What are the characteristics of an ethical dilemma? And how do we handle them in the area of early childhood education? These are some of the questions that will be dealt with in this chapter.......What are the characteristics of an ethical dilemma? And how do we handle them in the area of early childhood education? These are some of the questions that will be dealt with in this chapter....
Ethics courses are part of most dental curricula, but have no standard, universally accepted outline or structure. Bribery was investigated by a student who had experienced it as a problem himself, highlighting the point that students will be more engaged in ethics education when it addresses issues directly relevant to them.
Whisenant, Warren A.; Pedersen, Paul M.; Clavio, Galen
Athletic administrators and decision makers within interscholastic athletics are expected to embrace a code of ethics that serves as a set of rules to guide their professional behavior. Included within this code are areas of controversy that present gender-related ethical dilemmas for administrators. Three specific ethical dilemmas involve (1)…
Iyalomhe, G B S
Ethical problems routinely arise in the hospital and outpatient practice settings and times of dilemma do occur such that practitioners and patients are at cross-roads where choice and decision making become difficult in terms of ethics. This paper attempts a synopsis of the basic principles of medical ethics, identifies some ethical dilemmas that doctors often encounter and discusses some strategies to address them as well as emphasizes the need for enhanced ethics education both for physicians and patients particularly in Nigeria. Literature and computer programmes (Medline and PsychoInfo databases) were searched for relevant information. The search showed that the fundamental principles suggested by ethicists to assist doctors to evaluate the ethics of a situation while making a decision include respect for autonomy, beneficence, non-maleficence and justice. Although the above principles do not give answers as to how to handle a particular situation, they serve as a guide to doctors on what principles ought to apply to actual circumstances. The principles sometimes conflict with each other leading to ethical dilemmas when applied to issues such as abortion, contraception, euthanasia, professional misconduct, confidentiality truth telling, professional relationship with relatives, religion, traditional medicine and business concerns. Resolution of dilemmas demand the best of the doctor's knowledge of relevant laws and ethics, his training and experience, his religious conviction and moral principles as well as his readiness to benefit from ethics consultation and the advice of his colleagues. Ethics education should begin from the impressionable age in homes, continued in the medical schools and after graduation to ensure that doctors develop good ethical practices and acquire the ability to effectively handle ethical dilemmas. Also, education of patients and sanction of unethical behaviour will reduce ethical dilemmas.
Christensen, Anne Vinggaard; Christiansen, Anne Hjøllund; Petersson, Birgit
's legal right to choose TOP 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......: A qualitative study consisting of ten individual interviews with Danish midwives, all of whom had taken part in late TOP. RESULTS: Current practice of late TOP resembles the practice of normal deliveries and is influenced by a growing personalisation of the aborted foetus. The midwives strongly supported women...... counsel women/couples after prenatal diagnosis. CONCLUSIONS: The midwives' practice in relation to late TOP was characterised by an acknowledgement of the growing ethical status of the foetus and the emotional reactions of the women/couples going through late TOP. Other professions as well as structural...
Schaefer, C; Weissbach, L
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.
De Vries, Kay; Plaskota, Marek
Palliative sedation is a method of symptom management frequently used in hospices to treat uncontrolled symptoms at the end of life. There is a substantial body of literature on this subject; however, there has been little research into the experiences of hospice nurses when administering palliative sedation in an attempt to manage the terminal restlessness experienced by cancer patients. Semistructured interviews were conducted with a purposive sample of seven hospice nurses who had cared for at least one patient who had undergone palliative sedation within the past year in a hospice in the south of England in the United Kingdom. A phenomenological approach and Colaizzi's stages of analysis were employed to develop themes from the data. Facilitating a "peaceful death" was the primary goal of the nurses, where through the administration of palliative sedation they sought to enable and support patients to be "comfortable," "relaxed," and "calm" at the terminal stage of their illness. Ethical dilemmas related to decision making were a factor in achieving this. These were: medication decisions, "juggling the drugs," "causing the death," sedating young people, the family "requesting" sedation, and believing that hospice is a place where death is hastened. Hospice nurses in the U.K. frequently encounter ethical and emotional dilemmas when administering palliative sedation. Making such decisions about using palliative sedation causes general discomfort for them. Undertaking this aspect of care requires confidence and competence on the part of nurses, and working within a supportive hospice team is of fundamental importance in supporting this practice.
Dich, Trine; Hansen, Tina; Algers, Anne
) 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......'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...
It is difficult to speak of ethic dilemmas in a society that has relativism as the oficial philosophical and political doctrine, i.e., stable values and behavior references, are denied, both in health care and in any other area of human knowledge. In the field of medical sciences it is even pretended to pass from the observational methodology to a field of manipulation and manipulability. It is the very Ethic that is presented as a dilemma. In these conditions one needs to know the lines of thought that are defended, to replace and make disappear the stable ethic references: ecletism, historicism, scientificism, pragmatism, and nihilism itself, that lead to the 'new ethic paradigm', that has created by itself a pseudo-spirituality. The truth is we are adrift in the 'Ethic of Convenience' which changes according to the majorities. In this setting the way to go is to rediscover the abandoned ethic values: only with an objective ethic, with sound references and foundations, it is possible to re-establish and perfect the patient-physician relationship, for a better social health. And this begins with the ethic problem of human life.
LaMontagne, Ramona Marie
This qualitative study examined the perceptions of human resource managers who had faced ethical dilemmas in the workplace, to gain an understanding of how they felt their life experiences shaped their values in making ethical decisions. The experiences of ten human resource managers who believed they chose a right course of action when faced with…
May 8, 2015 ... As an academic/clinical educator and congruently as an observer within this context ... As an academic/clinical educator, one is at times faced with dilemmas in student placement that challenge one's personal and ... clients could feel a sense of abandonment, loneliness and experience negative emotions.
Professional responsibilities, tradition, and personal conscience along with legal, philosophical, and religious convictions dictate nursing interventions. Inevitably, these factors embrace life-sustaining therapies; however, in view of complications, prognosis, pain and suffering, and their own views of quality of life, some patients express wishes inconsistent with life-sustaining measures. In other situations, the health care provider as well as the patient may view heroic efforts as more debilitating than resortative. Resolving the conflict while preserving the patient's best interests requires a confrontation with the status of "do-not resuscitate" policies within th e nurse's institution, informed consent, refusal, and competency as the necessary underpinnings for the development of an ethical and legal posture within the profession, with which to approach significant decisions regarding life-sustaining therapies. Literally every hour of every day nurses are immediately and directly involved with resolving ethical dilemmas based upon judgements and interpretations of oral or written orders, patient and family wishes, professional training, and an infinite number of other factors. When clear policies or orders are lacking, the nurse is left with the burden of making a life or death decision. It is imperative that professional nurses assess the administrative, legal, and ethical ramifications of their actions in terms of ethical codes of practice, patients' rights, institutional and personal liability, civil and criminal laws, and private conscience. An understanding of these issues, passive and active euthansia, state and national trends, and uniform legislation can assist in resolutions of the no-code dilemma. Nursing as a profession must strive to develop sound and consistent guidelines and rationale for the scope of practice in ethical dilemmas.
Filaković, Pavo; Pozgain, Ivan
Ethics in the contemporary psychiatry, as well as in medicine in general, is based on the two core ethical traditions: deontological and theological. Good ethical decision takes into the consideration both traditions, and is preceded with ethical dilemmas to provide the best possible care to the patients in that moment. In the article are presented most recent research results of the literature about ethical dilemmas in psychiatry. Ethical dilemmas in everyday practice as well as compliance with the patients, psychiatric consultations, informed consent, treatment of personality disorders, pharmacological investigations, forensic psychiatry, forced hospitalisation, promotion of mental health, and dealing with the stigma of the mental diseases are showed in the article. The authors emphasize the necessity of constant questioning of ethical dilemmas in the contemporary psychiatry, because of the special status of psychiatry as a potentially risky field in practice, and because of intensive pharmacological investigations in psychiatric patients.
The World Bank is committed to "work[ing] with countries to improve the health, nutrition and population outcomes of the world's poor, and to protect[ing] the population from the impoverishing effects of illness, malnutrition and high fertility".(1) Ethical issues arise in the interpretation of these objectives and in helping countries formulate strategies and policies. It is these ethical issues--which are often not acknowledged by commentators--that are the subject of this paper. It asks why there should be a focus on the poor, and explores the link between improving the health of the poor, and reducing health inequalities between the poor and better-off. It discusses difficult ethical issues at both the global level (including debt relief and the link between country ownership and donor commitment) and the country level (including user fees and whether providing assistance to the non-poor may in the long run be a way of helping the poor).
Denig, Stephen J.; Quinn, Terrence
Schools are ethical organizations. The daily schedule of educational administrators is filled with ethical dilemmas and moral decisions. As reflective practitioners, school leaders know that the decisions that are made and the values that underlie those decisions are filled with moral implications for the entire school community. In this paper,…
Morgan, Carol A; McDonald, Michael
Veterinarians frequently encounter situations that are morally charged and potentially difficult to manage. Situation involving euthanasia, end-of-life care, economics, and inadequate provision of care create practical and moral dilemmas. Ethical tension may be attributable to differences in beliefs regarding the moral value of animals, client and veterinary responsibilities, and deciding what is best for an animal. Veterinarians can employ communication skills used in medical situations to explore the reasons underpinning ethical dilemmas and to search for solutions with clients, staff, and colleagues.
Sandra Santana López
Full Text Available A review on the ethical dilemmas in the diagnosis of hypertension and some elements in the emergence of the bioethics concept was performed. Ethical conflicts that appear at each stage of diagnosis of hypertension: at the time of providing the information, at the point of indication and performance of diagnostic tests, when communicating the diagnosis and during subsequent decision making were identified. We conclude that technological development will introduce new ethical decisions in the diagnosis of hypertension that will increasingly involve the interests of society and create, in one way or another, ethical and moral conflict in the decision making process.
This paper is based on my experience with teaching a course on ethical dilemmas faced by individuals, managers and businesses in contemporary societies. Modern economic thinking generally presumes that individuals and businesses in a society follow their own self-interest, or private economic incentives. The course highlighted the importance of ethical considerations for action that are based on consideration of others rather than ones own. Four significant ethical dilemmas of modern societie...
Steven I. Miller
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.
Full Text Available Palliative sedation is a unique concern for the patient as well as the family. It is a difficult serious ethical dilemma for the physicians to handle. The conflicting ethical principles of autonomy, beneficence and nonmaleficence in continuing versus discontinuing all supportive devices raise concerns among health professionals whether this is euthanasia (physician-assisted suicide or is just prolonging the patient's unnecessary suffering.
Izard, Ralph S.; Hesterman, Vicki
In a study to examine journalistic integrity, two recent surveys answered by a combined total of 1,936 American journalists requested responses to questions as well as to specific hypothetical ethical dilemmas. In Survey A (conducted in 1983), questions were structured to provide information on beliefs and/or news media policy in four categories…
Ehrich, Lisa Catherine; Kimber, Megan; Millwater, Jan; Cranston, Neil
Over recent decades, the field of ethics has been the focus of increasing attention in teaching. This is not surprising given that teaching is a moral activity that is heavily values-laden. Because of this, teachers face ethical dilemmas in the course of their daily work. This paper presents an ethical decision-making model that helps to explain…
Brown, Timothy; Armstrong, Stephen A.; Bore, Samuel; Simpson, Chris
School counselors frequently face ethical dilemmas. These dilemmas often involve relationships with principals, parents, and other stakeholders. School counselors may confront complex ethical issues involving confidentiality, student safety, parental rights,and social media. The American School Counselor Association recommends following an ethical…
Feldman, Brenda J.
Discusses how a high school journalism advisor dealt with ethical issues (including source attribution) surrounding the publication of a story about violation of school board policies by representatives of a nationally recognized ring company. (RS)
Barlow, Nichola Ann; Hargreaves, Janet; Gillibrand, Warren P
Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification. Participants and context: Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis. Ethical considerations: Ethical approval was obtained from the local National Research Ethics Committee. Four major themes emerged: 'best for the patient', 'accountability', 'collaboration and conflict' and 'concern for others'. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas. Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing
Aim: To discuss the ethics dilemmas of the early detection of overweight and obesity. Methods: Analysis of the ethical aspects of early detection. Results: The early detection of overweight and obesity entails a number of ethical dilemmas because it may both be helpful and harmful. It may help...
Kadooka, Yasuhiro; Okita, Taketoshi; Asai, Atsushi
A murder case that had some features in common with the Tarasoff case occurred in Sasebo City, Japan, in 2014. A 15-year-old high school girl was murdered and her 16-year-old classmate was arrested on suspicion of homicide. One and a half months before the murder, a psychiatrist who had been examining the girl called a prefectural child consultation centre to warn that she might commit murder, but he did not reveal her name, considering it his professional duty to keep it confidential. Article 134 of the Japanese Criminal Law states that doctors should not disclose patient information obtained in clinical practice without a legitimate reason, but the Japanese Supreme Court has not specified what constitutes a legitimate reason. Mass media and commentators suggested that the murder could have been prevented if the psychiatrist had disclosed the girl's name to the authorities or had isolated her coercively in a psychiatric ward. However, the authors disagree with such claims. This article discusses obligations imposed on concerned individuals and third party members in cases involving ethical dilemmas regarding patient confidentiality and information disclosure. It is concluded that everyone should fulfill their obligations to prevent such tragedies and one should judge the appropriateness of others' actions based not on the consequences of their actions, but on the processes used to decide on a course of action and their commitment. It is necessary for us to establish a society in which concerned parties can do what they think is ethically best without fearing ungrounded charges. © 2016 John Wiley & Sons Ltd.
Joan K. Pierson
Full Text Available Because most organizations depend on computer systems that electronically store important data to perform crucial business functions, the integrity of these information systems is paramount. Securing company systems, however, is not always an easy task. More sophisticated systems often provide widespread access to computer resources and increased user knowledge, which may lead to added difficulties in maintaining security. This paper explores whistleblowing employees' exposing illegal or unethical computer practices taking place in the organization as a method of computer security and the support for whistleblowing found in codes of ethical conduct formulated by professional societies.
Wells, Joseph K
This article illustrates an ethical dilemma that I faced while treating an 86-year-old woman at her home. The ethical dilemma was caused due to several factors such as the expectations of the client (client/consumer rights), organisational expectations (employer, governmental and payer-source regulations) and my own personal values (one's moral philosophies, perceived social responsibilities, sense of professional duty) and how they all interact with each other. The case is a classic example of a seemingly simple yet frequent dilemma encountered by occupational and physical therapists in the United States serving clients who are covered by Medicare (the government's health insurance) for home health. The article is aimed at highlighting the various ethical principles involved in clinical decision-making, and it suggests methods for resolution of ethical dilemmas. Although the article is based against the backdrop of the US health care system, students and health care practitioners globally can relate to it.
Full Text Available The main purpose of the article is to support the idea of institutionalizing business ethics education at all business schools. Further, the article stresses the importance of using ethical-economic dilemmas in business ethics education. It argues that business students should learn that managerial work is too complex to make do with expertise and experience and help them to acquire the skill of ethical reflection of economic activity. Solving ethical-economic dilemmas in business ethics courses helps to develop cognitive skills in considering economic or managerial problems on the basis of ethical and economic interaction. In order to support the main purpose stated above, we aimed at getting a picture of how respondents assess and solve an ethical-economic dilemma. Hence, this article presents results of an empirical investigation of the ethical decision-making (EDM process on a sample of Slovak students of Management.
Babalola, Olubukola; Grant-Kels, Jane M; Parish, Lawrence Charles
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. Copyright © 2012 Elsevier Inc. All rights reserved.
Professor PhD Turlea Eugeniu; PhD Student Mocanu Mihaela
Resolving ethical dilemmas is a difficult endeavor in any field and financial auditing makes no exception. Ethical dilemmas are complex situations which derive from a conflict and in which a decision among several alternatives is needed. Ethical dilemmas are common in the work of the financial auditor, whose mission is to serve the interests of the public at large, not those of the auditee’s managers who mandate him/her. The objective of the present paper is to offer support in resolving ethi...
Eberholst, Mads Kaemsgaard; Hartley, Jannie Møller; Olsen, Maria Bendix
This article looks at journalism students' experiences in a course that simulates an online newsroom. On the basis of a quantitative survey and more qualitative reflections from the students, we explore the dilemmas that students experience "working" as online journalists and how these are related to broader issues of journalistic…
Liégeois, A; Van Audenhove, C
Ethical dilemmas in community mental health care is the focus of this article. The dilemmas are derived from a discussion of the results of a qualitative research project that took place in five countries of the European Union. The different stakeholders are confronted with the following dilemmas: community care versus hospital care (clients); a life with care versus a life without care (informal carers); stimulation of the client toward greater responsibility versus protection against such responsibility (professionals); budgetary control versus financial incentives (policy makers), and respect for the client versus particular private needs (neighbourhood residents). These dilemmas are interpreted against the background of a value based ethical model. This model offers an integral approach to the dilemmas and can be used to determine policy. The dilemmas are discussed here as the result of conflicting values-namely autonomy and privacy, support and safety, justice and participation, and trust and solidarity.
