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Andrada Pârvu

Latest posts by Andrada Pârvu (see all)

  • Considerations on the particularities of the ilness and death perception for rroma people - 23/07/2015
  • CONSIDERATII PRIVIND PARTICULARITATI ALE PERCEPTIEI BOLII SI MORTII LA RROMI - 23/07/2015
  • Models of decision making in pediatrics – part I - 23/07/2015

Articole semnate de acelasi autor in Revista Romana de Pediatrie:

Considerations on the particularities of the ilness and death perception for rroma people

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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Considerations on the particularities of the ilness and death perception for rroma people

Silvia Dumitraş, Rodica Gramma, Gabriel Roman, Andrada Pârvu, Mariana Enache, Stefana Maria Moisa and Beatrice Ioan

ABSTRACT

Through time, the rromas succeeded in maintaining a set of cultural and spiritual characteristics that helped them keep their ethnic identity and their social cohesion. They maintained the Romani language, their social structures, customary, magical-ritualistic and religious complexes, non-verbal types of language, traditional clothing and nomadic style of life. Objective. Identifying the perception of disease and death in the rroma traditional communities. Material and method. The qualitative research was conducted in rroma communities form Cluj and Iaşi counties. The investigative tool was the individual phenomenological interview. 23 interviews were conducted in Iasi and 25 in Cluj County, with chronic rroma patients and caregivers. A phenomenological analysis was used to point out the major topics resulting from the transcription. Results. Disease is interpreted mystically, as a punishment from God or as a curse. There is the belief that all life’s events are predetermined and inevitable. The disease is often associated with shame, being a representation of the spiritual and moral impurity. The rromas know or they have an intuition regarding the real risk factors for their illnesses. Conclusions. In the studied rroma communities, death and disease are taboo topics. Most rromas define health as the absence of the disease, while the disease is a debilitating phenomenon in direct link with death. The diagnostic is reduced to putting a label on the patient’s symptoms. As long as there are no symptoms, the disease does not exist and so the rromas do not respect the recommendations the physician made.

Key words: ethnic identity, rrom, disease, death

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Silvia Dumitraş

CONSIDERATII PRIVIND PARTICULARITATI ALE PERCEPTIEI BOLII SI MORTII LA RROMI

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

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DOAJ
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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

CONSIDERATII PRIVIND PARTICULARITATI ALE PERCEPTIEI BOLII SI MORTII LA RROMI

Silvia Dumitraş, Rodica Gramma, Gabriel Roman, Andrada Pârvu, Mariana Enache, Stefana Maria Moisa and Beatrice Ioan

REZUMAT

De-a lungul timpului, rromii au reuşit să conserve o serie de caracteristici culturale şi spirituale care i-a ajutat să-şi păstreze identitatea etnică şi coeziunea socială. Acestea sunt manifestate, în principal, prin menţinerea elementelor de limbă Rromani, structurilor sociale, complexelor cutumiare, magico-ritualice şi religioase, tipurilor de limbaj non-verbal şi port tradiţional şi, nu în ultimul rând, a nomadismului. Obiectiv. Identificarea percepţiei bolii şi morţii în comunităţile tradiţionale de rromi. Material şi metodă. Cercetarea, de tip calitativ, a fost realizată în rândul unor comunitaţi rrome din judeţele Cluj şi Iaşi. Instrumentul de investigare a fost interviul individual de tip fenomenologic. Au fost efectuate 23 de interviuri în Iaşi şi 25 de interviuri în Cluj, cu pacienţi rromi bolnavi cronici şi aparţinători. S-a realizat o analiză fenomenologică pentru punctarea subiectelor majore care reies din transcrieri. Rezultate. Boala este interpretată în sensuri mistice, ca pedeapsă de la Dumnezeu sau ca blestem. Există credinţa că toate evenimentele vieţii sunt predeterminate şi inevitabile. Boala se asociază frecvent cu sentimentul ruşinii, fiind o reprezentare a impurităţii spirituale şi morale. Rromii sunt conştienţi sau intuiesc factorii de risc reali care provoacă îmbolnăvirea. Concluzii. În comunităţile de rromi studiate, moartea şi boala sunt subiecte tabu. Majoritatea rromilor definesc sănătatea ca absenţă a bolii, iar boala este un fenomen dizabilitant, în directă legatură cu moartea. Diagnosticul se reduce doar la a eticheta simptomele bolnavului. Atât timp cât nu prezintă simptome, pentru rromi boala nu există şi ca atare ei nu respectă recomandările medicului.

