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1

Ethical dilemmas faced in practice.  

UK PubMed Central (United Kingdom)

The terms 'ethics' and 'welfare' are often used in the veterinary sphere. Jen Hall, the young graduate representative on BVA Council, says that, as a farm animal practitioner, she is faced with ethical dilemmas on a daily basis and, more often than not, these are related to welfare.

2013-09-01

2

Exploring Ethical Dilemmas Using the "Drifting Goals" Archetype  

Science.gov (United States)

This article demonstrates how the system archetype "drifting goals" can be used in the classroom to explore ethical dilemmas. System archetypes provide a framework that shifts the focus from seeing ethical dilemmas as stemming solely from the acts of individuals to exploring the systemic structures that are responsible for generic patterns of…

Bardoel, E. Anne; Haslett, Tim

2006-01-01

3

Evidence, Ethics & Social Policy Dilemmas  

Directory of Open Access Journals (Sweden)

Full Text Available Within the philosophy of the social sciences, the relationship between evidence, ethics, and social policy is in need of further analysis. The present paper is an attempt to argue that while important social policies can, and perhaps ought to be, grounded in ethical theory, they are seldom articulated in this fashion due to the ambiguity surrounding the "evidence condition." Using a consequentialist-utilitarian framework, and a case study of a policy dilemma, the authors analyze the difficulties associated with resolving policy-based dilemmas which must appeal to evidential support as a justification for an ethical stand. Implication for the relevance of ethics to social policy formulation are discussed in detail.

Steven I. Miller; L. Arthur Safer

1993-01-01

4

Code of ethics and ethical dilemmas' management in health professions  

Directory of Open Access Journals (Sweden)

Full Text Available As the main interest of health professionals is for the well-being of patients/clients, ethical decision making is one of the prominent elements of his/her professionalism. Aim: The present study aims to illustrate the role of ethical judgment and the so-called "moral imagination" in health professions. Method and material: Review of theoretical and research literature, including both classic and recent sources about ethical dilemmas that health professionals may anticipate, as well as the suggested ways to manage these dilemmas. Results: Health professionals often have to act in complicated situations. Review of relevant literature indicates that the professionals' ethical decisions are structured not only through the codes of ethics, but also through other collective practices, such as organizational culture and cultural schemas about the role of health professional. Resorting to schematic thinking may temporarily release the professional from his/her concerns, but in the long run, it may devoid him/her of the sense of satisfaction from work and of the ability to offer clients the optimal care. The development of the so-called "moral imagination" permits the professional to advance from the typical application of the rules to actual ethical judgment. Conclusions: Ethical decision making presupposes not only a thorough knowledge of ethical guidelines, but also the development of the ability to openly reflect upon the ethical dimensions of an issue (moral imagination) that allows health professionals to overcome schematic thinking and investigate comprehensive solutions to ethical dilemmas.

Sofia Triadafyllidou; Evangelos Papageorgiou

2011-01-01

5

Surgical nurses' perceptions of ethical dilemmas, moral distress and quality of care.  

UK PubMed Central (United Kingdom)

AIM: To describe surgical nurses' perceived levels of ethical dilemmas, moral distress and perceived quality of care and the associations among them. BACKGROUND: Nurses are committed to providing quality care. They can experience ethical dilemmas and moral distress while providing patient care. Little research has focused on the effect of moral distress or ethical dilemmas on perceived quality of care. DESIGN: Descriptive, cross-sectional study. METHOD: After administration and institutional Research Ethics Committee approval, a researcher requested 119 surgical nurses working in two Israeli hospitals to fill out three questionnaires (personal background characteristics; Ethical Dilemmas in Nursing and Quality of Nursing Care). Data collection took place from August 2007 to January 2008. RESULTS: Participant mean age was 39·7 years. The sample consisted mostly of women, Jewish and married staff nurses. The majority of nurses reported low to moderate levels of ethical dilemma frequency but intermediate levels of ethical dilemma intensity. Frequency of ethical dilemmas was negatively correlated with level of nursing skill, meeting patient's needs and total quality of care. No important correlations were found between intensity of ethical dilemmas and quality of care. CONCLUSIONS: Levels of ethical dilemma frequency were higher than intensity. Nurses tended to be satisfied with their level of quality of care. Increased frequency of ethical dilemmas was associated with some aspects of perceived quality of care. RELEVANCE TO CLINICAL PRACTICE: Quality of care is related to ethical dilemmas and moral distress among surgical nurses. Therefore, efforts should be made to decrease the frequency of these feelings to improve the quality of patient care.

DeKeyser Ganz F; Berkovitz K

2012-07-01

6

Caring ethics and a Somali reproductive dilemma.  

UK PubMed Central (United Kingdom)

The use of traditional ethical methodologies is inadequate in addressing a constructed maternal-fetal rights conflict in a multicultural obstetrical setting. The use of caring ethics and a relational approach is better suited to address multicultural conceptualizations of autonomy and moral distress. The way power differentials, authoritative knowledge, and informed consent are intertwined in this dilemma will be illuminated by contrasting traditional bioethics and a caring ethics approach. Cultural safety is suggested as a way to develop a relational ontology. Using caring ethics and a relational approach can alleviate moral distress in health-care providers, while promoting collaboration and trust between providers and their patients and ultimately decreasing reproductive disparities. This article examines how a relational approach can be applied to a cross-cultural reproductive dilemma.

Narruhn R; Schellenberg IR

2013-06-01

7

Action ethical dilemmas in surgery: an interview study of practicing surgeons  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The aim of this study was to describe the kinds of ethical dilemmas surgeons face during practice. Methods Five male and five female surgeons at a University hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of physicians and nurses about ethically difficult situations in surgical units. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. Results No gender differences were found in the kinds of ethical dilemmas identified among male and female surgeons. The main finding was that surgeons experienced ethical dilemmas in deciding the right treatment in different situations. The dilemmas included starting or withholding treatment, continuing or withdrawing treatment, overtreatment, respecting the patients and meeting patients' expectations. The main focus in the narratives was on ethical dilemmas concerning the patients' well-being, treatment and care. The surgeons narrated about whether they should act according to their own convictions or according to the opinions of principal colleagues or colleagues from other departments. Handling incompetent colleagues was also seen as an ethical dilemma. Prioritization of limited resources and following social laws and regulations represented ethical dilemmas when they contradicted what the surgeons considered was in the patients' best interests. Conclusion The surgeons seemed confident in their professional role although the many ethical dilemmas they experienced in trying to meet the expectations of patients, colleagues and society also made them professionally and personally vulnerable.

Torjuul Kirsti; Nordam Ann; Sørlie Venke

2005-01-01

8

Ethical dilemmas in journal publication.  

UK PubMed Central (United Kingdom)

Physicians often face tremendous pressures and incentives to publish, sometimes leading to a compromise of ethical standards, either consciously or unconsciously. From the vantage of ethical authorship, we discuss what constitutes authorship; avoidance of ghost authorship; plagiarism, as well as self-plagiarism and duplicate publication; falsification; and fabrication. Editors also face ethical challenges, including how best to manage peer-review bias, to address reviewer tardiness, and to locate reviewers with appropriate expertise and professionalism. Editors need to deal with authors who fragment their work into multiple publications to enhance their curriculum vitae ("salami factor"), as well as to manage the financial benefits of advertising and to avoid conflicts of interest for the journal. Both authors and editors should be straightforward and principled throughout the publication process.

Babalola O; Grant-Kels JM; Parish LC

2012-03-01

9

Ethical Dilemma of Governmental Wiretapping  

CERN Multimedia

USA Government wiretapping activities is a very controversial issue. Undoubtedly this technology can assist law enforced authority to detect / identify unlawful or hostile activities; however, this task raises severe privacy concerns. In this paper, we have discussed this complex information technology issue of governmental wiretapping and how it effects both public and private liberties. Legislation has had a major impact on the uses and the stigma of wiretapping for the war on terrorism. This paper also analyzes the ethical and legal concerns inherent when discussing the benefits and concerns of wiretapping. The analysis has concluded with the effects of wiretapping laws as they relate to future government actions in their fight against terrorists.

Mullikin, Arwen; Rahman, M

2010-01-01

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Ethical and legal dilemmas in infertility treatment  

Directory of Open Access Journals (Sweden)

Full Text Available One of the main characteristics of the new millennium is the affirmation of human rights in all aspects of human existence, with the intention of turning declarative statements into reality. Development of up-to-date assisted reproductive technologies (ART) and their application in infertility treatment have raised numerous ethical, legal, religious, social and other questions. In vitro fertilization, donation of gametes, embryos and pre-embryos, cryopreservation of gametes, embryos, ovarian and testicular tissues, embryo transfer, genetic reproductive techniques, cloning and other sophisticated methods used in infertility treatment require cooperation between the medical and legal professions. Ethical aspects of human reproduction and assisted fertilization are based on full respect of the life of an individual even before conception, from pre-embryo stage, via embryo stage and fetus stage to a newborn infant. Regarding investigative and clinical projects, this standpoint implies the legalization of all ART procedures, unencumbered exchange of information and consensus about their application, and adherence to the basic ethical principles of autonomy benefit, justice and common welfare. Ethical postulates provide unequivocal directions in the creation of new life and resolve all possible ethical dilemmas, protecting the rights of doctors and participant in relevant procedures alike and reasserting the crucial principle - respect of human dignity.

Dragojevi?-Diki? Svetlana; Dragani? Saveta; Diki? Sr?an S.; Pilija Vladimir

2004-01-01

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Nuclear weapons and medicine: some ethical dilemmas.  

UK PubMed Central (United Kingdom)

The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured destruction and increasing the risk of nuclear war. Medical planning and civil defence preparations for nuclear war have recently been increased in several countries although there is little evidence that they will be of significant value in the aftermath of a nuclear conflict. These developments have raised new ethical dilemmas for those in health professions. If there is any risk of use of weapons of mass destruction, then support for deterrence with these weapons as a policy for national or global security appears to be incompatible with basic principles of medical ethics and international law. The primary medical responsibility under such circumstances is to participate in attempts to prevent nuclear war.

Haines A; de B White C; Gleisner J

1983-12-01

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Nuclear weapons and medicine: some ethical dilemmas.  

Science.gov (United States)

The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured destruction and increasing the risk of nuclear war. Medical planning and civil defence preparations for nuclear war have recently been increased in several countries although there is little evidence that they will be of significant value in the aftermath of a nuclear conflict. These developments have raised new ethical dilemmas for those in health professions. If there is any risk of use of weapons of mass destruction, then support for deterrence with these weapons as a policy for national or global security appears to be incompatible with basic principles of medical ethics and international law. The primary medical responsibility under such circumstances is to participate in attempts to prevent nuclear war. PMID:6668585

Haines, A; de B White, C; Gleisner, J

1983-12-01

13

Ethical Dilemmas of Swedish School Leaders: Contrasts and Common Themes  

Science.gov (United States)

Being a skillful school leader presumes the competence to judge the ethical consequences of actions. This implies a need for all school agents to discover and analyze what values are at stake and, in turn, reconcile didactic rationality with ethical rationality. This article aims to explore ethical dilemmas in daily school practice, experienced…

Norberg, Katarina; Johansson, Olof

2007-01-01

14

Religion and the Military: A Growing Ethical Dilemma.  

Science.gov (United States)

Ethical dilemmas over the issue of freedom of personal religious expression and fair treatment for all faith groups are creating conflicts within the military, both inside and outside the chaplaincies. A lawsuit filed by a group of Navy chaplains alleging...

L. P. Greenslit

2006-01-01

15

Pediatric liver transplantation - ethical dilemmas in a disabled patient.  

UK PubMed Central (United Kingdom)

Allocation of medical resources, especially resources with absolute scarcity such as organs for transplant, is a difficult task. Medical, surgical, and ethical considerations should be evaluated. In solid organ transplantation, ethics committees are the gate keepers that deal with moral philosophy when moral values are in conflict. Often, no good solution to a dilemma in these medical ethics exists. Our case presents split living liver donation for retransplantation in a mentally disabled girl, with few medical ethics principles at stake.

Toker A; Salzer L

2012-09-01

16

A quick guide to ethical theory in healthcare: solving ethical dilemmas in nutrition support situations.  

Science.gov (United States)

Ethical dilemmas can be challenging for the nutrition support clinician who is accustomed to evidence-based practice. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle's virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, nonmaleficence, and justice). Adopting a step-by-step approach can simplify the process of resolving ethical problems. PMID:16556920

Ferrie, Suzie

2006-04-01

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Exploring how IBCLCs manage ethical dilemmas: a qualitative study  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Professional health care practice should be based on ethical decisions and actions. When there are competing ethical standards or principles, one must choose between two or more competing options. This study explores ethical dilemmas experienced by International Board Certified Lactation Consultants. Methods The investigator interviewed seven International Board Certified Lactation Consultants and analyzed the interviews using qualitative research methods. Results "Staying Mother-Centred" emerged as the overall theme. It encompassed six categories that emerged as steps in managing ethical dilemmas: 1) recognizing the dilemma; 2) identifying context; 3) determining choices; 4) strategies used; 5) results and choices the mother made; and 6) follow-up. The category, "Strategies used", was further analyzed and six sub-themes emerged: building trust; diffusing situations; empowering mothers; finding balance; providing information; and setting priorities. Conclusions This study provides a framework for understanding how International Board Certified Lactation Consultants manage ethical dilemmas. Although the details of their stories changed, the essence of the experience remained quite constant with the participants making choices and acting to support the mothers. The framework could be the used for further research or to develop tools to support IBCLCs as they manage ethical dilemmas and to strengthen the profession with a firm ethics foundation.

Noel-Weiss Joy; Cragg Betty; Woodend A

2012-01-01

18

Liberal democracy and nuclear despotism: two ethical foreign policy dilemmas  

Directory of Open Access Journals (Sweden)

Full Text Available This article advances a critical analysis of John Rawls's justification of liberal democratic nuclear deterrence in the post-Cold War era as found in The Law of Peoples. Rawls's justification overlooked how nuclear-armed liberal democracies are ensnared in two intransigent ethical dilemmas: one in which the mandate to secure liberal constitutionalism requires both the preservation and violation of important constitutional provisions in domestic affairs, and the other in which this same mandate requires both the preservation and violation of the liberal commitment to international legal arrangements and to the rule of law generally. On this view, the choice to violate constitutional provisions and international legal arrangements is evidence of nuclear despotism. Moreover, this choice does not imply that the ethical foreign policy dilemmas were resolved. Instead, it implies that the dilemmas force liberal democratic governments into implementing ethically paradoxical policy outcomes.

Thomas E. Doyle

2013-01-01

19

Parental preference or child well-being: an ethical dilemma.  

UK PubMed Central (United Kingdom)

An ethical dilemma that is not uncommon to encounter when caring for children occurs when parental preference does not appear to be in the child's best interest. Challenges facing the health care team are further amplified when the family's cultural background does not match that of the team. A case study will be used to illustrate the challenges of a pediatric palliative care ethical dilemma further complicated by cultural diversity. Review of the child's medical condition, patient/parent preferences, quality of life, and contextual features will be followed by an analysis and recommendations for resolution of this challenging situation.

Turner HN

2010-02-01

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Leadership styles in ethical dilemmas when head nurses make decisions.  

UK PubMed Central (United Kingdom)

BACKGROUND: The overlooked aspect in Lithuania is the dearth of leaders among head nurses, who bear the responsibility for decisions in ethical dilemmas. Understanding the application of leadership styles is fundamental to ensuring head nurses' abilities to influence outcomes for healthcare providers and patients. AIM: To identify the leadership styles applied by head nurses in decision making in ethical dilemmas on hospital wards. METHODS: The data were collected by questionnaires completed by head nurses (n?=?278) working in five major state-funded hospitals in each of the five regions of Lithuania. The data were analysed using SPSS 16.0, calculating descriptive statistics and analysis of variance. FINDINGS: Head nurses apply democratic, affiliative, transformational and sustainable leadership styles when resolving ethical dilemmas. The application of leadership styles is associated not only with specific situations, but also with certain background factors, such as years of experience in a head nurse's position, ward specialization and the incidence of ethical dilemmas. Nurses having been in a head nurse's position over 10 years use primitive leadership styles, notably bureaucratic leadership, more often than do those head nurses with only a few years of experience in such a position. CONCLUSIONS: The results highlight the need for head nurses to reflect on their practices and to find new ways of learning from practice, colleagues and patients. Head nurses' managerial decisions due to their 'executive power' can turn into a new state-of-the-art leadership in nursing.

Zydziunaite V; Lepaite D; Suominen T

2013-06-01

 
 
 
 
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ETHICAL REASONING: THE IMPACT OF ETHICAL DILEMMA, EGOISM AND BELIEF IN JUST WORLD  

Directory of Open Access Journals (Sweden)

Full Text Available Following a 3 [dilemma: coercion and control (CC); conflict of interest (CI); personal integrity (PI)] × 2 (egoism: self; organization) × 2 (belief in just world (BJW): strong; weak) between-subjects factorial design, we hypothesized the main effects of ethical dilemma, egoism, and BJW, and their interaction on ethical reasoning. The first two factors were manipulated by means of six vignettes and the last factor was a subject variable. Experimental participants were 384 managers representing 14 manufacturing organizations. Overall, utilitarian reasoning appeared to be a frequently used type of reasoning in relation to personal integrity dilemma involving self-interest, whereas principled reasoning appeared to be a frequently used reasoning in relation to personal integrity dilemma involving organizational-interest. BJW interacted strongly with the two manipulated factors in predicting ethical reasoning. Implications of the study are discussed, potential caveats are specified and recommendations for future research are provided.

Noor Hazlina Ahmad; Mahfooz A. Ansari; Rehana Aafaqi

2005-01-01

22

Processes and Consequences in Business Ethical Dilemmas: The Oil Industry and Climate Changes  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This paper proposes a framework to examine business ethical dilemmas and business attitudes towards such dilemmas. Business ethical dilemmas can be understood as reflecting a contradiction between a socially detrimental process and a self-interested profitable consequence. This representation allows...

Le Menestrel, Marc; Van den Hove, Sybille; De Bettignies, Henri Claude

23

Designing and Introducing Ethical Dilemmas into Computer-Based Business Simulations  

Science.gov (United States)

This article makes two contributions to the teaching of business ethics literature. First, it describes the steps involved in developing effective ethical dilemmas to incorporate into a computer-based business simulation. Second, it illustrates these steps by presenting two ethical dilemmas that an instructor can incorporate into any business…

Schumann, Paul L.; Scott, Timothy W.; Anderson, Philip H.

2006-01-01

24

[Hospitalization by court order: ethical dilemmas experienced by nurses].  

UK PubMed Central (United Kingdom)

A qualitative study aimed at describing the situations experienced and the ethical dilemmas of nurses in the process of referring and receiving hospitalized patients by court order who require admission to the Intensive Care Unit (ICU). A partially structured interview was conducted with 10 nurses who worked in the ICU and 10 who worked in the Emergency Room (ER) in public and private hospitals in the metropolitan area of Porto Alegre, Brazil. The data was analyzed following the Semantic Analysis. The results indicated that nurses experienced ethical dilemmas associated with problems of overcrowding in emergency rooms and ICUs, poor specialized technology and orientation as to the benefits provided by law. We concluded that it is essential for nurses to participate in discussions that allow the planning of the different instances that have been promoting this often chaotic situation.

Vargas MA; Ramos FR; Schneider DG; Schneider N; dos Santos AC; Leal SM

2013-03-01

25

The oil industry and climate change: strategies and ethical dilemmas  

Energy Technology Data Exchange (ETDEWEB)

This paper explores the different climate change strategies chosen by three major multinational oil corporations: ExxonMobil, TotalFinaElf and BP Amoco. They are referred to, as the 'fight against emission constraints,' 'wait and see,' and 'proactive' strategies, respectively. The justifications given to support these strategies are identified. They cover the business, scientific, political, economic, technological and social dimensions. In a business ethics framework, the issue of climate change brings forth an ethical dilemma for the oil industry, in the form of a tension between profits and CO{sub 2} emissions. The strategies are analysed as three attitudes towards this dilemma: (i) placing priority on the business consequences while weakening the perception that anthropogenic greenhouse gas emissions are causing climate change; (ii) avoiding responsibility; and (iii) placing priority on the need for a modification of the business process while limiting the negative effect in terms of business consequences. In conclusion, we propose that beyond the ethical issues proper to climate change itself, additional ethical issues are raised if society at large is instrumentalised by an industry in its search for profit. Publicly gauging and valorising the ethical commitment of a corporation appear as ways of inducing more collaborative and proactive attitudes by business actors. (Author)

Hove, S. van den [MEDIAN, Valldoreix (Spain); Le Menestrel, M. [University Pompeu Fabra, Barcelona (Spain); Bettignies, H.C. de [INSEAD, Fontainebleau (France)

2002-07-01

26

The oil industry and climate change. Strategies and ethical dilemmas  

International Nuclear Information System (INIS)

This paper explores the different climate change strategies chosen by three major multinational oil corporations: ExxonMobil, TotalFinaElf and BP Amoco. They are referred to, as the 'fight against emission constraints,' 'wait and see', and 'proactive' strategies, respectively. The justifications given to support these strategies are identified. They cover the business, scientific, political, economic, technological and social dimensions. In a business ethics framework, the issue of climate change brings forth an ethical dilemma for the oil industry, in the form of a tension between profits and CO2 emissions. The strategies are analysed as three attitudes towards this dilemma: (1) placing priority on the business consequences while weakening the perception that anthropogenic greenhouse gas emissions are causing climate change; (2) avoiding responsibility; and (3) placing priority on the need for a modification of the business process while limiting the negative effect in terms of business consequences. In conclusion, we propose that beyond the ethical issues proper to climate change itself, additional ethical issues are raised if society at large is instrumentalised by an industry in its search for profit. Publicly gauging and valorising the ethical commitment of a corporation appear as ways of inducing more collaborative and proactive attitudes by business actors

2002-01-01

27

The oil industry and climate change. Strategies and ethical dilemmas  

Energy Technology Data Exchange (ETDEWEB)

This paper explores the different climate change strategies chosen by three major multinational oil corporations: ExxonMobil, TotalFinaElf and BP Amoco. They are referred to, as the 'fight against emission constraints,' 'wait and see', and 'proactive' strategies, respectively. The justifications given to support these strategies are identified. They cover the business, scientific, political, economic, technological and social dimensions. In a business ethics framework, the issue of climate change brings forth an ethical dilemma for the oil industry, in the form of a tension between profits and CO2 emissions. The strategies are analysed as three attitudes towards this dilemma: (1) placing priority on the business consequences while weakening the perception that anthropogenic greenhouse gas emissions are causing climate change; (2) avoiding responsibility; and (3) placing priority on the need for a modification of the business process while limiting the negative effect in terms of business consequences. In conclusion, we propose that beyond the ethical issues proper to climate change itself, additional ethical issues are raised if society at large is instrumentalised by an industry in its search for profit. Publicly gauging and valorising the ethical commitment of a corporation appear as ways of inducing more collaborative and proactive attitudes by business actors.

Van den Hove, S. [MEDIAN, Passeig Pintor Romero 8, 08197 Valldoreix (Spain); Le Menestrel, Marc [University Pompeu Fabra, Ramon Trias Fargas 25-27, 08005 Barcelona (Spain); De Bettignies, Henri-Claude [INSEAD, Boulevard de Constance, F-77305 Fontainebleau Cedex (France)

2002-07-01

28

The oil industry and climate change: strategies and ethical dilemmas  

International Nuclear Information System (INIS)

This paper explores the different climate change strategies chosen by three major multinational oil corporations: ExxonMobil, TotalFinaElf and BP Amoco. They are referred to, as the 'fight against emission constraints,' 'wait and see,' and 'proactive' strategies, respectively. The justifications given to support these strategies are identified. They cover the business, scientific, political, economic, technological and social dimensions. In a business ethics framework, the issue of climate change brings forth an ethical dilemma for the oil industry, in the form of a tension between profits and CO2 emissions. The strategies are analysed as three attitudes towards this dilemma: (i) placing priority on the business consequences while weakening the perception that anthropogenic greenhouse gas emissions are causing climate change; (ii) avoiding responsibility; and (iii) placing priority on the need for a modification of the business process while limiting the negative effect in terms of business consequences. In conclusion, we propose that beyond the ethical issues proper to climate change itself, additional ethical issues are raised if society at large is instrumentalised by an industry in its search for profit. Publicly gauging and valorising the ethical commitment of a corporation appear as ways of inducing more collaborative and proactive attitudes by business actors. (Author)

2002-01-01

29

The ethics of resuscitation: how do paramedics experience ethical dilemmas when faced with cancer patients with cardiac arrest?  

UK PubMed Central (United Kingdom)

INTRODUCTION: Research on prehospital emergency work traditionally has focused on medical issues, but paramedics often have to make ethical choices. The goal of this exploratory study was to understand how paramedics experience difficult ethical dilemmas regarding resuscitation of cancer patients. METHODS: Paramedics from ambulance services in Norway were interviewed about resuscitation of cancer patients with cardiac arrest. The qualitative study included naturalistic, semi-structured interviews and a cognitive-emotional, interpretive approach. RESULTS: All study participants believed that it ethically can be correct not to resuscitate if the patient is expected to survive for only a short time with a very low quality of life and severe negative illness experiences. However, this belief sometimes failed to match formal or informal guidelines and contextual factors such as expectations of relatives. When confronting these challenges, the majority of the paramedics relied heavily on the advice of medical experts, but some had to make more autonomous decisions. DISCUSSION: The concept of a double pressure situation can be used to analyze the ethical dilemmas regarding resuscitation of cancer patients. The pressure from "below" is grounded in individual caring frameworks, and in the belief that it can be wrong to resuscitate. The pressure from "above" is objective and system-related, related to uncertainty, and grounded in the fundamental and irreducible value of human life. CONCLUSIONS: The findings of this qualitative, exploratory study suggest that ethical concepts and analyses of double pressure situations should have an important role in education and training designed to prepare emergency personnel for difficult life and death choices. More research is needed to shed light on how ethical dilemmas arise in prehospital work.

Nordby H; Nøhr Ø

2012-02-01

30

Medical and ethical dilemma in brain death.  

Science.gov (United States)

For centuries, death has been defined, medically speaking, as the irreversible cessation of breathing and of nervous and cardiac activity. What radically changed this definition was the introduction of the concept "brain death" in 1968, by the "Ad Hoc Committee of the Harvard Medical School". According to it, the irreversible coma was associated with brain death and considered to be a criterion for the diagnosis of the deceased individual. The evergrowing need for transplant organs (provided this respects the dead honor rule, stipulating that organs can't be harvested unless someone is deceased) lead to making arbitrary decisions regarding the establishment of the exact time of death during the process of "losing life". What actually triggers the controversy related to the concept of brain death is the dilemma of associating this concept with that of biologic death or death of the person, the difference between the two being made by whether the mental characteristics are accepted or not in defining and individualizing the death of the human being. Given these circumstances, a dilemma appears--that of defining the death of the individual: we define death, as it has been for centuries, as the moment when the cardio-respiratory function no longer exists, which leads to the loss of tens of thousands of lives that might have been saved through transplant. Yet, this may lead to manipulating the border between life and death, with the risk of trespassing each individual's right to life. PMID:23272519

Streba, Irina; Damian, Simona; Ioan, Beatrice

31

Medical and ethical dilemma in brain death.  

UK PubMed Central (United Kingdom)

For centuries, death has been defined, medically speaking, as the irreversible cessation of breathing and of nervous and cardiac activity. What radically changed this definition was the introduction of the concept "brain death" in 1968, by the "Ad Hoc Committee of the Harvard Medical School". According to it, the irreversible coma was associated with brain death and considered to be a criterion for the diagnosis of the deceased individual. The evergrowing need for transplant organs (provided this respects the dead honor rule, stipulating that organs can't be harvested unless someone is deceased) lead to making arbitrary decisions regarding the establishment of the exact time of death during the process of "losing life". What actually triggers the controversy related to the concept of brain death is the dilemma of associating this concept with that of biologic death or death of the person, the difference between the two being made by whether the mental characteristics are accepted or not in defining and individualizing the death of the human being. Given these circumstances, a dilemma appears--that of defining the death of the individual: we define death, as it has been for centuries, as the moment when the cardio-respiratory function no longer exists, which leads to the loss of tens of thousands of lives that might have been saved through transplant. Yet, this may lead to manipulating the border between life and death, with the risk of trespassing each individual's right to life.

Streba I; Damian S; Ioan B

2012-07-01

32

Animal ethics dilemma : a computer supported learning tool  

DEFF Research Database (Denmark)

'Animal Ethics Dilemma' is a freely available computer-supported learning tool (www.animalethicsdilemma.net or www.aedilemma.net) which has been developed primarily for veterinary undergraduates but is applicable also to students in other fields of animal science. The objectives of the computer program are to promote students' understanding of the ethics related to animal use, to illustrate ethical dilemmas that arise in animal use, to broaden students' moral imagination, and to enable students to differentiate between types of ethical argument. The program comprises five case studies: (1) the blind hens; (2) ANDi the genetically modified monkey; (3) euthanasia of a healthy dog; (4) animal slaughter; and (5) rehabilitation of seals. Special consideration has been given to enhancing the pedagogic value of the program. Students can control their learning by selecting a variety of ways to explore the program; for example, they can navigate the program using the 'Assist Me' option, which explains the basis of theethical arguments. Reality text provides details of real events on which the case is based, and a glossary of terminology is available for the students to explore. Selected access to a case template is also available, enabling students and teachers to create their own case studies. Evaluation of the program has been ongoing during its development.

Dich, Trine; Hansen, Tina

2006-01-01

33

The pre-employment medical--ethical dilemmas for GPs.  

UK PubMed Central (United Kingdom)

BACKGROUND: In many workplaces, employment is conditional on a successful pre-employment medical examination. This examination is usually conducted by a general practitioner on the employers' panel of approved clinics or by an in-house company doctor. OBJECTIVE: This article uses a case study to illustrate some of the ethical dilemmas that may be faced by GPs in the course of performing a pre-employment medical examination. DISCUSSION: Ethical issues discussed in this article include: Is it ethical for employers (based on physicians' reports) to select workers based on 'absence of illness' rather than 'fitness for work'? Should physicians divulge the illness of potential workers to third parties? What are the boundaries of a clinician's duty of care in the pre-employment medical examination setting?

Thuraisingham C; Nalliah S

2013-04-01

34

The defective child. Ethical guidelines for painful dilemmas.  

Science.gov (United States)

The Surgeon General's regulations requiring treatment of defective newborns were criticized for being simplistic and for interfering in medical decision-making. This public policy regulation was at variance with many of the recommendations of the President's Commission for the Study of Ethical Problems in Medicine. Taking the President's Commission's report into consideration, this article proposes tentative guidelines for making difficult clinical decisions, which may form the basis of an institutional or a professional response to dilemmas surrounding the birth of a defective child. PMID:6230477

Drane, J F

35

Staff attitudes to talking openly about ethical dilemmas : the role of business ethics conceptions and trust  

DEFF Research Database (Denmark)

To ensure ethical employee behavior, companies often utilize several forms of mostly one-way communication such as codes of conduct. The extent to which these efforts, in addition to informing about the company stance on ethics, are able to positively influence behavior is disputed. Research on business ethics communication and behavior reveals that a good predictor of ethical conduct is open workplace dialogue about ethics.  In this paper, I therefore address the question: What influences employee attitudes to talking openly about ethical issues? Answers are proposed on the basis of focus group interviews at the healthcare company Novo Nordisk.   It was found that interest in discussing ethical issues was influenced by two main factors: employee conceptualizations of business ethics, and the level of inter-collegial trust, credibility, and confidence. In this paper, by examining these phenomena, I aim at providing insight that can help managers in their attempts to promote open workplace dialogue aboutethical issues.

Trapp, Leila

2010-01-01

36

How nurses and physicians face ethical dilemmas--the Croatian experience.  

UK PubMed Central (United Kingdom)

The aim of this study was to assess nurses' and physicians' ethical dilemmas in clinical practice. Nurses and physicians of the Clinical Hospital Centre Rijeka were surveyed (N=364). A questionnaire was used to identify recent ethical dilemma, primary ethical issue in the situation, satisfaction with the resolution, perceived usefulness of help, and usage of clinical ethics consultations in practice. Recent ethical dilemmas include professional conduct for nurses (8%), and near-the-end-of-life decisions for physicians (27%). The main ethical issue is limiting life-sustaining therapy (nurses 15%, physicians 24%) and euthanasia and physician-assisted suicide (nurses 16%, physicians 9%). The types of help available are similar for nurses and physicians: obtaining complete information about the patient (37% vs. 50%) and clarifying ethical issues (31% vs. 39%). Nurses and physicians experience similar ethical dilemmas in clinical practice. The usage of clinical ethics consultations is low. It is recommended that the individual and team consultations should be introduced in Croatian clinical ethics consultations services.

Sorta-Bilajac I; Baždari? K; Žagrovi? MB; Jan?i? E; Brozovi? B; ?engic T; ?orluka S; Agich GJ

2011-05-01

37

How nurses and physicians face ethical dilemmas--the Croatian experience.  

Science.gov (United States)

The aim of this study was to assess nurses' and physicians' ethical dilemmas in clinical practice. Nurses and physicians of the Clinical Hospital Centre Rijeka were surveyed (N=364). A questionnaire was used to identify recent ethical dilemma, primary ethical issue in the situation, satisfaction with the resolution, perceived usefulness of help, and usage of clinical ethics consultations in practice. Recent ethical dilemmas include professional conduct for nurses (8%), and near-the-end-of-life decisions for physicians (27%). The main ethical issue is limiting life-sustaining therapy (nurses 15%, physicians 24%) and euthanasia and physician-assisted suicide (nurses 16%, physicians 9%). The types of help available are similar for nurses and physicians: obtaining complete information about the patient (37% vs. 50%) and clarifying ethical issues (31% vs. 39%). Nurses and physicians experience similar ethical dilemmas in clinical practice. The usage of clinical ethics consultations is low. It is recommended that the individual and team consultations should be introduced in Croatian clinical ethics consultations services. PMID:21558110

Sorta-Bilajac, Iva; Baždari?, Ksenija; Žagrovi?, Morana Brklja?i?; Jan?i?, Ervin; Brozovi?, Boris; ?engic, Tomislav; ?orluka, Stipe; Agich, George J

2011-05-01

38

Ethical dilemmas surrounding the use of ventricular assist devices in supporting patients with end-stage organ dysfunction.  

UK PubMed Central (United Kingdom)

Successful practice of cardiovascular medicine requires familiarity with the complex ethical issues that accompany therapeutic innovation and diffusion. Even as technologies transition from experimental to standard care, challenges remain. Mechanical circulatory support devices, for instance, are increasingly conceptualized as conventional therapies. Despite this, or perhaps because of it, the ethical issues surrounding the use of these devices in patients with end-stage organ dysfunction are becoming increasingly apparent. In this paper, we provide an introduction to ethical considerations related to the use of ventricular assist devices (VADs) in end-stage organ failure, focusing on three stages or decision points: initiation, continued use, and deactivation. Our goal is not to exhaustively resolve these dilemmas but to illustrate how ethical considerations relate to decision making.

Bruce CR; Brody B; Majumder MA

2013-01-01

39

The relationship between ethical ideology and ethical behavior intentions: an exploratory look at physicians' responses to managed care dilemmas.  

UK PubMed Central (United Kingdom)

Within the past few years, managed care health insurance programs have become commonplace. With managed care programs, however, physicians are facing increasing ethical pressures. This paper examines the relationship between physicians' behavior intentions with respect to four managed care ethical scenarios and their responses to Forsyth's (1980) Ethics Position Questionnaire (EPQ). This is one of the first papers to compare this scale to behavioral intentions in the workplace. We provide a literature review of the ethical dilemmas that doctors face under a managed care system and conduct a national random sample of general practitioners and surgeons regarding the four managed care ethical dilemmas. The results show that the doctors surveyed are significantly more idealistic than relativistic. In relating the EPQ to the ethical scenarios, however, there was no support for the proposition that ethical ideology was related to the ethical behavioral intentions. This suggests more research is needed to establish the links between ethical positions, attitudes, and behavioral intentions. Finally, there were little differences in EPQ scores by practice or demographic variables, the only significant result being that general surgeons are significantly more idealistic than family practitioners.

Eastman JK; Eastman KL; Tolson MA

2001-06-01

40

Managing ethical dilemmas in community-based participatory research with vulnerable populations.  

UK PubMed Central (United Kingdom)

This article describes two ethical dilemmas encountered by our research team during a project working with undocumented immigrants in Toronto, Canada. This article aims to be transparent about the problems the research team faced, the processes by which we sought to understand these problems, how solutions were found, and how the ethical dilemmas were resolved. Undocumented immigrants are a vulnerable community of individuals residing in a country without legal citizenship, immigration, or refugee status. There are more than half a million undocumented immigrants in Canada. Through an academic-community partnership, a study was conducted to understand the experiences of undocumented immigrants seeking health care in Toronto. The lessons outlined in this article may assist others in overcoming challenges and ethical dilemmas encountered while doing research with vulnerable communities.

Campbell-Page RM; Shaw-Ridley M

2013-07-01

 
 
 
 
41

Ethical dilemmas in the care of cancer patients near the end of life.  

Science.gov (United States)

By definition, an ethical dilemma involves the need to choose from among two or more morally acceptable options or between equally unacceptable courses of action, when one choice prevents selection of the other. Advances in medicine, increasing economic stress, rise of patient self-determination and differing values between healthcare workers and patients are among the many factors contributing to the frequency and complexity of ethical issues in healthcare. In the cancer patient near the end of life, common ethical dilemmas include those dealing with artificial nutrition and hydration, truth-telling and disagreements over management plans. It would stand the clinician in good stead to be aware of these issues and have an approach toward dealing with such problems. In addition, organisations have a responsibility to ensure that systems are in place to minimise its occurrence and ensure that staff are supported through the process of resolving dilemmas and conflicts that may arise. PMID:22252176

Ong, W Y; Yee, C M; Lee, A

2012-01-01

42

Ethical dilemmas in the care of cancer patients near the end of life.  

UK PubMed Central (United Kingdom)

By definition, an ethical dilemma involves the need to choose from among two or more morally acceptable options or between equally unacceptable courses of action, when one choice prevents selection of the other. Advances in medicine, increasing economic stress, rise of patient self-determination and differing values between healthcare workers and patients are among the many factors contributing to the frequency and complexity of ethical issues in healthcare. In the cancer patient near the end of life, common ethical dilemmas include those dealing with artificial nutrition and hydration, truth-telling and disagreements over management plans. It would stand the clinician in good stead to be aware of these issues and have an approach toward dealing with such problems. In addition, organisations have a responsibility to ensure that systems are in place to minimise its occurrence and ensure that staff are supported through the process of resolving dilemmas and conflicts that may arise.

Ong WY; Yee CM; Lee A

2012-01-01

43

The clinician's dilemma: Two dimensions of ethical care.  

UK PubMed Central (United Kingdom)

There is a continuing intense medico-ethico-legal debate around legalized euthanasia and physician assisted suicide such that ethically informed clinicians often agree with the arguments but feel hesitant about the conclusion, especially when it may bring about a change in law. We argue that this confusion results from the convergence of two continua that underpin the conduct of a clinician and are especially prominent in psychiatry. The two continua concern the duty of care and the importance of patient autonomy and they do not quite map into traditional divides in debates about sanctity of life, paternalism, and autonomy. As ethical dimensions, they come into sharp focus in the psychological complexities of end-of-life care and they form two key factors in most ethical and legal or disciplinary deliberations about a clinician's actions. Whereas both dimensions are important when a clinician reflects on what s/he has done or should do, they need careful balancing in a request for euthanasia or physician assisted suicide where the patient wants to take a decisive role in his or her own end-of-life care. However, end-of-life is also a situation where clinicians often encounter 'cries for help' so that both continua are importantly in play. Balancing these two continua without using blunt legal instruments is often required in psychiatric care in such a way as to problematize the idea that patient decisions should dominate the care options available. A simplistic approach to that issue arguably plays into what has been called an 'impoverished construction of life and death' and, some would say, devalues the basic commitments fundamental to medical care.

Gillett G; Chamberlain J

2013-07-01

44

Ethical Dilemmas in Hospice and Palliative Care Units for Advanced Cancer Patients  

Directory of Open Access Journals (Sweden)

Full Text Available Ethical dilemmas that face heathcare team members referring patients to hospice programs include the ability of clinicians to predict accurately a patient bad prognosis. They affect day-to-day patient management in palliative care programs including healthcare team members concern over the use of morphine because possible respiratory depression in the patient, the question of providing enteral or parenteral nutritional support to patients who refuse to eat and the question of providing parenteral fluids to patients who are unable to take fluids during the terminal phrases of illness. A final ethical dilemma concerns the methodology for quality of life research in palliative care. Understanding and resolving these ethical dilemmas is an important factor determining the quality of the caring for the patient. The ethical dilemmas that are discussed in the article likely to occur in this period can be prevented through his/her participation in the decisions concerning his or her treatment. [Archives Medical Review Journal 2013; 22(1.000): 65-79

Beyhan Bag; Nesrin Reis

2013-01-01

45

Metastatic unknown primary tumour presenting in pregnancy: a rarity posing an ethical dilemma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This brief report raises the ethical dilemma encountered by an obstetrician involved in the care of a pregnant woman with life?threatening disease. This is a particularly difficult issue if the maternal well?being is in conflict with the survival of the unborn child.

Patni, Shalini; Wagstaff, John; Tofazzal, Nasima; Bonduelle, Myriam; Moselhi, Marsham; Kevelighan, Euan; Edwards, Steve

46

The ethical Dilemma of lifestyle change: designing for sustainable schools and sustainable citizenship  

Directory of Open Access Journals (Sweden)

Full Text Available This paper explores how participation and sustainability are being addressed by architects within the Building Schools for the Future (BSF) programme in the UK. The intentions promoted by the programme are certainly ambitious, but the ways to fulfil these aims are ill-explored. Simply focusing on providing innovative learning technologies, or indeed teaching young people about physical sustainability features in buildings, will not necessarily teach them the skills they will need to respond to the environmental and social challenges of a rapidly changing world. However, anticipating those skills is one of the most problematic issues of the programme. The involvement of young people in the design of schools is used to suggest empowerment, place-making and to promote social cohesion but this is set against government design literature which advocates for exemplars, standard layouts and best practice, all leading to forms of standardisation. The potentials for tokenistic student involvement and conflict with policy aims are evident. This paper explores two issues: how to foster in young people an ethic towards future generations, and the role of co-design practices in this process. Michael Oakeshott calls teaching the conversation of mankind. In this paper, I look at the philosophy of Hannah Arendt, Emmanuel Levinas, Maurice Merleau-Ponty and Luce Irigaray to argue that investigating the ethical dilemmas of the programme through critical dialogue with students offers an approach to meeting government objectives, building sustainable schools, and fostering sustainable citizenship.

Andrea Wheeler

2009-01-01

47

The business of ethics. Hospitals need to focus on managerial ethics as much as clinical ethics.  

UK PubMed Central (United Kingdom)

Business ethics begins with the recognition of the various values and "goods" involved in judgements of what to do. Four key values are individual rights, individual self-interest, the company's best interest, and the public good. Often a company has to choose which of these goals or values should be subordinated to another. Business ethics, then, must clarify priorities among these values and establish priority principles to resolve conflicts. One approach to contemporary business ethics emphasizes personal integrity, focusing on conflicts of interest; another approach stresses social responsibility, focusing on the effect of company policy on groups and individuals in society. In business, most of the attention to conflicts of interest focuses on the conflict between employee self-interest and the firm's interest. Healthcare organizations may need to focus on potential conflicts between the patient's interest and the institution's or physician's interest. Physician referrals and pharmaceutical companies' marketing practices are two areas with potential conflicts. Not-for-profit organizations have been quicker than the business world to acknowledge social responsibility. In many ways, however, the social impact of healthcare policies and decisions has not been as carefully considered as it should be. Institutionalizing deliberation about clinical ethical issues has helped to raise awareness about the ethical dimensions of medical care. It would also be useful to institutionalize attention to business ethics in healthcare.

Weber LJ

1990-01-01

48

Governance of dual-use research: an ethical dilemma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Scenarios where the results of well-intentioned scientific research can be used for both good and harmful purposes give rise to what is now widely known as the “dual-use dilemma”. There has been growing debate about the dual-use nature of life science research with implications for making biological...

Selgelid, Michael J

49

Resolving Ethical Dilemmas: Exploring the Role of Moral Principles.  

Science.gov (United States)

We sought to answer two questions via this exploratory study. First, we investigated whether or not individual differences in moral principle selection/preference existed in response to six moral dilemmas. Second, we sought to find out whether they were r...

A. Blais M. Thompsom

2008-01-01

50

Dilemas éticos en el cuidado enfermero/ Ethics dilemmas in nursing care  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Objetivo: Describir situaciones que plantean dilemas éticos propios del ejercicio de la enfermería que influyen en los significados otorgados por los pacientes al cuidado. Metodología: se revisaron los datos obtenidos en entrevistas en profundidad de dos estudios fenomenológicos realizados con 21 participantes adultos que habían estado hospitalizados. Los datos se analizaron según el esquema propuesto por Cohen, Kahan y Steeves. Resultados y discusión: Situaciones (more) de cuidado descritas por los participantes muestran como en decisiones tomadas por los enfermeros desplazan a los pacientes del papel protagónico en el cuidado y cusan rechazo y malestar. Conclusiones: Enfoques de práctica de enfermería basada en decisiones erróneas que no responden a las expectativas de los pacientes requieran de la identificación de dilemas para resolverlos en beneficio de los pacientes y contribuir a la humanización y calidad. Abstract in english Objective: To describe situations involving typical ethical dilemmas in nursing practice that influence patients' meanings about nursing care. Methodology: Data obtained from two phenomenological studies with 21 adults participants who were hospitalized and were interviewed in depth. The analysis was carried out according to the outline proposed by Cohen, Kahan and Steeves. Outcomes and discussion: Participants described situations in which nurses deprived them the protag (more) onist role as they should have in nursing care. This aspect contributed to patient's rejection toward care. Conclusion: Nursing practice focuses based on erroneous decisions that don't comply to patients expectations required identification of dilemmas which must had been solved in a benefical way to patients in order to contribute to humanization and quality.

Beltrán-Salazar, Óscar

2011-06-01

51

Ethical dilemmas in patient selection for a new kidney transplant program in Guyana, South America.  

UK PubMed Central (United Kingdom)

INTRODUCTION: We describe ethical/moral issues in patient selection in a new living donor kidney transplant program in Guyana, South America. CASE REPORTS: Over 3 years, we screened 450 patients with chronic kidney disease among which 70 were suitable for kidney transplantation. There were five patients whose evaluations raised possible ethical dilemmas: one had nonadherence to dialysis; two of Guyanese origin living abroad wished to have the transplant performed in Guyana; a minor wished to donate to her mother; and another subject was considering commercialization of the transplant process. RESULTS: Since inception of the renal replacement program in 2008, we have completed 13 living kidney transplantations, 17 peritoneal dialysis placements, and 20 vascular access procedures. In the five patients wherein faced ethical dilemmas, three were rejected for consideration despite having living donors: one was nonadherent, the second excluded due to an attempt to commercialize the process, and the third, a minor who wished to donate to the mother. The other two patients were considered Guyanese ex-patriots acceptable for the program. DISCUSSION: The consequence of kidney failure in Guyana prior to introduction of renal replacement therapy was a virtual death sentence. These cases illustrate ethical dilemmas serving to throw into stark relief the implications of decisions made in a developing country versus those in a developing country.

Guy SR; Womble AL; Jindal TR; Doyle A; Friedman EA; Elster EA; Falta EM; Jindal RM

2013-01-01

52

Nurse Activism in the newborn intensive care unit: Actions in response to an ethical dilemma.  