Cole, Cristie M; Falcone, Tatiana; Caplan, Rochelle; Timmons-Mitchell, Jane; Jares, Kristine; Ford, Paul J
To date, only a very narrow window of ethical dilemmas in psychogenic nonepileptic seizures (PNES) has been explored. Numerous distinct ethical dilemmas arise in diagnosing and treating pediatric and adolescent patients with PNESs. Important ethical values at stake include trust, transparency, confidentiality, professionalism, autonomy of all stakeholders, and justice. In order to further elucidate the ethical challenges in caring for this population, an ethical analysis of the special challenges faced in four specific domains is undertaken: (1) conducting and communicating a diagnosis of PNESs, (2) advising patients about full transparency and disclosure to community including patients' peers, (3) responding to requests to continue antiepileptic drugs, and (4) managing challenges arising from school policy and procedure. An analysis of these ethical issues is essential for the advancement of best care practices that promote the overall well-being of patients and their families. Copyright © 2014 Elsevier Inc. All rights reserved.
Full Text Available The article offers an insight on the ethical dilemmas specific to a public sector and brings some suggestions for coping with these. Ethics management is a complex system that deals also with ethical dilemmas. The instruments and tools of ethics management are helpful in dealing with these issues. There are a lot of cases in which public employees do not know what to do or how to react in a certain situation, so, a debate on this subject is very useful for people working in public institutions.
One of the fundamental precepts in the training of students in a clinical discipline involves appropriate placement and supervision in order for learning outcomes to be achieved. As an academic/clinical educator, one is at times faced with dilemmas in student placement that challenge one's personal and professional ethics.
Turner, Helen N
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. Copyright 2010 Elsevier Inc. All rights reserved.
Vuković Rodríguez, Jadranka; Juričić, Živka
Formal training in pharmacy ethics is relatively new in Croatia, and the professional code of ethics is more than 20 years old. Very little is known about how practicing pharmacists implement ethical considerations and relevant professional guidelines in their work. This study aimed to provide the first description of the perceptions and attitudes of Croatian community pharmacists toward ethics in pharmacy practice, how often they face certain ethical dilemmas and how they resolve them. A cross-sectional survey of 252 community pharmacists, including community pharmacists and pre-licensing trainees, was conducted in Zagreb, Croatia. This group accounts for 18% of licensed pharmacists in Croatia. The survey questions included four sections: general sociodemographic information, multiple-choice questions, pre-defined ethical scenarios, and ethical scenarios filled in by respondents. More than half of pharmacists (62.7%) face ethical dilemmas in everyday work. Nearly all (94.4%) are familiar with the current professional code of ethics in Croatia, but only 47.6% think that the code reflects the changes that the pharmacy profession faces today. Most pharmacists (83.3%) solve ethical dilemmas on their own, while nearly the same proportion (75.4%) think that they are not adequately trained to deal with ethical dilemmas. The pre-defined ethical scenarios experienced by the largest proportion of pharmacists are being asked to dispense a drug to someone other than the patient (93.3%), an unnecessary over-the-counter medicine (84.3%), a generic medicine clinically equivalent to the prescribed one (79.4%), or hormonal contraception over the counter (70.4%). The results demonstrate a need to improve formal pharmacy ethics education and training in how to assess ethical issues and make appropriate decisions, which implies the need for stronger collaboration between pharmacists and their professional association. Our results also highlight an urgent need to revise and update the
Atonement, as the representative work of British writer Ian McEwan, is of high educational significance. This article wil adopt Ethical Literary Criticism to analyze the ethical dilemmas and ethical choices of two characters in the novel: Briony and Robbie. By putting the characters into diversified ethical problems, the writer has strengthened the necessity of reflection and atonement in real life, and also the moral responsibilities one should bear. The analysis of characters' ethical problems can better highlight the writer's moral value.
Faily, Shamal; McAlaney, John; Iacob, C.
Penetration testers are required to attack systems to evaluate their security, but without engaging in unethical behaviour while doing so. Despite work on hacker values and studies into security practice, there is little literature devoted to the ethical pressures associated with penetration testing. This paper presents several ethical dilemmas and dimensions associated with penetration testing;\\ud these shed light on the ethical positions taken by Penetration testers, and help identify poten...
Blevins, Rodney D.
Approved for public release; distribution in unlimited. This study examines ethical dilemmas in the workplace and how organizational members move to resolve these challenges. Existing research was reviewed to gain insight and determine current views of ethical dilemmas experienced at work. A study was then conducted with Supply Corps Officers in the U.S. Navy to better understand the dilemmas they face in their daily work life. Officers were asked to think of a critical incident when they ...
Pacsi, Alsacia L
Nursing often deals with ethical dilemmas in the clinical arena. A case study demonstrates an ethical dilemma faced by healthcare providers who care for and treat Jehovah's Witnesses who are placed in a critical situation due to medical life-threatening situations. A 20-year-old, pregnant, Black Hispanic female presented to the Emergency Department (ED) in critical condition following a single-vehicle car accident. She exhibited signs and symptoms of internal bleeding and was advised to have a blood transfusion and emergency surgery in an attempt to save her and the fetus. She refused to accept blood or blood products and rejected the surgery as well. Her refusal was based on a fear of blood transfusion due to her belief in Bible scripture. The ethical dilemma presented is whether to respect the patient's autonomy and compromise standards of care or ignore the patient's wishes in an attempt to save her life. This paper presents the clinical case, identifies the ethical dilemma, and discusses virtue ethical theory and principles that apply to this situation.
Rasmussen, Lisa M
Clinical ethics consultation is on the horns of a dilemma. One horn skewers the field for its lack of standards, while the other horn skewers it for proposing arbitrary or deeply contested foundations. I articulate the dilemma by discussing several critiques of the field and the challenge of formulating standards and suggest that the solution lies, at least until a robust consensus emerges, with establishing a list of proscriptive standards to guide the field.
Ruiz López, Justo; Navarro Zaragoza, Javier; Carrillo Navarro, Francisco; Luna Maldonado, Aurelio
After reviewing the existing bibliography in the last 20 years, we concluded that there is a lack of information regarding the ethical conflicts that affect to pediatrics in their daily practice. It produces certain degree of uncertainty in these professionals at the time of solving these problems. We made a systematic search in the main data bases, finding more than 150 articles related, of which 80 were considered outstanding. After studying them, we have found 40 ethical dilemmas, related to some principle of solution and that we described in this article. Through them we can find such important dilemmas as those related to physical disability, palliative care or consent from children.
Full Text Available Physical therapy is a medical specialty where the professionals help restore movement and function when someone is affected by injury, illness or disability. This paper wishes to establish the connection between ethics, physiotherapy and bioengineering. The research method was achieved using academic database searches based on specific keywords. A SWOT analysis of the physiotherapy devices utilization and design was made, for extracting ethical considerations. The main results suggest that physiotherapy devices are able to generate ethical dilemmas, classified in 4 main items: (1 Bioengineering in physical therapy, ethical and clinical standards for manufacturers; (2 Social impact of physical therapy devices and ethical issues; (3 Inter-professional lack of communication and ethical concerns; (4 Bioengineering ethical research and education. As conclusions, for the physical therapy or electrotherapy research equipment development, a multidisciplinary team is needed. The equipment used in rehabilitation must fulfil specific technical and scientific requirements drafted by the professionals.
Paulins, V. Ann; Lombardy, Lisa
Ethical dilemmas observed by students in retailing internships were the basis for a survey in which students indicated their perceptions as to whether case situations involved unethical behavior. Expanded case situations were offered to students for further exploration. The specific questions posed in this study included the following: (1) In what…
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.
Teer, Faye P.; Kruck, S. E.
It is important for students to be prepared to act ethically when they face real world situations that test their ethical leadership. The purpose of this study was to examine university students' responses to ethical dilemmas. One hundred and sixty two students in numerous majors and both undergraduate and graduate classifications responded to a…
This article explores a cross-occupational approach for dealing with ethical dilemmas by comparing teaching and nursing. Findings indicate more shared patterns of ethical dilemmas (such as caring for needs for others versus following formal codes) than dilemmas specific to teaching (e.g., advancing universal values versus advancing knowledge) or…
Hou, Wen-Li; Kuo, Ya-Wen; Huang, Mei-Chih
Marital violence or intimate partner violence is a serious and recurring public health issue. In the clinical setting, battered women often seek medical advice, because of the health problems that result from marital violence. Thus, nursing staff are the first persons to come into contact with the battered women. Can nurses execute their notify responsibility to prevent continued injury before obtained the woman's agreement? Will this action violate the principle of autonomy or not? Nurses would face an ethical dilemma when they care for battered women. The purpose of this article is to use Aroskar's ethical decision making model to analyze and clarify the ethical dilemmas involved in managing marital violence, including: under the value systems of the person, the profession, and time to illustrate the basic information, decision theory dimensions, and ethical theories or positions. It is hoped that this article provides an ethical decision making model for the ethical dilemmas facing nurses who manage marital violence in the clinical setting.
Yönt, Gülendam Hakverdioğlu; Korhan, Esra Akin; Dizer, Berna; Gümüş, Fatma; Koyuncu, Rukiye
Nurses are more likely to face the dilemma of whether to resort to physical restraints or not and have a hard time making that decision. This is a descriptive study. A total of 55 nurses participated in the research. For data collection, a question form developed by researchers to determine perceptions of ethical dilemmas by nurses in the application of physical restraint was used. A descriptive analysis was made by calculating the mean, standard deviation, and maximum and minimum values. The nurses expressed (36.4%) having difficulty in deciding to use physical restraint. Nurses reported that they experience ethical dilemmas mainly in relation to the ethic principles of nonmaleficence, beneficence, and convenience. We have concluded that majority of nurses working in critical care units apply physical restraint to patients, although they are facing ethical dilemmas concerning harm and benefit principles during the application.
Kopala, Beverly; Burkhart, Lisa
To propose two NANDA diagnoses--ethical dilemma and moral distress--and to distinguish between the NANDA diagnosis decisional conflict and the proposed nursing diagnosis of ethical dilemma. Journal articles, books, and focus group research findings. Moral/ethical situations exist in health care. Nurses' experiences of ethical dilemmas and moral distress are extrapolated to the types and categories of ethical dilemmas and moral distress that patients experience and are used as the basis for development of two new nursing diagnoses. The two proposed NANDA diagnoses fill a void in current standardized terminology. It is important that nurses have the ability to diagnose ethical or moral situations in health care. Currently, NANDA does not offer a means to document this important phenomenon. The creation of two sets of nursing diagnoses, ethical dilemma and moral distress, will enable nurses to recognize and track nursing care related to ethical or moral situations.
Ilsa Lottes; Hanna Hopia; Mariël Kanne
Abstract Background: Healthcare professionals encounter ethical dilemmas and concerns in their practice. More research is needed to understand these ethical problems and to know how to educate professionals to respond to them. Research objective: To describe ethical dilemmas and concerns at work
Buelow, Janet R.; Mahan, Pamela L.; Garrity, April W.
Ethical dilemmas are experienced by all individuals, but are especially prevalent among healthcare professionals. Universities and colleges preparing students to work and provide care in this arena are currently addressing this challenge through traditional ethics courses and lectures. However, student perspectives of the major ethical dilemmas in…
Ganz, Freda D; Wagner, Nurit; Toren, Orly
Nurse managers are placed in a unique position within the healthcare system where they greatly impact upon the nursing work environment. Ethical dilemmas and moral distress have been reported for staff nurses but not for nurse middle managers. To describe ethical dilemmas and moral distress among nurse middle managers arising from situations of ethical conflict. The Ethical Dilemmas in Nursing-Middle Manager Questionnaire and a personal characteristics questionnaire were administered to a convenience sample of middle managers from four hospitals in Israel. Middle managers report low to moderate levels of frequency and intensity of ethical dilemmas and moral distress. Highest scores were for administrative dilemmas. Middle managers experience lower levels of ethical dilemmas and moral distress than staff nurses, which are irrespective of their personal characteristics. Interventions should be developed, studied, and then incorporated into institutional frameworks in order to improve this situation. © The Author(s) 2014.
The purpose of this paper is to show that the consideration of value is necessary to understand moral dilemmas in engineering ethics. First, the author shows that moral dilemmas are not fully understood in engineering ethics and argues that it is due to the lack of understanding of value. Second, the author considers the concept of value from the viewpoint of ‘desirability’ . Finally, three suggestions for improving engineering ethics in the understanding of moral dilemmas are made.
Newton, M J
It is often assumed that the central problem in a medical ethics issue is determining which course of action is morally correct. There are some aspects of ethical issues that will yield to such analysis. However, at the core of important medical moral problems is an irreducible dilemma in which all possible courses of action, including inaction, seem ethically unsatisfactory. When facing these issues ethical behaviour depends upon an individual's understanding and acceptance of this painful dilemma without recourse to external moral authority. PMID:3806633
Spencer, G E
The application of the best interests principle in current legislation creates an ethical dilemma in relation to children's consent to treatment. The guiding principle of the UN Convention on the Rights of the Child (1989) symbolises a formal expression of children's participation rights. Children's rights to consent to treatment are granted on socially determined ideals of competency. Children's participation in health care is increasingly advocated in legislation but many barriers remain. Nurses can facilitate children's participation through communicating information and creating partnerships with children.
Woloshin, Phyllis Lerman
This report describes a study undertaken to assess student choices in medical ethical dilemmas. Medical ethical dilemmas are interpreted to include problems such as abortion, euthanasia, sterilization, experimentation on humans, allocation of scarce medical resources, and physician and health personnel training. The major purpose of the study was…
This article identifies and discusses ethical dilemmas inherent when undertaking research with children or other vulnerable populations: power relations, risks and benefits, and informed consent and confidentiality (Maguire, 2005). Ethical dilemmas often arise when researchers attempt to merge the interests of their research and the interests of…
Sprouse, Fay Simpson
Ethical dilemmas, situations involving a conflict between values or principles, often arise when employees of school districts violate laws or professional codes of behavior. Ethical dilemmas also occur when there are inequities in educational programming, resulting in missed opportunities for students. This qualitative study, conducted with the…
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.
Silén, Marit; Tang, Ping Fen; Wadensten, Barbro; Ahlström, Gerd
This study concerns Swedish nurses' experiences of workplace stress and the occurrence of ethical dilemmas in a neurological setting. Qualitative interviews were conducted with 21 nurses. The interview results were subjected to qualitative latent content analysis and sorted into 4 content areas: workplace distress, ethical dilemmas, managing distress and ethical dilemmas, and quality of nursing. Common workplace stressors were high workload and lack of influence. These were perceived to have negative consequences for the quality of nursing. Ethical dilemmas mainly concerned decision making on initiation or withdrawal of treatment, which was experienced as a troublesome situation where conflicts could arise. The nurses managed the distress and ethical dilemmas by accepting and adjusting to the situation and seeking support from colleagues. They also endeavored to gain new strength in their private lives.
Hopia, Hanna; Lottes, Ilsa; Kanne, Mariël
Healthcare professionals encounter ethical dilemmas and concerns in their practice. More research is needed to understand these ethical problems and to know how to educate professionals to respond to them. To describe ethical dilemmas and concerns at work from the perspectives of Finnish and Dutch healthcare professionals studying at the master's level. Exploratory, qualitative study that used the text of student online discussions of ethical dilemmas at work as data. Participants' online discussions were analyzed using inductive content analysis. The sample consisted of 49 students at master's level enrolled in professional ethics courses at universities in Finland and the Netherlands. Permission for conducting the study was granted from both universities of applied sciences. All students provided their informed consent for the use of their assignments as research data. Participants described 51 problematic work situations. Among these, 16 were found to be ethical dilemmas, and the remaining were work issues with an ethical concern and did not meet criteria of a dilemma. The most common problems resulted from concerns about quality care, safety of healthcare professionals, patients' rights, and working with too few staff and inadequate resources. The results indicated that participants were concerned about providing quality of care and raised numerous questions about how to provide it in challenging situations. The results show that it was difficult for students to differentiate ethical dilemmas from other ethical work concerns. Online discussions among healthcare providers give them an opportunity to relate ethical principles to real ethical dilemmas and problems in their work as well as to critically analyze ethical issues. We found that discussions with descriptions of ethical dilemmas and concerns by health professionals provide important information and recommendations not only for education and practice but also for health policy. © The Author(s) 2015.
Bhola, Poornima; Sinha, Ananya; Sonkar, Suruchi; Raguram, Ahalya
Ethical dilemmas are inevitable during psychotherapeutic interactions, and these complexities and challenges may be magnified during the training phase. The experience of ethical dilemmas in the arena of therapy and the methods of resolving these dilemmas were examined among 35 clinical psychologists in training, through an anonymous and confidential online survey. The trainees' responses to four open-ended questions on any one ethical dilemma encountered during therapy were analysed, using thematic content analysis. The results highlighted that the salient ethical dilemmas related to confidentiality and boundary issues. The trainees also raised ethical questions regarding therapist competence, the beneficence and non-maleficence of therapeutic actions, and client autonomy. Fifty-seven per cent of the trainees reported that the dilemmas were resolved adequately, the prominent methods of resolution being supervision or consultation and guidance from professional ethical guidelines. The trainees felt that the professional codes had certain limitations as far as the effective resolution of ethical dilemmas was concerned. The findings indicate the need to strengthen training and supervision methodologies and professional ethics codes for psychotherapists and counsellors in India.