Cuvinte cheie: identitate etnică, rrom, boală, moarte

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Silvia Dumitraş

Models of decision making in pediatrics – part I

SELECT ISSUE

Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
Scopus
NLM Catalog
Ebsco Host - Medline
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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

Models of decision making in pediatrics – part I

Stefana Maria Moisa, Rodica Gramma, Andrada Pârvu, Silvia Dumitraş, Mariana Enache, Gabriel Roman, Laurentiu Lucaci and Beatrice Ioan

ABSTRACT

Until recently, the parent was considered to be the legal guardian of the minor aged less than 18-21 years worldwide, thus being entitled and obligated to make medical decisions for the minor. But experience has showed that this model of decision making may not always work in the best interest of the child, especially when parents are part of extremist religious groups. The next step in pediatric decision making ethics was represented by the ability of the doctors to sue parents that refused treatment that was necessary to the child for religious reasons, which was followed by introducing the concept of “emancipated minor”, able to make his/her own healthcare decisions. Recently, British Columbia and New Brunswick regions of Canada have adopted a law that allows “capable” minors to make decisions concerning their own healthcare, the ability to make such decisions being evaluated by the doctor and not depending on the child’s age, but on the degree of his/her neurocognitive development. Paradoxically, this model increases the responsibility of the doctor, who has to evaluate if the minor is competent to make such decisions and if the decision that was made is in the patient’s best medical interest. In this context, the doctor might not be aware of certain social, cultural and religious aspects that might guide the minor’s decision, and this model does not eliminate medical paternalism, but it offers it new faces. The Dutch legislation permits euthanasia of competent persons aged more than 12, that request the active ending of their own life. Recently, this country has adopted the Groningen Protocol, a series of medical guidelines that allow the euthanasia on newborns with incurable diseases and a predicted deficient life quality. Those who oppose this protocol state that applying it opens the way to eugenics. World legislation is heterogeneous regarding pediatric decision making. Each of the presented models has apparently insurmountable deficiencies. This paper was written during the Project “Postdoctoral Studies in the Field of Health Policies Ethics” POSDRU/89/1.5/S/61879 cofinanced by the Social European Fund through the Sectorial Operational Program for Human Resources Development, 2007-2013.

Key words: decision making, pediatrics

Full text | PDF

Stefana Maria Moisa

MODELE DE LUARE A DECIZIILOR IN PEDIATRIE – PARTEA I

SELECT ISSUE

Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
Scopus
NLM Catalog
Ebsco Host - Medline
Google Academic
Semantic Scholar

HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

MODELE DE LUARE A DECIZIILOR IN PEDIATRIE – PARTEA I

Stefana Maria Moisa, Rodica Gramma, Andrada Pârvu, Silvia Dumitraş, Mariana Enache, Gabriel Roman, Laurentiu Lucaci and Beatrice Ioan

