Lisa Dahlager - Academia.edu (original) (raw)
Papers by Lisa Dahlager
Social Science & Medicine, Oct 1, 2005
Tensions over ethics in research occasionally arise when anthropologists and other social scienti... more Tensions over ethics in research occasionally arise when anthropologists and other social scientists study health services in medical institutions. In order to resolve this type of conflict, and to facilitate mutual learning rather than mutual recrimination, we describe two general categories of research ethics framing: those of anthropology and those of medicine. The latter, we propose, has tended to focus on protection of the individual through preservation of autonomy-principally expressed through the requirement of informed consent-whereas the former has attended more to political implications. After providing few examples of concrete conflicts, we outline four issues that characterise the occasional clashes between social scientists and medical staff, and which deserve further consideration: (1) a discrepancy in the way anthropologists perceive patients and medical staff; (2) ambiguity concerning the role of medical staff in anthropological research; (3) impediments to informed consent in qualitative research projects; and (4) property rights in data. Our contention is that enhanced dialogue could serve to invigorate the ethical debate in both traditions.
Journal of Critical Care, Oct 1, 2020
Background: Life-threatening illness can be devastating for patients as they experience shifting ... more Background: Life-threatening illness can be devastating for patients as they experience shifting levels of consciousness, recurrent delirium, and repeated setbacks. Narrative Medicine and its sub-discipline Narrative Critical Care increase healthcare professionals' understanding of the patient perspective, and interpretation of their stories is a means to improving practice. Purpose: We aimed to investigate book length first-person accounts of critical illness to gain a deeper understanding of universal and individual patient responses and to provide an example of Narrative Critical Care. Method: We performed a comparative literary analysis of five books supported by the Biographical Narrative Interpretive Method (BNIM) that moves through stages of structural analysis, thematic analysis, and cross-case theoretisation. Findings: Universal patient responses evolved through five existential dichotomies of life/death, sanity/madness, before/after, gain/loss and inner strength/external support. Individual patient responses were expressed as turning points along the illness trajectory, and biographical continuity was restored by integration of new self and old self. Conclusion: We uncovered commonalities and differences in storied accounts of critical illness and survival. New insights might enable healthcare professionals to personalize patient care. More consistency is needed during transitions and rehabilitation of intensive care survivors.
PubMed, Sep 20, 1999
The increasing prevalence of obesity has created a need for alternative counselling sites. This r... more The increasing prevalence of obesity has created a need for alternative counselling sites. This retrospective study evaluates the results of a 12 week slimming course for obese subjects held at Danish pharmacies at one year follow-up. Two hundred and sixty-nine obese (BMI > 25 kg/m2, 32 +/- 4.5 [mean +/- SD]) paid 550 Dkr each for a 12 weeks slimming course held at 19 Danish pharmacies with groups of 8-20 subjects each. The age was between 18 to 81 years, 259 were females. The course included eight sessions of 1 1/2 hour education in nutrition and physiology aiming for a dietary change toward a low-fat, high carbohydrate diet. Self-reported body weight was assessed on at the pharmacy scale before and after the course and again after three, six and 12 months follow-up. One hundred and ninety-one or 71% of subjects completed the 12 week slimming programme. The average weight loss was 5.3 and 6.2 kg among females and males, respectively. The weight loss maintenance was assessed at one year follow-up in 122 (45%) of the subjects who entered the course and was 4.0 and 6.7 kg in 118 females and four males, respectively. At one year follow-up 40 subjects (20%) of the subjects who completed the course had maintained a weight loss > 5 kg. In conclusion, the initial weight loss, and maintenance and drop-out rate are comparable with results from general practitioners and hospital out-patient clinics, but the costs are substantially lower.
Distinktion: Journal Of Social Theory, 2001
... Ideen er, at personen har behov for forskellige former for statte, afhaengigt af hvilken fase... more ... Ideen er, at personen har behov for forskellige former for statte, afhaengigt af hvilken fase vedkommende befinder sig i. Samtalen betragtes sorn et vaerktraj ti1 at identificere, hvor i forandringsprocessen patienten befinder sig for hermed at kume yde den relevante statte ...
Maanedsskrift for Praktisk Laegegerning, May 1, 2016
Clinical Ethics, Mar 1, 2006
occupation with ethical issues from the late 1960s onwards, and a current sense of predicament. T... more occupation with ethical issues from the late 1960s onwards, and a current sense of predicament. The two traditions have differed remarkably, however, in their perception of ethical problems. Specifically, we suggest that anthropology has come to view the political implications of the research endeavour as a key concern, whereas medicine has focused on respect for the individual and the implications of acquiring or failing to acquire informed consent. The emergence of medical research ethics The medical profession has often referred to the Hippocratic Oath as its ethical foundation and has taken the principle of benevolence as its starting point, conditioned by the key restriction 'First, Do No Harm'. As medicine has broadened its parameters to include research, and as wider processes of democratization have changed the perception of the relationship between doctor and patient, the adequacy of the Hippocratic Oath has been questioned. A push for greater patient autonomy in medical research was globally initiated after World War II in the Nuremberg Code. Informed consent was stressed as a precondition for all medical research. Different medical events during the 1960s led to the World Medical Association's Declaration of Helsinki in 1964. The Declaration stressed that researchers should not take ethical responsibility entirely on themselves: a view later sustained by Henry Beecher's oft-cited whistle-blowing article in 1966. 1 The Tuskegee case and the following Belmont Report also
Routledge eBooks, Aug 15, 2023
Social Science & Medicine, Oct 1, 2005
Tensions over ethics in research occasionally arise when anthropologists and other social scienti... more Tensions over ethics in research occasionally arise when anthropologists and other social scientists study health services in medical institutions. In order to resolve this type of conflict, and to facilitate mutual learning rather than mutual recrimination, we describe two general categories of research ethics framing: those of anthropology and those of medicine. The latter, we propose, has tended to focus on protection of the individual through preservation of autonomy-principally expressed through the requirement of informed consent-whereas the former has attended more to political implications. After providing few examples of concrete conflicts, we outline four issues that characterise the occasional clashes between social scientists and medical staff, and which deserve further consideration: (1) a discrepancy in the way anthropologists perceive patients and medical staff; (2) ambiguity concerning the role of medical staff in anthropological research; (3) impediments to informed consent in qualitative research projects; and (4) property rights in data. Our contention is that enhanced dialogue could serve to invigorate the ethical debate in both traditions.
