Oren Asman
Dr. Oren Asman is a Senior Lecturer in the Department of Nursing, School of Health Professions, Faculty of Medicine, in Tel Aviv University. His LLB (Bachelor of Laws) and LLM (Master of Laws) were obtained in Haifa University Faculty of Law and his LLD (Doctor of Laws) is from the Hebrew University in Jerusalem. Dr. Asman was a Visiting Scholar at the Kennedy Institute of Ethics (Philosophy, Georgetown), the Harvard Project on Disability (Harvard Law School), and Johns Hopkins School of Nursing. He has received several research grants in the United States, Germany and Israel. He is a member of the editorial board of the Journal of Medicine and Law (in Hebrew) and serves as a reviewer for journals in the sphere of law, medicine, and nursing.Since 2018 Dr. Asman serves as Executive Director of the Bioethics and Law Center (in progress) at the Sackler Faculty of Medicine in Tel Aviv University.Dr. Asman chaired the scientific program of the World Congress of Medical Law and Bioethics, as a collaborative effort of the Bioethics and Law Center and the World Association for Medical Law (where he served as Vice President from 2012-2018). Dr. Asman presented over 120 papers at international conferences in more than 20 countries and states. He was a visiting lecturer in Bioethics at the MCI Business School in Innsbruck, Austria
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Videos by Oren Asman
For more than 100 videos of the centers' meetings and activities please see our YouTube channel:
https://www.youtube.com/channel/UCzsc4GKdUdEgB25kJmw8qng?app=desktop
Papers by Oren Asman
Communication via social networks has different norms than in the “offline” world and broadens the sphere of student-teacher interactions. Facebook is mainly used for social interaction and information sharing. However, it also serves as an education and learning platform. This risks boundary-blurred behaviors between students and their academic teachers in the virtual space. The current study examines the differences in perceived subjective norms, attitudes, and reported behaviors of academic teachers and nursing students’ boundary-blurred behaviors with each other on Facebook.
Methods
A cross-sectional study was utilized, guided by the Theory of Reasoned Action (TRA), examining attitudes, subjective norms, and reported virtual behaviors that signify blurred student-teacher boundaries. Data were collected among 223 nursing students and 78 academic teachers. The university’s ethics committee approved the research (#21.9.19).
Results
Consistent with the TRA, a significant correlation was found between virtual boundary-blurred behaviors and attitudes (r = .55, P < .001), university subjective norms (r = .48, p < .001), and peers’ subjective norms (r = .47, p < .001). Nursing students’ attitudes were significantly (t = 5.81; p < .001) more favorable towards boundary-blurred behaviors (M = 2.40, SD = 0.91) than those of academic-teachers (M = 1.71, SD = 0.83), and so were the perceived subjective norms of their student peers (M = 2.72, SD = 1.15) compared to those of their teachers (M = 2.09, SD = 1.14). Interestingly, the difference in reports of boundary-blurred Facebook behaviors between teachers (M = 1.36, SD = 0.52) and students (M = 1.49, SD = 0.70) was not significant. Boundary-blurred behaviors for teachers were best predicted by attitudes and perceived subjective norms of the university [R2 = 0.62; F(5,72) = 23.31], and for students by attitudes and perceived subjective norms of their peers [R2 = 0.45; F)5,216) = 28.88].
Conclusions
The differences demonstrated between students and teachers may emanate from the perception of the teacher’s role and generational gaps. These may lead to miscommunication and the crossing of boundaries. The findings indicate the importance of setting more explicit guidelines for using social media in the context of student-teacher communication.
We propose that an adaptive decision-making support model could effectively incorporate elements from both these frameworks. This can be evidenced by the principles underpinning the Israeli Legal Aid Shared Decision Making “Collaborative Support Pact Protocol”, that have developed from the experience of providing decision support. The protocol typically involves the initial definition and drafting of the decision support pact, the specification of various support domains, and the desired outcomes in each domain, all of which are facilitated by a third-party mediator, usually a jurist. The pact may be revised later, reflecting ongoing decision-support interactions. In certain domains, it may be agreed to apply the mental prosthesis approach. By merging these models, a dynamic and respectful relationship is fostered that can adapt to the unique needs and circumstances of each supported individual.