REZUMAT

Până recent, în întreaga lume se considera că părintele este tutorele legal al copilului cu vârsta mai mică de 18-21 ani, acest lucru atragând după sine dreptul şi obligaţia de a lua decizii medicale în numele minorului. Experienţa a arătat, însă, că acest model de luare a deciziilor poate să nu lucreze întotdeauna în interesul copilului, în special în situaţia în care părinţii fac parte din anumite grupuri religioase. Următorul pas în etica luării deciziilor în pediatrie a fost reprezentat de posibilitatea medicilor de a acţiona în instanţă părinţii care refuzau tratamentul necesar copiilor din motive religioase, etapă urmată de aceea a introducerii conceptului de „minor emancipat“, capabil de a lua decizii privind propria sănătate. Recent, în Canada, regiunile British Columbia şi New Brunswick au adoptat o lege care permite minorilor „capabili“ să ia decizii privind propria sănătate, capacitatea de luare a deciziilor fiind evaluată de medic şi nedepinzând de vârsta copilului, ci de gradul de dezvoltare neurocognitivă a acestuia. Acest model creşte, în mod paradoxal, responsabilitatea medicului, care trebuie să evalueze dacă minorul este competent decizional şi dacă decizia luată de acesta este în acord cu propriul interes al copilului din punct de vedere medical. În acest context, medicul poate fi depăşit de unele aspecte sociale, culturale şi religioase care ar ghida decizia minorului, iar acest model nu elimină paternalismul în medicină, ci doar îi oferă alte valenţe. Legislaţia olandeză permite euthanasia în cazul persoanelor competente, cu vârsta mai mare de 12 ani, care solicită întreruperea activă a propriei vieţi. Recent, această ţară a adoptat Protocolul Groningen, o serie de ghiduri medicale şi legale care permit euthanasia nou-născuţilor cu boli incurabile şi cu o calitate prezisă a vieţii deficitară. Opozanţii protocolului afirmă faptul că aplicarea acestuia deschide drumul spre eugenie. Legislaţia mondială este heterogenă în ceea ce priveşte luarea deciziilor medicale la copil. Fiecare dintre modelele prezentate are deficienţe aparent insurmontabile. Această lucrare a fost realizată în cadrul Proiectului „Studii postdoctorale în domeniul eticii politicilor de sănătate“ POSDRU/89/1.5/S/61879 cofinanţat din Fondul Social European prin Programul Operaţional Sectorial pentru Dezvoltarea Resurselor Umane 2007-2013.

Cuvinte cheie: luarea deciziilor, pediatrie

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Stefana Maria Moisa

Models of decision making in pediatrics – part II

SELECT ISSUE

Revista Romana de PEDIATRIE | Volumul LXII, Nr. 2, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
Scopus
NLM Catalog
Ebsco Host - Medline
Google Academic
Semantic Scholar

HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

Models of decision making in pediatrics – part II

Stefana Maria Moisa, Rodica Gramma, Andrada Pârvu, Silvia Dumitraş, Mariana Enache, Gabriel Roman, Laurentiu Lucaci and Beatrice Ioan

ABSTRACT

Until recently, the parent was considered to be the legal guardian of the minor aged less than 18-21 years worldwide, thus being entitled and obligated to make medical decisions for the minor. But experience has showed that this model of decision making may not always work in the best interest of the child, especially when parents are part of extremist religious groups. The next step in pediatric decision making ethics was represented by the ability of the doctors to sue parents that refused treatment that was necessary to the child for religious reasons, which was followed by introducing the concept of “emancipated minor”, able to make his/her own healthcare decisions. Recently, British Columbia and New Brunswick regions of Canada have adopted a law that allows “capable” minors to make decisions concerning their own healthcare, the ability to make such decisions being evaluated by the doctor and not depending on the child’s age, but on the degree of his/her neurocognitive development. Paradoxically, this model increases the responsibility of the doctor, who has to evaluate if the minor is competent to make such decisions and if the decision that was made is in the patient’s best medical interest. In this context, the doctor might not be aware of certain social, cultural and religious aspects that might guide the minor’s decision, and this model does not eliminate medical paternalism, but it offers it new faces. The Dutch legislation permits euthanasia of competent persons aged more than 12, that request the active ending of their own life. Recently, this country has adopted the Groningen Protocol, a series of medical guidelines that allow the euthanasia on newborns with incurable diseases and a predicted deficient life quality. Those who oppose this protocol state that applying it opens the way to eugenics. World legislation is heterogeneous regarding pediatric decision making. Each of the presented models has apparently insurmountable deficiencies. This paper was written during the Project “Postdoctoral Studies in the Field of Health Policies Ethics” POSDRU/89/1.5/ S/61879 cofinanced by the Social European Fund through the Sectorial Operational Program for Human Resources Development, 2007-2013.

