User:Caitlin.mady/sandbox

Caitlin is in Physical & Health Education at McGill University, she began in 2015. She is also Health coach and group instructor at UNI Training

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Here is a link to my program

Article Evaluation:

My first thought on reading the wikipedia article on physical education is that the introductory paragraph is very short without any pertinent information.

I noticed there was missing information about PE and South America.

The two citations I tried did work

Carp, Ontario:

I am unfamiliar with this location therefore I will have to research prior to making any contribution to this article

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Autonomy EDITS:

Introduction In development or moral, political, and bioethical philosophy, autonomy[1] is the capacity to make an informed, un-coerced decision. Autonomous organizations or institutions are independent or self-governing. Autonomy can also be defined from human resource perspective and it means a level of discretion granted to an employee in his or her work. In such cases, autonomy is known to bring some sense of job satisfaction among the employees. Autonomy is a term that is also widely used and in the field of medicine. As a matter of fact, personal autonomy is greatly recognized and valued in health care. Medicine Autonomy can be defined as the ability of the person to make his or her own decisions. This faith in autonomy is the central premise of the concept of informed consent and shared decision making. In a medical context, respect for a patient's personal autonomy is considered one of many fundamental ethical principles in medicine. This idea, while considered essential to today's practice of medicine, was developed in the last 50 years. According to Tom Beauchamp and James Childress (in Principles of Biomedical Ethics), the Nuremberg trials detailed accounts of horrifyingly exploitative medical "experiments" which violated the subjects' physical integrity and personal autonomy.[12] These incidences prompted calls for safeguards in medical research, such as the Nuremberg Code which stressed the importance of voluntary participation in medical research. It is believed that the Nuremberg Code served as the premise for many current documents regarding research ethics.[13] Respect for autonomy became incorporated in health care and patients could be allowed to make personal decisions about the health care services that they receive. Notably, autonomy has several aspects as well as challenges that affect health care operations. The manner in which a patient is handled may undermine or support autonomy of a patient and for this reason, the way a patient is communicated to becomes very crucial. A good relationship between a patient and a health care practitioner needs to be well defined to ensure that autonomy of a patient is respected. Just like in any other life situation, a patient would not like to be under the control of another person. The move to emphasize respect for patient’s autonomy rose from the vulnerabilities that were pointed out in regards to autonomy. However, autonomy does not only apply in a research context. Users of the health care system have the right to be treated with respect for their autonomy, instead of being dominated by the physician. This is referred to as paternalism. While paternalism is meant to be overall good for the patient, this can very easily interfere with autonomy.[14] Through the therapeutic relationship, a thoughtful dialogue between the client and the physician may lead to better outcomes for the client, as he or she is more of a participant in decision-making. Autonomy varies and some patients find it overwhelming especially the minors when faced with emergency situations. It is important to note that not very patient is capable of making an autonomous decision. Those who are unable to make the decisions prompt a challenge to medical practitioners since it becomes difficult to determine the ability of a patient to make a decision. To some extent, it has been said that emphasis of autonomy in health care has undermined the practice of health care practitioners to improve the health of their patient as necessary. The scenario has led to tension in the relationship between a patient and a heath care practitioner. This is because as much as a physician want to prevent a patient from suffering, he or she still has to respect autonomy. Beneficence allows physicians to act responsibly in their practice, which may involve overlooking autonomy. The gap between a patient and a physician has led to problems because in other cases, the patients have complained of not being adequately informed. The seven elements of informed consent (as defined by Beauchamp and Childress) include threshold elements (competence and voluntariness), information elements (disclosure, recommendation, and understanding) and consent elements (decision and authorization).[15] Some philosophers such as Harry Frankfurt consider Beauchamp and Childress criteria insufficient. They claim that an action can only be considered autonomous if it involves the exercise of the capacity to form higher-order values about desires when acting intentionally.