This dissertation was used to addresses a group of individuals who work as eye bank coordinators. These individuals call families and approach them for eye donations from a loved one who has just passed away. An interpretative phenomenological analysis (IPA) was used to explain the lived experience of eye bank coordinators who call families for consent of eye tissue. The focus was to understand the dedication of the coordinators to giving the gift of sight and exploring the positive and negative experiences of eye bank coordinators. IPA is used for a keen understanding of eye bank coordinators, and the investigator gained insight as to why their role and well-being is important to eye banks by conducting and analyzing the interviews through the lived experiences of eye bank coordinators. The theoretical underpinnings of this research were based on the theory of planned behavior and self-perception theory. Four participants were interviewed as to their positive and negative experiences in their daily work. The research questions were What are the positive and negative experiences of eye bank coordinators when requesting permission for eye donations from bereaved families (RQ1)? and How do the positive and negative lived experience of eye bank coordinators influence their adjustment of strategies when requesting permission for eye donations from bereaved families (RQ2)? Encountering positive and enthusiastic family donors, needing to understand the situation or grief of family members, encountering closed-minded family members, and limited negative encounters experienced were the main themes that addressed RQ1. The main themes that addressed RQ2 were having the energy and motivation to seek for more donors, ensuring the right information was conveyed to the families, feeling more relaxed and comfortable, continuing to explain and ensure the correct information was conveyed, coaching and collecting oneself back, knowing how to read the actions and reactions of families, and learning from experiences and becoming more cautious.

A Autorização por Representação é utilizada quando uma pessoa está impossibilitada - ou não habilitada legalmente - para consentir com um determinado procedimento assistencial ou com a participação em um projeto de pesquisa. Um dos diversos fatores que podem influenciar o representante durante o processo de autorização é a idade da pessoa representada. Com o objetivo de avaliar a diversidade no processo de obtenção da Autorização por Representação em situações assistenciais e de pesquisa em crianças e idosos foram desenvolvidos dois estudos. O primeiro foi um estudo transversal que visou avaliar o Desenvolvimento Psicológicomoral como um indicativo da capacidade para consentir em uma amostra de adolescentes e idosos. Não houve diferença entre o grupo de adolescentes e o de idosos em relação ao Desenvolvimento Psicológico-moral. O segundo estudo comparou o processo de obtenção da Autorização por Representação quanto ao grupo etário dos representados e a situação assistencial ou de pesquisa, através de uma simulação de um processo de autorização por representação. Os instrumentos utilizados foram Termos de Consentimento fictícios, compreendendo situações de assistência e pesquisa clínica em crianças e idosos. Do total de participantes, 97,0% responderam que autorizariam a realização do procedimento assistencial, 81,5% deles lembravam dos riscos do procedimento descritos no Termo de Consentimento e 78,0% lembravam dos benefícios. Em relação à participação em pesquisa, 23,5% dos entrevistados já haviam participado de projetos de pesquisa, sendo que 61,1% autorizariam a participação de seu familiar representado em um projeto de pesquisa. O fato de o maior índice de Autorizações por Representação corresponder ao procedimento assistencial provavelmente seja em razão da assistência representar uma necessidade e a pesquisa uma possibilidade. Quanto aos participantes lembrarem mais dos benefícios do que dos riscos provavelmente seja porque os benefícios vislumbrariam uma possibilidade de melhora da situação clínica em que supostamente o familiar encontrava-se. / Consent by proxy is obtained when a person is unable or legally unauthorized to provide consent for the performance of a medical procedure or participation in a research project. One of the several factors that may affect proxies during the consent process is the age of the person that they represent. The same procedure may be authorized for the elderly but not for a child, or vice-versa. A better understanding of the variables that make up the complex process of obtaining consent by proxy contributes to improving the management of these situations by the involved professionals. Two studies were conducted in order to evaluate several variables of the process of obtaining consent by proxy for medical care or clinical research involving children and the elderly. The first was a cross-sectional study to evaluate moral development as a marker of the competence to provide consent in a sample of adolescents and elderly people using a specific instrument. No differences were found in moral development between the groups of adolescents and elderly people according to the references used in the study. The second study compared the process of obtaining consent by proxy for medical care or clinical research in different age groups. The study was a simulation of the process of obtaining consent by proxy. The instruments were simulated consent terms for medical care or participation in research involving children or the elderly. Of all participants, 97.0% would authorize the medical procedure, 81.5% recalled the risks of the procedure described in the consent term, and 78.0% recalled its benefits. The analysis of participation in research showed that 23.5% of the respondents had already participated in research projects and 61.1% would provide consent for the participation of a family member in a research project. Medical procedures were mostly consented by proxies, which may be explained by the fact that medical assistance is a need, whereas research remains as a possibility. Participants recalled more benefits than risks, which may be assigned to the fact that benefits would indicate a possibility of clinical improvement of the condition that was simulated for their family member.