Science.gov (United States)

Nurses working in a newborn intensive care unit report that treatment decision disagreements for infants in their care may lead to ethical dilemmas involving all health-care providers. Applying Rest's Four-Component Model of Moral Action as the theoretical framework, this study examined the responses of 224 newborn intensive care unit nurses to the Nurses Ethical Involvement Survey. The three most frequent actions selected were as follows: talking with other nurses, talking with doctors, and requesting a team meeting. The multiple regression analysis indicates that newborn intensive care unit nurses with greater concern for the ethical aspects of clinical practice (p = .001) and an increased perception of their ability to influence ethical decision making (p = .018) were more likely to display Nurse Activism. Future research is necessary to identify other factors leading to and inhibiting Nurse Activism as these findings explained just 8.5% of the variance. PMID:23454980

Settle, Peggy Doyle

2013-03-01

53

Nurse Activism in the newborn intensive care unit: Actions in response to an ethical dilemma.  

UK PubMed Central (United Kingdom)

Nurses working in a newborn intensive care unit report that treatment decision disagreements for infants in their care may lead to ethical dilemmas involving all health-care providers. Applying Rest's Four-Component Model of Moral Action as the theoretical framework, this study examined the responses of 224 newborn intensive care unit nurses to the Nurses Ethical Involvement Survey. The three most frequent actions selected were as follows: talking with other nurses, talking with doctors, and requesting a team meeting. The multiple regression analysis indicates that newborn intensive care unit nurses with greater concern for the ethical aspects of clinical practice (p = .001) and an increased perception of their ability to influence ethical decision making (p = .018) were more likely to display Nurse Activism. Future research is necessary to identify other factors leading to and inhibiting Nurse Activism as these findings explained just 8.5% of the variance.

Settle PD

2013-03-01

54

Cómo resuelven los trabajadores sociales los dilemas éticos Solving Ethical Dilemmas in Social Work  

Directory of Open Access Journals (Sweden)

Full Text Available La profesión del Trabajo Social es una profesión ética. Los profesionales del Trabajo Social a menudo necesitan tomar decisiones éticas en su práctica profesional y son muy diversos los caminos y fuentes que consultan a la hora de orientar estas decisiones. En el artículo se visualizan cuáles son los principales caminos que consultan los trabajadores sociales a la hora de decidir qué hacer frente a un dilema ético. Mediante técnicas de análisis multivariante (análisis factorial y cluster analysis) se han encontrado diferentes tipologías de profesionales, así como cinco ejes en torno a los que pivota la toma de decisiones éticas en el ámbito profesional. Es un estudio pionero en este ámbito que utiliza la combinación metodológica cuantitativa-cualitativa con el fin de ofrecer una forma de comprender cómo resuelven los trabajadores sociales en activo los dilemas éticos. Social Work is an ethical profession. Social workers have to take ethical decisions in their professional practice and they have different resources to take those decisions. In this article we show the main strategies they use to decide what to do to solve an ethical dilemma. We have used factorial and cluster analysis and we have found different groups of professionals. We also describe five main actions they use to take ethical decisions in social interventions. We present a study using quantitative and qualitative methodologies to understand how social workers solve ethical dilemmas.

Alberto Ballestero; Juan Jesús Viscarret; María Jesús Úriz

2011-01-01

55

Development of ethical dilemma scale Japanese nurse faced physical restraints to elderly patients with dementia  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: This study aimed to develop an ethical dilemma scale for nurses faced with the use of physical restraint when caring for elderly patients with dementia. Methods: We used a previously established 20-item dilemma scale. The objective and method of the study were explained to the head of nursing at 17 selected hospitals, and 121 nurses working in the general wards of 14 hospitals (excluding emergency department wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms and intensive care units) who agreed to participate were enrolled in 2000. Seventy-six nurses from one of the hospitals were selected after eight years (2008) to provide a comparison. Ethical considerations: The study was conducted with the approval of the ethics committee at Meiji University of Integrative Medicine. Results and discussion: Four factors were compared between 2000 and 2008: “execution of treatment and security”, “characteristic features in nursing of elderly patients with dementia”, “cooperative relationship in nursing”, and “priorities in nursing”. The cumulative contribution ratio was 65.3% (KMO = 0.77, p = 0.000) in 2000 and 72.5% (KMO = 0.78, p = 0.000) in 2008. Therefore, the scale dilemma nurse faced physical restraints to elderly patients with dementia in Japan was developed 4 facoters from 17-delremmas items of 20 items.

Miwa Yamamoto; Masako Nakamura; Shigeru Sakuraba

2013-01-01

56

Legal, Ethical, and Financial Dilemmas in Electronic Health Record Adoption and Use  

Science.gov (United States)

Electronic health records (EHRs) facilitate several innovations capable of reforming health care. Despite their promise, many currently unanswered legal, ethical, and financial questions threaten the widespread adoption and use of EHRs. Key legal dilemmas that must be addressed in the near-term pertain to the extent of clinicians' responsibilities for reviewing the entire computer-accessible clinical synopsis from multiple clinicians and institutions, the liabilities posed by overriding clinical decision support warnings and alerts, and mechanisms for clinicians to publically report potential EHR safety issues. Ethical dilemmas that need additional discussion relate to opt-out provisions that exclude patients from electronic record storage, sale of deidentified patient data by EHR vendors, adolescent control of access to their data, and use of electronic data repositories to redesign the nation's health care delivery and payment mechanisms on the basis of statistical analyses. Finally, one overwhelming financial question is who should pay for EHR implementation because most users and current owners of these systems will not receive the majority of benefits. The authors recommend that key stakeholders begin discussing these issues in a national forum. These actions can help identify and prioritize solutions to the key legal, ethical, and financial dilemmas discussed, so that widespread, safe, effective, interoperable EHRs can help transform health care.

Singh, Hardeep

2011-01-01

57

Has Our Knowledge of Neuroscience Led to Ethical Dilemmas?  

Science.gov (United States)

This is a lesson dealing with a new subdivision of bioethics called neuroethics. As our knowledge of the brain and nervous system expands, so do the ethical issues that result from this knowledge. This new area of study results from our increasing research in the field of neurobiology. In the first part of this activity, students will discuss the stigma associated with psychological illness. They will then be introduced to Dr. Kay Jamison who discusses some of the ethical implications of bipolar disorder. The class will take part in an activity called a Topical Barometer where they will have to choose a position regarding an ethical decision. In Part 2 of the activity, they will write a position paper after exploring the topic of drug enhancement, another controversial issue in the world of neuroscience. From the original handout text by Caren Gough

Musante, Susan

58

Painful dilemmas: the ethics of animal-based pain research  

DEFF Research Database (Denmark)

While it has the potential to deliver important human benefits, animal-based pain research raises ethical questions, because it involves inducing pain in sentient beings. Ethical decision-making, connected with this variety of research, requires informed harm-benefit analysis, and the aim of this paper is to provide information for such an analysis. We present an overview of the different models and their consequences for animal welfare, showing that, of the many animal models available, most have a considerable welfare impact on the animal. While the usual approach to pain control through administration of analgesic substances is usually unsuitable in pain research, refinement remains an option, both within the experimental protocol and in general husbandry and handling. Drawing on the overview, we develop a discussion of the ethical acceptability of animal-based pain research against the background of the kinds of harm done to the animals involved, the potential for refinement, and the expected benefits ofthe research.

Magalhães-Sant'Ana, M.; SandØe, Peter

2009-01-01

59

Accountability to Research Participants: Unresolved Dilemmas and Unravelling Ethics  

Science.gov (United States)

Drawing on findings from an ethnographic study of Romani Gypsy groups in England (1996-2000), along with data from follow-up work involving original and additional participants (2005-ongoing), this paper explores several ethical issues that arose. It traces developing relationships across a 13-year period, identifying the problems of attempting to…

Levinson, Martin P.

2010-01-01

60

A Right to Die?: Ethical Dilemmas of Euthanasia.  

Science.gov (United States)

Euthanasia is considered an important social issue of the 1990s. Mental health professionals should understand the differences between voluntary, involuntary, passive, and active euthanasia; mercy killing, and assisted suicide. Encourages counselors to ethically formulate client-supportive positions to help clients face life-and-death decisions.…

Albright, Dianne E.; Hazler, Richard J.

1992-01-01

 
 
 
 
61

Intervening in Alcoholism: How to resolve an ethical dilemma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A case of alcoholism, often encountered in family practice, can illustrate some of the ethical issues that are inherent in the practice of medicine. The concepts of autonomy, paternalism, and beneficence are explored within the context of this clinical example. The nature of alcoholism, options for ...

Calam, Betty

62

Online Privacy, Security and Ethical Dilemma: A Recent Study.  

Science.gov (United States)

The Internet remains as a wonder for the 21st century and its growth is phenomenon. According to a recent survey, the online population is now about 500 million globally and if this trend continues, it should reach 700 million by the end of 2002. This exponential growth of the Internet has given rise to several security, privacy and ethical

Karmakar, Nitya L.

63

Student midwives' responses to reproductive ethics: a qualitative focus group approach using case scenarios.  

UK PubMed Central (United Kingdom)

OBJECTIVE: the aim of this study was to gain an understanding of how midwifery students respond to a range of ethical dilemmas which they may encounter in clinical practice in relation to the use of reproductive technologies. DESIGN: during a series of focus groups, student midwives were asked to consider four novel scenarios, which highlighted some of the most controversial issues in contemporary reproductive ethics. These included assisted reproduction for older women, surrogacy and mental health, sex selection and reproductive cloning. SETTING: a University in the East Midlands, England. PARTICIPANTS: purposeful sampling was adopted which resulted in four focus groups with a total of 16 student midwives. FINDINGS: a process of thematic analysis generated four key themes: choice and expectation, consumer society; distributive justice; parental rights and welfare of the child. CONCLUSIONS: our results suggest that student midwives are sensitive to the range of ethical dilemmas associated with the increased use of technology in human reproduction, and construct distinct boundaries in relation to what is considered of benefit or good to the mother, parents, the child and to society and what is considered harmful to the individual, the child and society. They also expressed their opposition to the excessive use of technological intervention, preferring instead to maintain a more naturalistic approach to reproduction. This is especially significant where concerns about the welfare of the child are articulated.

Church S; Ekberg M

2013-08-01

64

The ethical dilemma of embryonic stem cell research.  

UK PubMed Central (United Kingdom)

To determine the knowledge, attitude, and ethical concerns of medical students and graduates with regard to Embryonic Stem Cell (ESC) research. This questionnaire based descriptive study was conducted at the Civil Hospital Karachi (CHK), Pakistan from February to July 2008. A well structured questionnaire was administered to medical students and graduate doctors, which included their demographic profile as well as questions in line with the study objective. Informed consent was taken and full confidentiality was assured to the participants. Data were entered in a Statistical Package for Social Sciences (SPSS version.12) and analyzed. A total of 204 male and 216 female medical students and doctors were administered questionnaires out of which 105 males (51.4%) and 108 females (50%) were aware of the embryonic stem cell research and its ethical implications. Forty percent males and 47% of females were of the opinion that life begins at conception. Forty-six percent males and 39% females were in favor of stem cell research while only 31% males and 28% females supported the ESC research. Less than 1/3 of students supported using frozen embryos for research purposes while more than 2/3 indicated that they were unlikely to support abortion for stem cell research purposes. The majority of the students were in favor of stem cell research with some reservations regarding ESC research. A sizeable number of students withheld their views, reflecting their poor understanding of medical ethics. The result of the study indicates a need for incorporating bioethics into the medical curriculum.

Manzar N; Manzar B; Hussain N; Hussain MF; Raza S

2013-03-01

65

[Cancer screening: curative or harmful? An ethical dilemma facing the physician].  

UK PubMed Central (United Kingdom)

Early detection based on prostate-specific antigen (PSA) presumably can reduce prostate cancer mortality. At the same time it is associated with a comparatively high rate of overdiagnosis involving tumors that would not have become apparent without screening since they would have remained asymptomatic during the patient's entire life. Current studies show that the probability of such an overdiagnosis is 12-48 times higher than one which would save a man's life. Thus, overdiagnosis poses an ethical dilemma for physicians: their actions (screening examination) can turn a healthy individual into a chronically ill person. This profoundly contradicts the principle of medical ethics to"do no harm." An open debate on whether early detection can be reconciled with doctors' ethical duties is hampered by the implications of liability law, faulty economic incentives, and the pressures of competition as well as the empirical practice of many physicians to overestimate the benefits of cancer screening.

Schaefer C; Weissbach L

2011-12-01

66

[Cancer screening: curative or harmful? An ethical dilemma facing the physician].  

Science.gov (United States)

Early detection based on prostate-specific antigen (PSA) presumably can reduce prostate cancer mortality. At the same time it is associated with a comparatively high rate of overdiagnosis involving tumors that would not have become apparent without screening since they would have remained asymptomatic during the patient's entire life. Current studies show that the probability of such an overdiagnosis is 12-48 times higher than one which would save a man's life. Thus, overdiagnosis poses an ethical dilemma for physicians: their actions (screening examination) can turn a healthy individual into a chronically ill person. This profoundly contradicts the principle of medical ethics to"do no harm." An open debate on whether early detection can be reconciled with doctors' ethical duties is hampered by the implications of liability law, faulty economic incentives, and the pressures of competition as well as the empirical practice of many physicians to overestimate the benefits of cancer screening. PMID:22009258

Schaefer, C; Weissbach, L

2011-12-01

67

The ethical dilemma of embryonic stem cell research.  

Science.gov (United States)

To determine the knowledge, attitude, and ethical concerns of medical students and graduates with regard to Embryonic Stem Cell (ESC) research. This questionnaire based descriptive study was conducted at the Civil Hospital Karachi (CHK), Pakistan from February to July 2008. A well structured questionnaire was administered to medical students and graduate doctors, which included their demographic profile as well as questions in line with the study objective. Informed consent was taken and full confidentiality was assured to the participants. Data were entered in a Statistical Package for Social Sciences (SPSS version.12) and analyzed. A total of 204 male and 216 female medical students and doctors were administered questionnaires out of which 105 males (51.4%) and 108 females (50%) were aware of the embryonic stem cell research and its ethical implications. Forty percent males and 47% of females were of the opinion that life begins at conception. Forty-six percent males and 39% females were in favor of stem cell research while only 31% males and 28% females supported the ESC research. Less than 1/3 of students supported using frozen embryos for research purposes while more than 2/3 indicated that they were unlikely to support abortion for stem cell research purposes. The majority of the students were in favor of stem cell research with some reservations regarding ESC research. A sizeable number of students withheld their views, reflecting their poor understanding of medical ethics. The result of the study indicates a need for incorporating bioethics into the medical curriculum. PMID:22038063

Manzar, Nabeel; Manzar, Bushra; Hussain, Nuzhat; Hussain, M Fawwad Ahmed; Raza, Sajjad

2011-10-29

68

The Ethical Dilemma Of The Usa Government Wiretapping  

Directory of Open Access Journals (Sweden)

Full Text Available USA Government wiretapping activities is a very controversial issue. Undoubtedly this technology canassist law enforced authority to detect / identify unlawful or hostile activities; however, this task raisessevere privacy concerns. In this paper, we have discussed this complex information technology issue ofgovernmental wiretapping and how it effects both public and private liberties. Legislation has had amajor impact on the uses and the stigma of wiretapping for the war on terrorism. This paper alsoanalyzes the ethical and legal concerns inherent when discussing the benefits and concerns ofwiretapping. The analysis has concluded with the effects of wiretapping laws as they relate to futuregovernment actions in their fight against terrorists.

Arwen Mullikin; Syed (Shawon) M. Rahman

2010-01-01

69

Quality focus shining on corporate ethics.  

UK PubMed Central (United Kingdom)

Compliance just scratches the surface of a comprehensive ethics policy. Being true to your mission is a critical component of governance responsibilities. Quality managers play an important role in feedback, implementation.

2003-01-01

70

Ethical dilemma of recovering organs before donor death.  

Science.gov (United States)

Organ transplant has had a momentous effect in improving global health over the years. However, there exists a sizeable discrepancy between the supply and demand of organs, especially in developing countries, where lack of expertise, financial constraints, and inadequate transplant facilities have been obstacles. According to current practice, donors must be dead before unpaired vital organs can be recovered. Equal health warrants needs-based health care for everyone. Recovering viable organs from donors while they are alive, but with death inevitable, may be significant to persons on waiting lists. Future policies in organ transplantation must be made after thorough consideration of all aspects of donation and dealing with the inequalities of health care. These pose a challenge for medicolegal and ethical organizations. PMID:21819377

Khalid, Umair; Khalil, Sarwat

2011-08-01

71

Ethical dilemma of recovering organs before donor death.  

UK PubMed Central (United Kingdom)

Organ transplant has had a momentous effect in improving global health over the years. However, there exists a sizeable discrepancy between the supply and demand of organs, especially in developing countries, where lack of expertise, financial constraints, and inadequate transplant facilities have been obstacles. According to current practice, donors must be dead before unpaired vital organs can be recovered. Equal health warrants needs-based health care for everyone. Recovering viable organs from donors while they are alive, but with death inevitable, may be significant to persons on waiting lists. Future policies in organ transplantation must be made after thorough consideration of all aspects of donation and dealing with the inequalities of health care. These pose a challenge for medicolegal and ethical organizations.

Khalid U; Khalil S

2011-08-01

72

Parental rights and decision making regarding vaccinations: ethical dilemmas for the primary care provider.  

UK PubMed Central (United Kingdom)

PURPOSE: To discuss the ethical dilemma that a primary care nurse practitioner (NP) must face when parents refuse to have their children immunized. DATA SOURCES: Review of published literature on the topic. CONCLUSIONS: By listening carefully to their concerns, responding honestly, and providing clear information about the risks and benefits, NPs may be able to build trust and to convince once hesitant parents to have their children immunized. For those parents who refuse, NPs may feel uncertain on how to respond. By considering the ethical principles to which they are bound, autonomy, beneficence, and non-maleficence, NPs can work with the parents to decide what treatment is best for the child. IMPLICATIONS FOR PRACTICE: Providing truthful information to parents and utilizing public awareness through recent discussions in the media and on the Internet may be able to obviate many of the concerns of parents, which may be getting in the way of universal immunization.

Fernbach A

2011-07-01

73

The problem of choice in major dilemmas of obstetrics- actors, roles, ethical arguments and influences  

Directory of Open Access Journals (Sweden)

Full Text Available The article discusses the principle of autonomy of patientss choice in a highly sensitive area, the obstetrics, regarding two issues which arise many dilemmas and debates, the induced abortion and the elective cesarean section..It brings up many pro and cons ethical arguments, reviews the various points of view and historical, legal, religious and humanist influences.Article stresses the need to adapt the old ethic principles to the realities of the actual complex society and the necessity of fully respect for the fundamental rights of the patient, including autonomy. Article leaves still open the problem of the influence of various factors on patients choice, and the need for the physician to assure the observance of this right.

Ingrid-Laura FIRULEASA

2010-01-01

74

Dilema ético de la eutanasia/ Ethical dilemma of euthanasia  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish La eutanasia significa una muerte buena. Desde el punto de vista jurídico, es la muerte sin sufrimiento físico provocada por propia voluntad de un enfermo incurable. En la práctica consiste en administrar drogas, fármacos u otras sustancias que alivien el dolor aunque con ello se acorte la vida. La decisión de la aplicación de la eutanasia ha sido un problema persistente en la historia de la humanidad, ideologías diversas se enfrentan defendiendo sus argumentos de (more) si debe o no practicarse. El objetivo de este trabajo, es exponer las consideraciones éticas, científicas y religiosas, sobre la práctica de la eutanasia a partir de un análisis histórico desde los tiempos de Platón hasta la actualidad. Lo verdaderamente importante es que el hombre, como ser racional, capaz de revolucionar constantemente la ciencia y la técnica y de transformar la naturaleza en beneficio de la especie, debe también morir con dignidad. Abstract in english Euthanasia means nice death. From the legal viewpoint, it means physical suffering-free provoked death willingly accepted by a terminally-ill patient. In practice, it means to administer drugs, pharmaceuticals or other substances that release pain even though they may reduce lifetime. The decision for euthanasia has been a persistent controversy in the history of mankind; thus various ideologies clash in support of arguments in favour or against this practice. The objecti (more) ve of this paper is to present ethical, scientific and religious considerations on the implementation of euthanasia, taking as a basis a historical analysis covering from Platon up to the present times. It is really important that man, as a rational being capable of permanently revolutionizing science and technique and transforming nature for the benefit of the species, should also die with dignity.

Creagh Peña, Mabel

2012-03-01

75

Dilema ético de la eutanasia Ethical dilemma of euthanasia  

Directory of Open Access Journals (Sweden)

Full Text Available La eutanasia significa una muerte buena. Desde el punto de vista jurídico, es la muerte sin sufrimiento físico provocada por propia voluntad de un enfermo incurable. En la práctica consiste en administrar drogas, fármacos u otras sustancias que alivien el dolor aunque con ello se acorte la vida. La decisión de la aplicación de la eutanasia ha sido un problema persistente en la historia de la humanidad, ideologías diversas se enfrentan defendiendo sus argumentos de si debe o no practicarse. El objetivo de este trabajo, es exponer las consideraciones éticas, científicas y religiosas, sobre la práctica de la eutanasia a partir de un análisis histórico desde los tiempos de Platón hasta la actualidad. Lo verdaderamente importante es que el hombre, como ser racional, capaz de revolucionar constantemente la ciencia y la técnica y de transformar la naturaleza en beneficio de la especie, debe también morir con dignidad.Euthanasia means nice death. From the legal viewpoint, it means physical suffering-free provoked death willingly accepted by a terminally-ill patient. In practice, it means to administer drugs, pharmaceuticals or other substances that release pain even though they may reduce lifetime. The decision for euthanasia has been a persistent controversy in the history of mankind; thus various ideologies clash in support of arguments in favour or against this practice. The objective of this paper is to present ethical, scientific and religious considerations on the implementation of euthanasia, taking as a basis a historical analysis covering from Platon up to the present times. It is really important that man, as a rational being capable of permanently revolutionizing science and technique and transforming nature for the benefit of the species, should also die with dignity.

Mabel Creagh Peña

2012-01-01

76

Ethical dilemmas of health care in the developing nations.  

UK PubMed Central (United Kingdom)

Limited resources, widespread poverty, and the absence of health insurance pose daily ethical problems for Third World physicians, who must balance their roles as individual patient advocates against a desire to provide health care to the greatest number of children. Pakistan has a per capita income of Rs. 7,220 (US$ 380) per year, or Rs. 800 (US$ 32) per month. The annual population growth of the country is 3.1%, and approximately 360,000 infants are born each year in Karachi, the largest city in the country. The Aga Khan University Hospital, a private teaching institution, is the only hospital in Karachi with a Level III Neonatal Intensive Care Unit (NICU). The financial and medical data of 200 infants admitted to the NICU in 1988 were reviewed retrospectively, and compared with those of two specific subgroups. (1) Among 15 infants who underwent surgical intervention, the average total cost of hospitalization was Rs. 36,040 (US$ 1,900) per patient, with an average daily cost of Rs. 923 (US$ 49). The longest hospital stay was 6 months, for a child who had total colonic aganglionosis associated with a short gut syndrome. There were two deaths in this group. (2) Of the 21 premature neonates admitted having Idiopathic Respiratory Distress Syndrome (IRDS) during this period, the total hospitalization cost per patient was Rs. 23,260 (US$ 788), with a daily cost of Rs. 1,050 (US$ 55). Eleven patients required ventilatory support. There were 16 survivors. Among both groups, 6% of all revenues generated in the NICU were used to help families pay for the bills under a welfare scheme.

Moazam F; Lakhani M

1990-04-01

77

[Informed consent or choice? An ethical dilemma in oncology practice].  

Science.gov (United States)

How articulate information, mutidisciplinary practice, choice and decision of the treatment in a good patient-doctor relationship, an ethical relationship ? Doctor is an expert who gets the information (patients have more and more others sources of information). Choice of the treatment depends of the facts (the evidence) and personal values (the preferences). The selection between the different options (most often they are several options) may be done by the physician or by physicians in a multidisciplinary clinics, in the presence of the patient or not. The final decision to do or not the treatment belongs to the patient (who is not always aware of that). Initial sharing of the information between patient and doctor may permit the patient to choose himself the best option. More complete is sharing of the information, more the patient is able to do a free choice (without the influence of the doctor). It is often possible (genetics, prevention, screening, adjuvant treatments) to share in full the available information (knowing its relativity and limits). In oncology, the full sharing of the information is not always realistic, neither asked by the patient. Nevertheless, it is possible to go progressively with the patient to a preferred choice through a deliberative process, a co-construction of the decision. But often, the doctor refer to a pre-established protocol, build by physicians, representing the choice of the majority (doctors and/or patients) in the "same" situation. Only one option is offered to the patient from whom consent is asked, the information been then delivered to explain the choice already done. This paternalistic attitude is very effective, comfortable and don't alter the satisfaction of the majority of the patients, however, it limits the patient's autonomy. The patient is not allowed to choose between all the possibilities but accept or refuse the doctor's choice. With the extreme variability of the situations, it would be illusive to defend a unique attitude. Doctor has yet to try to adapt himself to every single case. PMID:17535783

Vennin, Philippe

2007-05-01

78

Bioethics for clinicians: 12. Ethical dilemmas that arise in the care of pregnant women: rethinking "maternal-fetal conflicts".  

Digital Repository Infrastructure Vision for European Research (DRIVER)

When a pregnant woman makes a decision or acts in a manner that may be detrimental to the health and well-being of her fetus, her physician may be faced with an ethical dilemma. Is the physician's primary duty to respect the woman's autonomy, or to promote behaviour that may be in the best interest ...

Flagler, E; Baylis, F; Rodgers, S

79

Feeling trapped and being torn: Physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background This study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection. The aim of this study was to illuminate the meanings of being in ethically difficult situations that led to the burden of a troubled conscience, as narrated by physicians working in dialysis care. Method A phenomenological hermeneutic method was used to analyze the transcribed narrative interviews with five physicians who had varying lengths of experience in nephrology. Results The analysis shows that physicians working in hemodialysis care suffered from a troubled conscience when they felt torn by conflicting demands and trapped in irresolution. They faced ethical dilemmas where they were forced to make crucial decisions about life or death, or to prioritize when squeezed between time restraints and professional and personal demands. In these ethical dilemmas the physicians avoided arousing conflicts, were afraid of using their authority, were burdened by moral responsibility and felt devalued and questioned about their way of handling the situation. The findings point to another way of encountering ethical dilemmas, being guided by their conscience. This mean sharing the agony of deciding how to act, being brave enough to bring up the crucial problem, feeling certain that better ways of acting have not been overlooked, being respected and confirmed regarding decisions made. Conclusion The meanings of being in ethically difficult situations that led to the burden of a troubled conscience in those working in hemodialysis care, indicate the importance of increasing the level of communication within and among various professional groups - to transform being burdened by a troubled conscience into using conscience as a guide - in situations where no way of solving the problem seems to be good.

Grönlund Catarina; Dahlqvist Vera; Söderberg Anna IS

2011-01-01

80

The Moral Values and Dilemmas in Romanian University. The Influence of Prosperity on Ethical Behavior  

Directory of Open Access Journals (Sweden)

Full Text Available Upon analysis, it appears that education is the only solution to prevail over this moral crisis; the dilemma of contemporary society, faced with this moral challenge, lies at the crossroads between philosophy and pedagogy. Moral value education cannot be reduced to “civic education” or to “human rights education”, as it lies at the crossroads between the logic of the mind and the logic of the heart, which generate values together. A “new ethics” is necessary, one which must reflect our historical standpoint, because the overthrow of a set of values and the inauguration of a “new moral” cannot be achieved by one “brilliant Zarathustra”.The questions of our papers are: What was and what is it now the University? And what are university professors’ responsibilities? Are the social-economical changes influencing the academic activity?

Magdalena IORGA

2012-01-01

 
 
 
 
81

Shall I become a zombie? Stories of illness, ethical dilemmas and visions of society.  

UK PubMed Central (United Kingdom)

Three controversial ethical issues, among others, stir the debate in health care institutions, in medical associations, and in the whole society: the care of patients in persistent vegetative state, the regulation of artificial procreation, some individual requests for reshaping an healthy body. Dealing with these dilemmas, typical of advanced medical science and technological practice, implies not only balancing carefully the burdens and benefits for suffering persons, families, equipes, hospitals, cultural and religious communities, but also imaging and realizing new visions of a just society, of a beneficent (without paternalism) medicine and generally of a good life, where each moral agent could write in front of all and in worthy, convincing ways, the next chapter of the book of his/her own life.

Cattorini P

2009-01-01

82

The referee’s dilemma. The ethics of scientific communities and game theory  

Directory of Open Access Journals (Sweden)

Full Text Available This article argues that various deviations from the basic principles of the scientific ethos – primarily the appearance of pseudoscience in scientific communities – can be formulated and explained using specific models of game theory, such as the prisoner’s dilemma and the iterated prisoner’s dilemma. The article indirectly tackles the deontology of scientific work as well, in which it is assumed that there is no room for moral skepticism, let alone moral anti-realism, in the ethics of scientific communities. Namely, on the basis of the generally accepted dictum of scientific endeavor as the pursuit of knowledge exclusively for knowledge’s sake, scientifically »right« behavior is seen to be clearly defined and distinguishable from scientifically »wrong« behavior. After elucidating the basic principles of game theory, the article illustrates – by using imaginary and real cases, as well as some views from the philosophyof biology (the units of selection debate) – how this sort of reasoning could be applied in an analysis of the functioning of science.

Tomislav Bracanovic

2002-01-01

83

Ethical and social dilemmas in community-based controlled trials in situations of poverty: a view from a South African project.  

UK PubMed Central (United Kingdom)

All psychological and social research presents ethical dilemmas, many of which centre around the difficulties which flow from the power imbalances between those conducting the research and the research respondents or participants. Issues of power are magnified in research undertaken in contexts of poverty, and there is a burgeoning literature on ethical issues in research in developing countries. In this article, we augment the existing literature by focusing on the experiences of an assessor working in a controlled trial of a mother-infant intervention in a poor South African community. We consider issues of community expectations, the presentation to our project of physical health problems, the issue of HIV/AIDS, cultural beliefs which impact on the research, child protection issues, and the tensions between research assessment and ubuntu--a cultural norm which requires helpful engagement with others. We suggest that our experiences may assist with the development of further research.

Nama N; Swartz L

2002-07-01

84

Ethical and social dilemmas in community-based controlled trials in situations of poverty: a view from a South African project.  

Science.gov (United States)

All psychological and social research presents ethical dilemmas, many of which centre around the difficulties which flow from the power imbalances between those conducting the research and the research respondents or participants. Issues of power are magnified in research undertaken in contexts of poverty, and there is a burgeoning literature on ethical issues in research in developing countries. In this article, we augment the existing literature by focusing on the experiences of an assessor working in a controlled trial of a mother-infant intervention in a poor South African community. We consider issues of community expectations, the presentation to our project of physical health problems, the issue of HIV/AIDS, cultural beliefs which impact on the research, child protection issues, and the tensions between research assessment and ubuntu--a cultural norm which requires helpful engagement with others. We suggest that our experiences may assist with the development of further research. PMID:16881161

Nama, Nosisana; Swartz, Leslie

85

Ethical issues in presymptomatic genetic testing for minors: a dilemma in Li-Fraumeni syndrome.  

UK PubMed Central (United Kingdom)

In 2001, a French expert panel recommended that presymptomatic tests should not be carried out on minors in families affected by Li-Fraumeni syndrome (LFS), flying in the face of possible parental demands for such testing. We decided to investigate the legitimacy of such a recommendation. We conducted a national multicenter survey using self-administered questionnaires mailed to French oncogeneticists in 33 regional centers in France. We aimed to (1) determine the extent to which these doctors were confronted with parental requests for TP53 testing, (2) study how they responded to these requests and the arguments used and (3) assess the attitude of oncogeneticists concerning the normative framework regulating the prescription of tests for minors. Twenty oncogeneticists stated that they had managed at least one LFS family. Eleven of these doctors had been confronted with parental requests for testing and three had prescribed such tests on at least one occasion. The oncogeneticists gave balanced medical, psychological and ethical arguments, highlighting the dilemma they face in the decision-making process. This dilemma is due to the lack of a consensus concerning this recommendation, which aims to protect the minor by limiting presymptomatic tests to cases in which a clear medical benefit can be demonstrated but which prevents the unique situation of particular families from being taken into account. In conclusion, the recommendation has a normative status but first, from a clinical stance, it is difficult to dissociate it from the evaluation of individual family situations, and second, the benefit of a specific medical follow-up for TP53 mutation carriers is currently being investigated.

Fresneau B; Brugières L; Caron O; Moutel G

2013-06-01

86

[Ethical dilemmas in gastroenterology practice in Latin-American countries: the AIGE survey].  

Science.gov (United States)

A survey sponsored by the Interamerican Association of Gastroenterology (AIGE) related to decision making in conflictive ethical situations in the setting of gastroenterological practice was designed (AJ-JCG). Seven problem-cases with 3 to 5 pre-established and not-excluding answers each, demographic and occupational data were included, by public invitation during 1996-97 AIGE educational activities in La Plata (Argentina), Montevideo (Uruguay) and Santo Domingo (Dominican Republic). Data were inserted in a computerised data base, and chi square, Fischer and Maentel-Henzel tests were used for statistical studies. 118 out of 460 doctors registered to educational activities answered at the survey (25.6%). Mean age was 42 +/- 15 years and 57.6% were male; 48.5% were under 10 years of professional practice and 19.5% were over 20 years. Gastroenterology was the main specialty in 89.8%. Although only 15.2% of participants reported as not having Ethical Committee (EC) in their institutions, the option of consulting was not very frequently selected, except in cases of request about pregnancy interruption in the HCV infected mother (22.9%), inclusion of the young alcoholic cirrhotic man in the waiting list for liver trasplant (17.8%), and the Jehova's Witness conscious patient with bleeding esophageal varices (13.5%). Cases of direct communication to the patient of early colon cancer diagnosis (66.1%), and inclusion of the young end stage alcoholic cirrhotic patient in the waiting list for liver trasplantation (65.2%), had the higher consensus. On the other hand, lower consensus (39%) was seen in the case of variceal bleeding in the encephalopathic Witness of Jehova patient. Differential criterla were observed related to sex: 38% of women versus 14.7% of men (p 20 years of professional exercise asked for patient consent and accepted his decision, versus 52.7 and 27.5% in 0-9 and 10-19 years group respectively (p < 0.05). Usual medical and social worries as communication (truth, informed consent), the autonomic decision of biological death versus the sacrament of life, justice in allocation resources, confidentiality and social concern, abortion, and many other controversies linked to tecno-scientific development, impact the practice of Gastroenterology in latinoamerican countries. However medical answers to ethical dilemmas are not uniform. Although our results ought to be verified by other studies they clearly suggest the needs for systematic incorporation of applicated Ethics in pre and postgraduate Gastroenterology curricula, besides the regular activities of our regional institutions. PMID:10491718

Jmelnitzky, A C; Cohen, H; Fossman, E; Ovando, L; Costa Gil, J E

1999-01-01

87

THE PARADIGM OF ANTIGONE AND GACEL SAYAH: An approach to historical and contemporary Ethical/moral dilemmas of Journalism  

Directory of Open Access Journals (Sweden)

Full Text Available This work intends to locate and to explore the complexities ofsome classical moral dilemmas in human history considering twoparadigms as references: Antigone’s, created by Sophocles; andGacel Sayah’s, created by Vázquez-Figueroa. The work situatesboth historical and contemporary dilemmas of journalism andpoints out examples furnished by professionals in activity andacademic experts. At the same time, it relates immediate conflicts to particularities of journalistic activity – from the historical perspective of consolidation of values to the present scenario of professional journalism in both Cyberspace and the Information Society (in which ethics, techniques and aesthetics try to structure the perspective of moral convergence in order to support the activity and its social credibility and legitimacy).

Francisco José Castilhos Karam

2009-01-01

88

THE PARADIGM OF ANTIGONE AND GACEL SAYAH: An approach to historical and contemporary Ethical/moral dilemmas of Journalism  

Directory of Open Access Journals (Sweden)

Full Text Available This work intends to locate and to explore the complexities ofsome classical moral dilemmas in human history considering twoparadigms as references: Antigone’s, created by Sophocles; andGacel Sayah’s, created by Vázquez-Figueroa. The work situatesboth historical and contemporary dilemmas of journalism andpoints out examples furnished by professionals in activity andacademic experts. At the same time, it relates immediate conflicts to particularities of journalistic activity – from the historical perspective of consolidation of values to the present scenario of professional journalism in both Cyberspace and the Information Society (in which ethics, techniques and aesthetics try to structure the perspective of moral convergence in order to support the activity and its social credibility and legitimacy).

Francisco José Castilhos Karam

2011-01-01

89

[Ethical dilemmas in gastroenterology practice in Latin-American countries: the AIGE survey  

UK PubMed Central (United Kingdom)

A survey sponsored by the Interamerican Association of Gastroenterology (AIGE) related to decision making in conflictive ethical situations in the setting of gastroenterological practice was designed (AJ-JCG). Seven problem-cases with 3 to 5 pre-established and not-excluding answers each, demographic and occupational data were included, by public invitation during 1996-97 AIGE educational activities in La Plata (Argentina), Montevideo (Uruguay) and Santo Domingo (Dominican Republic). Data were inserted in a computerised data base, and chi square, Fischer and Maentel-Henzel tests were used for statistical studies. 118 out of 460 doctors registered to educational activities answered at the survey (25.6%). Mean age was 42 +/- 15 years and 57.6% were male; 48.5% were under 10 years of professional practice and 19.5% were over 20 years. Gastroenterology was the main specialty in 89.8%. Although only 15.2% of participants reported as not having Ethical Committee (EC) in their institutions, the option of consulting was not very frequently selected, except in cases of request about pregnancy interruption in the HCV infected mother (22.9%), inclusion of the young alcoholic cirrhotic man in the waiting list for liver trasplant (17.8%), and the Jehova's Witness conscious patient with bleeding esophageal varices (13.5%). Cases of direct communication to the patient of early colon cancer diagnosis (66.1%), and inclusion of the young end stage alcoholic cirrhotic patient in the waiting list for liver trasplantation (65.2%), had the higher consensus. On the other hand, lower consensus (39%) was seen in the case of variceal bleeding in the encephalopathic Witness of Jehova patient. Differential criterla were observed related to sex: 38% of women versus 14.7% of men (p < 0.01) refuse the interruption of pregnancy to the infected HCV patient because of personal convictions against abortion. In the case of suspected HIV co-infection in the IVD HBsAG + carrier, 46% of women vs. 27.9% of men (p < 0.05) indicate HIV screening test without any explanation to the patient because "he could transmit a fatal disease". In this same case, time from graduation was related to differences in option selection: 80.9% in the group > 20 years of professional exercise asked for patient consent and accepted his decision, versus 52.7 and 27.5% in 0-9 and 10-19 years group respectively (p < 0.05). Usual medical and social worries as communication (truth, informed consent), the autonomic decision of biological death versus the sacrament of life, justice in allocation resources, confidentiality and social concern, abortion, and many other controversies linked to tecno-scientific development, impact the practice of Gastroenterology in latinoamerican countries. However medical answers to ethical dilemmas are not uniform. Although our results ought to be verified by other studies they clearly suggest the needs for systematic incorporation of applicated Ethics in pre and postgraduate Gastroenterology curricula, besides the regular activities of our regional institutions.

Jmelnitzky AC; Cohen H; Fossman E; Ovando L; Costa Gil JE

1999-01-01

90

Ethical Dilemma Factor in Regarding Physical Restraints to Elderly of Female Nurses with the Living Together Experience  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospitals who also live with elderly adults at home. Method: The study used the questionnaire method with an independently prepared questionnaire. Participants: The objective of the study was explained to the persons in charge of nursing in the selected 17 hospitals, and 1929. Finally, this study of participants were 524 female nurses working in general 54 wards (excluding the emergency wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms, and intensive care units) at community hospitals who also live with elderly adults at home. Results and conclusions: Cronbach’s overall coefficient for the 20 items of dilemma was high (0.78) and the factor analysis extracted four dilemma factors as having a characteristic value of 1 (Kaiser-Meyer-Olkin measure value = 0.81) with a cumulative contribution ratio of 64.5%. The high Cronbach’s for these items (0.86, 0.88, 0.87 and 0.81) confirmed the internal consistencies. With respect to the dilemma where nurses working in general wards at community hospitals who also live with elderly adults at home are faced with the physical restraint of elderly persons, four factors in the clarification of the dilemma were extracted: accomplishment of medical-treatment and accident prevention, characteristic features in nursing for elderly patients with dementia, healthcare professional relationship in nursing for elderly patients with dementia, and priorities on the accident prevention for elderly patients with dementia. Therefore, the construction of four systems to cope with these dilemmas is suggested. These systems would enable practising nurses to: (i) institution of policies to encourage discussion between nurses and other medical staff to reach consensus on treatment; (ii) allocating elderly care specialists to wards to promote alternatives to restraints; (iii) establishment of safety standards to define nurses’ responsibilities; and (iv) institution of continuous ethical education for nurses.

Miwa Yamamoto; Shizue Mizuno; Masako Aota

2012-01-01

91

Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial.  

UK PubMed Central (United Kingdom)

BACKGROUND: Depression is one of the more severe and serious health problems because of its morbidity, disabling effects and for its societal and economic burden. Despite the variety of existing pharmacological and psychological treatments, most of the cases evolve with only partial remission, relapse and recurrence.Cognitive models have contributed significantly to the understanding of unipolar depression and its psychological treatment. However, success is only partial and many authors affirm the need to improve those models and also the treatment programs derived from them. One of the issues that requires further elaboration is the difficulty these patients experience in responding to treatment and in maintaining therapeutic gains across time without relapse or recurrence. Our research group has been working on the notion of cognitive conflict viewed as personal dilemmas according to personal construct theory. We use a novel method for identifying those conflicts using the repertory grid technique (RGT). Preliminary results with depressive patients show that about 90% of them have one or more of those conflicts. This fact might explain the blockage and the difficult progress of these patients, especially the more severe and/or chronic. These results justify the need for specific interventions focused on the resolution of these internal conflicts. This study aims to empirically test the hypothesis that an intervention focused on the dilemma(s) specifically detected for each patient will enhance the efficacy of cognitive behavioral therapy (CBT) for depression. DESIGN: A therapy manual for a dilemma-focused intervention will be tested using a randomized clinical trial by comparing the outcome of two treatment conditions: combined group CBT (eight, 2-hour weekly sessions) plus individual dilemma-focused therapy (eight, 1-hour weekly sessions) and CBT alone (eight, 2-hour group weekly sessions plus eight, 1-hour individual weekly sessions). METHOD: Participants are patients aged over 18 years meeting diagnostic criteria for major depressive disorder or dysthymic disorder, with a score of 19 or above on the Beck depression inventory, second edition (BDI-II) and presenting at least one cognitive conflict (implicative dilemma or dilemmatic construct) as assessed using the RGT. The BDI-II is the primary outcome measure, collected at baseline, at the end of therapy, and at 3- and 12-month follow-up; other secondary measures are also used. DISCUSSION: We expect that adding a dilemma-focused intervention to CBT will increase the efficacy of one of the more prestigious therapies for depression, thus resulting in a significant contribution to the psychological treatment of depression. TRIAL REGISTRATION: ISRCTN92443999; ClinicalTrials.gov Identifier: NCT01542957.

Feixas G; Bados A; García-Grau E; Montesano A; Dada G; Compañ V; Aguilera M; Salla M; Soldevilla JM; Trujillo A; Paz C; Botella L; Corbella S; Saúl-Gutiérrez LA; Cañete J; Gasol M; Ibarra M; Medeiros-Ferreira L; Soriano J; Ribeiro E; Caspar F; Winter D

2013-01-01

92

Language acquisition, motherhood, and the perpetual preservation of ethical dialogue: a model for ethical discourse focusing on Julia Kristeva  

Directory of Open Access Journals (Sweden)

Full Text Available This article proposes that Julia Kristeva’s semiotic view of language supports the mother/child paradigm as a model for ethical discourse. Her defense of motherhood, particularly her discussion of the sacredness of maternal love and the mother tongue, strengthens the argument that motherhood is a primary means of preserving language acquisition and ethical development. It focuses on motherhood’s ability to ensure, protect and preserve the possibility of productive ethical discourse through verbal and non-verbal means of communication. This article discusses the constraints of language, and its effects on the actualization of self.

Jennifer Lemma

2009-01-01

93

Bringing compassion to the ethical dilemma in killing kangaroos for conservation: comment on "Conservation through sustainable use" by Rob Irvine.  

Science.gov (United States)

Ethical debate on the killing of kangaroos has polarised conservation and animal welfare science, yet at the heart of these scientific disciplines is the unifying aim of reducing harm to non-human animals. This aim provides the foundation for common ground, culminating in the development of compassionate conservation principles that seek to provide mechanisms for achieving both conservation and welfare goals. However, environmental decision-making is not devoid of human interests, and conservation strategies are commonly employed that suit entrenched positions and commercial gain, rather than valuing the needs of the non-human animals in need of protection. The case study on the wild kangaroo harvest presents just such a dilemma, whereby a conservation strategy is put forward that can only be rationalised by ignoring difficulties in the potential for realising conservation benefits and the considerable welfare cost to kangaroos. Rather than an open debate on the ethics of killing game over livestock, in this response I argue that efforts to bring transparency and objectivity to the public debate have to date been obfuscated by those seeking to maintain entrenched interests. Only by putting aside these interests will debate about the exploitation of wildlife result in humane, compassionate, and substantive conservation benefits. PMID:23595959

Ramp, Daniel

2013-04-18

94

Bringing compassion to the ethical dilemma in killing kangaroos for conservation: comment on "Conservation through sustainable use" by Rob Irvine.  

UK PubMed Central (United Kingdom)

Ethical debate on the killing of kangaroos has polarised conservation and animal welfare science, yet at the heart of these scientific disciplines is the unifying aim of reducing harm to non-human animals. This aim provides the foundation for common ground, culminating in the development of compassionate conservation principles that seek to provide mechanisms for achieving both conservation and welfare goals. However, environmental decision-making is not devoid of human interests, and conservation strategies are commonly employed that suit entrenched positions and commercial gain, rather than valuing the needs of the non-human animals in need of protection. The case study on the wild kangaroo harvest presents just such a dilemma, whereby a conservation strategy is put forward that can only be rationalised by ignoring difficulties in the potential for realising conservation benefits and the considerable welfare cost to kangaroos. Rather than an open debate on the ethics of killing game over livestock, in this response I argue that efforts to bring transparency and objectivity to the public debate have to date been obfuscated by those seeking to maintain entrenched interests. Only by putting aside these interests will debate about the exploitation of wildlife result in humane, compassionate, and substantive conservation benefits.

Ramp D

2013-06-01

95

Intimidad, confidencialidad y dilema ético: A propósito de un caso Privacy, Confidentiality and the Ethical Dilemma: A Case Study.  

