands the ability to gather information across stretches of time and space that are beyond the reach of a single autonomous agent, the next generation of Bayesian algorithms must capitalize on opportunities to draw upon the sensing and perception abilities of humans-in/on-the-loop. This work summarizes our recent research toward harnessing `human sensors' for information gathering tasks. The basic idea behind is to allow human end users (i.e. non-experts in robotics, statistics, machine learning, etc.) to directly `talk to' the information fusion engine and perceptual processes aboard any autonomous agent. Our approach is grounded in rigorous Bayesian modeling and fusion of flexible semantic information derived from user-friendly interfaces, such as natural language chat and locative hand-drawn sketches. This naturally enables `plug and play' human sensing with existing probabilistic algorithms for planning and perception, and has been successfully demonstrated with human-robot teams in target localization applications.

Native voice, self-concept and the moral case for personalized voice technology.

PubMed

Nathanson, Esther

2017-01-01

Purpose (1) To explore the role of native voice and effects of voice loss on self-concept and identity, and survey the state of assistive voice technology; (2) to establish the moral case for developing personalized voice technology. Methods This narrative review examines published literature on the human significance of voice, the impact of voice loss on self-concept and identity, and the strengths and limitations of current voice technology. Based on the impact of voice loss on self and identity, and voice technology limitations, the moral case for personalized voice technology is developed. Results Given the richness of information conveyed by voice, loss of voice constrains expression of the self, but the full impact is poorly understood. Augmentative and alternative communication (AAC) devices facilitate communication but, despite advances in this field, voice output cannot yet express the unique nuances of individual voice. The ethical principles of autonomy, beneficence and equality of opportunity establish the moral responsibility to invest in accessible, cost-effective, personalized voice technology. Conclusions Although further research is needed to elucidate the full effects of voice loss on self-concept, identity and social functioning, current understanding of the profoundly negative impact of voice loss establishes the moral case for developing personalized voice technology. Implications for Rehabilitation Rehabilitation of voice-disordered patients should facilitate self-expression, interpersonal connectedness and social/occupational participation. Proactive questioning about the psychological and social experiences of patients with voice loss is a valuable entry point for rehabilitation planning. Personalized voice technology would enhance sense of self, communicative participation and autonomy and promote shared healthcare decision-making. Further research is needed to identify the best strategies to preserve and strengthen identity and sense of self.

The Brazilian health system between norms and facts: mitigated universalization and subsidized stratification.

PubMed

Bahia, Lígia

2009-01-01

This paper will focus on recent changes in the relationships between the public and the private sector within the health assistance network, by analyzing selected information on health services and on legal rules related to supporting the private assistance subsystem. This approach recasts analyses which articulate the simultaneous examination of both the material and political instances that permanently redefine the range of activity of SUS. Considering the limitations of the empirical bases here analyzed, one questions the implied assumptions in the meanings of autonomy sustained both in the public and in the private components, departing from hypotheses on the delineation of independent tendencies toward the expansion of universal coverage and he restratification of supply and demand.

The frail elderly: a matter of caring.

PubMed

Erlen, Judith A

2007-01-01

Nurses caring for patients with orthopaedic problems often encounter elderly patients in their caseload. These patients have variable levels of functioning; some may be frail and, therefore, require greater assistance and possibly more time with their care. This loss of function and need for more assistance increases their vulnerability and creates challenges for nurses and other healthcare providers who are delivering patient care. This article offers a brief description of the frail elderly and examines their increasing vulnerability and their need for additional protection, preserving their dignity and respecting their autonomy, and how caring helps to guide nurses in addressing the special needs of this particularly vulnerable patient population. Sensitivity, patience, trust, compassion, and clinical competence matter when caring for the frail elderly.

Robots for Astrobiology!

NASA Technical Reports Server (NTRS)

Boston, Penelope J.

2016-01-01

The search for life and its study is known as astrobiology. Conducting that search on other planets in our Solar System is a major goal of NASA and other space agencies, and a driving passion of the community of scientists and engineers around the world. We practice for that search in many ways, from exploring and studying extreme environments on Earth, to developing robots to go to other planets and help us look for any possible life that may be there or may have been there in the past. The unique challenges of space exploration make collaborations between robots and humans essential. The products of those collaborations will be novel and driven by the features of wholly new environments. For space and planetary environments that are intolerable for humans or where humans present an unacceptable risk to possible biologically sensitive sites, autonomous robots or telepresence offer excellent choices. The search for life signs on Mars fits within this category, especially in advance of human landed missions there, but also as assistants and tools once humans reach the Red Planet. For planetary destinations where we do not envision humans ever going in person, like bitterly cold icy moons, or ocean worlds with thick ice roofs that essentially make them planetary-sized ice caves, we will rely on robots alone to visit those environments for us and enable us to explore and understand any life that we may find there. Current generation robots are not quite ready for some of the tasks that we need them to do, so there are many opportunities for roboticists of the future to advance novel types of mobility, autonomy, and bio-inspired robotic designs to help us accomplish our astrobiological goals. We see an exciting partnership between robotics and astrobiology continually strengthening as we jointly pursue the quest to find extraterrestrial life.

Autonomic Management of Space Missions. Chapter 12

NASA Technical Reports Server (NTRS)

Hinchey, Michael G.; Rash, James L.; Truszkowski, Walt; Rouff, Christopher A.; Sterritt, Roy

2006-01-01

With NASA s renewed commitment to outer space exploration, greater emphasis is being placed on both human and robotic exploration. Even when humans are involved in the exploration, human tending of assets becomes cost-prohibitive or in many cases is simply not feasible. In addition, certain exploration missions will require spacecraft that will be capable of venturing where humans cannot be sent. Early space missions were operated manually from ground control centers with little or no automated operations. In the mid-l980s, the high costs of satellite operations prompted NASA, and others, to begin automating as many functions as possible. In our context, a system is autonomous if it can achieve its goals without human intervention. A number of more-or-less automated ground systems exist today, but work continues with the goal being to reduce operations costs to even lower levels. Cost reductions can be achieved in a number of areas. Ground control and spacecraft operations are two such areas where greater autonomy can reduce costs. As a consequence, autonomy is increasingly seen as a critical approach for robotic missions and for some aspects of manned missions. Although autonomy will be critical for the success of future missions (and indeed will enable certain kinds of science data gathering approaches), missions imbued with autonomy must also exhibit autonomic properties. Exploitation of autonomy alone, without emphasis on autonomic properties, will leave spacecraft vulnerable to the dangerous environments in which they must operate. Without autonomic properties, a spacecraft may be unable to recognize negative environmental effects on its components and subsystems, or may be unable to take any action to ameliorate the effects. The spacecraft, though operating autonomously, may then sustain a degradation of performance of components or subsystems, and consequently may have a reduced potential for achieving mission objectives. In extreme cases, lack of autonomic properties could leave the spacecraft unable to recover from faults. Ensuring that exploration spacecraft have autonomic properties will increase the survivability and therefore the likelihood of success of these missions. In fact, over time, as mission requirements increased demands on spacecraft capabilities and longevity, designers have gradually built more autonomicity into spacecraft. For example, a spacecraft in low-earth orbit may experience an out-of-bounds perturbation of its attitude (orientation) due to increased drag caused by increased atmospheric density at its altitude as a result of a sufficiently large solar flare. If the spacecraft was designed to recognize the excessive attitude perturbation, it could decide to protect itself by going into a safe-hold mode where its internal configuration and operation are altered to conserve power and its coarse attitude is adjusted to point its solar panels toward the Sun to maximize power generation. This is an example of a simple type of autonomic behavior that has actually occurred. Future mission concepts will be increasingly dependent on space system survivability enabled by more advanced types of autonomic behaviors

Innovative methods and tools for professionals working in supported living services for intellectually disabled persons.

PubMed

Gruiz, Katalin

2015-01-01

Autonomy of mid-seriously and seriously intellectually disabled persons is encouraged both by legislations on human rights and the modern social care and services. The process leading to the maximum possible autonomy is illustrated by a developmental spiral in our model. Specialty of the development is that the personal educational projects are realized during everyday activities. The process requires conscious professionals with an empowering and motivating attitude, with adult relationship to the intellectually disabled persons and versatile skills and tools. In this educational relationship the social professional and the supported person are equal partners moving together along the spiral of human development. An innovative tool-battery has been developed aiding support-staff in the 'pedagogical' task embedded into everyday social services. The tool-battery and its first application in supported living services of the Hungarian Down Foundation are introduced in this paper.

Disability Life Writing and the Problem of Dependency in The Autobiography of Gaby Brimmer.

PubMed

Adams, Rachel

2017-03-01

Independence was a core value of the movement for disability rights. People with disabilities did not have to be dependent, advocates claimed; they were robbed of autonomy by poverty, social prejudice, and architectural barriers. Recently, critics have noted that the emphasis on independence equates personhood with autonomy, reason, and self-awareness, thereby excluding those who are incapable of self-determination. The stigma of dependency is communicated to caregivers whose work is devalued and undercompensated. These values are echoed in the life writing of people with disabilities, which tends to present a singular narrative voice, even when the author requires assistance in the physical or intellectual work of composition. The 1979 Mexican memoir-testimonio Gaby Brimmer, collaboratively authored by the acclaimed journalist Elena Poniatowska, Brimmer, her mother, and her paid caregiver is a notable exception. Consisting of interwoven dialogue among its three informants, Gaby Brimmer enacts dependency at the level of form, while exploring the challenges and opportunities of interdependence in societies that devalue the giving and receiving of care.

Self-determined motivation in rehabilitating professional rugby union players.

PubMed

Carson, Fraser; Polman, Remco C J

2017-01-01

The aim of the present study was to explore the views of professional rugby union players during the early rehabilitation, late rehabilitation and return to play stages, following anterior cruciate ligament (ACL) injury. A qualitative dominant, mixed methodological approach was utilized with five players who had suffered an ACL injury requiring reconstructive surgery. A longitudinal approach, concurrent with each player's rehabilitation, consisting of twice monthly interviews, a self-report diary and three established questionnaires (MOS-Social Support Survey, Sherbourne & Stewart, 1991; Sport Climate Questionnaire, Deci & Ryan, n.d.; Injury Rehabilitation Questionnaire, Deci & Ryan, n.d.) were completed. Theoretical thematic analysis was conducted on three distinct phases (Early Limited Participation phase, 10 higher order themes; Late Limited Rehabilitation phase, 11 higher order themes; and Return to Play phase, 9 higher order themes) and coded relating to autonomy, competence and relatedness. The findings suggest that increased autonomy and control assist emotional and behavioral responses during rehabilitation and return to play, while development of competence increases self-confidence.

Impact of financial incentives on clinical autonomy and internal motivation in primary care: ethnographic study.

PubMed

McDonald, Ruth; Harrison, Stephen; Checkland, Kath; Campbell, Stephen M; Roland, Martin

2007-06-30

To explore the impact of financial incentives for quality of care on practice organisation, clinical autonomy, and internal motivation of doctors and nurses working in primary care. Ethnographic case study. Two English general practices. 12 general practitioners, nine nurses, four healthcare assistants, and four administrative staff. Observation of practices over a five month period after the introduction of financial incentives for quality of care introduced in the 2004 general practitioner contract. After the introduction of the quality and outcomes framework there was an increase in the use of templates to collect data on quality of care. New regimens of surveillance were adopted, with clinicians seen as "chasers" or the "chased," depending on their individual responsibility for delivering quality targets. Attitudes towards the contract were largely positive, although discontent was higher in the practice with a more intensive surveillance regimen. Nurses expressed more concern than doctors about changes to their clinical practice but also appreciated being given responsibility for delivering on targets in particular disease areas. Most doctors did not question the quality targets that existed at the time or the implications of the targets for their own clinical autonomy. Implementation of financial incentives for quality of care did not seem to have damaged the internal motivation of the general practitioners studied, although more concern was expressed by nurses.

Impact of financial incentives on clinical autonomy and internal motivation in primary care: ethnographic study

PubMed Central

Harrison, Stephen; Checkland, Kath; Campbell, Stephen M; Roland, Martin

2007-01-01

Objective To explore the impact of financial incentives for quality of care on practice organisation, clinical autonomy, and internal motivation of doctors and nurses working in primary care. Design Ethnographic case study. Setting Two English general practices. Participants 12 general practitioners, nine nurses, four healthcare assistants, and four administrative staff. Main outcome measure Observation of practices over a five month period after the introduction of financial incentives for quality of care introduced in the 2004 general practitioner contract. Results After the introduction of the quality and outcomes framework there was an increase in the use of templates to collect data on quality of care. New regimens of surveillance were adopted, with clinicians seen as “chasers” or the “chased,” depending on their individual responsibility for delivering quality targets. Attitudes towards the contract were largely positive, although discontent was higher in the practice with a more intensive surveillance regimen. Nurses expressed more concern than doctors about changes to their clinical practice but also appreciated being given responsibility for delivering on targets in particular disease areas. Most doctors did not question the quality targets that existed at the time or the implications of the targets for their own clinical autonomy. Conclusions Implementation of financial incentives for quality of care did not seem to have damaged the internal motivation of the general practitioners studied, although more concern was expressed by nurses. PMID:17580318

In defense of the dignity of being human.

PubMed

Gaylin, W

1984-08-01

The concept of human dignity is examined in terms of the religious belief that man is created in God's image and from the Kantian viewpoint that man's autonomy gives special value to our species. The theory of psychic determinism and the prospect of genetic engineering of humans are seen as attacks on self determination. Five additional attributes that make humans "special" are explored: conceptual thought, the capacity for technology, our range of emotions, "Lamarckian" environmental genetics, and the freedom to change and modify ourselves.

Why Bioethics Needs a Disability Moral Psychology.

PubMed

Stramondo, Joseph A

2016-05-01

The deeply entrenched, sometimes heated conflict between the disability movement and the profession of bioethics is well known and well documented. Critiques of prenatal diagnosis and selective abortion are probably the most salient and most sophisticated of disability studies scholars' engagements with bioethics, but there are many other topics over which disability activists and scholars have encountered the field of bioethics in an adversarial way, including health care rationing, growth-attenuation interventions, assisted reproduction technology, and physician-assisted suicide. The tension between the analyses of the disabilities studies scholars and mainstream bioethics is not merely a conflict between two insular political groups, however; it is, rather, also an encounter between those who have experienced disability and those who have not. This paper explores that idea. I maintain that it is a mistake to think of this conflict as arising just from a difference in ideology or political commitments because it represents a much deeper difference-one rooted in variations in how human beings perceive and reason about moral problems. These are what I will refer to as variations of moral psychology. The lived experiences of disability produce variations in moral psychology that are at the heart of the moral conflict between the disability movement and mainstream bioethics. I will illustrate this point by exploring how the disability movement and mainstream bioethics come into conflict when perceiving and analyzing the moral problem of physician-assisted suicide via the lens of the principle of respect for autonomy. To reconcile its contemporary and historical conflict with the disability movement, the field of bioethics must engage with and fully consider the two groups' differences in moral perception and reasoning, not just the explicit moral and political arguments of the disability movement. © 2016 The Hastings Center.

The Challenges of Human-Autonomy Teaming

NASA Technical Reports Server (NTRS)

Vera, Alonso

2017-01-01

Machine intelligence is improving rapidly based on advances in big data analytics, deep learning algorithms, networked operations, and continuing exponential growth in computing power (Moores Law). This growth in the power and applicability of increasingly intelligent systems will change the roles humans, shifting them to tasks where adaptive problem solving, reasoning and decision-making is required. This talk will address the challenges involved in engineering autonomous systems that function effectively with humans in aeronautics domains.

Relational autonomy in the care of the vulnerable: health care professionals' reasoning in Moral Case Deliberation (MCD).

PubMed

Heidenreich, Kaja; Bremer, Anders; Materstvedt, Lars Johan; Tidefelt, Ulf; Svantesson, Mia

2017-12-14

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 protecting 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.

Coordinating a Team of Robots for Urban Reconnaisance

DTIC Science & Technology

2010-11-01

Land Warfare Conference 2010 Brisbane November 2010 Coordinating a Team of Robots for Urban Reconnaisance Pradeep Ranganathan , Ryan...without inundating him with micro- management . Behavorial autonomy is also critical for the human operator to productively interact Figure 1: A...today’s systems, a human operator controls a single robot, micro- managing every action. This micro- management becomes impossible with more robots: in

Canadian nurse practitioner job satisfaction.

PubMed

LaMarche, Kimberley; Tullai-McGuinness, Susan

2009-01-01

To examine the level of job satisfaction and its association with extrinsic and intrinsic job satisfaction characteristics among Canadian primary healthcare nurse practitioners (NPs). A descriptive correlational design was used to collect data on NPs' job satisfaction and on the factors that influence their job satisfaction. A convenience sample of licensed Canadian NPs was recruited from established provincial associations and special-interest groups. Data about job satisfaction were collected using two valid and reliable instruments, the Misener Nurse Practitioner Job Satisfaction Survey and the Minnesota Satisfaction Questionnaire. Descriptive statistics, Pearson correlation and regression analysis were used to describe the results. The overall job satisfaction for this sample ranged from satisfied to highly satisfied. The elements that had the most influence on overall job satisfaction were the extrinsic category of partnership/collegiality and the intrinsic category of challenge/autonomy. These findings were consistent with Herzberg's Dual Factor Theory of Job Satisfaction. The outcomes of this study will serve as a foundation for designing effective human health resource retention and recruitment strategies that will assist in enhancing the implementation and the successful preservation of the NP's role.

Policy of Labor Management and Health Education: a ProgeSUS experience.

PubMed

Magnago, Carinne; Pierantoni, Celia Regina; França, Tania; Vieira, Swheelen de Paula; Miranda, Rômulo Gonçalves de; Nascimento, Dayane Nunes

2017-05-01

To evaluate the stage of labor management and education policies in municipal and state health secretariats (SMS and SES, respectively), having as reference the adherence to a qualification and structuring program of work management and education in the Unified Health System. A descriptive and quantitative study, developed with 519 representatives from the Human Resources (HR) area of SMS and SES, through a survey composed of 56 questions, via a computer-assisted telephone interview in 2012. Responses were processed in a computerized database and the data treated by descriptive statistics. Changes in professional qualification, the establishment of job and salary plans and negotiation processes were identified; on the other hand, there was no progress related to the financial and budgetary autonomy of the area of work management and health education. It is observed progress in the incorporation of innovations in the management in SES and SMS from the process of training of managers and financial induction. It is necessary to monitor and periodically evaluate the operationalization of labor and education policies aimed at strengthening them, correcting directions and implementing innovative actions.

Functional autonomy of distant-acting human enhancers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Visel, Axel; Akiyama, Jennifer A.; Shoukry, Malak

2009-02-19

Many human genes are associated with dispersed arrays of transcriptional enhancers that regulate their expression in time and space. Studies in invertebrate model systems have suggested that these elements function as discrete and independent regulatory units, but the in vivo combinatorial properties of vertebrate enhancers remain poorly understood. To explore the modularity and regulatory autonomy of human developmental enhancers, we experimentally concatenated up to four enhancers from different genes and used a transgenic mouse assay to compare the in vivo activity of these compound elements with that of the single modules. In all of the six different combinations of elementsmore » tested, the reporter gene activity patterns were additive without signs of interference between the individual modules, indicating that regulatory specificity was maintained despite the presence of closely-positioned heterologous enhancers. Even in cases where two elements drove expression in close anatomical proximity, such as within neighboring subregions of the developing limb bud, the compound patterns did not show signs of cross-inhibition between individual elements or novel expression sites. These data indicate that human developmental enhancers are highly modular and functionally autonomous and suggest that genomic enhancer shuffling may have contributed to the evolution of complex gene expression patterns in vertebrates« less

Autonomy and organ sales, revisited.

PubMed

Taylor, James Stacey

2009-12-01

In this paper I develop and defend my arguments in favor of the moral permissibility of a legal market for human body parts in response to the criticisms that have been leveled at them by Paul M. Hughes and Samuel J. Kerstein.

Assistive technology applied to education of students with visual impairment.

PubMed

Alves, Cássia Cristiane de Freitas; Monteiro, Gelse Beatriz Martins; Rabello, Suzana; Gasparetto, Maria Elisabete Rodrigues Freire; de Carvalho, Keila Monteiro

2009-08-01

Verify the application of assistive technology, especially information technology in the education of blind and low-vision students from the perceptions of their teachers. Descriptive survey study in public schools in three municipalities of the state of São Paulo, Brazil. The sample comprised 134 teachers. According to the teachers' opinions, there are differences in the specificities and applicability of assistive technology for blind and low-vision students, for whom specific computer programs are important. Information technology enhances reading and writing skills, as well as communication with the world on an equal basis, thereby improving quality of life and facilitating the learning process. The main reason for not using information technology is the lack of planning courses. The main requirements for the use of information technology in schools are enough computers for all students, advisers to help teachers, and pedagogical support. Assistive technology is applied to education of students with visual impairment; however, teachers indicate the need for infrastructure and pedagogical support. Information technology is an important tool in the inclusion process and can promote independence and autonomy of students with visual impairment.

A literature review on the levels of automation during the years. What are the different taxonomies that have been proposed?

PubMed

Vagia, Marialena; Transeth, Aksel A; Fjerdingen, Sigurd A

2016-03-01

In this paper we present a literature review of the evolution of the levels of autonomy from the end of the 1950s up until now. The motivation of this study was primarily to gather and to compare the literature that exists, on taxonomies on levels of automation. Technical developments within both computer hardware and software have made it possible to introduce autonomy into virtually all aspects of human-machine systems. The current study, is focusing on how different authors treat the problem of different levels of automation. The outcome of this study is to present the differences between the proposed levels of automation and the various taxonomies, giving the potential users a number of choices in order to decide which taxonomy satisfies their needs better. In addition, this paper surveys deals with the term adaptive automation, which seems to be a new trend in the literature on autonomy. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Adjustably Autonomous Multi-agent Plan Execution with an Internal Spacecraft Free-Flying Robot Prototype

NASA Technical Reports Server (NTRS)

Dorais, Gregory A.; Nicewarner, Keith

2006-01-01

We present an multi-agent model-based autonomy architecture with monitoring, planning, diagnosis, and execution elements. We discuss an internal spacecraft free-flying robot prototype controlled by an implementation of this architecture and a ground test facility used for development. In addition, we discuss a simplified environment control life support system for the spacecraft domain also controlled by an implementation of this architecture. We discuss adjustable autonomy and how it applies to this architecture. We describe an interface that provides the user situation awareness of both autonomous systems and enables the user to dynamically edit the plans prior to and during execution as well as control these agents at various levels of autonomy. This interface also permits the agents to query the user or request the user to perform tasks to help achieve the commanded goals. We conclude by describing a scenario where these two agents and a human interact to cooperatively detect, diagnose and recover from a simulated spacecraft fault.

Reproductive autonomy of women and girls under the Convention on the Rights of Persons with Disabilities.

PubMed

Ngwena, Charles G

2018-01-01

Women and girls with disabilities have historically been denied the freedom to make their own choices in matters relating to their reproduction. In the healthcare sector they experience multiple discriminatory practices. Women and girls with intellectual disabilities are particularly vulnerable to coerced or forced medical interventions. The present article considers the contribution the Convention on the Rights of Persons with Disabilities makes towards affirming the rights of women and girls with disabilities to enjoy reproductive autonomy, including autonomy related to reproductive health, on an equal basis with individuals without disabilities. The Convention is paradigm-setting in its maximal approach to affirming the rights of individuals with disabilities to make autonomous choices under conditions of equality and non-discrimination. The Convention is the first human rights treaty to clearly affirm that impairment of decision-making skills is not a justification for depriving a person with cognitive or intellectual disability of legal capacity. © 2017 International Federation of Gynecology and Obstetrics.

Who's Got the Bridge? - Towards Safe, Robust Autonomous Operations at NASA Langley's Autonomy Incubator

NASA Technical Reports Server (NTRS)

Allen, B. Danette; Cross, Charles D.; Motter, Mark A.; Neilan, James H.; Qualls, Garry D.; Rothhaar, Paul M.; Tran, Loc; Trujillo, Anna C.; Crisp, Vicki K.

2015-01-01

NASA aeronautics research has made decades of contributions to aviation. Both aircraft and air traffic management (ATM) systems in use today contain NASA-developed and NASA sponsored technologies that improve safety and efficiency. Recent innovations in robotics and autonomy for automobiles and unmanned systems point to a future with increased personal mobility and access to transportation, including aviation. Automation and autonomous operations will transform the way we move people and goods. Achieving this mobility will require safe, robust, reliable operations for both the vehicle and the airspace and challenges to this inevitable future are being addressed now in government labs, universities, and industry. These challenges are the focus of NASA Langley Research Center's Autonomy Incubator whose R&D portfolio includes mission planning, trajectory and path planning, object detection and avoidance, object classification, sensor fusion, controls, machine learning, computer vision, human-machine teaming, geo-containment, open architecture design and development, as well as the test and evaluation environment that will be critical to prove system reliability and support certification. Safe autonomous operations will be enabled via onboard sensing and perception systems in both data-rich and data-deprived environments. Applied autonomy will enable safety, efficiency and unprecedented mobility as people and goods take to the skies tomorrow just as we do on the road today.

