35 results on '"Andria Bianchi"'
Search Results
2. The Elephant in the Nursery: Paediatric Exceptionalism?
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James Anderson, Randi Zlotnik Shaul, and Andria Bianchi
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paediatrics ,children ,priority ,resource allocation ,ethics ,Ethics ,BJ1-1725 - Abstract
Prior to the COVID-19 pandemic (hereafter, ‘the pandemic’), there was already widespread concern about the adequacy of health care resources across Canada. The COVID-19 pandemic exacerbated these concerns exponentially, widening already significant cracks in provincial health care systems. Currently the system is struggling with the exacerbation of wait times for surgeries previously delayed by mandated closures during the pandemic. In Ontario, the backlog of surgeries, and associated backlogs in radiology and other services critical to paediatric care, led to the creation of a consortium of paediatric hospitals committed to advocacy for more funding for paediatrics. Thus far, the provincial and federal governments have agreed to a one-time cash infusion, but the consortium is calling for a permanent increase in funding for paediatrics. A challenge is that the adult sector has also suffered from delays and backlogs. Furthermore, as already noted, older adults have borne the brunt of morbidity and mortality associated with COVID-19. The challenge for the paediatric sector is whether and how to defend the prioritization of children and youth. In this paper, we review four approaches to just allocation – utilitarian ageism, fair innings, the prudential lifespan approach, and prioritarian ageism – and examine their strengths and weaknesses. We conclude by endorsing prioritarian ageism (prioritarianism). Prioritarianism retains the strengths of utilitarian ageism and fair innings while avoiding their weaknesses. Furthermore, because prioritarianism does not treat age as an independent moral criterion, allocation schemes based on this foundation are less susceptible to legal challenge and may be more palatable to the general public.
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- 2024
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3. Factors That Influence Successful Adoption of Real-Time Location Systems for Use in a Dementia Care Setting: Mixed Methods Study
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Lynn Haslam-Larmer, Alisa Grigorovich, Leia Shum, Andria Bianchi, Kristine Newman, Andrea Iaboni, and Josephine McMurray
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Geriatrics ,RC952-954.6 - Abstract
BackgroundTechnology has been identified as a potential solution to alleviate resource gaps and augment care delivery in dementia care settings such as hospitals, long-term care, and retirement homes. There has been an increasing interest in using real-time location systems (RTLS) across health care settings for older adults with dementia, specifically related to the ability to track a person’s movement and location. ObjectiveIn this study, we aimed to explore the factors that influence the adoption or nonadoption of an RTLS during its implementation in a specialized inpatient dementia unit in a tertiary care rehabilitation hospital. MethodsThe study included data from a brief quantitative survey and interviews from a convenience sample of frontline participants. Our deductive analysis of the interview used the 3 categories of the Fit Between Individuals, Task, and Technology framework as follows: individual and task, individual and technology, and task and technology. The purpose of using this framework was to assess the quality of the fit between technology attributes and an individual’s self-reported intentions to adopt RTLS technology. ResultsA total of 20 health care providers (HCPs) completed the survey, of which 16 (80%) participated in interviews. Coding and subsequent analysis identified 2 conceptual subthemes in the individual-task fit category, including the identification of the task and the perception that participants were missing at-risk patient events. The task-technology fit category consisted of 3 subthemes, including reorganization of the task, personal control in relation to the task, and efficiency or resource allocation. A total of 4 subthemes were identified in the individual-technology fit category, including privacy and personal agency, trust in the technology, user interfaces, and perceptions of increased safety. ConclusionsBy the end of the study, most of the unit’s HCPs were using the tablet app based on their perception of its usefulness, its alignment with their comfort level with technology, and its ability to help them perform job responsibilities. HCPs perceived that they were able to reduce patient search time dramatically, yet any improvements in care were noted to be implied, as this was not measured. There was limited anecdotal evidence of reduced patient risk or adverse events, but greater reported peace of mind for HCPs overseeing patients’ activity levels.
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- 2024
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4. User Perception of Smart Home Surveillance Among Adults Aged 50 Years and Older: Scoping Review
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Jessica Percy Campbell, Jacob Buchan, Charlene H Chu, Andria Bianchi, Jesse Hoey, and Shehroz S Khan
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Information technology ,T58.5-58.64 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundSmart home technology (SHT) can be useful for aging in place or health-related purposes. However, surveillance studies have highlighted ethical issues with SHTs, including user privacy, security, and autonomy. ObjectiveAs digital technology is most often designed for younger adults, this review summarizes perceptions of SHTs among users aged 50 years and older to explore their understanding of privacy, the purpose of data collection, risks and benefits, and safety. MethodsThrough an integrative review, we explored community-dwelling adults’ (aged 50 years and older) perceptions of SHTs based on research questions under 4 nonmutually exclusive themes: privacy, the purpose of data collection, risk and benefits, and safety. We searched 1860 titles and abstracts from Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, Scopus, Web of Science Core Collection, and IEEE Xplore or IET Electronic Library, resulting in 15 included studies. ResultsThe 15 studies explored user perception of smart speakers, motion sensors, or home monitoring systems. A total of 13 (87%) studies discussed user privacy concerns regarding data collection and access. A total of 4 (27%) studies explored user knowledge of data collection purposes, 7 (47%) studies featured risk-related concerns such as data breaches and third-party misuse alongside benefits such as convenience, and 9 (60%) studies reported user enthusiasm about the potential for home safety. ConclusionsDue to the growing size of aging populations and advances in technological capabilities, regulators and designers should focus on user concerns by supporting higher levels of agency regarding data collection, use, and disclosure and by bolstering organizational accountability. This way, relevant privacy regulation and SHT design can better support user safety while diminishing potential risks to privacy, security, autonomy, or discriminatory outcomes.