A Autorização por Representação é utilizada quando uma pessoa está impossibilitada - ou não habilitada legalmente - para consentir com um determinado procedimento assistencial ou com a participação em um projeto de pesquisa. Um dos diversos fatores que podem influenciar o representante durante o processo de autorização é a idade da pessoa representada. Com o objetivo de avaliar a diversidade no processo de obtenção da Autorização por Representação em situações assistenciais e de pesquisa em crianças e idosos foram desenvolvidos dois estudos. O primeiro foi um estudo transversal que visou avaliar o Desenvolvimento Psicológicomoral como um indicativo da capacidade para consentir em uma amostra de adolescentes e idosos. Não houve diferença entre o grupo de adolescentes e o de idosos em relação ao Desenvolvimento Psicológico-moral. O segundo estudo comparou o processo de obtenção da Autorização por Representação quanto ao grupo etário dos representados e a situação assistencial ou de pesquisa, através de uma simulação de um processo de autorização por representação. Os instrumentos utilizados foram Termos de Consentimento fictícios, compreendendo situações de assistência e pesquisa clínica em crianças e idosos. Do total de participantes, 97,0% responderam que autorizariam a realização do procedimento assistencial, 81,5% deles lembravam dos riscos do procedimento descritos no Termo de Consentimento e 78,0% lembravam dos benefícios. Em relação à participação em pesquisa, 23,5% dos entrevistados já haviam participado de projetos de pesquisa, sendo que 61,1% autorizariam a participação de seu familiar representado em um projeto de pesquisa. O fato de o maior índice de Autorizações por Representação corresponder ao procedimento assistencial provavelmente seja em razão da assistência representar uma necessidade e a pesquisa uma possibilidade. Quanto aos participantes lembrarem mais dos benefícios do que dos riscos provavelmente seja porque os benefícios vislumbrariam uma possibilidade de melhora da situação clínica em que supostamente o familiar encontrava-se. / Consent by proxy is obtained when a person is unable or legally unauthorized to provide consent for the performance of a medical procedure or participation in a research project. One of the several factors that may affect proxies during the consent process is the age of the person that they represent. The same procedure may be authorized for the elderly but not for a child, or vice-versa. A better understanding of the variables that make up the complex process of obtaining consent by proxy contributes to improving the management of these situations by the involved professionals. Two studies were conducted in order to evaluate several variables of the process of obtaining consent by proxy for medical care or clinical research involving children and the elderly. The first was a cross-sectional study to evaluate moral development as a marker of the competence to provide consent in a sample of adolescents and elderly people using a specific instrument. No differences were found in moral development between the groups of adolescents and elderly people according to the references used in the study. The second study compared the process of obtaining consent by proxy for medical care or clinical research in different age groups. The study was a simulation of the process of obtaining consent by proxy. The instruments were simulated consent terms for medical care or participation in research involving children or the elderly. Of all participants, 97.0% would authorize the medical procedure, 81.5% recalled the risks of the procedure described in the consent term, and 78.0% recalled its benefits. The analysis of participation in research showed that 23.5% of the respondents had already participated in research projects and 61.1% would provide consent for the participation of a family member in a research project. Medical procedures were mostly consented by proxies, which may be explained by the fact that medical assistance is a need, whereas research remains as a possibility. Participants recalled more benefits than risks, which may be assigned to the fact that benefits would indicate a possibility of clinical improvement of the condition that was simulated for their family member.