Guy, Timothy Michael
This research study explores the intersection of school leadership and ethics. This study used the hermeneutic phenomenological approach described by Max Van Manen (1990, 2014) to explore the question: How do school leaders experience ethical dilemmas in their role as school leaders? Hermeneutic phenomenology seeks to find the meaning of a phenomenon, which in this case is the experience of an ethical dilemma. Hermeneutic refers to the interpretive-reflective-analytical component and phenom...
Agyapong, V I O
A case is described of a fifty year old single man who made disclosures about criminal sexual practices during a psychiatric assessment. In common practice with other professional men, a doctor is under a duty not to disclose, without the consent of his patient, information which he has gained in his professional capacity other than in exceptional circumstances. We discuss the ethical and legal considerations surrounding issues of medical confidentiality and the dilemma that sometimes face clinicians, when they feel obliged, in the public interest, to disclose information they have gained in confidence. Breach of confidences can have deleterious consequences; particularly for the doctor-patient relationship, but failure to disclose in some situations could have serious implications for the well-being of the wider society. Doctors should be aware of the basic principles of confidentiality and the ethical and legal framework around which they are built.
Kenny, Belinda; Lincoln, Michelle; Balandin, Susan
Purpose: To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Method: Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual…
Full Text Available Despite the increase in and evolving nature of armed conflicts, the ethical issues faced by military physicians working in such contexts are still rarely examined in the bioethics literature. Military physicians are members of the military, even if they are non-combatants; and their role is one of healer but also sometimes humanitarian. Some scholars wonder about the moral compatibility of being both a physician and soldier. The ethical conflicts raised in the literature regarding military physicians can be organized into three main perspectives: 1 moral problems in military medicine are particular because of the difficulty of meeting the requirements of traditional bioethical principles; 2 medical codes of ethics and international laws are not well adapted to or are too restrictive for a military context; and 3 physicians are social actors who should either be pacifists, defenders of human rights, politically neutral or promoters of peace. A review of the diverse dilemmas faced by military physicians shows that these differ substantially by level (micro, meso, macro, context and the actors involved, and that they go beyond issues of patient interests. Like medicine in general, military medicine is complex and touches on potentially contested views of the roles and obligations of the physician. Greater conceptual clarity is thus needed in discussions about military medical ethics.
Kim, Kyunghee; Han, Yonghee; Kim, Ji-su
In the changing medical environment, professional stress continuously increases as the individual's quality of life suffers. Of all the healthcare professions, nursing is especially prone to burnout, compassion fatigue and reduced compassion satisfaction, due to the tensions resulting from the physical and psychological stress of caring for extremely ill patients. This study examined the professional quality of life of clinical nurses in Korea and the relationship between their experiences in ethical dilemmas and professional values. This was a cross-sectional study of a convenience sample consisting of 488 clinical nurses. We used four questionnaires to measure the participants' demographic characteristics, experiences in ethical dilemmas, professional nursing values and professional quality of life (ProQOL assessment, Version 5). Ethical considerations: This study received approval from the Institutional Review Board of Bronco Memorial Hospital. Written informed consent was given by all participants. The nurses' professional quality of life was affected by ethical dilemmas and professional nursing values. The factors influencing compassion satisfaction were age, client domain of ethical dilemmas, social awareness, professionalism of nursing and the roles of nursing services in professional values. The factors influencing burnout were marital status (married), religion (yes), human life domain, professional work domain of ethical dilemmas, social awareness and the role of nursing services in nursing professional values. The factors influencing secondary traumatic stress were human life domain, client domain and the professional work domain of ethical dilemmas. Intervention to help nurses increase their professional quality of life will have a greater chance of success if they are based on the nurses' values and beliefs about the ethical dilemmas they face and foster the establishment of positive professional values. © The Author(s) 2014.
Norberg, Katarina; Johansson, Olof
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…
Greenslit, Lawrence P
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...
Blais, Ann-Renee; Thompsom, Megan
.... As part of a larger study on moral decision making, 64 participants read and reflected upon six ethical dilemmas, rated the extent to which 5 moral principles influenced their decisions regarding...
These dilemmas are at the heart of the book under review: Development ... economics and ethics; part two delves into special problems and applications; and part three ... in rising consumption levels and improved standards of living. The free ...
Mariño, Tania Cruz; Armiñán, Rubén Reynaldo; Cedeño, Humberto Jorge; Mesa, José Miguel Laffita; Zaldivar, Yanetza González; Rodríguez, Raúl Aguilera; Santos, Miguel Velázquez; Mederos, Luis Enrique Almaguer; Herrera, Milena Paneque; Pérez, Luis Velázquez
Predictive testing protocols are intended to help patients affected with hereditary conditions understand their condition and make informed reproductive choices. However, predictive protocols may expose clinicians and patients to ethical dilemmas that interfere with genetic counseling and the decision making process. This paper describes ethical dilemmas in a series of five cases involving predictive testing for hereditary ataxias in Cuba. The examples herein present evidence of the deeply controversial situations faced by both individuals at risk and professionals in charge of these predictive studies, suggesting a need for expanded guidelines to address such complexities.
Calleja-Sordo, Elisa Constanza; de Hoyos, Adalberto; Méndez-Jiménez, Jorge; Altamirano-Bustamante, Nelly F; Islas-Andrade, Sergio; Valderrama, Alejandro; García-Peña, Carmen; Altamirano-Bustamante, Myriam M
The purpose of this study is to determine empirically the state of the art of the medical care, when healthcare personal is confronted with ethical dilemmas related with the care they give to the geriatric population. An observational, longitudinal, prospective and qualitative study was conducted by analyzing the correlation between healthcare personnel-patient relationship, and ethical judgments regarding dilemmas that arise in daily clinical practice with geriatric patients. Mexican healthcare personnel with current active practices were asked to write up an ethical dilemma that arose frequently or that had impacted their medical practice. From the narrative input, we were able to draw up a database with 421 dilemmas, and those corresponding to patients 60 years and older were selected (n = 54, 12.8 %). The axiological analysis of the narrative dilemmas of geriatric patients was made using dialectical empiricism. The axiological analysis values found most frequently were classified into three groups: the impact of healthcare, the roles of the physician, and refusal of therapy; the healthcare role of educator, caring for the patients' life and the risk of imminent death where the values found more often. The persistence and universality of certain dilemmas in geriatrics calls for awareness and requires a good training in the ethical discernment of these dilemmas. This would help to improve substantially the care and the life quality of this population.
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. PMID:22824376
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.
Jenlink, Patrick M.; Jenlink, Karen Embry
In this paper the authors examine an ethical dilemma approach to case-based pedagogy for leadership preparation, which was used in a doctoral studies program. Specifically, the authors argue that preparing educational leaders for the ethical dilemmas and moral decision-making that define schools requires assessing current programs and pedagogical…
Denardin, Daniela; Telles, Jorge Alberto B; Betat, Rosilene da Silveira; Fell, Paulo Renato K; Cunha, André Campos da; Targa, Luciano Vieira; Zen, Paulo Ricardo G; Rosa, Rafael Fabiano M
OBJECTIVE To review the history, epidemiology, etiology, gestational aspects, diagnosis and prognosis of imperfect twinning. DATA SOURCES Scientific articles were searched in PubMed, SciELO and Lilacs databases, using the descriptors "conjoined twins", "multiple pregnancy", "ultrasound", "magnetic resonance imaging" and "prognosis". The research was not delimited to a specific period of time and was supplemented with bibliographic data from books. The description of conjoined twins is legendary. The estimated frequency is 1/45,000-200,000 births. These twins are monozygotic, monochorionic and usually monoamniotic. They can be classified by the most prominent fusion site, by the symmetry between the conjoined twins or by the sharing structure. The diagnosis can be performed in the prenatal period or after birth by different techniques, such as ultrasound, magnetic resonance imaging and echocardiography. These tests are of paramount importance for understanding the anatomy of both fetuses/children, as well as for prognosis and surgical plan determination. CONCLUSIONS Although imperfect twinning is a rare condition, the prenatal diagnosis is very important in order to evaluate the fusion site and its complexity. Hence, the evaluation of these children should be multidisciplinary, involving mainly obstetricians, pediatricians and pediatric surgeons. However, some decisions may constitute real ethical dilemmas, in which different points should be discussed and analyzed with the health team and the family.
Ethical dilemmas from a national purposive sample of Turkish counsellors (N = 172) were collected using critical incidents technique. Content analysis was performed with open coding guided by the classification of American Counseling Association code of ethics. Incidents regarding confidentiality and privacy (56.4%), with 37.1% involving incidents…
Mortari, Luigina; Harcourt, Deborah
This article will explore some of the ethical dilemmas that confront researchers when they seek to invite children's participation in research. It firstly tracks the historical landscape of ethical research and will examine the influence of the United Nations Convention on the Rights of the Child (UNCRC) on participatory research with children.…
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.
Philosophy tries to provide rules and principles enabling us to solve the ethical dilemmas we face in a wide sense, and, also, in particular fields as (geo)sciences. One alleged goal of ethics is to figure out how to solve ethical dilemmas. But, is it possible to solve such dilemmas? And what can we do if we cannot? An ethical dilemma is a problem that offers an alternative between two or more solutions, none of which proves to be fully acceptable in practice. Dilemmas arise because of conflict between the rightness or wrongness of the actions/means and the goodness or badness of the consequences/ends. They involve an apparent conflict between moral imperatives, in which to follow one would result in violating another. Can a geoscientist answer those dilemmas that appear in the exercise of his/her profession? Always? In some cases? Not at all? What if we cannot? Have we? As geoscientists, we hold the knowledge (our scientific principles), not perfect, thus fallible, and always subject to changes and improvements. If we have to do what is right, based on our principles, despite potentially bad consequences, then we have to be sure that the principle is an absolute true. But, are our scientific principles such a true? Deontological theories may deny that consequences are of any concern, provided the intention was a good one. However, if our principles are not perfect (and we know that): can we answer in one or other direction to geoethical dilemmas in good faith? Although, if a geoscientist action does usually go for the best consequences, sometimes bad consequences may be accepted. But, who have to decide to accept the bad consequences? If ethical dilemmas with a conflict between means and ends cannot simply be solved by a geoscientist, where is our duty? If there is no real solution to the conflict of the right with the good, in the sense that a solution usually seems to be expected, what has to be our professional attitude? When we have duties of omission and when
Thomas E. Doyle
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.
Häggström, Elisabeth; Mbusa, Ester; Wadensten, Barbro
The aim of this study was to describe Tanzanian nurses' meaning of and experiences with ethical dilemmas and workplace distress in different care settings. An open question guide was used and the study focused on the answers that 29 registered nurses supplied. The theme, ;Tanzanian registered nurses' invisible and visible expressions about existential conditions in care', emerged from several subthemes as: suffering from (1) workplace distress; (2) ethical dilemmas; (3) trying to maintaining good quality nursing care; (4) lack of respect, appreciation and influence; and (5) a heavy workload that did not prevent registered nurses from struggling for better care for their patients. The analysis shows that, on a daily basis, nurses find themselves working on the edge of life and death, while they have few opportunities for doing anything about this situation. Nurses need professional guidance to gain insight and be able to reflect on their situations, so that they do not become overloaded with ethical dilemmas and workplace distress.
Sullivan, Sherry Elaine
Prospective teachers are involved in a process of induction into a culture of teaching that has rules, or codes of conduct for engaging in teaching practice. This same culture of teaching exists within a larger culture of schooling that also has values and norms for behaviors, that over time have become institutionalized. Teacher educators are faced with the challenging task of preparing preservice teachers to resolve dilemmas that arise from conflicts between the pressure to adopt traditional teaching practices of schooling, or to adopt inquiry-based teaching practices from their university methods classes. One task for researchers in teacher education is to define with greater precision what factors within the culture of schooling hinder or facilitate implementation of inquiry-based methods of science teaching in schools. That task is the focus of this study. A qualitative study was undertaken using a naturalistic research paradigm introduced by Lincoln and Guba in 1985. Participant observation, interviews, discourse analysis of videotapes of lessons from the methods classroom and written artifacts produced by prospective teachers during the semester formed the basis of a grounded theory based on inductive analysis and emergent design. Unstructured interviews were used to negotiate outcomes with participants. Brief case reports of key participants were also written. This study identified three factors that facilitated or hindered the prospective teachers in this research success in implementing inquiry-based science teaching in their field placement classrooms: (a) the culture of teaching/teacher role-socialization, (b) the culture of schooling and its resistance to change, and (c) the culture of teacher education, especially in regards to grades and academic standing. Some recommendations for overcoming these persistent obstacles to best practice in elementary science teaching include: (a) preparing prospective teachers to understand and cope with change
Henderson, Kathryn L.; Malone, Stefanie L.
Learning to navigate ethical dilemmas is important in counseling students' training. According to the Council for the Accreditation of Counseling and Related Educational Programs (2009 standards, counseling students must receive ethics education. A common goal for counselor educators is to assist students in translating ethical theory into…
O'Donnell, Lolita T
To describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute hospital setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice in case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the
O'Donnell, Lolita T
The purpose of this study was to describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute care setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice of case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between
This is a reflective account of an ethical dilemma encountered while on placement on a cardiology ward. Reflection is a process which allows practitioners to reveal and expose thoughts, behaviours and feelings that are present at a particular time. All reflective models are based on the principle that purposeful reflection results in a better understanding and awareness, thus enhancing clinical practice (Driscoll and Teh 2001). The Gibbs' Reflective Cycle has been selected for its simplicity and ease of use to aid personal development. The dilemma was identified and analysed from a professional, ethical and legal perspective. Pseudonyms are used to maintain confidentiality and protect the identities of all parties involved.
Full Text Available Directors and boards face many challenges in terms of managing complexity. A key factor of success in practicing good corporate governance is the board’s ability to cope with paradox. The purpose of this research has been to explore the core corporate governance dilemmas facing boards. The investigation was qualitative in nature using the Delphi technique. Six core corporate governance dilemmas facing board members were identified one of which is not mentioned in the international literature. The findings should provide directors with an ability to identify the nature of the paradoxes they need to respond to.
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
Most moral dilemmas in medicine are analysed using the four principles with some consideration of consequentialism but these frameworks have limitations. It is not always clear how to judge which consequences are best. When principles conflict it is not always easy to decide which should dominate. They also do not take account of the importance of the emotional element of human experience. Virtue ethics is a framework that focuses on the character of the moral agent rather than the rightness of an action. In considering the relationships, emotional sensitivities, and motivations that are unique to human society it provides a fuller ethical analysis and encourages more flexible and creative solutions than principlism or consequentialism alone. Two different moral dilemmas are analysed using virtue ethics in order to illustrate how it can enhance our approach to ethics in medicine. PMID:14519840
Most moral dilemmas in medicine are analysed using the four principles with some consideration of consequentialism but these frameworks have limitations. It is not always clear how to judge which consequences are best. When principles conflict it is not always easy to decide which should dominate. They also do not take account of the importance of the emotional element of human experience. Virtue ethics is a framework that focuses on the character of the moral agent rather than the rightness of an action. In considering the relationships, emotional sensitivities, and motivations that are unique to human society it provides a fuller ethical analysis and encourages more flexible and creative solutions than principlism or consequentialism alone. Two different moral dilemmas are analysed using virtue ethics in order to illustrate how it can enhance our approach to ethics in medicine.
DeKeyser Ganz, Freda; Berkovitz, Keren
To describe surgical nurses' perceived levels of ethical dilemmas, moral distress and perceived quality of care and the associations among them. 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. Descriptive, cross-sectional study. 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. 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. 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. 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. © 2011 Blackwell Publishing Ltd.
Mahfooz A. Ansari; Noor Hazlina Ahmad; Rehana Aafaqi
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...
Sheather, Julian; Shah, Tejshri
Médecins Sans Frontières (MSF) is an independent medical humanitarian organisation working in over 70 countries. It has provided medical assistance for over 35 years to populations vulnerable through conflict, disease and inadequate health systems. Medical ethics define the starting point of the relationship between medical staff and patients. The ethics of humanitarian interventions and of research in conflict settings are much debated. However, less is known about the ethical dilemmas faced by medical humanitarian staff in their daily work. Ethical dilemmas can be intensified in humanitarian contexts by insecure environments, lack of optimum care, language barriers, potentially heightened power discrepancies between care providers and patients, differing cultural values and perceptions of patients, communities and medical staff. Time constraints, stressful conditions and lack of familiarity with ethical frameworks can prevent reflection on these dilemmas, as can frustration that such reflection does not necessarily provide instant solutions. Lack of reflection, however, can be distressing for medical practitioners and can reduce the quality of care. Ethical reflection has a central role in MSF, and the organisation uses ethical frameworks to help with clinical and programmatic decisions as well as in deliberations over operational research. We illustrate and discuss some real ethical dilemmas facing MSF teams. Only by sharing and seeking guidance can MSF and similar actors make more thoughtful and appropriate decisions. Our aim in sharing these cases is to invite discussion and dialogue in the wider medical community working in crisis, conflict or with severe resource limitations.