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- 2024
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5. Age-related bias and artificial intelligence: a scoping review
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Charlene H. Chu, Simon Donato-Woodger, Shehroz S. Khan, Rune Nyrup, Kathleen Leslie, Alexandra Lyn, Tianyu Shi, Andria Bianchi, Samira Abbasgholizadeh Rahimi, and Amanda Grenier
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History of scholarship and learning. The humanities ,AZ20-999 ,Social Sciences - Abstract
Abstract There are widespread concerns about bias and discriminatory output related to artificial intelligence (AI), which may propagate social biases and disparities. Digital ageism refers to ageism reflected design, development, and implementation of AI systems and technologies and its resultant data. Currently, the prevalence of digital ageism and the sources of AI bias are unknown. A scoping review informed by the Arksey and O’Malley methodology was undertaken to explore age-related bias in AI systems, identify how AI systems encode, produce, or reinforce age-related bias, what is known about digital ageism, and the social, ethical and legal implications of age-related bias. A comprehensive search strategy that included five electronic bases and grey literature sources including legal sources was conducted. A framework of machine learning biases spanning from data to user by Mehrabi et al. is used to present the findings (Mehrabi et al. 2021). The academic search resulted in 7595 articles that were screened according to the inclusion criteria, of which 307 were included for full-text screening, and 49 were included in this review. The grey literature search resulted in 2639 documents screened, of which 235 were included for full text screening, and 25 were found to be relevant to the research questions pertaining to age and AI. As a result, a total of 74 documents were included in this review. The results show that the most common AI applications that intersected with age were age recognition and facial recognition systems. The most frequent machine learning algorithms used were convolutional neural networks and support vector machines. Bias was most frequently introduced in the early ‘data to algorithm’ phase in machine learning and the ‘algorithm to user’ phase specifically with representation bias (n = 33) and evaluation bias (n = 29), respectively (Mehrabi et al. 2021). The review concludes with a discussion of the ethical implications for the field of AI and recommendations for future research.
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- 2023
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6. Clinical ethics consultations: a scoping review of reported outcomes
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Jennifer A. H. Bell, Marina Salis, Eryn Tong, Erica Nekolaichuk, Claudia Barned, Andria Bianchi, Daniel Z. Buchman, Kevin Rodrigues, Ruby R. Shanker, and Ann M. Heesters
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Clinical ethics consultation ,Moral case deliberation ,Scoping review ,Outcomes ,Effectiveness research ,Medical philosophy. Medical ethics ,R723-726 - Abstract
Abstract Background Clinical ethics consultations (CEC) can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council (MRC) proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. Objective The primary objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization. Methods We searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. Results Forty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality (n = 31), process factors (n = 23), and clinical factors (n = 19). The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes. Conclusions This scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC.
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- 2022
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7. Where Do I Go to Wait? Ethical Considerations During the 90 Day Reflection Period for MAiD
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Kesi Disha, Andria Bianchi, Ruby Shanker, and Nikolija Lukich
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Medical Assistance in Dying ,bioethics ,rehabilitation ,polyphony ,MAID ,Ethics ,BJ1-1725 - Abstract
Canada’s Medical Assistance in Dying (MAID) legislation changed in 2021; persons without a reasonably foreseeable natural death (RFND) could now be eligible for MAID and would have to wait at least 90 days before their intervention. This legislative change caused a new ethically complex question to arise, which we explore in this commentary, namely: Where should individuals without a RFND wait (for 90 days) in a publicly funded health system?
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- 2023
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8. Ageism and Artificial Intelligence: Protocol for a Scoping Review
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Charlene H Chu, Kathleen Leslie, Jiamin Shi, Rune Nyrup, Andria Bianchi, Shehroz S Khan, Samira Abbasgholizadeh Rahimi, Alexandra Lyn, and Amanda Grenier
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Medicine ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
BackgroundArtificial intelligence (AI) has emerged as a major driver of technological development in the 21st century, yet little attention has been paid to algorithmic biases toward older adults. ObjectiveThis paper documents the search strategy and process for a scoping review exploring how age-related bias is encoded or amplified in AI systems as well as the corresponding legal and ethical implications. MethodsThe scoping review follows a 6-stage methodology framework developed by Arksey and O’Malley. The search strategy has been established in 6 databases. We will investigate the legal implications of ageism in AI by searching grey literature databases, targeted websites, and popular search engines and using an iterative search strategy. Studies meet the inclusion criteria if they are in English, peer-reviewed, available electronically in full text, and meet one of the following two additional criteria: (1) include “bias” related to AI in any application (eg, facial recognition) and (2) discuss bias related to the concept of old age or ageism. At least two reviewers will independently conduct the title, abstract, and full-text screening. Search results will be reported using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guideline. We will chart data on a structured form and conduct a thematic analysis to highlight the societal, legal, and ethical implications reported in the literature. ResultsThe database searches resulted in 7595 records when the searches were piloted in November 2021. The scoping review will be completed by December 2022. ConclusionsThe findings will provide interdisciplinary insights into the extent of age-related bias in AI systems. The results will contribute foundational knowledge that can encourage multisectoral cooperation to ensure that AI is developed and deployed in a manner consistent with ethical values and human rights legislation as it relates to an older and aging population. We will publish the review findings in peer-reviewed journals and disseminate the key results with stakeholders via workshops and webinars. Trial RegistrationOSF Registries AMG5P; https://osf.io/amg5p International Registered Report Identifier (IRRID)DERR1-10.2196/33211
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- 2022
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9. Licit Substance Use in Physical Rehabilitation Settings
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Brynne McArthur, Alexandra Campbell, and Andria Bianchi
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substance use ,rehabilitation ,harm reduction ,person-centred ,patient-centred ,Ethics ,BJ1-1725 - Abstract
The purpose of this commentary is to consider circumstances under which it may be ethical to permit patients to use licit substances in rehabilitation contexts. While the content of this commentary may be transferable to other healthcare spaces, our focus on rehabilitation is based on some important distinctions that exist between rehabilitation and acute care spaces.