Maternal health care professionals' perspectives on the provision and use of antenatal and delivery care: a qualitative descriptive study in rural Vietnam

PubMed Central

2010-01-01

Background High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. Method The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Result Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. Conclusion Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment. PMID:20946681

Maternal health care professionals' perspectives on the provision and use of antenatal and delivery care: a qualitative descriptive study in rural Vietnam.

PubMed

Graner, Sophie; Mogren, Ingrid; Duong, Le Q; Krantz, Gunilla; Klingberg-Allvin, Marie

2010-10-14

High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.

Do Some People Need Autonomy More Than Others? Implicit Dispositions Toward Autonomy Moderate the Effects of Felt Autonomy on Well-Being.

PubMed

Schüler, Julia; Sheldon, Kennon M; Prentice, Mike; Halusic, Marc

2016-02-01

The present studies examined whether implicit or explicit autonomy dispositions moderate the relationship between felt autonomy and well-being. Study 1 (N = 187 undergraduate students) presents an initial test of the moderator hypothesis by predicting flow experience from the interaction of autonomy need satisfaction and autonomy dispositions. Study 2 (N = 127 physically inactive persons) used vignettes involving an autonomy (un)supportive coach to test a moderated mediation model in which perceived coach autonomy support leads to well-being through basic need satisfaction. Again, the effects of need satisfaction on well-being were hypothesized to be moderated by an implicit autonomy disposition. Study 1 showed that individuals with a strong implicit autonomy (but not power or achievement) motive disposition derived more flow experience from felt autonomy than individuals with a weak implicit autonomy disposition. Study 2 revealed that perceived autonomy support from sports coaches, which we experimentally induced with a vignette method, leads to autonomy satisfaction, leading in turn to positive effects on well-being. This indirect effect held at high and average but not low implicit autonomy disposition. The results indicate that the degree to which people benefit from autonomy need satisfaction depends on their implicit disposition toward autonomy. © 2014 Wiley Periodicals, Inc.

Practitioners' opinions on Food and Nutrition Care Indicators in assisted living facilities for older adults.

PubMed

Chao, Shirley Y; Dwyer, Johanna T; Houser, Robert F; Tennstedt, Sharon; Jacques, Paul

2008-09-01

This study assessed the utility of the 57-indicator Food and Nutrition Care Indicators Checklist for assessing food and nutrition services in assisted-living facilities for older adults among registered dietitians (RDs). They were members of two American Dietetic Association practice groups focusing on aging and long-term care and were also employed in assisted-living facilities. The 1,281 respondents rated the importance of each checklist item and provided their views on the role of assisted-living facilities and their level of agreement with statements regarding the importance of residents' autonomy for making food choices and their ability to make wise dietary choices. Registered dietitians practicing in assisted-living facilities considered all of the domains on food and nutrition quality indicators on the Food and Nutrition Care Indicators Checklist to be highly important (92% of dining room environment items, 83% of foodservice operations, 92% of general nutrition, and 89% of therapeutic nutrition items). They preferred a service style that included both health and amenities, as did national health and aging experts. Registered dietitians should work with other professionals to further validate the checklist, promote its use, and establish optimal service models for food and nutrition services in assisted-living facilities for older adults.

Operator Informational Needs for Multiple Autonomous Small Vehicles

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.; Fan, Henry; Cross, Charles D.; Hempley, Lucas E.; Cichella, Venanzio; Puig-Navarro, Javier; Mehdi, Syed Bilal

2015-01-01

With the anticipated explosion of small unmanned aerial vehicles, it is highly likely that operators will be controlling fleets of autonomous vehicles. To fulfill the promise of autonomy, vehicle operators will not be concerned with manual control of the vehicle; instead, they will deal with the overall mission. Furthermore, the one operator to many vehicles is becoming a constant meme with various industries including package delivery, search and rescue, and utility companies. In order for an operator to concurrently control several vehicles, his station must look and behave very differently than the current ground control station instantiations. Furthermore, the vehicle will have to be much more autonomous, especially during non-normal operations, in order to accommodate the knowledge deficit or the information overload of the operator in charge of several vehicles. The expected usage increase of small drones requires presenting the operational information generated by a fleet of heterogeneous autonomous agents to an operator. NASA Langley Research Center's Autonomy Incubator has brought together researchers in various disciplines including controls, trajectory planning, systems engineering, and human factors to develop an integrated system to study autonomy issues. The initial human factors effort is focusing on mission displays that would give an operator the overall status of all autonomous agents involved in the current mission. This paper will discuss the specifics of the mission displays for operators controlling several vehicles.

Deep Space Spaceflight: The Challenge of Crew Performance in Autonomous Operations

NASA Astrophysics Data System (ADS)

Thaxton, S. S.; Williams, T. J.; Norsk, P.; Zwart, S.; Crucian, B.; Antonsen, E. L.

2018-02-01

Distance from Earth and limited communications in future missions will increase the demands for crew autonomy and dependence on automation, and Deep Space Gateway presents an opportunity to study the impacts of these increased demands on human performance.

The epigenetic effects of assisted reproductive technologies: ethical considerations.

PubMed

Roy, M-C; Dupras, C; Ravitsky, V

2017-08-01

The use of assisted reproductive technologies (ART) has increased significantly, allowing many coping with infertility to conceive. However, an emerging body of evidence suggests that ART could carry epigenetic risks for those conceived through the use of these technologies. In accordance with the Developmental Origins of Health and Disease hypothesis, ART could increase the risk of developing late-onset diseases through epigenetic mechanisms, as superovulation, fertilization methods and embryo culture could impair the embryo's epigenetic reprogramming. Such epigenetic risks raise ethical issues for all stakeholders: prospective parents and children, health professionals and society. This paper focuses on ethical issues raised by the consideration of these risks when using ART. We apply two key ethical principles of North American bioethics (respect for autonomy and non-maleficence) and suggest that an ethical tension may emerge from conflicting duties to promote the reproductive autonomy of prospective parents on one hand, and to minimize risks to prospective children on the other. We argue that this tension is inherent to the entire enterprise of ART and thus cannot be addressed by individual clinicians in individual cases. We also consider the implications of the 'non-identity problem' in this context. We call for additional research that would allow a more robust evidence base for policy. We also call upon professional societies to provide clinicians with guidelines and educational resources to facilitate the communication of epigenetic risks associated with ART to patients, taking into consideration the challenges of communicating risk information whose validity is still uncertain.

Ethical considerations in the regulation of euthanasia and physician-assisted death in Canada.

PubMed

Landry, Joshua T; Foreman, Thomas; Kekewich, Michael

2015-11-01

On February 6th 2015 the Supreme Court of Canada (SCC) released their decision on Carter v Canada (Attorney General) to uphold a judgment from a lower court which determined that the current prohibition in Canada on physician-assisted dying violated the s. 7 [Charter of Rights and Freedoms] rights of competent adults whose medical condition causes intolerable suffering. The purpose of this piece is to briefly examine current regulations from Oregon (USA), Belgium, and the Netherlands, in which physician-assisted death and/or euthanasia is currently permitted, as well as from the province of Quebec which recently passed Bill-52, "An Act Respecting End-of-Life Care." We present ethical considerations that would be pertinent in the development of policies and regulations across Canada in light of this SCC decision: patient and provider autonomy, determining a relevant decision-making standard for practice, and explicating challenges with the SCC criteria for assisted-death eligibility with special consideration to the provision of assisted-death, and review of assisted-death cases. [It is not the goal of this paper to address all questions related to the regulation and policy development of euthanasia and assisted death in Canada, but rather to stimulate and guide the conversations in these areas for policy makers, professional bodies, and regulators.]. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

"This is my way": reimagining disability, in/dependence and interconnectedness of persons and assistive technologies.

PubMed

Gibson, Barbara E; Carnevale, Franco A; King, Gillian

2012-01-01

Postmodernism provides a radical alternative to the dominant discourses of Western societies that emphasize autonomy and independence. It suggests a reimagining of the relationship between the self and the body and the increasingly blurred boundaries between biology and machine. The purpose of this article is to explore in/dependence through a discussion of interconnectedness of persons and assistive technologies. Drawing on postmodern theories, we discuss the interconnections inherent in disability experiences through the case example of Mimi, an adolescent girl with severe physical disabilities. We consider how Mimi, her assistive technologies and her parents can be viewed as assemblages of bodies/technologies/subjectivities that together achieve a set of practices. An examination of these various couplings suggests different understandings of disability that open up possibilities for multiple connections and reimagines dependencies as connectivities. Connectivity can be embraced to explore multiple ways of being-in-the-world for all persons and problematizes the goals of independence inherent in rehabilitation practices.

The More, the Better? Curvilinear Effects of Job Autonomy on Well-Being From Vitamin Model and PE-Fit Theory Perspectives.

PubMed

Stiglbauer, Barbara; Kovacs, Carrie

2017-12-28

In organizational psychology research, autonomy is generally seen as a job resource with a monotone positive relationship with desired occupational outcomes such as well-being. However, both Warr's vitamin model and person-environment (PE) fit theory suggest that negative outcomes may result from excesses of some job resources, including autonomy. Thus, the current studies used survey methodology to explore cross-sectional relationships between environmental autonomy, person-environment autonomy (mis)fit, and well-being. We found that autonomy and autonomy (mis)fit explained between 6% and 22% of variance in well-being, depending on type of autonomy (scheduling, method, or decision-making) and type of (mis)fit operationalization (atomistic operationalization through the separate assessment of actual and ideal autonomy levels vs. molecular operationalization through the direct assessment of perceived autonomy (mis)fit). Autonomy (mis)fit (PE-fit perspective) explained more unique variance in well-being than environmental autonomy itself (vitamin model perspective). Detrimental effects of autonomy excess on well-being were most evident for method autonomy and least consistent for decision-making autonomy. We argue that too-much-of-a-good-thing effects of job autonomy on well-being exist, but suggest that these may be dependent upon sample characteristics (range of autonomy levels), type of operationalization (molecular vs. atomistic fit), autonomy facet (method, scheduling, or decision-making), as well as individual and organizational moderators. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Catholic University.

ERIC Educational Resources Information Center

Danneels, Godfried

2001-01-01

Explores the nature and mission of the Catholic university, addressing a wide range of topics, including the search for truth, the full depth of humanity, institutional autonomy, harmonization of knowledge, ties to the church, cross-cultural dialogue, evangelization, academic freedom, pluralism, the Catholic sensibility, and leadership. (EV)

PREDOMOS study, impact of a social intervention program for socially isolated elderly cancer patients: study protocol for a randomized controlled trial.

PubMed

Crétel-Durand, Elodie; Nouguerède, Emilie; Le Caer, Hervé; Rousseau, Frédérique; Retornaz, Frédérique; Guillem, Olivier; Couderc, Anne-Laure; Greillier, Laurent; Norguet, Emmanuelle; Cécile, Maud; Boulahssass, Rabia; Le Caer, Francoise; Tournier, Sandrine; Butaud, Chantal; Guillet, Pierre; Nahon, Sophie; Poudens, Laure; Kirscher, Sylvie; Loubière, Sandrine; Diaz, Nadine; Dhorne, Jean; Auquier, Pascal; Baumstarck, Karine

2017-04-12

Cancer incidence and social isolation increase along with advanced age, and social isolation potentiates the relative risk of death by cancer. Once spotted, social isolation can be averted with the intervention of a multidisciplinary team. Techniques of automation and remote assistance have already demonstrated their positive impact on falls prevention and quality of life (QoL), though little is known about their impact on socially isolated elderly patients supported for cancer. The primary objective of the PREDOMOS study is to evaluate the impact of establishing a Program of Social intervention associated with techniques of Domotic and Remote assistance (PS-DR) on the improvement of QoL of elderly isolated patients, treated for locally advanced or metastatic cancer. The secondary objectives include treatment failure, tolerance, survival, and autonomy. This trial is a multicenter, prospective, randomized, placebo-controlled, open-label, two-parallel group study. The setting is 10 French oncogeriatric centers. Inclusion criteria are patients aged at least 70 years with a social isolation risk and a histological diagnosis of cancer, locally advanced or metastatic disease. The groups are (1) the control group, receiving usual care; (2) the experimental group, receiving usual care associating with monthly social assistance, domotic, and remote assistance. Participants are randomized in a 1:1 allocation ratio. Evaluation times involve inclusion (randomization) and follow-up (12 months). The primary endpoint is QoL at 3 months (via European Organization for Research and Treatment of Cancer (EORTC) QLQ C30); secondary endpoints are social isolation, time to treatment failure, toxicity, dose response-intensity, survival, autonomy, and QoL at 6 months. For the sample size, 320 individuals are required to obtain 90% power to detect a 10-point difference (standard deviation 25) in QoL score between the two groups (20% loss to follow-up patients expected). The randomized controlled design is the most appropriate design to demonstrate the efficacy of a new experimental strategy (Evidence-Based Medicine Working Group classification). National and international recommendations could be updated based on the findings of this study. ClinicalTrials.gov, NCT02829762 . Registered on 29 June 2016.

The Chains on All My People Are the Chains on Me: Restrictions to Collective Autonomy Undermine the Personal Autonomy and Psychological Well-Being of Group Members.

PubMed

Kachanoff, Frank J; Taylor, Donald M; Caouette, Julie; Khullar, Thomas H; Wohl, Michael J A

2018-01-11

Four studies assessed the potentially detrimental effects that restrictions to collective autonomy (i.e., a group's freedom to determine and practice its own identity) may have for the personal autonomy and psychological well-being of group members. In Study 1, using 3 distinct samples (NSample1a = 123, NSample1b = 129, NSample1c = 370), correlational and cross-cultural evidence indicates that perceived restrictions to the collective autonomy of one's group is directly associated with reduced personal autonomy, and indirectly associated with diminished well-being through personal autonomy. In Study 2 (N = 411), a longitudinal assessment of group members over 3 time-points during a 4-month period found that group members who perceived greater collective autonomy restriction also experienced reduced personal autonomy, and in turn, reduced psychological well-being over time. In Study 3 (N = 255), group members described a time during which their ingroup had (or did not have) its collective autonomy unduly restricted by other groups. Participants who were primed to think that their group lacked collective autonomy reported reduced feelings of personal autonomy, and reduced psychological well-being (compared with those primed to think their group had collective autonomy). In Study 4 (N = 389), collective autonomy was manipulated within the context of an intensive laboratory simulation. Collective autonomy-restricted group members experienced less personal autonomy than those who did not have their collective autonomy restricted. Together these findings suggest that restrictions to a group's collective autonomy may have detrimental consequences for the personal autonomy and psychological well-being of group members. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Dignity reevaluated: A theological examination of human dignity and the role of the Church in bioethics and end-of-life care

PubMed Central

Genuis, Quentin I. T.

2016-01-01

Predominant among the terminological ambiguities that plague contemporary bioethics is confusion attending the meaning of the term “human dignity,” particularly as it applies to so-called end-of-life discussions. This study surveys current trends in treatment of the concept of dignity, examining relevant thinkers who see dignity as redundant or as capability-dependent. These inadequate views are contrasted with an attitude, based theologically in Mark 5, that understands human dignity to represent an absolute characteristic that is donated graciously to all bearers of imago Dei. Human dignity must thus be affirmed as inviolable and independent of autonomy, rationality, or capability. A specific task of the Christian Church is to faithfully recognize and proclaim this dignity. This investigation is particularly relevant in the face of contemporary discussions regarding euthanasia and physician-assisted death. Lay Summary: Much of the polarization within the contemporary bioethical discussion proceeds out of confusion regarding how we ought to define the terms of the debate. If we may take the existing debates regarding euthanasia and physician-assisted death as an example, we may understand the vital need for a sensible definition of the term that stands at the heart of the arguments of both sides of the debate: “human dignity.” As such, this study seeks to define dignity in a logical, theological, deeply personal, and highly practical fashion, and to outline the critical role of the Church within such an understanding. Sometimes, when I walk into the room, he ignores me. Sometimes he thinks I am someone else. Most often he is asleep, subjugated by drugs designed to prevent agitation, although “agitation” is the sterilized hospital word for what I would call unbridled panic, total disorientation. The night he had the stroke, they had to tie him to the bed just to keep him in the hospital. And they wouldn't let me see him because he had been calling my name. Very dramatic, but most of his suffering, and our grief, is not dramatic. It is just the mundane process of one man slowly fading, becoming, every day, more of a stranger to himself and to those he loves. PMID:27833177

Multigenerational Independent Colony for Extraterrestrial Habitation, Autonomy, and Behavior Health (MICEHAB): An Investigation of a Long Duration, Partial Gravity, Autonomous Rodent Colony

NASA Technical Reports Server (NTRS)

Rodgers, Erica M.; Simon, Matthew A.; Antol, Jeffrey; Chai, Patrick R.; Jones, Christopher A.; Klovstad, Jordan J.; Neilan, James H.; Stillwagen, Frederic H.; Williams, Phillip A.; Bednara, Michael;

CAALYX: a new generation of location-based services in healthcare.

PubMed

Boulos, Maged N Kamel; Rocha, Artur; Martins, Angelo; Vicente, Manuel Escriche; Bolz, Armin; Feld, Robert; Tchoudovski, Igor; Braecklein, Martin; Nelson, John; Laighin, Gearóid O; Sdogati, Claudio; Cesaroni, Francesca; Antomarini, Marco; Jobes, Angela; Kinirons, Mark

2007-03-12

Recent advances in mobile positioning systems and telecommunications are providing the technology needed for the development of location-aware tele-care applications. This paper introduces CAALYX--Complete Ambient Assisted Living Experiment, an EU-funded project that aims at increasing older people's autonomy and self-confidence by developing a wearable light device capable of measuring specific vital signs of the elderly, detecting falls and location, and communicating automatically in real-time with his/her care provider in case of an emergency, wherever the older person happens to be, at home or outside.

Defining the Levels of Adjustable Autonomy: A Means of Improving Resilience in an Unmanned Aerial System

DTIC Science & Technology

2014-09-01

efficient yet safe operations. • Further understanding of human psychology in the operation of autonomous systems. • Interfaces, be they visual...that system, especially when included in aspects or during times where automation backup is required, when the human-operators anticipatory skills...political and psychological domains, where it connotes self-determination (Christman 2009). The autonomous systems domain that has evolved since

Autonomy in Materials Research: A Case Study in Carbon Nanotube Growth (Postprint)

DTIC Science & Technology

2016-10-21

built an Autonomous Research System (ARES)—an autonomous research robot capable of first-of-its-kind closed-loop iterative materials experimentation...ARES exploits advances in autonomous robotics , artificial intelligence, data sciences, and high-throughput and in situ techniques, and is able to...roles of humans and autonomous research robots , and for human-machine partnering. We believe autonomous research robots like ARES constitute a

[Physicians and professionalism. Patients and information].

PubMed

Carvallo, Aurelio

2005-02-01

In the present time, the advances in sciences brought by technology are worshiped. This contributes to dehumanize human relationships. Medical profession is a commitment to oneself, society and social justice. Scientific and humanist formation must coexist during the training of new physicians. The main objective of medical profession is the relationship with patients. Patients have acquired increasing autonomy and a deliberative relationship is the closest to the ideal medical action. The relationship must be based in autonomy, beneficence, lack of maleficence and justice. The patient must receive all the information about his ailment and the diagnostic and therapeutic alternatives in a clear and intelligible language. This will allow to obtain a fully conscious informed consent from the patient. Asking for this consent, gives the patient the opportunity to practice his responsibility and to decide the best for him in a friendly and confident environment. In the middle of science and technology, a close contact with ethics and humanism will allow a better understanding of the integrity of subjects, specially when they are ill.

[Job Satisfaction: a quality indicator in nursing human resource management].

PubMed

Siqueira, Vera Thânia Alves; Kurcgant, Paulina

2012-02-01

This descriptive study addresses the job satisfaction of nurse managers and clinical nurses working at the Hematology and Hemotherapy Services of a public hospital in São Paulo. The study objectives were to identify the factors that caused job satisfaction among nurse managers and clinical nurses, and support the results in the development of indicators to evaluate the quality of nursing human resource management. The components of the study were: autonomy, interaction, professional status, job requirements, organizational norms and remuneration. Participants were 44 nurses. Data were collected using a Job Satisfaction Index (JSI) questionnaire. In conclusion, this study permitted the identification of the clinical nurse group, which was the most satisfied, with a JSI of 10.5; the managerial group scored 10.0. Regarding the satisfaction levels in regards to the current activity, 88.9% of the nurse managers reported feeling satisfied, as did 90.9% of clinical nurses. For both groups, autonomy was the component with the highest level of professional satisfaction.

Intermediate Levels of Autonomy within the SSM/PMAD Breadboard

NASA Technical Reports Server (NTRS)

Dugal-Whitehead, Norma R.; Walls, Bryan

1995-01-01

The Space Station Module Power Management and Distribution (SSM/PMAD) bread-board is a test bed for the development of advanced power system control and automation. Software control in the SSM/PMAD breadboard is through co-operating systems, called Autonomous Agents. Agents can be a mixture of algorithmic software and expert systems. The early SSM/PMAD system was envisioned as being completely autonomous. It soon became apparent, though, that there would always be a need for human intervention, at least as long as a human interacts with the system in any way. In a system designed only for autonomous operation, manual intervention meant taking full control of the whole system, and loosing whatever expertise was in the system. Several methods for allowing humans to interact at an appropriate level of control were developed. This paper examines some of these intermediate modes of autonomy. The least humanly intrusive mode is simple monitoring. The ability to modify future behavior by altering a schedule involves high-level interaction. Modification of operating activities comes next. The coarsest mode of control is individual, unplanned operation of individual Power System components. Each of these levels is integrated into the SSM/PMAD breadboard, with support for the user (such as warnings of the consequences of control decisions) at every level.

Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project

NASA Technical Reports Server (NTRS)

Shively, Jay

2017-01-01

Over the past 5 years, the UAS integration into the NAS project has worked to reduce technical barriers to integration. A major focus of this work has been in support of RTCA SC-228. This committee has recently published the first UAS integration minimum performance standards (MOPS). This work has spanned detect and avoid (DAA) as well as command and control comm datalinks. I will discuss DAA efforts with focus on the human systems work. I will discuss how automation was discussed and addressed within this context. ICAO stood up a remotely piloted aircraft systems (RPAS) panel in 2014. They have developed an RPAS manual and are now working to revise existing annexes and standards and recommended practices. The Human In The System (HITS) has worked to infuse human factors guidelines into those documents. I will discuss that effort as well as how ICAO has defined and address autonomy. There is a great deal of interest in the control of multiple vehicles by a single operator. The UAS EXCOM Science and Research Panel (SARP) is holding a workshop on this topic in late June. I will discuss research performed on this topic when I worked for the Army and on-going work within the division and a NATO working group on Human-Autonomy Teaming.

Contingency Management with Human Autonomy Teaming

NASA Technical Reports Server (NTRS)

Shively, Robert J.; Lachter, Joel B.

2018-01-01

Automation is playing an increasingly important role in many operations. It is often cheaper faster and more precise than human operators. However, automation is not perfect. There are many situations in which a human operator must step in. We refer to these instances as contingencies and the act of stepping in contingency management. Here we propose coupling Human Autonomy Teaming (HAT) with contingency management. We describe two aspects to HAT, bi-directional communication, and working agreements (or plays). Bi-directional communication like Crew Resource Management in traditional aviation, allows all parties to contribute to a decision. Working agreements specify roles and responsibilities. Importantly working agreements allow for the possibility of roles and responsibilities changing depending on environmental factors (e.g., situations the automation was not designed for, workload, risk, or trust). This allows for the automation to "automatically" become more autonomous as it becomes more trusted and/or it is updated to deal with a more complete set of possible situations. We present a concrete example using a prototype contingency management station one might find in a future airline operations center. Automation proposes reroutes for aircraft that encounter bad weather or are forced to divert for environmental or systems reasons. If specific conditions are met, these recommendations may be autonomously datalinked to the affected aircraft.

Autonomy-Supportive Parenting and Autonomy-Supportive Sibling Interactions: The Role of Mothers' and Siblings' Psychological Need Satisfaction.