Elaine P. Congress
Full Text Available Recognizing ethical issues and dilemmas that arise in professional practice is crucial for social work practitioners, educators, and students. After a discussion about the limited, although growing, literature on social work ethics, the ten main tenets form the most current NASW Code of Ethics are presented. These topics include limits to confidentiality, confidentiality and technology, confidentiality in family and group work, managed care, cultural competence, dual relationships, sexual relationships, impairment and incompetence of colleagues, application to administrators and relevance to social work educators. In addition to understanding the Code of Ethics, social workers can use the ETHIC model of decision making for resolving ethical dilemmas. This easy to use five step process includes examining personal, agency, client, and professional values, thinking about ethical standards and relevant laws, hypothesizing about consequences, identifying the most vulnerable, and consulting with supervisors and colleagues. A case example involving confidentiality, HIV/AIDS and family therapy demonstrates how social workers can use the ETHIC model.
Zydziunaite, V; Lepaite, D; Suominen, T
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. To identify the leadership styles applied by head nurses in decision making in ethical dilemmas on hospital wards. 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. 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. 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. © 2013 The Authors. International Nursing Review © 2013 International Council of Nurses.
The aim of this study is to explore ethical dilemmas in critical incidents and the emerged responses that these incidents elicit. Most teachers try to suppress these incidences because of the unpleasant feelings they evoke. Fifty teachers participated in the study. A three-stage coding process derived from grounded theory was utilized. A taxonomy…
Malaria vector research presents several dilemmas relating to the various ways in which humans are used in the malaria vector research enterprise. A review of the past and present practices reveals much about the prevailing attitudes and assumptions with regard to the ethical conduct of research involving humans.
Kenny, Belinda; Lincoln, Michelle; Balandin, Susan
To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual narrative transcriptions were analyzed by using the participant's words to develop an ethical story that described and interpreted their responses to dilemmas. Key concepts from individual stories were then coded into group themes to reflect participants' reasoning processes. Five major themes reflected participants' approaches to ethical reasoning: (a) focusing on the well-being of the client, (b) fulfilling professional roles and responsibilities, (c) attending to professional relationships, (d) managing resources, and (e) integrating personal and professional values. SLPs demonstrated a range of ethical reasoning processes: applying bioethical principles, casuistry, and narrative reasoning when managing ethical dilemmas in the workplace. The results indicate that experienced SLPs adopted an integrated approach to ethical reasoning. They supported clients' rights to make health care choices. Bioethical principles, casuistry, and narrative reasoning provided useful frameworks for facilitating health professionals' application of codes of ethics to complex professional practice issues.
Mahfooz A. Ansari
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.
Isolated cutaneous leishmaniasis over face – A diagnostic dilemma. Santosh K. Swain, Ishwar C. Behera, Mahesh C. Sahu, Maitreyee Panda. Abstract. Cutaneous Leishmaniasis (CL) is a disease caused by an intracellular protozoa belong to the genus Leishmania, transmitted by the bite of a sandfly. It has diverse clinical ...
Dierckx de Casterlé, B; Grypdonck, M; Vuylsteke-Wauters, M; Janssen, P J
In literature as well as in nursing practice a growing concern about nurses' ethical competence can be observed. Based on the cognitive theory of moral development by Kohlberg, this research examined nursing students' ethical behaviour in five nursing dilemmas. Ethical behaviour refers not only to the ethical reasoning of nursing students but also to the relationship between reasoning and behaviour. Kohlberg's definition of morality was refined by adding a care perspective. The results show that the majority of students can be located in the fourth moral stage according to Kohlberg's theory, that is, the conventional level of moral development. This finding implies that students are still guided by professional rules, norms and duties, and have not (yet) succeeded in making personal ethical decisions on the basis of their own principles and acting according to such decisions.
Carpenter, Robert O; Austin, Mary T; Tarpley, John L; Griffin, Marie R; Lomis, Kimberly D
We propose that the standardized work-hour limitations have created an ethical dilemma for residents. A survey tool was designed to assess factors that influence the number of hours residents work and report. The program directors of pediatrics, internal medicine, and general surgery at our institution supported their residents' participation. A voluntary, anonymous survey of these residents was performed. One hundred seventy of 265 eligible residents were surveyed. Eighty-one percent of residents surveyed responded. Eighty percent of respondents reported exceeding work-hour restrictions at least once within the past 6 months. The factor of greatest influence measured was concern for patient care (80%). Forty-nine percent of respondents admitted underreporting their work hours. The Accreditation Council for Graduate Medical Education work-hour restrictions have created an ethical dilemma for residents. Our data show that a significant number of residents feel compelled to exceed work-hour regulations and report those hours falsely.
Johnson, Robert L.; Liu, Jin; Burgess, Yin
In this mixed-methods study we investigated the development of a generalized ethics decision-making model that can be applied in considering ethical dilemmas related to student assessment. For the study, we developed five scenarios that describe ethical dilemmas associated with student assessment. Survey participants (i.e., educators) completed an…
Schumann, Paul L.; Scott, Timothy W.; Anderson, Philip H.
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…
Full Text Available The present paper focuses on the ethical issues resulting from recruitment outsourcing in Bangladesh. It is a case based explorative study. Besides secondary data, both outsourced employees and employers who engage in outsourcing for their organization were interviewed to reach the valid data. Poor salary and benefit structure of the outsourced employees, different folded discrimination between in-house and outsourced employees, employee poaching from the competitors with the help of 3rd parties are some of the findings of the study that are creating ethical dilemma for organizations and employees as well. Both from the demographic perspective and subject matter the study is original one.
This paper explores the possibility of moral conflict in Kant’s ethics. An analysis of the only explicit discussion of the topic in his published writings confirms that there is no room for genuine moral dilemmas. Conflict is limited to nonconclusive ‘grounds’ of obligation. They arise only in the sphere of ethical duty and, though defeasible, ought to be construed as the result of valid arguments an agent correctly judges to apply in the situation at hand. While it is difficult to determine ...
Hove, S. van den; Le Menestrel, M.; Bettignies, H.C. de
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 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)
Van den Hove, S.; Le Menestrel, Marc; De Bettignies, Henri-Claude
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
Background. Ethics training strives to facilitate critical thinking, objective analysis and clinical reasoning skills to equip students with the ability to make an impartial and unbiased decision in different contexts and diverse client populations. This enhances students' learning experiences. Occupational therapy (OT) students ...
Ingrid Adriana Alvarez Osses
Full Text Available This investigation seeks to expound a critical ethic of hegemonic globalisation. We reflect on the common good ethics of Franz Hinkelammert, the contribution made by the intercultural dialogue of Raúl Fornet-Betancourt, the Ethics of Liberation of Enrique Dussel, and the situated, contextual thinking of Rodolfo Kusch. At the same time, the text reflects on the dilemmas of globalisation, especially with respect to polarisation and mutual incomprehension. We attempt to descry prospects for a situated critical ethic in the face of the cultural and economic order which governs the world. It is also important to consider the relevance of other assumptions which seek to change the logic of negation and non-recognition that have led to the Self and Totality. As part of this prospect, we propose a reconstructive ethic for the rehabilitation of a world order which has no ears for the voice of the victims of the profit imperative and a functional ethic based on utilitarism. This reveals a void in supportive behavior which demands a more responsible attitude towards those sectors which have always been passed over. Thus we propose an ethic which will strengthen dialogue in pursuit of other possibilities for the human race.
Kipperman, Barry; Morris, Patricia; Rollin, Bernard
Small animal veterinarians' opinions were investigated regarding the frequency and nature of ethical dilemmas encountered, beliefs regarding euthanasia and balancing client and animal interests, prevalence and value of ethics training and proposals to mitigate the stressful effects of ethical dilemmas. The majority (52 per cent) of 484 respondents in the USA indicated via an online survey experiencing an ethical dilemma regarding the interests of clients and those of their patients at least weekly. Scenarios involving client financial concerns were commonly reported causes of ethical conflicts. While only 20 per cent of respondents indicated that other practitioners prioritise patient interests, 50 per cent of respondents characterised their own behaviour as prioritising patients. Most respondents (52 per cent) reported that ethical dilemmas are the leading cause, or are one of many equal causes, of work-related stress. Less experienced practitioners, general practitioners and associate veterinarians were more likely to encounter situations they defined as ethical dilemmas, and female respondents were more likely to find ethical dilemmas stressful. Most small animal veterinarians experience ethical dilemmas regularly, which contribute to moral stress. Results suggested that most small animal practitioners believe that greater awareness of moral stress and providing training in ethical theories and tools for coping with ethical dilemmas can ameliorate moral stress. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Nurses are increasingly confronted with situations of moral difficulty, such as not to feed terminally ill patients, whistle blowing, or participation in termination of pregnancy. Most of these moral dilemmas are often analyzed using the principle-based approach which applies the four moral principles of justice, autonomy, beneficence, and non-malificence. In some instances, consequentialism is considered, but these frameworks have their limitations. Their limitations has to do with a consideration for the interpersonal nature of clinical nursing practice on the one hand, and is not always clear on how to judge which consequences are best on the other hand. When principles are in conflict it is not always easy to decide which principle should dominate. Furthermore, these frameworks do not take into account the importance of the interpersonal and emotional element of human experience. On the contrary, decision-making about moral issues in healthcare demands that nurses exercise rational control over emotions. This clearly focuses the attention on the nurse as moral agent and in particular their character. In this article I argue that virtue ethics as an approach, which focus of the character of a person, might provide a more holistic analysis of moral dilemmas in nursing and might facilitate more flexible and creative solutions when combined with other theories of moral decision-making. Advancing this argument, firstly, I provide the central features of virtue ethics. Secondly I describe a story in which a moral dilemma is evident. Lastly I apply virtue ethics as an approach to this moral dilemma and in particular focusing on the virtues inherent in the nurse as moral agent in the story.
Full Text Available Nurses are increasingly confronted with situations of moral difficulty, such as not to feed terminally ill patients, whistle blowing, or participation in termination of pregnancy. Most of these moral dilemmas are often analyzed using the principle-based approach which applies the four moral principles of justice, autonomy, beneficence, and nonmalificence. In some instances, consequentialism is considered, but these frameworks have their limitations. Their limitations has to do with a consideration for the interpersonal nature of clinical nursing practice on the one hand, and is not always clear on how to judge which consequences are best on the other hand. When principles are in conflict it is not always easy to decide which principle should dominate. Furthermore, these frameworks do not take into account the importance of the interpersonal and emotional element of human experience. On the contrary, decision making about moral issues in healthcare demands that nurses exercise rational control over emotions. This clearly focuses the attention on the nurse as moral agent and in particular their character. In this article I argue that virtue ethics as an approach, which focus of the character of a person, might provide a more holistic analysis of moral dilemmas in nursing and might facilitate more flexible and creative solutions when combined with other theories of moral decision-making. Advancing this argument, firstly, I provide the central features of virtue ethics. Secondly I describe a story in which a moral dilemma is evident. Lastly I apply virtue ethics as an approach to this moral dilemma and in particular focusing on the virtues inherent in the nurse as moral agent in the story.
Full Text Available Sustaining vital functions in critically ill in the ICU frequently allows prolongation of patient’s life even in circumstances where the treatment has lost its medical rationale and/or there is no hope for the patient’s condition to improve. Decision-making about termination of such treatment – usually referred to as futile, useless or inappropriate –, frequently presents a difficult ethical dilemma not only for the intensivists and other health-care workers but also for the patients and their relatives. The principles of biomedical ethics present a useful framework for decision-making in ethical dilemmas but cannot offer sufficiently explicit guidelines. Besides, the concepts of futility or futile treatment in the ICU are also not unequivocally defined. Thus, the decision regarding continuing or stopping treatment should be based on careful evaluation of the balance between its expected efficiency and benefits on the one hand and the burden imposed upon the patient on the other. If the burden clearly exceeds the expected benefits, the ethically sound decision is to terminate such treatment.
Space tourism is an important new venture, however it raises several issues that must be addressed; namely, the medical implications associated with space flight and potential for ethical problems surrounding the safety of such travel. It seems highly likely that businesses involved in space tourism could find themselves liable for any passenger deaths or injuries, if they are found to have been negligent. This paper, therefore, discusses such issues as the medical facilities that need to be made available on board a space facility, and the companies' duty to disclose to potential passengers the risks associated with microgravity and the likelihood of space sickness, loss of bone density, disease, and pregnancy.
Stojanov, Trajce; Unsal, Zeynep
Philosophers weren`t thinking a lot about terrorism before the terrorist attacks in the United States on 11 September 2001. Or even when they were thinking the main concern was how to deal with terrorism. But after this attack terrorism was high on the philosophical agenda mainly manifested as an ethical problem. The key concern was: can terrorism be morally justified? That is the issue we are dealing in this paper too. But, the answer of this question largely depends on the treatment of t...
Gordon, Joan Claire
Presents a process for solving ethical dilemmas: define the problem; identify facts; determine values; "slice" the problem different ways--duties, virtues, rights, and common good; rank ethical considerations; consult colleagues; and take action. (SK)
Results of a survey asking public school counselors in Virginia to indicate their most common and most challenging ethical dilemmas are presented. Ninety-two school counselors reported that the most common and challenging ethical dilemmas included those involving student confidentiality, dual relationship with faculty, parental rights, and acting…
Hartley, Michael T.; Cartwright, Brenda Y.
Purpose: This study surveyed current and projected ethical dilemmas of rehabilitation counselors. Method: As a mixed-methods approach, the study used both quantitative and qualitative analyses. Results: Of the 211 participants who completed the survey, 116 (55.0%) reported an ethical dilemma. Based on the descriptions, common themes involved roles…
Beveridge, Scott; Garcia, Jorge; Siblo, Matt
Purpose: To examine the nature of ethical dilemmas most frequently reported by rehabilitation counselors in the private and public sectors and determine if significant differences exist in how practitioners experience ethical dilemmas in these two settings. Method: A mixed-methods internet-based survey design was utilized and included descriptive,…
Thunman, Elin; Persson, Marcus
With the aim of contributing to the research about the educational use of social media, the paper explores teachers' experiences of ethical dilemmas on Facebook. The paper draws upon focus group interviews with Swedish secondary teachers. Two main categories of ethical dilemmas, related to the border between private and professional, are detected.…
Norlyk, Annelise; Haahr, Anita; Hall, Elisabeth
To discuss ethical and methodological challenges related to in-depth interviews with patients and partners when interviewed together or separately. Increased interest in exploring illness phenomena from both patients' and partners' perspectives has emerged. The decision about how to collect data is challenging. Patients and partners can be interviewed separately or together; in both scenarios researchers face complex questions of methodology and ethics. This paper contributes to the ongoing debate on individual or joint interviewing and the effect of absence/presence of the partner on data collection. Discussion paper that draws on data from three phenomenological studies. Referring to three cases from our phenomenological studies, we discuss the different types of ethical and methodological dilemmas faced when undertaking joint and separate interviews with couples. Furthermore, we discuss how the unexpected presence of the partner potentially influences the data gathered from the patient. The cases demonstrate the interrelatedness of ethics and methodology in studies based on in-depth interviews with couples. Nurse researchers may be caught up in a dilemma between ethical concerns and methodological considerations. We argue that the presence of the partner during an interview session might influence the data and favour expressions of shared rather than individual experiences of the phenomenon studied. Furthermore, we argue that ethical concerns must be given higher priority than methodology when interviewing couples. An increased awareness of the tension between ethical and methodological challenges in joint or individual interviewing with patients and partners is necessary, as this issue is underexposed. © 2015 John Wiley & Sons Ltd.
Levinas's ethics has in the last decades exerted a significant influence on Nursing and Caring Science. The core of Levinas's ethics - his analyses of how our subjectivity is established in the ethical encounter with our neighbour or the Other - is applied both to healthcare practice and in the project of building an identity of Nursing and Caring Science. Levinas's analyses are highly abstract and metaphysical, and also non-normative. Thus, his analyses cannot be applied directly to practical problems and questions. Theorists in Nursing and Caring Science are generally aware of this. Nevertheless, many of them use Levinas's analyses to explore and solve questions of practical and normative character. This article focuses on the challenges and dilemmas of using Levinas in this manner. The article is divided into two parts. The first part presents some central ideas of Levinas's ethics based on the latter part of his authorship. The main focus is on the radicalism of Levinas's critique of the symbolic order (which includes concepts, categories, knowledge, etc.) - or as he puts it 'the said' - as a basis for subjectivity and responsibility. Levinas's notions of saying, anarchy, and singularity accentuate this point of view. These notions refer to conditions in the language, which counteract the symbolic order in the ethical encounter to such an extent that it becomes an incomprehensible. Levinas gives the argumentation a metaphysical frame: The encounter with the incomprehensible is an encounter with the Holy, which is not the ontological God, but a metaphysical desire. It is a mystery as to what this means, and herein lies possibly the main challenge when using Levinas's ethics in science and research: How to maintain the radicalism of his critique of the symbolic order when this is to be communicated in a scientific context that expects clarification of statements and ideas? The second part of the article explores this question by examining how some theorists use
Albright, Dianne E.; Hazler, Richard J.