Directory of Open Access Journals (Sweden)

Full Text Available La información es una cuestión clave en las relaciones asistenciales. Podemos afirmar que resulta imprescindible para el desarrollo de nuestras profesiones. La información que obtenemos de la interacción con los pacientes debemos compartirla con los profesionales con los que trabajamos. Básicamente, esa información procede de la concesión que nos hacen las personas con las que tratamos, y se nos otorga en la confianza de que será utilizada para conseguir el fin concreto que la intervención profesional se propone. Entendemos, por lo tanto, que el valor nuclear que orienta esa relación profesional-paciente está en su carácter confidencial. Así mismo, la confidencialidad camina unida necesariamente a la intimidad de las personas, e implica fundamentalmente una cuestión de respecto por el paciente. También apela directamente a nuestra responsabilidad profesional. Y es en el ejercicio y en el marco de interacción cotidiana con otros profesionales donde surgen los dilemas éticos. Este artículo analiza un dilema ético mediante el método de resolución de casos utilizado en Comités de Ética. Su objetivo es pedagógico y quiere contribuir a la reflexión en la práctica del trabajo social. Information is a key issue in care relationships. It might be said that it is essential for caregivers, who need to share the information obtained from interaction with patients with the professionals they work with. Basically it is information that the patients provide because they trust caregivers, and they give it in the confidence that it will be used to achieve the specific purpose of our professional intervention. Therefore, confidentiality can be considered to be the core value that guides this professional-patient relationship. Furthermore, confidentiality necessarily goes hand-in-hand with people's privacy and primarily involves respect for the patient. It also appeals directly to professional responsibility, and it is precisely in daily interaction among professionals where ethical dilemmas arise. This article analyses an ethical dilemma by means of the method of resolution of cases used in Ethics Committees. Its aim is pedagogical and wants to contribute to reflection about the practice of Social Work.

Carmen Valois-Nuñez

2011-01-01

96

Über ethische Dilemmata beim Implementieren von "Coteaching" Addressing Ethical Dilemmas in Implementing Coteaching Sobre dilemmas éticos en la implementación de la coenseñanza  

Directory of Open Access Journals (Sweden)

Full Text Available In diesem Artikel werden einige ethische Probleme thematisiert, die in der Literatur beschrieben werden. Wir haben herausgefunden, dass durch den Einbezug aller Teilnehmenden in das Forschungsdesign bei diesen eine Aneignung des Coteaching-Modells stattfand. Dies führte zu einer intensiveren Beteiligung an der Implementierung von und an der Kommunikation über Coteaching. Bevor das Coteaching eingesetzt wurde, fand jeweils eine Besprechung mit der Schulleitung statt, in deren Rahmen das Coteaching-Modell verfeinert wurde und die Coteacher – Lehrer(innen), Referendar(inn)e(n) und Universitätsdozent(inn)en –gemeinsam die möglichen ethischen Dilemmata thematisierten. Die Coteacher verfassten einen Praxisleitfaden, dem alle zustimmten. Coteaching wurde in diesem Praxiskontext eingeführt. URN: urn:nbn:de:0114-fqs0604206This paper addresses some of the ethical dilemmas that have been reported in the literature. We found that including all coteaching participants in the research design gave them ownership of the coteaching model. This led to fuller engagement in implementing coteaching and in communication. Prior to coteaching placements school principals met with us to refine the model of coteaching, and coteachers (classroom teachers, pre-service teachers and university tutors) jointly addressed ethical issues which may arise. Coteachers produced a code of practice to which all signed up. Coteaching was enacted within this community of practice. URN: urn:nbn:de:0114-fqs0604206Este artículo aborda algunos de los dilemas éticos que se han discutido en la literatura. Encontramos que incluir a todos los participantes de la coenseñanza en el diseño de la investigación les dio la apropriación del modelo mismo. Este llevó a un compromiso mas alto en la implementación de la coenseñanza y en la comunicación. Antes de la implementación de la coenseñanza, los directores de escuelas se reunieron con nosotros para ajustar el modelo y los co-maestros (maestros de clase, maestros de pre-servicio y tutores universitarios) abordaron colectivamente las cuestiones de ética que pudieran surgir. Los co-maestros produjeron un código de práctica que todos firmaron. La coenseñanza se actuó dentro de esta comunidad de práctica. URN: urn:nbn:de:0114-fqs0604206

Colette Murphy; Jim Beggs

2006-01-01

97

El dilema ético de la fluoración del agua potable/ The ethical dilemma of water fluoridation  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Dental caries remains a worldwide public health problem because of its magnitude and impact on affected people's quality of life. Among preventive strategies, water fluoridation is one of the most important, but its value still remains uncertain after more than a half of Century of its use. The aim of this study is to analyse some of the ethical arguments for and against water fluoridation and to determine if empirical data allow to decide if there are correct policies fr (more) om a bioethical perspective. Autonomy, compulsory medication (mass medication), precautionary principle, justice in health care and ethics of protection are discussed. It is concluded that fluoridation is beneficial and that there is no ethical reason to oppose it, based on a specific kind of ethics developed to analyse and clarify complex public health's issues

Mendoza V, Carolina

2007-11-01

98

El dilema ético de la fluoración del agua potable The ethical dilemma of water fluoridation  

Directory of Open Access Journals (Sweden)

Full Text Available Dental caries remains a worldwide public health problem because of its magnitude and impact on affected people's quality of life. Among preventive strategies, water fluoridation is one of the most important, but its value still remains uncertain after more than a half of Century of its use. The aim of this study is to analyse some of the ethical arguments for and against water fluoridation and to determine if empirical data allow to decide if there are correct policies from a bioethical perspective. Autonomy, compulsory medication (mass medication), precautionary principle, justice in health care and ethics of protection are discussed. It is concluded that fluoridation is beneficial and that there is no ethical reason to oppose it, based on a specific kind of ethics developed to analyse and clarify complex public health's issues

Carolina Mendoza V

2007-01-01

99

Ethical aspects and dilemmas of preparing, writing and publishing of the scientific papers in the biomedical journals.  

UK PubMed Central (United Kingdom)

INTRODUCTION: In this paper author discussed about preparing and submitting manuscripts - scientific, research, professional papers, reviews and case reports. Author described it from the Editor's perspective, and specially talked about ethical aspects of authorship, conflict of interest, copyright, plagiarism and duplicate publication from the point of view of his experiences as Editor-in-Chief of several biomedical journals and Chief of Task Force of European Federation of Medical Informatics journals and member of Task Force of European Cardiology Society journals. The scientific process relies on trust and credibility. The scientific community demands high ethical standards to conduct biomedical research and to publish scientific contents. During the last decade, disclosure of conflicts of interest (COI ), (also called competing loyalties, competing interests or dual commitments), has been considered as a key element to guarantee the credibility of the scientific process. Biases in design, analysis and interpretation of studies may arise when authors or sponsors have vested interests. Therefore, COI should be made clear to the readers to facilitate their own judgment and interpretation of their relevance and potential implications. RESULTS AND DISCUSSION: Authors are responsible to fully disclose potential COI . In October 2009 the ICMJE proposed an electronic "uniform" format for COI disclosure. Four main areas were addressed: authors´ associations with entities that supported the submitted manuscript (indefinite time frame), associations with commercial entities with potential interest in the general area of the manuscript (time frame 36 months), financial association of their spouse and children and, finally, non-financial associations potentially relevant to the submitted manuscript. Consumers of medical scholarship expect a reliable system of disclosure in which journals and authors make disclosures appropriately and consistently. There is a stigma surrounding the reporting of COI that should be progressively overcome. Further actions are required to increase awareness of the importance of COI disclosure and to promote policies aimed to enhance transparency in biomedical research. In this article author discuss about important ethical dilemmas in preparing, writing and publishing of scientific manuscripts in biomedical journals.

Masic I

2012-09-01

100

Anthropological contributions for thinking and acting in the health area and its ethical dilemmas.  

Science.gov (United States)

This paper attempts to analyze the way in which the issue of ethics in social research is dealt by institutional commissions based in biomedicine criteria. This discussion is particularly important for Social Sciences in Health, as our projects must necessarily be presented to Committees for assessment. In actual fact, Resolution N masculine 196/1996 issued by the National Health Council establishes this mandatory requirement for all social areas. However, there is a question among researchers working with social issues, arguing that the health sector is moving outside its field when attempting to regulate actions in other fields of investigation. Grounded on philosophical anthropology, this paper is divided into three parts: (1) elements of anthropological foundations of ethics; (2) contributions of Anthropology to thinking about ethics and human rights in health; (3) internal and external questioning about anthropological practice. I conclude that if the ethical issue that involves human beings cannot be reduced to the procedures established by Ethics Committees, discussions in greater depth are required among social scientists on the construction of a practice based on and guided by respect for the intersubjectivity of all the players engaged in a research project. PMID:18813549

Minayo, Maria Cecília de Souza

 
 
 
 
101

Integrating care when the end is near: ethical dilemmas in end-of-life care.  

UK PubMed Central (United Kingdom)

An integrated and collaborative team provides the best clinical care of patients and families during end-of-life moments. Behavioral Health Clinicians (BHCs) bring a skill set for facilitating team interactions, attending to group process, as well as making space for the patient or family voice in the care, often with more time available for these roles. Through a case scenario, this article explores the relevant existing codes of ethics and professional conduct for professionals practicing in integrated care settings as they pertain to end-of-life transitions and care. Most notably, potential ethical issues pertaining to patient autonomy, scope of practice, confidentiality, multiple relationships, and record keeping all come to play during end-of-life care when practicing in an integrated primary care setting. Gaps in the existing codes are discussed and recommendations for providing ethically informed patient- and family-centered end-of-life care are suggested.

Rosenberg T; Speice J

2013-03-01

102

At the ethical crossroads: how a gastroenterology procedure unit negotiated a solution for a reoccurring ethical dilemma.  

Science.gov (United States)

The gastroenterology procedures environment has proven to be fertile ground for the realization of moral distress as it relates to the practice of nursing. Specifically, nurses are expected to fulfill their duty as advocates for their clients at all times and within all contexts; however, their ability to discharge this essential function has been complicated by such influential factors as sedating medications, competing ethical motivations, discordant conclusions of moral reasoning and action, as well as competing institutional factors. This article begins with a fictional case study to introduce readers to the contextual essence of the moral distress that a group of gastroenterology nurses was collectively experiencing. Subsequently, the aim of this article was to explicate how one department, with the aid of an ethics committee, negotiated a process similar to the case study to develop a pragmatic policy and identify an educational primer that encourages nurses to reexamine and value the tangible realities inherent and expected of an advocate in the dynamically complex environment that characterizes all gastroenterology procedure environments where gastroenterology nurses practice. PMID:23364363

Gair, Jonathan

103

At the ethical crossroads: how a gastroenterology procedure unit negotiated a solution for a reoccurring ethical dilemma.  

UK PubMed Central (United Kingdom)

The gastroenterology procedures environment has proven to be fertile ground for the realization of moral distress as it relates to the practice of nursing. Specifically, nurses are expected to fulfill their duty as advocates for their clients at all times and within all contexts; however, their ability to discharge this essential function has been complicated by such influential factors as sedating medications, competing ethical motivations, discordant conclusions of moral reasoning and action, as well as competing institutional factors. This article begins with a fictional case study to introduce readers to the contextual essence of the moral distress that a group of gastroenterology nurses was collectively experiencing. Subsequently, the aim of this article was to explicate how one department, with the aid of an ethics committee, negotiated a process similar to the case study to develop a pragmatic policy and identify an educational primer that encourages nurses to reexamine and value the tangible realities inherent and expected of an advocate in the dynamically complex environment that characterizes all gastroenterology procedure environments where gastroenterology nurses practice.

Gair J

2013-01-01

104

Challenges in international medicine: ethical dilemmas, unanticipated consequences, and accepting limitations.  

UK PubMed Central (United Kingdom)

While personal and organizational challenges occur in every area of health care, practitioners of international medicine face unique problems and dilemmas that are rarely discussed in training programs. Health professions schools, residency and fellowship programs, nongovernmental organizations (NGOs), and government programs have a responsibility to make those new to international medicine aware of the special circumstances that they may face and to provide methods for understanding and dealing with these circumstances. Standard "domestic" approaches to such challenges may not work in international medicine, even though these challenges may appear to be similar to those faced in other clinical settings. How should organizations ensure that well-meaning health intervention efforts do not cause adverse unintended sequelae? How should an individual balance respect for cultural uniqueness and local mores that may profoundly differ from his or her own beliefs, with the need to remain a moral agent true to one's self? When is acceptance the appropriate response to situations in which limitations of resources seem to preclude any good solution? Using a case-based approach, the authors discuss issues related to the four major international medicine domains: clinical practice (postdisaster response, resource limitations, standards of care), medical systems and systems development (prehospital care, wartime casualties, sustainable change, cultural awareness), teaching (instruction and local resources, professional preparation), and research (questionable funded studies, clinical trials, observational studies). It is hoped that this overview may help prepare those involved with international medicine for the challenges and dilemmas they may face and help frame their responses to these situations.

Iserson KV; Biros MH; James Holliman C

2012-06-01

105

Managerji HRM in njihove eti?ne dileme = Human Resource Managers and Their Ethical Dilemma  

Directory of Open Access Journals (Sweden)

Full Text Available Douglas Renwick (2003) said that the personnel function plays therole of guardian of employees’ wellbeing, but on the other hand, hesaid that personnel managers also tamper with the wellbeing of employees.Looking at Renwick’s theory through Ulrich’s model of personnelmanagers as guardians of employees’ wellbeing, they play therole of strategic partners, managers of the changes and the role of theemployees representatives. Gantz and Hayes (in Payne and Wayland,1999) explicated a few fields where we can talk of ethical conflict whileperforming these roles: discrimination, psychological tests, anti-unionbehaviour, design of work flow, job insecurity, discipline, confidentiality,privacy, and firing because of technological redundancy. In this paperwe explore the field of potential and real ethical conflicts of humanresource managers.What are the most important values of humanresources managers? In which areas do ethical conflicts occur?And how do they solve these conflicts on an everyday basis? We usedquestionnaires to gather data on these issues. We found out that managerswho are in leading positions suffer the most, next are those whohave had long tenure. In this situation ethical codes don’t help much.

Mateja Primoži?; Dana Mesner Andoljšek

2011-01-01

106

Sick or Sinner? An Ethical Dilemma that Changes with the Times  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The work of the family physician is occasionally enlivened by an unusual patient problem. The particular episode described and discussed in this case report called into question the moral and ethical standards of both medicine and society. Issues of responsibility for unacceptable behaviour by an in...

Griffiths, Dorothy E.

107

Informed Consent for Case Reports: The Ethical Dilemma of Right to Privacy Versus Pedagogical Freedom  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A new international standard of editorial policy calls for written informed consent by the subject of every case report. Although this appears to be ethically appealing, the authors posit that in some situations, requesting informed consent may be unethical, can harm patients, and may erode the use ...

Levine, Stephen B.; Stagno, Susan J.

108

Expanding organ donation in the UK: ethical, moral and logistical dilemmas.  

Science.gov (United States)

In the UK, three patients die every day waiting for an organ transplant. Despite there being 18.7 million donors currently registered in the UK, donation rates remain low. This review discusses the legal, ethical and social aspects of organ donation in the UK, and looks at some controversial solutions adopted in other countries. PMID:24022552

Dave, Rajiv; James, Camilla; Ahmad, Niaz

2013-09-01

109

Expanding organ donation in the UK: ethical, moral and logistical dilemmas.  

UK PubMed Central (United Kingdom)

In the UK, three patients die every day waiting for an organ transplant. Despite there being 18.7 million donors currently registered in the UK, donation rates remain low. This review discusses the legal, ethical and social aspects of organ donation in the UK, and looks at some controversial solutions adopted in other countries.

Dave R; James C; Ahmad N

2013-09-01

110

Parental Choices and Ethical Dilemmas Involving Disabilities: Special Education and the Problem of Deliberately Chosen Disabilities  

Science.gov (United States)

Ethical issues regarding children with disabilities have long involved their treatment after they are born. These issues remain important, but children may be deliberately created with or without characteristics that are usually thought of as disabilities. Preimplantation genetic diagnosis (PGD) and related technologies that involve human…

Kauffman, James M.; Hallahan, Daniel P.

2009-01-01

111

The ethical dilemmas associated with working in an immigration removal centre.  

UK PubMed Central (United Kingdom)

The purpose of this paper is to share with colleagues some of the ethical problems encountered in working in an environment unfamiliar to the vast majority of psychiatrists. The author, a consultant psychiatrist with 17 plus years' experience in the NHS, spent a year working part-time in Colnbrook Immigration Removal Centre; an institution holding just over 300 men who are held in administrative detention for periods of time ranging from days to years pending decisions on their immigration status. About 50% of these men have criminal records and the turnover of detainees is fast and unpredictable. The paper describes some of the everyday ethical problems encountered by the author together with some background to the working environment and attempts to tease out some of the key pillars upon which the doctor's work is based in order to inform the limitations and challenges she/he faces.

Allen D

2013-01-01

112

Grounded for an ethical dilemma: disequilibrium in a commercial airline pilot.  

Science.gov (United States)

This article presents the case of a 41-year-old airline pilot with benign paroxysmal positional vertigo who requests that his diagnosis not be disclosed to his commercial airline employer or his aviation medical examiner because it may result in the suspension of medical certification. The legal and ethical requirements for physicians reporting impaired pilots are discussed as well as practical recommendations for handling such situations. The argument is made that a physician's obligation to honor patient confidentiality should not take precedence over his or her duty to protect the safety and well-being of the airplane passengers and the general public. If the patient chooses not to self-report, a physician has an ethical obligation to report the patient's medical condition to the Federal Aviation Administration. PMID:23042065

Kirschen, Matthew P; Friedlander, Joel A

2012-10-01

113

Grounded for an ethical dilemma: disequilibrium in a commercial airline pilot.  

UK PubMed Central (United Kingdom)

This article presents the case of a 41-year-old airline pilot with benign paroxysmal positional vertigo who requests that his diagnosis not be disclosed to his commercial airline employer or his aviation medical examiner because it may result in the suspension of medical certification. The legal and ethical requirements for physicians reporting impaired pilots are discussed as well as practical recommendations for handling such situations. The argument is made that a physician's obligation to honor patient confidentiality should not take precedence over his or her duty to protect the safety and well-being of the airplane passengers and the general public. If the patient chooses not to self-report, a physician has an ethical obligation to report the patient's medical condition to the Federal Aviation Administration.

Kirschen MP; Friedlander JA

2012-10-01

114

Stakeholder Analysis: Using the Jigsaw Method for Ethical Dilemmas in Business  

Directory of Open Access Journals (Sweden)

Full Text Available Stakeholder analysis is an essential part of business education as students develop awareness of the different perspectives that influence business and the difficult decisions made by business, government and communities. An important aspect of learning is to think critically about who is presenting the viewpoint and the conclusions they have drawn. We have found that the Jigsaw Method is a powerful way to learn the importance of different viewpoints in the teaching of ethical practice and sustainability.

Leigh N Wood; Peter Dixon

2011-01-01

115

Low utilization of extra embryos in donor oocyte in vitro fertilization cycles: an ethical dilemma to donor management.  

UK PubMed Central (United Kingdom)

PURPOSE: To explore outcomes of donor In Vitro Fertilization (IVF) cycles with regards to cryopreservation and utilization of extra embryos after fresh transfer. METHODS: A database search was performed to identify all consecutive fresh donor oocyte cycles from January 1, 2000 to December 31, 2010 at a private fertility laboratory. Parameters analyzed included: number of oocytes retrieved, number of patients choosing embryo cryopreservation, number of patients returning for frozen embryo transfer (FET), and pregnancy outcomes. RESULTS: A total of 1070 fresh oocyte donor cycles were identified. Average number of oocytes retrieved was 16.9?±?7.9, and average number of embryos transferred was 2.3?±?0.96. Sixty-six percent of patients cryopreserved excess embryos following fresh transfer, and only 40 % of these patients ultimately returned for FET. Patients who conceived in their fresh cycle were much less likely to return for FET than those who did not (25 % v 65 %, p?ethical dilemmas when considering the large numbers of remaining embryos that will never be utilized.

Cook H; Briton-Jones C; Hill D

2013-06-01

116

The use of pornographic materials by adolescent male cancer patients when banking sperm in the UK: legal and ethical dilemmas.  

Science.gov (United States)

Increased awareness of the importance of fertility concerns to teenage cancer survivors is leading to growing numbers of male teenagers being offered sperm banking at the time of diagnosis. This is now extending to males diagnosed with other conditions where gonadotoxic agents are used in treatment. The storage of sperm in these circumstances is a challenging aspect of health care, given the complex issues and timescale involved. UK law has been enacted to protect legal minors from the potentially harmful effects of exposure to pornographic materials, yet there is reason to suppose that their use in this context could have therapeutic benefit in aiding successful masturbation. This paper uses material gained through consultation with the eleven largest UK sperm banks and 94 male teenage cancer survivors, to discuss the associated legal and ethical dilemmas, including those around the role of parents/carers. Findings suggest that there is variable practice in sperm banks, that almost a quarter of teenage males wanted access to soft porn when banking sperm, and half wanted to bring in their own materials. It concludes that there is an urgent need for any legal barriers to the therapeutic use of pornographic materials to be understood and examined. PMID:17786648

Crawshaw, Marilyn A; Glaser, Adam W; Pacey, Allan A

2007-09-01

117

The use of pornographic materials by adolescent male cancer patients when banking sperm in the UK: legal and ethical dilemmas.  

UK PubMed Central (United Kingdom)

Increased awareness of the importance of fertility concerns to teenage cancer survivors is leading to growing numbers of male teenagers being offered sperm banking at the time of diagnosis. This is now extending to males diagnosed with other conditions where gonadotoxic agents are used in treatment. The storage of sperm in these circumstances is a challenging aspect of health care, given the complex issues and timescale involved. UK law has been enacted to protect legal minors from the potentially harmful effects of exposure to pornographic materials, yet there is reason to suppose that their use in this context could have therapeutic benefit in aiding successful masturbation. This paper uses material gained through consultation with the eleven largest UK sperm banks and 94 male teenage cancer survivors, to discuss the associated legal and ethical dilemmas, including those around the role of parents/carers. Findings suggest that there is variable practice in sperm banks, that almost a quarter of teenage males wanted access to soft porn when banking sperm, and half wanted to bring in their own materials. It concludes that there is an urgent need for any legal barriers to the therapeutic use of pornographic materials to be understood and examined.

Crawshaw MA; Glaser AW; Pacey AA

2007-09-01

118

Ethical Dilemma and Management of Infertility in HIV Seropositive Discordant Couples: A Case Study in Nigeria.  

UK PubMed Central (United Kingdom)

The traditional African society places an invaluable premium on procreation and, in some communities, a woman's place in her matrimony is only confirmed on positive reproductive outcome. Infertility is rife in Nigeria, and HIV/acquired immunodeficiency syndrome (AIDS) infection is a global pandemic, which has led to a drop in life expectancy across the world. In Nigeria, a number of cultural norms relating to gender roles and power dynamics constitute a serious barrier to issues of sexuality and infertility. Couples are concerned about their infertility diagnostic test being disclosed to each other, especially before marriage. This concern is understandable, especially in an environment that lacks the modern concepts and attitude toward sexual matters. This is complicated by the advent of HIV/AIDS infection and the societal mind-set that look at seropostive individuals as transgressors. At present, sexual and reproductive health rights are currently not in place because ethical issues are not given prominence by many physicians in Nigeria. A case of an infertile and seropostive discordant couple, which raised a lot of medical and ethical concerns, is presented here to awaken the consciousness of Nigerian physicians and stimulate discussions on the ethical matters such as this in clinical practice.

Umeora O; Chukwuneke F

2013-01-01

119

Ethical Dilemma and Management of Infertility in HIV Seropositive Discordant Couples: A Case Study in Nigeria.  

Science.gov (United States)

The traditional African society places an invaluable premium on procreation and, in some communities, a woman's place in her matrimony is only confirmed on positive reproductive outcome. Infertility is rife in Nigeria, and HIV/acquired immunodeficiency syndrome (AIDS) infection is a global pandemic, which has led to a drop in life expectancy across the world. In Nigeria, a number of cultural norms relating to gender roles and power dynamics constitute a serious barrier to issues of sexuality and infertility. Couples are concerned about their infertility diagnostic test being disclosed to each other, especially before marriage. This concern is understandable, especially in an environment that lacks the modern concepts and attitude toward sexual matters. This is complicated by the advent of HIV/AIDS infection and the societal mind-set that look at seropostive individuals as transgressors. At present, sexual and reproductive health rights are currently not in place because ethical issues are not given prominence by many physicians in Nigeria. A case of an infertile and seropostive discordant couple, which raised a lot of medical and ethical concerns, is presented here to awaken the consciousness of Nigerian physicians and stimulate discussions on the ethical matters such as this in clinical practice. PMID:23634339

Umeora, Ouj; Chukwuneke, Fn

2013-01-01

120

ETHICAL ASPECTS AND DILEMMAS OF PREPARING, WRITING AND PUBLISHING OF THE SCIENTIFIC PAPERS IN THE BIOMEDICAL JOURNALS  

Science.gov (United States)

Introduction: In this paper author discussed about preparing and submitting manuscripts - scientific, research, professional papers, reviews and case reports. Author described it from the Editor’s perspective, and specially talked about ethical aspects of authorship, conflict of interest, copyright, plagiarism and duplicate publication from the point of view of his experiences as Editor-in-Chief of several biomedical journals and Chief of Task Force of European Federation of Medical Informatics journals and member of Task Force of European Cardiology Society journals. The scientific process relies on trust and credibility. The scientific community demands high ethical standards to conduct biomedical research and to publish scientific contents. During the last decade, disclosure of conflicts of interest (COI ), (also called competing loyalties, competing interests or dual commitments), has been considered as a key element to guarantee the credibility of the scientific process. Biases in design, analysis and interpretation of studies may arise when authors or sponsors have vested interests. Therefore, COI should be made clear to the readers to facilitate their own judgment and interpretation of their relevance and potential implications. Results and Discussion: Authors are responsible to fully disclose potential COI . In October 2009 the ICMJE proposed an electronic “uniform” format for COI disclosure. Four main areas were addressed: authors´ associations with entities that supported the submitted manuscript (indefinite time frame), associations with commercial entities with potential interest in the general area of the manuscript (time frame 36 months), financial association of their spouse and children and, finally, non-financial associations potentially relevant to the submitted manuscript. Consumers of medical scholarship expect a reliable system of disclosure in which journals and authors make disclosures appropriately and consistently. There is a stigma surrounding the reporting of COI that should be progressively overcome. Further actions are required to increase awareness of the importance of COI disclosure and to promote policies aimed to enhance transparency in biomedical research. In this article author discuss about important ethical dilemmas in preparing, writing and publishing of scientific manuscripts in biomedical journals.

Masic, Izet

2012-01-01

 
 
 
 
121

Corporate management and clinical autonomy: the ethical dilemma in mental health.  

UK PubMed Central (United Kingdom)

Funding constraints and management practices are increasing pressure on clinical autonomy within Australian mental health services. The introduction of total quality management, output-based funding and changes to public mental health policy have promoted business-like efficiency and increased control of resources. It is argued that such moves significantly circumscribe the discretionary authority that mental health professionals have previously enjoyed. This paper attempts to highlight the ethical and moral tension inherent with a corporate management approach, and calls for mental health services to acknowledge the value of intellectual capital, creativity and innovation.

Nielsen B; Ward P

1997-01-01

122

Psychiatry and human rights in Latin America: ethical dilemmas and the future.  

UK PubMed Central (United Kingdom)

This paper addresses the context in which ethical and human right issues as they pertain to psychiatry are discussed in Latin America. Dependency and institutional instability are singled out as pervading characteristics influencing the analysis of issues and the design of mental health policies. According to the landmark 1990 Declaration of Caracas all countries in the region have progressed towards implementing measures designed to improve the condition of the populations regarding mental health care and research. Several principles are now universally accepted and, while there is still room for improvement, provision of services and better contexts for scientific development make it possible to expect advances in the future.

Lolas F

2010-01-01

123

[Ethical dilemma in research: informed consent in clinical studies on persons with dementia].  

UK PubMed Central (United Kingdom)

With the world's population aging, there is an increase in the number of demented elderly. It is vital to study this phenomenon in epidemiological and clinical studies, particularly the effects on the increasing numbers of demented elderly. Researchers need to understand the factors predicting the general decline in the demented elderly. However, before any research is undertaken, it is necessary to obtain approval from the Local Internal Review Board. This committee is responsible to maintain accepted national and international ethical standards. The basis for recruitment to a study is the signature on the informed consent form, where the patient is required to understand the study, internalize the study's aim, to consider all options and finally, to express an opinion. Potential elderly participants need to have their judgment evaluated before signing the form. In cases where the subject is incapable, some countries, including Israel, require that there be a legal guardianship. This is a long and complicated process that causes researchers not to recruit demented patients into a study which may actually be beneficial to all. Some countries allow a proxy to sign informed consent forms to permit the demented subject to participate in the study. Often the threshold may depend on the invasiveness of the intervention. The problem of proxies to sign informed consent form troubles researchers worldwide. This article addresses the history and development of ethics in research, and raises the issue to promote an official policy for proxy consent signing.

Sinoff G

2012-09-01

124

[Ethical dilemma in research: informed consent in clinical studies on persons with dementia].  

Science.gov (United States)

With the world's population aging, there is an increase in the number of demented elderly. It is vital to study this phenomenon in epidemiological and clinical studies, particularly the effects on the increasing numbers of demented elderly. Researchers need to understand the factors predicting the general decline in the demented elderly. However, before any research is undertaken, it is necessary to obtain approval from the Local Internal Review Board. This committee is responsible to maintain accepted national and international ethical standards. The basis for recruitment to a study is the signature on the informed consent form, where the patient is required to understand the study, internalize the study's aim, to consider all options and finally, to express an opinion. Potential elderly participants need to have their judgment evaluated before signing the form. In cases where the subject is incapable, some countries, including Israel, require that there be a legal guardianship. This is a long and complicated process that causes researchers not to recruit demented patients into a study which may actually be beneficial to all. Some countries allow a proxy to sign informed consent forms to permit the demented subject to participate in the study. Often the threshold may depend on the invasiveness of the intervention. The problem of proxies to sign informed consent form troubles researchers worldwide. This article addresses the history and development of ethics in research, and raises the issue to promote an official policy for proxy consent signing. PMID:23367746

Sinoff, Gary

2012-09-01

125

Nursing and the resolution of ethical dilemmas Enfermería y la resolución de los dilemas éticos Enfermagem e a resolução dos dilemas éticos  

Directory of Open Access Journals (Sweden)

Full Text Available Inherent to Nursing Care, ethical dimension includes having to decide about the dilemmas that arise in practice. Experience shows that generally we do not have a reference and then sufficient training to judge the ethical quality of our decisions and actions, reason why, in this article some methods are introduced that will facilitate this ethical analysis when faced with a conflict or dilemma that warrants it.La dimensión ética, inherente al Cuidado de Enfermería, incluye el tener que decidir sobre los dilemas que se presentan en su práctica. Generalmente, la experiencia muestra que no poseemos una referencia ni suficiente entrenamiento, para juzgar la calidad ética de nuestras decisiones y acciones, razón por la cual, en este artículo se muestran algunos métodos que facilitarán este análisis ético frente a un conflicto o dilema que así lo amerite.A dimensão ética, inerente ao Cuidado de Enfermagem, inclui o ter que decidir sobre os dilemas que se apresentam em sua prática. A experiência mostra que geralmente não possuímos uma referência e depois suficiente treinamento, para julgar a qualidade ética de nossas decisões e ações, razão pela qual, neste artigo se mostram alguns métodos que facilitarão esta análise ética frente a um conflito ou dilema que assim o amerite.

Liliana Basso-Musso

2012-01-01

126

Ethical dilemma of mandated contraception in pharmaceutical research at catholic medical institutions.  

UK PubMed Central (United Kingdom)

The Catholic Church proscribes methods of birth control other than sexual abstinence. Although the U.S. Food and Drug Administration (FDA) recognizes abstinence as an acceptable method of birth control in research studies, some pharmaceutical companies mandate the use of artificial contraceptive techniques to avoid pregnancy as a condition for participation in their studies. These requirements are unacceptable at Catholic health care institutions, leading to conflicts among institutional review boards, clinical investigators, and sponsors. Subjects may feel coerced by such mandates to adopt contraceptive techniques inconsistent with their personal situation and beliefs; women committed to celibacy or who engage exclusively in non-heterosexual activities are negatively impacted. We propose principles to insure informed consent to safeguard the rights of research subjects at Catholic institutions while mitigating this ethical conflict. At the same time, our proposal respects the interests of pharmaceutical research agencies and Catholic moral precepts, and fully abides by regulatory guidance.

Casey MJ; O'Brien R; Rendell M; Salzman T

2012-01-01

127

Ethical dilemma of mandated contraception in pharmaceutical research at catholic medical institutions.  

Science.gov (United States)

The Catholic Church proscribes methods of birth control other than sexual abstinence. Although the U.S. Food and Drug Administration (FDA) recognizes abstinence as an acceptable method of birth control in research studies, some pharmaceutical companies mandate the use of artificial contraceptive techniques to avoid pregnancy as a condition for participation in their studies. These requirements are unacceptable at Catholic health care institutions, leading to conflicts among institutional review boards, clinical investigators, and sponsors. Subjects may feel coerced by such mandates to adopt contraceptive techniques inconsistent with their personal situation and beliefs; women committed to celibacy or who engage exclusively in non-heterosexual activities are negatively impacted. We propose principles to insure informed consent to safeguard the rights of research subjects at Catholic institutions while mitigating this ethical conflict. At the same time, our proposal respects the interests of pharmaceutical research agencies and Catholic moral precepts, and fully abides by regulatory guidance. PMID:22694032

Casey, Murray Joseph; O'Brien, Richard; Rendell, Marc; Salzman, Todd

2012-01-01

128

Authorship: an ethical dilemma of science/ Autoria: um dilema ético da ciência  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese CONTEXTO AND OBJETIVO: Com o avanço científico e tecnológico ocorrido a partir dos anos 60, surgiu um crescente aumento do número de pesquisas científicas e uma inflação de co-autorias. Ao longo do tempo, observou-se que numerosas publicações mostravam autores ou co-autores cuja participação na pesquisa publicada havia sido mínima ou até mesmo inexistente. O objetivo deste trabalho é analisar, através da literatura, as situações de má-conduta em autoria: (more) tipos, principais causas, conseqüências e normas éticas; e estabelecer propostas para que as publicações científicas apresentem um maior comprometimento ético. TIPO DE ESTUDO E LOCAL: Revisão narrativa realizada na Faculdade de Medicina de Itajubá, Minas Gerais, Brasil. MÉTODO: Análise de publicações sobre autoria, através das bases de dados Medline, Lilacs e SciELO. RESULTADOS E CONCLUSÕES: Freqüentes tipos de má conduta são autoria "presenteada", fragmentação e duplicação em publicações. As causas que mais induzem a essas situações parecem ser a pressão exercida pela academia e o desejo de ascensão social e profissional. Esse viés na ciência, acrescido de outras formas de autoria antiética, continua até hoje, apesar dos critérios definidos pelo Comitê Internacional de Editores de Periódicos Médicos, o Grupo de Vancouver. RECOMENDAÇÕES: São propostas várias ações juntoàs instituições de ensino, agências de fomento à pesquisa, órgãos reguladores e associações de classe, para que se institua uma política de avaliação que priorize a qualidade das publicações, bem como o estabelecimento de preceitos éticos em pesquisa e produção científica. Abstract in english CONTEXT AND OBJECTIVE: The scientific and technological progress that has taken place since the 1960s has brought an ever-growing volume of scientific research, and inflation in co-authorship. Over this period, it has been observed that an increasing number of publications have listed authors or co-authors whose participation in the published research was minimal or even nonexistent. The objective of this work was to analyze reports in the literature regarding misconduct (more) in authorship: its types, chief causes, consequences and ethical guidelines; and to outline proposals for greater ethical commitment in scientific publication. DESIGN AND SETTING: Narrative review undertaken at Faculdade de Medicina de Itajubá, Minas Gerais, Brazil. METHODS: Analysis of publications about authorship using the Medline, Lilacs and SciELO databases. RESULTS AND CONCLUSIONS: Frequent types of misconduct were gift authorship and divided and redundant publications. The chief causes of these practices seem to be the pressure exerted by academia and the desire for social and professional development. Such factors have brought an increase in unethical behavior. This bias in science continues despite the criteria defined by the International Committee of Medical Journal Editors, the Vancouver group. RECOMMENDATIONS: Various actions are proposed for educational institutions, research development agencies, regulatory agencies and professional associations. The aim is to establish an evaluation policy that gives primacy to the quality of publications and sets ethical principles for scientific research.

Grieger, Maria Christina Anna

2005-11-01

129

Body enhancement through female genital cosmetic surgery creates ethical and rights dilemmas.  

UK PubMed Central (United Kingdom)

Female genital cosmetic surgery is surgery performed on a woman within a normal range of variation of human anatomy. The issues are heightened by a lack of long-term and substantive evidence-based literature, conflict of interest from personal financial gain through performing these procedures, and confusion around macroethical and microethical domains. It is a source of conflict and controversy globally because the benefit and harm of offering these procedures raise concerns about harmful cultural views, education, and social vulnerability of women with regard to both ethics and human rights. The rights issues of who is defining normal female anatomy and function, as well as the economic vulnerability of women globally, bequeath the profession a greater responsibility to ensure that there is adequate health and general education-not just among patients but broadly in society-that there is neither limitation nor interference in the decision being made, and that there are no psychological disorders that could be influencing such choices.

Cain JM; Iglesia CB; Dickens B; Montgomery O

2013-08-01

130

The conceptual and practical ethical dilemmas of using health discussion board posts as research data.  

UK PubMed Central (United Kingdom)

BACKGROUND: Increasing numbers of people living with a long-term health condition are putting personal health information online, including on discussion boards. Many discussion boards contain material of potential use to researchers; however, it is unclear how this information can and should be used by researchers. To date there has been no evaluation of the views of those individuals sharing health information online regarding the use of their shared information for research purposes. OBJECTIVE: To explore the views of contributors to online diabetes discussion boards with regards to if (and how) they feel their contributions to boards should be used by health researchers. METHODS: A qualitative approach was employed using online semistructured asynchronous (email) interviews. Interpretative description methodology was used to assess the interview transcripts, and quotations were extracted and anonymized to support each theme. RESULTS: 26 interviews were carried out. Participants agreed that forum posts are in the public domain and that aggregated information could be freely used by researchers. This was agreed to be a good way of ensuring that the view of people living with diabetes is being heard in research. There was no consensus on the need for permission to use individual information, such as quotations, with some people happy for this to be freely used and others feeling that permission is necessary. CONCLUSIONS: Participants acknowledged the dichotomy of having placed information into the public domain in an unrestricted way, with some interviewees also wanting to retain control of its use. The Internet is a new research location, and rather than trying to apply traditional ethical norms to this new genre, a new modus operandi is required. The authors propose introducing new norms for presenting research carried out with online discussion boards.

Bond CS; Ahmed OH; Hind M; Thomas B; Hewitt-Taylor J

2013-01-01

131

Applying Applied Ethics through ethics consulting.  

UK PubMed Central (United Kingdom)

Applied Ethics is frequently described as a discipline of philosophy that concerns itself with the application of moral theories such as deontology and utilitarianism to real world dilemmas. However, these applications often remain restricted to the academic world. The focus of new versions ethics consulting has since the mid-1980s shifted from what the ethicist knows to what the ethicist does or enables. This shift remodelled the ethicist's role to that of a facilitator in an inherently social process of moral inquiry. Applying these developments in the Namibian context has already proved to be of great value to the local health care industry.

Moore W

2010-04-01

132

Applying Applied Ethics through ethics consulting.  

Science.gov (United States)

Applied Ethics is frequently described as a discipline of philosophy that concerns itself with the application of moral theories such as deontology and utilitarianism to real world dilemmas. However, these applications often remain restricted to the academic world. The focus of new versions ethics consulting has since the mid-1980s shifted from what the ethicist knows to what the ethicist does or enables. This shift remodelled the ethicist's role to that of a facilitator in an inherently social process of moral inquiry. Applying these developments in the Namibian context has already proved to be of great value to the local health care industry. PMID:20227344

Moore, W

2010-04-01

133

Governance of dual-use research: an ethical dilemma/ Gérer le double usage de la recherche: un dilemme éthique/ La gobernanza del doble uso de las investigaciones, un dilema ético  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish La posibilidad de usar los resultados de investigaciones científicas bienintencionadas con fines beneficiosos o con ánimo de causar daño da lugar a lo que hoy día se conoce en general como el dilema del «doble uso». Más concretamente, ha cobrado intensidad el debate sobre el doble uso de las investigaciones en ciencias de la vida que puedan facilitar la producción de armas biológicas. En este artículo se examinan varias publicaciones que han generado bastante po (more) lémica en ese campo y se analizan críticamente algunas novedades de interés en materia de políticas, sobre todo en los Estados Unidos de América. Aunque el problema del doble uso constituye en lo fundamental un dilema ético, en la mayoría de los debates sobre las investigaciones de doble uso han participado principalmente científicos y expertos en seguridad más que especialistas en ética. Es importante que haya más aportaciones desde el campo de la ética en los debates sobre la gobernanza de las investigaciones de doble uso. Abstract in english Scenarios where the results of well-intentioned scientific research can be used for both good and harmful purposes give rise to what is now widely known as the "dual-use dilemma". There has been growing debate about the dual-use nature of life science research with implications for making biological weapons. This paper reviews several controversial publications that have been the focus of debates about dual-use life science research and critically examines relevant policy (more) developments, particularly in the United States of America. Though the dual-use dilemma is inherently ethical in nature, the majority of debates about dual-use research have primarily involved science and security experts rather than ethicists. It is important that there is more ethical input into debates about the governance of dual-use research.

Selgelid, Michael J

2009-09-01

134

Moral and Ethical Dilemmas in Canadian Forces Military Operation: Qualitative and Descriptive Analyses of Commanders' Operational Experiences.  

Science.gov (United States)

Military operations have always held the potential for the encountering of moral dilemmas by military personnel. The current research involved secondary data analyses of an intensive interview study of Canadian Forces senior officers, each of whom had con...

B. D. Adams M. H. Thompson M. M. Thompson

2008-01-01

135

Ethical Issues in Physiatrist Practice  

Directory of Open Access Journals (Sweden)

Full Text Available Editorial on Ethical Issues. Medical ethics is at the centre of medical practice. It isrightly gaining much needed renewed focus and attentionin the evolving scenario. The impetus for it may beattributed to the revelations that arose through Nurembergtrials, the framework elements that define research andpublications related compulsions, and indeed the contextand state of affairs of present day medical jurisprudence.The physiatrist’s practice cannot remain untouched bythe moral and ethical dilemmas faced in today’s world.Although the pillars of the specialty are grounded in the

Hand G

2008-01-01

136

El diagnóstico de preimplantación genética. Perspectivas científicas y dilemas bioéticos/ The diagnosis of genetic pre-implantation. Scientific Perspectives and bio-ethical dilemma  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish El diagnóstico de preimplantación genética (DPG) es la prueba más reciente entre las técnicas de diagnóstico genético. En este trabajo se analiza su desarrollo, sus indicaciones médicas y los dilemas bioéticos que se pueden llegar a presentar con su uso indiscriminado. Se propone, además, unas preguntas que guíen la toma de decisiones para implantar o no un embrión con algún defecto genético. Por último, se analizan algunos argumentos filosóficos a favor y en contra del PDG. Abstract in english The diagnosis of genetic pre-implantation (PGD) is the most recent test amongst the genetic diagnostic techniques. This works analyses its development, medical indications and bio-ethical dilemma that may occur with indiscriminate use. It has been proposed as well that some questions guiding the physicians in the decision making process to implant or not an embryo with some genetic defect. And last, some philosophical issues are also analyzed in pro or against PGD.

Mejía, Orlando

2005-12-01

137

El diagnóstico de preimplantación genética. Perspectivas científicas y dilemas bioéticos The diagnosis of genetic pre-implantation. Scientific Perspectives and bio-ethical dilemma  

Directory of Open Access Journals (Sweden)

Full Text Available El diagnóstico de preimplantación genética (DPG) es la prueba más reciente entre las técnicas de diagnóstico genético. En este trabajo se analiza su desarrollo, sus indicaciones médicas y los dilemas bioéticos que se pueden llegar a presentar con su uso indiscriminado. Se propone, además, unas preguntas que guíen la toma de decisiones para implantar o no un embrión con algún defecto genético. Por último, se analizan algunos argumentos filosóficos a favor y en contra del PDG.The diagnosis of genetic pre-implantation (PGD) is the most recent test amongst the genetic diagnostic techniques. This works analyses its development, medical indications and bio-ethical dilemma that may occur with indiscriminate use. It has been proposed as well that some questions guiding the physicians in the decision making process to implant or not an embryo with some genetic defect. And last, some philosophical issues are also analyzed in pro or against PGD.

Orlando Mejía

2005-01-01

138

Ethics in Organizational Leadership.  

Science.gov (United States)

This paper provides both a workable definition of, and examines those factors which may contribute to, an ethical dilemma in organizational leadership. To accomplish these purposes, it examines both individual ethical standards and the effects of legal de...

R. C. Hartjen

1984-01-01

139

Ethical Dilemma Factor in Regarding Physical Restraints to Elderly of Female Nurses with the Living Together Experience  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospitals who also live with elderly adults at home. Method: The study used the questionnair...

Miwa Yamamoto; Shizue Mizuno; Masako Aota

140

Ethical issues occurring within nursing education.  

UK PubMed Central (United Kingdom)

The large body of literature labeled "ethics in nursing education" is entirely devoted to curricular matters of ethics education in nursing schools, that is, to what ought to be the ethics content that is taught and what theory or issues ought to be included in all nursing curricula. Where the nursing literature actually focuses on particular ethical issues, it addresses only single topics. Absent from the literature, however, is any systematic analysis and explication of ethical issues or dilemmas that occur within the context of nursing education. The objective of this article is to identify the spectrum of ethical issues in nursing education to the end of prompting a systematic and thorough study of such issues, and to lay the groundwork for research by identifying and provisionally typologizing the ethical issues that occur within the context of academic nursing.

Fowler MD; Davis AJ

2013-03-01

 
 
 
 
141

Ethical and Bioethical Dilemmas in Paediatric Primary Health Care Setting Dilemas éticos y bioéticos de la práctica pediátrica en la Atención Primaria de Salud  

Directory of Open Access Journals (Sweden)

Full Text Available Medical Ethics gathers a group of principles and standards that rule out the behaviour amongst the health staff and amongst the doctor-patient and doctor-relatives relationship in order to preserve the patient’s health, treatment and rehabilitation. Bioethics has its bases on society in the health-patient team, and decisions can be taken by an Ethics Commission with the patient’s participation in the decision-taking process. The paediatrician in the primary health care setting should give a qualified health attention not only to the children but to their family members too due to the specialists’ commitment with the Cuban public health in general. Therefore, this bibliographical review is carried out to reflect on the main ethical dilemmas at the primary health care setting in the paediatric practice.La ética médica es el conjunto de principios y normas que rigen entre los profesionales de la salud, la relación del médico con sus pacientes, con sus familiares, con otros profesionales de la salud, para lograr la preservación de la salud, el tratamiento y recuperación de los pacientes. La bioética se fundamenta en la sociedad en el equipo salud-paciente, las decisiones pueden ser tomadas por el Comité de Ética y el paciente toma parte en las decisiones. El pediatra de la Atención Primaria de Salud tiene la responsabilidad moral de brindar una atención esmerada, pues su compromiso no es solo con el niño y su familia, es también con la salud pública cubana y el país en general. Para reflexionar sobre los principales dilemas éticos y bioéticos en el ejercicio de la práctica pediátrica en la Atención Primaria de Salud se realizó esta revisión

José Jesús García Mendiola; Gisselle Chi Gil; Maite Piñeiro Barreiro; Niurka Tamara Callejas Sánchez

2011-01-01

142

Ethical challenges embedded in qualitative research interviews with close relatives.  