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- 2022
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10. Accessing Indigenous Long-Term Care
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Danielle Gionnas, Andria Bianchi, Leonard Benoit, and Kevin Rodrigues
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Indigenous ,Long-Term Care ,Equity ,Cultural Inclusivity ,Ethics ,BJ1-1725 - Abstract
The purpose of this commentary is to present and respond to the gap that currently exists in providing culturally inclusive residential long-term care options for Indigenous peoples in Ontario. After presenting statistics regarding the Indigenous population and long-term care options, we argue that we have an ethical responsibility to offer more culturally inclusive long-term care.
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- 2021
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11. Questioning the Ethics of Promoting Weight Loss in Clinical Practice
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Andria Bianchi and Maria Ricupero
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social determinants ,weight cycling ,weight bias ,weight stigma ,weight inclusive ,Ethics ,BJ1-1725 - Abstract
This case study considers the ethical defensibility of recommending weight loss as a treatment for patients with higher body mass indexes. Recommending weight loss may be motivated by clinicians’ biases toward people living in larger bodies, misperceptions about weight and its relevancy to overall health, and a failure to consider other ethical factors such as those related to equity and the social determinants of health.
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- 2020
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12. Contracting Compliance: A Discussion of the Ethical Implications of Behavioural Contracts in the Rehabilitation Setting
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Jane Cooper, Ann Heesters, Andria Bianchi, Kevin Rodrigues, and Nathalie Brown
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contracts ,patient contracts ,behaviours ,rehabilitation ,ethics ,Ethics ,BJ1-1725 - Abstract
The pervasive use of contracts in healthcare is a source of unease for many healthcare ethicists and patient advocates. This commentary examines the use of such contracts with individuals in rehabilitation settings who have complex medical and behavioural issues. The goals of this paper are to examine the many factors that can lead to contract use, to discuss some legal and ethical implications of contract use, and to assess contract use in light of concerns about health equity. The paper concludes with some practical alternatives to the use of such contracts, and refers specifically to tools that might be borrowed from the field of behavioural therapy.
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- 2019
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13. Something’s Got to Give: Reconsidering the Justification for a Gender Divide in Sport
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Andria Bianchi
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transgender ,trans women ,sport ,testosterone ,gender ,gender binary ,Logic ,BC1-199 ,Philosophy (General) ,B1-5802 - Abstract
The question of whether transgender athletes should be permitted to compete in accordance with their gender identity is an evolving debate. Most competitive sports have male and female categories. One of the primary challenges with this categorization system, however, is that some transgender athletes (and especially transgender women) may be prevented from competing in accordance with their gender identity. The reason for this restriction is because of the idea that transgender women have an unfair advantage over their cisgender counterparts; this is seen as a problem since sports are typically guided a principle called ‘the skill thesis’, which suggests that sports are supposed to determine who is most skillful by maintaining a fair starting point. In this paper, I argue that if the skill thesis ought to be maintained and there continues to exist no conclusive evidence in support of unfair advantages possessed by trans women, then we may want to re-consider the gender binary in sport. Rather than having male/female categories, it may make more sense to categorize athletes based other sport-specific factors (e.g., height, weight, etc.). This may help to maintain the skill thesis while at the same time removing potentially unfair and discriminatory barriers against transgender athletes.