Looking into the future, CAI-based psychotherapy presents an increasingly challenging question about therapeutic alliance in a post-humanistic interaction: How may the (human) patient experience, cognitively and emotionally, the (now machine-generated) therapist’s compassion, empathy, good intentions, and understanding? How would perceived incidents of transference, “rupture and repair”, or simply moments of quiet and reflection, be experienced in this computer-human interaction? Based on a CAI-patient alliance conceptualization, we look for an ethical framework that considers etiquette, virtue and care ethics, boundaries, harm reduction, patient’s self-fulfillment and personal exposure.
English Abstract: The paper presents a case-based analysis of the ethical and legal aspects of outrageous behavior towards patients in the mental health setting. The elements of “outrageous behavior” as developed in the Anglo-American law are first presented, followed by a description of the ethical and legal framework of “outrageous behavior” in Israel that relates to damages resulting from therapy. Finally, clinical scenarios that may potentially result in such legal claims are presented along with clinical options to reduce the legal risk.
Keywords: התנהגות מקוממת, אתיקה בבריאות נפש, רשלנות בטיפול נפשי, אחריות מקצועית בבריאות נפש
Suggested Citation
המחברים דוחים את הטענה כאילו יישום עקרונות המשפט הטיפולי פירושו לראות בוועדה הפסיכיאטרית גוף מטפל ומבהירים כי הכרה ברגשות, התנהגויות, רווחה ובריאות נפשית של המטופל הן עיקרי גישה של משפטנות טיפולית אולם אין בה כדי להגדיר הליך משפטי זה כטיפול פסיכיאטרי. לגישתם, השימוש בכלים המקצועיים הרלוונטיים, שעומדים לרשות חברי הוועדה, במסגרת הסמכות המשפטית והמקצועית שלה, נועדים לאפשר לה להגשים בצורה המיטבית את תכליתו של חוק הטיפול בחולי הנפש – לטפל. לאור האמור, חובה להבהיר מהי משפטנות טיפולית ובדגש על הרישא: משפטנות. יישום עקרונות המשפט הטיפולי, Therapeutic Jurisprudence, בעבודת הוועדה אינם טיפול במובן הקליני אלא משפטנות טיפולית במשמעות של "משפט מקדם בריאות". עוד מציעים המחברים כי יישום עקרונות משפטנות טיפולית נכון הן להליכים של אשפוז וטיפול במסגרת צו פלילי והן להליכים במסגרת הוראה אזרחית, שכן "הנפש היא אותה הנפש".
The study aimed to (1) examine health behaviors and perceived health among nurses; (2) analyze the effect of nurses’ personal and work characteristics on these variables; and (3) explore the relationship between health behaviors and nurses’ health perception.
Design and methods
A cross-sectional study was conducted among nurses working in health care organizations (HCOs) across Israel. An email with the online questionnaire was sent to nurses working in 19 HCOs across Israel during September–December 2018.
Findings:
Of 18,120 nurses employed, 3542 completed the survey. Mean age was 44.8 years, 91% were female), 64.6% were hospital nurses and 52.8% were clinical staff nurses. Two-thirds of nurses did not achieve the physical activity (PA) target; the majority reported unfavorable eating habits; 66% slept less than 7 h at night and 15% smoke. Hospital nurses working night shifts reported the least favorable health behaviors. Non-Jewish nurses had less eating habits compared with Jewish nurses. Nurses born in the Former Soviet Union perceived their health as significantly worse than that of the other respondents. Binomial logistic regression demonstrated that, age, Israeli origin, achieving the PA target, having food breaks during work, consuming a Mediterranean diet, sleeping at least 7 h, undergoing screening tests as recommended, and not smoking predicted better health perception among nurses.