PubMed

van der Kaap-Deeder, Jolene; Vansteenkiste, Maarten; Soenens, Bart; Loeys, Tom; Mabbe, Elien; Gargurevich, Rafael

2015-11-01

Autonomy-supportive parenting yields manifold benefits. To gain more insight into the family-level dynamics involved in autonomy-supportive parenting, the present study addressed three issues. First, on the basis of self-determination theory, we examined whether mothers' satisfaction of the psychological needs for autonomy, competence, and relatedness related to autonomy-supportive parenting. Second, we investigated maternal autonomy support as an intervening variable in the mother-child similarity in psychological need satisfaction. Third, we examined associations between autonomy-supportive parenting and autonomy-supportive sibling interactions. Participants were 154 mothers (M age = 39.45, SD = 3.96) and their two elementary school-age children (M age = 8.54, SD = 0.89 and M age = 10.38, SD = 0.87). Although mothers' psychological need satisfaction related only to maternal autonomy support in the younger siblings, autonomy-supportive parenting related to psychological need satisfaction in both siblings and to an autonomy-supportive interaction style between siblings. We discuss the importance of maternal autonomy support for family-level dynamics. © 2015 by the Society for Personality and Social Psychology, Inc.

Human-directed local autonomy for motion guidance and coordination in an intelligent manufacturing system

NASA Astrophysics Data System (ADS)

Alford, W. A.; Kawamura, Kazuhiko; Wilkes, Don M.

1997-12-01

This paper discusses the problem of integrating human intelligence and skills into an intelligent manufacturing system. Our center has jointed the Holonic Manufacturing Systems (HMS) Project, an international consortium dedicated to developing holonic systems technologies. One of our contributions to this effort is in Work Package 6: flexible human integration. This paper focuses on one activity, namely, human integration into motion guidance and coordination. Much research on intelligent systems focuses on creating totally autonomous agents. At the Center for Intelligent Systems (CIS), we design robots that interact directly with a human user. We focus on using the natural intelligence of the user to simplify the design of a robotic system. The problem is finding ways for the user to interact with the robot that are efficient and comfortable for the user. Manufacturing applications impose the additional constraint that the manufacturing process should not be disturbed; that is, frequent interacting with the user could degrade real-time performance. Our research in human-robot interaction is based on a concept called human directed local autonomy (HuDL). Under this paradigm, the intelligent agent selects and executes a behavior or skill, based upon directions from a human user. The user interacts with the robot via speech, gestures, or other media. Our control software is based on the intelligent machine architecture (IMA), an object-oriented architecture which facilitates cooperation and communication among intelligent agents. In this paper we describe our research testbed, a dual-arm humanoid robot and human user, and the use of this testbed for a human directed sorting task. We also discuss some proposed experiments for evaluating the integration of the human into the robot system. At the time of this writing, the experiments have not been completed.

UAV Research at NASA Langley: Towards Safe, Reliable, and Autonomous Operations

NASA Technical Reports Server (NTRS)

Davila, Carlos G.

2016-01-01

Unmanned Aerial Vehicles (UAV) are fundamental components in several aspects of research at NASA Langley, such as flight dynamics, mission-driven airframe design, airspace integration demonstrations, atmospheric science projects, and more. In particular, NASA Langley Research Center (Langley) is using UAVs to develop and demonstrate innovative capabilities that meet the autonomy and robotics challenges that are anticipated in science, space exploration, and aeronautics. These capabilities will enable new NASA missions such as asteroid rendezvous and retrieval (ARRM), Mars exploration, in-situ resource utilization (ISRU), pollution measurements in historically inaccessible areas, and the integration of UAVs into our everyday lives all missions of increasing complexity, distance, pace, and/or accessibility. Building on decades of NASA experience and success in the design, fabrication, and integration of robust and reliable automated systems for space and aeronautics, Langley Autonomy Incubator seeks to bridge the gap between automation and autonomy by enabling safe autonomous operations via onboard sensing and perception systems in both data-rich and data-deprived environments. The Autonomy Incubator is focused on the challenge of mobility and manipulation in dynamic and unstructured environments by integrating technologies such as computer vision, visual odometry, real-time mapping, path planning, object detection and avoidance, object classification, adaptive control, sensor fusion, machine learning, and natural human-machine teaming. These technologies are implemented in an architectural framework developed in-house for easy integration and interoperability of cutting-edge hardware and software.

Do no harm: a defense of markets in healthcare.

PubMed

Kline, William

2010-09-01

This paper argues that the rules that constitute a market protect autonomy and increase welfare in healthcare. Markets do the former through protecting rights to self-ownership and a cluster of rights that protect its exercise. Markets protect welfare by organizing and protecting trades. In contrast, prohibition destroys legitimate markets, giving rise to so-called black markets that harm both the autonomy and well-being of agents. For example, a fee-for-service medical system is a highly developed and specialized market. It is individuals working together, through the division of labor, to provide mutual insurance. This coordination, and the benefits it makes possible, is not possible without injunctions against harm. Prohibitions on harm are not mere ethical niceties, they are practice rules for both healthcare and markets. Placing the doctor within a healthcare market actually reinforces the doctor's moral obligation, and the legal enforcement of that obligation, not to harm. Similarly, markets reinforce patient rights to self-determination through legal and institutional enforcement of the harm principle in the form of the protection of certain basic welfare rights to life, bodily integrity, property, trade, and contract. Since the establishment of markets protects agent autonomy and welfare, and prohibition directly harms the same, there are strong reasons for establishing markets to protect trade in precisely those areas where autonomy and well-being are most vulnerable to exploitation, for example, the trade in human kidneys.

A semi-qualitative study of attitudes to vaccinating adolescents against human papillomavirus without parental consent.

PubMed

Brabin, Loretta; Roberts, Stephen A; Kitchener, Henry C

2007-02-09

The first vaccine to prevent human papillomavirus (HPV) and cervical cancer has been licensed, and in future, vaccination may be routinely offered to 10-14 year old girls. HPV is a sexually transmitted virus and some parents may refuse consent for vaccination. Under-16s in the UK have a right to confidential sexual health care without parental consent. We investigated parents' views on making available HPV vaccination to adolescent minors at sexual health clinics without parental consent. This was a semi-qualitative analysis of views of parents of 11-12 year old school children collected as part of a population-based survey of parental attitudes to HPV vaccination in Manchester. Parents were firstly asked if they agreed that a well-informed child should be able to request vaccination at a sexual health clinic without parental consent, and secondly, to provide a reason for this answer. Ethical perspectives on adolescent autonomy provided the framework for descriptive analysis. 307 parents answered the question, and of these, 244 (80%) explained their views. Parents with views consistent with support for adolescent autonomy (n = 99) wanted to encourage responsible behaviour, protect children from ill-informed or bigoted parents, and respected confidentiality and individual rights. In contrast, 97 parents insisted on being involved in decision-making. They emphasised adult responsibility for a child's health and guidance, erosion of parental rights, and respect for cultural and moral values. Other parents (n = 48) wanted clearer legal definitions governing parental rights and responsibilities or hoped for joint decision-making. Parents resistant to adolescent autonomy would be less likely to consent to future HPV vaccination, (67%) than parents supporting this principle (89%; p < 0.001). In the UK, the principle of adolescent autonomy is recognised and logically should include the right to HPV vaccination, but this may concern parents who would otherwise approve vaccination.

Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education.

PubMed

Chang, Yu-Kai; Chen, Senlin; Tu, Kun-Wei; Chi, Li-Kang

2016-09-01

Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE) students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61) or the control group (n = 65) for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students' perceived autonomy and intrinsic motivation.

Ethical challenges in the use of social service robots for elderly people.

PubMed

Körtner, T

2016-06-01

Socially assistive robots are increasingly discussed as solutions in care and domestic use for the support of senior adults; however, this raises ethical questions which hitherto have not been considered or were not predictable. The most important questions are those of privacy and data protection, safety and responsibility as well as involvement of vulnerable persons and deception. Consequently, the ethical principles of nonmaleficence, beneficence, autonomy and fairness should be transposed to robotics. Clear answers and solutions are not yet available for every ethical challenge in robotics; however, the development of ethical guidelines for deployment of robots and research in the field of social service robots (SSR) are essential steps in order to embed ethics into dealing with socially assistive robots. This article provides some practical suggestions on this issue from a robotics project.

Masculinity and Fatherhood: New Fathers' Perceptions of Their Female Partners' Efforts to Assist Them to Reduce or Quit Smoking.

PubMed

Kwon, Jae-Yung; Oliffe, John L; Bottorff, Joan L; Kelly, Mary T

2015-07-01

Health promotion initiatives to reduce smoking among parents have focused almost exclusively on women to support their cessation during pregnancy and postpartum, while overlooking the importance of fathers' smoking cessation. This study was a secondary analysis of in-depth interviews with 20 new and expectant fathers to identify how they perceived their female partners' efforts to assist them to reduce or quit smoking. Social constructionist gender frameworks were used to theorize and develop the findings. Three key themes were identified: support and autonomy in men's smoking cessation, perception of challenging men's freedom to smoke, and contempt for men's continued smoking. The findings suggest that shifts in masculinities as men take up fathering should be considered in designing smoking cessation interventions for fathers. © The Author(s) 2014.

Advances in Autonomous Systems for Missions of Space Exploration

NASA Astrophysics Data System (ADS)

Gross, A. R.; Smith, B. D.; Briggs, G. A.; Hieronymus, J.; Clancy, D. J.

New missions of space exploration will require unprecedented levels of autonomy to successfully accomplish their objectives. Both inherent complexity and communication distances will preclude levels of human involvement common to current and previous space flight missions. With exponentially increasing capabilities of computer hardware and software, including networks and communication systems, a new balance of work is being developed between humans and machines. This new balance holds the promise of meeting the greatly increased space exploration requirements, along with dramatically reduced design, development, test, and operating costs. New information technologies, which take advantage of knowledge-based software, model-based reasoning, and high performance computer systems, will enable the development of a new generation of design and development tools, schedulers, and vehicle and system health monitoring and maintenance capabilities. Such tools will provide a degree of machine intelligence and associated autonomy that has previously been unavailable. These capabilities are critical to the future of space exploration, since the science and operational requirements specified by such missions, as well as the budgetary constraints that limit the ability to monitor and control these missions by a standing army of ground- based controllers. System autonomy capabilities have made great strides in recent years, for both ground and space flight applications. Autonomous systems have flown on advanced spacecraft, providing new levels of spacecraft capability and mission safety. Such systems operate by utilizing model-based reasoning that provides the capability to work from high-level mission goals, while deriving the detailed system commands internally, rather than having to have such commands transmitted from Earth. This enables missions of such complexity and communications distance as are not otherwise possible, as well as many more efficient and low cost applications. One notable example of such missions are those to explore for the existence of water on planets such as Mars and the moons of Jupiter. It is clear that water does not exist on the surfaces of such bodies, but may well be located at some considerable depth below the surface, thus requiring a subsurface drilling capability. Subsurface drilling on planetary surfaces will require a robust autonomous control and analysis system, currently a major challenge, but within conceivable reach of planned technology developments. This paper will focus on new and innovative software for remote, autonomous, space systems flight operations, including flight test results, lessons learned, and implications for the future. An additional focus will be on technologies for planetary exploration using autonomous systems and astronaut-assistance systems that employ new spoken language technology. Topics to be presented will include a description of key autonomous control concepts, illustrated by the Remote Agent program that commanded the Deep Space 1 spacecraft to new levels of system autonomy, recent advances in distributed autonomous system capabilities, and concepts for autonomous vehicle health management systems. A brief description of teaming spacecraft and rovers for complex exploration missions will also be provided. New software for autonomous science data acquisition for planetary exploration will also be described, as well as advanced systems for safe planetary landings. Current results of autonomous planetary drilling system research will be presented. A key thrust within NASA is to develop technologies that will leverage the capabilities of human astronauts during planetary surface explorations. One such technology is spoken dialogue interfaces, which would allow collaboration with semi-autonomous agents that are engaged in activities that are normally accomplished using language, e.g., astronauts in space suits interacting with groups of semi-autonomous rovers and other astronauts. This technology will be described and discussed in the context of future exploration missions and the major new capabilities enabled by such systems. Finally, plans and directions for the future of autonomous systems will be presented.

The loved ones: families, intimates and patient autonomy.

PubMed

O'Donovan, Katherine; Gilbar, Roy

2003-05-01

Patient autonomy is one of the central values in medical ethics. It is generally understood as recognition of patients' rights as free individuals answerable only to themselves. This emphasis on the individual leaves open the question of the position of the patients' 'loved ones', that is of families and significant others. The authors examine this question in three areas of law and medical ethics. Organ donation offers an example of preference given by medical ethics to family views, notwithstanding an expressed wish of the deceased to donate, and the legal position protecting such a request. Decisions concerning the treatment of incompetent patients illustrate consideration for the family in medical ethics, but hesitations in both law and ethics in accepting family views once expressed. And the tension between the interests of patients and family members over the access to genetic information usually results in respecting the patient's right to confidentiality. This individualistic perception of autonomy, as adopted by medical law, overlooks the patient's relationships with others and is too narrow to face the complexities of human lives.

Responses to assisted suicide requests: an interview study with Swiss palliative care physicians.

PubMed

Gamondi, Claudia; Borasio, Gian Domenico; Oliver, Pam; Preston, Nancy; Payne, Sheila

2017-08-11

Assisted suicide in Switzerland is mainly performed by right-to-die societies. Medical involvement is limited to the prescription of the drug and certification of eligibility. Palliative care has traditionally been perceived as generally opposed to assisted suicide, but little is known about palliative care physicians' involvement in assisted suicide practices. This paper aims to describe their perspectives and involvement in assisted suicide practices. A qualitative interview study was conducted with 23 palliative care physicians across Switzerland. Thematic analysis was used to interpret data. Swiss palliative care physicians regularly receive assisted suicide requests while none reported having received specific training in managing these requests. Participants reported being involved in assisted suicide decision making most were not willing to prescribe the lethal drug. After advising patients of the limits on their involvement in assisted suicide, the majority explored the origins of the patient's request and offered alternatives. Many participants struggled to reconcile their understanding of palliative care principles with patients' wishes to exercise their autonomy. The majority of participants had no direct contact with right-to-die societies, many desired better collaboration. A desire was voiced for a more structured debate on assisted suicide availability in hospitals and clearer legal and institutional frameworks. The Swiss model of assisted suicide gives palliative care physicians opportunities to develop roles which are compatible with each practitioner's values, but may not correspond to patients' expectations. Specific education for all palliative care professionals and more structured ways to manage communication about assisted suicide are warranted. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Experimental Evaluation of Verification and Validation Tools on Martian Rover Software

NASA Technical Reports Server (NTRS)

Brat, Guillaume; Giannakopoulou, Dimitra; Goldberg, Allen; Havelund, Klaus; Lowry, Mike; Pasareanu, Corina; Venet, Arnaud; Visser, Willem

2003-01-01

To achieve its science objectives in deep space exploration, NASA has a need for science platform vehicles to autonomously make control decisions in a time frame that excludes intervention from Earth-based controllers. Round-trip light-time is one significant factor motivating autonomy capability, another factor is the need to reduce ground support operations cost. An unsolved problem potentially impeding the adoption of autonomy capability is the verification and validation of such software systems, which exhibit far more behaviors (and hence distinct execution paths in the software) than is typical in current deepspace platforms. Hence the need for a study to benchmark advanced Verification and Validation (V&V) tools on representative autonomy software. The objective of the study was to access the maturity of different technologies, to provide data indicative of potential synergies between them, and to identify gaps in the technologies with respect to the challenge of autonomy V&V. The study consisted of two parts: first, a set of relatively independent case studies of different tools on the same autonomy code, second a carefully controlled experiment with human participants on a subset of these technologies. This paper describes the second part of the study. Overall, nearly four hundred hours of data on human use of three different advanced V&V tools were accumulated, with a control group that used conventional testing methods. The experiment simulated four independent V&V teams debugging three successive versions of an executive controller for a Martian Rover. Defects were carefully seeded into the three versions based on a profile of defects from CVS logs that occurred in the actual development of the executive controller. The rest of the document is structured a s follows. In section 2 and 3, we respectively describe the tools used in the study and the rover software that was analyzed. In section 4 the methodology for the experiment is described; this includes the code preparation, seeding of defects, participant training and experimental setup. Next we give a qualitative overview of how the experiment went from the point of view of each technology; model checking (section 5), static analysis (section 6), runtime analysis (section 7) and testing (section 8). The find section gives some preliminary quantitative results on how the tools compared.

Wage Slavery or Creative Work?

PubMed Central

Mirowsky, John

2013-01-01

Western philosophical and scientific traditions often view human work as inherently onerous, wearisome, and degrading. Adam Smith, writing in the eighteenth century, saw work as the toil and trouble that is the real price humans pay for everything they need or want. Karl Marx, writing in the nineteenth century, considered wage labor alienating, but saw the possibility of self-expressive work. Dupré and Gagnier, a philosopher and a critic writing near the end of the twentieth century, agreed that work could be self-fulfilling, but only for an elite minority. This article summarizes the Western philosophical views of work from ancient to modern times. It reframes the philosophical positions as empirical questions and addresses them with statistics and models drawn from a 1995 U.S. survey. Observations suggest that work, in modern America, is not usually alienated. The great majority of Americans rate their paid work or other main daily activities (mostly unpaid work) as more autonomous and creative than not. Emotional well-being and the sense of control over one’s own life increase with the degree of autonomy and creativity. The employed report less autonomous but more creative activity than do the nonemployed. Emotional well-being and perceived control correlate more strongly with creativity than with autonomy. The overall association thus favors employment, especially for the poorly educated, even though they give up more autonomy when employed. On the whole, work in modern America seems more self-fulfilling than onerous, alienating, or degrading. PMID:24156083

Paternalism and Utilitarianism in Research with Human Participants

PubMed Central

Resnik, David B.

2012-01-01

In this article I defend a rule utilitarian approach to paternalistic policies in research with human participants. Some rules that restrict individual autonomy can be justified on the grounds that they help to maximize the overall balance of benefits over risks in research. The consequences that should be considered when formulating policy include not only likely impacts on research participants, but also impacts on investigators, institutions, sponsors, and the scientific community. The public reaction to adverse events in research (such as significant injury to participants or death) is a crucial concern that must be taken into account when assessing the consequences of different policy options, because public backlash can lead to outcomes that have a negative impact on science, such as cuts in funding, overly restrictive regulation and oversight, and reduced willingness of individuals to participate in research. I argue that concern about the public reaction to adverse events justifies some restrictions on the risks that competent, adult volunteers can face in research that offers them no significant benefits. The paternalism defended here is not pure, because it involves restrictions on the rights of investigators in order to protect participants. It also has a mixed rationale, because individual autonomy may be restricted not only to protect participants from harm but also to protect other stakeholders. Utility is not the sole justification for paternalistic research policies, since other considerations, such as justice and respect for individual rights/autonomy, must also be taken into account. PMID:23076346

Paternalism and utilitarianism in research with human participants.

PubMed

Resnik, David B

2015-03-01

In this article I defend a rule utilitarian approach to paternalistic policies in research with human participants. Some rules that restrict individual autonomy can be justified on the grounds that they help to maximize the overall balance of benefits over risks in research. The consequences that should be considered when formulating policy include not only likely impacts on research participants, but also impacts on investigators, institutions, sponsors, and the scientific community. The public reaction to adverse events in research (such as significant injury to participants or death) is a crucial concern that must be taken into account when assessing the consequences of different policy options, because public backlash can lead to outcomes that have a negative impact on science, such as cuts in funding, overly restrictive regulation and oversight, and reduced willingness of individuals to participate in research. I argue that concern about the public reaction to adverse events justifies some restrictions on the risks that competent, adult volunteers can face in research that offers them no significant benefits. The paternalism defended here is not pure, because it involves restrictions on the rights of investigators in order to protect participants. It also has a mixed rationale, because individual autonomy may be restricted not only to protect participants from harm but also to protect other stakeholders. Utility is not the sole justification for paternalistic research policies, since other considerations, such as justice and respect for individual rights/autonomy, must also be taken into account.

Adjustable Autonomy Testbed

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Schrenkenghost, Debra K.

2001-01-01

The Adjustable Autonomy Testbed (AAT) is a simulation-based testbed located in the Intelligent Systems Laboratory in the Automation, Robotics and Simulation Division at NASA Johnson Space Center. The purpose of the testbed is to support evaluation and validation of prototypes of adjustable autonomous agent software for control and fault management for complex systems. The AA T project has developed prototype adjustable autonomous agent software and human interfaces for cooperative fault management. This software builds on current autonomous agent technology by altering the architecture, components and interfaces for effective teamwork between autonomous systems and human experts. Autonomous agents include a planner, flexible executive, low level control and deductive model-based fault isolation. Adjustable autonomy is intended to increase the flexibility and effectiveness of fault management with an autonomous system. The test domain for this work is control of advanced life support systems for habitats for planetary exploration. The CONFIG hybrid discrete event simulation environment provides flexible and dynamically reconfigurable models of the behavior of components and fluids in the life support systems. Both discrete event and continuous (discrete time) simulation are supported, and flows and pressures are computed globally. This provides fast dynamic simulations of interacting hardware systems in closed loops that can be reconfigured during operations scenarios, producing complex cascading effects of operations and failures. Current object-oriented model libraries support modeling of fluid systems, and models have been developed of physico-chemical and biological subsystems for processing advanced life support gases. In FY01, water recovery system models will be developed.

Wage Slavery or Creative Work?

PubMed

Mirowsky, John

2011-07-01

Western philosophical and scientific traditions often view human work as inherently onerous, wearisome, and degrading. Adam Smith, writing in the eighteenth century, saw work as the toil and trouble that is the real price humans pay for everything they need or want. Karl Marx, writing in the nineteenth century, considered wage labor alienating, but saw the possibility of self-expressive work. Dupré and Gagnier, a philosopher and a critic writing near the end of the twentieth century, agreed that work could be self-fulfilling, but only for an elite minority. This article summarizes the Western philosophical views of work from ancient to modern times. It reframes the philosophical positions as empirical questions and addresses them with statistics and models drawn from a 1995 U.S. survey. Observations suggest that work, in modern America, is not usually alienated. The great majority of Americans rate their paid work or other main daily activities (mostly unpaid work) as more autonomous and creative than not. Emotional well-being and the sense of control over one's own life increase with the degree of autonomy and creativity. The employed report less autonomous but more creative activity than do the nonemployed. Emotional well-being and perceived control correlate more strongly with creativity than with autonomy. The overall association thus favors employment, especially for the poorly educated, even though they give up more autonomy when employed. On the whole, work in modern America seems more self-fulfilling than onerous, alienating, or degrading.

The ethics of managing affective and emotional states to improve informed consent: autonomy, comprehension, and voluntariness.

PubMed

Braude, Hillel; Kimmelman, Jonathan

2012-03-01

Over the past several decades the 'affective revolution' in cognitive psychology has emphasized the critical role affect and emotion play in human decision-making. Drawing on this affective literature, various commentators have recently proposed strategies for managing therapeutic expectation that use contextual, symbolic, or emotive interventions in the consent process to convey information or enhance comprehension. In this paper, we examine whether affective consent interventions that target affect and emotion can be reconciled with widely accepted standards for autonomous action. More specifically, the ethics of affective consent interventions is assessed in terms of key elements of autonomy, comprehension and voluntariness. While there may appear to be a moral obligation to manage the affective environment to ensure valid informed consent, in circumstances where volunteers may be prone to problematic therapeutic expectancy, this moral obligation needs to be weighed against the potential risks of human instrumentalization. At this point in time we do not have enough information to be able to justify clearly the programmatic manipulation of human subjects' affective states. The lack of knowledge about affective interventions requires corresponding caution in its ethical justification. © 2010 Blackwell Publishing Ltd.

A Human-Autonomy Teaming Approach for a Flight-Following Task

NASA Technical Reports Server (NTRS)

Brandt, Summer L.; Russell, Ricky; Lachter, Joel; Shively, Robert

2017-01-01

Managing aircraft is becoming more complex with increasingly sophisticated automation responsible for more flight tasks. With this increased complexity, it is becoming more difficult for operators to understand what the automation is doing and why. Human involvement with increasingly autonomous systems must adjust to allow for a more dynamic relationship involving cooperation and teamwork. As part of an ongoing project to develop a framework for human-autonomy teaming (HAT) in aviation, a part-task study was conducted to demonstrate, evaluate and refine proposed critical aspects of HAT. These features were built into an automated recommender system on a ground station available from previous studies. Participants performed a flight-following task once with the original ground station (i.e., No HAT condition) and once with the HAT features enabled (i.e., HAT condition). Behavioral and subjective measures were collected; subjective measures are presented here. Overall, participants preferred the ground station with HAT features enabled compared to the station without the HAT features. Participants reported that the HAT displays and automation were preferred for keeping up with operationally important issues. Additionally, participants reported that the HAT displays and automation provided enough situation awareness to complete the task and reduced workload relative to the No HAT baseline.

Burnout syndrome in nursing assistants of a public hospital in the state of São Paulo.