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- 2019
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14. In defence of falling: the onomastics and ethics of 'therapeutic' falls in rehabilitation
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Angie Andreoli, Andria Bianchi, Alexandra Campbell, Julie Bernhardt, Mark Bayley, and Meiqi Guo
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Rehabilitation - Published
- 2022
15. User Perception of Smart Home Surveillance Among Adults Aged 50+: An Integrative Review (Preprint)
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Jessica Percy Campbell, Jacob Buchan, Charlene H. Chu, Andria Bianchi, Jesse Hoey, and Shehroz, S. Khan
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BACKGROUND Smart home technology (SHT) can be useful for aging in place or health related purposes. However, surveillance researchers have highlighted ethical issues with SHTs, including those pertaining to user privacy, security, and autonomy. OBJECTIVE As digital technology is most often designed for younger adults, this review summarizes user perceptions of SHTs with users aged 50+ to explore their understandings of privacy, purpose of data collection, risk and safety. METHODS Through an integrative review, we explored community-dwelling adults’ (aged 50+) perceptions of SHTs based on research questions under four non-mutually exclusive themes: privacy, purpose of data collection, risk and benefits, and safety. 15 user perception studies on SHT users aged 50+ were included. RESULTS The 15 included studies explored user perception of smart speakers, motion sensors, or home monitoring systems. 13 studies (87%) discussed user privacy concerns regarding data collection and access. Four studies (27%) explored user knowledge of data collection purposes. Seven studies (47%) featured risk-related concerns such as data breaches and third-party misuse, and benefits such as convenience. Nine studies (60%) reported user enthusiasm about the potential for home safety. CONCLUSIONS Due to the growing size of aging populations and advances in technological capabilities, regulators and designers should focus on user concerns. In conjunction with ethical by-design approaches, we recommend Taylor’s conception of data justice as a regulatory approach that can empower SHT users in their data management goals. This way, regulation and design can enhance safety benefits while diminishing risks to privacy, security, and autonomy.
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- 2023
16. COMMUNITY-DWELLING OLDER ADULTS’ PERCEPTIONS OF SMART HOME SURVEILLANCE: AN INTEGRATIVE REVIEW
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Shehroz Khan, Jessica Campbell, Jacob Buchan, Andria Bianchi, Jesse Hoey, and Charlene Chu
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Health (social science) ,Life-span and Life-course Studies ,Health Professions (miscellaneous) - Abstract
Background Many older adults wish to use smart homes for aging in place, health monitoring, and enhanced safety. However, concerns over privacy and security remain pressing. User perception studies can help to inform policy and design solutions. Aim: To explore community-dwelling older adults’ (50+) perceptions of smart home surveillance. Methods As part of a larger scoping review of smart home user perception based on four non-mutually exclusive categories: privacy, safety, purpose of data collection, and risk, we found 68 results. 15 studies focused on older adults exclusively and were included in this review. Results The included studies mainly focused on smart speakers, motion sensors, or home monitoring systems. 13 studies (87%) discussed user privacy concerns in terms of data collection and access. Nine studies (60%) reported that users were enthusiastic about the potential for home safety, improved health outcomes and independent living with smart homes. Seven risk awareness studies (47%) featured a range of perspectives on sharing sensitive information due to the possibility of data breaches and third-party misuse, with some reporting a willingness to trade privacy for enhanced safety. Finally, four studies (27%) explored user knowledge of data collection purposes. While many were uncertain of the details, users were generally more comfortable sharing smart home data with healthcare professionals than others. Conclusion This review has helped us in creating a user perception survey that is currently in the fielding stage. Given Canada’s increasing aging population and technological advances, privacy regulators and designers should focus on older adults’ concerns.
- Published
- 2022
17. The Ethical Defensibility of Harm Reduction and Eating Disorders
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Andria Bianchi, Kalam Sutandar, and Katherine Stanley
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Harm reduction ,medicine.medical_specialty ,Anorexia Nervosa ,Substance-Related Disorders ,Health Policy ,Addiction ,media_common.quotation_subject ,Anorexia ,Morals ,medicine.disease ,Mental illness ,Mental health ,Feeding and Eating Disorders ,Issues, ethics and legal aspects ,Eating disorders ,Harm Reduction ,Anorexia nervosa (differential diagnoses) ,medicine ,Humans ,Substance use ,medicine.symptom ,Psychiatry ,Psychology ,media_common - Abstract
Eating disorders are mental illnesses that can have a significant and persistent physical impact, especially for those who are not treated early in their disease trajectory. Although many persons with eating disorders may make a full recovery, some may not; this is especially the case when it comes to persons with severe and enduring anorexia nervosa (SEAN), namely, those who have had anorexia for between 6 and 12 years or more. Given that persons with SEAN are less likely to make a full recovery, a different treatment philosophy might be ethically warranted. One potential yet scarcely considered way to treat persons with SEAN is that of a harm reduction approach. A harm reduction philosophy is deemed widely defensible in certain contexts (e.g. in the substance use and addictions domain), and in this paper we argue that it may be similarly ethically defensible for treating persons with SEAN in some circumstances.
- Published
- 2020
18. Sexual Consent, Aging, and Dementia
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Andria Bianchi
- Published
- 2022
19. Sexual Consent, Dementia, and Well-Being
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Andria Bianchi
- Published
- 2022
20. Digital Ageism: Challenges and Opportunities in Artificial Intelligence for Older Adults
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Charlene H Chu, Rune Nyrup, Kathleen Leslie, Jiamin Shi, Andria Bianchi, Alexandra Lyn, Molly McNicholl, Shehroz Khan, Samira Rahimi, Amanda Grenier, Chu, Charlene H [0000-0002-0333-7210], Nyrup, Rune [0000-0002-9880-6912], Leslie, Kathleen [0000-0003-0581-126X], Shi, Jiamin [0000-0002-1187-1990], Bianchi, Andria [0000-0003-3802-0771], Khan, Shehroz [0000-0002-1195-4999], Rahimi, Samira [0000-0003-3781-1360], Grenier, Amanda [0000-0003-2251-6035], and Apollo - University of Cambridge Repository
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Ageism ,Machine Learning ,Technology ,Racism ,Bias ,Artificial Intelligence ,Humans ,General Medicine ,Geriatrics and Gerontology ,Gerontology ,Delivery of Health Care ,Aged - Abstract
Artificial intelligence (AI) and machine learning are changing our world through their impact on sectors including health care, education, employment, finance, and law. AI systems are developed using data that reflect the implicit and explicit biases of society, and there are significant concerns about how the predictive models in AI systems amplify inequity, privilege, and power in society. The widespread applications of AI have led to mainstream discourse about how AI systems are perpetuating racism, sexism, and classism; yet, concerns about ageism have been largely absent in the AI bias literature. Given the globally aging population and proliferation of AI, there is a need to critically examine the presence of age-related bias in AI systems. This forum article discusses ageism in AI systems and introduces a conceptual model that outlines intersecting pathways of technology development that can produce and reinforce digital ageism in AI systems. We also describe the broader ethical and legal implications and considerations for future directions in digital ageism research to advance knowledge in the field and deepen our understanding of how ageism in AI is fostered by broader cycles of injustice.