[16] What this means is that patients may understand their situation and choices but would not be autonomous unless the patient is able to form value judgements about their reasons for choosing treatment options they would not be acting autonomously. There are many different definitions of autonomy, many of which place the individual in a social context. See also: relational autonomy, which suggests that a person is defined through their relationships with others, and "supported autonomy"[17] which suggests that in specific circumstances it may be necessary to temporarily compromise the autonomy of the person in the short term in order to preserve their autonomy in the long-term. Other definitions of the autonomy imagine the person as a contained and self-sufficient being whose rights should not be compromised under any circumstance. In certain unique circumstances government may have the right to temporarily override the right to bodily integrity in order to preserve the life and well-being of the person. Such action can be described using the principle of "supported autonomy",[17] a concept that was developed to describe unique situations in mental health (examples include the forced feeding of a person dying from the eating disorder anorexia nervosa, or the temporary treatment of a person living with a psychotic disorder with antipsychotic medication). While controversial, the principle of supported autonomy aligns with the role of government to protect the life and liberty of its citizens. Terrence F. Ackerman has highlighted problems with these situations, he claims that by undertaking this course of action physician or governments run the risk of misinterpreting a conflict of values as a constraining effect of illness on a patient’s autonomy. Accordingly, the suitability of autonomy is influenced by the prevailing situation and not all cases seem to demand full adherence to a patient’s autonomy. Some instances may necessitate the physician to prioritize the health of the patient even if the patient refuses to comply. This is the same scenario explained above. Many people would feel that the duty of a physician to promote health should not be undermined. However, some people may feel that no matter the circumstance, autonomy should be respected. It means that the decision that a patient makes is respected by the physician, even if it is contrary to his or her health. Since the 1960s, there have been attempts to increase patient autonomy including the requirement that physician’s take bioethics courses during their time in medical school.[20] Despite large scale commitment to promoting patient autonomy, public mistrust of medicine in developed countries has remained.[21] Onora O'Neill has ascribed this lack of trust to medical institutions and professionals introducing measures that benefit themselves, not the patient. O’Neill claims that this focus on autonomy promotion has been at the expense of issues like distribution of healthcare resources and public health. Autonomy can be addressed from a real and an ideal perspective. In an ideal perspective, it is easy to push for autonomy as it is seen as a way of safeguarding patient’s freedom and decision-making. Real life situations become hard to respect autonomy and at the same time promote health among the patients. Failure to respect autonomy, a physician may find himself in legal problems. Finding a balance between the two conflicting factors in health care becomes a challenge. One proposal to increase patient autonomy is through the use of support staff. The use of support staff including medical assistants, physician assistants, nurse practitioners, nurses, and other staff that can promote patient interests and better patient care.[22] Nurses especially can learn about patient beliefs and values in order to increase informed consent and possibly persuade the patient through logic and reason to entertain a certain treatment plan.[23][24] This would promote both autonomy and beneficence, while keeping the physician’s integrity intact. Furthermore, Humphreys asserts that nurses should have professional autonomy within their scope of practice (35-37). Humphreys argues that if nurses exercise their professional autonomy more, then there will be an increase patient autonomy (35-37).

Child Development
Autonomy in childhood and adolescence is when one strives to gain a sense of oneself as a separate, self-governing individual. Between ages 1-3, during the second stage of Erikson's and Freud's stages of development, the psychosocial crisis that occurs is autonomy versus shame and doubt. The significant event that occurs during this stage is that children must learn to be autonomous, and failure to do so may lead to the child doubting their own abilities and feel ashamed. When a child becomes autonomous it allows them to explore and acquire new skills. Autonomy has two vital aspects wherein there is an emotional component where one relies more on themselves rather than their parents and a behavioural component where one makes decisions independently by using their judgement. The styles of child rearing affect the development of a child's autonomy. Authoritative child rearing is the most successful approach, where the parents engage in autonomy granting appropriate to their age and abilities. Autonomy in adolescence is closely related to their quest for identity. In adolescence parents and peers act as agents of influence. Peer influence in early adolescence may help the process of an adolescent to gradually become more autonomous by being less susceptible to parental or peer influence as they get older. In adolescence the most important development task is to develop a healthy sense of autonomy.