PubMed

Ferreira, Naiza do Nascimento; de Lucca, Sergio Roberto

2015-01-01

The burnout syndrome is a psychosocial phenomenon that arises as a response to chronic interpersonal stressors present at work. There are many aspects that make nursing assistants vulnerable to chronic stress situations that may lead to burnout, highlighting the low degree of autonomy in the healthcare staff and spending more in direct contact with patients. To assess the prevalence of the burnout syndrome in nursing assistants in a public hospital, as well as its association with socio-demographic and professional variables. A socio-demographic and professional questionnaire and the Maslach Burnout Inventory (MBI-SS) were applied to 534 nursing assistants. The prevalence of burnout syndrome among nursing assistants was 5.9%. High emotional exhaustion was observed in 23.6%, 21.9% showed high depersonalization, and 29.9% low professional achievement. It was found statistically significant associations between emotional exhaustion, job sector and marital status; depersonalization, having children and health problems; low professional achievement and job sector and number of jobs. There was association between job satisfaction and the three dimensions. Professionals working in the health area must pay intense and extended attention to people who are dependent upon others. The intimate contact of the nursing assistants with hard-to-handle patients, as well as being afraid to make mistakes in healthcare are additional chronic stress factors and burnout syndrome cases related in this study.

Technology Development to Support Human Health and Performance in Exploration Beyond Low Earth Orbit

NASA Technical Reports Server (NTRS)

Kundrot, C.E.; Steinberg, S. L.; Charles, J. B.

2011-01-01

In the course of defining the level of risks and mitigating the risks for exploration missions beyond low Earth orbit, NASA s Human Research Program (HRP) has identified the need for technology development in several areas. Long duration missions increase the risk of serious medical conditions due to limited options for return to Earth; no resupply; highly limited mass, power, volume; and communication delays. New space flight compatible medical capabilities required include: diagnostic imaging, oxygen concentrator, ventilator, laboratory analysis (saliva, blood, urine), kidney stone diagnosis & treatment, IV solution preparation and delivery. Maintenance of behavioral health in such an isolated, confined and extreme environment requires new sensory stimulation (e.g., virtual reality) technology. Unobtrusive monitoring of behavioral health and treatment methods are also required. Prolonged exposure to weightlessness deconditions bone, muscle, and the cardiovascular system. Novel exercise equipment or artificial gravity are necessary to prevent deconditioning. Monitoring of the degree of deconditioning is required to ensure that countermeasures are effective. New technologies are required in all the habitable volumes (e.g., suit, capsule, habitat, exploration vehicle, lander) to provide an adequate food system, and to meet human environmental standards for air, water, and surface contamination. Communication delays require the crew to be more autonomous. Onboard decision support tools that assist crew with real-time detection and diagnosis of vehicle and habitat operational anomalies will enable greater autonomy. Multi-use shield systems are required to provide shielding from solar particle events. The HRP is pursuing the development of these technologies in laboratories, flight analog environments and the ISS so that the human health and performance risks will be acceptable with the available resources.

Soar: A Unified Theory of Cognition?

ERIC Educational Resources Information Center

Waldrop, M. Mitchell

1988-01-01

Describes an artificial intelligence system known as SOAR that approximates a theory of human cognition. Discusses cognition as problem solving, working memory, long term memory, autonomy and adaptability, and learning from experience as they relate to artificial intelligence generally and to SOAR specifically. Highlights the status of the…

Liberal Education, Human Development, and Social Vision.

ERIC Educational Resources Information Center

Gregory, Marshall W.

1982-01-01

Examines the effects of the post-Sputnik knowledge explosion. Critizes universities for teaching facts and information without values and applications and faults apathetic students who narrowly focus on job openings, pay scales, and retirement plans. Urges colleges to develop intellectual autonomy and the powers of imagination, sensitivity, and…

Respect for patient autonomy in forensic psychiatric nursing.

PubMed

Rose, Donald N

2005-01-01

A fundamental issue that forensic psychiatric nurses struggle with is respect for patient autonomy, as the two liberal prerequisites for autonomy, liberty and rationality, are either absent or compromised in forensic psychiatric settings. In this paper, a contemporary feminist perspective of autonomy, relational autonomy, will be advanced as an alternative approach to the traditional liberalist, Kantian, perspective of autonomy. The concepts of autonomy, paternalism, and justice will be discussed in relation to forensic psychiatric nursing.

From autonomy to creativity: a multilevel investigation of the mediating role of harmonious passion.

PubMed

Liu, Dong; Chen, Xiao-Ping; Yao, Xin

2011-03-01

Building on self-determination theory, we theorized about and demonstrated, through 2 multilevel field studies, the pivotal role of harmonious passion in translating organizational autonomy support and individual autonomy orientation into job creativity. Results based on 3-level data from 856 members in 111 teams within 23 work units of a porous metal company (Study 1) and from 525 employees in 98 teams of 18 branches of a large commercial bank (Study 2) revealed 2 major findings. First, organizational autonomy support from a higher organizational level (unit or branch) compensated for the effect of autonomy support from a lower organizational level (team) or individual autonomy orientation on employees' harmonious passion. Second, harmonious passion mediated the interactive effects of unit (branch) autonomy support and team member autonomy orientation, of team autonomy support and team member autonomy orientation, and of unit (branch) autonomy support and team autonomy support on individual creativity. We discuss the theoretical and practical implications of these findings in the organizational context. PsycINFO Database Record (c) 2011 APA, all rights reserved.

The Evolution of Autonomy.

PubMed

Stammers, Trevor

2015-01-01

There can be little doubt, at least in the Western world, that autonomy is theruling principle in contemporary bioethics. In spite of its 'triumph' however,the dominance of the utilitarian concept of autonomy is being increasinglyquestioned. In this paper, I explore the nature of autonomy, how it came todisplace the Hippocratic tradition in medicine and how different conceptsof autonomy have evolved. I argue that the reduction of autonomy to'the exercise of personal choice' in medicine has led to a 'tyranny of autonomy' which can be inimical to ethical medical practice rather than conducive to it.I take the case of Kerrie Wooltorton as an illustration of how misplacedadherence to respect for patient autonomy can lead to tragic consequences.An analysis of autonomy based on the work of Rachel Haliburton isdescribed and applied to the role of autonomy in a recent bioethicaldebate--that arising from Savulescu's proposal that conscientious objection by health-care professionals should not be permitted in the NHS. Inconclusion, I suggest Kukla's concept of conscientious autonomy as onepromising pathway to circumvent both the limitations and adverse effectsof the dominance of current (mis)understandings of autonomy in biomedical ethics.

Assisted suicide and the savings clause.

PubMed

Helminski, F

1995-06-01

In December 1994, the Michigan Supreme Court decided a group of cases comprising constitutional challenges to a Michigan statute against assisted suicide and prosecutions of Dr. Jack Kevorkian for his role in two incidents of suicide. The court rejected arguments that the statute infringed a right of "personal autonomy" under the Fourteenth Amendment to the US Constitution; it noted that, although US Supreme Court opinions indicate that decisions to withdraw or reject life-sustaining treatment are constitutionally protected, a legal difference exists between permitting death to occur by natural means and taking affirmative steps to end life. The Michigan court also decided that Kevorkian could not be charged with murder for supplying only the means by which suicide occurred, but he could be charged with a common law crime of assisting in suicide although the statute outlawing such actions became effective only after the suicides occurred. Because suicide was a crime under the prerevolutionary English Common Law, which forms the foundation of Michigan law, assisting in suicide is also a residual crime under the "savings clause" of the Michigan statutes, which incorporates common law crimes into the law of that state when no superseding statute exists.

Early and middle adolescents' autonomy development: impact of maternal HIV/AIDS.

PubMed

Murphy, Debra A; Greenwell, Lisa; Resell, Judith; Brecht, Mary-Lynn; Schuster, Mark A

2008-04-01

Progression toward autonomy is considered of central importance during the adolescent period. For young adolescents with an HIV-infected parent, there may be additional challenges. This study investigated current autonomy among early and middle adolescents affected by maternal HIV (N = 108), as well as examined longitudinally the children's responsibility taking when they were younger (age 6-11; N = 81) in response to their mother's illness and their current autonomy as early/middle adolescents. In analyses of self-care and family autonomy, children with greater attachment to their mothers had higher autonomy, and there was a trend for children who drink or use drugs alone to have lower autonomy. In analyses of management autonomy, attachment to peers was associated with higher autonomy. Trajectory group findings indicate that those children who had taken on more responsibility for instrumental caretaking roles directly because of their mother's illness showed better autonomy development as early and middle age adolescents. Therefore, 'parentification' of young children with a mother with HIV may not negatively affect later autonomy development.

Breast milk donation after neonatal death in Australia: a report.

PubMed

Carroll, Katherine E; Lenne, Brydan S; McEgan, Kerri; Opie, Gillian; Amir, Lisa H; Bredemeyer, Sandra; Hartmann, Ben; Jones, Rachel; Koorts, Pieter; McConachy, Helen; Mumford, Patricia; Polverino, Jan

2014-01-01

Lactation and breast milk can hold great value and meaning for grieving mothers who have experienced a recent death of an infant. Donation to a human milk bank (HMB) as an alternative to discarding breast milk is one means of respecting the value of breast milk. There is little research, national policy discussion, or organizational representation in Australia on the subject of breast milk donation after infant death. On 29 November 2013 the Mercy Hospital for Women in Melbourne, Australia hosted Australia's first National Stakeholder Meeting (NSM) on the topic of milk donation after neonatal death. The NSM drew together representatives from Australian HMBs, neonatal intensive care units (NICUs) currently using donor human milk, and Australia's chief NICU parent support organization. The NSM was video-recorded and transcribed, and analyzed thematically by researchers. This article reports the seven dominant themes discussed by stakeholders during the NSM: the spectrum of women's lactation and donation experiences after infant death; the roles of the HMB and NICU in meeting the needs of the bereaved donor; how bereaved mothers' lactation autonomy may interface with a HMB's donation guidelines; how milk donation may be discussed with bereaved mothers; the variation between four categories of milk donation after neonatal death; the impact of limited resources and few HMBs on providing donation programs for bereaved mothers in Australia. This article provides evidence from researchers and practitioners that can assist HMB staff in refining their bank's policy on milk donation after infant death, and provides national policy makers with key considerations to support lactation, human milk banking, and bereavement services nation-wide.

Overview of research addressing ethical dimensions of participation in traumatic stress studies: autonomy and beneficence.

PubMed

Newman, Elana; Kaloupek, Danny

2009-12-01

One element of the design of human research studies is ethically informed decision-making. Key issues include the safety, costs, and benefits of participation. Historically, much of this decision-making was based on opinion rather than formal evidence. Recently, however, investigators in the traumatic stress field have begun to collect data that are relevant to these decisions. In this article, the authors focus on issues emanating from the ethical concepts of autonomy and respect for persons and beneficence and nonmaleficence, and then summarize relevant evidence from studies with trauma-exposed individuals. Discussion addresses implications of this evidence for research practice and policy, and identifies some potentially informative data collections opportunities for future trauma studies.

Enabling technologies for transition to utilization of space-based resources and operations

NASA Technical Reports Server (NTRS)

Sadin, S. R.; Litty, J. D.

1985-01-01

This article explores a potential scenario for the further development of space infrastructure resources and operations management. It is a scenario that transitions from the current ground-based system to an architecture that is predominantly space-based by exploiting key mission systems in an operational support role. If this view is accurate, an examination of the range of potential infrastructure elements and how they might interact in a maximally productive space-based operations complex is needed, innovative technologies beyond the current Shuttle and Space Station legacy need to be identified, and research programs pursued. Development of technologies within the areas of telerobotics, machine autonomy, human autonomy, in-space manufacturing and construction, propulsion and energy is discussed.

Medical treatment of dementia patients at the end of life: can the law accommodate the personal identity and welfare problems?

PubMed

Lewis, Penney

2006-09-01

This article considers whether two significant philosophical objections to autonomy-based legal approaches to decision-making for incompetent individuals could be accommodated by the law. These philosophical objections are known as the personal identity and welfare problems. The article first sets out the autonomy-based approaches and their objections. Next, the present legal position is briefly canvassed in a comparative vein. Finally, the article suggests how the personal identity and welfare problems might be accommodated were legislators minded to do so, by proposing specific statutory amendments to the recent English legislation on advance decisions and evaluating their viability, particularly in light of the European Convention on Human Rights.

Caregiver's education level, not income, as determining factor of dietary intake and nutritional status of individuals cared for at home.

PubMed

Correa, B; Leandro Merhi, V A; Pagotto Fogaca, K; Marques de Oliveira, M R

2009-08-01

Home care should intervene in the nutritional status of the elderly. To analyze the nutritional status of the elderly assisted by a Home Care Program (PAD) and associate it with income and education level of the caregiver. Thirty-four individuals of both genders who received home care from PAD. The MNA (Mini Nutritional Assessment) was used along with arm circumference. Dietary intake assessment was done with three 24-hour recalls in non-consecutive days. We collected data on income, education level of the caregiver and user in years of formal education and autonomy of user. The differences between the proportions of the nominal variables were tested by the chi-square test. The continuous variables were tested for normality and if normal, the Student's t-test or ANOVA was applied. The adopted significance level was P < 0.05. The studied sample represented individuals older than 65 years, assisted by PAD and 100% dependent on the caregiver. MNA revealed that 38.2% of the users were malnourished and 61.8% were at risk for malnourishment. Energy, fiber, vitamin E, calcium and zinc intakes were inadequate. Education level of the caregivers was a determining factor (P=0.01) for the nutritional status of the elderly while no association was found with respect to income. These findings allows us to conclude that the nutritional status of this population is worrisome and that it may be associated with low quality of life influenced by the education level of the caregiver, but also by age, economic conditions and limited autonomy of this population.

Individual responsibility for healthcare financing: application of an analytical framework exploring the suitability of private financing of assistive devices.

PubMed

Tinghög, Gustav; Carlsson, Per

2012-12-01

To operationalise and apply a conceptual framework for exploring when health services contain characteristics that facilitate individuals' ability to take individual responsibility for health care through out-of-pocket payment. In addition, we investigate if the levels of out-of-pocket payment for assistive devices (ADs) in Sweden are in line with the proposed framework. Focus groups were used to operationalise the core concepts of sufficient knowledge, individual autonomy, positive externalities, sufficient demand, affordability, and lifestyle enhancement into a measurable and replicable rationing tool. A selection of 28 ADs were graded separately as having high, medium, or low suitability for private financing according to the measurement scale provided through the operationalised framework. To investigate the actual level of private financing, a questionnaire about the level of out-of-pocket payment for the specific ADs was administered to county councils in Sweden. Concepts were operationalised into three levels indicating possible suitability for private financing. Responses to the questionnaire indicate that financing of ADs in Sweden varies across county councils as regards co-payment, full payment, discretionary payment for certain healthcare consumer groups, and full reimbursement. According to the framework, ADs commonly funded privately were generally considered to be more suitable for private financing. Sufficient knowledge, individual autonomy, and sufficient demand did not appear to influence why certain ADs were financed out-of-pocket. The level of positive externalities, affordability, and lifestyle enhancement appeared to be somewhat higher for ADs that were financed out-of-pocket, but the differences were small. Affordability seemed to be the most influential concept.

Exploring the Readability of Consent Forms in Human Research in the United States Army

DTIC Science & Technology

2005-03-01

subjects: autonomy (respect for persons), beneficence, and justice. Readability of consent forms 12 The report also defined how these principles apply to...Regional Medical Command, Fort Sam Houston, Texas CPT Heidi P. Mon) U.S. Army-Baylor University Graduate Program in Health Care Administration March...United States v. Karl Brandt, 1947). The opinion in that case included 10 basic principles for human research, called the Nuremberg Code

Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education

PubMed Central

Chang, Yu-Kai; Chen, Senlin; Tu, Kun-Wei; Chi, Li-Kang

2016-01-01

Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE) students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61) or the control group (n = 65) for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students’ perceived autonomy and intrinsic motivation. Key points The SDT is a relevant theoretical framework for elementary school physical education. Using the quasi-experimental research design, this study is one of the earlies studies supporting that elementary school PE teachers can manipulate the instructional context using the SDT to increase students’ perceived autonomy and intrinsic motivation. Increasing students’ perceived autonomy may not lead to significant changes in other SDT constructs (i.e., amotivation, external regulation, introjected regulation, and identified regulation). PMID:27803624

Herbert Marcuse's Critical Theory of the Media.

ERIC Educational Resources Information Center

Daley, Patrick J.

As a member of the Frankfurt School of critical theory, Herbert Marcuse believed that industrial capitalism and the bureaucratization of society stripped humans of any claims to autonomy and undermined their critical expression with a functional language. However, Marcuse did no more than point an inchoate ideological finger at the production side…

Academic Freedom 2--A Human Rights Report.

ERIC Educational Resources Information Center

Daniel, John, Ed.; And Others

The ten essays in this book examine issues related to academic freedom and university autonomy. Chapter 1 serves as an introduction, providing an overview of the situation in universities worldwide, including national and international initiatives to promote academic freedom. It also discusses the role of the World University Service in this…

Team Building [in HRD].

ERIC Educational Resources Information Center

1995

These five papers are from a symposium that was facilitated by Susan Dougherty at the 1995 conference of the Academy of Human Resource Development (HRD). "The Relationship between Productivity and Work Team Autonomy and Team Process Effectiveness" (Candice L. Phelan) reports that correlation analysis of results of a study of 21 work teams revealed…

Humanism and Autonomy in the Neoliberal Reform of Teacher Training

ERIC Educational Resources Information Center

Kascak, Ondrej; Pupala, Branislav; Petrova, Zuzana

2011-01-01

This article analyses the discursive unities which make possible the current transformation of teacher training and our understanding of teaching as a profession, while focusing particularly on European educational policy and the situation in Slovakia. Using Foucault's archaeological method, we reconstruct the discursive link points between the…

Kant on Dignity and Education

ERIC Educational Resources Information Center

Giesinger, Johannes

2012-01-01

In this essay, Johannes Giesinger discusses the educational significance of Immanuel Kant's conception of human dignity. According to Kant, Giesinger claims, children can and should be educated for dignity: on the one hand, children realize their dignity by developing the capacity for moral autonomy; on the other hand, this capacity can only…

Autonomy and the Republic of Science

ERIC Educational Resources Information Center

Muller, J.

2006-01-01

This article represents a consideration of the proposal by Michael Peters that peer review should be democratically extended. It begins by tracing the struggle between the natural sciences (the Quadrivium) and the humanities (the Trivium) in the medieval university to the present day, concluding that the Quadrivium has established a decisive…

[Euthanasia: legal comparison in selected European countries].

PubMed

Doležal, Adam

2018-01-01

This article deals with the subject of euthanasia (all its forms) and other end-of-life decisions, such as assisted suicide, withdrawing and whithholding life-sustaining treatments. Among other things, the article will also deal with the issue of the offense of Homicide by the Victims Request. Based on an empirical historical method, the article compares the various selected legal orders. From this analysis, it draws some conclusions that have an impact on ethical discourse. First of all, the terminology is defined in the article, which is very important in this area. Further, German law is being analysed, with emphasis on Nazi Germany. On that basis, the so-called reductio ad Hitlerum argument is rejected. Research continues and is followed by another states, the Netherlands, Belgium and Switzerland. By analysing them, the following ethical arguments used in euthanasia debates are examined: the argument of a slippery slope and the argument of respect for autonomy. Finally, the judgment of the European Court of Human Rights in the Pretty case is also analysed. On this case, we can demonstrate, how insufficient is argument of human dignity. The last part is dedicated to the Czech Republic and its legal order. Firstly, it focuses on the history of the legal regulation of euthanasia, but the main part deals with the current legal situation. In addition to the recent state of affairs, the bill of Death with dignity act is also being examined. At the end of the article it is pointed out that the Czech regulation is insufficient and changes are necessary. However, the proposed bill of Death with dignity act is not the right way to follow. Rather, it may be wise to adopt an amendment to the Penal Code that would introduce the offense of Homicide by the Victims Request.Key words: assisted suicide - euthanasia - Homicide by the Victims Request - medical futility - withdrawing and whithholding life-sustaining treatment.

The effects of autonomy support on salivary alpha-amylase: The role of individual differences.

PubMed

Sieber, Vanda; Schüler, Julia; Wegner, Mirko

2016-12-01

The empirical evidence for the relationship between autonomy-supportive environments and physiological stress is inconsistent. Whereas some studies report a decrease in stress in autonomy-supportive environments, other studies show a negative effect of autonomy on physiological stress. As previous research has not considered individual differences within this relationship, the present research aims to close this empirical gap by proposing that an implicit autonomy disposition, which is defined as a dispositional preference for self-determination, serves as a moderator. In an experiment, we tested whether the autonomy disposition moderates the effect of different teaching styles (controlling, autonomy-supportive, and neutral) on the acute physiological stress response (salivary alpha-amylase) in adolescents (N=69). The study revealed that participants with a high implicit autonomy disposition displayed lower salivary alpha-amylase responses when exposed to autonomy-supportive vignettes compared to when they were exposed to controlling or neutral teaching styles. The opposite pattern was found in students with a low implicit autonomy disposition. The results illustrate that experimentally induced variations in autonomy support lead to different physiological stress responses, depending on individual differences in the implicit autonomy disposition. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Euthanasia - an attempt to organize issue].

PubMed

Kirmes, Tomasz; Wilk, Mateusz; Chowaniec, Czesław

This article is an attempt to complete and holistically discuss problem of euthanasia, especially its ethical and legal aspects, comparing to Polish law. The subject of euthanasia arouse interest of the society because it touches one of the most important aspects of life, which is the death. Even bigger emotions are aroused amongst physicians. They are forced to put on the line the life as biggest value on the one side and autonomy of human being on the other. It also touches the empathy for suffering. The euthanasia was divided into three forms: active euthanasia, passive euthanasia and assisted suicide. Any form of euthanasia is illegal in Poland according to both the Penal Code and Code of Medical Ethics. Range of possible penal consequences perpetrator is very wide from waiver of punishment to life imprisonment and it comes from different penal qualification of the euthanasia. Qualification of the euthanasia is based on terms of intent of perpetrator's act, request of patient, strong empathy for suffering if the patient and decision based on up-to-date medical knowledge. It is valuable to mention "do-not-resuscitate" DNR procedure, which in case of medical futility is legally accepted in Poland, but in other form may be qualified as passive euthanasia.

The Perioperative Nurse Surgeon's Assistant: Issues and challenges associated with this emerging advanced practice nursing role in Australia.

PubMed

Lynn, Andrew; Brownie, Sonya

2015-01-01

The aim of this study was to obtain Perioperative Nurse Surgeon's Assistants' views about their emerging new role in contemporary nursing practice in Australia. Internationally advanced practice nursing has led to a range of specialist roles aimed at delivering higher quality, efficient nursing care. In 2005 an Australian university developed the Perioperative Nurse Surgeon's Assistant graduate education and training program to provide nurses with an opportunity to gain advanced practice knowledge and extended skills specifically in the perioperative setting. This study was a qualitative research design that used online surveys and in-depth interviews to explore the issues and challenges associated with the introduction of the (currently non-accredited) Perioperative Nurse Surgeon's Assistant role in Australia. Experienced Australia perioperative nurses who had undertaken graduate education and training in this field were recruited for this study. Data were collected between August and October 2011. An inductive thematic analysis was used to interpret the findings. Eighteen nurses completed the online survey and six were interviewed (n = 24). Nurses cited their commitment to professional development and the delivery of high quality patient care, along with surgeons' encouragement for them to complete specialist clinical training, as key reasons for undertaking Perioperative Nurse Surgeon's Assistant education and training. The Perioperative Nurse Surgeon's Assistant role led to greater job satisfaction and autonomy, and assisted nurses to better meet the needs of patients, surgeons and clinical perioperative teams. Without formal recognition of the Perioperative Nurse Surgeon's Assistant role its future in the Australian health care system is under threat.

The Assisted Decision-Making (Capacity) Bill 2013: content, commentary, controversy.

PubMed

Kelly, B D

2015-03-01

Ireland's Assisted Decision-Making (Capacity) Bill (2013) aims to reform the law relating to persons who require assistance exercising their decision-making capacity. When finalised, the Bill will replace Ireland's outdated Ward of Court system which has an all-or-nothing approach to capacity; does not adequately define capacity; is poorly responsive to change; makes unwieldy provision for appointing decision-makers; and has insufficient provision for review. To explore the content and implications of the Assisted Decision-Making (Capacity) Bill. Review of the content of the Assisted Decision-Making (Capacity) Bill and related literature. The new Bill includes a presumption of capacity and defines lack of capacity. All interventions must minimise restriction of rights and freedom, and have due regard for "dignity, bodily integrity, privacy and autonomy". The Bill proposes legal frameworks for "assisted decision-making" (where an individual voluntarily appoints someone to assist with specific decisions relating to personal welfare or property and affairs, by, among other measures, assisting the individual to communicate his or her "will and preferences"); "co-decision-making" (where the Circuit Court declares the individual's capacity is reduced but he or she can make specific decisions with a co-decision-maker to share authority); "decision-making representatives" (substitute decision-making); "enduring power of attorney"; and "informal decision-making on personal welfare matters" (without apparent oversight). These measures, if implemented, will shift Ireland's capacity laws away from an approach based on "best interests" to one based on "will and preferences", and increase compliance with the United Nations' Convention on the Rights of Persons with Disabilities.