- Published
- 2021
21. Ageism and Artificial Intelligence: Protocol for a Scoping Review (Preprint)
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Charlene H Chu, Kathleen Leslie, Jiamin Shi, Rune Nyrup, Andria Bianchi, Shehroz S Khan, Samira Abbasgholizadeh Rahimi, Alexandra Lyn, and Amanda Grenier
- Abstract
BACKGROUND Artificial intelligence (AI) has emerged as a major driver of technological development in the 21st century, yet little attention has been paid to algorithmic biases toward older adults. OBJECTIVE This paper documents the search strategy and process for a scoping review exploring how age-related bias is encoded or amplified in AI systems as well as the corresponding legal and ethical implications. METHODS The scoping review follows a 6-stage methodology framework developed by Arksey and O’Malley. The search strategy has been established in 6 databases. We will investigate the legal implications of ageism in AI by searching grey literature databases, targeted websites, and popular search engines and using an iterative search strategy. Studies meet the inclusion criteria if they are in English, peer-reviewed, available electronically in full text, and meet one of the following two additional criteria: (1) include “bias” related to AI in any application (eg, facial recognition) and (2) discuss bias related to the concept of old age or ageism. At least two reviewers will independently conduct the title, abstract, and full-text screening. Search results will be reported using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guideline. We will chart data on a structured form and conduct a thematic analysis to highlight the societal, legal, and ethical implications reported in the literature. RESULTS The database searches resulted in 7595 records when the searches were piloted in November 2021. The scoping review will be completed by December 2022. CONCLUSIONS The findings will provide interdisciplinary insights into the extent of age-related bias in AI systems. The results will contribute foundational knowledge that can encourage multisectoral cooperation to ensure that AI is developed and deployed in a manner consistent with ethical values and human rights legislation as it relates to an older and aging population. We will publish the review findings in peer-reviewed journals and disseminate the key results with stakeholders via workshops and webinars. CLINICALTRIAL OSF Registries AMG5P; https://osf.io/amg5p INTERNATIONAL REGISTERED REPORT DERR1-10.2196/33211
- Published
- 2021
22. Overcoming Challenges to Support Clinician-Scientist Roles in Canadian Academic Health Sciences Centres
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Helen Kelly, Joy Richards, Sue Bookey-Bassett, and Andria Bianchi
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Academic Medical Centers ,Canada ,Medical education ,Biomedical Research ,030504 nursing ,Clinician scientist ,business.industry ,Health Personnel ,Best practice ,Academic practice ,Mentoring ,Allied health professions ,Research Personnel ,Grounded theory ,03 medical and health sciences ,0302 clinical medicine ,Work (electrical) ,Health care ,Humans ,030212 general & internal medicine ,0305 other medical science ,business ,Psychology ,Biomedical sciences - Abstract
Clinician-scientists (CSs) make significant contributions to the healthcare system, yet their roles are not fully understood, supported or recognized by healthcare leaders or policy makers. CSs are healthcare professionals with advanced research training who continue to pursue clinical work and are considered an essential component of the research infrastructure in academic health sciences centres. The current literature supports the role of CSs but is also clear that there are multiple challenges in attracting and retaining clinicians to the role. To gain a comprehensive understanding of the current status of the CS role, two literature reviews were conducted. The findings reported here include an overview of: the education and training preparation for CS roles; the importance of the CS role; barriers and challenges to developing and implementing the CS role; and strategies for supporting and sustaining CS roles in practice. The paper further describes one Canadian academic health sciences centre's approach to supporting and increasing the number of CSs from nursing and allied health professions to support academic practice. Non-physician CSs may conduct research using multiple research designs across the research continuum from randomized controlled trials to grounded theory or qualitative descriptive approaches. Their research generally focuses on practice-based issues such as best practices for managing pain or frailty or evaluating the effectiveness of new approaches to care. Researchers and healthcare leaders in other organizations may find this work helpful for establishing their own structures to enhance research capacity and practice-based research, especially for non-physician CSs.