Conclusions:
Nurses, particularly hospital-based, non-Jewish and immigrants from the Soviet Union, demonstrated unfavorable health behaviors that may negatively affect their wellbeing and health perception.
Clinical relevance:
Interventions aimed at improving the health-promoting mindset of nurses have the potential to improve their health and wellbeing and to enable them to become role models and health educators for patients and their families.
In the current paper, the relevance of this philosophically based legal tool is examined in the context of Deep Brain Stimulation device that may change personality and behaviours.
For more than 100 videos of the centers' meetings and activities please see our YouTube channel:
https://www.youtube.com/channel/UCzsc4GKdUdEgB25kJmw8qng?app=desktop
Communication via social networks has different norms than in the “offline” world and broadens the sphere of student-teacher interactions. Facebook is mainly used for social interaction and information sharing. However, it also serves as an education and learning platform. This risks boundary-blurred behaviors between students and their academic teachers in the virtual space. The current study examines the differences in perceived subjective norms, attitudes, and reported behaviors of academic teachers and nursing students’ boundary-blurred behaviors with each other on Facebook.
Methods
A cross-sectional study was utilized, guided by the Theory of Reasoned Action (TRA), examining attitudes, subjective norms, and reported virtual behaviors that signify blurred student-teacher boundaries. Data were collected among 223 nursing students and 78 academic teachers. The university’s ethics committee approved the research (#21.9.19).
Results
Consistent with the TRA, a significant correlation was found between virtual boundary-blurred behaviors and attitudes (r = .55, P < .001), university subjective norms (r = .48, p < .001), and peers’ subjective norms (r = .47, p < .001). Nursing students’ attitudes were significantly (t = 5.81; p < .001) more favorable towards boundary-blurred behaviors (M = 2.40, SD = 0.91) than those of academic-teachers (M = 1.71, SD = 0.83), and so were the perceived subjective norms of their student peers (M = 2.72, SD = 1.15) compared to those of their teachers (M = 2.09, SD = 1.14). Interestingly, the difference in reports of boundary-blurred Facebook behaviors between teachers (M = 1.36, SD = 0.52) and students (M = 1.49, SD = 0.70) was not significant. Boundary-blurred behaviors for teachers were best predicted by attitudes and perceived subjective norms of the university [R2 = 0.62; F(5,72) = 23.31], and for students by attitudes and perceived subjective norms of their peers [R2 = 0.45; F)5,216) = 28.88].
Conclusions
The differences demonstrated between students and teachers may emanate from the perception of the teacher’s role and generational gaps. These may lead to miscommunication and the crossing of boundaries. The findings indicate the importance of setting more explicit guidelines for using social media in the context of student-teacher communication.
We propose that an adaptive decision-making support model could effectively incorporate elements from both these frameworks. This can be evidenced by the principles underpinning the Israeli Legal Aid Shared Decision Making “Collaborative Support Pact Protocol”, that have developed from the experience of providing decision support. The protocol typically involves the initial definition and drafting of the decision support pact, the specification of various support domains, and the desired outcomes in each domain, all of which are facilitated by a third-party mediator, usually a jurist. The pact may be revised later, reflecting ongoing decision-support interactions. In certain domains, it may be agreed to apply the mental prosthesis approach. By merging these models, a dynamic and respectful relationship is fostered that can adapt to the unique needs and circumstances of each supported individual.
Looking into the future, CAI-based psychotherapy presents an increasingly challenging question about therapeutic alliance in a post-humanistic interaction: How may the (human) patient experience, cognitively and emotionally, the (now machine-generated) therapist’s compassion, empathy, good intentions, and understanding? How would perceived incidents of transference, “rupture and repair”, or simply moments of quiet and reflection, be experienced in this computer-human interaction? Based on a CAI-patient alliance conceptualization, we look for an ethical framework that considers etiquette, virtue and care ethics, boundaries, harm reduction, patient’s self-fulfillment and personal exposure.