A System for Fault Management for NASA's Deep Space Habitat

NASA Technical Reports Server (NTRS)

Colombano, Silvano P.; Spirkovska, Liljana; Aaseng, Gordon B.; Mccann, Robert S.; Baskaran, Vijayakumar; Ossenfort, John P.; Smith, Irene Skupniewicz; Iverson, David L.; Schwabacher, Mark A.

2013-01-01

NASA's exploration program envisions the utilization of a Deep Space Habitat (DSH) for human exploration of the space environment in the vicinity of Mars and/or asteroids. Communication latencies with ground control of as long as 20+ minutes make it imperative that DSH operations be highly autonomous, as any telemetry-based detection of a systems problem on Earth could well occur too late to assist the crew with the problem. A DSH-based development program has been initiated to develop and test the automation technologies necessary to support highly autonomous DSH operations. One such technology is a fault management tool to support performance monitoring of vehicle systems operations and to assist with real-time decision making in connection with operational anomalies and failures. Toward that end, we are developing Advanced Caution and Warning System (ACAWS), a tool that combines dynamic and interactive graphical representations of spacecraft systems, systems modeling, automated diagnostic analysis and root cause identification, system and mission impact assessment, and mitigation procedure identification to help spacecraft operators (both flight controllers and crew) understand and respond to anomalies more effectively. In this paper, we describe four major architecture elements of ACAWS: Anomaly Detection, Fault Isolation, System Effects Analysis, and Graphic User Interface (GUI), and how these elements work in concert with each other and with other tools to provide fault management support to both the controllers and crew. We then describe recent evaluations and tests of ACAWS on the DSH testbed. The results of these tests support the feasibility and strength of our approach to failure management automation and enhanced operational autonomy.

A System for Fault Management and Fault Consequences Analysis for NASA's Deep Space Habitat

NASA Technical Reports Server (NTRS)

Colombano, Silvano; Spirkovska, Liljana; Baskaran, Vijaykumar; Aaseng, Gordon; McCann, Robert S.; Ossenfort, John; Smith, Irene; Iverson, David L.; Schwabacher, Mark

2013-01-01

NASA's exploration program envisions the utilization of a Deep Space Habitat (DSH) for human exploration of the space environment in the vicinity of Mars and/or asteroids. Communication latencies with ground control of as long as 20+ minutes make it imperative that DSH operations be highly autonomous, as any telemetry-based detection of a systems problem on Earth could well occur too late to assist the crew with the problem. A DSH-based development program has been initiated to develop and test the automation technologies necessary to support highly autonomous DSH operations. One such technology is a fault management tool to support performance monitoring of vehicle systems operations and to assist with real-time decision making in connection with operational anomalies and failures. Toward that end, we are developing Advanced Caution and Warning System (ACAWS), a tool that combines dynamic and interactive graphical representations of spacecraft systems, systems modeling, automated diagnostic analysis and root cause identification, system and mission impact assessment, and mitigation procedure identification to help spacecraft operators (both flight controllers and crew) understand and respond to anomalies more effectively. In this paper, we describe four major architecture elements of ACAWS: Anomaly Detection, Fault Isolation, System Effects Analysis, and Graphic User Interface (GUI), and how these elements work in concert with each other and with other tools to provide fault management support to both the controllers and crew. We then describe recent evaluations and tests of ACAWS on the DSH testbed. The results of these tests support the feasibility and strength of our approach to failure management automation and enhanced operational autonomy

From solidarity to autonomy: towards a redefinition of the parameters of the notion of autonomy.

PubMed

Fainzang, Sylvie

2016-12-01

Starting from examples of concrete situations in France, I show that autonomy and solidarity can coexist only if the parameters of autonomy are redefined. I show on the one hand that in situations where autonomy is encouraged, solidarity nevertheless remains at the foundation of their practices. On the other hand, in situations largely infused with family solidarity, the individual autonomy may be put in danger. Yet, based on my ethnographic observations regarding clinical encounters and medical secrecy, I show that while solidarity may endanger individual autonomy, it does not necessarily endanger autonomy itself. The social practices observable in France reflect the reality of an autonomy that goes beyond the individual, a reality that involves a collective subject and includes solidarity. The opposition between these two values can then be resolved if the content of the notion of autonomy is understood to be dependent on its cultural context of application and on its social use.

"Goodbye Dolly?" The ethics of human cloning.

PubMed Central

Harris, J

1997-01-01

The ethical implications of human clones have been much alluded to, but have seldom been examined with any rigour. This paper examines the possible uses and abuses of human cloning and draws out the principal ethical dimensions, both of what might be done and its meaning. The paper examines some of the major public and official responses to cloning by authorities such as President Clinton, the World Health Organisation, the European parliament, UNESCO, and others and reveals their inadequacies as foundations for a coherent public policy on human cloning. The paper ends by defending a conception of reproductive rights of "procreative autonomy" which shows human cloning to be not inconsistent with human rights and dignity. PMID:9451604

Paternalism, autonomy and reciprocity: ethical perspectives in encounters with patients in psychiatric in-patient care.

PubMed

Pelto-Piri, Veikko; Engström, Karin; Engström, Ingemar

2013-12-06

Psychiatric staff members have the power to decide the options that frame encounters with patients. Intentional as well as unintentional framing can have a crucial impact on patients' opportunities to be heard and participate in the process. We identified three dominant ethical perspectives in the normative medical ethics literature concerning how doctors and other staff members should frame interactions in relation to patients; paternalism, autonomy and reciprocity. The aim of this study was to describe and analyse statements describing real work situations and ethical reflections made by staff members in relation to three central perspectives in medical ethics; paternalism, autonomy and reciprocity. All staff members involved with patients in seven adult psychiatric and six child and adolescent psychiatric clinics were given the opportunity to freely describe ethical considerations in their work by keeping an ethical diary over the course of one week and 173 persons handed in their diaries. Qualitative theory-guided content analysis was used to provide a description of staff encounters with patients and in what way these encounters were consistent with, or contrary to, the three perspectives. The majority of the statements could be attributed to the perspective of paternalism and several to autonomy. Only a few statements could be attributed to reciprocity, most of which concerned staff members acting contrary to the perspective. The result is presented as three perspectives containing eight values.•Paternalism; 1) promoting and restoring the health of the patient, 2) providing good care and 3) assuming responsibility.•Autonomy; 1) respecting the patient's right to self-determination and information, 2) respecting the patient's integrity and 3) protecting human rights.•Reciprocity; 1) involving patients in the planning and implementation of their care and 2) building trust between staff and patients. Paternalism clearly appeared to be the dominant perspective among the participants, but there was also awareness of patients' right to autonomy. Despite a normative trend towards reciprocity in psychiatry throughout the Western world, identifying it proved difficult in this study. This should be borne in mind by clinics when considering the need for ethical education, training and supervision.

I want what you've got: Cross platform portabiity and human-robot interaction assessment.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Julie L. Marble, Ph.D.*.; Douglas A. Few; David J. Bruemmer

2005-08-01

Human-robot interaction is a subtle, yet critical aspect of design that must be assessed during the development of both the human-robot interface and robot behaviors if the human-robot team is to effectively meet the complexities of the task environment. Testing not only ensures that the system can successfully achieve the tasks for which it was designed, but more importantly, usability testing allows the designers to understand how humans and robots can, will, and should work together to optimize workload distribution. A lack of human-centered robot interface design, the rigidity of sensor configuration, and the platform-specific nature of research robot developmentmore » environments are a few factors preventing robotic solutions from reaching functional utility in real word environments. Often the difficult engineering challenge of implementing adroit reactive behavior, reliable communication, trustworthy autonomy that combines with system transparency and usable interfaces is overlooked in favor of other research aims. The result is that many robotic systems never reach a level of functional utility necessary even to evaluate the efficacy of the basic system, much less result in a system that can be used in a critical, real-world environment. Further, because control architectures and interfaces are often platform specific, it is difficult or even impossible to make usability comparisons between them. This paper discusses the challenges inherent to the conduct of human factors testing of variable autonomy control architectures and across platforms within a complex, real-world environment. It discusses the need to compare behaviors, architectures, and interfaces within a structured environment that contains challenging real-world tasks, and the implications for system acceptance and trust of autonomous robotic systems for how humans and robots interact in true interactive teams.« less

Prediction of user preference over shared-control paradigms for a robotic wheelchair.

PubMed

Erdogan, Ahmetcan; Argall, Brenna D

2017-07-01

The design of intelligent powered wheelchairs has traditionally focused heavily on providing effective and efficient navigation assistance. Significantly less attention has been given to the end-user's preference between different assistance paradigms. It is possible to include these subjective evaluations in the design process, for example by soliciting feedback in post-experiment questionnaires. However, constantly querying the user for feedback during real-world operation is not practical. In this paper, we present a model that correlates objective performance metrics and subjective evaluations of autonomous wheelchair control paradigms. Using off-the-shelf machine learning techniques, we show that it is possible to build a model that can predict the most preferred shared-control method from task execution metrics such as effort, safety, performance and utilization. We further characterize the relative contributions of each of these metrics to the individual choice of most preferred assistance paradigm. Our evaluation includes Spinal Cord Injured (SCI) and uninjured subject groups. The results show that our proposed correlation model enables the continuous tracking of user preference and offers the possibility of autonomy that is customized to each user.

[Experience assisting an AIDS-infected homosexual patient and his same-sex partner make a do-not-resuscitate decision].

PubMed

Wang, Shu-Jang; Lai, Pei-Yu; Liou, Siao-Ying; Ko, Wen-Chien; Ko, Nai-Ying

2012-10-01

Family members play an important role in the process of writing advance directives. Homosexual men infected with HIV often wish to authorize their intimate same-sex partner or friends rather than immediate family members to make medical decisions on their behalf. Although same-sex marriage is currently illegal in Taiwan, HIV infected homosexual patients are able to write advance directives appointing their same-sex partner to be their surrogate decision maker for end-of-life medical decisions. This case report describes an experience assisting a homosexual patient with HIV to write his advance directives. The nurse assisted the patient and his partner to make a self-determined decision not to resuscitate. Family conferences held to discuss the patient's decisions regarding resuscitation helped legitimize his partner's primary role in making end-of-life healthcare decisions on his behalf. As an advocate for patient rights, nurses should understand the law as it relates to homosexuality and end-of-life decision making, inform patients on the durable power of autonomy, and help execute their advance directives.

Communication and information barriers to health assistance for deaf patients.

PubMed

Pereira, Patrícia Cristina Andrade; Fortes, Paulo Antonio de Carvalho

2010-01-01

In Brazil, recent regulations require changes in private and public health systems to make special services available to deaf patients. In the present article, the researchers analyze the perceptions of 25 sign language-using patients regarding this assistance. The researchers found communication difficulties between these patients and health services staff, as well as a culture clash and a harmful inability among the service providers to distinguish among the roles of companions, caretakers, and professional translator/interpreters. Thus, it became common for the patients to experience prejudice in the course of treatment and information exchange, damage to their autonomy, limits on their access to services, and reduced efficacy of therapy. The researchers conclude that many issues must be dealt with if such barriers to health access are to be overcome, in particular the worrying degree of exclusion of deaf patients from health care systems.

The Vernacular Landscape of Assisted Living

PubMed Central

Roth, Erin G.; Eckert, J. Kevin

2011-01-01

This article is an exploration into the vernacular landscape of Assisted Living (AL), a conceptual idea borrowed from cultural geographer J.B. Jackson, which distinguishes formalized, planned space from those spaces which are unintended and often created spontaneously--vernacular. Based upon three large-scale, multi-year ethnographic studies in Maryland, we consider some of the ways people who live in AL relate to and respond to the built environment, at times subverting the intended purpose of design to make it their own. The conflict that often ensues over both planned and vernacular public and private space, we propose is ultimately the product of living within an environment that is both someone’s home as well as a place of business, whose job it is to keep people safe. Within this physical context of vernacular private and public spaces, this article enriches understandings about the way autonomy and privacy expresses itself. PMID:21949467

Addressing the ethical, legal, and social issues raised by voting by persons with dementia.

PubMed

Karlawish, Jason H; Bonnie, Richard J; Appelbaum, Paul S; Lyketsos, Constantine; James, Bryan; Knopman, David; Patusky, Christopher; Kane, Rosalie A; Karlan, Pamela S

2004-09-15

This article addresses an emerging policy problem in the United States participation in the electoral process by citizens with dementia. At present, health care professionals, family caregivers, and long-term care staff lack adequate guidance to decide whether individuals with dementia should be precluded from or assisted in casting a ballot. Voting by persons with dementia raises a series of important questions about the autonomy of individuals with dementia, the integrity of the electoral process, and the prevention of fraud. Three subsidiary issues warrant special attention: development of a method to assess capacity to vote; identification of appropriate kinds of assistance to enable persons with cognitive impairment to vote; and formulation of uniform and workable policies for voting in long-term care settings. In some instances, extrapolation from existing policies and research permits reasonable recommendations to guide policy and practice. However, in other instances, additional research is necessary.

A cross-cultural comparison of the coexistence and domain superiority of individuating and relating autonomy.

PubMed

Yeh, Kuang-Hui; Bedford, Olwen; Yang, Yung-Jui

2009-06-01

The consensus definition of autonomy in the psychological literature emphasizes self-governance through free volition, not separation or independence from others. Since the concept of self may differ cross-culturally, several researchers have tried to incorporate types of self into the notion of autonomy; however, only the dual model of autonomy has been able to do this while retaining an emphasis on volition. The dual model describes two distinct forms of autonomy-individuating and relating-each with superior function in a specific domain of individual functioning. Individuating autonomy represents a volitional capacity to act against social constraints and offers a route to achieve an independent self-identity by expressing individualistic attributes and distinctions. Relating autonomy represents a volitional capacity to act by emphasizing the harmony of self-in-relation-to-others, the quality of interpersonal relationships, and self-transcendence. These two forms of autonomy have been shown to coexist at the individual level in a Taiwanese sample. This study takes the next step, with a cross-cultural test of the coexistence and domain superiority hypotheses of individuating and relating autonomy. Participants included 306 college students from Taiwan and 183 college students from the United States. Structural equation modelling by multigroup analyses confirmed the cross-cultural equivalence of the two-factor individuating autonomy and relating autonomy measurement model. Across both samples the two forms of autonomy were shown to be mutually inclusive and not exclusive or independent. The domain-superior function of each form of autonomy was also confirmed cross-culturally; each form of autonomy has a dominant, but not necessarily exclusive, domain of functioning. Specifically, individuating autonomy was more associated with intrapersonal than interpersonal domain dependent variables, while relating autonomy was more associated with interpersonal than intrapersonal domain dependent variables. Limitations of the study and considerations for future research are discussed.

[How to handle the dilemma of driving for patients with Alzheimer's disease? A survey of advices provided by French caregivers guides].

PubMed

Mietkiewicz, Marie-Claude; Ostrowski, Madeleine

2015-09-01

For many old people, driving takes an important place in the daily living activities and contributes to carry on their autonomy and self-esteem. However, many studies showed a link between car accidents and Alzheimer's disease, even in the early stages of dementia, and people caring for these patients inevitably ask the question: "Is my patient with Alzheimer's disease still able to drive his car?" Guides devoted to caregivers can play an important role to improve the knowledge of Alzheimer's disease and to afford advices for patients managing. To assess how these guides handle the question of patients driving, we made a survey of the 46 French caregiver guides (re)published between 1988 and 2013. The question of driving is raised with more or less details in 31 guides. All state that driving should be discontinued but that the consequences of this decision on the patient autonomy should be taken into account. A few guides provide clues to assess driving competence for the patients, and many propose advices to support the implementation of the driving discontinuity decision, such as to discuss with the patient to persuade him to stop driving, to ask for assistance by the family physician, to hide the car's keys or to disconnect its battery... In France, physicians are not allowed to prohibit driving or to report dangerous driving to authorities. Ultimately, the caregivers remain faced with the ethical dilemma to choose between safety and the patient's autonomy preservation. Therefore the responsibility for the patient to persist or give up driving only falls to them.

The Generation of Situational Awareness within Autonomous Systems - A Near to Mid term Study - Analysis

DTIC Science & Technology

2006-07-01

mobility in complex terrain, robot system designers are still seeking workable processes for mapbuilding, with enduring problems that either require...human) robot system designers /users can seek to control the consequences of robot actions, deliberate or otherwise. A notable particular application...operators a sufficient feeling of presence; if not, robot system designers will have to provide autonomy to the robot to make up for the gaps in human input

Public health and human values

PubMed Central

Häyry, M

2006-01-01

The ends and means of public health activities are suggested to be at odds with the values held by human individuals and communities. Although promoting longer lives in better health for all seems like an endeavour that is obviously acceptable, it can be challenged by equally self‐evident appeals to autonomy, happiness, integrity and liberty, among other values. The result is that people's actual concerns are not always adequately dealt with by public health measures and assurances. PMID:16943332

CAALYX: a new generation of location-based services in healthcare

PubMed Central

Boulos, Maged N Kamel; Rocha, Artur; Martins, Angelo; Vicente, Manuel Escriche; Bolz, Armin; Feld, Robert; Tchoudovski, Igor; Braecklein, Martin; Nelson, John; Ó Laighin, Gearóid; Sdogati, Claudio; Cesaroni, Francesca; Antomarini, Marco; Jobes, Angela; Kinirons, Mark

2007-01-01

Recent advances in mobile positioning systems and telecommunications are providing the technology needed for the development of location-aware tele-care applications. This paper introduces CAALYX – Complete Ambient Assisted Living Experiment, an EU-funded project that aims at increasing older people's autonomy and self-confidence by developing a wearable light device capable of measuring specific vital signs of the elderly, detecting falls and location, and communicating automatically in real-time with his/her care provider in case of an emergency, wherever the older person happens to be, at home or outside. PMID:17352802

Institutional Autonomy Revisited: Autonomy Justified and Accounted

ERIC Educational Resources Information Center

Moses, Ingrid

2007-01-01

Australian universities have enjoyed large-scale autonomy. In a society that increasingly regards university education from an instrumentalist point of view, universities' anxious safeguarding of their autonomy is widely seen as an attempt to evade accountability. Yet there has been an acceptance that a corollary to autonomy is accountability.…

Law, autonomy and advance directives.

PubMed

Willmott, Lindy; White, Ben; Mathews, Ben

2010-12-01

The principle of autonomy underpins legal regulation of advance directives that refuse life-sustaining medical treatment. The primacy of autonomy in this domain is recognised expressly in the case law, through judicial pronouncement, and implicitly in most Australian jurisdictions, through enactment into statute of the right to make an advance directive. This article seeks to justify autonomy as an appropriate principle for regulating advance directives and relies on three arguments: the necessity of autonomy in a liberal democracy; the primacy of autonomy in medical ethics discourse; and the uncontested importance of autonomy in the law on contemporaneous refusal of medical treatment. This article also responds to key criticisms that autonomy is not an appropriate organising principle to underpin legal regulation of advance directives.

Respect for rational autonomy.

PubMed

Walker, Rebecca L

2009-12-01

The standard notion of autonomy in medical ethics does not require that autonomous choices not be irrational. The paper gives three examples of seemingly irrational patient choices and discusses how a rational autonomy analysis differs from the standard view. It then considers whether a switch to the rational autonomy view would lead to overriding more patient decisions but concludes that this should not be the case. Rather, a determination of whether individual patient decisions are autonomous is much less relevant than usually considered in determining whether health care providers must abide by these decisions. Furthermore, respect for rational autonomy entails strong positive requirements of respect for the autonomy of the person as a rational decision maker. The rationality view of autonomy is conceptually stronger than the standard view, allows for a more nuanced understanding of the practical moral calculus involved in respecting patient autonomy, and promotes positive respect for patient autonomy.

Exploring the experiences of bereaved families involved in assisted suicide in Southern Switzerland: a qualitative study.

PubMed

Gamondi, Claudia; Pott, Murielle; Forbes, Karen; Payne, Sheila

2015-06-01

In Switzerland, helping with assisted suicide under certain conditions is not prosecuted. With approximately 300 cases annually, this leaves behind a large group of bereaved people where its consequences are mostly unknown. The study aimed to explore family involvement in decision making prior to assisted suicide, and to examine their ways of coping during the bereavement period. A qualitative interview study used the principles of Grounded Theory analysis. Eleven relatives of eight patients, who died in Southern Switzerland after assisted suicide, participated in semistructured interviews. The large majority of family members faced moral dilemmas during the decision-making phase. Their respect for patient's autonomy was a key justification to resolve dilemmas. Two types of involvement were identified: categorised as 'passive' when the decision making was located with the patient, and 'active' when assisted suicide was proposed by the family member and/or the relative was involved in some way. The relatives reported feelings of isolation during and after assisted suicide. Family members reported fear of social stigma and did not openly disclose assisted suicide as the cause of death. None of those interviewed received formal psychological support. Bereaved families express moral dilemmas, feelings of isolation and secrecy in the management of assisted suicide in Southern Switzerland. These features seem underestimated and not sufficiently recognised by the healthcare professionals. Management of assisted suicide requests should include consideration of family members' needs, in addition to those of the patient. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Nontherapeutic quality improvement: The conflict of organizational ethics and societal rule of law.

PubMed

Rie, Michael A; Kofke, W Andrew

2007-02-01

Critical care ethics focuses largely on patient autonomy. Cost containment is necessary but requires rationing and limitations on a patient's right to consume beneficial services. No laws address a process of autonomy rights limitation to consume resources in the intensive care unit. We analyzed the frictional interface between necessary cost containment as a quality improvement activity contrasted with individual autonomy in the context of the evolution of research ethics. Scholarly books, peer-reviewed articles, congressional record, legal sources, the World Wide Web, and the National Archives and Records Administration were evaluated in the context of current cost-containment-driven nontherapeutic quality improvement activities. Three generations in the evolution of human research ethics are identified: 1) Hippocrates to Nuremberg Code, 2) Nuremberg to Belmont, and 3) Belmont to present. Similar ethical lapses, which place the individual at risk without disclosure for the good of future patients, have arisen recurrently in the course of history and continue presently when nontherapeutic quality improvement activities are framed as a human research activity with essentially no ethical oversight. Consequently, fiduciary obligations of professionals and their employer-institutions to their mutual patients may be at odds, creating complex layers of conflicted decision making. Nonetheless, professional Hippocratic duty to "the patient" must be congruent with the organizational ethos of limited funding "stewardship" to produce meaningful patient care. Medicine's integrity is legally protected and mandated under the state interests (parens patria doctrine) of the common law. When hospitals (society and its health insurance methods) fail to ration transparently under "cost-containment ethics," they threaten the ethical integrity of the medical profession.

Reconceptualizing Autonomy: A Relational Turn in Bioethics.

PubMed

Jennings, Bruce

2016-05-01

History's judgment on the success of bioethics will not depend solely on the conceptual creativity and innovation in the field at the level of ethical and political theory, but this intellectual work is not insignificant. One important new development is what I shall refer to as the relational turn in bioethics. This development represents a renewed emphasis on the ideographic approach, which interprets the meaning of right and wrong in human actions as they are inscribed in social and cultural practices and in structures of lived meaning and interdependence; in an ideographic approach, the task of bioethics is to bring practice into theory, not the other way around. The relational turn in bioethics may profoundly affect the critical questions that the field asks and the ethical guidance it offers society, politics, and policy. The relational turn provides a way of correcting the excessive atomism of many individualistic perspectives that have been, and continue to be, influential in bioethics. Nonetheless, I would argue that most of the work reflecting the relational turn remains distinctively liberal in its respect for the ethical significance of the human individual. It moves away from individualism, but not from the value of individuality.In this review essay, I shall focus on how the relational turn has manifested itself in work on core concepts in bioethics, especially liberty and autonomy. Following a general review, I conclude with a brief consideration of two important recent books in this area: Jennifer Nedelsky's Law's Relations and Rachel Haliburton's Autonomy and the Situated Self. © 2016 The Hastings Center.

Respect for autonomy in the healthcare context: observations from a qualitative study of young adults with cerebral palsy.