- Published
- 2019
23. Contracting Compliance: A Discussion of the Ethical Implications of Behavioural Contracts in the Rehabilitation Setting
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Nathalie Brown, Jane Cooper, Andria Bianchi, Ann Heesters, and Kevin Rodrigues
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Social Sciences and Humanities ,Health (social science) ,medicine.medical_treatment ,rehabilitation ,contrats ,Compliance (psychology) ,lcsh:Ethics ,Health care ,éthique ,medicine ,contracts ,Rehabilitation ,business.industry ,Health Policy ,Field (Bourdieu) ,comportements ,Public relations ,ethics ,Health equity ,patient contracts ,Philosophy ,behaviours ,Sciences Humaines et Sociales ,lcsh:BJ1-1725 ,réadaptation ,business ,contrats de patients - Abstract
The pervasive use of contracts in healthcare is a source of unease for many healthcare ethicists and patient advocates. This commentary examines the use of such contracts with individuals in rehabilitation settings who have complex medical and behavioural issues. The goals of this paper are to examine the many factors that can lead to contract use, to discuss some legal and ethical implications of contract use, and to assess contract use in light of concerns about health equity. The paper concludes with some practical alternatives to the use of such contracts, and refers specifically to tools that might be borrowed from the field of behavioural therapy., L’utilisation généralisée de contrats dans les soins de santé est une source de malaise pour de nombreux éthiciens de la santé et associations de patients. Ce commentaire examine l’utilisation de tels contrats avec des personnes en milieu de réadaptation ayant des problèmes médicaux et comportementaux complexes. Les objectifs de ce commentaire sont d’examiner les nombreux facteurs qui peuvent conduire à l’utilisation de contrats, de discuter de certaines implications juridiques et éthiques de l’utilisation de contrats et d’évaluer leur utilisation à la lumière des préoccupations relatives à l’équité en matière de santé. Le commentaire conclut par quelques alternatives pratiques à l’utilisation de tels contrats et se réfère spécifiquement aux outils pouvant être empruntés au domaine de la thérapie comportementale.
- Published
- 2019
24. Intellectual Disabilities and Autism: Ethics and Practice
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Andria Bianchi, Janet A. Vogt, Andria Bianchi, and Janet A. Vogt
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- Bioethics, Developmental psychology, Emotions, Intellect
- Abstract
This book meaningfully reflects upon difficult, timely, and debated ethics questions relating to people with intellectual disabilities (IDs) and autistic people. The book challenges now dated perceptions and introduces innovative ideas by leading scholars regarding some of the most complex, controversial, and relevant ethical dilemmas involving these neurodiverse populations. People with IDs and/or those on the autism spectrum continue to experience various forms of oppression and unjust treatment across the globe, despite the UN Convention on the Rights of Persons with Disabilities (CRPD). The collection explores questions such as: Can people with IDs make informed decisions about their medical treatment, living circumstances, and overall life? What are the ethical implications of selective termination of pregnancy based on a gene linked to a condition conferring intellectual impairment? How can we ensure that people with IDs and autistic people are meaningfully included in research? Can people with IDs successfully parent? How can we support the capabilities of neurodiverse populations such that they enjoy the rights afforded by the CRPD? Each contributor critically examines how we can move forward to create a world that understands and respects the rights of every person with ID and/or autism. An indispensable read for bioethicists, ethics students, social justice scholars, and others interested in and working with people with IDs and autistic people.
- Published
- 2024
25. Questioning the Ethics of Promoting Weight Loss in Clinical Practice
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Maria Ricupero and Andria Bianchi
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Gerontology ,Health (social science) ,Social Sciences and Humanities ,education ,social determinants ,déterminants sociaux ,0603 philosophy, ethics and religion ,lcsh:Ethics ,03 medical and health sciences ,Weight loss ,stigmatisation du poids ,weight stigma ,medicine ,Social determinants of health ,biais de poids ,weight cycling ,weight inclusive ,Equity (economics) ,030503 health policy & services ,Health Policy ,06 humanities and the arts ,weight bias ,cycle du poids ,Clinical Practice ,poids inclusif ,Philosophy ,Weight stigma ,Sciences Humaines et Sociales ,060301 applied ethics ,medicine.symptom ,0305 other medical science ,Psychology ,lcsh:BJ1-1725 - Abstract
This case study considers the ethical defensibility of recommending weight loss as a treatment for patients with higher body mass indexes. Recommending weight loss may be motivated by clinicians’ biases toward people living in larger bodies, misperceptions about weight and its relevancy to overall health, and a failure to consider other ethical factors such as those related to equity and the social determinants of health., Cette étude de cas examine la défendabilité éthique de recommander la perte de poids comme traitement pour les patients ayant un indice de masse corporelle plus élevé. La recommandation d’une perte de poids peut être motivée par les préjugés des cliniciens à l’égard des personnes vivant dans des corps plus volumineux, par des perceptions erronées du poids et de sa pertinence pour la santé globale ainsi que par l’absence de prise en compte d’autres facteurs éthiques, tels que ceux liés à l’équité et aux déterminants sociaux de la santé.