English Abstract: The paper presents a case-based analysis of the ethical and legal aspects of outrageous behavior towards patients in the mental health setting. The elements of “outrageous behavior” as developed in the Anglo-American law are first presented, followed by a description of the ethical and legal framework of “outrageous behavior” in Israel that relates to damages resulting from therapy. Finally, clinical scenarios that may potentially result in such legal claims are presented along with clinical options to reduce the legal risk.
Keywords: התנהגות מקוממת, אתיקה בבריאות נפש, רשלנות בטיפול נפשי, אחריות מקצועית בבריאות נפש
Suggested Citation
המחברים דוחים את הטענה כאילו יישום עקרונות המשפט הטיפולי פירושו לראות בוועדה הפסיכיאטרית גוף מטפל ומבהירים כי הכרה ברגשות, התנהגויות, רווחה ובריאות נפשית של המטופל הן עיקרי גישה של משפטנות טיפולית אולם אין בה כדי להגדיר הליך משפטי זה כטיפול פסיכיאטרי. לגישתם, השימוש בכלים המקצועיים הרלוונטיים, שעומדים לרשות חברי הוועדה, במסגרת הסמכות המשפטית והמקצועית שלה, נועדים לאפשר לה להגשים בצורה המיטבית את תכליתו של חוק הטיפול בחולי הנפש – לטפל. לאור האמור, חובה להבהיר מהי משפטנות טיפולית ובדגש על הרישא: משפטנות. יישום עקרונות המשפט הטיפולי, Therapeutic Jurisprudence, בעבודת הוועדה אינם טיפול במובן הקליני אלא משפטנות טיפולית במשמעות של "משפט מקדם בריאות". עוד מציעים המחברים כי יישום עקרונות משפטנות טיפולית נכון הן להליכים של אשפוז וטיפול במסגרת צו פלילי והן להליכים במסגרת הוראה אזרחית, שכן "הנפש היא אותה הנפש".
The study aimed to (1) examine health behaviors and perceived health among nurses; (2) analyze the effect of nurses’ personal and work characteristics on these variables; and (3) explore the relationship between health behaviors and nurses’ health perception.
Design and methods
A cross-sectional study was conducted among nurses working in health care organizations (HCOs) across Israel. An email with the online questionnaire was sent to nurses working in 19 HCOs across Israel during September–December 2018.
Findings:
Of 18,120 nurses employed, 3542 completed the survey. Mean age was 44.8 years, 91% were female), 64.6% were hospital nurses and 52.8% were clinical staff nurses. Two-thirds of nurses did not achieve the physical activity (PA) target; the majority reported unfavorable eating habits; 66% slept less than 7 h at night and 15% smoke. Hospital nurses working night shifts reported the least favorable health behaviors. Non-Jewish nurses had less eating habits compared with Jewish nurses. Nurses born in the Former Soviet Union perceived their health as significantly worse than that of the other respondents. Binomial logistic regression demonstrated that, age, Israeli origin, achieving the PA target, having food breaks during work, consuming a Mediterranean diet, sleeping at least 7 h, undergoing screening tests as recommended, and not smoking predicted better health perception among nurses.
Conclusions:
Nurses, particularly hospital-based, non-Jewish and immigrants from the Soviet Union, demonstrated unfavorable health behaviors that may negatively affect their wellbeing and health perception.
Clinical relevance:
Interventions aimed at improving the health-promoting mindset of nurses have the potential to improve their health and wellbeing and to enable them to become role models and health educators for patients and their families.
In the current paper, the relevance of this philosophically based legal tool is examined in the context of Deep Brain Stimulation device that may change personality and behaviours.
Keywords End of life · Jewish law · Competence · Israeli law · Patient near death
Keywords Clinical research · CBRNE · Clinical ethics · Solidarity · Bioethics · Disasters ethics
Financial considerations can have a direct or indirect impact on the legal process, both technically (funding availability and ability) and psychologically (the importance attributed to financial considerations in human decision-making processes).