Key words: decision making, pediatrics

Full text | PDF

Stefana Maria Moisa

MODELE DE LUARE A DECIZIILOR IN PEDIATRIE – PARTEA A II-A

SELECT ISSUE

Revista Romana de PEDIATRIE | Volumul LXII, Nr. 2, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
Scopus
NLM Catalog
Ebsco Host - Medline
Google Academic
Semantic Scholar

HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

MODELE DE LUARE A DECIZIILOR IN PEDIATRIE – PARTEA A II-A

Stefana Maria Moisa, Rodica Gramma, Andrada Pârvu, Silvia Dumitraş, Mariana Enache, Gabriel Roman, Laurentiu Lucaci and Beatrice Ioan

REZUMAT

Până recent, în întreaga lume se considera că părintele este tutorele legal al copilului cu vârsta mai mică de 18-21 ani, acest lucru atrăgând după sine dreptul şi obligaţia de a lua decizii medicale în numele minorului. Experienţa a arătat, însă, că acest model de luare a deciziilor poate să nu lucreze întotdeauna în interesul copilului, în special în situaţia în care părinţii fac parte din anumite grupuri religioase. Următorul pas în etica luării deciziilor în pediatrie a fost reprezentat de posibilitatea medicilor de a acţiona în instanţă părinţii care refuzau tratamentul necesar copiilor din motive religioase, etapă urmată de aceea a introducerii conceptului de „minor emancipat“, capabil de a lua decizii privind propria sănătate. Recent, în Canada, regiunile British Columbia şi New Brunswick au adoptat o lege care permite minorilor „capabili“ să ia decizii privind propria sănătate, capacitatea de luare a deciziilor fi ind evaluată de medic şi nedepinzând de vârsta copilului, ci de gradul de dezvoltare neurocognitivă a acestuia. Acest model creşte, în mod paradoxal, responsabilitatea medicului, care trebuie să evalueze dacă minorul este competent decizional şi dacă decizia luată de acesta este în acord cu propriul interes al copilului din punct de vedere medical. În acest context, medicul poate fi depăşit de unele aspecte sociale, culturale şi religioase care ar ghida decizia minorului, iar acest model nu elimină paternalismul în medicină, ci doar îi oferă alte valenţe. Legislaţia olandeză permite euthanasia în cazul persoanelor competente, cu vârsta mai mare de 12 ani, care solicită întreruperea activă a propriei vieţi. Recent, această ţară a adoptat Protocolul Groningen, o serie de ghiduri medicale şi legale care permit euthanasia nou-născuţilor cu boli incurabile şi cu o calitate prezisă a vieţii deficitară. Opozanţii protocolului afirmă faptul că aplicarea acestuia deschide drumul spre eugenie. Legislaţia mondială este heterogenă în ceea ce priveşte luarea deciziilor medicale la copil. Fiecare dintre modelele prezentate are deficienţe aparent insurmontabile. Această lucrare a fost realizată în cadrul Proiectului „Studii postdoctorale în domeniul eticii politicilor de sănătate“ POSDRU/89/1.5/S/61879 cofinanţat din Fondul Social European prin Programul Operaţional Sectorial pentru Dezvoltarea Resurselor Umane 2007-2013.

Cuvinte cheie: luare a deciziilor, pediatrie

Full text | PDF

Stefana Maria Moisa


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