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.…
Ethical dilemma case-based examination (ethics Script Concordance Test, eSCT) is a written examination that can be delivered to a large group of examinees for the purpose of measuring high-level thinking. As it accommodates for diverse responses from experts, ethics SCT allows partial credits. The framework of ethics SCT includes a vignette with an ethical dilemma and a leading question, which asks the examinee to "agree" or "disagree", plus the shifts of prior decision by adding new information. In this article, the following tips for constructing this type of examination are provided: use "true" dilemmas, select an appropriate ethical issue, target high-level cognitive tasks, list key components, keep a single central theme, device quality scoring system, be important and plausible, be clear, select quality experts, validate, know the limitation, and be familiar with test materials. The use of eSCT to measure ethical reasoning ability appears to be both viable and desirable.
Al-Rasheedy, Intisar M; Al-Hameed, Fahad M
Glioblastoma multiforme (GBM) is the most common and malignant form of the glial tumors. Advanced and treated GBM is rarely associated with pregnancy for many reasons. Glioblastoma multiforme presenting during pregnancy carries unique challenges to the patient, baby, family, and health care providers. We describe an unusual case of advanced GBM that was treated with maximum doses of chemotherapy and radiations, and she became pregnant and presented at eighteenth weeks of gestation. Her medical management was associated with a significant ethical dilemma. We managed to deliver the baby safely through cesarean section at week 28 despite the critical condition of the mother. Unfortunately, the mother died 2 weeks post delivery. We concluded that although recurrent and treated GBM is rarely associated with pregnancy and carries dismal prognosis, but if it occurs, it can still be carried, and a multidisciplinary team work is the key for successful outcome.
Ulvik, Marit; Smith, Kari; Helleve, Ingrid
Education is described as a moral enterprise and many of the professional dilemmas teachers encounter have an ethical aspect. Research on ethical situations that novice teachers experience, however, seems to be limited, and we know little about how teacher education can prepare student-teachers for dealing with ethical issues. In this article a…
Kolay Akfert, Serpil
The purpose of this study is to determine the ethical dilemmas experiencing by the counsellors who work at different conditions and what they do to solve these dilemmas as well as the obstacles they have to deal with while resolving the dilemmas. This is a qualitative study in which multi-state pattern was used. For this research, 40 counsellors…
Mihaela Cristina ONICA
Full Text Available The actual global crisis, fueled by financial scandals and political instability, has allowed the development of some factors that might be attributed to some deficiencies in the field of professional ethics. The accountability professional must respect certain regulated rules and principles, but the continuous change in the modern business environment makes the accounting professional face numerous challenges. That is why it is important for each accounting professional to respect the ethic requirements each time, by avoiding or mitigating, and even foreseeing, in some cases, the risk of error making, and, thus, protecting the image of the accounting entity.
Bringedal, Berit; Isaksson Rø, Karin; Magelssen, Morten; Førde, Reidun; Aasland, Olaf Gjerløv
We present and discuss the results of a Norwegian survey of medical doctors' views on potential ethical dilemmas in professional practice. The study was conducted in 2015 as a postal questionnaire to a representative sample of 1612 doctors, among which 1261 responded (78%). We provided a list of 41 potential ethical dilemmas and asked whether each was considered a dilemma, and whether the doctor would perform the task, if in a position to do so. Conceptually, dilemmas arise because of tensions between two or more of four doctor roles: the patient's advocate, a steward of societal interests, a member of a profession and a private individual. 27 of the potential dilemmas were considered dilemmas by at least 50% of the respondents. For more than half of the dilemmas, the anticipated course of action varied substantially within the professional group, with at least 20% choosing a different course than their colleagues, indicating low consensus in the profession. Doctors experience a large range of ethical dilemmas, of which many have been given little attention by academic medical ethics. The less-discussed dilemmas are characterised by a low degree of consensus in the profession about how to handle them. There is a need for medical ethicists, medical education, postgraduate courses and clinical ethics support to address common dilemmas in clinical practice. Viewing dilemmas as role conflicts can be a fruitful approach to these discussions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
This article examines the ethical dilemmas that are specific to qualitative research methodology. These dilemmas concern the issues of withdrawal from the study, anonymity and confidentiality, which are discussed. Each aspect examines how it was dealt with using the researcher's reflections. The research was positioned within an interpretive…
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
Tønnessen, Siri; Ursin, Gøril; Brinchmann, Berit Støre
Care-managers are responsible for the public administration of individual healthcare decisions and decide on the volume and content of community healthcare services given to a population. The purpose of this study was to investigate the conflicting expectations and ethical dilemmas these professionals encounter in their daily work with patients and to discuss the clinical implications of this. The study had a qualitative design. The data consisted of verbatim transcripts from 12 ethical reflection group meetings held in 2012 at a purchaser unit in a Norwegian city. The participants consist of healthcare professionals such as nurses, occupational therapists, physiotherapists and social workers. The analyses and interpretation were conducted according to a hermeneutic methodology. This study is part of a larger research project. Two main themes emerged through the analyses: 1. Professional autonomy and loyalty, and related subthemes: loyalty to whom/what, overruling of decisions, trust and obligation to report. 2. Boundaries of involvement and subthemes: private or professional, care-manager or provider and accessibility. Underlying values and a model illustrating the dimensions of professional responsibility in the care-manager role are suggested. The study implies that when allocating services, healthcare professionals need to find a balance between responsibility and accountability in their role as care-managers.
Christensen, Anne Vinggaard; Hjøllund Christiansen, Anne; Petersson, Birgit
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...
Kenny, Belinda J.; Lincoln, Michelle; Blyth, Katrina; Balandin, Susan
Background: Speech pathologists are confronted by ethical issues when they need to make decisions about client care, address team conflict, and fulfil the range of duties and responsibilities required of health professionals. However, there has been little research into the specific nature of ethical dilemmas experienced by speech pathologists and…
Norlyk, Annelise; Haahr, Anita; Hall, Elisabeth
to collect data is challenging. Patients and partners can be interviewed separately or together; in both scenarios researchers face complex questions of methodology and ethics. This paper contributes to the ongoing debate on individual or joint interviewing and the effect of absence/presence of the partner...... on data collection. Design Discussion paper that draws on data from three phenomenological studies. Data sources Referring to three cases from our phenomenological studies, we discuss the different types of ethical and methodological dilemmas faced when undertaking joint and separate interviews...... with couples. Furthermore, we discuss how the unexpected presence of the partner potentially influences the data gathered from the patient. Implication for nursing The cases demonstrate the interrelatedness of ethics and methodology in studies based on in-depth interviews with couples. Nurse researchers may...
Ajibola, Ayodeji J; Netzloff, Michael; Samaraweera, Ranji; Omar, Said A
We report the clinical characteristics and the outcome of two cases of pontocerebellar hypoplasia (PCH) in one family. The objective of this report is to describe the mode of presentation, discuss the clinical course, and address the dilemma of prenatal diagnosis and the prospects for genetic diagnosis for PCH. The first case is a 4-year-old boy in whom the diagnosis was made in the neonatal period. Despite extensive prenatal follow-up during the mother's subsequent pregnancy, prenatal diagnosis could not be made and a second affected child was born. Both siblings have severe developmental delay. The cases raise an important ethical dilemma about the most appropriate intervention if the mother of a child affected with PCH becomes pregnant. PCH is considered to have an autosomal-recessive mode of inheritance and a recurrence risk of 25% in each pregnancy. Until recently when genetic mutations in PCH types 2, 4, and 6 began to be identified, the lack of well-recognized genetic testing precluded experts from making clear recommendations. The best advice to these parents was difficult or elusive. With two children currently affected, should the parents terminate or continue with the latest pregnancy? Extensive monitoring with serial prenatal ultrasound failed in the previous pregnancy and resulted in the birth of the second affected child. It is evident that serial ultrasound scan may not be helpful in making the diagnosis prenatally. Therefore, other diagnostic modalities such as magnetic resonance imaging may be necessary and should be considered. With the identification of genetic basis or mutations in PCH types 2, 4, and 6 and possible development of commercial genetic testing for these types of PCH, reproductive decision or genetic testing during pregnancy should be recommended to affected families to enable informed choices. Thieme Medical Publishers.
Sortedahl, Charlotte; Mottern, Nina; Campagna, Vivian
The purpose of this article is to examine how case managers are routinely confronted by ethical dilemmas within a fragmented health care system and given the reality of financial pressures that influence life-changing decisions. The Code of Professional Conduct for Case Managers (Code), published by the Commission for Case Manager Certification, acknowledges "case managers may often confront ethical dilemmas" (Code 1996, Rev. 2015). The Code and expectations that professional case managers, particularly those who are board certified, will uphold ethical and legal practice apply to case managers in every practice setting across the full continuum of health care. This discussion acknowledges the ethical dilemmas that case managers routinely confront, which empowers them to seek support, guidance, and resources to support ethical practice. In addition, the article seeks to raise awareness of the effects of burnout and moral distress on case managers and others with whom they work closely on interdisciplinary teams.
Miller, Seumas; Selgelid, Michael J
The dual-use dilemma arises in the context of research in the biological and other sciences as a consequence of the fact that one and the same piece of scientific research sometimes has the potential to be used for bad as well as good purposes. It is an ethical dilemma since it is about promoting good in the context of the potential for also causing harm, e.g., the promotion of health in the context of providing the wherewithal for the killing of innocents. It is an ethical dilemma for the researcher because of the potential actions of others, e.g., malevolent non-researchers who might steal dangerous biological agents, or make use of the original researcher's work. And it is a dilemma for governments concerned with the security of their citizens, as well as their health. In this article we construct a taxonomy of types of "experiments of concern" in the biological sciences, and thereby map the terrain of ethical risk. We then provide a series of analyses of the ethical problems and considerations at issue in the dual-use dilemma, including the impermissibility of certain kinds of research and possible restrictions on dissemination of research results given the risks to health and security. Finally, we explore the main available institutional responses to some of the specific ethical problems posed by the dual-use dilemma in the biological sciences.
Chiu, W; Wilson, D
This paper addresses the nurse manager's role regarding chemically-dependent nurses in the workplace. The manager may intervene by: terminating the contract of the impaired colleague; notifying a disciplinary committee; consulting with a counselling committee; or referring the impaired nurse to an employee assistance programme. A dilemma may arise about which of these interventions is ethically the best. The ethical theories relevant to nursing involve ethical relativism, utilitarianism, Kantian ethics, Kohlberg's justice, and Gilligan's ethic of care. Nurse managers first need to understand these theories in order to clarify their own perceptions and attitudes towards chemical dependency, and then satisfactorily resolve this ethical dilemma. Education and social learning are routes to a better understanding of chemical dependency and to broadening the ethical dimensions of nurse managers.
Yeh, Mei-Yu; Wu, Shu-Mei; Che, Hui-Lian
OBJECTIVES Improving nurses' competence in resolving clinical ethical issues must start with ethics education in training and clinical practice. However, many students complain that they cannot apply classroom learning to actual clinical scenarios. This study explored ethical issues and dilemmas, and their impact experienced by student nurses in clinical practice. METHODS Focus groups were conducted with 44 first-year student nurses from a 2-year college course in northern Taiwan. Interviews were tape-recorded and verbatim transcripts were analysed using content analysis. RESULTS Students expressed and discussed their views in eight focus groups. Analysis of interviews revealed five themes: frustration at inability to help some patients; oppression caused by lower status; lack of honesty and ethical courage; powerlessness, and self-encouragement in adversity. CONCLUSIONS Taiwanese nurse ethics training was only recently introduced and the curriculum has not addressed the clinical reality in Taiwan. This reality includes limitations arising from the medical hierarchy and the socio-cultural role of families in medical decision making, which may inhibit ethical judgements and decision making. In clinical dilemmas, the most common problems faced by Taiwanese nursing students involved not knowing how to handle some situations, inability to abide by principles, and a lack of appropriate role models. Hence, we suggest that nursing ethics education should: (i) integrate scenarios involving ethical dilemmas into daily routines; (ii) give students opportunities to discuss their feelings about their experiences; (iii) allow teachers and students to talk about scenarios with ethical implications, and (iv) provide students with opportunities to reflect on clinical scenarios in order to clarify their values and learn how to respect the value of life.
Full Text Available Brain death (BD, as the irreversible and permanent loss of cerebral and brainstem function, is relatively uncommon among newborns who need life support. It is considered the result of an acute and irreversible central nervous system insult. Asphyxia, severe intracranial hemorrhage and infection are the most common causes of BD in children. BD diagnosis is usually based on clinical criteria. Dilemmas about life prolonging treatment for severely compromised infants – as brain dead infants are – has become challenging since neonatal intensive care unit (NICU care has developed, quality of life and resource issues are nowadays continuously underlined. Caring for premature babies is expensive and costs have risen especially since an increased number of infants with handicaps survives. Intensivists’ main duty is first to save lives and then to interrupt treatment in certain conditions like detrimental brain damage. The objective of this article is to present ethical decisions regarding brain dead newborns in order to balance between organ donation necessities and withholding/withdrawing treatment, with respect to the important role of infants’ parents in the process.
Lindy, Cheryl; Schaefer, Florence
To discover nurse managers' perception of negative workplace behaviours (bullying) encountered by staff on their unit. Background Negative workplace behaviour is a worldwide phenomenon happening in all types of work settings. Absent from the literature were studies specific to the nurse managers' perception on this topic. A phenomenological qualitative research methodology was used to gain insight into the perceptions of nurse managers about negative workplace behaviours that they have observed or addressed. Nurse Managers described their perceptions of, and experiences pertaining to, instances of negative workplace behaviour. Six themes emerged from the data analysis: 'that's just how she is', 'they just take it', 'a lot of things going on', 'old baggage', 'three sides to a story' and 'a management perspective'. Nurse Managers had observed, experienced and/or had received reports of negative workplace behaviours. While some felt comfortable addressing the behaviour, others experienced ethical dilemmas when trying to treat all fairly. The results of the present study provide guidance for nurse managers to address negative workplace behaviours occurring on their units.
Tarvydas, Vilia; Barros-Bailey, Mary
This study reports the results of an international qualitative study conducted to inform the process of revising the Commission on Rehabilitation Counselor Certification's Code of Professional Ethics for Rehabilitation Counselors. The online survey gathered information regarding ethical dilemmas from a sample of certified rehabilitation counselors…
Garcia, Jorge; Froehlic, Robert; McGuire-Kuletz, Maureen; Rejiester, Nicole
This study examined which of two training models delivered through the internet led to better cultural competence in resolving ethical dilemmas with a sample of rehabilitation professionals. One type of training involved teaching a transcultural integrative model of ethical decision-making while the other training involved using the same…
Boyum, Eric N; Brown, Douglas; Zihni, Ahmed M; Keune, Jason D; Hong, Barry A; Kodner, Ira J; Ray, Shuddhadeb
This article addresses a difficult ethical dilemma that transplant surgeons may potentially encounter: whether a patient with a psychiatric illness is a good candidate for a liver transplant. This case study illustrates the challenges involved when considering the ethical principles of patient self-determination, distributive justice of scarce medical resources, "social worth," and protection of vulnerable patient populations. Are patients with psychiatric illness able to provide consent for transplantation? Is it possible to avoid misallocating valuable donor organs and, at the same time, fairly allocate these resources? This article seeks to answer these questions and provide insight into this ethical dilemma.
Chih, An-Hsuan; Su, Peijen; Hu, Wen-Yu; Yao, Chien-An; Cheng, Shao-Yi; Lin, Yen-Chun; Chiu, Tai-Yuan
The current ethical dilemmas met by healthcare professionals were never compared with those 15 years ago when the palliative care system was newly developing in Taiwan. The aim of the study was to investigate the ethical dilemmas met by palliative care physicians and nurses in 2013 and compare the results with the survey in 1998. This cross-sectional study surveyed 213 physicians and nurses recruited from 9 representative palliative care units across Taiwan in 2013. The compared survey in 1998 studied 102 physicians and nurses from the same palliative care units. All participants took a questionnaire to survey the "frequency" and "difficulty" of 20 frequently encountered ethical dilemmas, which were grouped into 4 domains by factor analysis. The "ethical dilemma" scores were calculated and then compared across 15 years by Student's t tests. A general linear model analysis was used to identify significant factors relating to a high average "ethical dilemma" score in each domain. All of the highest-ranking ethical dilemmas in 2013 were related to insufficient resources. Physicians with less clinical experience had a higher average "ethical dilemma" score in clinical management. Physicians with dissatisfaction in providing palliative care were associated a higher average "ethical dilemma" score in communication. Nurses reported higher "ethical dilemma" scores in all items of resource allocation in 2013. Further analysis confirmed that, in 2013, nurses had a higher average "ethical dilemma" score in resource allocation after adjustment for other relating factors. Palliative care nursing staff in Taiwan are more troubled by ethical dilemmas related to insufficient resources than they were 15 years ago. Training of decision making in nurses under the framework of ethical principles and community palliative care programs may improve the problems. To promote the dignity of terminal cancer patients, long-term fundraising plans are recommended for countries in which the
Molyneux, Sassy; Tsofa, Benjamin; Barasa, Edwine; Nyikuri, Mary Muyoka; Waweru, Evelyn Wanjiku; Goodman, Catherine; Gilson, Lucy
There is a growing interest in the ethics of Health Policy and Systems Research (HPSR), and especially in areas that have particular ethical salience across HPSR. Hyder et al (2014) provide an initial framework to consider this, and call for more conceptual and empirical work. In this paper, we respond by examining the ethical issues that arose for researchers over the course of conducting three HPSR studies in Kenya in which health managers and providers were key participants. All three studies involved qualitative work including observations and individual and group interviews. Many of the ethical dilemmas researchers faced only emerged over the course of the fieldwork, or on completion, and were related to interactions and relationships between individuals operating at different levels or positions in health/research systems. The dilemmas reveal significant ethical challenges for these forms of HPSR, and show that potential 'solutions' to dilemmas often lead to new issues and complications. Our experiences support the value of research ethics frameworks, and suggest that these can be enriched by incorporating careful consideration of context embedded social relations into research planning and conduct. Many of these essential relational elements of ethical practice, and of producing quality data, are given stronger emphasis in social science research ethics than in epidemiological, clinical or biomedical research ethics, and are particularly relevant where health systems are understood as social and political constructs. We conclude with practical and research implications. © 2016 The Authors Developing World Bioethics Published by John Wiley & Sons Ltd.