UK PubMed Central (United Kingdom)

Nurse researchers engaged in qualitative interviews with patients and spouses in healthcare may often experience being in unforeseen ethical dilemmas. Researchers are guided by the bioethical principles of justice, beneficence, non-maleficence, respect for human rights and respect for autonomy through the entire research process. However, these principles are not sufficient to prepare researchers for unanticipated ethical dilemmas related to qualitative research interviews. We describe and discuss ethically challenging and difficult moments embedded in two cases from our own phenomenological interview studies. We argue that qualitative interviews involve navigation between being guided by bioethics as a researcher, being a therapist/nurse and being a fellow human being or even a friend. The researchers' premises to react to unexpected situations and act in a sound ethical manner must be enhanced, and there is a need for an increased focus on the researchers' ethical preparation and to continually address and discuss cases from their own interviews.

Haahr A; Norlyk A; Hall EO

2013-06-01

143

Internação por ordem judicial: dilemas éticos vivenciados por enfermeiros/ Internación por orden judicial: dilemas éticos vividos por enfermeros/ Hospitalization by court order: ethical dilemmas experienced by nurses  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Pesquisa qualitativa, cujo objetivo foi descrever as situações vivenciadas e os dilemas éticos dos enfermeiros no percurso de encaminhamento e recebimento, por ordem judicial, de pacientes com indicação de internação em Unidade de Terapia Intensiva (UTI). Foi efetivada entrevista parcialmente estruturada com 10 enfermeiros, que atuam em UTI e 10 que atuam em emergência de hospitais públicos e privados da região metropolitana de Porto Alegre, Brasil. Os dados for (more) am submetidos à análise temática. Os resultados indicam que os enfermeiros vivenciam dilemas éticos consequentes aos problemas de superlotação das UTI e das emergências, da precária tecnologia especializada, da orientação quanto ao benefício concedido pela lei. Concluiu-se que é fundamental a participação dos enfermeiros em debates que possibilitem mapear as diferentes instâncias que têm promovido esta situação, muitas vezes caótica. Abstract in spanish Investigación cualitativa cuyo objetivo fue describir las situaciones vividas y los dilemas éticos de los enfermeros en el transcurso del envío y recibimiento por orden judicial de pacientes con indicación de internamiento en la Unidad de Cuidados Intensivos (UCI). Se realizó una entrevista parcialmente estructurada con 10 enfermeros que actuaban en la UCI y 10 que actuaban en Emergencias de hospitales públicos y privados de la región metropolitana de Porto Alegre, (more) Brasil. Los datos fueron analizados según el Análisis Temático. Los resultados indican que los enfermeros experimentan dilemas éticos consiguientes problemas de hacinamiento en emergencia y UCI, especialista en tecnología pobre, la orientación en cuanto a los beneficios establecidos por la ley. Se concluye que es fundamental la participación de los enfermeros en debates que posibiliten mapear las diferentes instancias que han promovido esta situación muchas veces caótica. Abstract in english A qualitative study aimed at describing the situations experienced and the ethical dilemmas of nurses in the process of referring and receiving hospitalized patients by court order who require admission to the Intensive Care Unit (ICU). A partially structured interview was conducted with 10 nurses who worked in the ICU and 10 who worked in the Emergency Room (ER) in public and private hospitals in the metropolitan area of Porto Alegre, Brazil. The data was analyzed follow (more) ing the Semantic Analysis. The results indicated that nurses experienced ethical dilemmas associated with problems of overcrowding in emergency rooms and ICUs, poor specialized technology and orientation as to the benefits provided by law. We concluded that it is essential for nurses to participate in discussions that allow the planning of the different instances that have been promoting this often chaotic situation.

Vargas, Mara Ambrosina de Oliveira; Ramos, Flávia Regina Souza; Schneider, Dulcinéia Ghizoni; Schneider, Nadir; Santos, Alessandra Ceci dos; Leal, Sandra Maria Cezar

2013-03-01

144

What Is Ethics in Research and Why Is It Important?  

Science.gov (United States)

... After considering these questions, a person facing an ethical dilemma may decide to ask more questions, gather more ... a person who makes a decision in an ethical dilemma should be able to justify his or her ...

145

MILD DILEMMAS  

Directory of Open Access Journals (Sweden)

Full Text Available This paper argues that, while the existence of strong moral dilemmas is notoriously controversial, a case can be made for the existence of mild dilemmas. It is common for people to feel that they are caught in some type of moral dilemma. If mild dilemmas are a genuine feature of the moral terrain, perceptions by ordinary people that they are caught in a moral dilemma are to some extent vindicated.

Gregory Mellema

2010-01-01

146

Las posibilidades de la terapia génica y sus dilemas bioéticos/ The possibilities of gene therapy and its bio-ethical dilemmas  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish La terapia génica tiene, de acuerdo con Anderson, cuatro niveles de aplicación: las células somáticas, las células germinales, la terapia perfectiva y la manipulación eugenésica. Se hace un análisis de los dilemas bioéticos en cada nivel de terapia y se plantea el denominado Argumento Evolutivo para cuestionar los deseos de algunos científicos de iniciar terapia génica de células germinales. De igual manera, se advierte de los peligros de iniciar terapia perfe (more) ctiva y la manipulación eugénica por las implicaciones sociales y políticas de una reactivación de programas de eugenesia positiva. Abstract in english According to Anderson, gene therapy has four levels of application; somatic cells, germinal cells, perfective therapy and eugenic manipulation. An analysis of the bio-ethical dilemma in each therapy level is made and the so called Evolution Concept is stated to question the wish of some scientists to start gene therapy from germ cells. Likewise, there is a warning about the hazards of starting perfective therapy and eugenic manipulation due to the social and political implications of positive eugenics programs reactivation.

Mejía, Orlando

2005-06-01

147

Las posibilidades de la terapia génica y sus dilemas bioéticos The possibilities of gene therapy and its bio-ethical dilemmas  

Directory of Open Access Journals (Sweden)

Full Text Available La terapia génica tiene, de acuerdo con Anderson, cuatro niveles de aplicación: las células somáticas, las células germinales, la terapia perfectiva y la manipulación eugenésica. Se hace un análisis de los dilemas bioéticos en cada nivel de terapia y se plantea el denominado Argumento Evolutivo para cuestionar los deseos de algunos científicos de iniciar terapia génica de células germinales. De igual manera, se advierte de los peligros de iniciar terapia perfectiva y la manipulación eugénica por las implicaciones sociales y políticas de una reactivación de programas de eugenesia positiva.According to Anderson, gene therapy has four levels of application; somatic cells, germinal cells, perfective therapy and eugenic manipulation. An analysis of the bio-ethical dilemma in each therapy level is made and the so called Evolution Concept is stated to question the wish of some scientists to start gene therapy from germ cells. Likewise, there is a warning about the hazards of starting perfective therapy and eugenic manipulation due to the social and political implications of positive eugenics programs reactivation.

Orlando Mejía

2005-01-01

148

Focus on Ethics and Public Relations Practice in a University Classroom  

Science.gov (United States)

Public relations action relies on sound decision making about how to inspire cooperation between an organization and its publics. Such thinking must uphold principles for ethical communication. Effectively combining ethics with public relations practice for students is key. A pedagogical approach to public relations ethics, hinging on selected…

Smudde, Peter M.

2011-01-01

149

Re-focusing the ethical discourse on personalized medicine: a qualitative interview study with stakeholders in the German healthcare system.  

UK PubMed Central (United Kingdom)

BACKGROUND: In recent years, personalized medicine (PM) has become a highly regarded line of development in medicine. Yet, it is still a relatively new field. As a consequence, the discussion of its future developments, in particular of its ethical implications, in most cases can only be anticipative. Such anticipative discussions, however, pose several challenges. Nevertheless, they play a crucial role for shaping PM's further developments. Therefore, it is vital to understand how the ethical discourse on PM is conducted, i.e. on what - empirical and normative - assumptions ethical arguments are based regarding PM's current and future developments. METHODS: To gather this information, we conducted a qualitative interview study with stakeholders in the German health care system. Our purposive sample included 17 representatives of basic research, clinical research, health economics, regulatory authorities, reimbursement institutions, pharmaceutical industry, patient organizations, as well as clinicians and legal experts involved in PM developments or policy making. We used an interview guide with open-ended questions and analyzed transcriptions of the interviews by means of qualitative content analysis. RESULTS: The respondents addressed a multitude of concerns in the context of research on as well as application of personalized preventive and therapeutic measures both on the individual and on the societal level. Interestingly, regarding future developments of PM the ethical evaluation seemed to follow the rule: the less likely its application, the more problematic a PM measure is assessed. The more likely its application, on the other hand, the less problematic it is evaluated. CONCLUSIONS: The results of our study suggest re-focusing the ethical discourse on PM in Germany towards a constructive ethical monitoring which ensures to include only, nevertheless all of the actual and/or potential concerns that are ethically relevant in order to allow balancing them against the actual and potential ethically relevant benefits of PM measures. To render this possible, we propose a strategy for evaluating ethical concerns in the context of PM.

Schleidgen S; Marckmann G

2013-01-01

150

Ethics Training in Psychiatry  

Directory of Open Access Journals (Sweden)

Full Text Available Although ethics training is one of the core components of psychiatric education, it is not sufficiently addressed in the curricula of many educational institutions. It is shown that many of the psychiatry residents received no ethics training in both residency and medical school. Predictably, over half of the psychiatry residents had faced an ethical dilemma that they felt unprepared to meet, and nearly all of them indicated ethics education would have helped them to solve this dilemma. In addition to learning about the fundamental topics of ethics like confidentiality, boundary violations, justice, benefience and nonmaleficence, psychiatrists must also learn to deal with other hidden ethical dilemmas which are mostly due to the changing world order. It is obvious that residency training should include a well developed ethics curriculum. However, some still believe that ethical principles cannot be taught and are formed in one’s early moral development. Accepting the fact that teaching ethics is difficult, we believe that it is getting easier with the new methods for teaching in medicine. These methods are clinical supervisions, rol-models, case studies, role playing, small group discussions, team based learning and “let’s talking medicine” groups which is a useful methods for discussing ethics dilemmas on daily practice and C.A.R.E (Core Beliefs, Actions, Reasons, Experience) which is a special training method for teaching ethics. In this review, the need of ethics training in residency curriculum will be discussed and new methods for teaching ethics will be proposed.

Ayse Devrim Basterzi; Sinan Guloksuz

2009-01-01

151

'They say Islam has a solution for everything, so why are there no guidelines for this?' Ethical dilemmas associated with the births and deaths of infants with fatal abnormalities from a small sample of Pakistani Muslim couples in Britain.  

UK PubMed Central (United Kingdom)

This paper presents ethical dilemmas concerning the termination of pregnancy, the management of childbirth, and the withdrawal of life-support from infants in special care, for a small sample of British Pakistani Muslim parents of babies diagnosed with fatal abnormalities. Case studies illustrating these dilemmas are taken from a qualitative study of 66 families of Pakistani origin referred to a genetics clinic in Southern England. The paper shows how parents negotiated between the authoritative knowledge of their doctors, religious experts, and senior family members in response to the ethical dilemmas they faced. There was little knowledge or open discussion of the view that Islam permits the termination of pregnancy for serious or fatal abnormality within 120 days and there was considerable disquiet over the idea of ending a pregnancy. For some parents, whether their newborn baby would draw breath was a main worry, with implications for the baby's Muslim identity and for the recognition of loss the parents would receive from family and community. This concern sometimes conflicted with doctors' concerns to minimize risk to future pregnancies by not performing a Caesarean delivery if a baby is sure to die. The paper also identifies parents' concerns and feelings of wrong-doing regarding the withdrawal of artificial life-support from infants with multiple abnormalities. The conclusion considers some of the implications of these observations for the counselling and support of Muslim parents following the pre- or neo-natal diagnosis of fatal abnormalities in their children.

Shaw A

2012-11-01

152

The role of veterinarians in equestrian sport: A comparative review of ethical issues surrounding human and equine sports medicine.  

Science.gov (United States)

Veterinarians have a key role in providing medical care for sports horses during and between competitions, but the standard client:veterinarian relationship that exists in companion and production animal medicine is distorted by the involvement of third parties in sports medicine, resulting in distinct ethical dilemmas which warrant focused academic attention. By comparing the existing literature on human sports medicine, this article reviews the ethical dilemmas which face veterinarians treating equine athletes, and the role of regulators in contributing to or resolving those dilemmas. Major ethical dilemmas occur both between and during competitions. These include conflicts of responsibility, conflicts between the need for client confidentiality and the need to share information in order to maximise animal welfare, and the need for an evidence base for treatment. Although many of the ethical problems faced in human and equine sports medicine are similar, the duty conferred upon a veterinarian by the licensing authority to ensure the welfare of animals committed to his or her care requires different obligations to those of a human sports medicine doctor. Suggested improvements to current practice which would help to address ethical dilemmas in equine sports medicine include an enhanced system for recording equine injuries, the use of professional Codes of Conduct and Codes of Ethics to establish acceptable responses to common ethical problems, and insistence that treatment of equine athletes is evidence-based (so far as possible) rather than economics-driven. PMID:23773811

Campbell, Madeleine L H

2013-06-15

153

The role of veterinarians in equestrian sport: A comparative review of ethical issues surrounding human and equine sports medicine.  

UK PubMed Central (United Kingdom)

Veterinarians have a key role in providing medical care for sports horses during and between competitions, but the standard client:veterinarian relationship that exists in companion and production animal medicine is distorted by the involvement of third parties in sports medicine, resulting in distinct ethical dilemmas which warrant focused academic attention. By comparing the existing literature on human sports medicine, this article reviews the ethical dilemmas which face veterinarians treating equine athletes, and the role of regulators in contributing to or resolving those dilemmas. Major ethical dilemmas occur both between and during competitions. These include conflicts of responsibility, conflicts between the need for client confidentiality and the need to share information in order to maximise animal welfare, and the need for an evidence base for treatment. Although many of the ethical problems faced in human and equine sports medicine are similar, the duty conferred upon a veterinarian by the licensing authority to ensure the welfare of animals committed to his or her care requires different obligations to those of a human sports medicine doctor. Suggested improvements to current practice which would help to address ethical dilemmas in equine sports medicine include an enhanced system for recording equine injuries, the use of professional Codes of Conduct and Codes of Ethics to establish acceptable responses to common ethical problems, and insistence that treatment of equine athletes is evidence-based (so far as possible) rather than economics-driven.

Campbell ML

2013-06-01

154

Medical students' understanding of ethical issues in the ambulatory setting.  

UK PubMed Central (United Kingdom)

BACKGROUND: The education of medical students concerning ethical issues focuses mainly on critically ill hospitalized patients. However, in the outpatient setting physicians encounter many problems that require ethical decision making. The present study is an assessment of medical students' awareness and understanding of ethical issues commonly encountered in the ambulatory setting. METHODS: A questionnaire was designed to evaluate general knowledge of medical ethics using 12 clinical vignettes. These vignettes depict situations in the ambulatory setting which involve ethical problems. The questionnaire was distributed to medical students who were asked to state whether an ethical issue was present, its significance, and what the specific issue was. RESULTS: Students' abilities to identify that an ethical issue was involved in each vignette ranged from 34.2% to 96.4%. A majority of students identified the presence of an ethical dilemma in seven out of 12 vignettes. The significance rating varied from 2.8 to 4.4 on a scale of 1 to 5. The results indicate that traditional education in medical ethics does not necessarily prepare students to recognize these problems in the clinical setting. CONCLUSIONS: The medical students surveyed for this study seem to be variably prepared to recognize obvious ethical dilemmas in the ambulatory setting. Medical education must prepare students to recognize and appropriately manage these commonly encountered situations.

Knabe BJ; Stearns JA; Glasser M

1994-07-01

155

Juan's Dilemma  

Science.gov (United States)

When life hands you lemons, make a battery! In this article, the authors describe an activity they refer to as Juan's Dilemma , an extension of the familiar lemon-battery activity (Goodisman 2001). Juan's Dilemma integrates oxidation and reduction

Palmquist, Bruce; Balandova, Evguenia; Sorey, Timothy; Hunt, Vanessa

2010-10-01

156

Cómo enfrenta el hinduismo un dilema ético-clínico How does Hinduism analyze an ethical clinical dilemma  

Directory of Open Access Journals (Sweden)

Full Text Available It is indispensable for physicians to understand and recognize the fusion of different cultures, to deliver the best possible service to patients with different cultural backgrounds, especially when ethical-medical problems are involved. The Hindu community in Chile differs in significant ways with the western culture. This is especially true for some issues such as the belief in reincarnation or gender inequality, among others. These discrepancies can be relevant for the analysis of several bioethical problems. Therefore, it is necessary to understand the different beliefs, traditions and Hindu visions. We hereby present a review of Hinduism, its relation with medical practice and, as an example, a case of abortion in a Hindu family. Reviewing the traditions, beliefs and methods will help to understand and respect the beliefs of different cultures in contemporary and globalized bioethics.

Suraj Samtani B; Mariana Jadue Z; Juan Pablo Beca I

2009-01-01

157

Dilemas éticos en el trabajo de campo: temas olvidados en la investigación cualitativa en salud en Iberoamérica Ethical dilemmas in fieldwork: forgotten issues in qualitative health research in Iberoamerica  

Directory of Open Access Journals (Sweden)

Full Text Available En este trabajo se exploran algunos dilemas éticos enfrentados durante el trabajo de campo en la investigación cualitativa en salud. La premisa es que los códigos éticos no son suficientes para orientar las relaciones entre los investigadores y los informantes siendo necesaria una práctica reflexiva para enfrentar los mismos. La reflexión se centra en cuatro situaciones del trabajo de campo y sus dilemas. El tiempo social de la vida académica estructura la agenda de trabajo y el investigador se enfrenta a la disyuntiva de seguir los tiempos y ritmos de la academia o negociar con los informantes una agenda conjunta. El investigador también debe decidir cuál de sus múltiples identidades habrá de utilizar para ser aceptado, y al mismo tiempo decidir si oculta o no quien es realmente. En el establecimiento de una relación de intimidad con los informantes el investigador debe resolver si abre su vida personal. Y al momento de definir las formas de reciprocidad, decidir si lo hará de acuerdo a los valores de la academia o a los de los nativos. Se concluye argumentando la necesidad de crear una práctica reflexiva sobre estos y otros dilemas dirigida a colocar una agenda de temas y formas de descolonización en el debate ético en Iberoamérica.This paper explores some ethical dilemmas faced while doing fieldwork. Ethical norms are not enough to appraise the relationship between researchers and participants; a reflexivity practice is needed to understand the dilemmas aroused during this process. Here four issues faced during fieldwork are presented. The academic social time usually defines the schedule of fieldwork; hence, the researcher may decide to follow the academic schedule or to arrange a different schedule with informants. Researchers usually decide which part of their identity will be disclosed for introducing themselves to the informants; but may also decide to hide who really he/she is. Researchers may cope with the dilemma to disclose their private life to informants during the fieldwork. Researchers also may decide to behave according to academic cultural norms of reciprocity or according to the cultural norms of participants. Finally, a reflexivity movement should be developed in Iberoamerica to define an agenda on ethical issues and to develop decolonizing strategies to debate these ethical dilemmas.

Leticia Robles-Silva

2012-01-01

158

Dilemas éticos en el trabajo de campo: temas olvidados en la investigación cualitativa en salud en Iberoamérica/ Ethical dilemmas in fieldwork: forgotten issues in qualitative health research in Iberoamerica  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish En este trabajo se exploran algunos dilemas éticos enfrentados durante el trabajo de campo en la investigación cualitativa en salud. La premisa es que los códigos éticos no son suficientes para orientar las relaciones entre los investigadores y los informantes siendo necesaria una práctica reflexiva para enfrentar los mismos. La reflexión se centra en cuatro situaciones del trabajo de campo y sus dilemas. El tiempo social de la vida académica estructura la agenda d (more) e trabajo y el investigador se enfrenta a la disyuntiva de seguir los tiempos y ritmos de la academia o negociar con los informantes una agenda conjunta. El investigador también debe decidir cuál de sus múltiples identidades habrá de utilizar para ser aceptado, y al mismo tiempo decidir si oculta o no quien es realmente. En el establecimiento de una relación de intimidad con los informantes el investigador debe resolver si abre su vida personal. Y al momento de definir las formas de reciprocidad, decidir si lo hará de acuerdo a los valores de la academia o a los de los nativos. Se concluye argumentando la necesidad de crear una práctica reflexiva sobre estos y otros dilemas dirigida a colocar una agenda de temas y formas de descolonización en el debate ético en Iberoamérica. Abstract in english This paper explores some ethical dilemmas faced while doing fieldwork. Ethical norms are not enough to appraise the relationship between researchers and participants; a reflexivity practice is needed to understand the dilemmas aroused during this process. Here four issues faced during fieldwork are presented. The academic social time usually defines the schedule of fieldwork; hence, the researcher may decide to follow the academic schedule or to arrange a different schedu (more) le with informants. Researchers usually decide which part of their identity will be disclosed for introducing themselves to the informants; but may also decide to hide who really he/she is. Researchers may cope with the dilemma to disclose their private life to informants during the fieldwork. Researchers also may decide to behave according to academic cultural norms of reciprocity or according to the cultural norms of participants. Finally, a reflexivity movement should be developed in Iberoamerica to define an agenda on ethical issues and to develop decolonizing strategies to debate these ethical dilemmas.

Robles-Silva, Leticia

2012-03-01

159

Ethical dilemmas in scientific publication: pitfalls and solutions for editors/ Dilemas éticos na publicação científica: dificuldades e soluções para editores  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Editores de revistas científicas precisam estar atentos aos mecanismos de disseminação de condutas inadequadas no processo de publicação. Este artigo fornece definições, formas de documentar a extensão do problema e exemplos de iniciativas para conter fraudes editorias. Fabricação, falsificação, duplicação, autoria-fantasma, autoria concedida, falta de ética na aprovação de manuscritos, não-divulgação desses fatos, publicação "salami", conflitos de i (more) nteresse, autocitação, submissão e publicação duplicadas, e plágio são problemas comuns. A conduta editorial inadequada inclui: falha em seguir o processo devido, atraso nas decisões e comunicação com os autores, falhas na revisão, e confundir o conteúdo de um periódico com seu potencial promocional e de propaganda. Os editores podem ser advertidos por seus pares por não investigar comportamento científico suspeito, por não se retratar quando indicado ou não obedecer as seis principais fontes internacionais de orientação em pesquisa, publicação e política editorial. Os editores estão em posição privilegiada para promover práticas adequadas, adotando orientações éticas e claras sobre os procedimentos adotados nos periódicos. Assim, revisores, editores, autores e leitores terão condições de compreender e seguir as normas de publicação. Abstract in english Editors of scientific journals need to be conversant with the mechanisms by which scientific misconduct is amplified by publication practices. This paper provides definitions, ways to document the extent of the problem, and examples of editorial attempts to counter fraud. Fabrication, falsification, duplication, ghost authorship, gift authorship, lack of ethics approval, non-disclosure, 'salami' publication, conflicts of interest, auto-citation, duplicate submission, dupl (more) icate publications, and plagiarism are common problems. Editorial misconduct includes failure to observe due process, undue delay in reaching decisions and communicating these to authors, inappropriate review procedures, and confounding a journal's content with its advertising or promotional potential. Editors also can be admonished by their peers for failure to investigate suspected misconduct, failure to retract when indicated, and failure to abide voluntarily by the six main sources of relevant international guidelines on research, its reporting and editorial practice. Editors are in a good position to promulgate reasonable standards of practice, and can start by using consensus guidelines on publication ethics to state explicitly how their journals function. Reviewers, editors, authors and readers all then have a better chance to understand, and abide by, the rules of publishing.

Gollogly, Laragh; Momen, Hooman

2006-08-01

160

Ethical dilemmas in scientific publication: pitfalls and solutions for editors Dilemas éticos na publicação científica: dificuldades e soluções para editores  

Directory of Open Access Journals (Sweden)

Full Text Available Editors of scientific journals need to be conversant with the mechanisms by which scientific misconduct is amplified by publication practices. This paper provides definitions, ways to document the extent of the problem, and examples of editorial attempts to counter fraud. Fabrication, falsification, duplication, ghost authorship, gift authorship, lack of ethics approval, non-disclosure, 'salami' publication, conflicts of interest, auto-citation, duplicate submission, duplicate publications, and plagiarism are common problems. Editorial misconduct includes failure to observe due process, undue delay in reaching decisions and communicating these to authors, inappropriate review procedures, and confounding a journal's content with its advertising or promotional potential. Editors also can be admonished by their peers for failure to investigate suspected misconduct, failure to retract when indicated, and failure to abide voluntarily by the six main sources of relevant international guidelines on research, its reporting and editorial practice. Editors are in a good position to promulgate reasonable standards of practice, and can start by using consensus guidelines on publication ethics to state explicitly how their journals function. Reviewers, editors, authors and readers all then have a better chance to understand, and abide by, the rules of publishing.Editores de revistas científicas precisam estar atentos aos mecanismos de disseminação de condutas inadequadas no processo de publicação. Este artigo fornece definições, formas de documentar a extensão do problema e exemplos de iniciativas para conter fraudes editorias. Fabricação, falsificação, duplicação, autoria-fantasma, autoria concedida, falta de ética na aprovação de manuscritos, não-divulgação desses fatos, publicação "salami", conflitos de interesse, autocitação, submissão e publicação duplicadas, e plágio são problemas comuns. A conduta editorial inadequada inclui: falha em seguir o processo devido, atraso nas decisões e comunicação com os autores, falhas na revisão, e confundir o conteúdo de um periódico com seu potencial promocional e de propaganda. Os editores podem ser advertidos por seus pares por não investigar comportamento científico suspeito, por não se retratar quando indicado ou não obedecer as seis principais fontes internacionais de orientação em pesquisa, publicação e política editorial. Os editores estão em posição privilegiada para promover práticas adequadas, adotando orientações éticas e claras sobre os procedimentos adotados nos periódicos. Assim, revisores, editores, autores e leitores terão condições de compreender e seguir as normas de publicação.

Laragh Gollogly; Hooman Momen

2006-01-01

 
 
 
 
161

Ethical psychiatry in an uncertain world: conversations and parallel truths.  

UK PubMed Central (United Kingdom)

Psychiatric practice is often faced with complex situations that seem to pose serious moral dilemmas for practitioners. Methods for solving these dilemmas have included the development of more objective rules to guide the practitioner such as utilitarianism and deontology. A more modern variant on this objective model has been 'Principlism' where 4 mid level rules are used to help solve these complex problems. In opposition to this, there has recently been a focus on more subjective criteria for resolving complex moral dilemmas. In particular, virtue ethics has been posited as a more sensitive method for helping doctors to reason their way through difficult ethical issues. Here the focus is on the character traits of the practitioner. Bloch and Green advocated another way whereby more objective methods such as Principlism and virtue ethics are combined to produce what they considered sound moral reasoning in psychiatrists. This paper points out some difficulties with this approach and instead suggests that a better model of ethical judgment could be developed through the use of narratives or stories. This idea puts equal prima facie value on the patient's and the psychiatrist's version of the dilemma they are faced with. It has the potential to lead to a more genuine empathy and reflective decision-making.

Carson AM; Lepping P

2009-01-01

162

Ethical psychiatry in an uncertain world: conversations and parallel truths.  

Science.gov (United States)

Psychiatric practice is often faced with complex situations that seem to pose serious moral dilemmas for practitioners. Methods for solving these dilemmas have included the development of more objective rules to guide the practitioner such as utilitarianism and deontology. A more modern variant on this objective model has been 'Principlism' where 4 mid level rules are used to help solve these complex problems. In opposition to this, there has recently been a focus on more subjective criteria for resolving complex moral dilemmas. In particular, virtue ethics has been posited as a more sensitive method for helping doctors to reason their way through difficult ethical issues. Here the focus is on the character traits of the practitioner. Bloch and Green advocated another way whereby more objective methods such as Principlism and virtue ethics are combined to produce what they considered sound moral reasoning in psychiatrists. This paper points out some difficulties with this approach and instead suggests that a better model of ethical judgment could be developed through the use of narratives or stories. This idea puts equal prima facie value on the patient's and the psychiatrist's version of the dilemma they are faced with. It has the potential to lead to a more genuine empathy and reflective decision-making. PMID:19555473

Carson, Alexander M; Lepping, Peter

2009-06-25

163

Ethical psychiatry in an uncertain world: conversations and parallel truths  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Psychiatric practice is often faced with complex situations that seem to pose serious moral dilemmas for practitioners. Methods for solving these dilemmas have included the development of more objective rules to guide the practitioner such as utilitarianism and deontology. A more modern variant on this objective model has been 'Principlism' where 4 mid level rules are used to help solve these complex problems. In opposition to this, there has recently been a focus on more subjective criteria for resolving complex moral dilemmas. In particular, virtue ethics has been posited as a more sensitive method for helping doctors to reason their way through difficult ethical issues. Here the focus is on the character traits of the practitioner. Bloch and Green advocated another way whereby more objective methods such as Principlism and virtue ethics are combined to produce what they considered sound moral reasoning in psychiatrists. This paper points out some difficulties with this approach and instead suggests that a better model of ethical judgment could be developed through the use of narratives or stories. This idea puts equal prima facie value on the patient's and the psychiatrist's version of the dilemma they are faced with. It has the potential to lead to a more genuine empathy and reflective decision-making.

Carson Alexander M; Lepping Peter

2009-01-01

164

Ethical challenges in oncology, explored through a series of vignettes.  

UK PubMed Central (United Kingdom)

The specialty of medical oncology poses many ethical dilemmas to the practicing physician. In this article, we have chosen to focus on three of those challenges, presenting them in the form of vignettes. The first dilemma deals with the difficulties physicians encounter secondary to the rising cost of cancer therapies when choosing and communicating about treatment plans with patients. The second scenario addresses difficulties associated with communicating prognosis to cancer patients, and the third challenge focuses on cancer treatment strategies for patients nearing the end of life.

Tenner L; Helft PR

2013-02-01

165

Teaching research ethics better: focus on excellent science, not bad scientists.  

UK PubMed Central (United Kingdom)

A recent report of the United States' Presidential Commission for the Study of Bioethical Issues highlights how important it is for the research community to enjoy the "earned confidence" of the public and how creating a "culture of responsibility" can contribute to that confidence. It identifies a major role for "creative, flexible, and innovative" ethics education in creating such a culture. Other recent governmental reports from various nations similarly call for a renewed emphasis on ethics education in the sciences. We discuss why some common approaches to ethics education in the graduate sciences fail to meet the goals envisioned in the reports and we describe an approach, animated by primary attention on excellent science as opposed to bad scientists, that we have employed in our ethics teaching that we think is better suited for inspiring and sustaining responsible, trustworthy science.

Yarborough M; Hunter L

2013-06-01

166

Information technology and ethics: An exploratory factor analysis  

Energy Technology Data Exchange (ETDEWEB)

Ethical dilemmas are situations in which a decision results in unpleasant consequences. The unpleasant consequences are treated as a zero-sum game in which someone always loses. Introducing information technology (IT) to a situation makes the recognition of a potential loser more abstract and difficult to identify, thus an ethical dilemma may go unrecognized. The computer mediates the human relationship which causes a lost sense of contact with a person at the other end of the computer connection. In 1986, Richard O. Mason published an essay identifying privacy, accuracy, property, and Access (PAPA) as the four main ethical issues of the information age. Anecdotes for each issue describe the injured party`s perspective to identify consequences resulting from unethical use of information and information technology. This research sought to validate Mason`s social issues empirically, but with distinct differences. Mason defined issues to raise awareness and initiate debate on the need for a social agenda; our focus is on individual computer users and the attitudes they hold about ethical behavior in computer use. This study examined the attitudes of the computer user who experiences the ethical dilemma to determine the extent to which ethical components are recognized, and whether Mason`s issues form recognizable constructs.

Conger, S. [Southern Methodist Univ., Dallas, TX (United States); Loch, K.D. [Georgia State Univ., Atlanta, GA (United States); Helft, B.L. [Baruch College, New York, NY (United States)

1994-12-31

167

A distanásia como geradora de dilemas éticos nas Unidades de Terapia Intensiva: considerações sobre a participação dos enfermeiros/ Disthanasia as an ethical dilemma at the Intensive Care Units: considerations about nurses involvement/ La distanasia como generadora de dilemas éticos en las Unidades deTerapia Intensiva: algunos aspectos a cerca de lo envolvimiento de los enfermeros  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A distanásia apresenta-se como uma das fontes geradoras de dilemas éticos nas Unidades de Terapia Intensiva (UTI). Discute-se o contexto que favorece a prática da distanásia nesse ambiente, com ênfase na utilização excessiva do suporte tecnológico. Tecemos comentários sobre a participação dos familiares e profissionais envolvidos, principalmente médicos e enfermeiros, considerando-se o papel sócio-profissional atribuído a cada um. Pretende-se com as consider (more) ações apresentadas, fornecer subsídios para a reflexão do tema, com vistas a uma participação mais ativa dos enfermeiros de UTI nos dilemas éticos relacionados à distanásia. Abstract in spanish La distanasia se presenta como una de las fuentes generadoras de los dilemas éticos en las Unidades de Terapia Intensiva (UTI) Discute el contexto que favorece la práctica de la distanasia en este ambiente, con énfasis en la utilización excesiva del arsenal tecnologico. Además de los comentarios sobre la posición de los familiares y de los profesionales involucrados, principalmente los médicos y enfermeros, se consideró el papel socio-profesional que se atribuye a (more) cada uno. Para finalizar, los profesionales del area son estimulados a refletir sobre el tema y los enfermeros a participar de manera más activa en las discusiones de los dilemas éticos relacionados a la distanasia. Abstract in english Disthanasia is conceptualized and presented as an ethical dilemma in Intensive Care Units (ICU). The context favoring the disthanasia practice on this environment focusing the excessive use of technological devices will be discussed. The study will approach the family, physician and nurse?s participation in the situations, considering the social and professional role of each one. This study aims to provide support for healthcare professionals to reflect on this subject, aiming the nurse?s more effective participation on ethical dilemmas related to disthanasia.

Toffoletto, Maria Cecilia; Zanei, Suely S. Viski; Hora, Edilene Curvelo; Nogueira, Gisele Puerta; Miyadahira, Ana Maria K; Kimura, Miako; Padilha, Kátia Grillo

2005-09-01

168

A distanásia como geradora de dilemas éticos nas Unidades de Terapia Intensiva: considerações sobre a participação dos enfermeiros La distanasia como generadora de dilemas éticos en las Unidades deTerapia Intensiva: algunos aspectos a cerca de lo envolvimiento de los enfermeros Disthanasia as an ethical dilemma at the Intensive Care Units: considerations about nurses involvement  

Directory of Open Access Journals (Sweden)

Full Text Available A distanásia apresenta-se como uma das fontes geradoras de dilemas éticos nas Unidades de Terapia Intensiva (UTI). Discute-se o contexto que favorece a prática da distanásia nesse ambiente, com ênfase na utilização excessiva do suporte tecnológico. Tecemos comentários sobre a participação dos familiares e profissionais envolvidos, principalmente médicos e enfermeiros, considerando-se o papel sócio-profissional atribuído a cada um. Pretende-se com as considerações apresentadas, fornecer subsídios para a reflexão do tema, com vistas a uma participação mais ativa dos enfermeiros de UTI nos dilemas éticos relacionados à distanásia.La distanasia se presenta como una de las fuentes generadoras de los dilemas éticos en las Unidades de Terapia Intensiva (UTI) Discute el contexto que favorece la práctica de la distanasia en este ambiente, con énfasis en la utilización excesiva del arsenal tecnologico. Además de los comentarios sobre la posición de los familiares y de los profesionales involucrados, principalmente los médicos y enfermeros, se consideró el papel socio-profesional que se atribuye a cada uno. Para finalizar, los profesionales del area son estimulados a refletir sobre el tema y los enfermeros a participar de manera más activa en las discusiones de los dilemas éticos relacionados a la distanasia.Disthanasia is conceptualized and presented as an ethical dilemma in Intensive Care Units (ICU). The context favoring the disthanasia practice on this environment focusing the excessive use of technological devices will be discussed. The study will approach the family, physician and nurse’s participation in the situations, considering the social and professional role of each one. This study aims to provide support for healthcare professionals to reflect on this subject, aiming the nurse’s more effective participation on ethical dilemmas related to disthanasia.

Maria Cecilia Toffoletto; Suely S. Viski Zanei; Edilene Curvelo Hora; Gisele Puerta Nogueira; Ana Maria K Miyadahira; Miako Kimura; Kátia Grillo Padilha

2005-01-01

169

Dilemas éticos em UTI: contribuições da Teoria dos Valores de Max Scheler/ Ethical dilemmas in ICU: contributions of Max Scheler's Theory of Values/ Dilemas éticos en UTI: contribuciones de la Teoría de Valores de Max Scheler  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese O estudo objetivou refletir, tomando como base o referencial teórico de Max Scheler, sobre os dilemas éticos vivenciados por enfermeiros na UTI, e sobre os valores que norteiam suas atitudes e decisões. Trata-se de pesquisa qualitativa, tendo sido entrevistados dez enfermeiros da UTI de um hospital universitário. Identificou-se a vivência de dilemas éticos referentes à terminalidade relacionada aos limites de intervenções e de utilização dos recursos materiais, (more) além da questão da transfusão de sangue em caso de restrição religiosa. Os valores identificados foram: respeito, dignidade do paciente, conhecimento científico, humildade, paixão pela profissão e amor a Deus. A teoria dos valores constitui importante subsídio para enfermagem por permitir a abordagem de uma ética humanizadora da práxis, especialmente nas situações de dilemas éticos. Abstract in spanish El objetivo del estudio fue reflexionar, con base en el marco teórico de Max Scheler, sobre los dilemas éticos experimentados por enfermeros en la UCI, y sobre los valores que orientan sus actitudes y decisiones,. Se trata de investigación cualitativa y fueran entrevistados diez enfermeros de la UCI de un hospital universitario. Identificada la experiencia de los dilemas éticos relativos a la condición terminal sobre los límites de la intervención y el uso de los r (more) ecursos materiales, más allá de la cuestión de la transfusión de sangre en caso de restricciones religiosas. Los valores identificados fueron: el respeto, la dignidad del paciente, el conocimiento científico, la humildad, la pasión por la profesión y el amor de Dios. La teoría del valor constituye un instrumento importante para la enfermería, permitiendo el uso de una ética humana de la práctica en situaciones de dilemas éticos. Abstract in english The study aimed to reflect, based on the theoretical framework of Max Scheler, about the ethical dilemmas experienced by nurses in the ICU, and about the values that guide their actions and decisions,. This is qualitative research, and ten ICU nurses have been interviewed at a university hospital. It was identified the experience of ethical dilemmas related to the terminality related to the limits of intervention and use of material resources, as well as the issue of bloo (more) d transfusion in case of religious restrictions. The values identified were: respect, dignity of the patient, scientific knowledge, humility, passion for the profession and love of God. The theory of values is an important tool for nursing because it allows the approach of an ethics of humanizing praxis, especially in situations of ethical dilemmas.

Medeiros, Marlise Barros de; Pereira, Eliane Ramos; Silva, Rose Mary Costa Rosa Andrade; Silva, Marcos Andrade

2012-04-01

170

Ethics in oncology nursing  

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Full Text Available In the process of cancer treatment and care, the ethical duties of the cancer nurses contribute to preventing ethical dilemmas, resolving ethical problems, and most importantly maintaining an ethical cancer care system. The ethical duties of humanistic caregiving, disclosure, honesty, relief of pain and suffering, fair distribution of resources, provision of adequate palliative care, and assistance to patients and families for imminent death, which are the hallmarks of oncology nursing, are justified by the values, professional standards and the contemporary roles of nursing. Therefore, ethical competency of the oncology nurse is an inevitable requirement.

Nermin ERSOY

2009-01-01

171

Spirituality in nursing theory and practice: dilemmas for Christian bioethics.  

Science.gov (United States)

Moral strangerhood is due in part to competing worldviews. The profession of nursing is experiencing a paradigm shift which creates ethical dilemmas for both Christian nurses and Christian patients. Nursing's new focus on spirituality and spiritual care presents itself as broadly defining a desired state or patient outcome -- spiritual integrity -- supposed to be applicable to all patients of all faiths. Analysis of nursing's definition of spirituality reveals assumptions and values consistent with an Eastern/New Age worldview which may cause hostility towards Christian patients stereotyped as dogmatic or noncompliant. PMID:11656651

Salladay, Susan Anthony; Shelly, Judith Allen

1997-03-01

172

Spirituality in nursing theory and practice: dilemmas for Christian bioethics.  

UK PubMed Central (United Kingdom)

Moral strangerhood is due in part to competing worldviews. The profession of nursing is experiencing a paradigm shift which creates ethical dilemmas for both Christian nurses and Christian patients. Nursing's new focus on spirituality and spiritual care presents itself as broadly defining a desired state or patient outcome -- spiritual integrity -- supposed to be applicable to all patients of all faiths. Analysis of nursing's definition of spirituality reveals assumptions and values consistent with an Eastern/New Age worldview which may cause hostility towards Christian patients stereotyped as dogmatic or noncompliant.

Salladay SA; Shelly JA

1997-03-01

173

Integrated ethics for the clinical systems manager.  

UK PubMed Central (United Kingdom)

This article describes how clinical systems managers can integrate clinical ethics, management ethics, and the social responsibility of business or organizational leaders (business ethics) to resolve ethical dilemmas they may encounter. Three examples are discussed: policy on use of resources, personnel issues, and managed care and the current backlash against it.

Weber LJ

1998-09-01

174

From Cases to Capacity? A Critical Reflection on the Role of 'Ethical Dilemmas' in the Development of Dual-Use Governance.  

UK PubMed Central (United Kingdom)

The dual-use issue is often framed as a series of paralyzing 'dilemmas' facing the scientific community as well as institutions which support innovation. While this conceptualization of the dual-use issue can be useful in certain contexts (such as in awareness-raising and as part of educational activities directed at the scientific community) its usefulness is more limited when reflecting on the governance and politics of the dual-use issue. Within this paper, key shortcomings of the dilemma framing are outlined. It is argued that many of the issues raised in the most recent debates about 'dual-use' bird flu research remain unresolved. This includes questions about the trajectories of certain lines of research, as well as broader trends in the practice and governance of science. This leads to difficult questions about current approaches to the dual-use issue within the US, as well as internationally.

Edwards B; Revill J; Bezuidenhout L

2013-05-01

175

[Toward a practical ethic].  

Science.gov (United States)

The relationship between ethics and philosophy and jurisdiction is described; different kinds of ethics are presented. The increasing pressure of liberal points of view has boosted the ethics of utility. The ethics of care oppose a too rational utilitarianism, taking into consideration relationships such as the caregiver-patient relationship. In the multicultural society ethics of care and virtue ethics are being criticised for not giving universal answers to ethical dilemmas. Can one still define "doing good"? Is "doing good" so culturally biased that it no longer provides the basis for ethical conduct? An accurate procedural assessment of values, sometimes interpreted quite differently in different cultures, could be a tool to judge values in a less relativistic way. PMID:18506970

Vanbelle, Guido

2007-01-01

176

Care-based ethical reasoning among first-year nursing and social services students.  

UK PubMed Central (United Kingdom)

AIM: This paper is a report of a study conducted to describe nursing and social services students' ethical reasoning at the start of their studies. BACKGROUND: Gilligan argued that there are two modes of moral reasoning - the ethic of justice, focusing on individuals' rights, and the ethic of care, focusing on responsibilities in relationships. Recent research has established the ethic of care as a developmental phenomenon. It has been widely argued that the ethic of care is crucial for nursing, but there has been little international research in this area. METHOD: Participants were first-year nursing and social services students in Finland (N =112). Their care-based moral reasoning was measured using the Ethic of Care Interview, and their ethical reasoning on an abortion-related dilemma was analysed by content analysis. Expressed ethical codes and principles were calculated according to levels. The data were collected over a 5-month period in 2007-2008. FINDINGS: Students' level of care reasoning was varied. Their current level of care reasoning was reflected in their responses to the ethical dilemma. Ethical reasoning at each level and its specific premises constituted a distinct entity. Use of the principle of self-determination was positively related to levels of care development. Care-based moral reasoning constitutes the bedrock for ethical reasoning among these novice students. CONCLUSION: Educators should be sensitive to the variation in students' current developmental levels in care reasoning. Reflective discussion on real-life ethical conflicts should be an explicit part of education and clinical practice in caring professions.

Juujärvi S; Pesso K; Myyry L

2011-02-01

177

Ethische Dilemmata bei der Implementierung des "Coteaching"-Modells: eine Ausleuchtung bis in den letzten Winkel Warts and All: Ethical Dilemmas in Implementing the Coteaching Model Sin maquillaje: dilemas éticos en la implementación del modelo de coenseñanza  

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Full Text Available In diesem Beitrag werden die ethischen Dilemmata untersucht, mit denen Forschende konfrontiert wurden, die sich zwischen ihren eigenen philosophischen Perspektiven und denen ihrer Kollegen und Kollegen aus dem Feld auftaten. Ethische Probleme wurden dabei auf drei verschiedenen Ebenen sichtbar: während der Durchführung des "Coteaching", im Zusammenhang mit unseren Forschungsbemühungen zum Coteaching und im Rahmen der Diskussion unserer Ergebnisse. Statt zu einer spezifischen Schlussfolgerung zu gelangen, thematisiert dieser Artikel die Probleme und ihre jeweilige Komplexität. Unsere Absicht ist es, durch einen solchen Metalog den Dialog unter den Lehrern und Lehrerinnen voran zu treiben, die eine Einbettung des Coteaching in schon vorhandene traditionelle Programme planen. URN: urn:nbn:de:0114-fqs0604181This paper examines the ethical dilemmas that the researchers encountered between their philosophical perspectives and those of their colleagues from the field. We found that ethical issues emerged on three levels: during our enactment of the coteaching model, in our research endeavors on coteaching, and in discussing findings. Rather than reaching specific conclusions, this paper addresses the issues and their complexities. It is our intention that this metalogue will promote dialogue among teacher educators who plan to incorporate coteaching into existing traditional pre-service programs. URN: urn:nbn:de:0114-fqs0604181Este artículo examina los dilemas éticos que los investigadores encontraron en el campo entre sus perspectivas filosóficas y las de sus colegas. Encontramos que las cuestiones éticas emergieron en tres niveles: durante nuestra actuación del modelo de coenseñanza, en nuestras labores de investigación sobre la coenseñanza, y en la discusión de resultados. Más que llegar a conclusiones específicas este artículo aborda los problemas y sus compejidades. Es nuestra intención que este metálogo promueva el diálogo entre los educadores de maestros que planean incorporar la coenseñanza dentro de los programas de pre-servicio tradicionales. URN: urn:nbn:de:0114-fqs0604181

Jennifer Gallo-Fox; Beth Wassell; Kathryn Scantlebury; Matthew Juck

2006-01-01

178

Assisted or Hastened Death: The Healthcare Practitioner’s Dilemma  

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Full Text Available Assisting or hastening death is a dilemma with many ethical as well as practical issues facing healthcare practitioners in many countries worldwide now. Various arguments for and against assisted dying have been made over time but the call from the public for legalisation of euthanasia or assisted suicide has never been stronger. While many studies have documented the reluctance of medical and other health professionals to be involved in the practice of assisted dying or euthanasia, there is still much open debate in the public domain. Those who have the most experience of palliative care are strongest in their opposition to assisted death or euthanasia. This paper explores salient practical and ethical considerations for healthcare practitioners associated with assisted death, with a focus on examining the concepts of autonomy for patients and healthcare practitioners. The role of the healthcare practitioner has clearly and undoubtedly changed over time with advances in healthcare practices but the duty of care has not changed. The dilemmas for healthcare practitioners thus who have competent patients requesting hastened death extends far beyond acting within a country’s laws as they go to the very heart of the relationship between the practitioner and patient.