PubMed

Racine, E; Larivière-Bastien, D; Bell, E; Majnemer, A; Shevell, M

2013-11-01

Respect for patient autonomy is a cornerstone of contemporary medical ethics and clinical practice. In its different shapes and forms (e.g. being informed, being engaged in discussions and decisions about medical care and being supported in developing healthcare preferences and choices), patient autonomy has been fostered by both paediatric and adult professional societies. The transition from paediatric to adult care creates a complex situation where autonomy for medical decisions shifts to the developing adolescent. More specific challenges to respect for autonomy may be experienced by young adults with cerebral palsy in the transition period where, for example, language and motor impairments may affect communication skills and this may be conflated with cognitive disability. To characterize perspectives towards autonomy in the healthcare context for young adults with cerebral palsy. We carried out semi-structured interviews with 14 young adults (aged 18-25) with cerebral palsy. The audiotaped interviews were transcribed verbatim and analysed using a conventional thematic qualitative content analysis. Participants displayed a range of attitudes towards autonomy, suggesting that the value of autonomy is considered in light of competing values and of context. Testimonials from participants demonstrated that both contextual (e.g. ill-adapted health care, lack of specialized public transport) and relational (e.g. attitudes towards parental involvement in decision making) factors negatively or positively impact autonomy. We observed that there were four key elements interwoven in participants' characterization of autonomy: the coupling of decisional and physical autonomy, the influences of family and society on autonomy, the influence of healthcare professionals on autonomy and the need for preparation for autonomy. © 2012 John Wiley & Sons Ltd.

The Developmental Cycle: Teachings on the Eight Stages of Growth of a Human Being.

ERIC Educational Resources Information Center

Coyhis, Don

1997-01-01

Ties Native American Medicine Wheel teachings on the cycle of life to Eric Erickson's work on the eight developmental stages: trust, autonomy, initiative, accomplishment, identity, intimacy, generativity, and integrity. To have healthy communities, people need to move successfully through these stages. Knowing about these stages can help a person…

Education and the Two Phases of Urbanization.

ERIC Educational Resources Information Center

Peachey, Paul

The struggle between the country and the city has always been a part of human history, but with the industrial revolution, large societies possessing urban attributes came into existence while the cities proper began to lose their bounded autonomy. Entire populations are now transformed into a single industrial economy, even though they may live…

Impacts of Globalisation on Higher Education Reform in China: A Trend of Decentralisation and Autonomy

ERIC Educational Resources Information Center

Xu, Shihong

2005-01-01

By tracing back the historical context of educational changes, this article explores in detail the impacts of globalisation on China's higher education reform. A trend of decentralisation in both rights and responsibilities is revealed in terms of structural adjustment, human resource exploitation and retention, curriculum development, and…

Beyond the Absence of Disease or Infirmity: The Case for Sexual Wellness

ERIC Educational Resources Information Center

Daugherty, Timothy K.; Julian, Hannah M.; Lynch, Nicole M.; Chen, Stephanie J.; Whipple, Tanya L.; Ginsburg, Austin F.

2016-01-01

Examined a version of the Substance Abuse and Mental Health Services Administration (SAMHSA) wellness model that was revised to include a ninth factor, sexual wellness: "understanding the human body, choosing the type and size of one's family, and experiencing satisfaction (alone or with consenting others) while maintaining autonomy,…

Thinking Differently about Guidance: Power, Children's Autonomy and Democratic Environments

ERIC Educational Resources Information Center

Millei, Zsuzsa

2012-01-01

This article critiques guidance approaches to discipline, that are employed in early childhood environments with an aim to create democratic environments for children, and as part of "good" practices. Advocates of guidance claim that this is a more humane or democratic approach to discipline that empowers children, and therefore, power…

The suppressed legacy of Nuremberg.

PubMed

Burt, R A

1996-01-01

The story of patient self-determination cannot be told without the Nuremberg trials. Patient autonomy was the first criterion enunciated by the Nuremberg judges and has served as a touchstone for human subject research and patient care ever since. Yet this ideal was in an important sense irrelevant at the moment it was originally proclaimed.

Commodification of Ghana's Volta River: An Example of Ellul's Autonomy of Technique

ERIC Educational Resources Information Center

Agbemabiese, Lawrence; Byrne, John

2005-01-01

Jacques Ellul argued that modernity's nearly exclusive reliance on science and technology to design society would threaten human freedom. Of particular concern for Ellul was the prospect of the technical milieu overwhelming culture. The commodification of the Volta River in order to modernize Ghana illustrates the Ellulian dilemma of the autonomy…

The Relation between Balanced Need Satisfaction and Adolescents' Motivation in Physical Education

ERIC Educational Resources Information Center

Mouratidis, Athanasios; Barkoukis, Vassilis; Tsorbatzoudis, Charalambos

2015-01-01

Self-determination theory posits that satisfaction of the needs for autonomy, competence and relatedness represents the basic nutriments for humans' optimal functioning. It also postulates that with greater the degree to which these three needs are equally satisfied, the quality of motivation is further enhanced. Yet, this premise has remained…

The moral agency of institutions: effectively using expert nurses to support patient autonomy.

PubMed

Charles, Sonya

2017-08-01

Patient autonomy-with an emphasis on informed consent and the right to refuse treatment-is a cornerstone of modern bioethics. Within discussions about patient autonomy, feminist bioethicists have argued for a relational approach to autonomy. Under a relational framework, we must look beyond the individual moment of choice to include the role relationships and specific contexts can play in supporting or undermining autonomy. Given the day-to-day interactions they have with patients, nurses play a significant role in helping patients understand the nature of their illnesses and make truly informed decisions. However, the skills of expert nurses also support patient autonomy in more subtle ways. Specifically, nurses develop skills of attunement that help them to find subtle ways to support patient autonomy. However, in order to effectively do this, nurses need institutions that support their professional autonomy. In this paper, I look at the ways nurses have been inhibited in their professional autonomy both as a profession and as individual practitioners. I argue that turning our attention to institutions and the role they play in supporting or undermining nurses' autonomy can help promote nurses' professional autonomy and thereby enhance patient autonomy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Public Health Autonomy: A Critical Reappraisal.

PubMed

Zimmerman, Frederick J

2017-11-01

The ethical principle of autonomy is among the most fundamental in ethics, and it is particularly salient for those in public health, who must constantly balance the desire to improve health outcomes by changing behavior with respect for individual freedom. Although there are some areas in which there is a genuine tension between public health and autonomy-childhood vaccine mandates, for example-there are many more areas where not only is there no tension, but public health and autonomy come down to the same thing. These areas of overlap are often rendered invisible by a thin understanding of autonomy. Better integrating newer theoretical insights about autonomy into applied ethics can make discussions of public health ethics more rigorous, incisive, and effective. Even more importantly, bringing modern concepts of autonomy into public health ethics can showcase the many areas in which public health and autonomy have the same goals, face the same threats, and can be mutually advanced by the same kinds of solutions. This article provides a schema for relational autonomy in a public health context and gives concrete examples of how autonomy can be served through public-health interventions. It marshals insights from sociology, psychology, and philosophy to advance a theory of autonomy and coercion that recognizes three potential threats to autonomy: threats to choice sets, threats to knowledge, and threats to preferences. © 2017 The Hastings Center.

Certification Considerations for Adaptive Systems

NASA Technical Reports Server (NTRS)

Bhattacharyya, Siddhartha; Cofer, Darren; Musliner, David J.; Mueller, Joseph; Engstrom, Eric

2015-01-01

Advanced capabilities planned for the next generation of aircraft, including those that will operate within the Next Generation Air Transportation System (NextGen), will necessarily include complex new algorithms and non-traditional software elements. These aircraft will likely incorporate adaptive control algorithms that will provide enhanced safety, autonomy, and robustness during adverse conditions. Unmanned aircraft will operate alongside manned aircraft in the National Airspace (NAS), with intelligent software performing the high-level decision-making functions normally performed by human pilots. Even human-piloted aircraft will necessarily include more autonomy. However, there are serious barriers to the deployment of new capabilities, especially for those based upon software including adaptive control (AC) and artificial intelligence (AI) algorithms. Current civil aviation certification processes are based on the idea that the correct behavior of a system must be completely specified and verified prior to operation. This report by Rockwell Collins and SIFT documents our comprehensive study of the state of the art in intelligent and adaptive algorithms for the civil aviation domain, categorizing the approaches used and identifying gaps and challenges associated with certification of each approach.

A model-Driven Approach to Customize the Vocabulary of Communication Boards: Towards More Humanization of Health Care.

PubMed

Franco, Natália M; Medeiros, Gabriel F; Silva, Edson A; Murta, Angela S; Machado, Aydano P; Fidalgo, Robson N

2015-01-01

This work presents a Modeling Language and its technological infrastructure to customize the vocabulary of Communication Boards (CB), which are important tools to provide more humanization of health care. Using a technological infrastructure based on Model-Driven Development (MDD) approach, our Modelin Language (ML) creates an abstraction layer between users (e.g., health professionals such as an audiologist or speech therapist) and application code. Moreover, the use of a metamodel enables a syntactic corrector for preventing creation of wrong models. Our ML and metamodel enable more autonomy for health professionals in creating customized CB because it abstracts complexities and permits them to deal only with the domain concepts (e.g., vocabulary and patient needs). Additionally, our infrastructure provides a configuration file that can be used to share and reuse models. This way, the vocabulary modelling effort will decrease our time since people share vocabulary models. Our study provides an infrastructure that aims to abstract the complexity of CB vocabulary customization, giving more autonomy to health professionals when they need customizing, sharing and reusing vocabularies for CB.

Autonomous and Autonomic Systems: A Paradigm for Future Space Exploration Missions

NASA Technical Reports Server (NTRS)

Truszkowski, Walter F.; Hinchey, Michael G.; Rash, James L.; Rouff, Christopher A.

2004-01-01

NASA increasingly will rely on autonomous systems concepts, not only in the mission control centers on the ground, but also on spacecraft and on rovers and other assets on extraterrestrial bodies. Automomy enables not only reduced operations costs, But also adaptable goal-driven functionality of mission systems. Space missions lacking autonomy will be unable to achieve the full range of advanced mission objectives, given that human control under dynamic environmental conditions will not be feasible due, in part, to the unavoidably high signal propagation latency and constrained data rates of mission communications links. While autonomy cost-effectively supports accomplishment of mission goals, autonomicity supports survivability of remote mission assets, especially when human tending is not feasible. Autonomic system properties (which ensure self-configuring, self-optimizing self-healing, and self-protecting behavior) conceptually may enable space missions of a higher order into any previously flown. Analysis of two NASA agent-based systems previously prototyped, and of a proposed future mission involving numerous cooperating spacecraft, illustrates how autonomous and autonomic system concepts may be brought to bear on future space missions.

[What is purchased, how and from whom by Seguro Popular in Mexico? Experience with strategic purchasing at national level and in a pioneer institution].

PubMed

González-Block, Miguel Ángel

2017-01-01

To analyze the scope of demand subsidies through strategic purchasing of health services. Interviews and document analyses at national level and a case study of the state of Hidalgo. SPSS explicitly prioritizes interventions to be financed and regulates prices and expenditure ceilings. Public providers are predominantly funded through the purchasing of inputs and the contracting of human resources, in the absence of competition and with a low degree of managerial autonomy. Seguro Popular in Hidalgo has diversified service providers and payment mechanisms. SPSS has ample opportunity to extend and deepen strategic purchasing. Greater decision-making autonomy of payers and providers is required, as well as regulations to promote provider networks in competitive environments.

Autonomy, moral constraints, and markets in kidneys.

PubMed

Kerstein, Samuel J

2009-12-01

This article concerns the morality of establishing regulated kidney markets in an effort to reduce the chronic shortage of kidneys for transplant. The article tries to rebut the view, recently defended by James Taylor, that if we hold autonomy to be intrinsically valuable, then we should be in favor of such markets. The article then argues that, under current conditions, the buying and selling of organs in regulated markets would sometimes violate two Kantian principles that are seen as moral constraints. One principle forbids expressing disrespect for the dignity of humanity; the other forbids treating others merely as means. In light of the moral danger posed by regulated markets, the article advocates an alternative way of diminishing the current organ shortage, namely opt-out systems of cadaveric organ donation.

Issues in the design of an executive controller shell for Space Station automation

NASA Technical Reports Server (NTRS)

Erickson, William K.; Cheeseman, Peter C.

1986-01-01

A major goal of NASA's Systems Autonomy Demonstration Project is to focus research in artificial intelligence, human factors, and dynamic control systems in support of Space Station automation. Another goal is to demonstrate the use of these technologies in real space systems, for both round-based mission support and on-board operations. The design, construction, and evaluation of an intelligent autonomous system shell is recognized as an important part of the Systems Autonomy research program. His paper describes autonomous systems and executive controllers, outlines how these intelligent systems can be utilized within the Space Station, and discusses a number of key design issues that have been raised during some preliminary work to develop an autonomous executive controller shell at NASA Ames Research Center.

Simulating Autonomous Telecommunication Networks for Space Exploration

NASA Technical Reports Server (NTRS)

Segui, John S.; Jennings, Esther H.

2008-01-01

Currently, most interplanetary telecommunication systems require human intervention for command and control. However, considering the range from near Earth to deep space missions, combined with the increase in the number of nodes and advancements in processing capabilities, the benefits from communication autonomy will be immense. Likewise, greater mission science autonomy brings the need for unscheduled, unpredictable communication and network routing. While the terrestrial Internet protocols are highly developed their suitability for space exploration has been questioned. JPL has developed the Multi-mission Advanced Communications Hybrid Environment for Test and Evaluation (MACHETE) tool to help characterize network designs and protocols. The results will allow future mission planners to better understand the trade offs of communication protocols. This paper discusses various issues with interplanetary network and simulation results of interplanetary networking protocols.

Heteronomous Citizenship: Civic Virtue and the Chains of Autonomy

ERIC Educational Resources Information Center

Swaine, Lucas

2010-01-01

In this article, I distinguish personal autonomy from heteronomy, and consider whether autonomy provides a suitable basis for liberalism. I argue that liberal government should not promote autonomy in all its citizens, on the grounds that not all members of liberal democracies require autonomy for a good life. I then outline an alternative option…

Oppression, Autonomy and the Impossibility of the Inner Citadel

ERIC Educational Resources Information Center

Nelsen, Peter

2010-01-01

This paper argues for a conception of autonomy that takes social oppression seriously without sapping autonomy of its valuable focus on individual self-direction. Building on recent work in relational accounts of autonomy, the paper argues that current conceptions of autonomy from liberal, feminist and critical theorists do not adequately account…

Does Parental Autonomy Support Relate to Adolescent Autonomy? An In-Depth Examination of a Seemingly Simple Question

ERIC Educational Resources Information Center

Fousiani, Kyriaki; Van Petegem, Stijn; Soenens, Bart; Vansteenkiste, Maarten; Chen, Beiwen

2014-01-01

In contemporary research on autonomy development, autonomy has been defined as independence (vs. dependence) or as self-endorsed (vs. controlled) functioning. Analogously, perceived parental autonomy support involves either perceived parental promotion of independence (PI) or perceived parental promotion of volitional functioning (PVF). The…

University Reform and Institutional Autonomy: A Framework for Analysing the Living Autonomy

ERIC Educational Resources Information Center

Maassen, Peter; Gornitzka, Åse; Fumasoli, Tatiana

2017-01-01

In this article we discuss recent university reforms aimed at enhancing university autonomy, highlighting various tensions in the underlying reform ideologies. We examine how the traditional interpretation of university autonomy has been expanded in the reform rationales. An analytical framework for studying how autonomy is interpreted and used…

A Latent Class Analysis of Maternal Responsiveness and Autonomy-Granting in Early Adolescence: Prediction to Later Adolescent Sexual Risk-Taking

PubMed Central

Lanza, H. Isabella; Huang, David Y. C.; Murphy, Debra A.; Hser, Yih-Ing

2013-01-01

The present study sought to extend empirical inquiry related to the role of parenting on adolescent sexual risk-taking by using latent class analysis (LCA) to identify patterns of adolescent-reported mother responsiveness and autonomy-granting in early adolescence and examine associations with sexual risk-taking in mid- and late-adolescence. Utilizing a sample of 12- to 14-year-old adolescents (N = 4,743) from the 1997 National Longitudinal Survey of Youth (NLSY97), results identified a four-class model of maternal responsiveness and autonomy-granting: low responsiveness/high autonomy-granting, moderate responsiveness/moderate autonomy-granting, high responsiveness/low autonomy-granting, high responsiveness/moderate autonomy-granting. Membership in the low responsiveness/high autonomy-granting class predicted greater sexual risk-taking in mid- and late-adolescence compared to all other classes, and membership in the high responsiveness/ moderate autonomy-granting class predicted lower sexual risk-taking. Gender and ethnic differences in responsiveness and autonomy-granting class membership were also found, potentially informing gender and ethnic disparities of adolescent sexual risk-taking. PMID:23828712

Patient Autonomy for the Management of Chronic Conditions: A Two-Component Re-conceptualization

PubMed Central

Naik, Aanand D.; Dyer, Carmel B.; Kunik, Mark E.; McCullough, Laurence B.

2010-01-01

The clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions (decisional autonomy) to the virtual exclusion of the capacity to execute the treatment plan (executive autonomy). However, the one-component concept of autonomy is problematic in the context of multiple chronic conditions. Adherence to complex treatments commonly breaks down when patients have functional, educational, and cognitive barriers that impair their capacity to plan, sequence, and carry out tasks associated with chronic care. The purpose of this article is to call for a two-component re-conceptualization of autonomy and to argue that the clinical assessment of capacity for patients with chronic conditions should be expanded to include both autonomous decision making and autonomous execution of the agreed-upon treatment plan. We explain how the concept of autonomy should be expanded to include both decisional and executive autonomy, describe the biopsychosocial correlates of the two-component concept of autonomy, and recommend diagnostic and treatment strategies to support patients with deficits in executive autonomy. PMID:19180389

A longitudinal research on the development of emotional autonomy during adolescence.

PubMed

Parra, Agueda; Oliva, Alfredo

2009-05-01

The purpose of the present paper was to study the development of emotional autonomy through adolescence analysing its association with family relationships. The development of emotional autonomy involves an increase in adolescents' subjective sense of his or her independence, especially in relation to parents. From some scholars emotional autonomy is a normative manifestation of the detachment process from parents, however, others point out that detachment from parental ties is not the norm, so high level of adolescent emotional autonomy is the consequence of negative family relationships. In our study a sample of 101 adolescents were followed for 5 years, from early to middle adolescence, and completed questionnaires to measure their emotional autonomy and the quality of their family relationships. Our results showed that over the course of adolescence some dimensions of emotional autonomy increase, meanwhile others decrease, so the global level of emotional autonomy global level remains stable. On the other hand, emotional autonomy is associated with negative family relationships, so emotional autonomy, more than a necessary process to become adult, could be indicating an insecure attachment to parents.

Effects of an autonomy-supportive exercise instructing style on exercise motivation, psychological well-being, and exercise attendance in middle-age women.

PubMed

Moustaka, Frederiki C; Vlachopoulos, Symeon P; Kabitsis, Chris; Theodorakis, Yannis

2012-01-01

The present study evaluated the effectiveness of an autonomy-supportive intervention based on self-determination theory in influencing perceptions of autonomy support, basic psychological needs, behavioral regulations, subjective vitality, and exercise behavior. 35 female exercise participants age 30 to 58 years who enrolled to an 8-week exercise program attended 24 exercise classes that were taught using either an autonomy-supportive (n = 19) or a lack of autonomy support (n = 16) instructing style. The experimental group reported an increase in perceived autonomy support, the fulfillment of the needs for autonomy and competence, identified regulation, intrinsic motivation, and subjective vitality. They also reported higher attendance rates during the program and greater participation to moderate and/or mild nonstructured exercise during 5 weeks after the end of the program. The control group reported a decrease in perceived autonomy support, the needs for autonomy and competence, intrinsic motivation, and subjective vitality. The results supported tenets of self-determination theory and highlighted the motivational and psychological benefits of an autonomy-supportive exercise instructing style among middle-age women.

Death with Dignity: The Developing Debate Among Health Care Professionals.

PubMed

Oakman, Brittany N; Campbell, Hope E; Runk, Lindsay M

2015-06-01

The right-to-die movement-known variously as death with dignity, physician-assisted suicide, or aid in dying-remains controversial. The recently publicized death of 29-year-old Brittany Maynard, who chose to end her life through physician-assisted suicide, forced many health care professionals to evaluate or re-evaluate their stance on the issue. Currently, only five states have aid-in-dying laws, but many others have bills under consideration. The legalized process for physician-assisted suicide has a strict set of procedures that physicians and patients must follow to ensure the competency and safety of all parties involved. Opposition against legalizing physician-assisted suicide encompasses more than simply moral, religious, or ethical differences. While some individuals believe that physician-assisted suicide gives patients autonomy in their end-of-life care, health care professionals also may have reservations about the liability of the situation. Pharmacists, in particular, play a pertinent role in the dispensing of, and counseling about, the medications used to assist patients in hastening their death. It is imperative that pharmacists be aware of the intended use of the particular medication so that they can make informed decisions about their participation and ensure that they perform all the necessary steps required to remain compliant with the laws or statutes in their jurisdiction. This practice places an increased burden on pharmacists to evaluate their opinion on the concept of death with dignity and whether or not they want to participate.

Depression in the context of disability and the "right to die".

PubMed

Gill, Carol J

2004-01-01

Arguments in favor of legalized assisted suicide often center on issues of personal privacy and freedom of choice over one's body. Many disability advocates assert, however, that autonomy arguments neglect the complex sociopolitical determinants of despair for people with disabilities. Specifically, they argue that social approval of suicide for individuals with irreversible conditions is discriminatory and that relaxing restrictions on assisted suicide would jeopardize, not advance, the freedom of persons with disabilities to direct the lives they choose. This paper examines the idea promoted by some proponents of assisted suicide that it is reasonable to be depressed about one's diminished quality of life in cases of irreversible illness or disability and, therefore, such depression should not call into question the individual's competence to request assistance in dying. The concept of rational depression is defined and examined in the context of: four real-life cases involving individuals with disabilities who requested assistance in dying; a set of criteria commonly applied to decision-making to determine rationality; and research bearing on the emotional status of people with disabilities. It is concluded that although disability is associated with particular socially mediated stressors, there is no theoretical or empirical evidence to indicate that depression and its role in the "right to die" is dynamically different, more natural, or more reasonable for disabled people than for non-disabled people.

A balanced intervention ladder: promoting autonomy through public health action.

PubMed

Griffiths, P E; West, C

2015-08-01

The widely cited Nuffield Council on Bioethics 'Intervention Ladder' structurally embodies the assumption that personal autonomy is maximized by non-intervention. Consequently, the Intervention Ladder encourages an extreme 'negative liberty' view of autonomy. Yet there are several alternative accounts of autonomy that are both arguably superior as accounts of autonomy and better suited to the issues facing public health ethics. We propose to replace the one-sided ladder, which has any intervention coming at a cost to autonomy, with a two-sided 'Balanced Intervention Ladder,' where intervention can either enhance or diminish autonomy. We show that not only the alternative, richer accounts of autonomy but even Mill's classic version of negative liberty puts some interventions on the positive side of the ladder. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Learning to Inhabit the Forest: Autonomy and Interdependence of Lives from a Mbya-Guarani Perspective.

PubMed

Remorini, Carolina

2015-01-01

This chapter examines the ideas of reciprocity, respect, autonomy, and interdependence of lives and the impact of these on children's learning. Using an ecological perspective that recognizes humans' relationship with other living beings that inhabit the forest, this chapter is based on ethnographic research conducted in two Mbya-Guarani communities (Argentina). Respect and reciprocity are key for children to develop as part of the community and the forest and they are related to children's well-being and health. I describe Mbya perspectives on children's growth and development, emphasizing the balance between interdependence and autonomy as complementary goals and values, providing examples of environmentally relevant skills to grow up in the forest. These skills are associated with particular ways of inhabiting the forest, including learning how to walk in it and developing entendimiento (understanding). These make possible children's integration in community life through their participation and collaboration in daily activities. I attempt to articulate these ideas with the theoretical framework of Learning by Observing and Pitching In, especially concerning ways of organizing and supporting children's learning processes in the context of their engagement with multiaged and more experienced group of people. © 2015 Elsevier Inc. All rights reserved.

Human-Robot Teaming: From Space Robotics to Self-Driving Cars

NASA Technical Reports Server (NTRS)

Fong, Terry

2017-01-01

In this talk, I describe how NASA Ames has been developing and testing robots for space exploration. In our research, we have focused on studying how human-robot teams can increase the performance, reduce the cost, and increase the success of space missions. A key tenet of our work is that humans and robots should support one another in order to compensate for limitations of manual control and autonomy. This principle has broad applicability beyond space exploration. Thus, I will conclude by discussing how we have worked with Nissan to apply our methods to self-driving cars, enabling humans to support autonomous vehicles operating in unpredictable and difficult situations.