Zydziunaite, V; Suominen, T
Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. Purpose: To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. Methods: The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (n=278) were nurse managers. The data were analyzed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. Results: The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients', relatives' and nurse managers' needs. Conclusions: Nurse managers exhibited leadership styles oriented to maintenance, focusing more on the "doing the job" than on managing the decision-making in ethical dilemmas.
Zydziunaite, Vilma; Suominen, Tarja
Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (N = 278) were nurse managers. The data were analysed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients,' relatives' and nurse managers' needs. Nurse managers exhibited leadership styles oriented to maintenance, focussing more on the 'doing the job' than on managing the decision-making in ethical dilemmas.
Ethics-related dilemmas arise in forensic psychiatry as in all psychiatric practice. Although most can be resolved by following the AAPL Ethics Guidelines and the AAPL Ethics Questions and Answers, the more complex ones inevitably have no easy solutions. Ethics-based duties can conflict without clear guidance on prioritization. Weighing competing factors necessitates more than merely following a rule, since there are potentially conflicting rules, and ethical practitioners may prioritize them differently. Concerns pertaining to the death penalty and defendants who are victims of discrimination are especially difficult. Such considerations usually are in the realm of aspirational ethics, with conclusions open to debate. They need consideration by most practitioners concerned with determining the most ethical course of action. Much as it is insufficient for an ethical citizen merely to avoid breaking the law, it is not enough to avoid violating any one guideline while remaining blind to context. Most such dilemmas need resolution long before testimony and arise first in the way the forensic assessment is conducted and in decisions on the data to be included in a report and how they are presented. Although there can be legitimate differences of opinion about how to weigh and resolve conflicting considerations, ethics-related dilemmas should not be sidestepped.
Marcus, Brian S; Shank, Gary; Carlson, Jestin N; Venkat, Arvind
Ethics consultation is a commonly applied mechanism to address clinical ethical dilemmas. However, there is little information on the viewpoints of health care providers towards the relevance of ethics committees and appropriate application of ethics consultation in clinical practice. We sought to use qualitative methodology to evaluate free-text responses to a case-based survey to identify thematically the views of health care professionals towards the role of ethics committees in resolving clinical ethical dilemmas. Using an iterative and reflexive model we identified themes that health care providers support a role for ethics committees and hospitals in resolving clinical ethical dilemmas, that the role should be one of mediation, rather than prescription, but that ultimately legal exposure was dispositive compared to ethical theory. The identified theme of legal fears suggests that the mediation role of ethics committees is viewed by health care professionals primarily as a practical means to avoid more worrisome medico-legal conflict.
Ong, W Y; Yee, C M; Lee, A
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.
Berger, Jesper Bull
The delivering of public services to citizens through the internet -- also known as e-government - has gained serious momentum, driven by political ambitions of improved efficiency. E-government, however, is considered complex and e-government failures are well known from media. Research of how e-government...... is enacted inside government is sparse. Technology mediated public services in real world entail ethical dilemmas. By extracting ethical dilemmas from a qualitative e-government participatory design study, this paper shows how ethical dilemmas may inform future e-government design and design processes....... The case, adoption of digital post in a local e-government setting, showed that design flaws, staff's concern for citizens and political fear of citizens' critique had an impact on e-government adoption....
Fresneau, Brice; Brugières, Laurence; Caron, Olivier; Moutel, Grégoire
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.
The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis. © The Royal Society of Medicine.
Blais, Ann-Renee; Thompsom, Megan
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...
Taís Alexandre Antunes Paes
Full Text Available This study aimed to analyze the ethical perception of students on ethical dilemmas of social, economic and environmental common tourist activity. The practice of tourism constantly presents ethical dilemmas in their social actors need to make decisions. Depending on how decisions are taken the effects of such actions, can generate benefits or harms to society due to the constant changes that occur between these social agents when there is the purchase of services and tourism products. It is due to such aspects that makes prominent analyze the ethical perception of the students, since they will be future decision makers and tourism service providers. In this way, we interviewed 103 undergraduate students of tourism course at a public university in northeastern Brazil considering a non-probability sampling for accessibility and convenience. For this analysis was developed with a range of social, economic and environmental nature scenarios. The items were based on six moral issues pertaining to the integrative model Jones (1991 which together form the moral intensity: the magnitude of the impact, social consensus effect of probability, time immediacy, concentration and proximity effect. Among the results is greater ethical awareness for environment-related dilemma and an unethical action tendency for economic die dilemma.
Bentzen, Martin Mose
The introduction of social robots into society will require that they follow ethical principles which go beyond consequentialism. In this paper, I show how to apply the principle of double effect to solve an ethical dilemma involving robots studied by Alan Winfield and colleagues. The principle......, the question of whether an action is permitted according to the principle of double effect is reduced to deciding whether a certain formula is true or otherwise....
Toren, Orly; Wagner, Nurith
This article considers ethical dilemmas that nurse managers may confront and suggests an ethical decision-making model that could be used as a tool for resolving such dilemmas. The focus of the article is on the question: Can nurse managers choose the ethically right solution in conflicting situations when nurses' rights collide with patients' rights to quality care in a world of cost-effective and economic constraint? Managers' responsibility is to ensure and facilitate a safe and ethical working environment in which nurses are able to give quality care to their patients. In nursing it is frequently declared that managers' main obligations are to patients' needs and their rights to receive quality care. However, managers' ethical responsibilities are not only to patients but also to the nurses working in their institution. This article describes a real (but disguised) situation from an Israeli health care context to illustrate the dilemmas that may arise. The question is posed of whether nurse managers can maintain patients' and nurses' rights and, at the same time, fulfill their obligation to the conflicting demands of the organization. The article also offers a way to solve conflict by using an ethical decision-making model.
This article explores the ethical tensions and dilemmas that arose for 2 U.S. social work students during an 8-month international clinical internship in northern Uganda. These students encountered cultural differences related to issues of confidentiality, autonomy, and self-determination. Student experiences were analyzed using the cultural…
Bent-Goodley, Tricia B.
This article examines findings from three focus groups conducted about resolving ethical dilemmas in the area of domestic violence. The study's findings point to the need to increase content on domestic violence throughout the social work curriculum and provide educational opportunities for field instructors and local professionals. Helping…
Sexual harassment in the workplace poses something of an ethical dilemma for career guidance practice. This is because it is now known that about half of all working women in the UK are likely to be victims at some stage of their employment and that the effects on individuals are invariably negative and can be positively harmful. What, therefore,…
Catacutan, Maria Rosario G.; de Guzman, Allan B.
This phenomenological study intends to capture and describe Filipino college deans' lived experiences of ethical dilemmas as they carry out their work as administrators. Using semi-structured in-depth interviews and following Collaizzi's method, data was collected and subjected to cool and warm analyses yielding a set of themes and sub-themes that…
This article focuses on the complexity of researching institutional culture and the ethical dilemmas posed in representing staff according to race and gender, drawing on three qualitative studies undertaken at a previously white South African university between 2000 and 2007. During the research process, issues of representation became a concern…
, research on business ethics communication and behavior indicates a relatively clear, positive link between open workplace dialogue about ethical issues and ethical conduct. 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 with staff at the Denmark and Brazil affiliates of the global 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 am at providing insight that can both inform scholars in these fields as well as help managers in their attempts to promote open workplace dialogue about ethical issues....
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 about ethical issues....
Yalof, J; Brabender, V
In this article, we argue that the student's first lessons in ethical decision making in personality assessment are in those assessment courses that have a practice component. In these courses, the student has an opportunity to experience in vivo how ethical problems are identified, addressed, and resolved. The faculty member's demonstration of a process wherein the ethical principles activated are highlighted and explored, will enable students to internalize a model for addressing future dilemmas. Four particular ethical situations are considered: (a) the students' procurement of personal experience with personality testing, (b) the identification of assessment participants, (c) the development of informed consent procedures for assessment participants, and (d) classroom presentations. This discussion does not provide concrete solutions to ethical problems but offers a consideration of the relevant ethical principles that any adequate solution must encompass.
Michaud, Pierre-André; Berg-Kelly, Kristina; Macfarlane, Aidan; Renteria, Saira-Christine; Wyss, Danielle; Benaroyo, Lazare
This chapter reviews some basic concepts underlying ethical issues in adolescence and provides a step-by-step procedure to address ethical dilemmas involving minor adolescents, based on a deliberative approach. "Deliberation" with the patient, along with involving the opinion of relevant stakeholders if possible, allows for a careful, multidisciplinary examination of all options, the medical and psychosocial consequences, and the moral values stressed by each option. Although the final decision regarding which ethical option should be chosen usually belongs to the health care providers and his or her patient, the deliberative approach provides the ingredients for sound, unbiased decision-making.
Severinsson, E; Hummelvoll, J K
This study addressed the factors that nursing staff perceived as creating job satisfaction in their working environment in addition to addressing the ethical dilemmas that staff experienced within an acute psychiatric care setting. It also addressed how clinical supervision contributed to job satisfaction among staff as well as the differences between staff who attended and staff who did not attend to clinical supervision. Data were analyzed using descriptive statistics. Overall, the results of this study showed that the factors influencing nurses are related to areas of dissatisfaction, for example, stress and experiences with shortcomings. Factors that contribute to job satisfaction or dissatisfaction were found to be related to the nurses' value systems. The ethical dilemmas that were specifically addressed involved how to care for patients and handle work in relation to patients' autonomy, how to approach the patient, how to provide care against the will of the patient, and what action was ethically right for each particular patient.
Andersen, Vibeke; Andersen, Anders Siig
In an effort to increase efficiency and democracy, the modernozation of the public sector has involved an increase in market and user control, an increased application of technology, a decentralization of responsibilities and competencies, and more management and personnel development initiatives....... The article analyze the learning environment in two govermental worksites in Denmark and shows how professional employees respond to the dilemmas posed by modernization at work.......In an effort to increase efficiency and democracy, the modernozation of the public sector has involved an increase in market and user control, an increased application of technology, a decentralization of responsibilities and competencies, and more management and personnel development initiatives...
Krautscheid, Lorretta C
Despite the inclusion of ethics education in the formal curriculum, students felt ill-prepared to manage ethical issues and protect patients' health and well-being. Nursing students reported knowing what should be done to promote optimal patient care; however, they also reported an inability to act on their convictions due to fear of reprisal, powerlessness, and low confidence. Bloom's Taxonomy guided the development and implementation of experiential-applied ethics education via microethical dilemmas embedded in existing high-fidelity simulation (HFS) scenarios. Students were unaware that ethical dilemmas would be presented, replicating complex and spontaneous practice environments. Students reported that the educational strategy was powerful, increasing ethical decision-making confidence, empowering effective advocacy, and building courage to overcome fears and defend ethical practice. Simulation extends ethics education beyond the cognitive domain, ensuring the purposeful integration of affective and psychomotor learning, which promotes congruence between knowing what to do and acting on one's convictions. [J Nurs Educ. 2017;56(1):55-58.]. Copyright 2017, SLACK Incorporated.
Despite the growing emphasis placed on the responsible conduct of research, little attention has been devoted to the question of what an individual should do upon discovering research misconduct. This article takes seriously the dilemma of a would-be whistleblower. It identifies ethical considerations that can be taken into account in moral decision-making about reporting research misconduct. It also offers rough guidelines about the moral significance of each consideration in the decision-making process based on the facts of the case in question. The article, therefore, offers tools for a would-be whistleblower to use to arrive at a defensible resolution to a difficult dilemma.
Billiot, Mary Jo; Daniel, David; Glandon, Sid; Glandon, TerryAnn
We examine the effect of different contexts in an educational process on measures of ethical sensitivity and levels of moral reasoning of accounting majors in the first Intermediate Accounting course. The educational process compared a context that centers on ethical issues with one that focuses on technical accounting issues. At the end of the…
Magalhães-Sant'Ana, M.; Sandøe, Peter; Olsson, I. A. S.
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...
In addition to the ethical practice of individual health professionals, bioethical debate about conflict of interest (CoI) must include the institutional ethics of public policy-making, as failure to establish independence from powerful stakeholder influence may pervert public health goals. All involved in public policy processes are ...
Lorenz, Susan G
Flexible work hours, including 12-hour shifts, have become a common scheduling option for nurses. The author explores whether 12-hour shifts are an ethical scheduling option for nurses because recent research suggests that 12-hour shifts are a potential hazard to patients. A multistep model for ethical decision making, reflecting the concept of procedural justice, is used to examine this issue.
Nurses are increasingly confronted with situations of moral difficulty, such as not to feed terminally ill patients, whistle blowing, or participation in termination of pregnancy. Most of these moral dilemmas are often analyzed using the principle-based approach which applies the four moral principles of justice, autonomy, beneficence, and nonmalificence. In some instances, consequentialism is considered, but these frameworks have their limitations. Their limitations has to do with a consider...
Bar-El, Yaron; Reisner, Shimon; Beyar, Rafael
Rambam Medical Center, the only tertiary care center and largest hospital in northern Israel, was subjected to continuous rocket attacks in 2006. This extreme situation posed serious and unprecedented ethical dilemmas to the hospital management. An ambiguous situation arose that required routine patient care in a tertiary modern hospital together with implementation of emergency measures while under direct fire. The physicians responsible for hospital management at that time share some of the moral dilemmas faced, the policy they chose to follow, and offer a retrospective critical reflection in this paper. The hospital's first priority was defined as delivery of emergency surgical and medical services to the wounded from the battlefields and home front, while concomitantly providing the civilian population with all elective medical and surgical services. The need for acute medical service was even more apparent as the situation of conflict led to closure of many ambulatory clinics, while urgent or planned medical care such as open heart surgery and chemotherapy continued. The hospital management took actions to minimize risks to patients, staff, and visitors during the ongoing attacks. Wards were relocated to unused underground spaces and corridors. However due to the shortage of shielded spaces, not all wards and patients could be relocated to safer areas. Modern warfare will most likely continue to involve civilian populations and institutes, blurring the division between peaceful high-tech medicine and the rough battlefront. Hospitals in high war-risk areas must be prepared to function and deliver treatment while under fire or facing similar threats.
van Baarle, Eva; Bosch, Jolanda; Widdershoven, Guy; Verweij, Desiree; Molewijk, Bert
Moral competence is important for soldiers who have to deal with complex moral dilemmas in practice. However, openly dealing with moral dilemmas and showing moral competence is not always easy within the culture of a military organization. In this article, based on analysis of experiences during a train the trainer course on military ethics, we…
Full Text Available The aim of the article is to show the possibility of applying assumptions from ethics of social consequences when making decisions about actions, as well as in situations of moral dilemmas, by persons performing occupations of public trust on a daily basis. Reasoning in the article is analytical and synthetic. Article begins with an explanation of the basic concepts of “profession” and “the profession of public trust” and a manifestation of the difference between these terms. This is followed by a general description of professions of public trust. The area and definition of moral dilemmas is emphasized. Furthermore, representatives of professions belonging to them are listed. After a brief characterization of axiological foundations and the main assumptions of ethics of social consequences, actions according to Vasil Gluchman and Włodzimierz Galewicz are discussed and actions in line with ethics of social consequences are transferred to the practical domain. The article points out that actions in professional life are obligatory, impermissible, permissible, supererogatory and unmarked in the moral dimension. In the final part of the article an afterthought is included on how to solve moral dilemmas when in the position of a representative of the profession of public trust. The article concludes with a summary report containing the conclusions that stem from ethics of social consequences for professions of public trust, followed by short examples.
aunts, uncles, sisters, brothers and in‑laws all work as a unit through life. Family relationships are guided by hierarchy and seniority. Individuals .... Nevertheless, the physician has to weigh the balance of the ... Ethical issues in professional life.
In social work, ethical principles have been important in several key respects, with regard to the nature of its mission; the relationships that social workers have with clients, colleagues, and members of the broader society; the methods of intervention that social workers use in their work. So, social work is situated between moral choice and professional ethical behavior, which allows orientating among the variety of moral requirements, evaluating activities taking into consideration moral...