- Published
- 2020
26. Deceased‐directed donation: Considering the ethical permissibility in a multicultural setting
- Author
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Andria Bianchi and Rebecca Greenberg
- Subjects
Health (social science) ,media_common.quotation_subject ,Culture ,Globe ,Morals ,Pediatrics ,Family centered care ,Globalization ,Directed Tissue Donation ,medicine ,Institution ,Humans ,Relevance (law) ,Ethics, Medical ,Family ,Bioethical Issues ,Sociology ,Child ,media_common ,business.industry ,Health Policy ,Cultural Diversity ,Guideline ,Public relations ,equipment and supplies ,Dissent and Disputes ,Tissue Donors ,Death ,Philosophy ,Policy ,medicine.anatomical_structure ,Multiculturalism ,Donation ,business - Abstract
This paper explores the ethics of deceased-directed donation (DDD) and brings a unique perspective to this issue-the relevance of providing family-centered care and culturally sensitive care to deceased donors, potential recipients, and their families. The significance of providing family-centered care is becoming increasingly prevalent, specifically in pediatric healthcare settings. Therefore, this topic is especially relevant to those working with and interested in pediatrics. As the world is becoming more diverse with globalization, assessing the cultural aspect of the ethics of DDD is increasingly salient. We provide a brief overview of DDD across the globe, review prominent arguments both for and against DDD, consider family-centered and culturally specific considerations, and offer considerations for the development of a policy or guideline. We determine that the practice of DDD is ethically defensible in certain circumstances and congruent with providing both family-centered and culturally sensitive care. Our analysis is relevant to any country with a diverse population and any healthcare provider or institution that operates under a framework of family-centered care, such as those in pediatric hospitals.
- Published
- 2018
27. The Burden of Over-Representation: Race, Sport and Philosophy
- Author
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Andria Bianchi
- Subjects
Philosophy ,Politics ,Race (biology) ,Identity (social science) ,Physical Therapy, Sports Therapy and Rehabilitation ,Gender studies ,Sociology ,Over representation - Abstract
Grant Farred’s The Burden of Over-representation: Race, Sport, and Philosophy analyzes three moments in sport history—in three chapters—through the intersecting lenses of race, identity, politics, ...
- Published
- 2019
28. Gender Testing in Sport: Ethics, cases and controversies
- Author
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Andria Bianchi
- Subjects
03 medical and health sciences ,0302 clinical medicine ,Health (social science) ,0502 economics and business ,05 social sciences ,Gender studies ,030229 sport sciences ,Sociology ,Discipline ,050212 sport, leisure & tourism ,Social Sciences (miscellaneous) - Abstract
Sandy Montanola and Aurelie Olivesi’s Gender Testing in Sport: Ethics, cases and controversies is a timely and engaging book that includes nine chapters from authors of different disciplinary backg...
- Published
- 2017
29. Considering sex robots for older adults with cognitive impairments
- Author
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Andria Bianchi
- Subjects
Health (social science) ,Bodily integrity ,Health Policy ,media_common.quotation_subject ,Cognition ,medicine.disease ,Meaningful life ,Developmental psychology ,Issues, ethics and legal aspects ,Quality of life (healthcare) ,Arts and Humanities (miscellaneous) ,Feeling ,medicine ,Dementia ,Narrative ,Psychology ,Duty ,media_common - Abstract
Determining whether and/or how to enable older persons with disabilities to engage in sex raises several ethical considerations. With the goal of enabling the sexual functioning of older adults with disabilities, Jecker argues that sex robots could be used as a helpful tool. In her article, ‘Nothing to be Ashamed of: Sex Robots for Older Adults with Disabilities’, Jecker acknowledges the importance of sexual functioning and the fact that ageist assumptions incorrectly classify older persons as asexual. Additionally, older adults may experience disabilities that negatively influence their sexual functioning, which is problematic since sex may be linked to the following capabilities: developing a meaningful life narrative; being healthy; experiencing bodily integrity; feeling and communicating emotions; affiliating with others and reflecting on and choosing a life plan.1 In accordance with Nussbaum’s capabilities approach,2 Jecker says that society has a duty to support these capabilities at a minimal threshold. And insofar as sexual functioning may be relevant to the capabilities for older adults with disabilities, then we need to respond accordingly. One way of achieving this aim is by providing access to sex robots. I agree that sex robots ought to be made available for older adults with disabilities. Nevertheless, the article inspires several areas for further exploration. As Jecker rightfully mentions, older adults are often incorrectly labelled as non-sexual. For instance, in their analysis of older individuals’ views on sex and quality of life, Gott …
- Published
- 2020
30. Transgender women in sport
- Author
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Andria Bianchi
- Subjects
Health (social science) ,05 social sciences ,Gender studies ,Testosterone (patch) ,030229 sport sciences ,Transgender women ,Gender binary ,03 medical and health sciences ,0302 clinical medicine ,0502 economics and business ,Transgender ,Psychology ,human activities ,050212 sport, leisure & tourism ,Social Sciences (miscellaneous) - Abstract
This paper considers whether transgender (trans*) women should be permitted to compete in female categories in sports. Trans* women are often criticized for competing in female categories because t...