In many cases – money can be seen as a moving force in the legal process, from the moment a person contemplates the idea of initiating it; throughout the process; and even after a judgment is reached.
הרצאות (ד"ר אורן אסמן)
1. מידות טובות בתקופה פחות טובה (אתיקה בזמן הקורונה), מדרשת לשכת עורכי הדין (2.11.2020)
2. צדק והקצאת משאבים בעידן הקורונה, מדרשת לשכת עורכי הדין (27.4.2020)
3. אוטונומיה, אשפוז כפוי וגישת המשפט הטיפולי, מדרשת לשכת עורכי הדין (19.4.2020)
4. היערכות למגיפת הקורונה בישראל: איזון ערכים בבריאות הציבור, תכנית מוסמך בחוג לסיעוד, אוניברסיטת תל אביב (11.3.2020)
5. המט(ו)פל במרכז – באתיקה ובמשפט, טקס הענקת תעודות ד"ר לרפואה, אוניברסיטת ת"א 18.6.2019
6. על המערכת הרפואית לשקול מחדש את מעורבותה בדוקו-ריאליטי בחדרי הלידה , אתנחתא, אונ' ת"א 21.5.2019
7. אתיקה רפואית בעידן הדיגיטאלי, 7.5.2019, רפואה והומניזם, אוניברסיטת תל אביב
אירועים אקדמיים ומקצועיים
8. זכויות החולה וחוק הטיפול בחולי הנפש: בחירה, כפיה וחלופות בטיפול פסיכיאטרי אקוטי המרכז לבריאות, משפט ואתיקה, אוניברסיטת חיפה (15.12.2021)
9. בריאות הנפש – הזכות לקבל טיפול רפואי בתנאים הולמים,פורום בריאות הנפש, לשכת עורכי הדין בישראל (25.8.2021)
10. פוסט טראומה: קליניקה, מחקר ומחלוקת פורום בריאות הנפש, לשכת עורכי הדין בישראל (13.5.2021)
11. "בלב פתוח ובנפש חפצה – על אשפוז כפוי - לרגל פרישתו של כב' השופט ברלינר" המרכז לביואתיקה ולמשפט, אוניברסיטת תל אביב (10.2.2021)
12. "חשבון נפש" – משפט טיפולי, האתגר הבא? הקריה האקדמית אונו, משרד הבריאות ומשרד המשפטים (31.12.2020)
13. אירוע המשפט המבוים הפומבי בנושא משפט ופסיכיאטריה , המרכז הבינתחומי (30.6.2020)
ראיונות בתקשורת
14. "המאבק חוצה היבשות על חייה של אלטע (פרשת אלטע פיקלסר)", חדשות השבת, כאן 11 (26.6.2021)
15. אתגרים בטיפול בחולת אנורקסיה המבקשת להשתחרר מאשפוז ו"חוזה יוליסס" בחוק הכשרות המשפטית: "אולפן שישי" בערוץ 2 (21.4.2017)
Public Lectures and Conferences videos on Health, Law, and Ethics (with Dr. Oren Asman)
16. Human Rights and the COVID-19 emergency regulations in Israel, The Ukrainian Advocates Association (May 2020)
17. Genetics, Data, Privacy, Ethics and Policy, Bioethics and Law Center, Tel Aviv University, (May 2019)
18. Medical Law and Bioethics - Connecting the Dots Internationally World Congress on Medical Law 1.9.2018)
19. Avoiding Ethical Pitfalls, Johns Hopkins School of Nursing (4.8.2016)
20. Legal Responsibilities of Senior Health Care Managers – Recent Israeli Cases, St. Petersburg International Legal Forum (17.5.2013)
21. Ethics in Forensic Medicine (Thomas T. Noguchi and Oren Asman) Kennedy Institute of Ethics, Georgetown University (10.4.2013)