Full Text Available The purpose of this study is to develop a reflection on ethics and practice of Journalism based on the production conditions of his professional exercise. It has been prepared in the basis of empirical material collected through the conduct of 15 interviews throughout the year of 2011 with professional journalists of the labour market of Fortaleza. Specifically for this study, I approach the relation between ethics, practice of Journalism and technologies.
Full Text Available The purpose of this study is to develop a reflection on ethics and practice of Journalism based on the production conditions of his professional exercise. It has been prepared in the basis of empirical material collected through the conduct of 15 interviews throughout the year of 2011 with professional journalists of the labour market of Fortaleza. Specifically for this study, I approach the relation between ethics, practice of Journalism and technologies.
Toleration is one of the fundamental principles that inform the design of a democratic and liberal society. Unfortunately, its adoption seems inconsistent with the adoption of paternalistically benevolent policies, which represent a valuable mechanism to improve individuals' well-being. In this paper, I refer to this tension as the dilemma of toleration. The dilemma is not new. It arises when an agent A would like to be tolerant and respectful towards another agent B's choices but, at the same time, A is altruistically concerned that a particular course of action would harm, or at least not improve, B's well-being, so A would also like to be helpful and seeks to ensure that B does not pursue such course of action, for B's sake and even against B's consent. In the article, I clarify the specific nature of the dilemma and show that several forms of paternalism, including those based on ethics by design and structural nudging, may not be suitable to resolve it. I then argue that one form of paternalism, based on pro-ethical design, can be compatible with toleration and hence with the respect for B's choices, by operating only at the informational and not at the structural level of a choice architecture. This provides a successful resolution of the dilemma, showing that tolerant paternalism is not an oxymoron but a viable approach to the design of a democratic and liberal society.
Piper, Llewellyn E; Tallman, Erin
This article examines the parameters and the dynamics of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that create an ethical leadership dilemma to satisfy patients in the hospital setting while still ensuring appropriate care for quality clinical outcomes. Under the Affordable Care Act, hospitals and health care systems are in a high-stakes struggle of winners and losers based on HCAHPS scores. This high-stakes struggle creates unintended consequences of an ethical dilemma of doing what is right for the patient versus doing whatever it takes to please the patient in order to achieve high scores of satisfaction that are tied to better reimbursements. This article also reports the results of a national survey of 500 chief executive officers by the authors about the attitudes and frustrations of chief executive officers confronting the wild unrest caused by HCAHPS.
According to the WHO Program, nurses should be active in public health care as equal members of a multiprofessional team. This position requires competent professional action, which also implies moral competence, especially necessitated by the coming paradigmatic changes caused by shifts in the previous and current boundaries of the paradigm human being. One reason for this shift are the greater medical technical possibilities. The medical definition of brain death as the death of a human being per se is one example of the altered boundary and its consequences. Must future components of the nursing metaparadigm be changed because of this? To what extent is nursing ethically obligated to integrate changes in social values into its metaparadigm, ethics and objectives? The nursing metaparadigm, Henderson's definition of nursing, the ICN's Basic Code of Ethics, and the nursing model according to Roper, Logan & Tierney were used as the basis in the analysis of the subject matter and problems. Furthermore, philosophical viewpoints of Jonas & Harris will be included to clarify the deontological and teleological aspects of standard ethics. Finally, conclusions are drawn about the intra- and interprofessional ethical discourse about brain death and organ transplantation among nursing professionals.
Christensen, Anne Vinggaard; Christiansen, Anne Hjøllund; Petersson, Birgit
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 (TOP) are still poorly described in the scientific literature. To explore Danish midwives' experiences with and attitudes towards late TOP. Focus was on how midwives perceive their own role in late TOP, and how their professional identity is influenced by working with late TOP in a time where prenatal screening is rapidly developing. A qualitative study consisting of ten individual interviews with Danish midwives, all of whom had taken part in late TOP. Current practice of late TOP 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 TOP 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. The midwives' practice in relation to late TOP was characterised by an acknowledgement of the growing ethical status of the foetus and the emotional reactions of the women/couples going through late TOP. 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 TOP. © 2012 The Authors Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.
RPA Field Simulations: Dilemma-Training for Legal and Ethical Decision-Making Professor Wilbur Scott Dept of...Sciences & Leadership all take the Capstone Experience Course (CEC) CEC offers several different kinds of projects, one consists of RPA Field...Simulation Two phases in RPA Field Simulation – classroom phase and field phase Purpose: link theoretical understanding/moral reasoning with
Muir, Adrienne; Spacey, Rachel; Cooke, Louise; Creaser, Claire
Purpose – This paper aims to consider selected results from the Arts and Humanities Research Council (AHRC) funded “Managing Access to the internet in Public Libraries” (MAIPLE) project, from 2012-2014. MAIPLE has explored the ways in which public library services manage use of the internet connections that they provide for the public. This included the how public library services balance their legal obligations and the needs of their communities in a public space and the ethical dilemmas tha...
van de Wiel, Henricus; Paarlberg, K.M.; Dermout, Sylvia Marguérite; Paarlberg, KM; van de Wiel, HBM
All healthcare professionals are regularly faced with the following question: “What is the wisest course; what is the right thing to do in this case or with this patient?” An inherent part of this kind of dilemma is that it involves pros and cons that are difficult to weigh against each other;
While Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges. This two-part paper proposes a version of virtue theory as a more grounded system of moral analysis. Part 2 examines the role of basic moral theory as the foundation to ethics and suggests how virtue theory can be used as a central framework for ethics while being inclusive of insights from deontology and consequentialism. © The Royal Society of Medicine.
Summary While Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges. This two-part paper proposes a version of virtue theory as a more grounded system of moral analysis. Part 2 examines the role of basic moral theory as the foundation to ethics and suggests how virtue theory can be used as a central framework for ethics while being inclusive of insights from deontology and consequentialism. PMID:25792615
Kramer, Roderick M; Bazerman, Max H
This book, in honor of David Messick, is about social decisions and the role cooperation plays in social life. Noted contributors who worked with Dave over the years will discuss their work in social judgment, decision making and ethics which was so important to Dave.The book offers a unique and valuable contribution to the fields of social psychology and organizational behavior. Ethical decision making, a central focus of this volume, is highly relevant to current scholarship and research in both disciplines. The volume will be suitable for graduate level courses in organizational behavior, s
Settle, Peggy Doyle
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.
Nigerian Journal of Ophthalmology / Jul-Dec 2014 / Vol 22 | Issue 2. 59. Address for ... universal applicability.[6,7]. In Nigeria ... As we approach the twilight of Vision 2020, a global initiative that ... Hypothetical five clinical scenarios that posed ethical questions in ..... towards a more holistic patient‑centered paradigm of care.
This paper focuses on the ethical position of the ethnographer when encountering unethical activities. Ethnography affords a rich insight into cultures, often behind previously secure doors but it is also a demanding science. Our gatekeepers control our access and our relationships with them can determine our destiny. This paper offers an exchange…
This book is written with the aim to stimulate discussion and studies on ethical aspects of nuclear waste management. It does not penetrate the technical details of the different stages of waste handling, but concentrates on questions such as our responsibility towards future generations etc
Until very recently, ethical issues were given little attention in administrator-preparation programs. This digest in Spanish outlines the ethical responsibilities of school leaders and the dilemmas that they face. It offers the following suggestions for resolving ethical dilemmas: (1) Leaders should have and be willing to act on a definite sense…
Kadam, Rashmi; Karandikar, Shashikant
The past few years have seen a tremendous rise in the number of clinical trials conducted in India. This is been attributed to the huge patient population, genetic diversity, and rich technical pool in our country. However, the economical upsurge in the clinical trial industry has also caused concerns pertaining to the efficiency of the Regulatory Agencies and Ethics Committees (EC). The EC plays an important role in the regulation of clinical research at the local level. However, it is seen that many ECs are oblivious to their roles and responsibilities. It is reported that ECs lack standard operating procedures, do not have a proper composition or adequate representation, thus affecting their functions in regulating clinical research. Moreover, ECs seem to function in isolation, as self-sufficient bodies, having no communication with the regulatory agency or other ECs. This brings forth the need for ECs to come together and share their experiences and observations, with the aim of updating themselves and refining their functions. Efforts also need to be focused on capacity building, centralized registration of ECs, and bringing an oversight mechanism in place. The Ethics Committees in India need to work in close association with forums such as the Forum for Ethics Review Committees in India and the Forum for Ethical Review Committees in Asia Pacific, in an effort towards empowering themselves.
Full Text Available The past few years have seen a tremendous rise in the number of clinical trials conducted in India. This is been attributed to the huge patient population, genetic diversity, and rich technical pool in our country. However, the economical upsurge in the clinical trial industry has also caused concerns pertaining to the efficiency of the Regulatory Agencies and Ethics Committees (EC. The EC plays an important role in the regulation of clinical research at the local level. However, it is seen that many ECs are oblivious to their roles and responsibilities. It is reported that ECs lack standard operating procedures, do not have a proper composition or adequate representation, thus affecting their functions in regulating clinical research. Moreover, ECs seem to function in isolation, as self-sufficient bodies, having no communication with the regulatory agency or other ECs. This brings forth the need for ECs to come together and share their experiences and observations, with the aim of updating themselves and refining their functions. Efforts also need to be focused on capacity building, centralized registration of ECs, and bringing an oversight mechanism in place. The Ethics Committees in India need to work in close association with forums such as the Forum for Ethics Review Committees in India and the Forum for Ethical Review Committees in Asia Pacific, in an effort towards empowering themselves.
Crha, I; Dostál, J; Ventruba, P; Kudela, M; Záková, J
To present a review of bioethical discussion and recommendations concerning posthumous sperm procurement and postmortem parenthood. Review article. Department of Obstetrics and Gynecology, Masaryk University, Brno, Department of Obstetrics and Gynecology, Palacky University, Olomouc. Literature search in Database of Abstracts of Reviews of the Evidence (DARE) and MEDLINEplus. Posthumous sperm procurement and cryopreservation must be performed within 36 hours after death. To established appropriate medical practice, it is important to consider all stakeholders in the decision-making process: the deceased, the requesting party, the child, the physician and the society. There are only few legislative measures concerning postmortem parenthood and posthumous sperm procurement. The essential elements for postmortem reproduction are: judicial order, ethics committee approval, bereavement period of at least 6 month before use. Posthumous sperm procurement is fraught with ethical and legal implications. All stakeholder should be considered. Society for reproductive medicine should prepare acceptable standard protocol.
Manzar, Nabeel; Manzar, Bushra; Hussain, Nuzhat; Hussain, M Fawwad Ahmed; Raza, Sajjad
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.
Gillett, Grant; Chamberlain, Joshua
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. Copyright © 2013 Elsevier Ltd. All rights reserved.
This article discusses health literacy and cultural factors that have implications for the ethical practice of health education. It specifically focuses on recent data that speaks to the challenges in carrying out patient education from the perspective of comprehension and equitable distribution of health-related information across diverse cultures and communities. It discusses strategies for reducing the negative impact of low health literacy among diverse groups and the importance of acknowledging this pervasive problem in the context of ensuring equity in the optimal delivery of health promotion messages.
The results of this study are also of particular relevance for the legal and professional Spanish auditing regulators as they face, at this moment, the challenge of developing a set of ethical standards that should improve the ethical judgment and behavior of accounting professionals.
Khalid, Umair; Khalil, Sarwat
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.
Alizadeh, Leila; Omani Samani, Reza
The use of donated embryos has offered hope for infertile couples who have no other means to have children. In Iran, fertility centers use fertile couples as embryo donors. In this paper, the advantages and disadvantages of this procedure will be discussed. We conclude that embryo-donation should be performed with frozen embryos thus preventing healthy donors from being harmed by fertility drugs. There must be guidelines for choosing the appropriate donor families. In countries where commercial egg donation is acceptable, fertile couples can be procured as embryo donors thus fulfilling the possible shortage of good quality embryos. Using frozen embryos seems to have less ethical, religious and legal problems when compared to the use of fertile embryo donors.
Samtani B, Suraj; Jadue Z, Mariana; Beca I, Juan Pablo
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.
Pillalamarri, Sudarshan Kumar; Holm, Claus
The differing nature of engagement and work assignments continuously exposes auditors to varied ethical dilemmas. These dilemmas may be, contextually, grey areas for which there may be no official guidelines. To resolve these situations, auditors either undertake prescriptive or deliberative...... were focused on ethical decision making ability of Danish auditors’, this study closes the loop by presenting an accounting students perspective. By providing an understanding of the complex issues involved in ethical decision-making, this study also serves strategically in strengthening ethics...
Busher, Hugh; James, Nalita
Hybrid communities using online and face-to-face communications to construct their practices are increasingly part of everyday life amongst people who have easy access to the internet. Researching these communities raises a number of challenges for researchers in the pursuit of ethical research. The paper begins by exploring what is understood by…
Oluwatoyin Folayan, Morenike; Gabriella Haire, Bridget; Adeniyi, Abiola A; Lanre Adeyemo, Wasiu
Dental caries is the main oral health challenge for children in Nigeria. Concern about its negative impact makes screening for caries in children an attractive public health strategy. The ability to detect the preclinical phase of caries, the availability of screening tools with high accuracy, and the possibility of treatment before onset of clinical symptoms with significant cost and health benefits, makes it appropriate for screening. However in Nigeria, the poor availability of highly specific and sensitive screening tools, poor access to oral health care and concerns with pre-screening consent, raise the question of the appropriateness of conducting screening programmes for children. We argue that a number of structural challenges associated with poor uptake of oral health care services need to be addressed before screening for caries can be considered ethically appropriate. These include facilitating access of children to quality oral health care and a systematic national approach to oral health implementation. Failure to address challenges associated with dental service utilization by children in Nigeria increases the risk of screening programmes promoting inequitable access to oral health care services.
Full Text Available In response to worsening social instability in China, among grassroots communities in the poorer central and western provinces in particular, the Chinese central government has made budgetary arrangements, since 2003, to increase investment at the grassroots level to improve the capacity of local governments to maintain social order. However, this action by central government has created a dilemma for local cadres: how to perform their duty to maintain social stability while also balancing a heavy fiscal burden caused in part by the receipt of insufficient additional budgetary subsidies from higher government. This paper is an account of and an analysis of how local cadres in China perform their official duties when faced with this dilemma.
Gormsen, Lise Kirstine; Søndergaard, Sara; Hoffmann, Tine
Work-in- progress Roundtable: Title: What ethical problems are out there? – a study of medical students’ reflexive writing about ethical dilemmas in the clinic. Authors: Lise Gormsen, MD, MHH, PhD., Institute of Clinical Medicine, Aarhus University, Denmark Jane Ege Møller, MA, PhD., Center...... Kristina Øgendahl Beeck, Medical student, Aarhus University, Denmark Corresponding and presenting author: Lise Gormsen, MD, MHH, Ph.D, Institute of Clinical Medicine, Aarhus University, Incuba/Skejby, building 2 Palle Juul-Jensens Boulevard 82, 8200 Aarhus N Denmark Phone: +45 23981599 Email: lise...... reflect themselves. Furthermore the material is ‘ negatively biased’ - the students write about the unsolved dilemmas. Conclusion: Reflective texts can be seen as data material that contains valuable knowledge, both concerning modes of reflection AND what types of ethical dilemmas that is a part...
Research confirms that students carrying out their fieldwork are faced with various ethical conundrums and are unsure as to how to address these. This study identifies and discusses four major issues in this regard, namely confidentiality issues, the distribution of limited resources, power struggles and conflicting values with ...
Brey, Philip A.E.
This essay examines ethical aspects of the use of facial recognition technology for surveillance purposes in public and semipublic areas, focusing particularly on the balance between security and privacy and civil liberties. As a case study, the FaceIt facial recognition engine of Identix
Loeser, John D; Cahana, Alex
The world of health care and the world of business have fundamentally different ethical standards. In the past decades, business principles have progressively invaded medical territories, leading to often unanticipated consequences for both patients and providers. Multidisciplinary pain management has been shown to be more effective than all other forms of health care for chronic pain patients; yet, fewer and fewer multidisciplinary pain management facilities are available in the United States. The amazing increase in interventional procedures and opioid prescriptions has not led to a lessening of the burden of chronic pain patients. Ethical dilemmas abound in the treatment of chronic pain patients: many are not even thought about by providers, administrators, insurance companies, or patients. We call for increased pain educational experiences for all types of health care providers and the separation of business concepts from pain-related health care.