Rod Duncan MacLeod; Donna M Wilson; Phillipa Malpas

2012-01-01

179

A meaty matter. Pet diet and the vegetarian's dilemma.  

UK PubMed Central (United Kingdom)

The present research examined pet ownership, current pet diet, and guilt associated with pet diet among a fairly large sample of non-meat-eaters (n=515). It specifically focused on the conflict that pits feeding one's pet an animal-based diet that may be perceived as best promoting their well-being with concerns over animal welfare and environmental degradation threatened by such diets, here labeled the vegetarian's dilemma. Questionnaire responses indicated that ethically motivated meat abstainers were more likely to own pets and owned more of them than those motivated by health concerns or a combination of ethical and health concerns. Vegans and those resisting meat on ethical grounds were more likely to feed their pet a vegetarian diet and expressed the greatest concerns over feeding their pet an animal-based diet. For vegans and ethical meat abstainers, it is suggested that questions concerning what to feed their pet approaches a tragic tradeoff contrasting two sacred values: protecting the well-being of their pets and protecting the well-being of other animals and the environment. For meat abstainers motivated by health concerns, this constitutes a relatively easy moral problem because the primary concern for such individuals is the health of their pet with less or no regard for other ramifications of the decision, i.e., harming other animals or the environment.

Rothgerber H

2013-09-01

180

A meaty matter. Pet diet and the vegetarian's dilemma.  

Science.gov (United States)

The present research examined pet ownership, current pet diet, and guilt associated with pet diet among a fairly large sample of non-meat-eaters (n=515). It specifically focused on the conflict that pits feeding one's pet an animal-based diet that may be perceived as best promoting their well-being with concerns over animal welfare and environmental degradation threatened by such diets, here labeled the vegetarian's dilemma. Questionnaire responses indicated that ethically motivated meat abstainers were more likely to own pets and owned more of them than those motivated by health concerns or a combination of ethical and health concerns. Vegans and those resisting meat on ethical grounds were more likely to feed their pet a vegetarian diet and expressed the greatest concerns over feeding their pet an animal-based diet. For vegans and ethical meat abstainers, it is suggested that questions concerning what to feed their pet approaches a tragic tradeoff contrasting two sacred values: protecting the well-being of their pets and protecting the well-being of other animals and the environment. For meat abstainers motivated by health concerns, this constitutes a relatively easy moral problem because the primary concern for such individuals is the health of their pet with less or no regard for other ramifications of the decision, i.e., harming other animals or the environment. PMID:23619313

Rothgerber, Hank

2013-04-22

 
 
 
 
181

The effects of ethical dilemmas regarding the use of physical restraints in eldercare on female nurses who care for their relatives in Japan  

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Full Text Available Purpose: This study sought to clarify the relationship between a nurse’s exposure to elderly relatives and their perspective in using restraints on the elderly in health care situations. Methods: We approached nursing staff supervisors at 17 general hospital wards and explained the objectives of the study. Supervisors at 14 hospitals agreed to participate, giving us a sampling pool of 1929 nurses. We used a chi square test to compare nurses who had spent time with elderly relatives and those who had not on several variables related to using restraints on elderly patients. Results and Conclusion: This study found that nurses who live with elderly family members were significantly more likely to believe that restraints cause diseases (including chronic diseases) based on a chi square test (p < 0.05). Therefore it would be important that essential was the experiences of individuals with elderly family members when making programs of decreasing nurse’s dilemma to restraining the elderly.

Miwa Yamamoto

2012-01-01

182

Dilemas éticos/ Ehtical dilemma  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Resumen Son múltiples los dilemas éticos que enfrentan los profesionales de enfermería en el cumplimiento de su labor y que sugieren una toma de decisión fundamentada en los conocimientos, habilidades y en la experiencia, pero donde la ética y la moral es la que posibilita que esta se soporte en valores, principios y argumentos éticos. Aplicar la Bioética y cumplir con los Derechos Humanos requiere una profunda modificación en toda la cultura sanitaria; ya sea en (more) los propios profesionales, en sus relaciones inter- e intraprofesionales, ya en la organización y gestión de los servicios. No basta con tener normativas, hay que realizar cambios y aportaciones delimitando el quehacer y estableciendo la corresponsabilización que permita la contribución de cada grupo profesional. En este artículo se realiza una reflexión sobre algunos dilemas éticos en el ámbito hospitalario, planteando situaciones dilemáticas que nos sirvan para tomar conciencia sobre la importancia de cuestiones tan relevantes como el respeto a la autonomía del paciente, el consentimiento informado, la justicia distributiva de los recursos sanitarios, entre otros. Abstract in english Abstract There are many ethical dilemmas that nursing professionals have to face in fulfilling their work and that suggest decision making should be based on knowledge, ability, skills and experience, but where ethics and morality are the ones that enable this work to be supported on values, principles and ethical arguments. Applying Bioethics and Human Rights requires a radical change in the whole culture of health; whether professionals themselves, in their personal and (more) intraprofessional relations, and in the organization and management of services. It is not enough to have rules, you have to make changes and contributions delineating the work and establishing joint responsibility, that allows the contribution of each professional group. This article is a reflection on ethical dilemmas taking place in hospitals, raising controversial situations that serve as awareness on the importance of such relevant issues as respect for patient autonomy, informed consent, and distributive justice of health resources, among others.

Villarreal Cantillo, Elizabeth; Visbal Illera, Gloria

2013-01-01

183

A pesquisa e os dilemas éticos do trabalho da Enfermagem/ The research and the ethical dilemmas of Nursing work/ La investigación y los dilemas éticos del trabajo de Enfermería  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Trata o presente artigo de uma reflexão acerca da pesquisa e dos dilemas éticos do trabalho da enfermagem, tendo como principal objetivo fornecer subsídios para ajudar a pensar o cuidar, no cotidiano profissional, no campo do ensino, da pesquisa e, particularmente, da assistência. Recorremos a autores que tratam a respeito da ética, do trabalho e da condição humana, buscando a articulação entre esses conhecimentos e o fazer da Enfermagem, em seu cotidiano. Conclu (more) ímos que diante da realidade da saúde, em meio a tantas adversidades com as quais nos deparamos, no dia-a-dia da prática profissional, seja no ensino, na pesquisa ou na assistência de Enfermagem, o pensar e agir com ética é uma condição estruturante, que enobrece e humaniza a profissão dando sentido às ações de seus profissionais. Abstract in spanish El presente artículo es una reflexión sobre la investigación y los dilemas éticos del trabajo de Enfermería, con el objetivo primordial de ofrecer subsidios para ayudar a pensar la atención, de acuerdo con la práctica profesional en el campo de la educación, la investigación, y en particular la asistencia. Recurrimos a autores que se ocupan de la ética, el trabajo y la condición humana, en la búsqueda de una relación entre este conocimiento y el quehacer de E (more) nfermería en su vida diaria. Se concluye que, dada la realidad de salud, en medio de tantas adversidades con las que nos enfrentamos en la práctica diaria, ya sea en la docencia, la investigación o la atención de enfermería, pensar y actuar de manera ética es una condición estructurante, que humaniza y dignifica la profesión y que da sentido a las acciones de sus profesionales. Abstract in english This paper is a reflection on research and the ethical dilemmas of nursing work, with the primary objective of providing subsidies to help thinking about care, according to professional practice in the field of education, research, and particularly of assistance. We rely on authors who deal about ethics, labor and human condition, finding a link between this knowledge and nursing's doing in its daily practice. We conclude that given the reality of health, amid so many adv (more) ersities with which we are faced in day-to-day practice, whether in teaching, research or nursing care, to think and to act ethically is a structuring condition, which humanizes and ennobles the profession giving meaning to the actions of its professionals.

Germano, Raimunda Medeiros

2013-09-01

184

Dilemmas in fetal medicine: premature application of technology or responding to women's choice?  

UK PubMed Central (United Kingdom)

It is argued that innovative health technologies (IHTs) may be changing the roles of both patients and health practitioners, and raising new issues, including ethical, legal and social dilemmas. This paper focuses on the innovative area of fetal medicine. All fetal treatment necessitates accessing the fetus through the pregnant woman's body, and non-surgical treatments have long been a part of pregnancy care. However, recent developments in this area, including the increasing routinisation of sophisticated antenatal ultrasound screening and the introduction of treatments including fetal surgery, may mark a shift in this specialty. The paper explores such shifts from the perspectives of medical and midwifery practitioners working in two Fetal Medicine Units. It examines the apparent effects of the orientation of fetal medicine on prevalent conceptualisations of the maternal-fetal relationship, and some of the consequences of this. It is argued that new forms of uncertainty, including complex risk and diagnostic information, and uncertain prognostic predictions set within the rhetoric of non-directive counselling and women's choice, are leading to unprecedented ethical dilemmas within this area. More widespread debate about such potential dilemmas needs to take place before, rather than following their introduction.

Williams C

2006-01-01

185

Dilemmas in fetal medicine: premature application of technology or responding to women's choice?  

Science.gov (United States)

It is argued that innovative health technologies (IHTs) may be changing the roles of both patients and health practitioners, and raising new issues, including ethical, legal and social dilemmas. This paper focuses on the innovative area of fetal medicine. All fetal treatment necessitates accessing the fetus through the pregnant woman's body, and non-surgical treatments have long been a part of pregnancy care. However, recent developments in this area, including the increasing routinisation of sophisticated antenatal ultrasound screening and the introduction of treatments including fetal surgery, may mark a shift in this specialty. The paper explores such shifts from the perspectives of medical and midwifery practitioners working in two Fetal Medicine Units. It examines the apparent effects of the orientation of fetal medicine on prevalent conceptualisations of the maternal-fetal relationship, and some of the consequences of this. It is argued that new forms of uncertainty, including complex risk and diagnostic information, and uncertain prognostic predictions set within the rhetoric of non-directive counselling and women's choice, are leading to unprecedented ethical dilemmas within this area. More widespread debate about such potential dilemmas needs to take place before, rather than following their introduction. PMID:16509940

Williams, Clare

2006-01-01

186

Ethical challenges related to elder care. High level decision-makers' experiences  

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Full Text Available Abstract Background Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. Methods A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Results Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Conclusion Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health care professionals concerning ways of dealing with ethical issues and the necessity of structures that facilitate dealing with them. Even if the high level decision-makers have learned to live with the ethical challenges that confronted them, it was obvious that they were not free from feelings of uncertainty, frustration and loneliness. Vulnerability was revealed regarding themselves and others. Their feelings of failure indicated that they felt something was at stake for the older adults in elder care and for themselves as well, in that there was the risk that important needs would go unmet.

Mamhidir Anna-Greta; Kihlgren Mona; Sorlie Venke

2007-01-01

187

Narrative analysis of the ethics in providing advance care planning.  

Science.gov (United States)

Our objective was to better understand the values and ethical dilemmas surrounding advance care planning through stories told by registered nurses and licensed social workers, who were employed as care managers within Area Agencies on Aging. We conducted eight focus groups in which care managers were invited to tell their stories and answer open-ended questions focusing on their interactions with consumers receiving home-based long-term care. Using narrative analysis to understand how our participants thought through particular experiences and what they valued, we identified seven themes representative of their work with consumers and families: humility, respect, responsibilities, boundaries, empowerment, courage, and veracity. PMID:23702895

Baughman, Kristin R; Aultman, Julie M; Ludwick, Ruth; O'Neill, Anne

2013-05-23

188

Global health: the ethical responsibility of the pharmaceutical industry.  

UK PubMed Central (United Kingdom)

Health as a global issue concerns all and clearly manifests global inequality. All stakeholders of the healthcare systems and disease treatment--including the pharmaceutical industry--have an ethical obligation to contribute to promoting global health. At Novo Nordisk we primarily focus on providing our contribution to global health through defeating diabetes. At the same time we stand by being a private company required to deliver a financial profit, which is why we must create positive results on the financial, the environmental and the social bottom lines. In this article we attempt to provide a brief overview of some of the initiatives that we think business companies can take--and therefore are also obliged to in promoting global health. Further, we have pointed out a number of dilemmas within research and development as well as business ethics that all companies face when they convert the ethical principles to daily practice globally.

Lassen LC; Thomsen MK

2007-02-01

189

A dimensão da ética na pesquisa em saúde com ênfase na abordagem qualitativa/ Ethic dimension in health research focusing on the qualitative approach  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Este artigo trata da dimensão ética na pesquisa em saúde, relacionando-a mais especificamente à abordagem qualitativa, a partir das contribuições das ciências sociais e em particular da etnografia, que pressupõe a construção de uma relação de confiança e respeito entre pesquisador e pesquisado que se configura paulatinamente. Os aspectos éticos permeiam a pesquisa qualitativa desde a escolha do objeto de estudo, as delimitações metodológicas, as análises (more) dos resultados até o compromisso de uma devolutiva das informações obtidas; pressupondo a valorização de uma relação interpessoal em que os diferentes interesses, valores e visões de mundo colocam-se como possibilidade ou não de uma construção conjunta do conhecimento. A escolha de um tema ou objeto de estudo está relacionada a uma trajetória de vida singular, em que a todo o momento o pesquisador deve se perguntar como compatibilizar a constituição da postura ética em relação aos pesquisados com seus desejos, sonhos, curiosidades e expectativas. O artigo tem o intuito de refletir sobre esses impasses vivenciados pelo pesquisador, ressaltando a importância da ética para o seu desenvolvimento pessoal, profissional e sociopolítico, valorizando o desejo pela autonomia do conhecimento, a solidariedade com os grupos sociais e com as pessoas envolvidas na pesquisa. A partir do relato de um processo de pesquisa, pretende-se contribuir para a compreensão de como os aspectos éticos são indissociáveis da pesquisa e do próprio pesquisador, trazendo elementos para a realização de pesquisas qualitativas especialmente no campo da saúde coletiva. Abstract in english This article addresses the ethical dimension in health research, relating it more specifically to the qualitative approach, based on contributions of the social sciences and ethnography in particular, as it presupposes building a relationship of trust and respect between researchers and researched subjects that is gradually configured. The ethical aspects permeate qualitative research from the choice of the subject matter, the methodological outlines, analysis of the resu (more) lts, to the commitment of providing a feedback for the researched subjects regarding the obtained information. The ethical aspects presuppose the value of an interpersonal relationship in which the different interests, values and worldviews stand as a possibility or not of a joint construction of knowledge. The choice of a subject or object of study is related to a particular life trajectory in which the researcher should ask himself, at all times, how to conciliate the constitution of an ethical attitude in relation to the researched subjects with his own desires, dreams, curiosities and expectations. The article aims to discuss such dilemmas experienced by the researcher, highlighting the importance of ethics for his personal, professional and socio-political growth, and emphasizing the desire for knowledge autonomy, solidarity with social groups and with people involved in the research. Based on the report of a research process, the article intends to contribute to the understanding of how ethical aspects are inextricably linked to research, and also to the researcher, bringing elements to the conduction of qualitative research especially in public health.

Silva, Carlos Roberto de Castro e; Mendes, Rosilda; Nakamura, Eunice

2012-03-01

190

Authorship versus "credit" for participation in research: a case study of potential ethical dilemmas created by technical tools used by researchers and claims for authorship by their creators.  

UK PubMed Central (United Kingdom)

The distinction between authorship and other forms of credit for contribution to a publication has been a persisting controversy that has resulted in numerous guidelines outlining the expected contributions of those claiming authorship. While there have been flagrant, well-publicized deviations from widely accepted standards, they are largely outnumbered by cases that are not publicity-worthy, and therefore remain known to only those directly involved with the inappropriate conduct. We discuss the definition and ethical requirements of authorship, offer a case example of the authorship debate created by a technical tool at our institution, and review parallels that support and dispute the authorship claims of our software developers. Ultimately, we conclude that development of a technical tool that enables data collection does not adequately substitute for contributions to study design and manuscript preparation for authorship purposes. Unless the designers of such a technical tool prospectively participate as a part of the project, they would not have an adequate understanding of the publication's genesis to defend it publicly and cannot be listed as authors. Therefore, it is incumbent upon project members to invite tool developers to participate at the beginning of such projects, and for tool developers to contribute to study design and manuscript preparation when they desire authorship listings.

Welker JA; McCue JD

2007-01-01

191

Present state of reproductive medicine in Japan – ethical issues with a focus on those seen in court cases  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Against a background of on the one hand, a declining demography and a conservative family register system that emphasizes the importance of the blood line, and on the other hand, an increase in the number of people undergoing fertility treatment, the absence of a legal regulatory framework concerning ART matters is likely to result in an increasing number of contradictory situations. It is against this background that the paper sets out to examine the judgements of court cases related to ART, with a particular focus on the legal determination of parental status, and to link these to aspects of the legal and socio-ethical environment within which the courts make their judgements. Methods The methods used were thorough investigation of all the court cases concerning ART in the public domain in Japan, including the arguments of the concerned parties and the judgements so far delivered. With the court cases as a central focal point, trends in Japan, including deliberations by government and academic societies, are reviewed, and the findings of surveys on the degree of understanding and attitudes among the people toward ART are summarized. Results In terms of the judgements to date, the central criteria used by the courts in determining parental status were the act of parturition and the consent of the husband of the concerned couple. The government and academic societies have displayed a cautious attitude toward ART, but the findings of attitude surveys among the people at large show a generally positive attitude toward ART. Attitudes toward the overwhelming importance hitherto attached to the bloodline are also seen to be changing. Conclusion The main conclusion is that in the absence of a legal regulatory framework for ART, there is likely to be an increase in the contradictions between the use of outdated legal precedents and the technical development of ART. Since much of the specialist discussion necessary for the formulation of a legal framework has already been carried out, the speedy enactment of comprehensive and at the same time flexible legislation would be highly desirable, but further wide-ranging discussion involving the general public is likely to be needed first.

Mayeda Mayumi

2006-01-01

192

Present state of reproductive medicine in Japan - ethical issues with a focus on those seen in court cases.  

UK PubMed Central (United Kingdom)

BACKGROUND: Against a background of on the one hand, a declining demography and a conservative family register system that emphasizes the importance of the blood line, and on the other hand, an increase in the number of people undergoing fertility treatment, the absence of a legal regulatory framework concerning ART matters is likely to result in an increasing number of contradictory situations. It is against this background that the paper sets out to examine the judgements of court cases related to ART, with a particular focus on the legal determination of parental status, and to link these to aspects of the legal and socio-ethical environment within which the courts make their judgements. METHODS: The methods used were thorough investigation of all the court cases concerning ART in the public domain in Japan, including the arguments of the concerned parties and the judgements so far delivered. With the court cases as a central focal point, trends in Japan, including deliberations by government and academic societies, are reviewed, and the findings of surveys on the degree of understanding and attitudes among the people toward ART are summarized. RESULTS: In terms of the judgements to date, the central criteria used by the courts in determining parental status were the act of parturition and the consent of the husband of the concerned couple. The government and academic societies have displayed a cautious attitude toward ART, but the findings of attitude surveys among the people at large show a generally positive attitude toward ART. Attitudes toward the overwhelming importance hitherto attached to the bloodline are also seen to be changing. CONCLUSION: The main conclusion is that in the absence of a legal regulatory framework for ART, there is likely to be an increase in the contradictions between the use of outdated legal precedents and the technical development of ART. Since much of the specialist discussion necessary for the formulation of a legal framework has already been carried out, the speedy enactment of comprehensive and at the same time flexible legislation would be highly desirable, but further wide-ranging discussion involving the general public is likely to be needed first.

Mayeda M

2006-01-01

193

Ethics and Nanotechnology  

Science.gov (United States)

This page from the Understanding Nano website introduces concepts of nanotechnology-related ethics. In addition to the reading materials, the page provides a list of websites and organizations that focus on ethics and nanotechnology.

2013-07-01

194

Reanimación cardiopulmonar en el paciente oncológico terminal: Dilemas éticos y bioéticos en Enfermería/ Cardiopulmonary resuscitation in terminal oncologic patient: Ethical and bioethical dilemmas in Nursing  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish La vida empieza a tener sentido cuando ayudas a otro, a ponerse de pie y a andar sabiendo que su camino llega al final. Con tal propósito se realizó un estudio descriptivo longitudinal en el contexto hospitalario del Hospital Universitario Dr. Celestino Hernández Robau de la provincia de Villa Clara en el período de octubre de 2005 a abril de 2006. Con el objetivo de determinar el nivel de conocimiento teórico práctico del personal de enfermería en el manejo de la (more) Reanimación Cardiopulmonar (RCP) en el paciente oncológico terminal en urgencias. Se tomó una muestra de 115 enfermeros, que constituyó el 65 % de los que laboran en las diferentes salas del centro hospitalario a partir de un muestreo probabilístico intencional, se incluyeron enfermeros licenciados así como técnicos que laboran en estos servicios, se excluyeron enfermeros en maestrías, licencias y certificados prolongados. Las variables estudiadas fueron nivel de actualización en RCP oncológica, conducta en la reanimación, valores en enfermería, criterio de eutanasia, manejo psicológico del paciente oncológico, principios éticos en enfermería. Se aplicaron encuestas, entrevistas a profundidad, formulario, criterio de expertos y revisión actualizada del tema. Se confeccionaron tablas y gráficos estadísticos con los resultados de los diferentes procederes en las etapas incluidas en el estudio. Se determinó que existe una relación psicoafectiva positiva paciente-enfermero, así como criterio adecuado de enfermería con respecto a la muerte digna y actualización científica sobre el manejo de la reanimación cardiopulmonar oncológica terminal Abstract in english Life starts to have sense when you help somebody else to stand up and to walk, knowing that they are going to die. A longitudinal and descriptive study was undertaken in the hospital context of "Dr. Celestino Hernández Robau" Hospital of Villa Clara Province from October 2005 to April 2006 to determine the level of theoretical and practical knowledge of the Nursing staff in the management of Cardiopulmonary Resuscitation (PCR) in terminal oncologic patients in the emerge (more) ncy service. A sample of 115 nurses (65%) was taken from those working in different wards of the hospital, starting from an intentional probabilistic sampling. Nursing licentiates, as well as technicians working in these services were included. Nurses who were taking Master's degree courses, and those with leaves of absence and prolonged medical certificates were excluded. The studied variables were: updating level in oncologic CPR, resuscitation behaviour, Nursing values, euthanasia criterion, psychological management of the oncologic patient and Nursing ethical principles. Surveys, in-depth interviews, questionnaires, expert's criteria and updated reviews of the topic were used. Statistical tables and graphics with the results of the different procedures in the stages included in the study were made. It was concluded that there was a positive psychoaffective patient-nurse relation, as well as a Nursing proper criterion regarding a dignified death, and an adequate scientific updating on the management of terminal oncologic cardiopulmonary resuscitation

Sardiñas Llerenas, Evaldo; Alvarez Pérez, Vivian M; Núñez Machado, Armando

2007-12-01

195

Reanimación cardiopulmonar en el paciente oncológico terminal: Dilemas éticos y bioéticos en Enfermería Cardiopulmonary resuscitation in terminal oncologic patient: Ethical and bioethical dilemmas in Nursing  

Directory of Open Access Journals (Sweden)

Full Text Available La vida empieza a tener sentido cuando ayudas a otro, a ponerse de pie y a andar sabiendo que su camino llega al final. Con tal propósito se realizó un estudio descriptivo longitudinal en el contexto hospitalario del Hospital Universitario Dr. Celestino Hernández Robau de la provincia de Villa Clara en el período de octubre de 2005 a abril de 2006. Con el objetivo de determinar el nivel de conocimiento teórico práctico del personal de enfermería en el manejo de la Reanimación Cardiopulmonar (RCP) en el paciente oncológico terminal en urgencias. Se tomó una muestra de 115 enfermeros, que constituyó el 65 % de los que laboran en las diferentes salas del centro hospitalario a partir de un muestreo probabilístico intencional, se incluyeron enfermeros licenciados así como técnicos que laboran en estos servicios, se excluyeron enfermeros en maestrías, licencias y certificados prolongados. Las variables estudiadas fueron nivel de actualización en RCP oncológica, conducta en la reanimación, valores en enfermería, criterio de eutanasia, manejo psicológico del paciente oncológico, principios éticos en enfermería. Se aplicaron encuestas, entrevistas a profundidad, formulario, criterio de expertos y revisión actualizada del tema. Se confeccionaron tablas y gráficos estadísticos con los resultados de los diferentes procederes en las etapas incluidas en el estudio. Se determinó que existe una relación psicoafectiva positiva paciente-enfermero, así como criterio adecuado de enfermería con respecto a la muerte digna y actualización científica sobre el manejo de la reanimación cardiopulmonar oncológica terminalLife starts to have sense when you help somebody else to stand up and to walk, knowing that they are going to die. A longitudinal and descriptive study was undertaken in the hospital context of "Dr. Celestino Hernández Robau" Hospital of Villa Clara Province from October 2005 to April 2006 to determine the level of theoretical and practical knowledge of the Nursing staff in the management of Cardiopulmonary Resuscitation (PCR) in terminal oncologic patients in the emergency service. A sample of 115 nurses (65%) was taken from those working in different wards of the hospital, starting from an intentional probabilistic sampling. Nursing licentiates, as well as technicians working in these services were included. Nurses who were taking Master's degree courses, and those with leaves of absence and prolonged medical certificates were excluded. The studied variables were: updating level in oncologic CPR, resuscitation behaviour, Nursing values, euthanasia criterion, psychological management of the oncologic patient and Nursing ethical principles. Surveys, in-depth interviews, questionnaires, expert's criteria and updated reviews of the topic were used. Statistical tables and graphics with the results of the different procedures in the stages included in the study were made. It was concluded that there was a positive psychoaffective patient-nurse relation, as well as a Nursing proper criterion regarding a dignified death, and an adequate scientific updating on the management of terminal oncologic cardiopulmonary resuscitation

Evaldo Sardiñas Llerenas; Vivian M Alvarez Pérez; Armando Núñez Machado

2007-01-01

196

Ethical difficulties in nursing, educational needs and attitudes about using ethics resources.  

UK PubMed Central (United Kingdom)

Ethical difficulties arise in healthcare practices. However, despite extensive research findings that demonstrate that most nurses are involved in recurrent ethical problems, institutions are not always able to effectively support nursing care professionals. The limited availability of ethics consultation services and traditional nursing training fails to meet the frequent and strong requests by health workers to support their ethical dilemmas. A questionnaire was administered to 374 nurses attending a specialist training and a lifetime learning programme in Italy. The respondents reported a high frequency of ethically sensitive situations, and they described the poor development of ethics support and a scarcity of ethics training programmes. The results suggest the importance of promoting ethics services that include consultation and ethics training. A need for systematic ethics educational activities was identified for improving the capacity of nurses to manage ethical issues in patient care.

Leuter C; Petrucci C; Mattei A; Tabassi G; Lancia L

2013-05-01

197

Ethical difficulties in nursing, educational needs and attitudes about using ethics resources.  

Science.gov (United States)

Ethical difficulties arise in healthcare practices. However, despite extensive research findings that demonstrate that most nurses are involved in recurrent ethical problems, institutions are not always able to effectively support nursing care professionals. The limited availability of ethics consultation services and traditional nursing training fails to meet the frequent and strong requests by health workers to support their ethical dilemmas. A questionnaire was administered to 374 nurses attending a specialist training and a lifetime learning programme in Italy. The respondents reported a high frequency of ethically sensitive situations, and they described the poor development of ethics support and a scarcity of ethics training programmes. The results suggest the importance of promoting ethics services that include consultation and ethics training. A need for systematic ethics educational activities was identified for improving the capacity of nurses to manage ethical issues in patient care. PMID:23186939

Leuter, Cinzia; Petrucci, Cristina; Mattei, Antonella; Tabassi, Gianpietro; Lancia, Loreto

2012-11-27

198

Dilemmas Faced by Nurses Regarding the Physical Restraint of Elderly Patients with Dementia in Japan  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This study aimed to clarify the dilemma of nurses working in general wards who face the ethical dilemma of restraining older people with dementia in Midwestern Japan. The study used the questionnaire method with an independently prepared questionnaire. The questionnaire was designed to ensure privac...

Miwa Yamamoto

199

Health Ethics Education for Health Administration Chaplains  

Science.gov (United States)

It is imperative for divinity and health administration programs to improve their level of ethics education for their graduates who work as health administration chaplains. With an initial presentation of the variation of ethical dilemmas presented in health care facilities covering social, organizational, and patient levels, we indicate the need…

Porter, Russell; Broussard, Amelia; Duckett, Todd

2008-01-01

200

An analytic approach to resolving problems in medical ethics.  

UK PubMed Central (United Kingdom)

Education in ethics among practising professionals should provide a systematic procedure for resolving moral problems. A method for such decision-making is outlined using the two classical orientations in moral philosophy, teleology and deontology. Teleological views such as utilitarianism resolve moral dilemmas by calculating the excess of good over harm expected to be produced by each feasible alternative for action. The deontological view focuses on rights, duties, and principles of justice. Both methods are used to resolve the 1971 Johns Hopkins case of a baby born with Down's syndrome and duodenal atresia.

Candee D; Puka B

1984-06-01

 
 
 
 
201

Ethics in the bank internet encounter : an explorative study  

DEFF Research Database (Denmark)

Purpose – The purpose of this paper is to discuss some ethical issues in the internet encounter between customer and bank. Empirical data related to the difficulties that customers have when they deal with the bank through internet technology and electronic banking. The authors discuss the difficulties that customers expressed from an ethical standpoint. Design/methodology/approach – The key problem of the paper is “how does research handle the user's lack of competence in a web-based commercial environment?” The authors illustrate this ethical dilemma with data from a Danish Bank collected in 2002. The data have been structured by an advanced text analytic method, Pertex (by generation of intentionality of verbal actors from text). Findings – The authors can conclude that the experience of lack of competency in internet banking implies a severe damage on the experience of the ethics of the good life and of the respect for the basic ethical principles of customer autonomy, dignity, integrity and vulnerability. However, increased experience of competency may imply experience of increased feeling of ethical superiority and of the good life among customers. Research limitations/implications – The important implication for managerial research of this study would be for banks to focus on customer competency with an ethical concern instead of only being concerned with technical solutions for effective internet operations. Practical implications – Since more and more businesses are digitally based, the authors can foresee a potential generic problem of lack of competence for certain age groups and also of people from different social groups. Originality/value – The paper provides an analysis of the ethics of on-line banking on the basis of Pertex methodology and with the use of basic ethical principles of autonomy, dignity, integrity and vulnerability.

Rendtorff, Jacob Dahl; Mattsson, Jan

2012-01-01

202

Ethical issues and challenges in pressure ulcer research - the research nurses' perspective.  

UK PubMed Central (United Kingdom)

AIM OF STUDY: This paper explores the issues faced by research nurses in pressure ulcer research through reflection on our own practice and subsequently addresses these issues through critical appraisal of the existing literature. METHODS: A critical reflection framework which provided an opportunity for group reflection and reflexivity was adopted to guide our reflection. Focus questions were formulated based on our reflections and used to inform our literature review. Keywords used in the literature review search included 'research nurse', ethical principles, ethical issues and reflection. A formal tool was used to appraise normative ethics articles. RESULTS: Reflection on our practice in pressure ulcer research identified four main issues: informed consent, confidentiality, methodological uncertainties and more generally the ethical dilemma of the conflict between our accountability and responsibility to the patients and obligations to the research studies. The notion of 'power relations' was found to permeate our practice as research nurses at all level. Six normative ethics papers were retrieved and critically appraised to aid our personal and professional learning and development in the conduct of ethical practice as research nurses in pressure ulcer research through the theory of practice which other research nurses and/or nurse researchers used in other disciplines. CONCLUSIONS: Four main ethical challenges and the issue of power relation were highlighted. Our reflection and the appraisal of the literature provided us the necessary knowledge and skills to better navigate these ethical challenges in the future.

Choo J; Blundell S; McGinnis E

2012-11-01

203

Synthetic biology ethics: a deontological assessment.  

UK PubMed Central (United Kingdom)

In this article I discuss the ethics of synthetic biology from a broadly deontological perspective, evaluating its morality in terms of the integrity of nature, the dignity of life and the relationship between God and his creation. Most ethical analyses to date have been largely consequentialist in nature; they reveal a dual use dilemma, showing that synbio has potential for great good and great evil, possibly more so than any step humanity has taken before. A deontological analysis may help to resolve this dilemma, by evaluating whether synbio is right or wrong in itself. I also assess whether deontology alone is a sufficient methodological paradigm for the proper evaluation of synbio ethics.

Heavey P

2013-10-01

204

IS ETHICAL HACKING ETHICAL?  

Directory of Open Access Journals (Sweden)

Full Text Available This paper explores the ethics behind ethical hacking and whether there are problems that lie with this new field of work. Since ethical hacking has been a controversial subject over the past few years, the question remains of the true intentions of ethical hackers. The paper also looks at ways in which future research could be looked intoto help keep ethical hacking, ethical.

DANISH JAMIL,; MUHAMMAD NUMAN ALI KHAN

2011-01-01

205

Ethical and Moral Decision Making: Praxis and Hermeneutics for School Leaders  

Science.gov (United States)

There has been a renewed interest in the inclusion of ethics as part of educators' training and interest in understanding the moral and ethical dimensions of educational practice. This research was designed to study the types of dilemmas school level leaders face, the characteristics of typical dilemmas, and the implications for leader…

Minnis, Joan Quinn

2011-01-01

206

An Ethics Primer: A Few Short Ethics Cases  

Science.gov (United States)

This resource is a PDF that provides teachers with several short ethics case studies: Two Tales of Rice (genetically modified food), Talk About Short (growth hormone for short stature -- fictionalized), and One Family's Dilemma (a family considers what to do about excess IVF embryos).

2008-01-01

207

A Student's Perspective on Medical Ethics Education.  

UK PubMed Central (United Kingdom)

Despite many efforts to increase ethics education in US medical schools, barriers continue to arise that impede the production of morally driven physicians who practice medicine with ideal empathy. Research has shown that, particularly during the clinical years, medical students lose the ability both to recognize ethical dilemmas and to approach such situations with compassionate reasoning. This article summarizes the current status of ethics education in US medical schools, described through the eyes of and alongside the story of a graduating medical student.

Terndrup C

2013-12-01

208

A Student's Perspective on Medical Ethics Education.  

UK PubMed Central (United Kingdom)

Despite many efforts to increase ethics education in US medical schools, barriers continue to arise that impede the production of morally driven physicians who practice medicine with ideal empathy. Research has shown that, particularly during the clinical years, medical students lose the ability both to recognize ethical dilemmas and to approach such situations with compassionate reasoning. This article summarizes the current status of ethics education in US medical schools, described through the eyes of and alongside the story of a graduating medical student.

Terndrup C

2013-06-01

209

Publication aspects of ethics in photogrammetry  

Science.gov (United States)

According to the Code of Ethics of the American Society for Photogrammetry and Remote Sensing (ASPRS), the principles on which ethics are founded consist of honesty, justice, and courtesy, forming a moral philosophy associated with mutual interest among men. We will cover in particular the ethical problems of publication of photogrammetric material in the various media. There are many such problems, and we often face a dilemma in selecting a course which is the right thing to do.

Thompson, Morris, M.

1991-01-01

210

An ethics framework for organizational change.  

UK PubMed Central (United Kingdom)

The proliferation of managed care has introduced conflicts of interest in health care that can create tension in the traditional care provider-patient relationship. In order to address the emerging trends and potential ethical dilemmas presented by managed care, health systems must develop a framework for intentional ethical reflection. The article outlines the essential elements of a caring ethical framework and describes how one integrated health system created a framework of ethical guiding principles and an ethical organizational structure to facilitate integration of those principles throughout the organization.

Koloroutis M; Thorstenson T

1999-01-01

211

Ethics of responsibility in a multicultural context.  

UK PubMed Central (United Kingdom)

Caring for patients from different cultural or religious backgrounds may create difficult ethical dilemmas for physicians. The article reviews four case histories, involving patients from the Navajo culture or the Christian Science Church, that highlight some of these ethical problems. It then discusses an "ethics of responsibility," which is based on and encompasses a variety of meanings of responsibility, including responsibility as recognition, as taking charge, as the ability to assess the consequences of one's actions, and as making a commitment. An ethics of responsibility provides a novel perspective for resolving ethical problems in medicine.

Turoldo F

2010-01-01

212

The impact of nursing education on ethical/moral decision making.  

UK PubMed Central (United Kingdom)

A study of 227 baccalaureate and 111 master's nursing students was conducted to determine the influence of the level of formal education on three selected factors: ethical/moral reasoning, attribution of responsibility, and ethical/moral dilemma resolution. Moral development theory and Heider's attribution of responsibility construct provided the theoretical framework. A comparison of the overall index of ethical/moral reasoning showed that graduate students reasoned at a higher level than undergraduate students. The amount of attribution of responsibility assigned and the dilemma resolution score did not differ for the two groups. The results of this study suggest that undergraduate and graduate nursing programs must place more emphasis on identifying dilemmas, increasing ethical/moral reasoning levels and attributing responsibility in a justifiable manner. Nurse researchers must continue to study how nurses respond in dilemma situations and how personal characteristics, factors in the environment, education, and the assignment of responsibility affect nurses' ability to resolve ethical/moral dilemmas.

Felton GM; Parsons MA

1987-01-01

213

The impact of nursing education on ethical/moral decision making.  

Science.gov (United States)

A study of 227 baccalaureate and 111 master's nursing students was conducted to determine the influence of the level of formal education on three selected factors: ethical/moral reasoning, attribution of responsibility, and ethical/moral dilemma resolution. Moral development theory and Heider's attribution of responsibility construct provided the theoretical framework. A comparison of the overall index of ethical/moral reasoning showed that graduate students reasoned at a higher level than undergraduate students. The amount of attribution of responsibility assigned and the dilemma resolution score did not differ for the two groups. The results of this study suggest that undergraduate and graduate nursing programs must place more emphasis on identifying dilemmas, increasing ethical/moral reasoning levels and attributing responsibility in a justifiable manner. Nurse researchers must continue to study how nurses respond in dilemma situations and how personal characteristics, factors in the environment, education, and the assignment of responsibility affect nurses' ability to resolve ethical/moral dilemmas. PMID:3029353

Felton, G M; Parsons, M A

1987-01-01

214

Psychiatric research: what ethical concerns do LRECs encounter? A postal survey. Local research ethics committees.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Psychiatric research can occasionally present particular ethical dilemmas, but it is not clear what kind of problems local research ethics committees (LRECs) actually experience in this field. We aimed to assess the type of problems that committees encounter with psychiatric research, using a postal...

Osborn, DP; Fulford, KW

215

Multilateral dilemmas  

Energy Technology Data Exchange (ETDEWEB)

This article focuses on the uncertainties involved with multilateral methods of producing a reservoir. The use of decision and risk analysis (DRA) to account for the risks and uncertainties identification of the optimum well type for a given application DRA in action, and the increasing number of operators wanting DRA studies are discussed. (UK)

Murphy, Steve

1998-06-01

216

Vulnerable participants in health research : methodological and ethical challenges  

DEFF Research Database (Denmark)

Ethical guidelines for conducting research are embedded in the Helsinki Declaration of 1964. We contend that these abstract and intentionally universal guidelines need to be appropriated for social and health care research, in which purpose and methods often deviate from medical research. The guidelines appear to be instrumental and over simplistic representations of the often “messy” realities surrounding the research process that is often guided by relational and local negotiations of ethical solutions. Vulnerable participants, for instance, challenge both professional and research ethics, leaving both professionals and researchers in ethical and moral dilemmas. In this article, we specifically focus on the methodological challenges of obtaining informed consent from drug users and terminally ill cancer patients in our PhD research. The question is how you can illuminate the needs and problems of vulnerable patients and - at the same time - respect their integrity without exposing them unnecessarily. The article illuminates the interactional construction of roles and relationships and how they affect the contextual construction of vulnerability. In this respect, we demonstrate that both patients and researchers are at risk of being vulnerable. In conclusion, we outline and advocate for a more contextualized approach and empirically-informed ethics to informed consent in research with potentially vulnerable participants.

Nordentoft, Helle Merete; Nanna, Kappel

2011-01-01

217

Cross-cultural considerations in clinical ethics consultations.  

UK PubMed Central (United Kingdom)

Cross-cultural encounters between patients and physicians are now commonplace. Although increasing attention has been given to cultural issues in clinical medicine, there has been little discussion of cultural differences presenting as ethical dilemmas. We report four cases in which such differences led to requests for ethics consultations. In analyzing these cases, we identify four elements that are essential for successful resolution of such dilemmas: (1) an ability to communicate effectively with patients and their families; (2) a sufficient understanding of the patient's cultural background; (3) identification of culturally relevant value conflicts; and (4) a willingness to pursue discussion of the ethical dilemma until a compromise is reached or an otherwise satisfactory resolution of the problem is achieved. We conclude with several practical guidelines for clinicians facing ethical dilemmas in cross-cultural interactions with patients.

Orr RD; Marshall PA; Osborn J

1995-02-01

218

The ABC of head and neck oncology publishing ethics.  

Science.gov (United States)

As medical editors, we are faced with a host of ethical dilemmas on a daily basis. Most are recognised and dealt with expediently, but the few that remain must be challenged as a cohesive body of editorial opinion. PMID:23104524

Upile, T; Jerjes, W; Sandison, A; Sudhoff, H; Wong, B J; Hopper, C

2012-09-09

219

Nuclear weapons and medicine: some ethical dilemmas.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured...

Haines, A; de B White, C; Gleisner, J

220

Procedure versus process: ethical paradigms and the conduct of qualitative research  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Research is fundamental to improving the quality of health care. The need for regulation of research is clear. However, the bureaucratic complexity of research governance has raised concerns that the regulatory mechanisms intended to protect participants now threaten to undermine or stifle the research enterprise, especially as this relates to sensitive topics and hard to reach groups. Discussion Much criticism of research governance has focused on long delays in obtaining ethical approvals, restrictions imposed on study conduct, and the inappropriateness of evaluating qualitative studies within the methodological and risk assessment frameworks applied to biomedical and clinical research. Less attention has been given to the different epistemologies underlying biomedical and qualitative investigation. The bioethical framework underpinning current regulatory structures is fundamentally at odds with the practice of emergent, negotiated micro-ethics required in qualitative research. The complex and shifting nature of real world settings delivers unanticipated ethical issues and (occasionally) genuine dilemmas which go beyond easy or formulaic ‘procedural’ resolution. This is not to say that qualitative studies are ‘unethical’ but that their ethical nature can only be safeguarded through the practice of ‘micro-ethics’ based on the judgement and integrity of researchers in the field. Summary This paper considers the implications of contrasting ethical paradigms for the conduct of qualitative research and the value of ‘empirical ethics’ as a means of liberating qualitative (and other) research from an outmoded and unduly restrictive research governance framework based on abstract prinicipalism, divorced from real world contexts and values.

Pollock Kristian

2012-01-01

 
 
 
 
221

Time and the Prisoner's Dilemma  

CERN Multimedia

This paper examines the integration of computational complexity into game theoretic models. The example focused on is the Prisoner's Dilemma, repeated for a finite length of time. We show that a minimal bound on the players' computational ability is sufficient to enable cooperative behavior. In addition, a variant of the repeated Prisoner's Dilemma game is suggested, in which players have the choice of opting out. This modification enriches the game and suggests dominance of cooperative strategies. Competitive analysis is suggested as a tool for investigating sub-optimal (but computationally tractable) strategies and game theoretic models in general. Using competitive analysis, it is shown that for bounded players, a sub-optimal strategy might be the optimal choice, given resource limitations.

Mor, Y; Mor, Yishay; Rosenschein, Jeffrey S.

2007-01-01

222

Ethical clinical practice and sport psychology: when two worlds collide.  

UK PubMed Central (United Kingdom)

From their own practices, the authors offer insight into potential ethical dilemmas that may frequently develop in an applied psychology setting in which sport psychology is also being practiced. Specific ethical situations offered for the reader's consideration include confidentiality with coaches, administration, parents, and athlete-clients; accountability in ethical billing practices and accurate diagnosing; identification of ethical boundaries in nontraditional practice settings (locker room, field, rink, etc.); and establishment of professional competence as it relates to professional practice and marketing.

Brown JL; Cogan KD

2006-01-01

223

Ethical clinical practice and sport psychology: when two worlds collide.  

Science.gov (United States)

From their own practices, the authors offer insight into potential ethical dilemmas that may frequently develop in an applied psychology setting in which sport psychology is also being practiced. Specific ethical situations offered for the reader's consideration include confidentiality with coaches, administration, parents, and athlete-clients; accountability in ethical billing practices and accurate diagnosing; identification of ethical boundaries in nontraditional practice settings (locker room, field, rink, etc.); and establishment of professional competence as it relates to professional practice and marketing. PMID:17036422

Brown, Jeffrey L; Cogan, Karen D

2006-01-01

224

Ethics in international health research: a perspective from the developing world  

Directory of Open Access Journals (Sweden)

Full Text Available Health research plays a pivotal role in addressing inequities in health and human development, but to achieve these objectives the research must be based on sound scientific and ethical principles. Although it is accepted that ethics play a central role in health research in developing countries, much of the recent debate has focused on controversies surrounding internationally sponsored research and has taken place largely without adequate participation of the developing countries. The relationship between ethical guidelines and regulations, and indigenously sponsored and public health research has not been adequately explored. For example, while the fundamental principles of ethical health research, such as community participation, informed consent, and shared benefits and burdens, remain sacrosanct other issues, such as standards of care and prior agreements, merit greater public debate within developing countries. In particular, the relationship of existing ethical guidelines to epidemiological and public health research merits further exploration. In order to support health research in developing countries that is both relevant and meaningful, the focus must be on developing health research that promotes equity and on developing local capacity in bioethics. Only through such proactive measures can we address the emerging ethical dilemmas and challenges that globalization and the genomics revolution will bring in their wake.

Bhutta Zulfiqar Ahmed

2002-01-01

225

Ethical dilemmas in blood transfusion in Jehovah's Witnesses: a legal-bioethical analysis Dilemas éticos en la transfusión sanguínea de Testigos de Jeová: un análisis jurídico-bioético Dilemas éticos na hemotransfusão em Testemunhas de Jeová: uma análise jurídico-bioética  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: To identify knowledge production by healthcare professionals about blood transfusion in Jehovah's Witnesses (JW), listing the therapeutic alternatives for blood transfusion in these individuals and citing the legal, ethical and bioethical standards regarding blood transfusion in JWs. METHODS: Data were collected in the LILACS and SciELO databases, Nursing journals and on http://www.google.com.br. Articles focusing on blood transfusion in JWs were included, and texts that were repeated or did not approach this theme were excluded. Content analysis was used. RESULTS: The thematic categories show that the JWs accept self-transfusion and are opposed to the medical practice of blood transfusion, even if it represents the continuity of life. CONCLUSION: Healthcare professionals experience ethical dilemmas when they need to perform blood transfusion in JWs due to the fact that religious freedom is not an absolute value, and the apparent collision of fundamental rights demands that a decision be made, centered on legal standards and bioethical principles.OBJETIVO: Identificar la producción de conocimiento por los profesionales de salud respecto a la transfusión sanguínea de Testigos de Jeova (TJ), listar las alternativas terapéuticas de la transfusión sanguínea en esos individuos y citar la ordenanza jurídica, ética y bioética en lo que concierne a la transfusión sanguínea en TJ. MÉTODOS: Se recolectaron datos en las bases de datos LILACS y SciELO, periódicos de Enfermería y en el http://www.google.com.br. Se incluyeron artículos enfocando la transfusión sanguínea en TJ, y se excluyeron a los que no abordaban esa temática o estaban repetidos. Se utilizó el análisis de contenido. RESULTADOS: Las categorías temáticas señalan que los TJ acatan la auto-transfusión y se contraponen a la práctica médica de la transfusión sanguínea, aunque ella represente la continuidad de la vida. CONCLUSIÓN: Los profesionales de salud vivencian dilemas éticos cuando precisan realizar transfusiones sanguíneas en TJ debido a que la libertad religiosa no es un valor absoluto y la aparente colisión de derechos fundamentales les exige una toma de decisión centrada en la ordenanza jurídica y en los principios bioéticos.OBJETIVO: Identificar a produção de conhecimento pelos profissionais de saúde acerca da hemotransfusão em Testemunhas de Jeová (TJ), listar as alternativas terapêuticas para a hemotransfusão nesses indivíduos e citar o ordenamento jurídico, ético e bioético no concernente a hemotransfusão em TJ. MÉTODOS: Coletaram-se dados nas bases de dados LILACS e SciELO, periódicos de Enfermagem e no http://www.google.com.br. Incluiram-se artigos enfocando hemotransfusão em TJ, e excluíram-se os que não abordassem essa temática ou estivessem repetidos. Utilizou-se a análise de conteúdo. RESULTADOS: As categorias temáticas sinalizam que as TJ acatam a auto-transfusão e se contrapõem à prática médica da hemotransfusão, mesmo que ela represente a continuidade da vida. CONCLUSÃO: Os profissionais de saúde vivenciam dilemas éticos quando precisam administrar hemotransfusão em TJ devido a liberdade religiosa não ser um valor absoluto e a aparente colisão de direitos fundamentais exigir uma tomada de decisão centrada no ordenamento jurídico e nos princípios bioéticos.