A Autorização por Representação é utilizada quando uma pessoa está impossibilitada - ou não habilitada legalmente - para consentir com um determinado procedimento assistencial ou com a participação em um projeto de pesquisa. Um dos diversos fatores que podem influenciar o representante durante o processo de autorização é a idade da pessoa representada. Com o objetivo de avaliar a diversidade no processo de obtenção da Autorização por Representação em situações assistenciais e de pesquisa em crianças e idosos foram desenvolvidos dois estudos. O primeiro foi um estudo transversal que visou avaliar o Desenvolvimento Psicológicomoral como um indicativo da capacidade para consentir em uma amostra de adolescentes e idosos. Não houve diferença entre o grupo de adolescentes e o de idosos em relação ao Desenvolvimento Psicológico-moral. O segundo estudo comparou o processo de obtenção da Autorização por Representação quanto ao grupo etário dos representados e a situação assistencial ou de pesquisa, através de uma simulação de um processo de autorização por representação. Os instrumentos utilizados foram Termos de Consentimento fictícios, compreendendo situações de assistência e pesquisa clínica em crianças e idosos. Do total de participantes, 97,0% responderam que autorizariam a realização do procedimento assistencial, 81,5% deles lembravam dos riscos do procedimento descritos no Termo de Consentimento e 78,0% lembravam dos benefícios. Em relação à participação em pesquisa, 23,5% dos entrevistados já haviam participado de projetos de pesquisa, sendo que 61,1% autorizariam a participação de seu familiar representado em um projeto de pesquisa. O fato de o maior índice de Autorizações por Representação corresponder ao procedimento assistencial provavelmente seja em razão da assistência representar uma necessidade e a pesquisa uma possibilidade. Quanto aos participantes lembrarem mais dos benefícios do que dos riscos provavelmente seja porque os benefícios vislumbrariam uma possibilidade de melhora da situação clínica em que supostamente o familiar encontrava-se. / Consent by proxy is obtained when a person is unable or legally unauthorized to provide consent for the performance of a medical procedure or participation in a research project. One of the several factors that may affect proxies during the consent process is the age of the person that they represent. The same procedure may be authorized for the elderly but not for a child, or vice-versa. A better understanding of the variables that make up the complex process of obtaining consent by proxy contributes to improving the management of these situations by the involved professionals. Two studies were conducted in order to evaluate several variables of the process of obtaining consent by proxy for medical care or clinical research involving children and the elderly. The first was a cross-sectional study to evaluate moral development as a marker of the competence to provide consent in a sample of adolescents and elderly people using a specific instrument. No differences were found in moral development between the groups of adolescents and elderly people according to the references used in the study. The second study compared the process of obtaining consent by proxy for medical care or clinical research in different age groups. The study was a simulation of the process of obtaining consent by proxy. The instruments were simulated consent terms for medical care or participation in research involving children or the elderly. Of all participants, 97.0% would authorize the medical procedure, 81.5% recalled the risks of the procedure described in the consent term, and 78.0% recalled its benefits. The analysis of participation in research showed that 23.5% of the respondents had already participated in research projects and 61.1% would provide consent for the participation of a family member in a research project. Medical procedures were mostly consented by proxies, which may be explained by the fact that medical assistance is a need, whereas research remains as a possibility. Participants recalled more benefits than risks, which may be assigned to the fact that benefits would indicate a possibility of clinical improvement of the condition that was simulated for their family member.

Strategies on informed consent process and capacity monitoring for mild dementia research are at developing state. We reflected on our experience and found that the successful collection of informed consent and full participation of PwD required the involvement of familiar healthcare professionals/care workers/staff at the recruitment and data collection stages and this needs to occur in an active support environment. Time is another important factor affecting the success of the study.

The late 1960s witnessed an unprecedented interest in the environment. One of the intellectual characteristics of this period was the rise of ecocentrism, a form of ecological reasoning that challenged the domination of anthropocentric environmental thinking and practice. The thesis briefly reviews the evolution of ecological forms of reason, and then poses two questions. The first question asks: "What is ecological reason and how does the literature conceptualise it?" This leads to a theoretical analysis of the forms of ecological reason discernable in the literature, and results in a 'matrix of ecological reason'. The three primary forms of ecological reason are described as 'Technocentric Ecology', 'Discursive Ecology' and 'Eco-social Ecology'. They differ in respect to different dimensions of ecological reason, the forms of communication employed (drawing here on Habermas), and the level of commitment to anthropocentrism or ecocentrism. This 'matrix' highlights the contested nature of ecological reason in the literature, and demonstrates that there is, yet, no clear agreement on what it means, or should mean. The second question examines the ecological rationality of environmental practice. The 'matrix' is employed in three case studies of environmental decisions that take place under the New Zealand Resource Management Act (RMA), and investigates the forms of ecological reason expressed in these decision processes. The results of this analysis show that Eco-social Ecology barely registers in these case studies, while the other two forms of ecological reason. Technocentric Ecology and Discursive Ecology are both highly visible in the rationality of the RMA, but with two important qualifiers. First, although there is a commitment to Discursive Ecology on the part of many professionals, there is also much concern that this form of reason undermines quality environmental decisions. Thus, there is significant ambiguity as to the role of the community (an important dimension of Discursive Ecology). This leads to the second qualifier. There is an uneasy relationship between these two forms of reason, at both the theoretical and practice level. This tension underpins the competing visions of the RMA as a scientifically driven process and as a community process. This thesis argues that this tension does not provide for a secure marriage of these two visions.