Integration of Systems with Varying Levels of Autonomy (Integration de Systemes a Niveau d’Autonomie Variable)

DTIC Science & Technology

2008-09-01

SCI-144 Integration of Systems with Varying Levels of Autonomy (Intégration de systèmes à niveau d’autonomie variable) This Report was...prepared by Task Group SCI-144 on “ System -Level Integration of Control plus Automation” and has been sponsored by the Systems Concepts and Integration... Systems with Varying Levels of Autonomy (Intégration de systèmes à niveau d’autonomie variable) This Report was prepared by Task Group SCI-144 on

Integration of Systems with Varying Levels of Autonomy (Integration de systemes a niveau d’autonomie variable)

DTIC Science & Technology

2008-09-01

SCI-144 Integration of Systems with Varying Levels of Autonomy (Intégration de systèmes à niveau d’autonomie variable) This Report was...prepared by Task Group SCI-144 on “ System -Level Integration of Control plus Automation” and has been sponsored by the Systems Concepts and Integration... Systems with Varying Levels of Autonomy (Intégration de systèmes à niveau d’autonomie variable) This Report was prepared by Task Group SCI-144 on

Implementing a resident acute care surgery service: Improving resident education and patient care.

PubMed

Kantor, Olga; Schneider, Andrew B; Rojnica, Marko; Benjamin, Andrew J; Schindler, Nancy; Posner, Mitchell C; Matthews, Jeffrey B; Roggin, Kevin K

2017-03-01

To simulate the duties and responsibilities of an attending surgeon and allow senior residents more intraoperative and perioperative autonomy, our program created a new resident acute care surgery consult service. We structured resident acute care surgery as a new admitting and inpatient consult service managed by chief and senior residents with attending supervision. When appropriate, the chief resident served as a teaching assistant in the operation. Outcomes were recorded prospectively and reviewed at weekly quality improvement conferences. The following information was collected: (1) teaching assistant case logs for senior residents preimplentation (n = 10) and postimplementation (n = 5) of the resident acute care surgery service; (2) data on the proportion of each case performed independently by residents; (3) resident evaluations of the resident acute care surgery versus other general operative services; (4) consult time for the first 12 months of the service (June 2014 to June 2015). During the first year after implementation, the number of total teaching assistant cases logged among graduating chief residents increased from a mean of 13.4 ± 13.0 (range 4-44) for preresident acute care surgery residents to 30.8 ± 8.8 (range 27-36) for postresident acute care surgery residents (P < .01). Of 323 operative cases, the residents performed an average of 82% of the case independently. There was a significant increase in the satisfaction with the variety of cases (mean 5.08 vs 4.52, P < .01 on a 6-point Likert scale) and complexity of cases (mean 5.35 vs 4.94, P < .01) on service evaluations of resident acute care surgery (n = 27) in comparison with other general operative services (n = 127). In addition, creation of a 1-team consult service resulted in a more streamlined consult process with average consult time of 22 minutes for operative consults and 25 minutes for nonoperative consults (range 5-90 minutes). The implementation of a resident acute care surgery service has increased resident autonomy, teaching assistant cases, and satisfaction with operative case variety, as well as the efficiency of operative consultation at our institution. Copyright © 2016 Elsevier Inc. All rights reserved.

A relational perspective on autonomy for older adults residing in nursing homes.

PubMed

Sherwin, Susan; Winsby, Meghan

2011-06-01

To review critically the traditional concept of autonomy, propose an alternative relational interpretation of autonomy, and discuss how this would operate in identifying and addressing ethical issues that arise in the context of nursing home care for older adults. Respect for patient autonomy has been the cornerstone of clinical bioethics for several decades. Important though this principle is, there is debate on how to interpret the core concept of autonomy. We review the appeal of the traditional approach to autonomy in health care and then identify some of the difficulties with this conception. We use philosophical methods to explain and discuss the traditional and relational conceptions of autonomy and we illuminate our discussion with examples of various contextual applications. We support the relational conception of autonomy as offering a richer, more contextualized understanding of autonomy which attends to the social, political and economic conditions that serve as background to an agent's deliberations. To illuminate these ideas, we discuss the situation of frail older adults who frequently find their autonomy limited not only by their medical conditions but also by cultural prejudices against the aged and by the conditions commonly found within the nursing homes in which many reside. We propose ways of improving the relational autonomy of this population. © 2010 Blackwell Publishing Ltd.

A relational perspective on autonomy for older adults residing in nursing homes

PubMed Central

Sherwin, Susan; Winsby, Meghan

2011-01-01

Abstract Aim  To review critically the traditional concept of autonomy, propose an alternative relational interpretation of autonomy, and discuss how this would operate in identifying and addressing ethical issues that arise in the context of nursing home care for older adults. Background  Respect for patient autonomy has been the cornerstone of clinical bioethics for several decades. Important though this principle is, there is debate on how to interpret the core concept of autonomy. We review the appeal of the traditional approach to autonomy in health care and then identify some of the difficulties with this conception. Methods  We use philosophical methods to explain and discuss the traditional and relational conceptions of autonomy and we illuminate our discussion with examples of various contextual applications. Conclusion  We support the relational conception of autonomy as offering a richer, more contextualized understanding of autonomy which attends to the social, political and economic conditions that serve as background to an agent’s deliberations. To illuminate these ideas, we discuss the situation of frail older adults who frequently find their autonomy limited not only by their medical conditions but also by cultural prejudices against the aged and by the conditions commonly found within the nursing homes in which many reside. We propose ways of improving the relational autonomy of this population. PMID:21029285

Motivating Proteges' Personal Learning in Teams: A Multilevel Investigation of Autonomy Support and Autonomy Orientation

ERIC Educational Resources Information Center

Liu, Dong; Fu, Ping-ping

2011-01-01

This study examined the roles of 3 multilevel motivational predictors in proteges' personal learning in teams: an autonomy-supportive team climate, mentors' autonomy support, and proteges' autonomy orientation. The authors followed 305 proteges in 58 teams for 12 weeks and found that all 3 predictors were positively related to the proteges'…

The Relationship between University Autonomy and Funding in England and Taiwan

ERIC Educational Resources Information Center

Chiang, Li-Chuan

2004-01-01

This paper aims to re-examine the effects of funding on university autonomy since the relationship between university autonomy and funding is likely to be interpreted as a linear effect; namely, the more funding the greater autonomy. Such a simplistic vision is less than complete since it ignores the complicated nature of university autonomy. The…

Desire for Increased Autonomy and Adolescents' Perceptions of Peer Autonomy: "Everyone Else Can; Why Can't I?"

ERIC Educational Resources Information Center

Daddis, Christopher

2011-01-01

Two studies examined adolescents' personal autonomy beliefs and their perceptions of peer autonomy. Study 1 sampled 527 adolescents (M = 15.40 years) and found that adolescents desired increased autonomy most over personal and multifaceted issues and least over moral and conventional issues. Younger adolescents and girls desired increased autonomy…

The Relationship between Teacher Autonomy and Stress, Work Satisfaction, Empowerment, and Professionalism

ERIC Educational Resources Information Center

Pearson, L. Carolyn; Moomaw, William

2005-01-01

The purpose of this study was to examine the relationship between teacher autonomy and on-the-job stress, work satisfaction, empowerment, and professionalism. Using a reliable and valid measure of curriculum autonomy and general teaching autonomy (TAS), it was found that as curriculum autonomy increased on-the-job stress decreased, but there was…

Threats to Autonomy in Consumer Societies and Their Implications for Education

ERIC Educational Resources Information Center

Schinkel, Anders; de Ruyter, Doret; Steutel, Jan

2010-01-01

The development of autonomy in children is a central concern of liberal philosophers of education. We endorse the liberal intuition that autonomy matters and that it is an appropriate aim of education. However, we divert from autonomy liberals, who defend a rather limited and demanding conception of autonomy that is closely connected with skills…

School Autonomy and District Support: How Principals Respond to a Tiered Autonomy Initiative in Philadelphia Public Schools

ERIC Educational Resources Information Center

Steinberg, Matthew P.; Cox, Amanda Barrett

2017-01-01

A tiered autonomy policy was recently implemented in Philadelphia, where select principals were granted autonomy to manage school operations while others were promised greater district support to improve school functioning. This article provides evidence on how principals used their autonomy and the extent of district support for non-autonomous…

On the Association between Adolescent Autonomy and Psychosocial Functioning: Examining Decisional Independence from a Self-Determination Theory Perspective

ERIC Educational Resources Information Center

Van Petegem, Stijn; Beyers, Wim; Vansteenkiste, Maarten; Soenens, Bart

2012-01-01

In the present study, we focus on the concept of adolescent autonomy and its relation with psychosocial functioning. Specifically, we aim to differentiate between 2 prevailing conceptualizations of autonomy, that is, (a) autonomy defined as independence versus dependence and (b) autonomy defined as self-endorsed versus controlled functioning. A…

Relations of Behavioral Autonomy to Health Outcomes Among Emerging Adults With and Without Type 1 Diabetes

PubMed Central

Reynolds, Kerry A.; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

2014-01-01

Objective To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. Methods High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. Results There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Conclusions Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. PMID:25157070

Design and Laboratory Implementation of Autonomous Optimal Motion Planning for Non-Holonomic Planetary Rovers

DTIC Science & Technology

2012-12-01

autonomy helped to maximize a Mars day journey, because humans could only plan the first portion of the journey based on images sent from the rover...safe trajectory based on its sensors [1]. The distance between Mars and Earth ranges from 100-200 million miles [1] and at this distance, the time...This feature worked for the pre- planned maneuvers, which were planned by humans the day before based on available sensory and visual inputs. Once the

On operator strategic behavior

NASA Technical Reports Server (NTRS)

Hancock, P. A.

1991-01-01

Deeper and more detailed knowledge as to how human operators such as pilots respond, singly and in groups, to demands on their performance which arise from technical systems will support the manipulation of such systems' design in order to accommodate the foibles of human behavior. Efforts to understand how self-autonomy impacts strategic behavior and such related issues as error generation/recognition/correction are still in their infancy. The present treatment offers both general and aviation-specific definitions of strategic behavior as precursors of prospective investigations.

Affordance Templates for Shared Robot Control

NASA Technical Reports Server (NTRS)

Hart, Stephen; Dinh, Paul; Hambuchen, Kim

2014-01-01

This paper introduces the Affordance Template framework used to supervise task behaviors on the NASA-JSC Valkyrie robot at the 2013 DARPA Robotics Challenge (DRC) Trials. This framework provides graphical interfaces to human supervisors that are adjustable based on the run-time environmental context (e.g., size, location, and shape of objects that the robot must interact with, etc.). Additional improvements, described below, inject degrees of autonomy into instantiations of affordance templates at run-time in order to enable efficient human supervision of the robot for accomplishing tasks.

Mars, the Moon, and the Ends of the Earth: Autonomy for Small Reactor Power Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wood, Richard Thomas

2008-01-01

In recent years, the National Aeronautics and Space Administration (NASA) has been considering deep space missions that utilize a small-reactor power system (SRPS) to provide energy for propulsion and spacecraft power. Additionally, application of SRPS modules as a planetary power source is being investigated to enable a continuous human presence for nonpolar lunar sites and on Mars. A SRPS can supply high-sustained power for space and surface applications that is both reliable and mass efficient. The use of small nuclear reactors for deep space or planetary missions presents some unique challenges regarding the operations and control of the power system.more » Current-generation terrestrial nuclear reactors employ varying degrees of human control and decision-making for operations and benefit from periodic human interaction for maintenance. In contrast, the control system of a SRPS employed for deep space missions must be able to accommodate unattended operations due to communications delays and periods of planetary occlusion while adapting to evolving or degraded conditions with no opportunity for repair or refurbishment. While surface power systems for planetary outposts face less extreme delays and periods of isolation and may benefit from limited maintenance capabilities, considerations such as human safety, resource limitations and usage priorities, and economics favor minimizing direct, continuous human interaction with the SRPS for online, dedicated power system management. Thus, a SRPS control system for space or planetary missions must provide capabilities for operational autonomy. For terrestrial reactors, large-scale power plants remain the preferred near-term option for nuclear power generation. However, the desire to reduce reliance on carbon-emitting power sources in developing countries may lead to increased consideration of SRPS modules for local power generation in remote regions that are characterized by emerging, less established infrastructures. Additionally, many Generation IV (Gen IV) reactor concepts have goals for optimizing investment recovery and economic efficiency that promote significant reductions in plant operations and maintenance staff over current-generation nuclear power plants. To accomplish these Gen IV goals and also address the SRPS remote-siting challenges, higher levels of automation, fault tolerance, and advanced diagnostic capabilities are needed to provide nearly autonomous operations with anticipatory maintenance. Essentially, the SRPS control system for several anticipated terrestrial applications can benefit from the kind of operational autonomy that is necessary for deep space and planetary SRPS-enabled missions. Investigation of the state of the technology for autonomous control confirmed that control systems with varying levels of autonomy have been employed in robotic, transportation, spacecraft, and manufacturing applications. As an example, NASA has pursued autonomy for spacecraft and surface exploration vehicles (e.g., rovers) to reduce mission costs, increase efficiency for communications between ground control and the vehicle, and enable independent operation of the vehicle during times of communications blackout. However, autonomous control has not been implemented for an operating terrestrial nuclear power plant nor has there been any experience beyond automating simple control loops for space reactors. Current automated control technologies for nuclear power plants are reasonably mature, and fully automated control of normal SRPS operations is clearly feasible. However, the space-based and remote terrestrial applications of SRPS modules require autonomous capabilities that can accommodate nonoptimum operations when degradation, failure, and other off-normal events challenge the performance of the reactor while immediate human intervention is not possible. The independent action provided by autonomous control, which is distinct from the more limited self action of automated control, can satisfy these conditions. Key characteristics that distinguish autonomous control include: (1) intelligence to confirm system performance and detect degraded or failed conditions, (2) optimization to minimize stress on SRPS components and efficiently react to operational events without compromising system integrity, (3) robustness to accommodate uncertainties and changing conditions, and (4) flexibility and adaptability to accommodate failures through reconfiguration among available control system elements or adjustment of control system strategies, algorithms, or parameters.« less

The assisted presentations of self in nursing home life.

PubMed

Næss, Anders; Fjær, Eivind Grip; Vabø, Mia

2016-02-01

In this paper, based on ethnographic data from five nursing homes, we introduce the concept of assisted self-presentation as an analytical tool for exploring how different care practices affect nursing home residents' dignity and sense of self. Practices of assisted self-presentation are geared at recognizing and preserving the individuality and autonomy of residents in situations where it may otherwise come under threat or be misrecognized. Sufficient or appropriate forms of attentiveness to residents' selves and sense of dignity is thus a matter of finding the right balance between intervening too much or too little in residents' production of their physical or social appearance. Here, staff-members' knowledge and recognition of the individuality of residents is essential. Whereas intervening too much in residents' appearance or performance of self might be perceived and experienced as pacifying, infantilizing, or as paternalistic overbearingness, intervening too little might be seen as neglectfulness or inhumane. Since practices of assisted self-presentation refer to a kind of social action, which will always be contingent upon the specific capacities and conditions of performing actors, it allows for the simultaneous recognition of failed or perverted work practices as well as promising practices through which residents' selves are successfully recognized. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cognitive architectures and autonomy: Commentary and Response

NASA Astrophysics Data System (ADS)

2012-11-01

Editors: Włodzisław Duch / Ah-Hwee Tan / Stan Franklin Autonomy for AGI Cristiano Castelfranchi 31 Are Disembodied Agents Really Autonomous? Antonio Chella 33 The Perception-…-Action Cycle Cognitive Architecture and Autonomy: the View from the Brain Vassilis Cutsuridis 36 Autonomy Requires Creativity and Meta-Learning Włodzisław Duch 39 Meta Learning, Change of Internal Workings, and LIDA Ryan McCall / Stan Franklin 42 An Appeal for Declaring Research Goals Brandon Rohrer 45 The Development of Cognition as the Basis for Autonomy Frank van der Velde 47 Autonomy and Intelligence Pei Wang 49 Autonomy, Isolation, and Collective Intelligence Nikolaos Mavridis 51 Response to Comments Kristinn R. Thórisson / Helgi Páll Helgasson 56

The appearance of Kant's deontology in contemporary Kantianism: concepts of patient autonomy in bioethics.

PubMed

Secker, B

1999-02-01

Kant's concept of autonomy and the Kantian notion of autonomy are often conflated in bioethics. However, the contemporary Kantian notion has very little at all to do with Kant's original. In order to further bioethics discourse on autonomy, I critically distinguish the contemporary Kantian notion from Kant's original concept of moral autonomy. I then evaluate the practical relevance of both concepts of autonomy for use in bioethics. I argue that it is not appropriate to appeal to either concept toward assessing which patients we ought to respect as autonomous. Finally, I sketch criteria for what I take to be a more promising concept of autonomy for patients.

The clinician's dilemma: two dimensions of ethical care.

PubMed

Gillett, Grant; Chamberlain, Joshua

2013-01-01

There is a continuing intense medico-ethico-legal debate around legalized euthanasia and physician assisted suicide such that ethically informed clinicians often agree with the arguments but feel hesitant about the conclusion, especially when it may bring about a change in law. We argue that this confusion results from the convergence of two continua that underpin the conduct of a clinician and are especially prominent in psychiatry. The two continua concern the duty of care and the importance of patient autonomy and they do not quite map into traditional divides in debates about sanctity of life, paternalism, and autonomy. As ethical dimensions, they come into sharp focus in the psychological complexities of end-of-life care and they form two key factors in most ethical and legal or disciplinary deliberations about a clinician's actions. Whereas both dimensions are important when a clinician reflects on what s/he has done or should do, they need careful balancing in a request for euthanasia or physician assisted suicide where the patient wants to take a decisive role in his or her own end-of-life care. However, end-of-life is also a situation where clinicians often encounter 'cries for help' so that both continua are importantly in play. Balancing these two continua without using blunt legal instruments is often required in psychiatric care in such a way as to problematize the idea that patient decisions should dominate the care options available. A simplistic approach to that issue arguably plays into what has been called an 'impoverished construction of life and death' and, some would say, devalues the basic commitments fundamental to medical care. Copyright © 2013 Elsevier Ltd. All rights reserved.

Professional Caregivers’ Perceptions on how Persons with Mild Dementia Might Experience the Usage of a Digital Photo Diary

PubMed Central

Harrefors, Christina; Sävenstedt, Stefan; Lundquist, Anders; Lundquist, Bengt; Axelsson, Karin

2012-01-01

Cognitive impairments influence the possibility of persons with dementia to remember daily events and maintain a sense of self. In order to address these problems a digital photo diary was developed to capture information about events in daily life. The device consisted of a wearable digital camera, smart phone with Global Positioning System (GPS) and a home memory station with computer for uploading the photographs and touch screen. The aim of this study was to describe professional caregiver’s perceptions on how persons with mild dementia might experience the usage of this digital photo diary from both a situation when wearing the camera and a situation when viewing the uploaded photos, through a questionnaire with 408 respondents. In order to catch the professional caregivers’ perceptions a questionnaire with the semantic differential technique was used and the main question was “How do you think Hilda (the fictive person in the questionnaire) feels when she is using the digital photo diary?”. The factor analysis revealed three factors; Sense of autonomy, Sense of self-esteem and Sense of trust. An interesting conclusion that can be drawn is that professional caregivers had an overall positive view of the usage of digital photo diary as supporting autonomy for persons with mild dementia. The meaningfulness of each situation when wearing the camera and viewing the uploaded pictures to be used in two different situations and a part of an integrated assistive device has to be considered separately. Individual needs and desires of the person who is living with dementia and the context of each individual has to be reflected on and taken into account before implementing assistive digital devices as a tool in care. PMID:22509232

A qualitative study of the determinants of dieting and non-dieting approaches in overweight/obese Australian adults

PubMed Central

2012-01-01

Background Dieting has historically been the main behavioural treatment paradigm for overweight/obesity, although a non-dieting paradigm has more recently emerged based on the criticisms of the original dieting approach. There is a dearth of research contrasting why these approaches are adopted. To address this, we conducted a qualitative investigation into the determinants of dieting and non-dieting approaches based on the perspectives and experiences of overweight/obese Australian adults. Methods Grounded theory was used inductively to generate a model of themes contrasting the determinants of dieting and non-dieting approaches based on the perspectives of 21 overweight/obese adults. Data was collected using semi-structured interviews to elicit in-depth individual experiences and perspectives. Results Several categories emerged which distinguished between the adoption of a dieting or non-dieting approach. These categories included the focus of each approach (weight/image or lifestyle/health behaviours); internal or external attributions about dieting failure; attitudes towards established diets, and personal autonomy. Personal autonomy was also influenced by another category; the perceived knowledge and self-efficacy about each approach, with adults more likely to choose an approach they knew more about and were confident in implementing. The time perspective of change (short or long-term) and the perceived identity of the person (fat/dieter or healthy person) also emerged as determinants of dieting or non-dieting approaches respectively. Conclusions The model of determinants elicited from this study assists in understanding why dieting and non-dieting approaches are adopted, from the perspectives and experiences of overweight/obese adults. Understanding this decision-making process can assist clinicians and public health researchers to design and tailor dieting and non-dieting interventions to population subgroups that have preferences and characteristics suitable for each approach. PMID:23249115

Does autonomy for public hospitals in developing countries increase performance? Evidence-based case studies.

PubMed

De Geyndt, Willy

2017-04-01

Governments in middle and low income countries have sought ways for the past decades to make their public hospitals more performing. The objectives of this assessment are to: (a) synthesize the experience of eleven countries at granting autonomy to their public hospitals and the obstacles encountered; (b) deduce which autonomy policies have or have not been effective documenting successes and failures; and (c) propose evidence-based recommendations to policy makers. Data for five countries are derived from the author's participation in the autonomy process augmented by current updates provided by national colleagues. Data for the other six countries are derived from publications available in the literature. Policies granting autonomy to public hospitals have had limited success. In all cases Boards of Directors have been created. Governance of autonomized hospitals by Boards however is obstructed by the resistance of central level entities to have their authority diminished. The Ministry of Finance tends to maintain control over revenues and expenditures. The Public Service Commission resists abdicating its role to hire, promote, transfer and dismiss government employees. The Ministry of Health attempts to keep its authority to appoint hospital staff, procure medical supplies and equipment; it may do so directly or indirectly by selecting and appointing Board members. Management information systems continue to collect activity measures to be aggregated at the national level for statistical purposes and do not provide financial and clinical data useful for decision making by the Boards and by senior management. Decentralizing decision making to the operational level has had limited success. Stakeholders at the central level devise strategies to maintain their power. Two main obstacles are delegating authority over human resources and finances that are sine qua non conditions for governing and increasing the performance of public hospitals. Copyright © 2017 Elsevier Ltd. All rights reserved.

Feminists on the inalienability of human embryos.

PubMed

McLeod, Carolyn; Baylis, Francoise

2006-01-01

The feminist literature against the commodification of embryos in human embryo research includes an argument to the effect that embryos are "intimately connected" to persons, or morally inalienable from them. We explore why embryos might be inalienable to persons and why feminists might find this view appealing. But, ultimately, as feminists, we reject this view because it is inconsistent with full respect for women's reproductive autonomy and with a feminist conception of persons as relational, embodied beings. Overall, feminists should avoid claims about embryos' being inalienable to persons in arguments for or against the commodification of human embryos.

Technology assessment of human spaceflight - Combining philosophical and technical issues

NASA Astrophysics Data System (ADS)

Fromm, J.; Hoevelmann, G. H.

1992-08-01

A transutilitarian rationale is proposed for assessing human spaceflight that is based on objectives for these endeavors and ethical norms of conduct. Specific attention is given to: presupposed/tacit reasons for including man in spaceflight and the restricted notion of rational/justifiable activity. It is shown that economic rationale is insufficient and unsuitable as a means for assessing manned spaceflight, and transutilitarian objectives are compiled that contribute to the motivation for manned flight. The transutilitarian motivations include: pioneering uncharted territory, enhancing national prestige, establishing space-related autonomy, promoting international cooperation, and enhancing science and the quality of human life.

Human factors in space station architecture 1: Space station program implications for human factors research

NASA Technical Reports Server (NTRS)

Cohen, M. M.

1985-01-01

The space station program is based on a set of premises on mission requirements and the operational capabilities of the space shuttle. These premises will influence the human behavioral factors and conditions on board the space station. These include: launch in the STS Orbiter payload bay, orbital characteristics, power supply, microgravity environment, autonomy from the ground, crew make-up and organization, distributed command control, safety, and logistics resupply. The most immediate design impacts of these premises will be upon the architectural organization and internal environment of the space station.

Restoration process of the need for autonomy: the early alarm stage.