Inacia Sátiro Xavier de França; Rosilene Santos Baptista; Virgínia Rosana de Sousa Brito

2008-01-01

226

Dilemas éticos na hemotransfusão em Testemunhas de Jeová: uma análise jurídico-bioética/ Ethical dilemmas in blood transfusion in Jehovah's Witnesses: a legal-bioethical analysis/ Dilemas éticos en la transfusión sanguínea de Testigos de Jeová: un análisis jurídico-bioético  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: Identificar a produção de conhecimento pelos profissionais de saúde acerca da hemotransfusão em Testemunhas de Jeová (TJ), listar as alternativas terapêuticas para a hemotransfusão nesses indivíduos e citar o ordenamento jurídico, ético e bioético no concernente a hemotransfusão em TJ. MÉTODOS: Coletaram-se dados nas bases de dados LILACS e SciELO, periódicos de Enfermagem e no http://www.google.com.br. Incluiram-se artigos enfocando hemotransfusã (more) o em TJ, e excluíram-se os que não abordassem essa temática ou estivessem repetidos. Utilizou-se a análise de conteúdo. RESULTADOS: As categorias temáticas sinalizam que as TJ acatam a auto-transfusão e se contrapõem à prática médica da hemotransfusão, mesmo que ela represente a continuidade da vida. CONCLUSÃO: Os profissionais de saúde vivenciam dilemas éticos quando precisam administrar hemotransfusão em TJ devido a liberdade religiosa não ser um valor absoluto e a aparente colisão de direitos fundamentais exigir uma tomada de decisão centrada no ordenamento jurídico e nos princípios bioéticos. Abstract in spanish OBJETIVO: Identificar la producción de conocimiento por los profesionales de salud respecto a la transfusión sanguínea de Testigos de Jeova (TJ), listar las alternativas terapéuticas de la transfusión sanguínea en esos individuos y citar la ordenanza jurídica, ética y bioética en lo que concierne a la transfusión sanguínea en TJ. MÉTODOS: Se recolectaron datos en las bases de datos LILACS y SciELO, periódicos de Enfermería y en el http://www.google.com.br. S (more) e incluyeron artículos enfocando la transfusión sanguínea en TJ, y se excluyeron a los que no abordaban esa temática o estaban repetidos. Se utilizó el análisis de contenido. RESULTADOS: Las categorías temáticas señalan que los TJ acatan la auto-transfusión y se contraponen a la práctica médica de la transfusión sanguínea, aunque ella represente la continuidad de la vida. CONCLUSIÓN: Los profesionales de salud vivencian dilemas éticos cuando precisan realizar transfusiones sanguíneas en TJ debido a que la libertad religiosa no es un valor absoluto y la aparente colisión de derechos fundamentales les exige una toma de decisión centrada en la ordenanza jurídica y en los principios bioéticos. Abstract in english OBJECTIVE: To identify knowledge production by healthcare professionals about blood transfusion in Jehovah's Witnesses (JW), listing the therapeutic alternatives for blood transfusion in these individuals and citing the legal, ethical and bioethical standards regarding blood transfusion in JWs. METHODS: Data were collected in the LILACS and SciELO databases, Nursing journals and on http://www.google.com.br. Articles focusing on blood transfusion in JWs were included, and (more) texts that were repeated or did not approach this theme were excluded. Content analysis was used. RESULTS: The thematic categories show that the JWs accept self-transfusion and are opposed to the medical practice of blood transfusion, even if it represents the continuity of life. CONCLUSION: Healthcare professionals experience ethical dilemmas when they need to perform blood transfusion in JWs due to the fact that religious freedom is not an absolute value, and the apparent collision of fundamental rights demands that a decision be made, centered on legal standards and bioethical principles.

França, Inacia Sátiro Xavier de; Baptista, Rosilene Santos; Brito, Virgínia Rosana de Sousa

2008-01-01

227

ETHICAL PERSPECTIVES IN OPEN AND DISTANCE EDUATION SYSTEM  

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Full Text Available Today, e-learning and various online education applications are used in many countries and educational institutions than ever before. Ethics deals with the principle governing ideal or good behavior, it focuses on what is right or what is wrong. Although in education, the ethical issues that they may be facing are not about of life and death issues. An ethical dilemma will take place when the educator faced with a decision that maybe incongruent with the organization’s values and policies. There are several examples of ethical issues in education. In this reason, the educator must be guided with the appropriate decision-making strategies. With the increasing use of new communication technologies, adoption of distance education by traditional educational institutes and owing to growing demand on the part of learners, it becomes more important to discuss the ethical issues. This important title provides academicians, students, and professionals with ethical insight into the world of e-learning through fascinating case studies that elucidate the issues through real-world examples. Pioneer’s experience in the field of distance education indicates that the profile of distance learners varies, cutting across barriers of gender, class and caste. The distance learner may be suffering from a sense of isolation as he/she makes a return to study after a gap of time or while working. It is there that the distance educator makes a positive, ethical and interventionist role by helping the student to learn beyond the stereotypical classroom situation and can act effectively as the friend, philosopher and guide of the learner. However, the industry of education is a serious one, requiring well defined ethics and values, well bound in visible legal outlines to regulate its exchange and distribution. Because as the industry grows, so do the issues of ethical concern such as plagiarism, electronic voyeurism, and licensing. The objective of this paper is to raise awareness of additional ethical issues in order to encourage further debate and consideration of these importance issues. The present paper will focus on the ethical values to be followed and implemented in the open distance education system

C. ANITHA (Corresponding Author),; T. S. HARSHA,

2013-01-01

228

When Research and Mandates Collide: The Challenges and Dilemmas of Teacher Education in the Era of NCLB  

Science.gov (United States)

In this article, the authors first describe their research, then discuss the ethical and professional dilemmas they face as teacher educators as a consequence of NCLB. Here, they offer some possible approaches to coping with these dilemmas in the context of university undergraduate and graduate teacher education programs. Their study examined the…

Altwerger, Bess; Arya, Poonam; Jin, Lijun; Jordan, Nancy L.; Laster, Barbara; Martens, Prisca; Wilson, G. Patricia; Wiltz, Nancy

2004-01-01

229

A systematic format for resolving ethical issues in clinical periodontics.  

UK PubMed Central (United Kingdom)

Ethical dilemmas are becoming increasingly common in dentistry and periodontics. Clinicians, challenged with such dilemmas, may not know how to apply the appropriate moral reasoning needed to resolve these situations especially when any of the five fundamental principles of ethics that form the foundation of the American Dental Association Principles of Ethics and Code of Professional Conduct--patient autonomy, nonmaleficence, beneficence, justice, and veracity--come into conflict with each other. The author describes one clinical case that presented with an ethical dilemma. An analytic framework, used in medicine, is introduced and used to solve the clinical case on whether to proceed with periodontal surgery on a patient who is not aware of his terminal prognosis from metastatic prostate cancer. Upon using the analytic framework, recommendations are made on the ethically appropriate path for the periodontist to follow in providing care for the patient's periodontal problem consistent with the principles of patient autonomy, respect for persons, and veracity.

Schloss AJ

2012-01-01

230

A systematic format for resolving ethical issues in clinical periodontics.  

Science.gov (United States)

Ethical dilemmas are becoming increasingly common in dentistry and periodontics. Clinicians, challenged with such dilemmas, may not know how to apply the appropriate moral reasoning needed to resolve these situations especially when any of the five fundamental principles of ethics that form the foundation of the American Dental Association Principles of Ethics and Code of Professional Conduct--patient autonomy, nonmaleficence, beneficence, justice, and veracity--come into conflict with each other. The author describes one clinical case that presented with an ethical dilemma. An analytic framework, used in medicine, is introduced and used to solve the clinical case on whether to proceed with periodontal surgery on a patient who is not aware of his terminal prognosis from metastatic prostate cancer. Upon using the analytic framework, recommendations are made on the ethically appropriate path for the periodontist to follow in providing care for the patient's periodontal problem consistent with the principles of patient autonomy, respect for persons, and veracity. PMID:23189804

Schloss, Alexander J

2012-01-01

231

Informed recruitment in partner studies of HIV transmission: an ethical issue in couples research  

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Full Text Available Abstract Background Much attention has been devoted to ethical issues related to randomized controlled trials for HIV treatment and prevention. However, there has been less discussion of ethical issues surrounding families involved in observational studies of HIV transmission. This paper describes the process of ethical deliberation about how best to obtain informed consent from sex partners of injection drug users (IDUs) tested for HIV, within a recent HIV study in Eastern Europe. The study aimed to assess the amount of HIV serodiscordance among IDUs and their sexual partners, identify barriers to harm reduction, and explore ways to optimize intervention programs. Including IDUs, either HIV-positive or at high risk for HIV, and their sexual partners would help to gain a more complete understanding of barriers to and opportunities for intervention. Discussion This paper focuses on the ethical dilemma regarding informed recruitment: whether researchers should disclose to sexual partners of IDUs that they were recruited because their partner injects drugs (i.e., their heightened risk for HIV). Disclosing risks to partners upholds the ethical value of respect for persons through informed consent. However, disclosure compromises the IDU's confidentiality, and potentially, the scientific validity of the research. Following a brief literature review, we summarize the researchers' systematic evaluation of this issue from ethical, scientific, and logistical perspectives. While the cultural context may be somewhat unique to Eastern Europe and Central Asia, the issues raised and solutions proposed here inform epidemiological research designs and their underlying ethical tensions. Summary We present ethical arguments in favor of disclosure, discuss how cultural context shapes the ethical issues, and recommend refinement of guidance for couples research of communicable diseases to assist investigators encountering these ethical issues in the future.

McNutt Louise-Anne; Gordon Elisa J; Uusküla Anneli

2009-01-01

232

Ethics revisited; further ethical explorations for biocommunicators.  

UK PubMed Central (United Kingdom)

This article explores further ethical considerations for biocommunicators. The focus is on professionalization and the need for professional standards to guide conduct and decisions. What makes formation of an ethical code for the profession of biocommunications desirable? Examples of issues facing the profession and general areas which may need to be examined in order to form a code are considered in relation to a philosophy of professionalism. The pros and cons of forming an ethics code are discussed. The authors call upon biomedical communications professionals to conscientiously deliberate the advantage or disadvantages of a code of ethics to the future of their profession.

Salladay S; Singarella T

1982-03-01

233

Ethics revisited; further ethical explorations for biocommunicators.  

Science.gov (United States)

This article explores further ethical considerations for biocommunicators. The focus is on professionalization and the need for professional standards to guide conduct and decisions. What makes formation of an ethical code for the profession of biocommunications desirable? Examples of issues facing the profession and general areas which may need to be examined in order to form a code are considered in relation to a philosophy of professionalism. The pros and cons of forming an ethics code are discussed. The authors call upon biomedical communications professionals to conscientiously deliberate the advantage or disadvantages of a code of ethics to the future of their profession. PMID:7068590

Salladay, S; Singarella, T

1982-03-01

234

Engineering ethics beyond engineers' ethics.  

UK PubMed Central (United Kingdom)

Engineering ethics is usually focused on engineers' ethics, engineers acting as individuals. Certainly, these professionals play a central role in the matter, but engineers are not a singularity inside engineering; they exist and operate as a part of a complex network of mutual relationships between many other people, organizations and groups. When engineering ethics and engineers' ethics are taken as one and the same thing the paradigm of the ethical engineer which prevails is that of the heroic engineer, a certain model of the ideal engineer: someone both quite individualistic and strong enough to deal with all the moral challenges that could arise. We argue that this is not the best approach, at least today in our interrelated world. We have achieved a high degree of independence from nature by means of technology. In exchange for this autonomy we have become increasingly tied up with very complex systems to which we constantly delegate new tasks and powers. Concerns about safety keep growing everywhere due to the fact that now we have a sensitive awareness of the huge amount of power we are both consuming and deploying, thus, new forms of dialogue and consensus have to be incorporated at different levels, in different forums and at different times. Within these democratic channels of participation not just the needs and interests, but also the responsibilities and mutual commitments of all parties should be taken into account.

Basart JM; Serra M

2013-03-01

235

Analyzing Accuracy and Accessibility in Information and Communication Technology Ethical Scenario Context  

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Full Text Available Problem statement: Recently, the development of Information and Communication Technology (ICT) is indispensable to life. The utilization of ICT has provided advantages for people, organizations and society as a whole. Nevertheless, the widespread and rapid use of ICT in society has exacerbated existing ethical issues or dilemmas and also led to the emergence of new ethical issues such as unauthorized access, software piracy, internet pornography, privacy protection, information gap and many others. Approach: Therefore, the aim of this study is to discuss several issues of the ICT ethics. It will focusing on two major issues, that is, data accuracy and accessibility. Results: The results indicated that more than half percentage of respondents tend to be ethical in data accuracy scenario and also in accessibility scenario. Several computer ethics scenarios that relate to the data accuracy and accessibility are presented and the results of analysis are then discussed. Conclusion: Based on the results in this study, computer ethics issues such as data accuracy and accessibility should receive more attention in the ICT field.

M. Masrom; Z. Ismail; R. N. Anuar; R. Hussein; N. Mohamed

2011-01-01

236

Ethical Issues in Irregular Migration Research in Europe  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This paper is concerned with the ethical issues arising for researchers engaged in the study of irregular migration. Based on the authors' research experiences, the paper goes beyond analysis of ethical dilemmas and aims to provide some guidance to researchers in this field. Irregular migration is b...

DÜVELL, Franck; TRIANDAFYLLIDOU, Anna; VOLLMER, Bastian

237

Role of the Medical Health Research and Ethics Committee (MHREC) in Brunei Darussalam.  

Directory of Open Access Journals (Sweden)

Full Text Available Applying ethical principles to medical research is an important safeguard for patients and researchers. In the most simplistic way, medical research is focused on finding cures for medical illnesses and improving patient care. The fundamental dilemma in medical research is whether it is acceptable to expose some individuals to risk for the benefit of others. Much research if not done well, cancause harm to individuals and institutions and may impact on time, resources and morale. Therefore, there is a need to regulate researchactivities to ensure compliance to basic research principles.

Jackson TAN, , ,; Ai Ting TEA; Connie TENGAH; Alice Mui Ling YONG

2013-01-01

238

Virtue Ethics in School Counseling: A Framework for Decision Making  

Science.gov (United States)

Virtue ethics focus on the motives that guide ethical decision making and action, and as such, are critical to the competent application of the counseling profession's ethical codes. Knowledge of virtue ethics deepens understanding of moral responsibilities and ethical reasoning in professional practice. This paper is an overview of virtue ethics

Wilczenski, Felicia L.; Cook, Amy L.

2011-01-01

239

Chimeras: an ethical consideration  

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Full Text Available Scientists have started with experimentation that raises difficult ethical questions. It comprises taking material from the human blueprint (DNA) and inserting this in various test animals. The purpose of such research is noble, namely the alleviation of hu- man suffering. Yet the ethical ramifications of blending the hu- man and animal genome are significant, especially for Chris- tians. The creation of all living entities after their kind and the image-bearing dignity attributed to man both come under se- vere ethical stress for those who presuppose divine order in God’s ecology.  For non-Christians the philosophical dilemma ought not to exist in the ethical sense if applied at the purest level. If the human is merely a kind of animal, along with and ontologically not diffe- rent from other animals, there is little logical reason to object to chimeric research apart from a concern about what such re- search and application might do to the order of life pragmati- cally. However, many non-Christian do object. Man is made in God’s image and the concept of human dignity and a universal sense of right and wrong still binds Christians and non-Chris- tians when considering ethics in the field of chimeric research. As the mixing of human stem cells with embryonic animals takes place, certain non-Christian authors protest that human dignity is being diminished and the animal essence is being vio- lated.

H. J.G. Zandman

2011-01-01

240

A Pedagogical Model for Ethical Inquiry into Socioscientific Issues In Science  

Science.gov (United States)

Internationally there is concern that many science teachers do not address socioscientific issues (SSI) in their classrooms, particularly those that are controversial. However with increasingly complex, science-based dilemmas being presented to society, such as cloning, genetic screening, alternative fuels, reproductive technologies and vaccination, there is a growing call for students to be more scientifically literate and to be able to make informed decisions on issues related to these dilemmas. There have been shifts in science curricula internationally towards a focus on scientific literacy, but research indicates that many secondary science teachers lack the support and confidence to address SSI in their classrooms. This paper reports on a project that developed a pedagogical model that scaffolded teachers through a series of stages in exploring a controversial socioscientific issue with students and supported them in the use of pedagogical strategies and facilitated ways of ethical thinking. The study builds on existing frameworks of ethical thinking. It presents an argument that in today's increasingly pluralistic society, these traditional frameworks need to be extended to acknowledge other worldviews and identities. Pluralism is proposed as an additional framework of ethical thinking in the pedagogical model, from which multiple identities, including cultural, ethnic, religious and gender perspectives, can be explored.

Saunders, Kathryn J.; Rennie, Léonie J.

2013-02-01

 
 
 
 
241

Environmental Studies and Utilitarian Ethics  

Science.gov (United States)

Environmental ethicists have focused much attention on the limits of utilitarianism and have generally defined "environmental ethics" in a manner that treats utilitarian environmental ethics as an oxymoron. This is unfortunate because utilitarian ethics can support strong environmental policies, and environmental ethicists have not yet produced a…

Wolff, Brian G.

2009-01-01

242

Empirical ethics, context-sensitivity, and contextualism.  

UK PubMed Central (United Kingdom)

In medical ethics, business ethics, and some branches of political philosophy (multi-culturalism, issues of just allocation, and equitable distribution) the literature increasingly combines insights from ethics and the social sciences. Some authors in medical ethics even speak of a new phase in the history of ethics, hailing "empirical ethics" as a logical next step in the development of practical ethics after the turn to "applied ethics." The name empirical ethics is ill-chosen because of its associations with "descriptive ethics." Unlike descriptive ethics, however, empirical ethics aims to be both descriptive and normative. The first question on which I focus is what kind of empirical research is used by empirical ethics and for which purposes. I argue that the ultimate aim of all empirical ethics is to improve the context-sensitivity of ethics. The second question is whether empirical ethics is essentially connected with specific positions in meta-ethics. I show that in some kinds of meta-ethical theories, which I categorize as broad contextualist theories, there is an intrinsic need for connecting normative ethics with empirical social research. But context-sensitivity is a goal that can be aimed for from any meta-ethical position.

Musschenga AW

2005-10-01

243

Alternrtivas de comprension y diálogo frente al dilema ético que ofrece Ia bioética. ¿Cómo enfrentar el uso de cultivos genéticamente modificados?/ ALTERNATIVES OF UNDERSTANDING AND DIALOGUE IN FRONT OF THE lETHICAL DILEMMA THAT OFFERS BIOETHICS, FACING THE USE OF GENETICALLY MODIFIED CULTURES/ ALTERNATIVAS DE COMPREENSÃO E DIÁLOGO OFERECIDAS PELA BIOÉTICA FRENTE AO DILEMA ÉTICO DERIVADO DA UTILIZAÇÃO DE CULTIVOS GENETICAMENTE MODIFICADOS  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese No primeiro lugar se examinarão de forma sistemática e reflexiva as virtudes e benefícios possíveis dos cultivos geneticamente modificados, assim como alguns dos argumentos acadêmicos e científicos que os apóiam. No segundo lugar, será abordada uma segunda posição a partir de seus próprios argumentos e pesquisa, um pouco mais incisiva e informada contra o uso e a manipulação desta classe de cultivos geneticamente modificados. Por último, mesmo que a intenç? (more) ?o deste artigo está na análise de alternativas de compreensão e diálogo do dilema ético que surge de utilizar organismos geneticamente modificados para a bioética, também está na necessidade urgente de criar uma hermenêutica bioética fundada nos princípios essenciais da precaução, da justiça e não-maleficência. Estes devem ser padrões dialógicos de encontro e discussão com o respeito e a tolerância que exige esse dilema ético e biotecnológico. Abstract in spanish En un primer momento, se hará un acercamiento sistemático y reflexivo a las posibles virtudes y beneficios de los cultivos genéticamente modificados. Así también, en un segundo momento, se abordará una postura más inquieta y prevenida con respecto al uso y manipulación de esta clase de cultivos genéticamente modificados. Finalmente, la reflexión gira en torno al análisis de las alternativas de comprensión y diálogo frente al dilema ético que ofrece el uso de (more) cultivos genéticamente modificados para la Bioética, la reflexión también depende de la urgente necesidad de una hermenéutica bioética emplazada en los principios esenciales de precaución y justicia y no maleficencia como pautas dialógicas de encuentro y discusión solícitas del respeto y tolerancia que requiere dicho dilema ético y biotecnológico. Abstract in english At initially addressed a systematic and thoughtful approach facing possible virtues and benefits of crops genetically modified, together with some of the academic and scientific arguments employees for the benefit of the sustainability of many of their performances. As well also, and in a second time, will be addressed from its own arguments and research, what we have chosen to draw a second position somewhat more restless and prevented regarding the use of handling of th (more) is class of crops genetically modified. Finally as well as understood that this monograph written intentionally revolves around the analysis of the understanding and dialogue with the ethical dilemma that offers the use of alternatives genetically modified for Bioethics crops, it is also the urgent need a hermeneutic located bioethics it on the essential caution, justice and not harm as dialogic principles guidelines and discussion of respect and tolerance meeting and discussion requires that ethical dilemma and biotechnological.

Arango Diago, Santiago Eliécer

2010-06-01

244

Ethics and its challenges  

Directory of Open Access Journals (Sweden)

Full Text Available I would like to look at some of the challenges of ethcis today. Therefore, in the first part I say something about ethics, the ethical theories and ethical concepts. Afterwords I am going to explain a little bit about the human dimensions, the dealing with experiences (i.e. work); because the human person has to decide the right thing in the right place on the right time, and in relatively freedom. In the end, there are some ideas about applied ethics which is necessary to focusing on the practical issues, too. Otherwise people who do not like the ethical discussions they could think that ethical ideas are selfsufficient and do not make sense, but I will tell them something else....

Johannes Michael Schnarrer

2006-01-01

245

Making an Ethical Decision: A Utilitarian Strategy.  

Science.gov (United States)

By identifying and weighing the effects of an act on each constituency, a matrix based on John Stuart Mill's theories of utilitarianism illuminates and helps resolve complex ethical dilemmas. Application of the approach is illustrated with a simulated case study concerning the issue of reputation in a small private college. (Author/MSE)

Price, Sandra J.

1992-01-01

246

Ethical assessment of research protocols: the experience of the Research Ethics Committee of the Hospital Israelita Albert Einstein (HIAE)  

Directory of Open Access Journals (Sweden)

Full Text Available This is a review article on the origin of the ethical analysis ofresearch protocols, the Brazilian and International legislation,including the Research Ethics Committee of Hospital IsraelitaAlbert Einstein. Since 1997, when the Committee was validatedits role has been recognized as that of a consultant and educator,participating on local and national scientific events andcollaborating with researchers in order to improve their projectsand learn to recognize ethical dilemmas in their protocols.

Sonia Maria Oliveira de Barros; José Pinus

2005-01-01

247

Authenticity or autonomy? When deep brain stimulation causes a dilemma.  

UK PubMed Central (United Kingdom)

While deep brain stimulation (DBS) for patients with Parkinson's disease has typically raised ethical questions about autonomy, accountability and personal identity, recent research indicates that we need to begin taking into account issues surrounding the patients' feelings of authenticity and alienation as well. In order to bring out the relevance of this dimension to ethical considerations of DBS, I analyse a recent case study of a Dutch patient who, as a result of DBS, faced a dilemma between autonomy and authenticity. This case study is meant to point out the normatively meaningful tension patients under DBS experience between authenticity and autonomy.

Kraemer F

2013-01-01

248

Authenticity or autonomy? When deep brain stimulation causes a dilemma.  

Science.gov (United States)

While deep brain stimulation (DBS) for patients with Parkinson's disease has typically raised ethical questions about autonomy, accountability and personal identity, recent research indicates that we need to begin taking into account issues surrounding the patients' feelings of authenticity and alienation as well. In order to bring out the relevance of this dimension to ethical considerations of DBS, I analyse a recent case study of a Dutch patient who, as a result of DBS, faced a dilemma between autonomy and authenticity. This case study is meant to point out the normatively meaningful tension patients under DBS experience between authenticity and autonomy. PMID:23355227

Kraemer, Felicitas

2013-01-26

249

A Situated Practice of Ethics for Participatory Visual and Digital Methods in Public Health Research and Practice: A Focus on Digital Storytelling.  

UK PubMed Central (United Kingdom)

This article explores ethical considerations related to participatory visual and digital methods for public health research and practice, through the lens of an approach known as "digital storytelling." We begin by briefly describing the digital storytelling process and its applications to public health research and practice. Next, we explore 6 common challenges: fuzzy boundaries, recruitment and consent to participate, power of shaping, representation and harm, confidentiality, and release of materials. We discuss their complexities and offer some considerations for ethical practice. We hope this article serves as a catalyst for expanded dialogue about the need for high standards of integrity and a situated practice of ethics wherein researchers and practitioners reflexively consider ethical decision-making as part of the ongoing work of public health. (Am J Public Health. Published online ahead of print August 15, 2013: e1-e9. doi:10.2105/AJPH.2013.301310).

Gubrium AC; Hill AL; Flicker S

2013-08-01

250

Strategy and the defense dilemma: nuclear policies and alliance politics  

Energy Technology Data Exchange (ETDEWEB)

Focusing on the emerging dilemmas of US defense, foreign and international economic policies, Professor Garvey calls for a realignment of military alliance strategies consistent with the new realities. He describes the nature of the US's dilemmas and posits the need for decoupling and relinking various facets of American strategic policy that will emphasize Asia and the relationship between commercial and security interests while deemphasizing Europe and the current nuclear commitment.

Garvey, G.

1984-01-01

251

Ethical problems in the treatment of schizophrenia [Problemy etyczne w terapii schizofrenii  

Directory of Open Access Journals (Sweden)

Full Text Available The authors present ethical dilemmas in the therapy, particularly family therapy, individual and group psychotherapy of schizophrenia in the context of the specific personality of persons suffering from schizophrenia as well as their experience

Kostecka, Ma?gorzata; Namys?owska, Irena; Ostoja-Zawadzka, Krystyna

2012-01-01

252

Virtue ethics and an ethics of care: complementary or in conflict?  

Directory of Open Access Journals (Sweden)

Full Text Available This paper compares and contrasts virtue ethics and care ethics to determine their mutual relation. It is argued that there is one tradition within virtue ethics that emphasises that virtue is knowledge and also focuses on direct altruism. There is no opposition between that form of virtue ethics and ethics of care. Furthermore, there are principled objections to generalising the necessarily asymmetric relations of an ethic of care to the case of justice as reciprocal fairness.

Alan Thomas

2011-01-01

253

Environmental ethics  

International Nuclear Information System (INIS)

[en] When the Homo Faber; to the beginning of the humanization, overcame the instinct that established a relationship balanced in the ecosphere between the animal and the nature, an interference it began in the relationship man-nature; since that was not adapted this but rather it began its transformation adapting the environment to its necessities. During miles of years the development of this production technique of the Homo Faber could be considered like a progressive and innocuous exploitation of the natural resources. At the present time, kind of a dialectical transformation of the quantity in a new quality characterizes the critical stadium of the new phase of the evolution inaugurated by the Homo Faber. We arrive this way today to that the production force, by means of the science and the technique, outlines us the problem of if for a bigger development in the productivity is necessary a progressive destruction of the ecosphere. That is to say, so that there is progress and will civilization be necessary a progressive interference of the natural balance, with the consequent setting in danger of the life? Moreover this article treats topics about their location and focuses, environmental ethics framed in the talkative ethics and virtues of the environmental ethics, among other topics

1994-01-01

254

A Student's Perspective on Medical Ethics Education.  

Science.gov (United States)

Despite many efforts to increase ethics education in US medical schools, barriers continue to arise that impede the production of morally driven physicians who practice medicine with ideal empathy. Research has shown that, particularly during the clinical years, medical students lose the ability both to recognize ethical dilemmas and to approach such situations with compassionate reasoning. This article summarizes the current status of ethics education in US medical schools, described through the eyes of and alongside the story of a graduating medical student. PMID:23793349

Terndrup, Christopher

2013-12-01

255

Landmændenes modstand - kontrollørernes dilemma  

DEFF Research Database (Denmark)

Ph.d. studie viser, at landmænd ønsker ikke blot en mere retfærdig og ensartet kontrol af dyrevelfærd, men også en kontrol med plads til helhedsvurdering og forståelse af den enkelte landmands situation. Kontrollørerne befinder sig i et dilemma mellem på den ene side alene at kontrollere overholdelse af regler - på den anden side også at vægte forebyggelse og læring.

Anneberg, Inger; SandØe, Peter

2013-01-01

256

Facing Management Dilemmas  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This article looks at how managers in large infrastructure projects in The Netherlands deal with difficult choices, which are labelled as dilemmas in this article, in their managerial activities. It presents the results of a survey of 32 managers in 18 complex decision-making projects in which publi...

Klijn, E.H.; Edelenbos, J.; Twist, M.J.W. van; Kort, M.B.

257

Dilemmas in Teaching Happiness  

Science.gov (United States)

|There is a burgeoning amount of research into happiness and greatly increased popular attention, so it seems logical to add a course on happiness to the university curriculum. We encountered, in developing and running such a course, a number of dilemmas that the topic of happiness makes especially acute. Should the teacher remain separate from…

Barker, Chris; Martin, Brian

2009-01-01

258

Synthetic biology ethics: a deontological assessment.  

Science.gov (United States)

In this article I discuss the ethics of synthetic biology from a broadly deontological perspective, evaluating its morality in terms of the integrity of nature, the dignity of life and the relationship between God and his creation. Most ethical analyses to date have been largely consequentialist in nature; they reveal a dual use dilemma, showing that synbio has potential for great good and great evil, possibly more so than any step humanity has taken before. A deontological analysis may help to resolve this dilemma, by evaluating whether synbio is right or wrong in itself. I also assess whether deontology alone is a sufficient methodological paradigm for the proper evaluation of synbio ethics. PMID:24010856

Heavey, Patrick

2013-10-01

259

Clinical ethics and values: how do norms evolve from practice?  

UK PubMed Central (United Kingdom)

Bioethics laws in France have just undergone a revision process. The bioethics debate is often cast in terms of ethical principles and norms resisting emerging social and technological practices. This leads to the expression of confrontational attitudes based on widely differing interpretations of the same principles and values, and ultimately results in a deadlock. In this paper I would like to argue that focusing on values, as opposed to norms and principles, provides an interesting perspective on the evolution of norms. As Joseph Raz has convincingly argued, "life-building" values and practices are closely intertwined. Precisely because values have a more indeterminate meaning than norms, they can be cited as reasons for action by concerned stakeholders, and thus can help us understand how controversial practices, e.g. surrogate motherhood, can be justified. Finally, norms evolve when the interpretations of the relevant values shift and cause a change in the presumptions implicit in the norms. Thus, norms are not a prerequisite of the ethical solution of practical dilemmas, but rather the outcome of the decision-making process itself. Struggling to reach the right decision in controversial clinical ethics situations indirectly causes social and moral values to change and principles to be understood differently.

Spranzi M

2013-02-01

260

Surveillance Pleasures : Existentialism and Ethics as Represented in Cinematic Art  

DEFF Research Database (Denmark)

The notorious intensification and digitalization of surveillance technologies and practices in today’s society has brought about numerous changes. These changes have been widely noticed, described and discussed across many academic disciplines. However, the contexts of entertainment, play and leisure have not been studied with the same intensity as e.g. policing, civil liberties and social sorting. This paper offers a study of trends in surveillance pleasures, i.e. watching and eavesdropping in popular culture. My focus is the existential aspects and ethical dilemmas of surveillance as portrayed in the movies Rear Window (1954) and The Conversation (1974). I argue that such research as well as studies of the experience of surveillance contributes to our theoretical insights into the ambiguous and ubiquitous phenomenon of surveillance.

Albrechtslund, Anders

 
 
 
 
261

A Computerised Business Ethics Expert System -A new approach to improving the ethical quality of business decision-making  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Where unethical business decision-making arises from failures of ethical perception, there is an important role for ethical training and decision-making tools. These may help business people to consider all relevant issues when assessing the ethical status of potential decisions. Ethical training programmes give business people a basic understanding of the principles which underlie ethical judgements and equip them with many of the necessary skills for dealing with the ethical dilemmas which they face in their jobs. Similarly, ethical decision-making tools may guide managers through the various ethical considerations which are relevant to business decision-making and help them to develop their ethical-perceptual skills. Furthermore, by establishing and reinforcing good ethical decision-making practices, training programmes and decision-making tools may also reduce the incidence of self-consciously unethical decision-making. A new approach to improving the ethical quality of business decision-making by the use of computerized business ethics expert systems is proposed. These systems have the potential to guide business people through a process of ethical evaluation while simultaneously fulfilling an educational role, thus providing many of the benefits of both training programmes and decision-making tools. While the prospect of a computer system which could simply make ethical judgements for business people is both unrealistic and undesirable, a system which leads human decision-makers through a structured assessment process has the potential for genuine benefits. Keywords: Expert Systems, Ethical Decision Making

Bernie Brenner

2007-01-01

262

[Animals and environmentalist ethics].  

UK PubMed Central (United Kingdom)

While environmental ethics and animal ethics have a common source of inspiration, they do not agree on the question of the status of animals. Environmental ethicists criticise the narrowness of the reason, focused on pain, given by animal ethicists and their strictly individual point of view; they maintain that their ethical concept is less emotional and more informed by science, with a broad point of view taking natural networks into account. Animal ethicists respond critically, accusing the environmental ethicists of not having any ethical foundation. There are, however, prospects for reconciling the two approaches, provided that they recognise two different ethical stances for animals: one based on the integrity of wild animals and the other based on a model contract for tame animals.

Guichet JL

2013-01-01

263

UNESCO's activities in ethics.  

UK PubMed Central (United Kingdom)

UNESCO is an intergovernmental organization with 193 Member States. It is concerned with a broad range of issues regarding education, science and culture. It is the only UN organisation with a mandate in science. Since 1993 it is addressing ethics of science and technology, with special emphasis on bioethics. One major objective of the ethics programme is the development of international normative standards. This is particularly important since many Member States only have a limited infrastructure in bioethics, lacking expertise, educational programs, bioethics committees and legal frameworks. UNESCO has recently adopted the Universal Declaration on Bioethics and Human Rights. The focus of current activities is now on implementation of this Declaration. Three activities are discussed that aim at improving and reinforcing the ethics infrastructure in relation to science and technology: the Global Ethics Observatory, the Ethics Education Programme and the Assisting Bioethics Committees project.

ten Have HA

2010-03-01

264

Developing ethical competence in health care organizations  

DEFF Research Database (Denmark)

Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy.

Kälvemark Sporrong, Sofia Beatrice; Arnetz, Bengt

2007-01-01

265

Quantum prisoner dilemma under decoherence  

Energy Technology Data Exchange (ETDEWEB)

It has recently been established that quantum strategies are superior to classical ones for games such as the prisoner's dilemma. However, quantum states are subject to decoherence. In this Letter, we investigate the effects of decoherence on a quantum game, namely the prisoner dilemma, through three prototype decoherence channels. We show that in the case of prisoner dilemma, the Nash equilibria are not changed by the effects of decoherence for maximally entangled states.

Chen, L.K.; Ang, Huiling; Kiang, D.; Kwek, L.C.; Lo, C.F

2003-09-29

266

Quantum prisoner dilemma under decoherence  

International Nuclear Information System (INIS)

[en] It has recently been established that quantum strategies are superior to classical ones for games such as the prisoner's dilemma. However, quantum states are subject to decoherence. In this Letter, we investigate the effects of decoherence on a quantum game, namely the prisoner dilemma, through three prototype decoherence channels. We show that in the case of prisoner dilemma, the Nash equilibria are not changed by the effects of decoherence for maximally entangled states

2003-09-29

267

Respecting patient autonomy versus protecting the patient's health: a dilemma for healthcare providers.  

UK PubMed Central (United Kingdom)

A 74-year-old man with multiple chronic medical problems was hospitalized for respiratory distress. He experienced recurrent aspiration and required frequent suctioning and endotracheal intubation on several occasions. The patient was deemed competent and steadfastly refused feeding tube placement. The patient demanded that he be allowed to eat a normal diet despite being told that it could lead to his death. The patient wanted to go home, but there was no one there to care for him. Additionally, neither a nursing home nor hospice would accept him in his present condition. The case is especially interesting because of the symbolic value of food and the plight of the patient who has no alternative to hospitalization. The hospital staff experienced considerable stress at having to care for him. They were uncertain whether their obligation was to respect his autonomy and continue to provide food or to protect his health by avoiding aspiration, pneumonia, and possible death by denying him food. This ethical dilemma posed by the professionals' duty to do what is in the patient's best interest versus the patient's right to decide treatment serves as the focus for this case study. Ethical, legal, and healthcare practitioners' considerations are explored. The case study concludes with specific recommendations for treatment.

Badger JM; Ladd RE; Adler P

2009-10-01

268

The case for a code of ethics in an ambulatory care setting.  

UK PubMed Central (United Kingdom)

The health care industry leads others in the development and use of professional codes of ethics. However, ambulatory care facilities continue to operate without coherent ethical guidelines addressing the workplace itself. New diagnostic and treatment capabilities, coupled with economic pressures, have intensified the ethical dilemmas facing the ambulatory care practice. This article argues that office codes of ethics decrease the risk of liability exposure, clarify the expectations of patients and staff, and foster responsible ethical reflection in the workplace. Material for this article was gathered from relevant literature in the areas of business ethics, bioethics, and health care management.

Montoya ID; Richard AJ

1995-07-01

269

Infanticide as Instructing Ethics in “Rostam and Sohrab”  

Directory of Open Access Journals (Sweden)

Full Text Available The present paper investigates the story of “Rostam and Sohrab” by Abolghasem Ferdowsi – the poet of the fourth century. This paper aims to demonstrate the relationship between infanticide by the major character of this work, Rostam, and ethical dilemmas in the light of Emmanuel Levinas’s notion of responsibility and depicts how instructing ethics will appear in the act of infanticide by him. Therefore, this paper shows how infanticide despite of being indecent is considered as an ethical dead in specific circumstances.Key words: Infanticide; Responsibility; Ethics

Hassan Shahabi; Marzieh Kouchaki

2013-01-01

270

Ethics for One World  

Directory of Open Access Journals (Sweden)

Full Text Available Technological advancement has made the increasing closeness among the diverse regions of the world inevitable. This article focuses on the ethical implications that this proximity entails. The author analyzes how global warming, commerce, and international law are topics that should interest and involve all nations because the decisions taken towards these matters have global consequences. He purports that there is a need to apply an ethic for one world that also goes beyond the human species.

Singer, Peter

2005-01-01

271

Environmental and Ethical Aspects of Sustainable Mining in Greenland  

DEFF Research Database (Denmark)

The increased use of scarce metals in combination with climate changes pave way for extensive extraction of mineral resources in Greenland. The focus of this study is on environmental ethical aspects of mining activities in a vulnerable and unspoiled arctic nature. Mining can have several economic and social benefits for Greenland. On the other hand, the environmental impacts from mining are well known. Through DPSIR (Drivers, Pressures, States, Impacts, Responses) and Stakeholder analysis, we assess how future mining in Greenland can be sustainably implemented. The analysis revealed that numerous stakeholders have to be taken into consideration with a wide range of different interests. The DPSIR analysis clarified the availability of various potential political responses that could affect the drivers, pressures, states and impacts of mining mainly focused on implementation of effective environmental regulation strategies. Our findings revealed different environmental ethical dilemmas of which the most critical is how Greenland can open up for mining, gain economical revenue while averting destruction of unspoiled regions and aesthetic impairment. We recommend strict environmental legislation involving use of the “polluter pay principle”, continuous monitoring of pollution and establishment of an industry-funded catastrophe trust fund. These initiatives can ensure economic benefits while environmental impacts remain negligible.

Hansen, Sinne HjælmsØ; Pedersen, Lise Celine

2013-01-01

272

What's the matter with business ethics?  

UK PubMed Central (United Kingdom)

The more business ethics secures its status in campuses across the country, the more bewildering it appears to actual managers. It's not that managers dislike the idea of doing the right thing. As University of Toronto Assistant Professor Andrew Stark argues, far too many business ethicists just haven't offered them the practical advice they need. Before business ethics became a formal discipline, advocates of corporate social responsibility claimed that the market would ultimately reward ethical behavior. But ethics and interests did not always intersect so fruitfully in the real world. And when they did not, managers were left in the dark to grope for the right ethical course. In the 1970s, the brand-new field of business ethics came onto the scene to address this issue. Critical of the "ethics pays" approach, academics held that ethics and interests can and do conflict. Still, scholars took an equally unrealistic line. To them, a manager's motivation could be either altruistic or self-interested, but never both. In short, ethicists still weren't addressing the difficult moral dilemmas that managers face on a day-to-day basis, and only recently have they begun to do so. After some initial stumbles, ethicists are getting their hands dirty and seriously considering the costs of doing the right thing. Finally, a new business ethics is emerging that acknowledges and accepts the messy world of mixed motives. As a result, novel concepts are springing up: moderation, pragmatism, minimalism, among others.(ABSTRACT TRUNCATED AT 250 WORDS)

Stark A

1993-05-01

273

The paucity of ethical analysis in allergology  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract While a growing body of research is uncovering the aetiology and effective treatments for allergy, research that assess the broader ethical implications of this disease is lacking significantly. This article will demonstrate both the paucity of academic research concerning ethical implications in allergy and explain why ethical analysis is integral to formulating effective health strategies for allergic disease. An exhaustive literature search of publications in French and English identified less than 35 academic articles focussed on the topic of ethics and allergy; this is a miniscule number when compared to the amount of articles published on ethical issues related to other chronic illnesses, such as obesity. It is important to demonstrate to allergy specialists the need for, and utility of, further incorporating ethical analyses in allergology; the current success of Ethical, Legal, Social Implications (ELSI) research programmes in human genetics and nanotechnology will serve as notable examples. Indeed, future research and innovation in allergy will undoubtedly encounter ethical dilemmas and the allergology community should play a significant role in helping to address these issues. However, incorporating ethical analyses in allergology does not imply that the allergology community must acquire extensive knowledge in bioethics; instead, interdisciplinary research that incorporates expertise from allergology and bioethics would enable allergy specialists to advance critical knowledge development in this largely overlooked domain of study.

Behrmann Jason

2013-01-01

274

Narrative responsibility and moral dilemma: A case study of a family's decision about a brain-dead daughter.  

UK PubMed Central (United Kingdom)

A brain death case is presented and reinterpreted using the narrative approach. In the case, two Japanese parents face a dilemma about whether to respect their daughter's desire to donate organs even though, for them, it would mean literally killing their daughter. We argue that the ethical dilemma occurred because the parents were confronted with two conflicting narratives to which they felt a "narrative responsibility," namely, the responsibility that drives us to tell, retell, and coauthor the (often unfinished) narratives of loved ones. We suggest that moral dilemmas arise not only from conflicts between moral justifications but also from conflicts between narratives and human relationships.

Kinjo T; Morioka M

2011-04-01

275

Narrative responsibility and moral dilemma: A case study of a family's decision about a brain-dead daughter.  

Science.gov (United States)

A brain death case is presented and reinterpreted using the narrative approach. In the case, two Japanese parents face a dilemma about whether to respect their daughter's desire to donate organs even though, for them, it would mean literally killing their daughter. We argue that the ethical dilemma occurred because the parents were confronted with two conflicting narratives to which they felt a "narrative responsibility," namely, the responsibility that drives us to tell, retell, and coauthor the (often unfinished) narratives of loved ones. We suggest that moral dilemmas arise not only from conflicts between moral justifications but also from conflicts between narratives and human relationships. PMID:21053084

Kinjo, Takanobu; Morioka, Masahiro

2011-04-01

276

Ethical challenges within Veterans Administration healthcare facilities: perspectives of managers, clinicians, patients, and ethics committee chairpersons.  

UK PubMed Central (United Kingdom)

To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration (VA) facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients (n = 32) and managers (n = 38); semi-structured interviews with managers (n = 31), clinicians (n = 55), and ethics committee chairpersons (n = 21). Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions.

Foglia MB; Pearlman RA; Bottrell M; Altemose JK; Fox E

2009-04-01

277

An Investigation of the Ethical Decision-Making of Preschool Teachers: A Cultural Study of a Sample in Turkey  

Science.gov (United States)

In this study, the ethical decision-making of preschool teachers (N = 26) in Samsun, on the northern coast of Turkey, was examined. For this analysis, six real-life dilemmas were prepared, chosen from the problems that most often arise in kindergartens in Turkey. These dilemmas addressed the commitment of the teacher to the child, to self, to the…

Ozturk, Safak

2011-01-01

278

Archaeology, Ethics, and Character: Using Our Cultural Heritage to Teach Citizenship  

Science.gov (United States)

Archaeology is a highly interdisciplinary field. Its main goal is to construct culture histories, but it uses many scientific methods in the process. Ethical dilemmas inherent in archaeology make it a good vehicle for teaching ethics and character in the classroom (Moe 2000). The interdisciplinary nature of the field makes it possible to weave…

Moe, Jeanne M.; Coleman, Carolee; Fink, Kristie; Krejs, Kirsti

2002-01-01

279

The social worker as moral citizen: ethics in action.  

UK PubMed Central (United Kingdom)

Social workers today face some of the most complex ethical dilemmas in the history of the profession. This article presents a framework of moral citizenship to guide ethical social work practice. The framework includes the action philosophies of philosopher Hannah Arendt and Lutheran theologian Paul Tillich integrated with concepts of professional responsibility and the unique contributions of social work pioneer Charlotte Towle. Social conscience and social consciousness, including awareness, thinking, feeling, and action, are major components of the framework.

Manning SS

1997-05-01

280

Ethical issues in health workforce development  

Directory of Open Access Journals (Sweden)

Full Text Available Increasing the numbers of health workers and improving their skills requires that countries confront a number of ethical dilemmas. The ethical considerations in answering five important questions on enabling health workers to deal appropriately with the circumstances in which they must work are described. These include the problems of the standards of training and practice required in countries with differing levels of socioeconomic development and different priority diseases; how a society can be assured that health practitioners are properly trained; how a health system can support its workers; diversion of health workers and training institutions; and the teaching of ethical principles to student health workers. The ethics of setting standards for the skills and care provided by traditional health-care practitioners are also discussed.