Journal of Critical Care, Oct 1, 2020
Background: Life-threatening illness can be devastating for patients as they experience shifting ... more Background: Life-threatening illness can be devastating for patients as they experience shifting levels of consciousness, recurrent delirium, and repeated setbacks. Narrative Medicine and its sub-discipline Narrative Critical Care increase healthcare professionals' understanding of the patient perspective, and interpretation of their stories is a means to improving practice. Purpose: We aimed to investigate book length first-person accounts of critical illness to gain a deeper understanding of universal and individual patient responses and to provide an example of Narrative Critical Care. Method: We performed a comparative literary analysis of five books supported by the Biographical Narrative Interpretive Method (BNIM) that moves through stages of structural analysis, thematic analysis, and cross-case theoretisation. Findings: Universal patient responses evolved through five existential dichotomies of life/death, sanity/madness, before/after, gain/loss and inner strength/external support. Individual patient responses were expressed as turning points along the illness trajectory, and biographical continuity was restored by integration of new self and old self. Conclusion: We uncovered commonalities and differences in storied accounts of critical illness and survival. New insights might enable healthcare professionals to personalize patient care. More consistency is needed during transitions and rehabilitation of intensive care survivors.
PubMed, Sep 20, 1999
The increasing prevalence of obesity has created a need for alternative counselling sites. This r... more The increasing prevalence of obesity has created a need for alternative counselling sites. This retrospective study evaluates the results of a 12 week slimming course for obese subjects held at Danish pharmacies at one year follow-up. Two hundred and sixty-nine obese (BMI > 25 kg/m2, 32 +/- 4.5 [mean +/- SD]) paid 550 Dkr each for a 12 weeks slimming course held at 19 Danish pharmacies with groups of 8-20 subjects each. The age was between 18 to 81 years, 259 were females. The course included eight sessions of 1 1/2 hour education in nutrition and physiology aiming for a dietary change toward a low-fat, high carbohydrate diet. Self-reported body weight was assessed on at the pharmacy scale before and after the course and again after three, six and 12 months follow-up. One hundred and ninety-one or 71% of subjects completed the 12 week slimming programme. The average weight loss was 5.3 and 6.2 kg among females and males, respectively. The weight loss maintenance was assessed at one year follow-up in 122 (45%) of the subjects who entered the course and was 4.0 and 6.7 kg in 118 females and four males, respectively. At one year follow-up 40 subjects (20%) of the subjects who completed the course had maintained a weight loss > 5 kg. In conclusion, the initial weight loss, and maintenance and drop-out rate are comparable with results from general practitioners and hospital out-patient clinics, but the costs are substantially lower.
Distinktion: Journal Of Social Theory, 2001
... Ideen er, at personen har behov for forskellige former for statte, afhaengigt af hvilken fase... more ... Ideen er, at personen har behov for forskellige former for statte, afhaengigt af hvilken fase vedkommende befinder sig i. Samtalen betragtes sorn et vaerktraj ti1 at identificere, hvor i forandringsprocessen patienten befinder sig for hermed at kume yde den relevante statte ...
Maanedsskrift for Praktisk Laegegerning, May 1, 2016
Clinical Ethics, Mar 1, 2006
occupation with ethical issues from the late 1960s onwards, and a current sense of predicament. T... more occupation with ethical issues from the late 1960s onwards, and a current sense of predicament. The two traditions have differed remarkably, however, in their perception of ethical problems. Specifically, we suggest that anthropology has come to view the political implications of the research endeavour as a key concern, whereas medicine has focused on respect for the individual and the implications of acquiring or failing to acquire informed consent. The emergence of medical research ethics The medical profession has often referred to the Hippocratic Oath as its ethical foundation and has taken the principle of benevolence as its starting point, conditioned by the key restriction 'First, Do No Harm'. As medicine has broadened its parameters to include research, and as wider processes of democratization have changed the perception of the relationship between doctor and patient, the adequacy of the Hippocratic Oath has been questioned. A push for greater patient autonomy in medical research was globally initiated after World War II in the Nuremberg Code. Informed consent was stressed as a precondition for all medical research. Different medical events during the 1960s led to the World Medical Association's Declaration of Helsinki in 1964. The Declaration stressed that researchers should not take ethical responsibility entirely on themselves: a view later sustained by Henry Beecher's oft-cited whistle-blowing article in 1966. 1 The Tuskegee case and the following Belmont Report also
Routledge eBooks, Aug 15, 2023