PubMed

Radel, Rémi; Pelletier, Luc G; Sarrazin, Philippe; Milyavskaya, Marina

2011-11-01

Autonomy is described by self-determination theory as a basic psychological need, essential for individuals' well-being. While basic needs are generally thought to induce a restorative response when thwarted, evidence for such a process is lacking for autonomy. To date, most evidence indicates that autonomy deprivation leads to disaffection of this need in favor of other motives. A temporal model based on the general adaptation syndrome was adapted to reconcile this seeming contradiction. Specifically, it is hypothesized that an early alarm response aimed at restoring the satisfaction of the need for autonomy should precede the later relinquishment and compensation of this need that would result from a prolonged deprivation. Three studies provide support for this model by showing the existence of the immediate autonomy restorative response. Using a controlling situation to manipulate autonomy deprivation, the authors demonstrate in Experiments 1 and 2 that a controlling context leads to enhanced accessibility and an approach bias for autonomy-related stimuli. Experiment 3 indicates that the urge to restore autonomy can also affect personal judgment, leading individuals to make more independent judgments, exercising a nonreactive form of autonomy. Integration of this model within self-determination theory is discussed.

The importance of autonomy support and the mediating role of work motivation for well-being: testing self-determination theory in a Chinese work organisation.

PubMed

Nie, Youyan; Chua, Bee Leng; Yeung, Alexander Seeshing; Ryan, Richard M; Chan, Wai Yen

2015-08-01

We examine relations between perceived organisational autonomy support and different types of work motivation and well-being outcomes in 266 teachers from two government schools in China. We hypothesised that greater autonomy support would be associated with more autonomous forms of employee motivation, and that teacher motivation would in turn mediate the effects of autonomy support on indicators of work well-being (i.e., job satisfaction, work stress and physical ill symptoms). Results generally supported the hypothesised relations between perceived autonomy support and SDT's five types of motivations. Findings also showed that perceived autonomy support predicted job satisfaction directly and indirectly through the mediating roles of intrinsic motivation, identified regulation, introjected regulation and external regulation. Perceived autonomy support predicted work stress directly and indirectly through the mediating roles of external regulation and amotivation. Autonomy support also predicted illness symptoms via the mediating roles of intrinsic motivation, introjected regulation and amotivation. The current findings highlight how perceived organisational support for autonomy relates to motivational differences in a Chinese work context, and the potential relevance of autonomy support for employee well-being. © 2014 International Union of Psychological Science.

Autonomy support for autonomous motivation in medical education.

PubMed

Kusurkar, Rashmi A; Croiset, Gerda

2015-01-01

Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT) classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.

Perceived environmental barriers to outdoor mobility and changes in sense of autonomy in participation outdoors among older people: a prospective two-year cohort study.

PubMed

Rantakokko, Merja; Portegijs, Erja; Viljanen, Anne; Iwarsson, Susanne; Kauppinen, Markku; Rantanen, Taina

2017-08-01

The aim was to study whether perceived environmental barriers to outdoor mobility affect changes in sense of autonomy in participation outdoors among community-dwelling older people over a two-year period. Community-dwelling people aged 75-90 years (n = 848) in central Finland were interviewed on two occasions, face-to-face at baseline and over the telephone two years later. Perceived environmental barriers to outdoor mobility were assessed using a 15-item structured questionnaire, and the sum scores categorized into tertiles (0, 1 and 2 or more barriers). Autonomy in participation outdoors was assessed with the 'Impact on Participation and Autonomy' (IPA) questionnaire using the autonomy outdoors subscale (score range 0-20, higher scores indicating more restricted autonomy). Scores for autonomy in participation outdoors were available for 848 participants at baseline (mean 6.2, SD = 3.8) and for 748 participants at the two-year follow-up (mean 6.7, SD = 3.9). At baseline, those reporting multiple environmental barriers had the most restricted autonomy, while those reporting no environmental barriers had the least restricted autonomy (p < .001). Over the follow-up, autonomy in participation outdoors declined more among those reporting multiple environmental barriers compared to those reporting none (age- and sex-adjusted group*time β = .629, s.e. = .277, p = .023). Adjustment for cognitive functioning, education, number of chronic conditions and change in walking difficulty did not influence the association. Perceived environmental barriers to outdoor mobility accelerate the decline in autonomy in participation outdoors among older community-dwelling people. Understanding factors affecting autonomy can help in finding ways to support the sense of autonomy as people age.

Autonomy support for autonomous motivation in medical education.

PubMed

Kusurkar, Rashmi A; Croiset, Gerda

2015-01-01

Background Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT) classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Discussion Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Conclusion Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.

Women's Autonomy and Its Correlates in Western Nepal: A Demographic Study.

PubMed

Bhandari, Tulsi Ram; Kutty, V Raman; Ravindran, T K Sundari

2016-01-01

Despite various efforts for enhancing women's autonomy in developing countries, many women are deprived of their capacity in decision-making on their household affairs as well as social issues. This paper aimed to examine women's autonomy and its associated factors in the Kapilvastu district of Nepal. We measured women's autonomy using a recently developed women's autonomy measurement scale from June to October 2014. Descriptive statistics, chi-square test and logistic multivariate modeling technique were applied for assessing the association of demographic and socio-economic characteristics of women and their autonomy. Mean score for women's autonomy was 23.34 ± 8.06 out of the possible maximum 48. It was found to be positively associated with higher age difference at marriage, advantaged caste/ethnicity, better employment for the husband, couple's education more than 10 years schooling, and higher economic status of the household. We found strong direct effect of women's education (OR = 8.14, CI = 3.77-17.57), husband's education (OR = 2.63, CI = 1.69-4.10) and economic status of household (OR = 1.42, CI = 1.01-2.03) on women's autonomy. When we adjusted women's education for husband's education, the odds ratio decreased by around 22% {from (OR = 8.14, CI = 3.77-17.57) to (OR = 6.32, CI = 2.77-14.46)} and was a mediator effect. The economic status of household also had mediator effect on women's autonomy through their education. Education status of women is a key predictor of women's autonomy in Kapilvastu district. Husband's education and economic status of the household are other important predictors of women's autonomy which have a mediator effect on women's autonomy. Improving educational status and economic conditions of both women and their husbands may be the best solution to promote women's autonomy.

Autonomy support for autonomous motivation in medical education

PubMed Central

Kusurkar, Rashmi A.; Croiset, Gerda

2015-01-01

Background Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT) classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Discussion Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Conclusion Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching. PMID:25953033

Eggs and Abortion: "Women-Protective" Language Used by Opponents in Legislative Debates over Reproductive Health.

PubMed

Jesudason, Sujatha; Weitz, Tracy

2015-01-01

In this paper we undertake an examination of the presence of similar "women-protective" discourses in policy debates occurring over two bills on reproductive-related topics considered during the 2013 California legislature session. The first bill (AB154), now signed into law, allows nurse practitioners, certified nurse midwives, and physician assistants to perform first-trimester aspiration abortions. The second bill (AB926), had it passed, would remove the prohibition on paying women for providing eggs to be used for research purposes. Using frame analysis we find evidence of similar protective arguments by opponents of both bills, although these advocates do not share ideological positions on abortion rights or women's autonomy. In the case of AB154, anti-abortion advocates use language and frames that call for protecting the health of women against the imputed interests of the "abortion industry." In the case of AB926, feminists and pro-choice advocates evoke similar frameworks for the protection of women against the interests of the "medical research industry." Both sides argue for the "protection of women," from opposing positions on the rights and autonomy of women in relationship to reproductive freedom. © 2015 American Society of Law, Medicine & Ethics, Inc.

Integration of multisensor hybrid reasoners to support personal autonomy in the smart home.

PubMed

Valero, Miguel Ángel; Bravo, José; Chamizo, Juan Manuel García; López-de-Ipiña, Diego

2014-09-17

The deployment of the Ambient Intelligence (AmI) paradigm requires designing and integrating user-centered smart environments to assist people in their daily life activities. This research paper details an integration and validation of multiple heterogeneous sensors with hybrid reasoners that support decision making in order to monitor personal and environmental data at a smart home in a private way. The results innovate on knowledge-based platforms, distributed sensors, connected objects, accessibility and authentication methods to promote independent living for elderly people. TALISMAN+, the AmI framework deployed, integrates four subsystems in the smart home: (i) a mobile biomedical telemonitoring platform to provide elderly patients with continuous disease management; (ii) an integration middleware that allows context capture from heterogeneous sensors to program environment's reaction; (iii) a vision system for intelligent monitoring of daily activities in the home; and (iv) an ontologies-based integrated reasoning platform to trigger local actions and manage private information in the smart home. The framework was integrated in two real running environments, the UPM Accessible Digital Home and MetalTIC house, and successfully validated by five experts in home care, elderly people and personal autonomy.

Integration of Multisensor Hybrid Reasoners to Support Personal Autonomy in the Smart Home

PubMed Central

Valero, Miguel Ángel; Bravo, José; Chamizo, Juan Manuel García; López-de-Ipiña, Diego

2014-01-01

The deployment of the Ambient Intelligence (AmI) paradigm requires designing and integrating user-centered smart environments to assist people in their daily life activities. This research paper details an integration and validation of multiple heterogeneous sensors with hybrid reasoners that support decision making in order to monitor personal and environmental data at a smart home in a private way. The results innovate on knowledge-based platforms, distributed sensors, connected objects, accessibility and authentication methods to promote independent living for elderly people. TALISMAN+, the AmI framework deployed, integrates four subsystems in the smart home: (i) a mobile biomedical telemonitoring platform to provide elderly patients with continuous disease management; (ii) an integration middleware that allows context capture from heterogeneous sensors to program environment's reaction; (iii) a vision system for intelligent monitoring of daily activities in the home; and (iv) an ontologies-based integrated reasoning platform to trigger local actions and manage private information in the smart home. The framework was integrated in two real running environments, the UPM Accessible Digital Home and MetalTIC house, and successfully validated by five experts in home care, elderly people and personal autonomy. PMID:25232910

Management of mutual health organizations in Ghana.

PubMed

Baltussen, R; Bruce, E; Rhodes, G; Narh-Bana, S A; Agyepong, I

2006-05-01

Mutual Health Organizations (MHO) emerged in Ghana in the mid-1990s. The organizational structure and financial management of private and public MHO hold important lessons for the development of national health insurance in Ghana, but there is little evidence to date on their features. This paper aims at filling this data gap, and at making recommendations to Ghanaian authorities on how to stimulate the success of MHO. Survey among 45 private and public MHO in Ghana in 2004-2005, asking questions on their structure, financial management and financial position. Private MHO had more autonomy in setting premiums and benefit packages, and had higher community participation in meetings than public MHO. MHO in general had few measures in place to control moral hazard and reduce adverse selection, but more measures to control fraud and prevent cost escalation. The vast majority of schemes were managed by formally trained and paid staff. The financial results varied considerably. Ghanaian authorities regulate the newly established public MHO, but may do good by leaving them a certain level of autonomy in decision-making and secure community participation. The financial management of MHO is suboptimal, which indicates the need for technical assistance.

QUALITY OF LIFE AND HEALTH SELF-PERCEPTION IN CHILDREN WITH POOR SCHOOL PERFORMANCE.

PubMed

Rezende, Bárbara Antunes; Lemos, Stela Maris Aguiar; Medeiros, Adriane Mesquita de

2017-01-01

To examine the association between quality of life and health self-perception of children with poor school performance, considering sociodemographic factors. An analytical, observational, cross-sectional study was conducted with 99 children aged 7 to 12 years receiving specialized educational assistance. Parents and legal guardians answered questions concerning the sociodemographic profile. For an assessment of the quality of life and proposed domains (autonomy, functioning, leisure, and family), the children completed the Autoquestionnarie Qualité de Vie Enfant Imagé (AUQEI) and answered a question concerning their self-perceived health. Data were analyzed using multiple linear regression, considering a 5% significance level. Among the evaluated children, 69 (69.7%) male participants with mean age of 8.7±1.5, 27% self-assessed their health status as poor/very poor, and 36.4% of the children reported having impaired quality of life. As for the domains assessed by AUQEI, there was statistical significance in the associations between family with age, autonomy with economic classification, and leisure and functioning with self-perceived health. The quality of life of children with academic underachievement is associated with their health self-perception and sociodemographic characteristics.

Fear of Life, Fear of Death, and Fear of Causing Death: How Legislative Changes on Assisted Dying Are Doomed to Fail.

PubMed

Häyry, Matti

2018-01-01

Fear of life, fear of death, and fear of causing death form a combination that prevents reasoned changes in laws concerning end-of-life situations. This is shown systematically in this article using the methods of conceptual analysis. Prevalent fears are explicated and interpreted to see how their meanings differ depending on the chosen normative stance. When the meanings have been clarified, the impact of the fears on the motivations and justifications of potential legislative reforms are assessed. Two main normative stances are evoked. The first makes an appeal to individual self-determination, or autonomy, and the second to the traditional professional ethics of physicians. These views partly share qualifying elements, including incurability and irreversibility of the patient's medical condition, proximity of death, the unbearable nature of suffering, and issues of voluntariness further shade the matter. The conclusion is that although many motives to change end-of-life laws are admirable, they are partly contradictory, as are calls for autonomy and appeals to professional ethics; to a degree that good, principled legislative solutions remain improbable in the foreseeable future.

In the company of women: enacting autonomy within the perinatal nursing relationship.

PubMed

Goldberg, Lisa

2003-11-01

An understanding of autonomy has important significance in North American health care. Although a respect for autonomy is necessary to protect the self-determination and agency of birthing women in hospital settings, I suggest that enactments of autonomy that are independent of relationships offer only an incomplete interpretation of such a vital concept. In this article I explore an understanding of autonomy situated within the context of a relational birthing narrative. In so doing, autonomy becomes conceptualized as contextual and concrete, giving rise to an embodied view of the birthing woman.

Effects of women's autonomy on maternal healthcare utilization in Bangladesh: Evidence from a national survey.

PubMed

Haider, Mohammad Rifat; Qureshi, Zaina P; Khan, M Mahmud

2017-12-01

This study aims to construct an index of women's autonomy to analyze its effect on maternal healthcare utilization in Bangladesh. Empirical modeling of the study used instrumental variable (IV) approach to correct for possible endogeneity of women's autonomy variable. Data from the Bangladesh Demographic and Health Survey (BDHS) 2011 was used for the study. Women's autonomy variable was obtained through factor analysis of variables related to autonomy in decision making regarding healthcare, financial autonomy and freedom of movement. Conditional mixed process (CMP) models were fitted for three maternal healthcare indicators: at least four antenatal care (ANC) by trained personnel, institutional delivery and postnatal care (PNC) by trained personnel. Study sample consisted of 8753 women with 5.5 mean years of schooling. Women with no formal education, of Islamic faith, from poorest wealth quintile, residing in rural areas and with low autonomy used the maternal healthcare least. Marginal effect shows that if women's autonomy score is increased by one unit, probability of maternal healthcare utilization will increase by 0.14 for ANC, 0.14 for institutional delivery, and 0.13 for PNC. Women's autonomy is an important driver of maternal healthcare utilization in Bangladesh. Results suggest that women participating in social and economic activities enhances their autonomy. Other factors affecting women's autonomy are female literacy, educational attainment and households' economic status. Copyright © 2017 Elsevier B.V. All rights reserved.

Association between women's autonomy and family planning outcome in couples residing in Isfahan.

PubMed

Kohan, Shahnaz; Talebian, Ferdos; Ehsanpour, Soheila

2014-09-01

One of the important factors in the prediction of family planning outcome is paying attention to women's role in decision making concerning fertility and household affairs. With the improvement of women's status and autonomy, their control over fertility is expected to increase. The present study aimed to investigate the association between women's autonomy and family planning outcome of the couples residing in Isfahan. This is cross-sectional study. Two hundred and seventy women of childbearing age, eligible for family planning and residing in Isfahan, were selected through random cluster sampling and they filled a researcher-made questionnaire. Women's autonomy was measured with the questions on their decision-making autonomy concerning household affairs and physical mobility autonomy. The association between women's autonomy and family planning outcome was analyzed through statistical methods. The results showed that the mean of women's decision-making, physical mobility, and general autonomy was 50. Women's autonomy had a direct significant association with the type of contraception method (P = 0.01) and the length of usage of their present contraception method (P = 0.04) as well as where they received family planning services (P = 0.02). Analysis of data revealed women with higher autonomy used a more efficient contraception method and continued their contraception method for a longer time, which leads to improvement of couples' family planning outcome. Therefore, family planning services should be planned and provided with women's autonomy under consideration.

Human Mars Surface Science Operations

NASA Technical Reports Server (NTRS)

Bobskill, Marianne R.; Lupisella, Mark L.

2014-01-01

Human missions to the surface of Mars will have challenging science operations. This paper will explore some of those challenges, based on science operations considerations as part of more general operational concepts being developed by NASA's Human Spaceflight Architecture (HAT) Mars Destination Operations Team (DOT). The HAT Mars DOT has been developing comprehensive surface operations concepts with an initial emphasis on a multi-phased mission that includes a 500-day surface stay. This paper will address crew science activities, operational details and potential architectural and system implications in the areas of (a) traverse planning and execution, (b) sample acquisition and sample handling, (c) in-situ science analysis, and (d) planetary protection. Three cross-cutting themes will also be explored in this paper: (a) contamination control, (b) low-latency telerobotic science, and (c) crew autonomy. The present traverses under consideration are based on the report, Planning for the Scientific Exploration of Mars by Humans1, by the Mars Exploration Planning and Analysis Group (MEPAG) Human Exploration of Mars-Science Analysis Group (HEM-SAG). The traverses are ambitious and the role of science in those traverses is a key component that will be discussed in this paper. The process of obtaining, handling, and analyzing samples will be an important part of ensuring acceptable science return. Meeting planetary protection protocols will be a key challenge and this paper will explore operational strategies and system designs to meet the challenges of planetary protection, particularly with respect to the exploration of "special regions." A significant challenge for Mars surface science operations with crew is preserving science sample integrity in what will likely be an uncertain environment. Crewed mission surface assets -- such as habitats, spacesuits, and pressurized rovers -- could be a significant source of contamination due to venting, out-gassing and cleanliness levels associated with crew presence. Low-latency telerobotic science operations has the potential to address a number of contamination control and planetary protection issues and will be explored in this paper. Crew autonomy is another key cross-cutting challenge regarding Mars surface science operations, because the communications delay between earth and Mars could as high as 20 minutes one way, likely requiring the crew to perform many science tasks without direct timely intervention from ground support on earth. Striking the operational balance between crew autonomy and earth support will be a key challenge that this paper will address.

Interpersonal sensitivity is correlated with sociotropy but not with autonomy in healthy subjects.

PubMed

Otani, Koichi; Suzuki, Akihito; Kamata, Mitsuhiro; Matsumoto, Yoshihiko; Shibuya, Naoshi; Sadahiro, Ryoichi

2012-02-01

Interpersonal sensitivity is a depression-prone personality trait closely related to anxious attachment, whereas sociotropy and autonomy are personality vulnerability factors in the cognitive theory of depression. In the present study, the relationships of interpersonal sensitivity with sociotropy and autonomy were studied in 362 healthy subjects. Interpersonal sensitivity was assessed using the Interpersonal Sensitivity Measure (IPSM), whereas sociotropy and autonomy were evaluated using the Sociotropy and Autonomy subscales, respectively, of the Sociotropy-Autonomy Scale. The IPSM was significantly correlated with the Sociotropy subscale (β = 0.61, p < 0.001) but not with the Autonomy subscale. All subscales of the IPSM correlated significantly with the Sociotropy subscale, and the correlation for the Separation Anxiety subscale (β = 0.56, p < 0.001) was strongest. The present study suggests that interpersonal sensitivity is correlated with sociotropy but not with autonomy in healthy subjects.

Collectivists' contingency and autonomy as predictors of buffet preferences among Taiwanese adolescents.

PubMed

Chiou, Wen-Bin

2006-01-01

In a culture or society with high collectivism, contingent orientation and constrained autonomy are the prominent characteristics of adolescents' self-construal. This article examined whether Taiwanese adolescents' contingency and autonomy were associated with their prevalent preferences for buffet consumption. Findings in a panel survey indicated that contingency was positively correlated with adolescents' buffet preference, whereas autonomy was negatively correlated. Moreover, the results showed that adolescents' contingent orientation and perceived autonomy could predict their subsequent buffet preference over a half-year period. A laboratory experiment showed that adolescents who perceived lower autonomy exhibited greater preferences for buffet over the other diet consumption. In general, the results suggest that collectivist adolescents' contingency and autonomy were related to their trait-like preferences for buffet, and the state-like preferences for buffet were affected by their perceived levels of autonomy. Findings provide further insights into the impact of adolescents' self-construal on their diet consumption.

Autonomy and autonomy competencies: a practical and relational approach.

PubMed

Atkins, Kim

2006-10-01

This essay will address a general philosophical concern about autonomy, namely, that a conception of autonomy focused on freedom of the will alone is inadequate, once we consider the effects of oppressive forms of socialization on individuals' formation of choices. In response to this problem, I will present a brief overview of Diana Meyers's account of autonomy as relational and practical. On this view, autonomy consists in a set of socially acquired practical competencies in self-discovery, self-definition, self-knowledge, and self-direction. This account provides a distinction between choices that express unreflectively internalized social norms and those that are the result of a critical 'self-reading'. I conclude that this practical conception of autonomy makes much higher demands upon nurses (and patients) than has previously been thought. In fact, if nurses are to be expected to genuinely promote autonomy, they are going to need specific training in counselling-type communication skills.

Teacher Autonomy in the United States: Establishing a Standard Definition, Validation of a Nationally Representative Construct and an Investigation of Policy Affected Teacher Groups

ERIC Educational Resources Information Center

Gwaltney, Kevin Dale

2012-01-01

This effort: 1) establishes an autonomy definition uniquely tailored for teaching, 2) validates a nationally generalizable teacher autonomy construct, 3) demonstrates that the model describes and explains the autonomy levels of particular teacher groups, and 4) verifies the construct can represent teacher autonomy in other empirical models. The…

Patient-Perceived Autonomy and Long-Acting Reversible Contraceptive Use: A Qualitative Assessment in a Midwestern, University Community.

PubMed

Zeal, Carley; Higgins, Jenny A; Newton, Shaunna R

2018-01-01

Long-acting reversible contraceptives (LARCs) are the most effective contraceptives and are first-line recommendations for most women. However, young women use these methods at relatively low rates. Given concern with contraceptive coercion, an underexamined factor contributing to LARC attitudes is women's perceived reproductive and bodily autonomy in regard to LARC. We conducted focus group discussions and interviews regarding LARC perceptions and knowledge with 50 women between the ages of 18 and 29. We used a modified grounded theory approach to analyze young women's impressions of autonomy in relation to contraceptives more generally and LARC more specifically, both among ever-users and never-users. Four themes emerged regarding women's perceived autonomy with LARC. Control over pregnancy, active participation versus external agent, control over bleeding patterns, and autonomy in the provider/patient relationship. Within most themes, women made both positive and negative associations between perceived autonomy and LARC. The provider/patient relationship was a modifier of other themes, in that cooperative relationships may overshadow other perceived reductions in autonomy, and more unbalanced relationships may heighten perceived reductions in autonomy. Ever-users were more likely to report increased autonomy with LARC use, whereas never-users were more likely to express concerns about loss of autonomy with LARC. This study suggests that perceived autonomy may influence women's perceptions of LARC as well as their uptake of these contraceptive methods, with several factors both positively and negatively related to women's perceived autonomy. We encourage the integration of these findings into patient-centered counseling as well as educational materials for LARC.

Patient-Perceived Autonomy and Long-Acting Reversible Contraceptive Use: A Qualitative Assessment in a Midwestern, University Community

PubMed Central

Zeal, Carley; Higgins, Jenny A.; Newton, Shaunna R.

2018-01-01

Abstract Long-acting reversible contraceptives (LARCs) are the most effective contraceptives and are first-line recommendations for most women. However, young women use these methods at relatively low rates. Given concern with contraceptive coercion, an underexamined factor contributing to LARC attitudes is women's perceived reproductive and bodily autonomy in regard to LARC. We conducted focus group discussions and interviews regarding LARC perceptions and knowledge with 50 women between the ages of 18 and 29. We used a modified grounded theory approach to analyze young women's impressions of autonomy in relation to contraceptives more generally and LARC more specifically, both among ever-users and never-users. Four themes emerged regarding women's perceived autonomy with LARC. Control over pregnancy, active participation versus external agent, control over bleeding patterns, and autonomy in the provider/patient relationship. Within most themes, women made both positive and negative associations between perceived autonomy and LARC. The provider/patient relationship was a modifier of other themes, in that cooperative relationships may overshadow other perceived reductions in autonomy, and more unbalanced relationships may heighten perceived reductions in autonomy. Ever-users were more likely to report increased autonomy with LARC use, whereas never-users were more likely to express concerns about loss of autonomy with LARC. This study suggests that perceived autonomy may influence women's perceptions of LARC as well as their uptake of these contraceptive methods, with several factors both positively and negatively related to women's perceived autonomy. We encourage the integration of these findings into patient-centered counseling as well as educational materials for LARC. PMID:29588877