Cash Richard

2005-01-01

 
 
 
 
281

Ethics Updates  

Science.gov (United States)

Created in 1994 by Professor Lawrence M. Hinman of the University of San Diego, the Ethics Updates site is designed primarily to be used to ethics instructors and their students. However, the site is rather interesting, so members of the general public may find themselves making a few return visits. Visitors can use the drop-down tabs on the top of the homepage to make their way through sections that cover some of the basic theories of ethics and also learn more about applied ethics in relation to such issues as animal rights, torture, and world hunger. Moving on, the "Resources" area includes case studies for discussion, a glossary of terms, classic texts in ethics, and ethics surveys. The site is rounded out by a search engine and a selection of videos that deal with various topics in ethics.

Hinman, Lawrence M.

282

The Importance of Teaching Ethics of Sustainability  

Science.gov (United States)

Purpose: The purpose of this paper is to describe the importance of a focus on ethics in sustainability education and present results from a pilot graduate-level course titled the Ethics of Sustainability. Design/methodology/approach: This is a case study presenting a qualitative evaluation from a pilot 14-week Ethics of Sustainability course.…

Biedenweg, Kelly; Monroe, Martha C.; Oxarart, Annie

2013-01-01

283

Teaching Ethics Across the Public Administration Curriculum.  

Science.gov (United States)

|Discusses the process of infusing ethics into courses across the graduate-level public administration curriculum, focusing on three areas: barriers to teaching ethics in public administration; a six-step method for incorporating ethics across the curriculum; and applying this method to overcome obstacles within programs, using organizational…

Hejka-Ekins, April

1998-01-01

284

Business ethics in ethics committees?  

Science.gov (United States)

The "Ethics committees" column in this issue of the Hastings Center Report features an introduction by Cynthia B. Cohen and four brief commentaries on the roles hospital ethics committees may play in the making of institutional and public health care policy in the 1990s. The pros and cons of a broader, more public role for ethics committees in reconciling the business and patient care aspects of health care delivery are debated by Cohen in "Ethics committees as corporate and public policy advocates," and by Philip Boyle in this article. Boyle is an associate for ethical studies at The Hastings Center. PMID:2228587

Boyle, P

285

Dilemmas of Modernity in Change  

Directory of Open Access Journals (Sweden)

Full Text Available The subject-matter of this paper is to try to find out some reference points in order to understand many dilemmas which accompanied modern society – its birth, evolution and spread throughout countries and centuries. The most frequent such dilemmas concerned the paramount criteria for choosing between individual or societal matters, between private propriety or public (state) one, between private or public interests, between market mechanism or government policy as basis of the best decisions in human actions and matters. While analyzing such inconsistencies and dilemmas we can better understand the real nature of modernity and liberalism, especially what some researchers call “postmodernity”.

Sultana Suta-Selejan

2006-01-01

286

Emotion Interference Solves Social Dilemma  

Directory of Open Access Journals (Sweden)

Full Text Available Roles of emotion in decision-making have been attracting attention in neuroeconomics and behavioral game theory. We mathematically demonstrate that “emotion interference”, a recently-discovered psychological phenomenon [1] helps to solve social dilemma in a one-shot prisoner’s dilemma game. Furthermore, the present theory also accounts for the violation of Savage’s sure-thing principle in the prisoner’s dilemma [2]. Furthermore, it is also explained that why people in the society with higher social mobility are more cooperative. Relations of the present work to recently evolving fields of neuroeconomics and quantum decision theory are discussed.

Taiki Takahashi

2012-01-01

287

Dilemmas of managing change : the case for change managers at Willow NHS trust.  

UK PubMed Central (United Kingdom)

The focus of my research was to investigate the dilemmas of change experienced by middle managers so that I can respond to the research problem (knowledge gap) concerning the ineffectiveness of change management strategies in the NHS.

Krishnan S

288

Toothbrush selection : A dilemma?  

Directory of Open Access Journals (Sweden)

Full Text Available The toothbrush is a fundamental tool used for accomplishing plaque control. Various types of toothbrushes available in the market keep the buyer in a state of dilemma as to which one to choose, due to lack of information about the "quality" of it. This study has been designed to understand whether all the products available in the market adhere to the specifications laid down by the ADA, which is universally accepted in standardization of a tooth brush. 95% of the brushes surveyed contain less number of bristles per tuft than specified and a large percentage deviate from the standard prescribed value for their bristle diameter and other dimensions. Few brushes labeled as "Soft" were "Medium" and labeled "Medium" were "Hard". The study will bring to light the quality of toothbrushes available in India for a rationalised selection of appropriate toothbrush by the community at large.

Sasan Dhiraj; Thomas Betsy; Bhat Mahalinga; Aithal K; Ramesh P

2006-01-01

289

Ethical considerations  

International Nuclear Information System (INIS)

[en] Some ethical questions about molecular biology and human radiation studies are raised. The questions relate to the following: genetic epidemiology leading to possible stigmatization of certain groups; protection of medical information, including samples, and respect for privacy; effect of genetic characterization on standards and procedures relating to occupational exposure; exclusion of vulnerable groups from research studies. On the positive side, there is increased funding within Canada for studies of ethical, legal and social issues, and internationally ethical standards are being developed

1995-04-25

290

Business Ethics, Strategy and Organizational Integrity : The Importance of Integrity as a Basic Principle of Business Ethics That Contributes to Better Economic Performance  

DEFF Research Database (Denmark)

With focus on the role of integrity in relation to business ethics versus economic strategy the chapter contains following sections: 1. The concept of organizational integrity as a moral notion as it is described in the work of Lynn-Sharp Paine on organizational integrity. 2. The concept of integrity as an economic notion as it is described in the recent work of Michael Jensen. This section will discuss recent efforts in the business economics literature to consider integrity as an important notion of strategy. 3. Paine contra Jensen: A virtue or a workability concept of integrity. Here the authors discuss the basic dilemmas and problems of integrating integrity, economic performance and strategy in the perspective of the two theories of about integrity of Paine and Jensen.

Rendtorff, Jacob Dahl

2011-01-01

291

Guest Editors’ Introduction On Understanding Ethical Behavior and Decision Making  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Behavioral ethics is an emerging field that takes an empirical, social scientific approach to the study of business ethics. In this special issue, we include six articles that fall within the domain of behavioral ethics and that focus on three themes—moral awareness, ethical decision making, and rea...

Cremer, D. de; Mayer, D.M.; Schminke, M.

292

Teaching public administration ethics in higher education on-line  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In performing their functions, public officials have to make ethical choices. Learning about making ethical choices should therefore not be left to choice. Public officials should be equipped with ethical decision-making skills. This paper focuses on the teaching of Public Administration ethics in h...

Mafunisa, M.J.(Mutuwafhethu John)

293

The Ethical Consumer  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This paper is done in cooperation with a small company in Roskilde called Bondegaarden. The aim of this project is to investigate how Bondegaarden can increase it sales by focusing on ethical initiatives. For the investigation there have been conducted seven interviews with existing and potential cu...

Lykke, Emilie; Ringvad Friederich, Andrea; Alexander Guhle, Mads; Fogt Rasmussen, Julie

294

Myths, magic and reality in nursing ethics: a personal perspective.  

UK PubMed Central (United Kingdom)

Ethics, especially in nursing, tends to be surrounded by myths and ideas that have more in common with magic than reality. This article argues from quotes of two medieval men, Thomas Aquinas and Meister Eckhart, that ethical behaviour among nurses is not something difficult or far-fetched, but something immediate, everyday, and often very simple. The more weighty ethical dilemmas are not diminished by this. Aspects of justice, compassion and courage are discussed from the point of view of relationships with clients and colleagues, and the need for (helpful) myths is stressed.

Tschudin V

1998-01-01

295

Dialysis in the frail elderly - a current ethical problem, an impending ethical crisis.  

Science.gov (United States)

The current practice of hemodialysis for the frail elderly frequently ignores core bioethical principles. Lack of transparency and shared decision making coupled with financial incentives to treat have resulted in problems of overtreatment near the end of life. Imminent changes in reimbursement for hemodialysis will reverse the financial incentives to favor not treating high-risk patients. In this article, we describe what is empirically known about the approach to hemodialysis today, and how it violates four core ethical principles. We then discuss how the new financial system turns physician and organizational incentives upside down in ways that may exacerbate the ethical dilemmas, but in the opposite direction. PMID:23686511

Thorsteinsdottir, Bjorg; Swetz, Keith M; Tilburt, Jon C

2013-05-18

296

Dialysis in the Frail Elderly - A Current Ethical Problem, an Impending Ethical Crisis.  

UK PubMed Central (United Kingdom)

The current practice of hemodialysis for the frail elderly frequently ignores core bioethical principles. Lack of transparency and shared decision making coupled with financial incentives to treat have resulted in problems of overtreatment near the end of life. Imminent changes in reimbursement for hemodialysis will reverse the financial incentives to favor not treating high-risk patients. In this article, we describe what is empirically known about the approach to hemodialysis today, and how it violates four core ethical principles. We then discuss how the new financial system turns physician and organizational incentives upside down in ways that may exacerbate the ethical dilemmas, but in the opposite direction.

Thorsteinsdottir B; Swetz KM; Tilburt JC

2013-05-01

297

Critical thinking by nurses on ethical issues like the termination of pregnancies  

Directory of Open Access Journals (Sweden)

Full Text Available This research forms part of a larger interdisciplinary research project on the termination of pregnancies. The focus of this part of the project is on the ethical issues related to termination of pregnancies. The practice of the professional nurse is confronted with ethical dilemmas and disputes. Whether the nurse chooses to participate in the termination of pregnancies or not, the core function of the nurse is that of counseling and ethical decisionmaking. Effective counseling requires empathy, respect for human rights and unconditional acceptance of a person. Making ethical decisions implies making critical decisions. It is self-evident, therefore, that such decisions should be based on sound arguments and logical reasoning. It is of vital importance that ethical decisions can be justified on rational ground. Decision-making is a critical thinking approach process for choosing the best action to meet a desired goal. The research question that is relevant for this paper is: Are nurses thinking critically about ethical issues like the termination of pregnancies? To answer the research question a qualitative, exploratory, descriptive design was used (Mouton, 1996:103-169). Registered nurses were selected purposively (Creswell, 1994:15). 1200 registered nurses completed the open-ended questionnaires. Focus group interviews were conducted with 22 registered nurses from a public hospital for women and child health services. Data analysis, using secondary data from open-ended questionnaires and transcribed focus group interviews, were based on the approach of Morse and Field (1994:25-34) and Strauss and Corbin (1990). The themes and categories from open coding were compared, conceptualized and linked with theories on critical thinking (Paul, 1994; Watson & Glaser, 1991 and the American Philosophical Association, 1990). The measures of Lincoln and Guba (1985) and Morse (1994) related to secondary data analysis were employed to ensure trustworthiness. Based on these findings the researcher concluded that nurses are not thinking critically when making ethical decisions concerning the termination of pregnancies. Recommendations are made as a possible solution for this problem.

A. Botes

2000-01-01

298

Evaluating the Intervention of an Ethics’ Class in Students’ Ethical Decision-Making: A Summative Review  

Directory of Open Access Journals (Sweden)

Full Text Available This summative evaluation is the result of two years’ of data reflecting the impact of an ethics class in terms of students’ ethical decision-making. The research compares aggregate responses from scenario-based pre- and post-survey open-ended survey questions designed to measure changes in ethical decision-making by comparing students’ cognitive and affective perceptions about ethical workplace behavior. Grounded  in constructivist theory, which explains how individuals “know” and “come to know something (Reeves, 2003), this intervention of an ethics class encourages students to make better and more informed ethical decisions in the workplace based on their understanding of their value and belief system. The findings suggest the intervention of an ethics class informed students’ cognitive and affective perceptions based on individual value and belief systems, strengthened student’s ability to remain open-minded and reconsider previous beliefs and actions from a 360 degree perspective, and increased student’s ability to apply new information to ethical dilemmas in the workplace.

Marquita Walker

2013-01-01

299

Teaching Business Ethics after the Financial Meltdown: Is It Time for Ethics with a Sermon?  

Science.gov (United States)

Our country is faced with a financial crisis of mammoth proportions: a crisis rooted in ethics, or rather, the lack of ethics. Critics are increasingly complaining that business schools focus too much teaching effort on maximizing shareholder value, with only a limited understanding of ethical and social aspects of business leadership. Business…

Cavaliere, Frank J.; Mulvaney, Toni P.; Swerdlow, Marleen R.

2010-01-01

300

Teaching Business Ethics after the Financial Meltdown: Is It Time for Ethics with a Sermon?  

Science.gov (United States)

|Our country is faced with a financial crisis of mammoth proportions: a crisis rooted in ethics, or rather, the lack of ethics. Critics are increasingly complaining that business schools focus too much teaching effort on maximizing shareholder value, with only a limited understanding of ethical and social aspects of business leadership. Business…

Cavaliere, Frank J.; Mulvaney, Toni P.; Swerdlow, Marleen R.

2010-01-01

 
 
 
 
301

Dissolving the engineering moral dilemmas within the Islamic ethico-legal praxes.  

UK PubMed Central (United Kingdom)

The goal of responsible engineers is the creation of useful and safe technological products and commitment to public health, while respecting the autonomy of the clients and the public. Because engineers often face moral dilemma to resolve such issues, different engineers have chosen different course of actions depending on their respective moral value orientations. Islam provides a value-based mechanism rooted in the Maqasid al-Shari'ah (the objectives of Islamic law). This mechanism prioritizes some values over others and could help resolve the moral dilemmas faced in engineering. This paper introduces the Islamic interpretive-evaluative maxims to two core issues in engineering ethics: genetically modified foods and whistleblowing. The study aims primarily to provide problem-solving maxims within the Maqasid al-Shari'ah matrix through which such moral dilemmas in science and engineering could be studied and resolved.

Solihu AK; Ambali AR

2011-03-01

302

Dissolving the engineering moral dilemmas within the Islamic ethico-legal praxes.  

Science.gov (United States)

The goal of responsible engineers is the creation of useful and safe technological products and commitment to public health, while respecting the autonomy of the clients and the public. Because engineers often face moral dilemma to resolve such issues, different engineers have chosen different course of actions depending on their respective moral value orientations. Islam provides a value-based mechanism rooted in the Maqasid al-Shari'ah (the objectives of Islamic law). This mechanism prioritizes some values over others and could help resolve the moral dilemmas faced in engineering. This paper introduces the Islamic interpretive-evaluative maxims to two core issues in engineering ethics: genetically modified foods and whistleblowing. The study aims primarily to provide problem-solving maxims within the Maqasid al-Shari'ah matrix through which such moral dilemmas in science and engineering could be studied and resolved. PMID:19937149

Solihu, Abdul Kabir Hussain; Ambali, Abdul Rauf

2009-11-24

303

The Rationalist's Dilemma  

Directory of Open Access Journals (Sweden)

Full Text Available In his book In Defense of Pure Reason Laurence BonJour proposed an account of a priori justification which essentially refers to so-called rational insights. Unfortunately, the reader is not equipped with a substantial answer to the question what such rational insights exactly are. And moreover, he is told that this is not an in any way decisive shortcoming of BonJour’s account of a priori justification — at least not a shortcoming which should motivate us to abandon his account. In order to support this thesis, BonJour refers to an analogy between the case of rational insights and the case of consciousness. He points out that we would not give up the use of the notion of consciousness, in spite of the fact that today there is still no satisfying answer to the question what consciousness exactly is. I will argue that the analogy BonJour refers to is in fact a persuasive one and can help him as well as other proponents of the rational-insight account to deal with some prominent objections. But taking the analogy seriously does consequently mean to undermine a favourite rationalist’s thesis: the autonomy claim. I conclude that the rationalist is confronted with a dilemma; he simply cannot have it both ways.

Vanessa Morlock

2006-01-01

304

Interprofessional collaboration-in-practice: the contested place of ethics.  

UK PubMed Central (United Kingdom)

The main question examined is: How do nurses and other healthcare professionals ensure ethical interprofessional collaboration-in-practice as an everyday practice actuality? Ethical interprofessional collaboration becomes especially relevant and necessary when interprofessional practice decisions are contested. To illustrate, two healthcare scenarios are analyzed through three ethics lenses. Biomedical ethics, relational ethics, and virtue ethics provide different ways of knowing how to be ethical and to act ethically as healthcare professionals. Biomedical ethics focuses on situated, reflective, and nonabsolute principled justification, all things considered; relational ethics on intersubjective, professional, and institutional relations; and virtue ethics on prephilosophical tradition and what it means to be good and to be human embedded in social and political community. Analysis suggests that interprofessional collaboration-in-practice may be more rhetoric than actuality. Key challenges of interprofessional collaboration-in-practice and specific conditions perpetuating dissension and conflict are outlined with specific education and policy recommendations included.

Ewashen C; McInnis-Perry G; Murphy N

2013-05-01

305

How close can you go? : Dilemmas of proximity in ethnographic eesearch  

DEFF Research Database (Denmark)

In ethnographic research the direct involvement and long-term engagement of the researcher constitute key elements. Acknowledgements of numerous publications resulting from ethnographic studies illustrate that the researchers are often deeply indebted to the research subjects for allowing the researchers to follow them around. Thus it is impossible to carry out ethnographic work without obtaining access, getting involved in, and sharing the lives of the people that are subjects to such studies. Gaining the access, which is clearly in the interest – even a prerequisite – of the ethnographer, might constitute a problem in itself, as it actualizes the question of the interest of the research to the participants. Why should they allow the researcher to enter and describe their circumstances of life? What kind of interest might they have or accept in sharing their experiences with a researcher? Once having gained access to participate in and describe the lives of the participants of a given context, the next ethical question facing the researcher is the one of involvement. Again, the researcher has an interest in obtaining as much confidence as possible, whereas the interest of the observed subjects might be more dubious and a matter of difficulty to handle by the researcher. The obvious dilemma of conflicting interests and difficult handling of proximity is our focus of interest in this paper: One side of this dilemma is to ask the question, how close you need to go to obtain the confidence of the participants in the research context and the necessary in-depth insight to understand their cultures and conditions of life. Another side of it is to ask, how close you can go without violating in a symbolic sense the lives of the participants and their rights of privacy. This further raises the question, how does the presence of the researcher alter the dynamics of the observed reality and the lives of the people in it? Not a new question asked in research, but still a necessary and ethical question to ask and deal with in any ethnographic work, and for the authors of the paper an important question in planning a longitudinal, ethnographic study of children labeled as talented athletes joggling school, training, competition, friends, and family. The study plan includes a vision of following the children in their daily lives in a way that is inspired by the intensive data-gathering techniques employed by Annette Lareau in her study of family patterns in the USA (Lareau, 2011). This raises preliminary questions as to how such a fieldwork can be carried out; both to ensure the necessary provision of empirical data to carry out ethnographic analyses and challenge existing theoretical frameworks, and to ensure that the subjects under scrutiny are not subject to ethical violations. With this in mind the above dilemmas of proximity will be addressed and discussed in our paper.

Rasmussen, Annette; Skrubbeltrang, Lotte Stausgaard

306

Health branding ethics  

DEFF Research Database (Denmark)

Commercial food health branding is a challenging branch of marketing because it might, at the same time, promote healthy living and be commercially viable. However, the power to influence individuals’ health behavior and overall health status makes it crucial for marketing professionals to take into account the ethical dimensions of health branding: this article presents a conceptual analysis of potential ethical problems in health branding. The analysis focuses on ethical concerns related to the application of three health brand elements (functional claims, process claims, and health symbols) as well as a number of general concerns that apply to health branding as such. Being a pioneering analysis, this article advances the academic understanding of health branding and provides practitioners with knowledge of important concerns to take into account when marketing health brands.

Anker, Thomas Boysen; SandØe, Peter

2011-01-01

307

Corporate ethical decision making in health care institutions.  

UK PubMed Central (United Kingdom)

The health care environment in which ethical decisions are made is changing rapidly. Ultimately, these changes may produce a more effective health care system. However, they also create new ethical dilemmas and greater complexity in ethical decision making. To clarify the problems of ethical decision making in health care institutions, and to define some guidelines for making these decisions, Ross Laboratories convened a roundtable of ethicists, attorneys, and health care practitioners, including physicians, nurses, and dietitians. The roundtable was chaired by Monsignor Charles Fahey of Fordham University's Third Age Center, who reflected on the discussions and, in this issue of Hospital Administration Currents, shares his thoughts on the issues of ethical decision making by corporate health care entities.

Fahey C

1987-01-01

308

The nursing shortage and ethics: up front and personal.  

UK PubMed Central (United Kingdom)

In times of crisis it is often that values and beliefs and, subsequently, our ethics are challenged. Authors in OJIN have addressed some of the ethical issues that nurses face in relation to crises in health care. For example, P. J. Maddox (1998) addressed ethical issues surrounding economic constraints and scarce resources. In this current issue of OJIN, Cheryl Peterson (2001) writes of the ethical dilemma nurses face in trying to comply with the Code for Nurses with Interpretive Statement, 1985 in light of the present nursing shortage. We invite you to read these and the other OJIN articles on the shortage and then submit to this column a story about how the nursing shortage has ethically affected you or your patients/clients.

Silva MC; Ludwick R

2001-01-01

309

Ethics Column: "Ethical Challenges in the Care of Elderly Persons  

Directory of Open Access Journals (Sweden)

Full Text Available Ethical issues are central to any discussion or reflection on aging and health care. The authors of the OJIN topic, Health Care and the Aging Population: What Are Today's Challenges?, address a variety of topics including quality of life, long-term care planning, geriatric education, frail elder care, and successful aging behaviors. Imbedded in these topics are ethical issues that are relevant to nursing and/or health care. Thus, the focus of this column is to examine select ethical issues in these five articles on aging. To frame our discussion, we will use the provisions of the 2001 American Nurses Association (ANA) Code of Ethics for Nurses with Interpretive Statements (referred hereafter as the Code). The Code represents the nursing profession’s public declaration of ethical duties and obligations and, as such, it serves as a basis for any discussion of ethics that involves nurses. Thus, the Code is applicable to us as we work with the aged, whether we make a home visit, administer a medication, answer a call light, develop a policy, or supervise a student. We begin the column with an overview of some of the ethical issues that are explicitly and implicitly discussed in each of the five articles and then examine how the ANA Code can inform and guide us with the ethical issues outlined.

Ludwick, R., Silva, M

2003-01-01

310

Towards a Christian ethic of work in South Africa  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english This paper draws on the academic field of Christian ethics and focuses attention on an ethic of work within the South African context. Key terms such as 'an ethic of work', 'a work ethic' and 'ethics at work' are discussed in relation to varied experiences of work. The issues of why one ought to work and what constitutes 'good' work are discussed with reference to current ethical and economic challenges. I argue that a Christian worldview, or understanding of reality, pro (more) vides a much more credible contribution to an ethic of work than either a materialist view of reality or a system of patronage.

Kretzschmar, Louise

2012-12-01

311

Extracorporeal membrane oxygenation clinical dilemmas.  

UK PubMed Central (United Kingdom)

Three scenarios are presented, based on real patients, illustrating various clinical dilemmas involving critical illness and extracorporeal membrane oxygenation (ECMO). The scenarios are outlined in the form of questions and answers. In most cases there is no single correct answer to the dilemmas presented. The pros and cons of particular interventions are discussed along with the actual treatment provided. In all cases, the ECMO circuit consisted of a polymethylpentene oxygenator (Quadrox PLS; MAQUET Cardiovascular, Hirlingen, Germany) and a centrifugal pump (Rotaflow; MAQUET Cardiovascular). Case 2 has been previously published as a letter to the editor (1).

Sidebotham D

2012-12-01

312

What's the matter with business ethics?  

Science.gov (United States)

The more business ethics secures its status in campuses across the country, the more bewildering it appears to actual managers. It's not that managers dislike the idea of doing the right thing. As University of Toronto Assistant Professor Andrew Stark argues, far too many business ethicists just haven't offered them the practical advice they need. Before business ethics became a formal discipline, advocates of corporate social responsibility claimed that the market would ultimately reward ethical behavior. But ethics and interests did not always intersect so fruitfully in the real world. And when they did not, managers were left in the dark to grope for the right ethical course. In the 1970s, the brand-new field of business ethics came onto the scene to address this issue. Critical of the "ethics pays" approach, academics held that ethics and interests can and do conflict. Still, scholars took an equally unrealistic line. To them, a manager's motivation could be either altruistic or self-interested, but never both. In short, ethicists still weren't addressing the difficult moral dilemmas that managers face on a day-to-day basis, and only recently have they begun to do so. After some initial stumbles, ethicists are getting their hands dirty and seriously considering the costs of doing the right thing. Finally, a new business ethics is emerging that acknowledges and accepts the messy world of mixed motives. As a result, novel concepts are springing up: moderation, pragmatism, minimalism, among others.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10126154

Stark, A

313

Water ethics perspectives in the Arab Region  

International Nuclear Information System (INIS)

Water ethics has only recently emerged in academic and development arenas as an independent field of professional discussion. Concerns over water conservation and adequate access to basic needs of water and sanitation pose a difficult ethical dilemma that should be addressed based on societal and ethical frame works. Issues such as water allocation and pricing, privatization of various water services and efficient water management need to be contested within an ethical framework according to principles of equity and social justice. This paper presents the basic concepts of water ethics, as well as water ethics perspectives and applications within the framework of integrated water resources management (IWRM) in the Arab Region, which suffers from one of the fastest growing water deficits in the world. The deteriorating status of the water resources situation in Arab Region is no longer tolerable due to the high costs in terms of negative environmental consequences and deteriorating livelihoods of poor populations associated with lack of access to clean water and sanitation. Nevertheless, most of the national efforts for IWRM implementation in the Region have been dominated by neo-liberal economic policies stressing privatization of various water services; cost recovery through different pricing and tariffication schemes; as well as sectoral water (re)allocation. However, many negative impacts due to the shift to neo-liberal market-led economies have been surfaced throughout the developing world in the past decade and a half, especially with respect to the increased levels of poverty and worsening environmental degradation. It is, therefore, critical to adopt IWRM approaches in the region within an ethical framework that takes full consideration of all social implications regarding the poor, and that could be used as a means to achieve water-related international goals of poverty reduction. Finally, the paper also shows that there is no contradiction between Islamic beliefs, which constitute the chief cultural and ethical source of most Arab societies, and worldwide accepted IWRM principles and associated ethical frameworks. (author)

2006-01-01

314

Ethics (lesson)  

Science.gov (United States)

Students examine some examples of ethical issues that have resulted from our expanded knowledge of neuroscience. They are asked to write a position paper describing their own point of view on one of these controversial topics.

2009-04-14

315

Business ethics.  

UK PubMed Central (United Kingdom)

Many situations in the business world require making a decision by assessing the merits of the case against a set of principles or guidelines. This article discusses the way business ethics applies to the food industry.

Stauffer JE

1991-06-01

316

Medical ethics in residency training  

Directory of Open Access Journals (Sweden)

Full Text Available Medical ethics education in residency training is one of the hot topics of continuous medical education debates. Its importance and necessity is constantly stressed in declarations and statements on national and international level. Parallel to the major structural changes in the organization and the finance model of health care system, patient-physician relationship, identity of physicianship, social perception and status of profession are changing. Besides, scientific developments and technological advancements create possibilities that never exists before, and bring new ethical dilemmas along with. To be able to transplant human organs has created two major problems for instance; procurement of organs in sufficient numbers, and allocating them to the patients in need by using some prioritizing criteria. All those new and challenging questions force the health care workers to find authentic and justifiable solutions while keeping the basic professional values. In that sense, proper medical ethics education in undergraduate and postgraduate term that would make physician-to-be’s and student-physicians acquire the core professional values and skill to notice, analyze and develop justifiable solutions to ethical problems is paramount. This article aims to express the importance of medical ethics education in residency training, and to propose major topics and educational methods to be implemented into. To this aim, first, undergraduate medical education, physician’s working conditions, the exam of selection for residency training, and educational environment were revised, and then, some topics and educational methods, which are oriented to educate physicians regarding the professional values that they should have, were proposed.

Murat Civaner; Özlem Sar?kaya; Harun Balc?o?lu

2009-01-01

317

Culpability and pain management/control in peripheral vascular disease using the ethics of principles and care.  

UK PubMed Central (United Kingdom)

The purposes of this article were to provide insight into the process of ethics and ethical inquiry and to explore the ethical issues of culpability and pain management/control. Critical care nurses who currently care for vascular patients identified these issues as occurring frequently in their practice. Authors in critical care nursing generally have limited the process of ethical inquiry to a theoretical framework built around an ethic of principles. The message many critical care nurses heard was that this one type of theoretical ethical framework was the totality of ethics. The application of these principles was ethical inquiry. For some nurses, the ethic of principles is sufficient. For others, an ethic of principles is either incomplete or foreign. This second group of nurses may believe that they have no moral voice if the language of ethics is only the language of principles. The language of principles, however, is not the only theoretical framework available. There is also the ethic of care, and ethical inquiry can include the application of that framework. Indeed, the language of the ethic of care may give a voice to nurses who previously felt morally mute. In fact, these two theoretical frameworks are not the only frameworks available to nurses. There is also virtue ethics, a framework not discussed in this article. A multiplicity of ethical frameworks is available for nurses to use in analyzing their professional and personal dilemmas. Recognizing that multiplicity, nurses can analyze their ethical dilemmas more comprehensively and effectively. Applying differing ethical frameworks can result in the same conclusions. This was the case for the issue of culpability.(ABSTRACT TRUNCATED AT 250 WORDS)

Omery A

1991-09-01

318

The dilemma of ethical political communication in South African elections  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In view of South Africa’s diversity, its unresolved issues of race and complex social legacy, election campaigns are highly sensitive. From a Reformed Christian perspective, a critical question is: To what extent is the political culture infused by the Biblical imperatives of brotherly love, respect...

L.M. Fourie; J.D. Froneman

319

Rudolph Hess, A Strategic Move or Ethical Dilemma.  

Science.gov (United States)

On 10 May, 1941, Rudolph Hess, Deputy Fuhrer and leader of the Nazi Party, flew secretly from Germany to England and surrendered to the British forces. Through a review of Hess's early life and associated literature, this study seeks to answer three histo...

T. M. Driskill

1990-01-01

320

The ethical dilemma posed by overly conservative environmental standards  

International Nuclear Information System (INIS)

The searing introduction of the public to the human health effects from large doses of ionizing radiation came from the nuclear weapon explosions at Hiroshima and Nagasaki, Japan at the end of World War II. The horrors of a war using such weapons are part of the human consciousness. This introduction created fear and concern over ionizing radiation from man-made radionuclides or natural radionuclides enhanced by man's activities. This leads to a public over-emphasis on reducing exposure to man-made ionizing radiation whatever the expense might be. A study that evaluated costs of 500 life saving interventions found that radiation control activities had a median cost of $27 million (US) per life per year and were four of the top ten most expensive [up to $34 billion (US) per life per year]. [Tengs, 1994] (author)

1996-01-01

 
 
 
 
321

The dilemma of ethical political communication in South African elections  

Directory of Open Access Journals (Sweden)

Full Text Available In view of South Africa’s diversity, its unresolved issues of race and complex social legacy, election campaigns are highly sensitive. From a Reformed Christian perspective, a critical question is: To what extent is the political culture infused by the Biblical imperatives of brotherly love, respect and compassion? Given the growing use of adversarial political advertising the following two questions arise and are specifically addressed: • Could it realistically be expected of Christian political communicators in a secular country such as South Africa to communicate with full respect to people at all times, or should they be excused if they try to win at all costs? and • How do political theorists view the issue? In answering these questions, social responsibility and the need for social harmony as precondition for free and fair political activities, as well as a Biblical perspective on communication are addressed. In view of these theoretical points of departure the role of emotional messages is discussed and evaluated. It is argued that all advertising, but specifically political advertising in an emotionally charged atmosphere such as an election campaign, could have a direct negative impact on social harmony and is therefore Biblically unacceptable. Examples from previous South African general elections are discussed and evaluated from a Biblical viewpoint. It is argued that parties should not merely campaign with the aim of winning an election, but rather with the intention of respecting voters while campaigning. Simultaneously they could promote democracy within a fragile social context. Any victory outside of these parameters will not stand the test of a Biblical critique. However, it would seem extremely difficult, if not impossible, to prescribe in any detail which types of negative advertisements are acceptable and which are not.

L.M. Fourie; J.D. Froneman

2007-01-01

322

The ethical dilemma of seeking appropriate CME sessions in February  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Wet West Coast winter syndrome caused Dr. John Anderson to seek a continuing medical education (CME) conference in sunnier climes, and he found one that was not quite within his field of family medicine. He offers this litany of epiphany, confession and redemption to anyone else considering sacrific...

Anderson, John F.

323

The Multi-Center Dilemma Project: an investigation on the role of cognitive conflicts in health.  

Science.gov (United States)

The Multi-Center Dilemma Project is a collaborative research endeavour aimed at determining the role of dilemmas--a kind of cognitive conflict, detected by using an adaptation of Kelly's Repertory Grid Technique--in a variety of clinical conditions. Implicative dilemmas appear in one third of the non-clinical group (n = 321) and in about half of the clinical group (n = 286), the latter having a proportion of dilemmas that doubles that of the non-clinical sample. Within the clinical group, we studied 87 subjects, after completing a psychotherapy process, and found that therapy helps to dissolve those dilemmas. We also studied, independently, a group of subjects diagnosed with social phobia (n = 13) and a group diagnosed with irritable bowel syndrome (n = 13) in comparison to non-clinical groups. In both health related problems, dilemmas seem to be quite relevant. Altogether, these studies, though preliminary (and with a small group size in some cases), yield a promising perspective to the unexplored area of the role of cognitive conflicts as an issue to consider when trying to understand some clinical conditions, as well as a focus to be dealt with in psychotherapy when dilemmas are identified. PMID:15139250

Feixas, Guillem; Saúl, Luis Angel

2004-05-01

324

Ethical decision-making and professional behaviour among nurses: a correlational study.  

UK PubMed Central (United Kingdom)

This study examined the relationship between nurses' ethical decision-making levels and their professional behaviours. Data were collected from 225 nurses who were recruited from university hospitals in Ankara using proportionate sampling. Data were analysed using descriptive statistics and Pearson correlations. Most of the nurses were familiar with ethical dilemmas in nursing practice. The Nursing Principled Thinking level was above average, while the Practical Consideration level was average. Nurses' professionalism level was low. There was a positive but weak correlation between professional behaviours of the nurses and their ethical decision-making levels. Increasing nurses' professionalism level can provide a positive contribution to the ethical decision-making level.

Cerit B; Dinç L

2013-03-01

325

So many ways to think. An overview of approaches to ethical issues in geriatrics.  

UK PubMed Central (United Kingdom)

This article provides an overview of ways to think about ethical issues in geriatrics. Principle-based approaches include deontology, utilitarianism, virtue theory, and natural law. Case-based approaches include casuistry, care, and narrative ethics. Pragmatism and feminism are methods that mesh case-based with principle-based considerations. Each of these approaches is explained and critiqued in relation to specific cases in geriatrics. The author concludes that clinical ethical decisions are optimized by considering, but not necessarily following, all of the available approaches to ethical dilemmas.

Mahowald MB

1994-08-01

326

Ethical issues in health-care inquiry: a discussion paper.  

UK PubMed Central (United Kingdom)

This paper is a discussion of the possible ethical dilemmas that may arise in both qualitative and quantitative research despite stringent methodological protocols. Three categories of ethical issues will be elaborated on, namely, researcher-participant relations, informed consent and confidentiality and privacy. These are of note because ethical dilemmas most often arise in these areas. Both qualitative and quantitative research types may thus present with problems associated with any, or a combination, of these categories. Methodological rigour will also be discussed as a vital component of any research study. Critics of the qualitative approach have often suggested that the innate lack of methodological rigour has resulted in the preponderance of ethical issues in qualitative studies. Qualitative studies, similar to quantitative studies, have mechanisms that guarantee rigour, quality and trustworthiness. These checks are at par with those of quantitative research but based on different criteria. Both types of research, then, can be considered equal in terms of methodological rigour, regardless of the nature. As no research approach can be perfectly free from threats of ethical issues, it is the researcher's responsibility to address these in ways that will be less harmful to the participants, bearing in mind ethical problems can arise at any time during the research endeavour.

Ignacio JJ; Taylor BJ

2013-02-01

327

[Ethical intervention in pragmatic regime].  

UK PubMed Central (United Kingdom)

This article analyzes the impact of the neo-pragmatist turn in social sciences from the point of view of the method of ethical intervention. It focuses specifically on the idea of building a "learning community" as the horizon for strengthening participative 'capacitation'. It finally points at the limits of such a perspective, from the point of view of institutional building of new subjectivities through and beyond the practices proposed by ethical interventions.

Maesschalck M

2012-09-01

328

Ethics and Validity Stance in Educational Assessment  

Directory of Open Access Journals (Sweden)

Full Text Available Assessment is a powerful tool which can shape curriculum, teaching and learning. One of the major topics which has been the focus of so much debate among the scholars is the concept of ethics in educational assessment systems. The purpose of this paper is to touch upon the issue of ethics in language assessment from validity perspectives. To ensure effective planning, implementation, and evaluation of learning, certain principles and guidelines for beliefs and behaviors are adopted. These principles and guidelines are identified as ethical standards. The central question to be addressed here is whether any test can be defended as ethical, or moral. This study also examines professional ethics, specifically ethical principles as they relate to educational assessment. And finally, some suggestions and guidelines will be offered for applying ethics in educational assessment to maximize validity and fair application of language test scores.

Masoomeh Estaji

2011-01-01

329

Retrievability, ethics and democracy  

International Nuclear Information System (INIS)

Ethics is always a social concern, an integrated part of laws and regulations. Treatment of ethics as a separate part in the decision making process is therefore always debatable. It cannot be introduced as an extraneous component to compensate for, or to improve, a morally flawed practice, and the margin for unethical practices is strongly circumscribed by regulation in the nuclear field, internationally. However, a discussion on different stakeholders and their different ethical concerns should always be welcome. One example is the implementer's views on ethics. Even if they are in complete parity with existing legal and regulatory goals, the goals may still represent the implementer's own motives and choices. Also, stakeholders may view the laws or regulations as unfair. In making the critique, the stakeholder simply formulates a separate political standpoint. Finally, an alternative discussion is to place existing regulations into an ethical perspective - adding a new dimension to the issues. Retrievability for high level waste repositories is often in focus in ethical discussions. Unfortunately, it is used in many ways and has become an unclear term. It may cover anything from planned recuperation to the property of waste being retrievable in years or tens of years, or in the distant time range of hundreds or thousands of years. The term retrievability is often proposed to cover mainly positive qualities such as the option of later changes to the repository or a new disposal concept. However, as ICRP and others have pointed out, it also implies the possibility of: i) operational exposures, ii) continuing risks of accidental releases, iii) financial provisions to cover operating costs and iv) continuing reliance on institutional control, thus imposing some burdens to future generations. In a certain sense, anything can be retrieved from any repository. There is therefore a need for a clear and operable definition of retrievability requirements, including the definition of the corresponding legal consequences. (author)

2000-01-01

330

Ethics of environmental concern  

Energy Technology Data Exchange (ETDEWEB)

The history of ideas and a philosophical investigation into normative ethics and some of its applications focus in this book on environmental concerns. Part one explores moral traditions, which may appear deficient because traditions have been misrepresented. Attitudes and ideas toward ecological problems have a basis in Jewish and Christian stewardship traditions. Part two re-examines moral principles in light of scientific discoveries that have generated and revealed new side effects of human actions on the complex systems of nature. If all worthwhile life is of intrinsic value, it is necessary to reassess and broaden the human obligation to ecology. The author disagrees with the movement to focus environmental ethics on the biosphere as an organic whole rather than on fellow creatures, although his principles embody constraints in the interests of future creaters. The book concludes with an assessment of principles on pollution, resources, population, and preservation. 302 references.

Attfield, R.

1983-01-01

331

[Participative research and health researcher's ethical formation].  

Science.gov (United States)

The present article discusses Ethics concept as dwell and way of dwelling, aiming to articulate it with some elements of participative research from an ethnographic matrix. Mainly, it focuses the idea of the ethical subject's autonomy, associating it with self-reflection and alterity in ethnography. Yet, it approaches the participative research in an ethnographic perspective as a praxis that induces to health researcher's ethical formation. PMID:18813555

Schmidt, Maria Luisa Sandoval

332

[Participative research and health researcher's ethical formation].  

UK PubMed Central (United Kingdom)

The present article discusses Ethics concept as dwell and way of dwelling, aiming to articulate it with some elements of participative research from an ethnographic matrix. Mainly, it focuses the idea of the ethical subject's autonomy, associating it with self-reflection and alterity in ethnography. Yet, it approaches the participative research in an ethnographic perspective as a praxis that induces to health researcher's ethical formation.

Schmidt ML

2008-03-01

333

Ethics Column:  

Directory of Open Access Journals (Sweden)

Full Text Available Ethics is concerned with the suffering humans cause one another and the related capacity of humans to recognize and address this suffering through the empathetic virtues of sympathy, compassion, and caring (Roberts, 1996). Much suffering throughout history can be related to the problem of "unacceptable" diversity among individuals or groups. Remembering the cruelties of the Nazi exterminations of Jews, slavery in the United States, and discrimination against homosexuals jolts us to awareness of the suffering of those who are "different." A task of ethics, then, is to include, rather than exclude (Post, 1995). One approach to an ethics of diversity for healthcare professionals is a call for intimate listening to the stories of those who are different, who may be unseen, marginalized, and excluded in our health care systems.

Sorrell, J

2003-01-01

334

Ethics and technology design  

DEFF Research Database (Denmark)

This article offers a discussion of the connection between technology and values and, specifically, I take a closer look at ethically sound design. In order to bring the discussion into a concrete context, the theory of Value Sensitive Design (VSD) will be the focus point. To illustrate my argument concerning design ethics, the discussion involves a case study of an augmented window, designed by the VSD Research Lab, which has turned out to be a potentially surveillance-enabling technology. I call attention to a "positivist problem" that has to do with the connection between the design context and the use context, which VSD seems to presuppose, and I argue that it is necessary to clearly distinguish between the two, since the designers' intentions do not always correspond with the users' practice; in fact, the relation between design and use is very complex and principally unpredictable. Thus, a design theory must accept that foresight is limited to anticipation rather than prediction. To overcome the positivist problem, I suggest a phenomenological approach to technology inspired by Don Ihde's concept of multistability. This argument, which is general in nature and thus applies to any theory of design ethics, is intended as a constructive criticism, which can hopefully contribute to the further development of design ethics.

Albrechtslund, Anders

2007-01-01

335

Ethical palliative family nursing care: a new concept of caring for patients and families.  

UK PubMed Central (United Kingdom)

The practice of nursing has a duty to educate, communicate, and resource patients and families during the period in which the solution to an ethical dilemma is predetermined by evidence-based practice. Clearly, there is a gap in the quality of care provided or the interpretation of the quality of care being provided during difficult ethical situations requiring a systematic change to increase patient and family comfort and satisfaction.

Maroon AM

2012-10-01

336

Ethical palliative family nursing care: a new concept of caring for patients and families.  

Science.gov (United States)

The practice of nursing has a duty to educate, communicate, and resource patients and families during the period in which the solution to an ethical dilemma is predetermined by evidence-based practice. Clearly, there is a gap in the quality of care provided or the interpretation of the quality of care being provided during difficult ethical situations requiring a systematic change to increase patient and family comfort and satisfaction. PMID:23169185

Maroon, Amanda M

337

Ethical perspectives of children's assent for research participation: deontology and on utilitarianism.  

UK PubMed Central (United Kingdom)

Is a child's assent to participate in research that does not have the potential to directly benefit the child ethically mandated? Analysis of this particular dilemma of health care research in children using two competing theories results in different answers. Deontology (principle-based ethics) will be contrasted with utilitarianism (consequentialism). Historical cases of research with children will be used as exemplars of these two theoretical positions.

Pieper P

2008-07-01

338

Ethical perspectives of children's assent for research participation: deontology and on utilitarianism.  

Science.gov (United States)

Is a child's assent to participate in research that does not have the potential to directly benefit the child ethically mandated? Analysis of this particular dilemma of health care research in children using two competing theories results in different answers. Deontology (principle-based ethics) will be contrasted with utilitarianism (consequentialism). Historical cases of research with children will be used as exemplars of these two theoretical positions. PMID:18814566

Pieper, Pam

339

The ethics of drug development and promotion: the need for a wider view.  

Science.gov (United States)

Ethical issues at the interface between the medical profession and the pharmaceutical industry have generally been approached from the vantage point of medical professionalism, with a focus on conflict of interest as the key ethical concern. Although conflicts of interest remain important, other ethical issues may be obscured unless a wider perspective is adopted. Besides medical professionalism, the ethics of the clinical therapeutic relationship, ethics of public health, and business ethics all provide additional insights. PMID:23047778

Brody, Howard

2012-11-01

340

The ethics of drug development and promotion: the need for a wider view.  

UK PubMed Central (United Kingdom)

Ethical issues at the interface between the medical profession and the pharmaceutical industry have generally been approached from the vantage point of medical professionalism, with a focus on conflict of interest as the key ethical concern. Although conflicts of interest remain important, other ethical issues may be obscured unless a wider perspective is adopted. Besides medical professionalism, the ethics of the clinical therapeutic relationship, ethics of public health, and business ethics all provide additional insights.

Brody H

2012-11-01

 
 
 
 
341

ETHICS, OBEDIENCE AND DISOBEDIENCE. THE NECESSITY TO PROMOTE ORGANIZATIONAL ETHICS WITHIN THE HEALTHCARE SYSTEM  

Directory of Open Access Journals (Sweden)

Full Text Available Many of the bibliographical references to the forms of ethics embedded in the hospital-related practices suggest, in return, a clear reference to the biomedical ethics involved in the healthcare of patients and also to the specific activity of ethics committees. Policies regarding abortion or those in favour of the termination of treatment expressed by patients in a vegetative condition through their biological testament -“the living will” (acc. Williamson & Jauch,1995) , are examples which often throw the medical world in the midst of difficult ethical dilemmas. Nevertheless, besides their strong social mission of taking care of the health of a population, hospitals are equally meant to deal with all the ethical aspects that leave their mark on each organization, either internally, or externally, irrespective of their specific branch and of their field of activity – the public or the private sphere. Our article highlights in a theoretical way the necessity and benefits to promote the organizational ethics within the healthcare system.

Daniela Tatiana AGHEORGHIESEI (CORODEANU)

2012-01-01

342

Ombud's corner: Use of sensemaking* in ethical decisions  

CERN Multimedia

In this series, the Bulletin aims to explain the role of the Ombuds at CERN by presenting practical examples of misunderstandings that could have been resolved by the Ombuds if he had been contacted earlier. Please note that, in all the situations we present, the names are fictitious and used only to improve clarity.   Taking ethical decisions can often be a dilemma - one that requires recognition and proper representation of multiple pieces of complex information, as well as an intuitive judgment about potential consequences. Pressure is particularly placed on organizational leaders, who are tasked with projects, partnerships and individuals. Constraining forces - be they personal, situational or environmental - can negatively influence any decision by decreasing ethical awareness, ethical sensitivity and ethical judgment. By creating mental compensatory models, the Sensemaking* technique serves to counteract these constraining forces that narrow the search and evaluation of&nbs...

Vincent Vuillemin

2012-01-01

343

Academic dishonesty and ethical reasoning: pharmacy and medical school students in New Zealand.  