- Published
- 2017
31. Factors Affecting the Implementation, Use, and Adoption of Real-Time Location System Technology for Persons Living With Cognitive Disabilities in Long-term Care Homes: Systematic Review
- Author
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Yalinie Kulandaivelu, Alisa Grigorovich, Josephine McMurray, Shehroz S. Khan, Kristine Newman, Andrea Iaboni, and Andria Bianchi
- Subjects
Data Analysis ,Health Informatics ,Context (language use) ,Review ,CINAHL ,PsycINFO ,lcsh:Computer applications to medicine. Medical informatics ,03 medical and health sciences ,wearable technology ,0302 clinical medicine ,Nursing ,Computer Systems ,assistive technology ,Agency (sociology) ,Health care ,Humans ,Cognitive Dysfunction ,real-time location system ,030212 general & internal medicine ,implementation science ,business.industry ,lcsh:Public aspects of medicine ,030503 health policy & services ,lcsh:RA1-1270 ,Long-Term Care ,ambulatory monitoring ,Real-time locating system ,Long-term care ,lcsh:R858-859.7 ,Alzheimer disease ,0305 other medical science ,Psychology ,business ,qualitative research ,dementia ,Qualitative research - Abstract
Background As the aging population continues to grow, the number of adults living with dementia or other cognitive disabilities in residential long-term care homes is expected to increase. Technologies such as real-time locating systems (RTLS) are being investigated for their potential to improve the health and safety of residents and the quality of care and efficiency of long-term care facilities. Objective The aim of this study is to identify factors that affect the implementation, adoption, and use of RTLS for use with persons living with dementia or other cognitive disabilities in long-term care homes. Methods We conducted a systematic review of the peer-reviewed English language literature indexed in MEDLINE, Embase, PsycINFO, and CINAHL from inception up to and including May 5, 2020. Search strategies included keywords and subject headings related to cognitive disability, residential long-term care settings, and RTLS. Study characteristics, methodologies, and data were extracted and analyzed using constant comparative techniques. Results A total of 12 publications were included in the review. Most studies were conducted in the Netherlands (7/12, 58%) and used a descriptive qualitative study design. We identified 3 themes from our analysis of the studies: barriers to implementation, enablers of implementation, and agency and context. Barriers to implementation included lack of motivation for engagement; technology ecosystem and infrastructure challenges; and myths, stories, and shared understanding. Enablers of implementation included understanding local workflows, policies, and technologies; usability and user-centered design; communication with providers; and establishing policies, frameworks, governance, and evaluation. Agency and context were examined from the perspective of residents, family members, care providers, and the long-term care organizations. Conclusions There is a striking lack of evidence to justify the use of RTLS to improve the lives of residents and care providers in long-term care settings. More research related to RTLS use with cognitively impaired residents is required; this research should include longitudinal evaluation of end-to-end implementations that are developed using scientific theory and rigorous analysis of the functionality, efficiency, and effectiveness of these systems. Future research is required on the ethics of monitoring residents using RTLS and its impact on the privacy of residents and health care workers.
- Published
- 2021
32. Micro Data: Wearable Devices Contribution to Improved Chronic Disease Management
- Author
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Andria, Bianchi and Bob, Parke
- Subjects
Chronic care ,Canada ,medicine.medical_specialty ,Self-management ,business.industry ,Patient demographics ,Vital signs ,MEDLINE ,Monitoring, Ambulatory ,Aging society ,Chronic disease ,Chronic Disease ,Humans ,Medicine ,business ,Intensive care medicine ,Delivery of Health Care ,Wearable technology ,Aged - Abstract
Issues involving chronic disease prevention and management (CDPM) are prevalent in today's aging society, and suggestions for improvement are essential to treat this patient demographic effectively. This article addresses the use of wearable devices for the medical community to improve CDPM by relying on the accumulation of micro data. For the patient, we recognize that these devices can be an effective tool to facilitate real-time monitoring of their vital signs and activity levels. With real-time monitoring and earlier responses, individuals can benefit by preventing, delaying or reducing exacerbations of chronic diseases. Use of these devices also has great benefit to the person and has the potential to decrease the individual's emergency room visits, hospital admissions and re-admissions. As patients and their healthcare providers work together to identify cumulative trends in their micro data, transitions in care planning will be enhanced, further contributing to improved chronic disease management.
- Published
- 2016
33. Autonomy, Sexuality, and Intellectual Disability
- Author
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Andria Bianchi
- Subjects
030214 geriatrics ,media_common.quotation_subject ,Human sexuality ,medicine.disease ,Developmental psychology ,03 medical and health sciences ,0302 clinical medicine ,Intellectual disability ,medicine ,030212 general & internal medicine ,Medical model of disability ,Psychology ,Autonomy ,media_common - Published
- 2016
34. Deceased Directed Donation
- Author
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Andria Bianchi and Rebecca Greenberg
- Subjects
Transplantation ,Donation ,Multi cultural ,Engineering ethics ,Sociology - Published
- 2018
35. Accessing Indigenous Long-Term Care
- Author
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Kevin Rodrigues, Andria Bianchi, Leonard Benoit, and Danielle Gionnas
- Subjects
Ethics ,Ethical responsibility ,cultural inclusivity ,education.field_of_study ,Economic growth ,Health (social science) ,Social Sciences and Humanities ,Health Policy ,équité ,Population ,Equity (finance) ,BJ1-1725 ,Indigenous ,soins de longue durée ,Autochtones ,Philosophy ,Long-term care ,equity ,Political science ,inclusion culturelle ,long-term care ,Sciences Humaines et Sociales ,education - Abstract
The purpose of this commentary is to present and respond to the gap that currently exists in providing culturally inclusive residential long-term care options for Indigenous peoples in Ontario. After presenting statistics regarding the Indigenous population and long-term care options, we argue that we have an ethical responsibility to offer more culturally inclusive long-term care., L’objectif de ce commentaire est de présenter et de combler les lacunes existant dans l’offre de soins de longue durée en établissement culturellement inclusifs pour les peuples autochtones de l’Ontario. Après avoir présenté des statistiques sur la population autochtone et les options de soins de longue durée, nous soutenons que nous avons la responsabilité éthique d’offrir des options de soins de longue plus inclusifs sur le plan culturel.
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