UK PubMed Central (United Kingdom)

BACKGROUND: There is ample evidence to suggest that academic dishonesty remains an area of concern and interest for academic and professional bodies. There is also burgeoning research in the area of moral reasoning and its relevance to the teaching of pharmacy and medicine. AIMS: To explore the associations between self-reported incidence of academic dishonesty and ethical reasoning in a professional student body. METHODS: Responses were elicited from 433 pharmacy and medicine students. A questionnaire eliciting responses about academic dishonesty (copying, cheating, and collusion) and their decisions regarding an ethical dilemma was distributed. Multivariate analysis procedures were conducted. RESULTS: The findings suggested that copying and collusion may be linked to the way students make ethical decisions. Students more likely to suggest unlawful solutions to the ethical dilemma were more likely to disclose engagement in copying information and colluding with other students. CONCLUSIONS: These findings imply that students engaging in academic dishonesty may be using different ethical frameworks. Therefore, employing ethical dilemmas would likely create a useful learning framework for identifying students employing dishonest strategies when coping with their studies. Increasing understanding through dialog about engagement in academic honesty will likely construct positive learning outcomes in the university with implications for future practice.

Henning MA; Ram S; Malpas P; Shulruf B; Kelly F; Hawken SJ

2013-06-01

344

Science, culture and (eco-)ethics  

Directory of Open Access Journals (Sweden)

Full Text Available EE Book 16 focuses on achievements and shortcomings of modern marine ecology. It also analysis the crux of all science: human capabilities and limitations of conducting research - of critically perceiving the world in and around us. Louis Legendre further examines the relationships between science and culture and underlines the significance of ethics, especially eco-ethics.

Louis Legendre

2004-01-01

345

Selecting the Perfect Baby The Ethics of "Embryo Design"  

Science.gov (United States)

This dilemma case is based on the true story of Jack and Lisa Nash, whose daughter Molly was born with a rare genetic disorder, Fanconi anemia. By having another child with specific genetic markers, the Nashes hoped to cure Molly using stem cells from the new baby’s umbilical cord blood. Students learn about developmental disorders and consider the ethical issues of genetic manipulation and fertility treatments. Although the case was written for beginning developmental psychology students, the issues raised involving genetic manipulation, advances in medical technology, and scientific ethics would be relevant in many other science courses.

Omarzu, Julia

2002-01-01

346

Further Discussion on the Construction of Ethics of Professional Accountants  

Directory of Open Access Journals (Sweden)

Full Text Available Any country is facing the problem of ethics of professional accountants, which also has been a focus of accounting theories for many years. Especially since the financial crisis in 2008 and the recession of world economy, business has been difficult, which makes the ethics of professional accountants more important. In perspective of business ethics, the author discusses the characteristics and the structure of ethics of professional accountants, locating the barriers for the construction of ethics of professional accountants and relevant reasons, and proposing the way for establishing the system of ethics of professional accountants.

Yong Cheng

2012-01-01

347

ETHICAL APPROACHES AND THEIR APPLICATION IN HOTEL MANAGERS' DECISION MAKING  

Directory of Open Access Journals (Sweden)

Full Text Available This study aims at evaluating the ethical approaches effective for managers working at hotel business when making decisions. Ethics, in the working place, refers to the rules of the workplace that an employee has to comply with, along with the rules of society. In the study, the concept of ethics has been examined within theories of ethics, followed by a conceptual framework of making ethical decisions. The scope of the study consists of interviews conducted with 60 managers working in a chain hotel. The interview consists of 5 different scenarios relating to ethical dilemmas. The scenarios are composed of three different ethics approaches (moral justice approach, subjective approach and contract -based theoretical approach). In the analysis of the data, the Manova Analysis was carried out. The results suggest that managers prefer the contract -based theoretical approach more frequently in decision making. It was also found that managers differ in their choice of ethical approaches in terms of the scenarios. This difference is caused by subjective approaches which are used when dealing with problems related to socio-cultural and institutional reputation and ecology.

Hatice Güçlü Nergiz; Meryem Ako?lan Kozak; Sabah Balta

2011-01-01

348

National scientific literature on nursing ethics: a systematic Review  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: To identify the most prevalent nursing ethical issues published in scientific Brazilian journals. Methods: A systematic literature review with the following inclusion criteria: (1) articles on Nursing Ethics written in Portuguese, English, French, and Spanish; (2) published in Brazilian journals; (3) in the period from January 1997 to February 2009. The search was carried out in four databases BDENF, LILACS, MEDLINE, and SCIELO. The key-words were ethics AND nursing. The selected studies were classified into categories. The content of the articles were analyzed using the Collective Subject Discourse. The categories generated discourses by organizing the main excerpts from the abstracts of the selected studies, which are the “key expressions”. Results: A hundred and thirty three articles that met the inclusion criteria were classified into eight categories: 1. Nursing Care; 2. Dilemmas and Controversies; 3. Education; 4. Legal Aspects; 5. Research; 6. Management; 7. Values and Beliefs; 8. Perspectives and Health Policies. The category “Nursing Care” prevailed in 36% of the selected articles, and it was classified into six subcategories. “Dilemmas and Controversies” was the second most prevalent category (15%). Conclusion: The number of theoretical papers on ethical issues is high, but there is little research on the ethical experiences in nursing practice.

Ilka Nicéia D’Aquino Oliveira Teixeira; Liliana Maria Labronici; Maria de Fátima Mantovani

2010-01-01

349

Selected anatomists: at the boundary of contemporary ethics.  

UK PubMed Central (United Kingdom)

Fascination with the interworkings of the human body has permeated scientific discovery for eons. Materials for dissection proved problematic for anatomists. Andreas Vesalius solved his dilemma by visiting local gallows where criminals had been executed. Eduard Pernkopf has been alleged to have taken some of his materials from victims of the Holocaust. Even today, executed criminals have served as subjects for anatomical educational purposes. These circumstances are explored and the contemporary ethics of each are compared.

Arango D; Greiffenstein P; O'Leary JP

2013-01-01

350

Preferences for Key Ethical Principles that Guide Business School Students  

Science.gov (United States)

Business ethics is presently a major component of the business school curriculum. Although there has been much attention focused on the impact of such coursework on instilling ethical decision-making (Nguyen et al., 2008), there is sparse research on how business students view the major ethical principles that serve as the foundation of business…

Guyette, Roger; Piotrowski, Chris

2010-01-01

351

Dilemas morais e praticas de saude/ Moral dilemmas and health practices/ Dilemas morales y practicas de salud  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Discute-se a emergência de dilemas morais nas práticas de saúde, tendo em vista a acelerada transição demográfica nos países em desenvolvimento e os crescentes custos dos sistemas públicos de saúde. São focalizadas duas dimensões do cuidado à saúde que têm ocupado um lugar importante na geração desses dilemas: a tensão entre as estratégias comerciais que contornam o mercado de produt (more) os de saúde e a expansão do acesso a esses produtos, por um lado, e o aumento da importância das tecnociências nas práticas de cuidado à saúde, por outro. Em conclusão, é discutida a importância da arbitragem política, social e jurídica na codificação ética desses dilemas e o papel do Estado Democrático de Direito nessa arbitragem. Abstract in spanish El texto discute la emergencia de dilemas morales en las prácticas de salud, teniendo en cuenta la acelerada transición demográfica en los países en desarrollo y los crecientes costos de los sistemas públicos de salud. Se hace énfasis en dos dimensiones del cuidado de la salud que han ocupado un lugar importante en la generación de tales dilemas. La tensión entre las estrategias comerciales que contornan el mercado de productos de s (more) alud y la expansión del acceso a dichos productos, por un lado, y el aumento de la importancia de las tecnociencias en las prácticas de cuidado de la salud, por el otro. En conclusión, se discute la importancia del arbitraje político, social y jurídico en la codificación ética de los dilemas y el papel del Estado Democrático de Derecho en el arbitraje. Abstract in english The emergence of moral dilemmas in health care practices, in view of the rapid demographic transition in developing countries, and skyrocketing public health care costs, is discussed. The focus is on two aspects of health care that have occupied an important place in the generation of these dilemmas. On the one hand, the tension between commercial strategies involving the health products market and the expansion of access to them and, on the other, the growth of techno-sc (more) iences in health care practices. In conclusion, the importance of the political, social and juridical arbitration on the ethical codifi cation of those dilemmas and the role of a Democratic State of Law in that arbitration is discussed.

Guimaraes, Reinaldo

2013-06-01

352

Wealth, Groups, Ethics  

Directory of Open Access Journals (Sweden)

Full Text Available For centuries, many scientists, many disciplines focused on how people make decisions. These approaches tend to be incompatible, if not orthogonal most case. In this article we attempt to give guidelines to a modeling approach, that will allow the description of a human “state vector”, which can be the basis for many decision making algorithms.First we will introduce a categorization of the things that determine the decisions of the individuals, and describe their characteristics and trade. Since the trade of things in separate groups is done in different fashion, they form groups on different grounds. These groups, formed by interaction among individuals, adhere to governing ethics – which serve the purpose of defining the rules of exchange where these have not been explicitly stated. And finally, we take a look how the two dominant ethics, the Commercial and the Guardian dominate the Teacher.

Katalin Martinás; András Margitay-Becht; Dana R. Herrera

2008-01-01

353

[The biologization of ethics].  

UK PubMed Central (United Kingdom)

Three ethics exist as a condition of possibility of any possible ethics, following a material and biological foundation. This content argument (not logical-formal) supposes a refutation of the naturalistic fallacy that the analytical philosophy attributes to Hume, in three areas of the ethical human experience: body, society and nature. These are: the ethics of the species [J. Habermas], the ethics of liberation [E. Dussel] and the ethics of the responsibility [H. Jonas]. This material argument is a philosophical foundation to considering for three types of applied ethics: medical bioethics, development ethics and environmental ethics.

Moreno Lax A

2010-01-01

354

Ethics and Transgenic Crops: a Review  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english This article represents a review of some of the ethical dilemmas that have arisen as a result of the development and deployment of transgenic crop plants. The potential for transgenic crops to alleviate human hunger and the possible effects on human health are discussed. Risks and benefits to the environment resulting from genetic engineering of crops for resistance to biotic and abiotic stresses are considered, in addition to effects on biodiversity. The socio-economic i (more) mpacts and distribution of benefits from transgenic technologies are reviewed. Fundamental issues of man?s relationship with nature and the environment, and theological matters are also addressed. An almost unprecedented amount of discussion has been stimulated on the merits and demerits of genetic engineering of crop plants, and has divided both the public and scientific communities. The arguments for and against transgenics are invariably based on visions of the new technology from widely different ethical perspectives.

Robinson, Jonathan

1999-08-01

355

[The ethics of prenatal diagnosis and therapy  

UK PubMed Central (United Kingdom)

Present ability to diagnose and treat fetal birth defects has achieved considerable sophistication. However, new scientific knowledge and resultant technologies create complex ethical dilemmas for society. Society has a critical stake both in the successful treatment of fetal disorders and in the maintenance of respect for the human dignity of the fetus. Therefore, prenatal diagnosis and therapy raises not only scientific issues but also ethical and legal ones which challenge many of our traditional concepts of the fetus. Undoubtedly, there is a need for involvement of not only individual patients but also society as a whole in setting rules and priorities for fetal therapy. In the meantime, the responsibility of those undertaking fetal therapy includes an obligation to report to the medical profession all results, good or bad, so that the merits and liabilities of fetal treatment can be established as soon as possible.

Kurjak A

1989-08-01

356

Ethics in Amos.  

Science.gov (United States)

Many have used the Bible to inform ethics, but I am not aware of a book in the Bible being studied and applied to military ethics. Christians in the military are more bound to Christian ethics than to military ethics, or any other ethical system. This pap...

R. Mosteller

1997-01-01

357

Is There Evil in Dying? Ethical and Legal Reflections concerning Induced Death  

Directory of Open Access Journals (Sweden)

Full Text Available The article analyzes the moral dilemmas associated with death and carries out a reflection on the questions that arise when death is considered trivial from the perspective of the individual who dies. Additionally, the article analyzes the ethical and legal consequences of acknowledging the moral autonomy of those who, in extreme circumstances, decide when and how to die.

Alejandra Zúñiga F.

2011-01-01

358

Ethical Imbalance: How the U.S. Army Overcame its Manning Crisis.  

Science.gov (United States)

The U.S. Army appears to be facing an ethical dilemma when it comes to manning these days. Ongoing military operations in Iraq and Afghanistan have created one of the greatest manning challenges the U.S. Army has faced since it dropped conscription as a m...

J. L. McConico

2009-01-01

359

‘With a Heavy Heart’:Ethics, Emotions and Rationality in Norwegian Immigration Administration  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This article analyses decision-making processes concerning applications for family immigration to Norway by giving an account of the dilemmas and challenges faced by the employees of the Norwegian immigration administration. I argue that these civil servants negotiate two somewhat different ethical ...

Eggebø, Helga

360

Dilemmas Faced by Nurses Regarding the Physical Restraint of Elderly Patients with Dementia in Japan  

Directory of Open Access Journals (Sweden)

Full Text Available This study aimed to clarify the dilemma of nurses working in general wards who face the ethical dilemma of restraining older people with dementia in Midwestern Japan. The study used the questionnaire method with an independently prepared questionnaire. The questionnaire was designed to ensure privacy and anonymity. The privacy and anonymity of study participants was assured. Of the 340 survey questionnaires distributed, 291 (85.6%) completed surveys were eligible number (12 additional surveys were returned without answers). An explanatory factor analysis revealed four dilemma factors among 15 items investigated (KMO value 0.84). These were: factor 1: “Execution of treatment and security,” ? = 0.91; factor 2: “approach in the nursing of older people with dementia,” ? = 0.93; factor 3: “A cooperative relationship in nursing of older people with dementia,” ? = 0.87; and factor 4: “Priorities in nursing,” ? = 0.81. The cumulative contribution ratio was 79.1%. We suggest that the program would enable nurses to cope with these dilemmas.

Miwa Yamamoto

2011-01-01

 
 
 
 
361

Ethical consideration.  

UK PubMed Central (United Kingdom)

The twofold distinction between interventions into the germ line and interventions into somatic cells on the one hand and between the treatment of diseases and enhancement on the other hand resulted in the concept of somatic gene therapy. There is a nearly unanimous agreement that somatic gene therapy has a high-ranking moral objective and uses methods that extend current techniques for treating diseases in a morally acceptable way. In its experimental phase principles of research ethics as the autonomy and the informed consent of the patient or the test person, a fair selection of test persons and a careful weighing of risks and benefits have to be taken into account and several specific points have to be considered. Experimental somatic gene therapy requires a positive vote of a competent and independent ethics committee.

Fuchs M

2011-01-01

362

Eer ethics  

Energy Technology Data Exchange (ETDEWEB)

Intelligent agents are personified as epers, electronic personas. Epers can take on various roles as business representatives, financial agents, game players, teachers or civil servants. The ethical deployment of epers requires that they be accountable to their originators, who, in turn, are responsible to the cyberspace communities in which they are involved. Epers must maintain integrity of information, carry out tasks as directed and report accurately on task status. Epers can be custodians of the truth, responsible for certifying that data has not been altered. Public service epers could chair electronic meetings, collect and validate votes on local issues and referee online {open_quotes}flame{close_quotes} wars. Epers` rights include those of privacy, autonomy and anonymity. They could decline to produce information aside from key identifiers and have the right to be protected from arbitrary deletion. Ethical issues include privacy protections, maintenance of appropriate access restrictions, and carrying out business in a secure and trustworthy manner.

Orwant, C.J.

1994-12-31

363

The Quest for Resolving Second Language Teaching Dilemma: A Review of the Proposed Solutions during the Last Two Decades  

Directory of Open Access Journals (Sweden)

Full Text Available This paper intends to address the issue of Second Language Teaching (SLT) Dilemma termed by Danesi (2003). It traces the major scholastic trends to this challenging dilemma in the area of SLT during the past two decades. The study gives a classified overview of two main theoretical trends to resolve this Dilemma. One theoretical trend expresses an ethno-culturally-oriented methodological reaction which focuses on the evolving perspectives on language teaching methods and approaches after the emergence of post-method era. With regard to this trend, the researcher particularly focuses on its two main responses to the SLT Dilemma chronologically listed as: Kumaravadivelu's (1994) "post-method pedagogy" and Larsen-Freeman's (1999) "seven I's". The other theoretical trend expresses a neurolinguisticlly-oriented methodological reaction to the SLT Dilemma which is related to bimodality theory developed by Danesi (2003). The researcher endeavourers to delve into the tenets and principles of these three specific responses to come up with a clear understanding of them which may coherently highlight the two investigated theoretical trends toward the SLT Dilemma accordingly. To this end, the researcher examines the different dimensions of these responses with reference to the following two theoretical questions: (a) why have the pervious methods and approaches failed to tackle the SLT Dilemma? , (b) how can the SLT Dilemma be resolved? In light of such a rationale, the study might be able to compare and elucidate the two investigated theoretical trends and consequently, it might shed more light on the issue of SLT Dilemma from a scholarly outlook.

Masoud Mahmoodzadeh

2011-01-01

364

Feline lungworms: what a dilemma.  

Science.gov (United States)

Aelurostrongylus abstrusus is regarded as the major lungworm infecting Felis catus, although other, albeit poorly studied, nematodes have been described from the respiratory system of domestic cats. Recent records of these neglected parasites have renewed the attention of the scientific community, but their actual role in respiratory disease in cats is blurred. The epidemiology, pathogenic role, and diagnosis of Troglostrongylus spp., Oslerus rostratus, and Capillaria aerophila in domestic cats are far from being clarified. Indeed, recent studies have provided novel information but have also given rise to relevant doubts. We discuss here the state of current knowledge regarding felid lungworms together with the dilemmas recently roused in the scientific literature. PMID:23928099

Traversa, Donato; Di Cesare, Angela

2013-08-05

365

Great dilemmas of spatial planning  

Directory of Open Access Journals (Sweden)

Full Text Available The planners often forget fundamental, unsolved dilemmas of their profession due to the everyday request and needs, and because those huge problems have permanent nature and they are consequently rarely considered as a main issue. The dichotomy between planning on the one and (neo) liberalism and market mechanisms on the other hand, together with the similar relations between economic development and spatial development and protection of space are always shaping spatial planning. The aim of this paper is to reconsider all those basic questions within the frame of current economic, social and political circumstances the trends.

?or?evi? Dejan; Dabovi? Tijana

2007-01-01

366

Perceived comfort level of medical students and residents in handling clinical ethics issues.  

UK PubMed Central (United Kingdom)

BACKGROUND: Studies have shown that medical students and residents believe that their ethics preparation has been inadequate for handling ethical conflicts. The objective of this study was to determine the self-perceived comfort level of medical students and residents in confronting clinical ethics issues. METHODS: Clinical medical students and residents at the University of Maryland School of Medicine completed a web-based survey between September 2009 and February 2010. The survey consisted of a demographic section, questions regarding the respondents' sense of comfort in handling a variety of clinical ethics issues, and a set of knowledge-type questions in ethics. RESULTS: Survey respondents included 129 medical students (response rate of 40.7%) and 207 residents (response rate of 52.7%). There were only a few clinical ethics issues with which more than 70% of the respondents felt comfortable in addressing. Only a slight majority (60.8%) felt prepared, in general, to handle clinical situations involving ethics issues, and only 44.1% and 53.2% agreed that medical school and residency training, respectively, helped prepare them to handle such issues. Prior ethics training was not associated with these responses, but there was an association between the level of training (medical students vs residents) and the comfort level with many of the clinical ethics issues. CONCLUSIONS: Medical educators should include ethics educational methods within the context of real-time exposure to medical ethics dilemmas experienced by physicians-in-training.

Silverman HJ; Dagenais J; Gordon-Lipkin E; Caputo L; Christian MW; Maidment BW 3rd; Binstock A; Oyalowo A; Moni M

2013-01-01

367

Does uncontrolled cardiac death for organ donation raise ethical questions? An opinion survey.  

UK PubMed Central (United Kingdom)

BACKGROUND: Organ donation after uncontrolled cardiac death raises complex ethical issues. We conducted a survey in a large hospital staff population, including caregivers and administrators, to determine their ethical viewpoints regarding organ donation after uncontrolled cardiac death. METHODS: Multicenter observational survey using a questionnaire, including information on the practical modalities of the procedure. Respondents were asked to answer 15 detailed ethical questions corresponding to different ethical issues raised in the literature. Ethical concerns was defined when respondents expressed ethical concerns in their answers to at least three of nine specifically selected ethical questions. RESULTS: One thousand one hundred ninety-six questionnaires were received, and 1057 could be analysed. According to our definition, 573 respondents out of 1057 (54%) had ethical concerns with regard to donation after cardiac death and 484 (46 %) had no ethical concerns. Physicians (55%) and particularly junior intensivists (65%) tended to have more ethical issues than nurses (52%) and hospital managers (37%). Junior intensivists had more ethical issues than senior intensivists (59%), emergency room physicians (46%) and transplant specialists (43%). CONCLUSION: Only 46% of hospital-based caregivers and managers appear to accept easily the legitimacy of organ donation after cardiac death. A significant number of respondents especially intensivists, expressed concerns over the dilemma between the interests of the individual and those of society. These results underline the need to better inform both healthcare professionals and the general population to help to the development of such procedure.

Goudet V; Albouy-Llaty M; Migeot V; Pain B; Dayhot-Fizelier C; Pinsard M; Gil R; Beloucif S; Robert R

2013-09-01

368

Organizational Commitment and Corporate Ethical Values: Exploring the Nexus between Employees' Psychological Contract and Firms' Ethical Behaviour in the Nigerian Insurance Industry  

Directory of Open Access Journals (Sweden)

Full Text Available Commitment of employees to their organisations has been one of the central research themes in organisational study. Though, many predictors of organisational commitment abound in the literature, much is however not known on how ethical behaviour in the organisation affects employees’ commitment. Considering the nature of insurance services, and high potentials for ethical dilemma in the industry, this study contributes to organisational commitment literature by providing further understanding on the impact of corporate ethical values on organisational commitment in Nigeria. Underpinned by cognitive dissonance theory, the study proposes a significant relationship between the two constructs. While controlling for some demographic factors, corporate ethical values was hypothesized as a significant determinant of organisational commitment. With data from 415 managers, collected through Hunt’s et al (1989) Corporate Ethical Value and Hunt’s et al (1985) organisational commitment scales, the results of the multivariate analysis were presented, and discussed with managerial implications.

Musa Obalola; Kunle Aduloju; Folake Olowokudejo

2012-01-01

369

Ethics education in chiropractic colleges: a North American survey.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The purposes of this study were to survey Council on Chiropractic Education-accredited chiropractic colleges in North America and to describe curricular details on the teaching of bioethics. METHODS: A custom-designed survey was sent to chiropractic colleges. Total number of contact hours, whether the ethics was a stand-alone course or integrated elsewhere, type of instructor, and if there was a required or recommended course text were queried. RESULTS: Of 19 surveys sent by mail, 15 surveys were returned. The average time in ethics instruction was 18.7 hours including lecture format, small group tutorial, and self-study. Chiropractic ethics education includes 8 areas of content (boundaries, law and jurisprudence, professionalism, basic ethic tenets/principles, ethical codes of conduct, prevention of financial and of sexual abuse, and resolving an ethical dilemma). Some colleges include content taught to students under the domain of law and jurisprudence. CONCLUSION: The results of this survey indicate that there are opportunities to further develop the educational ethics program at Council on Chiropractic Education-accredited colleges. All colleges currently offer bioethics teaching. An expanded role for this content is recommended so as to offer optimal benefit for students and practitioners.

Kinsinger S; Soave D

2012-07-01

370

An ethical framework for developing and sustaining a healthy workplace.  

Science.gov (United States)

Acute and critical care nurses provide care that is intellectually challenging and physically demanding in environments that are often characterized by ethical concerns and dilemmas. As complex adaptive systems, these environments include nurses, physicians, social workers, chaplains, case managers, and administrators who interact together in situations of tremendous uncertainty and frequently in the face of professional or social disagreement about patient/family care, processes, and outcomes. Nurses' ability to identify and resolve concerns in such situations as part of a collaborative ethical climate is a significant retention factor and a hallmark of a healthy workplace. The purpose of this article is to describe a pluralist ethical framework that evolved from the formation of a healthy workplace and that may be integrated to sustain an ethical climate. Discussion of development of a healthy workplace employing participatory action research will be followed by a description of ethical theories supporting the framework and their relevance to creating and sustaining a healthy workplace and ethical practice environment. Finally, specific application examples of the ethical framework from nursing units' staff participatory action research studies will be presented. PMID:19542971

Robichaux, Catherine; Parsons, Mickey L

371

An ethical framework for developing and sustaining a healthy workplace.  

UK PubMed Central (United Kingdom)

Acute and critical care nurses provide care that is intellectually challenging and physically demanding in environments that are often characterized by ethical concerns and dilemmas. As complex adaptive systems, these environments include nurses, physicians, social workers, chaplains, case managers, and administrators who interact together in situations of tremendous uncertainty and frequently in the face of professional or social disagreement about patient/family care, processes, and outcomes. Nurses' ability to identify and resolve concerns in such situations as part of a collaborative ethical climate is a significant retention factor and a hallmark of a healthy workplace. The purpose of this article is to describe a pluralist ethical framework that evolved from the formation of a healthy workplace and that may be integrated to sustain an ethical climate. Discussion of development of a healthy workplace employing participatory action research will be followed by a description of ethical theories supporting the framework and their relevance to creating and sustaining a healthy workplace and ethical practice environment. Finally, specific application examples of the ethical framework from nursing units' staff participatory action research studies will be presented.

Robichaux C; Parsons ML

2009-07-01

372

Informed Consent versus Involuntary Hospitalization in Psychiatric Practice. Ethical and Legal Approaches  

Directory of Open Access Journals (Sweden)

Full Text Available From its beginnings as social practice, medicine has always been confronted with ethical dilemmas. Ethical issues are brought into discussion mostly when the patient lacks awareness, when he does not understand, which means that he also does not accept the disease. In order to solve these dilemmas, the physician has to combine norms, habits, customs, religious beliefs and, first of all, legal standards specific to his space of action. Psychiatric diagnosis, especially, determines multiple ethical issues, from involuntary hospitalization to therapeutic methods. As it results from the Universal Declaration of Human Rights (art. 1, 3), the fundamental rights of a person are based on the acknowledgment of his human status, that all human beings are born free. Since the autonomy and responsibility of each person – including of the one who needs healthcare – are accepted as important values, his involvement or participation to the decision-making process regarding his own body or health must be acknowledged as a universal right.

Daniel RADOI; Mihaela RADOI

2013-01-01

373

"Robin Hood" of techno-Turkey or organ trafficking in the state of ethical beings.  

Science.gov (United States)

Dr S. is a famous transplant surgeon in the Middle East. He operates "underground" on wealthy patients in different countries, from Israel to Turkey to Russia. The media refer to him as the "Organ Mafia doctor," and patients diagnosed with renal failure speak of him sardonically as "Robin Hood," acknowledging that he takes organs from the poor to give to the rich. But ethical issues of organ trafficking are not limited to marginal private clinics and "Mafia" doctors. All-living related organ transplants in Turkey involve similar ethical dilemmas: many related or nonrelated organ recipients pay their donors, and demand continues to rise. This paper explores practices in state and university hospitals and the ethical dilemmas doctors encounter to understand where and how judicial, cultural, and social categories of "human rights" and "crime" are constructed in our high-tech world. PMID:15600114

Sanal, Aslihan

2004-09-01

374

"Robin Hood" of techno-Turkey or organ trafficking in the state of ethical beings.  

UK PubMed Central (United Kingdom)

Dr S. is a famous transplant surgeon in the Middle East. He operates "underground" on wealthy patients in different countries, from Israel to Turkey to Russia. The media refer to him as the "Organ Mafia doctor," and patients diagnosed with renal failure speak of him sardonically as "Robin Hood," acknowledging that he takes organs from the poor to give to the rich. But ethical issues of organ trafficking are not limited to marginal private clinics and "Mafia" doctors. All-living related organ transplants in Turkey involve similar ethical dilemmas: many related or nonrelated organ recipients pay their donors, and demand continues to rise. This paper explores practices in state and university hospitals and the ethical dilemmas doctors encounter to understand where and how judicial, cultural, and social categories of "human rights" and "crime" are constructed in our high-tech world.

Sanal A

2004-09-01

375

Faced with a dilemma: Danish midwives' experiences with and attitudes towards late termination of pregnancy  

DEFF Research Database (Denmark)

Background: The introduction of prenatal screening for all pregnant women in Denmark in 2004 has lead to an increase in the number of late terminations of pregnancy after the 12th week of pregnancy. Midwives’ experiences with late termination of pregnancy are still poorly described in scientific literature. Aim: To explore Danish midwives’ experiences with and attitudes towards late termination of pregnancy. Focus was on how midwives perceive their own role in late termination of pregnancy and how their professional identity is influenced by working with late termination of pregnancy in a time where prenatal screening is rapidly developing. Method: A qualitative study consisting of ten individual interviews with Danish midwives, all of whom had taken part in late termination of pregnancy. Results: Current practice of late termination of pregnancy resembles the practice of normal deliveries and is influenced by a growing personalisation of the aborted foetus. The midwives strongly supported women’s legal right to choose termination of pregnancy and considerations about the foetus’ right to live were suppressed. Midwives experienced a dilemma when faced with aborted foetuses that looked like newborns and when aborted foetuses showed signs of life after a termination. Furthermore, they were critical of how physicians counsel women/couples after prenatal diagnosis. Conclusions: The midwives’ practice in relation to late termination of pregnancy was characterised by an acknowledgement of the growing ethical status of the foetus and the emotional reactions of the women/couples going through late termination of pregnancy. Other professions as well as structural factors at the hospital highly influenced the midwives’ ability to organize their work with late terminations. There is a need for more thorough investigation of how to secure the best possible working conditions for midwives and how to optimise the care for women/couples going through late termination of pregnancy.

Christensen, Anne Vinggaard; HjØllund Christiansen, Anne

2012-01-01

376

A intervenção com clientes involuntários: complexidade e dilemas/ Involuntary clients intervention: complexity and dilemmas  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese O presente artigo de revisão da literatura centra-se na temática dos clientes involuntários. Analisaram-se criticamente os trabalhos de autores que: (1) propõem a sua caracterização, designadamente no que respeita ao posicionamento do cliente na situação de ajuda, concluindo-se pela complexidade da sua identificação; (2) conceptualizam o papel dos profissionais de saúde mental, bem como as singularidades da relação terapêutica, destacando a importância da a (more) liança, dos dilemas éticos e da motivação para a intervenção; (3) apresentam os modelos terapêuticos mais utilizados nestas situações, enfatizando-se as terapias colaborativas, e particularmente as centradas nas soluções, como as que melhor promovem o envolvimento destes clientes. Ao longo da pesquisa manteve-se a preocupação de rever obras abrangentes na área do acompanhamento psicológico que simultaneamente evidenciassem ou favorecessem uma perspectiva crítica e complexa sobre o tema. Na organização do artigo procurou-se seguir uma perspectiva diacrónica que mostrasse a evolução da conceptualização e praxis sobre a problemática. Abstract in english The involuntary clients issue is the core of this literature review article. Critical analysis was carried out over the work of authors who: (1) propose their characterization, namely in what concerns the client's positioning in a help situation, leading to a notion of complexity in its identification; (2) conceptualize the role of mental health technicians, as well as the singularities of the therapeutic relationship, highlighting the importance of the alliance, ethical (more) dilemmas and the motivation towards an intervention; (3) point out the therapeutic models mainly used in these situations, emphasizing collaborative therapies, particularly solution focused therapies, as those who better promote the involvement of clients. Reviewing extensive literature on psychological intervention that simultaneously underlined a critical and complex perspective on the matter was a constant concern throughout the research process. The article's structure is outlined diachronically so that the evolution of both conceptualization and praxis on the subject becomes clear.

Sotero, Luciana; Relvas, Ana Paula

2012-04-01

377

A intervenção com clientes involuntários: complexidade e dilemas Involuntary clients intervention: complexity and dilemmas  

Directory of Open Access Journals (Sweden)

Full Text Available O presente artigo de revisão da literatura centra-se na temática dos clientes involuntários. Analisaram-se criticamente os trabalhos de autores que: (1) propõem a sua caracterização, designadamente no que respeita ao posicionamento do cliente na situação de ajuda, concluindo-se pela complexidade da sua identificação; (2) conceptualizam o papel dos profissionais de saúde mental, bem como as singularidades da relação terapêutica, destacando a importância da aliança, dos dilemas éticos e da motivação para a intervenção; (3) apresentam os modelos terapêuticos mais utilizados nestas situações, enfatizando-se as terapias colaborativas, e particularmente as centradas nas soluções, como as que melhor promovem o envolvimento destes clientes. Ao longo da pesquisa manteve-se a preocupação de rever obras abrangentes na área do acompanhamento psicológico que simultaneamente evidenciassem ou favorecessem uma perspectiva crítica e complexa sobre o tema. Na organização do artigo procurou-se seguir uma perspectiva diacrónica que mostrasse a evolução da conceptualização e praxis sobre a problemática.The involuntary clients issue is the core of this literature review article. Critical analysis was carried out over the work of authors who: (1) propose their characterization, namely in what concerns the client's positioning in a help situation, leading to a notion of complexity in its identification; (2) conceptualize the role of mental health technicians, as well as the singularities of the therapeutic relationship, highlighting the importance of the alliance, ethical dilemmas and the motivation towards an intervention; (3) point out the therapeutic models mainly used in these situations, emphasizing collaborative therapies, particularly solution focused therapies, as those who better promote the involvement of clients. Reviewing extensive literature on psychological intervention that simultaneously underlined a critical and complex perspective on the matter was a constant concern throughout the research process. The article's structure is outlined diachronically so that the evolution of both conceptualization and praxis on the subject becomes clear.

Luciana Sotero; Ana Paula Relvas

2012-01-01

378

Animal ethics  

DEFF Research Database (Denmark)

This chapter describes and discusses different views concerning our duties towards animals. First, we explain why it is necessary to engage in thinking about animal ethics and why it is not enough to rely on feelings alone. Secondly, we present and discuss five different kinds of views about the nature of our duties to animals. They are: contractarianism, utilitarianism, the animal rights view, contextual views, and a respect for nature view. Finally, we briefly consider whether it is possible to combine elements from the presented views, and how to make up one’s mind.

Palmer, Clare; SandØe, Peter

2011-01-01

379

Commentary: compassion at the core of forensic ethics.  

UK PubMed Central (United Kingdom)

In 1982, Dr. Alan Stone raised a central dilemma in ethics for forensic psychiatry that has prompted significant and important discussion of the concerns about twisting justice, prostituting the profession, and operating without adequate ethics guidelines in the course of our work. In presidential addresses to the membership of the American Academy of Psychiatry and the Law (AAPL), Dr. Paul Appelbaum and Dr. Ezra Griffith have attempted to deal with Stone's challenges, the former by providing a theory of forensic ethics, the latter by advocating cultural formulation and narrative as the methodology of our work. In his present contribution, Dr. Griffith advances the idea of narrative to involve compassion for the subject of the evaluation. In so doing, he brings us to a far more satisfactory resolution of the dilemma described by Dr. Stone. The obligation to show compassion deserves to be at the core of any valuable statement of forensic ethics. The role of compassion in justice, as discussed, for example, by Simone Weil, warrants further interdisciplinary study.

Norko MA

2005-01-01

380

Ethical Codes of Nursing and the Practical Necessity in Iran  

Directory of Open Access Journals (Sweden)

Full Text Available "nNursing is a universal health care necessity. Nursing profession, similar to the other medical professions, is responsible to maintain public health promotion, prevent diseases, and also care and rehabilitate client, family and the soci¬ety. The inher-ent nature of nursing is respect for moral values and human rights. However, clinical ethical dilem¬mas occur for nurses at all levels, not always concerning patients. Although this is the primary area of concern, it is relevant to all areas of nursing practice and every aspect of their professional roles including research activity, education and management. The ethical codes of nursing, which set out the ethical behaviors expected of registered nurses, are considered indisputable with regard to nursing practice. There are some national codes in the world but the international code of ethics for nurses was first adopted by the International Council of Nurses. The current paper gives an overview of nursing ethics history, which will be followed by the study on the promotion and dissemination of the nursing ethical codes and guidelines. The concepts, topics and strategies of some codes will be stated in this paper. The present study also aims to emphasize nursing ethics in Iran. Despite the compiling of general and specific guidelines of biomedical research in Iran during recent decade, there have been limited activities on the issue of nursing codes of ethics. Iranian nurses should be educated and fully prepared to en-gage with ethical is¬sues in the field of nursing. Given the importance of sociocultural issues, it is necessary to compile nurs-ing codes of ethics according to Islamic culture of Iran

M Sanjari; F Zahedi; B Larijani

2008-01-01

 
 
 
 
381

The four principles: Can they be measured and do they predict ethical decision making?  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The four principles of Beauchamp and Childress - autonomy, non-maleficence, beneficence and justice - have been extremely influential in the field of medical ethics, and are fundamental for understanding the current approach to ethical assessment in health care. This study tests whether these principles can be quantitatively measured on an individual level, and then subsequently if they are used in the decision making process when individuals are faced with ethical dilemmas. Methods The Analytic Hierarchy Process was used as a tool for the measurement of the principles. Four scenarios, which involved conflicts between the medical ethical principles, were presented to participants who then made judgments about the ethicality of the action in the scenario, and their intentions to act in the same manner if they were in the situation. Results Individual preferences for these medical ethical principles can be measured using the Analytic Hierarchy Process. This technique provides a useful tool in which to highlight individual medical ethical values. On average, individuals have a significant preference for non-maleficence over the other principles, however, and perhaps counter-intuitively, this preference does not seem to relate to applied ethical judgements in specific ethical dilemmas. Conclusions People state they value these medical ethical principles but they do not actually seem to use them directly in the decision making process. The reasons for this are explained through the lack of a behavioural model to account for the relevant situational factors not captured by the principles. The limitations of the principles in predicting ethical decision making are discussed.

Page Katie

2012-01-01

382

Teaching Business Ethics or Teaching Business Ethically?  

Science.gov (United States)

Notes that one of the most important contexts for ethical decision-making is the nature and operation of "contemporary capitalisms." Suggests that rather than issuing a call for teaching business ethics, the author emphasizes the need for more ethical business teaching. (SG)

Stablein, Ralph

2003-01-01

383

The ethical health lawyer: an empirical assessment of moral decision making.  

UK PubMed Central (United Kingdom)

Writing in 1999, legal ethics scholar Brad Wendel noted that "[v]ery little empirical work has been done on the moral decision making of lawyers." Indeed, since the mid-1990s, few empirical studies have attempted to explore how attorneys deliberate about ethical dilemmas they encounter in their practice. Moreover, while past research has explored some of the ethical issues confronting lawyers practicing in certain specific areas of practice, no published data exists probing the moral mind of health care lawyers. As signaled by the creation of a regular column "devoted to ethical issues arising in the practice of health law" in the Journal of Law, Medicine & Ethics, the time to address the empirical gap in the professional ethics literature is now. Accordingly, this article presents data collected from 120 health care lawyers. Presenting this population with a number of hypothetical scenarios relating to how they would respond when confronting an ethical dilemma without an obvious solution or when facing a situation in which their personal values were in tension with their professional obligations, this article represents a first step toward better understanding how lawyers who practice in health care settings understand and resolve the moral discomfort they encounter in their professional lives.

Perry JE; Moore IN; Barry B; Clayton EW; Carrico AR

2009-01-01

384

The ethical health lawyer: an empirical assessment of moral decision making.  

Science.gov (United States)

Writing in 1999, legal ethics scholar Brad Wendel noted that "[v]ery little empirical work has been done on the moral decision making of lawyers." Indeed, since the mid-1990s, few empirical studies have attempted to explore how attorneys deliberate about ethical dilemmas they encounter in their practice. Moreover, while past research has explored some of the ethical issues confronting lawyers practicing in certain specific areas of practice, no published data exists probing the moral mind of health care lawyers. As signaled by the creation of a regular column "devoted to ethical issues arising in the practice of health law" in the Journal of Law, Medicine & Ethics, the time to address the empirical gap in the professional ethics literature is now. Accordingly, this article presents data collected from 120 health care lawyers. Presenting this population with a number of hypothetical scenarios relating to how they would respond when confronting an ethical dilemma without an obvious solution or when facing a situation in which their personal values were in tension with their professional obligations, this article represents a first step toward better understanding how lawyers who practice in health care settings understand and resolve the moral discomfort they encounter in their professional lives. PMID:19723257

Perry, Joshua E; Moore, Ilene N; Barry, Bruce; Clayton, Ellen Wright; Carrico, Amanda R

2009-01-01

385

The ethics of refusing a request for off-label deep brain stimulation currently in clinical trial.  

Science.gov (United States)

Physicians must ensure that patients understand that the principal aim of research is to increase generalizable knowledge. However, patients may hope for individual benefit as a secondary goal of participation. Highly motivated patients may request treatment off label if trial enrollment has ended, leading to ethical dilemmas for clinicians. This case uses early deep brain stimulation (DBS) as an example for exploring the ethically relevant questions related to the off-label use of medical devices. PMID:24092295

Fleming, James K; Charles, David

2013-10-01

386

Taking on organizational ethics. To do so, ethics committees must first prepare themselves.  

UK PubMed Central (United Kingdom)

Healthcare ethics committees which have focused almost entirely on clinical ethics, now need to prepare to deal with organizational ethics, a field that is attracting increasing attention. As they did with clinical ethics, ethics committees members must educate themselves in the demands of the newer field. As before, they must respect the perspectives of the actual decision makers while maintaining an independent framework for analyzing the issues at stake. They must ensure that management is properly represented on the committee if they need guidance from a professional ethicist they should seek one with a strong background in business ethics and social justice. Healthcare organizations are likely to need help with a wide range of ethical issues involving patient services (rationing of resources, for example), business and service plans (mergers and joint ventures, for example), business and professional integrity (conflicts of interest, for example), employee rights and responsibilities (downsizing, for example), and the organization's role in in the community (advocacy and lobbying, for example). To be helpful to the organization, the ethics committee must be prepared to say when cost factors trump other considerations and when they do not. An ethics committee will often be asked to give advice on specific occasions-a proposed new policy, for instance. The most important part of its response is its analysis of the issue. Finally, an ethics committee should view its organization as part of the larger social context.

Weber LJ

1997-05-01

387

Shaping an ethical workplace.  

UK PubMed Central (United Kingdom)

Ethical choices in business are often troublesome because business ethics are not simply an extension of personal ethics. Moral standards learned from private experiences may not translate to the business world. This article analyzes choices in the workplace and offer suggestions to move toward more ethical business practices.

Gallagher SM

1998-12-01

388

Ethics in Practice  

Science.gov (United States)

Ethics is defined as a set of guidelines and/or rules for the conduct of individual behavior in an organization or civil society. This ethical code of conduct is intended to guide policies, practices, and decision-making for employees on behalf of the organization. This article explores the importance of ethics, the basis for making ethical

Medlin, E. Lander

2010-01-01

389

An Ethics Primer  

Science.gov (United States)

This resource is a PDF that provides engaging, interactive, and classroom-friendly lesson ideas for integrating ethical issues into a science classroom. It also provides a basic background on ethics as a discipline, with straightforward descriptions of major ethical theories. Several decision-making frameworks are included to help students apply reasoned analysis to ethical issues.

2008-01-01

390

Seamless Integration of Ethics  

Science.gov (United States)

The ineffectiveness of business ethics education has received attention from the popular press and the Association to Advance Collegiate Schools of Business after repeated ethics scandals. One possibility is that teaching ethics is different from other content areas because ethics is best learned when the student does not know it is being taught.…

Beggs, Jeri Mullins

2011-01-01

391

Business ethics in developing countries  

Directory of Open Access Journals (Sweden)

Full Text Available Underlying this paper is the conviction that it is of the utmost importance that business ethics should indeed become an integral part of business culture in all, and therefore also in developing countries. It is not to be denied that business ethics has to a much larger extent become pari of the business culture' in developed countries than in developing countries. The primary aim of this paper is to provide an explanation for the fact that business ethics is fighting an uphill battle in becoming pari of the business culture in developing countries. Secondly, a thumbnail sketch is given of the preconditions that have to be fulfilled in order to stimulate the development of a moral business culture in developing countries. In order to achieve these goals I will focus mainly on Africa, and more specifically on South Africa.

G.J. Rossouw

1992-01-01

392

Ethics Primer: Ethics and Bioethics Lessons  

Science.gov (United States)

The Ethics Primer provides engaging, interactive, and classroom-friendly lesson ideas for integrating ethical issues into a science classroom. It also provides basic background on ethics as a discipline, with straightforward descriptions of major ethical theories. Several decision-making frameworks are included to help students apply reasoned analysis to ethical issues. Although the Primer is designed for secondary school science classrooms, it has been used by teachers in a variety of classes and grade levels. The Primer is free for download but the author requests information before accessing the file.

2007-01-01

393

Fostering Students' Knowledge and Argumentation Skills through Dilemmas in Human Genetics.  

Science.gov (United States)

Examines the outcomes of a unit that integrates explicit teaching of general reasoning patterns into the teaching of a specific science content. Focuses on the teaching of argumentation skills in the context of dilemmas in human genetics. (Contains 50 references.) (Author/YDS)

Zohar, Anat; Nemet, Flora

2002-01-01

394

Development Ethics and Human Development  

Digital Repository Infrastructure Vision for European Research (DRIVER)

‘Development ethics’ can be seen as comparable to business ethics, medical ethics, environmental ethics and similar areas of practical ethics. Each area of practice generates ethical questions about priorities and procedures, rights and responsibilities. So, first of all, ‘development ethics’ can be...

Gasper, D.R.

395

Ethical decision-making: the doctrine of sin and grace  

Directory of Open Access Journals (Sweden)

Full Text Available Ethical decision-making presupposes the possession of a free will. Central to a discussion on reformed ethics is the question of the bounds of freedom of the will. The reformed tradition, along with the wider Christian tradition, affirms that the will is not free in the Pelagian sense of being absolutely free, but is constrained by the effects of humanity’s fall from original righteousness. This ariticle considers the nature and extent to which the will is considered free, or no longer free at all. The question posed here, within the reformed theoretic ethical framework, is whether the will is so vitiated that a person is in- capable of any effective choice of action or inaction in the face of any moral dilemma, or does fallen humanity still possess some ability to make a free choice, albeit under conditions of impaired freedom of the will?

S. P. Giles

2009-01-01

396

[Citizenship and ethics as guidelines in nurse education].  

UK PubMed Central (United Kingdom)

Based on our experience as Nursing Professors, we wish, by means of this reflection, to urge a discussion on nursing professional training, following guidelines as Ethics, Human Rights, and Citizenship. We understand health is a human value which elicits further values, and the challenges we face in this area are not of a moral kind, like choosing between good and evil--they are ethical dilemmas, stemming from the wide range of contradictory imperatives that are at stake within this scenario. It is paramount, therefore, to promote the professional training of competent nurses so that they can think critically about fundamental issues arising in their daily practice, and act according to ethics and citizenship values.

Bellato R; Gaíva MA

2003-07-01

397

[Nursing and sport practices: learning with ethical dilemas].  

UK PubMed Central (United Kingdom)

This study aimed to identify the difficulties related to the first aids during one students competition and also it correlates the experience learned regarding technician aspects, cientifics and ethical approaches when the performance of the first-aid nurse. The report was taking into account the production basis regarding the performance of the first aids professionals and a workshop of consensus to solve ethical dilemmas. It was described the taking decision ethical, the material resources available and also the harms which might affected the physical integrity of the athletes and the interventions executed. It was concluded that the sports has a feature of preventive and curative medicine that demands the moral commitment of the organizers to provide the necessary material resources for occasion of some damage suffered for the athletes.

de França IS; Baptista RS; Brito VR; de Souza JA

2007-11-01