Flicker, Sarah; Travers, Robb; Guta, Adrian; McDonald, Sean; Meagher, Aileen
National and international codes of research conduct have been established in most industrialized nations to ensure greater adherence to ethical research practices. Despite these safeguards, however, traditional research approaches often continue to stigmatize marginalized and vulnerable communities. Community-based participatory research (CBPR) has evolved as an effective new research paradigm that attempts to make research a more inclusive and democratic process by fostering the development of partnerships between communities and academics to address community-relevant research priorities. As such, it attempts to redress ethical concerns that have emerged out of more traditional paradigms. Nevertheless, new and emerging ethical dilemmas are commonly associated with CBPR and are rarely addressed in traditional ethical reviews. We conducted a content analysis of forms and guidelines commonly used by institutional review boards (IRBs) in the USA and research ethics boards (REBs) in Canada. Our intent was to see if the forms used by boards reflected common CBPR experience. We drew our sample from affiliated members of the US-based Association of Schools of Public Health and from Canadian universities that offered graduate public health training. This convenience sample (n = 30) was garnered from programs where application forms were available online for download between July and August, 2004. Results show that ethical review forms and guidelines overwhelmingly operate within a biomedical framework that rarely takes into account common CBPR experience. They are primarily focused on the principle of assessing risk to individuals and not to communities and continue to perpetuate the notion that the domain of "knowledge production" is the sole right of academic researchers. Consequently, IRBs and REBs may be unintentionally placing communities at risk by continuing to use procedures inappropriate or unsuitable for CBPR. IRB/REB procedures require a new framework more
Travers, Robb; Guta, Adrian; McDonald, Sean; Meagher, Aileen
National and international codes of research conduct have been established in most industrialized nations to ensure greater adherence to ethical research practices. Despite these safeguards, however, traditional research approaches often continue to stigmatize marginalized and vulnerable communities. Community-based participatory research (CBPR) has evolved as an effective new research paradigm that attempts to make research a more inclusive and democratic process by fostering the development of partnerships between communities and academics to address community-relevant research priorities. As such, it attempts to redress ethical concerns that have emerged out of more traditional paradigms. Nevertheless, new and emerging ethical dilemmas are commonly associated with CBPR and are rarely addressed in traditional ethical reviews. We conducted a content analysis of forms and guidelines commonly used by institutional review boards (IRBs) in the USA and research ethics boards (REBs) in Canada. Our intent was to see if the forms used by boards reflected common CBPR experience. We drew our sample from affiliated members of the US-based Association of Schools of Public Health and from Canadian universities that offered graduate public health training. This convenience sample (n = 30) was garnered from programs where application forms were available online for download between July and August, 2004. Results show that ethical review forms and guidelines overwhelmingly operate within a biomedical framework that rarely takes into account common CBPR experience. They are primarily focused on the principle of assessing risk to individuals and not to communities and continue to perpetuate the notion that the domain of “knowledge production” is the sole right of academic researchers. Consequently, IRBs and REBs may be unintentionally placing communities at risk by continuing to use procedures inappropriate or unsuitable for CBPR. IRB/REB procedures require a new framework
Onarheim, Kristine Husøy; Norheim, Ole Frithjof; Miljeteig, Ingrid
High healthcare costs make illness precarious for both patients and their families' economic situation. Despite the recent focus on the interconnection between health and financial risk at the systemic level, the ethical conflict between concerns for potential health benefits and financial risk protection at the household level in a low-income setting is less understood. Using a seven-step ethical analysis, we examine a real-life dilemma faced by families and health workers at the micro level in Ethiopia and analyse the acceptability of limiting treatment for an ill newborn to protect against financial risk. We assess available evidence and ethical issues at stake and discuss the dilemma with respect to three priority setting criteria: health maximisation, priority to the worse-off and financial risk protection. Giving priority to health maximisation and extra priority to the worse-off suggests, in this particular case, that limiting treatment is not acceptable even if the total well-being gain from reduced financial risk is taken into account. Our conclusion depends on the facts of the case and the relative weight assigned to these criteria. However, there are problematic aspects with the premise of this dilemma. The most affected parties-the newborn, family members and health worker-cannot make free choices about whether to limit treatment or not, and we thereby accept deprivations of people's substantive freedoms. In settings where healthcare is financed largely out-of-pocket, families and health workers face tragic trade-offs. As countries move towards universal health coverage, financial risk protection for high-priority services is necessary to promote fairness, improve health and reduce poverty. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Full Text Available Within this essay the question of whether Kantian ethics is left defenseless in the face of evil is unfolded. Some thinkers claim that it is not advisable to rigorously adhere to the categorical imperative. That is to say, it is prudent only to follow the categorical imperative, acting in such a way that you may will that the maxim of your actions becomes a universal law, when one is dealing with other ethical beings. However, when dealing with evil, it is claimed that we should develop other special principles that allow for consequences favorable to the ethical party. This essay takes exception with this claim, demonstrating that for Kant such a problem would not have even appeared. Furthermore, this essay argues that to deviate from the moral principle does damage to the truth and humanity as a whole.
Full Text Available Introduction: In the age of neoliberalism, there are differences in the implementation of nursing activities due to business interests being integrated into nurse-patient relationships. An example of this is hotel-type nursing, which involves fulfilling patients’ needs by charging for nursing services (or by charging an additional fee for extra services. Whether this constitutes a contemporary nursing development or a danger is an important question. This paper explores an approach to resolving ethical dilemmas, which often emerge when the interests of businesses, nurses, and patients are integrated, as contemporary nursing is implemented according to community care principles.Methods: In a case study of nurses’ activities conducted in June 2013 and 2014 in three different institutions, the methods of observation and interviews were used. The collected data were analyzed using Strengths, Weaknesses, Opportunities, and Threats (SWOT methodology, and then verified and updated with a power diagram qualitative interpretation and the Decide, Establish, Consider, Identify, Develop, and Implement (DECIDE decision-making model.Results: Based on my study of hotel-type nursing, an approach to resolving ethical dilemmas which arise with the integration of business interests into nurse-patient relationships is explained.Discussion: Hotel-type nursing involves an adaptation by nurses to a change in their relationship with the patient. This adaptation must ensure that the nurse’s professionalism is recognized as being significantly more beneficial to the patient than a reduction of the nurse’s role to one of simply fulfilling a patient’s wishes.Conclusion: Hotel-type nursing can be advantageous in the development of contemporary nursing if nurses adhere to high ethical standards and practice self-control.
Luxardo, Natalia; Colombo, Graciela; Iglesias, Gabriela
The purpose of this article is to examine some obstacles and dilemmas related to methodological strategies and ethical considerations that arose during the fieldwork of research focused on family violence during the stages of pregnancy and childbirth in adolescent females in Buenos Aires during 2007. From this study, we are able to contribute some…
Professional guidelines have addressed ethical dilemmas posed by a few types of nontraditional procreative arrangements (e.g., gamete donations between family members), but many questions arise regarding how providers view and make decisions about these and other such arrangements. Thirty-seven ART providers and 10 patients were interviewed in-depth for approximately 1 h each. Interviews were systematically analyzed. Providers faced a range of challenges and ethical dilemmas concerning both the content and the process of decisions about requests for unconventional interfamilial and other reproductive combinations. Providers vary in how they respond - what they decide, who exactly decides (e.g., an ethics committee or not), and how - often undergoing complex decision-making processes. These combinations can involve creating or raising the child, and can shift over time - from initial ART treatment through to the child's birth. Patients' requests can vary from fully established to mere possibilities. Arrangements may also be unstable, fluid, or unexpected, posing challenges. Difficulties emerge concerning not only familial but social, combinations (e.g., between friends). These arrangements can involve blurry and confusing roles, questions about the welfare of the unborn child, and unanticipated and unfamiliar questions about how to weigh competing moral and scientific concerns - e.g., the autonomy of the individuals involved, and the potential risks and benefits. Clinicians may feel that these requests do not "smell right"; and at first respond with feelings of "yuck," and only later, carefully and explicitly consider the ethical principles involved. Proposed arrangements may, for instance, initially be felt to involve consanguineous individuals, but not in fact do so. Obtaining and verifying full and appropriate informed consent can be difficult, given implicit familial and/or cultural expectations and senses of duty. Social attitudes are changing, yet patients
The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis. PMID:25721113
The theory-practice-ethics gap - a new paradigm to contemplate. Practices based on tradition, rituals and outdated information are placed into a nonscientific paradigm called the theory-practice gap. Within this paradigm there is often a gap between theoretical knowledge and its application in practice. This theory-practice gap has always existed [Allmark, P., 1995. A classical view of the theory-practice gap in nursing. J. Adv. Nurs. 22 (1), 18-23; Hewison, A. et al., 1996. The theory-practice gap in nursing: a new dimension. J. Adv. Nurs. 24 (4), 754-761]. Its creation is often sited as a culmination of theory being idealistic and impractical, even if practical and beneficial, are often ignored. Most of the evidence relating to the non integration of theory and practice makes the assumption that environmental factors are responsible and will affect learning and practice outcomes, hence the "gap". In fact, it is the author's belief, that to "bridge the gap" between theory and practice an additional component is required, called ethics. A moral duty and obligation ensuring theory and practice integrate. In order to effectively implement new practices, one must deem these practices are worthy and relevant to their role as healthcare providers. Otherwise, we fall victims to providing nothing more than a lip service. This introduces a new concept which the author refers to as the theory-practice-ethics gap. This theory-practice-ethics gap must be considered when reviewing some of the unacceptable outcomes in health care practice. The author believes that there is a crisis of ethics where theory and practice integrate, and as a consequence, malfeasance. We are failing to fulfill our duty as healthcare providers and as patient advocates. One practice of major concern, which the author will endeavor to unfold relates to adult and pediatric resuscitation.
Riaz, Muhammad Kashif; Bal, Susan; Wise-Draper, Trisha
Metastatic cancer remains a devastating disease that threatens to disrupt entire family structures creating economic and psychosocial stress. Fortunately, great strides have resulted in improved therapies over the years but at a huge social-economic cost. The economic burden has risen greatly and carries with it new ethical concerns when deciding treatment. Here, we discuss the financial and ethical challenges that oncologists and their patients face in the era of novel treatment strategies. J. Surg. Oncol. 2016;114:323-328. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Lathrop, Breanna L; Cheney, Teresa B; Hayman, Annette B
The Making Ethical Decisions about Surgical Intervention (MEDSI) tool is designed to guide health care professionals, patients, and families faced with ethically charged decisions regarding surgical interventions for pediatric patients. MEDSI is built on the principles of beneficence, nonmaleficence, and patient autonomy and created to promote truth-telling, compassion, respect for patient cultural and religious preferences, and appropriate follow up in the clinical setting. Following an overview of the 8 steps that compose MEDSI, the tool is applied to the management of intersex infants. The birth of a child with a disorder of sexual development (DSD) and ambiguous genitalia presents an ethically challenging situation for the family and health care team. The use of the MEDSI model is demonstrated in a case study involving the decision of surgical intervention in the management of an intersex child.
Gentile, Ivan; Maraolo, Alberto E; Niola, Massimo; Graziano, Vincenzo; Borgia, Guglielmo; Paternoster, Mariano
Hepatitis C virus (HCV) infection affects about 200 million people worldwide and represents a leading cause of liver-related mortality. Eradication of HCV infection, achieved mainly through direct-acting antivirals (DAA), results in a decrease of mortality and an improvement of quality of life. These drugs have a maximal efficacy and an optimal tolerability. However, their high cost precludes a universal access even in wealthy countries. Areas covered: This article deals with the policies adopted for the use of the new anti-HCV drugs, especially in Europe and most of all in Italy, supposedly the developed country with the highest HCV prevalence. The literature search was performed using Pubmed and Web of Science. Moreover, national regulatory institutional websites were consulted. Expert commentary: The current policy of limitation to the access of the DAA presents a series of ethical issues that makes it non-applicable. A 'treat-all' strategy should resolve all ethical dilemmas, by virtue of the wide benefits of anti-HCV treatment not only for the advanced stage of infection, but also for the initial stages. A reduction in price of the drugs is the actual condition to achieve such a change.
Gramma, Rodica; Parvu, Andrada; Enache, Angela; Roman, G; Ioan, Beatrice
Informing the patient about his disease is a very important issue in the medical practice, thus communication becomes imperative in healthcare services. Communicating the diagnosis of a pathology that doesn't bear any imminent risk for life is a common procedure for physicians. However, the situation changes drastically in the case of a severe diagnosis or a hopeless prognosis, with terminally ill patients. In this article the authors proceed to a critical analysis of the dilemma of communication or non-communication of a severe diagnosis. The problem of communicating a severe diagnosis is described from a philosophical perspective (in terms of three fundamental ethical theories: Aristotle's theory of virtue, Kant's ethical theory and Bentham and Mill's moral theories). At the same time, certain physiological and medical approaches are presented. In order to avoid any communication conflict, especially considering the particular situation of the seriously ill patient in the context of the contemporary medical activities, the authors propose the debating of two opposing approaches: "the sacred lie principle" and "the justified medical truth" in the physician--patient relation.
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.
Ayalon, S; Gozal, Y; Kaufman, E
Conscious sedation and general anesthesia have been in the use of the dental profession since the first half of the 19th century. Although seemingly appealing to use due to alleviation of pain and anxiety induced by the dental treatment, the alteration of consciousness level of dental patients is not without risk. Morbidity and mortality due to dental treatment performed under general anesthesia were investigated at the last decades of the 20th century. The mortality rates found in these investigations were surprisingly high comparing to researches of morbidity and mortality due to other medical procedures, performed under general anesthesia. Therefore, although general anesthesia is sometimes the only way to treat certain patients, maintaining strict indications for dental treatment under general anesthesia is necessary. Conscious sedation was found as a safer alternative for achieving a level of consciousness enabling dental treatment in those patients who are unable to receive treatment in normal dental clinic settings. We therefore believe that conscious sedation should be the golden standard for the treatment of those patients. The practicing of dentistry in patients who have need of dental treatment under special settings such as general anesthesia and sedation raises ethical dilemmas to the caregiver. The following review will summarize the available data on morbidity and mortality due to dental treatment given under general anesthesia and conscious sedation. The ethical questions arising from their practicing will be discussed and some answers shall be proposed.
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.
Most accounts of the ethical problems facing researchers across a broad spectrum of research fields come from ethicists, ethics committees, and specialists committed to the study of ethics in human research. In contrast, this study reports on the ethical questions that researchers, themselves, report facing in their everyday practice. Fifty-five Swedish researchers contributed 109 examples of ethical dilemmas, conflicts, and problems in research. They were all researchers at the postdoctoral ...
Hightower, Bynum Blake; Klinker, JoAnn Franklin
This case study explores an ethical dilemma faced by a new junior high school principal. It is appropriate for use in all preparation course work, including the internship. Studies show that novice principal decision making differs from that of experienced principals in moral dilemmas, including following policy versus best interests of the…
Abstract. Ethical issues confront trauma clinicians on a daily basis. This article highlights the similarities of trauma ethical dilemmas to those faced by other emergency care providers and takes the reader through the inpatient aspects of trauma care.
Backholm, Klas; Idås, Trond
News journalists working on crisis-related assignments may experience dilemmas with regard to how to conduct their work without causing additional harm to first-hand victims. In this study, we investigated how exposure to journalistic ethical dilemmas during the Oslo/Utøya terror attack in 2011 and subsequent work-related guilt were related to the development of posttraumatic stress (PTS) reactions. Norwegian journalists (N = 371) covering the terror attack participated in a web-based survey 8-9 months after the incident. We found that females reported more ethical dilemmas during the assignment than males (n = 356, d = 0.51). We also found that being on the scene was not related to more exposure to dilemmas (n = 311, d = 0.01). Moreover, we discovered that work-related guilt had a significant indirect effect on the relationship between exposure to ethical dilemmas and severity of PTS reactions (n = 344, completely standardized indirect effect size = .11, 95% CI [.04, .19]. The results showed that exposure to ethical dilemmas may affect the development of long-term psychological impairment. We concluded that media organizations can prevent postcrisis impairment by preparing employees for possible exposure to dilemmas during crisis-related assignments. Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company.
Manos, Emmanouil; Gkika, Dimitra; Euthimiou, Christoforos; Lola, Vassiliki; Potonos, Stefanos; Kokkori, Ioanna; Tsiouda, Theodora; Pililitsis, Leonidas; Angel, Jacob
Background Lung cancer is second in frequency in both sexes, with very poor prognosis and high mortality rates. Smoking is the main cause. Malignant neoplasms of the lung on pregnancy are not very frequent. They constitute a direct threat for the woman’s life and simultaneously the outcome of pregnancy is doubtful. Objective We present this case because of the rarity of coexistence of lung neoplasm and pregnancy, in absence of treatment guidelines. The question of overcoming, by the attending physician, the ethical dilemmas and the medical protocols is apposed, in the progress and outcome of pregnancy, when lung malignant neoplasm coexists. Methods A 33-year-old woman, smoker, with occasional alcohol consumption and medical history of Leiden thrombophilia, is at 18-19 weeks of gestation. She presents to the emergency department of the general hospital with reported episodes of dyspnea and cough. She refers cough with difficulty in the elimination of sputum, dyspnea, orthopnea, facial and neck edema with venous distension, common symptoms of superior vena cava syndrome. The CT scan revealed a lung mass in the right upper lobe with the right hilum involved. The rest of the staging was negative. Results The first bronchoscopy revealed edema in the main carina and right upper lobe stenosis while the biopsy samples did not demonstrate a histological identification. Mediastinoscopy was followed and revealed a poorly differentiated carcinoma (primary pulmonary neuroendocrine tumor). Both patient and relatives consented to start chemotherapy treatment. After four cycles of chemotherapy with carboplatin + etoposide, the patient in the 7th month of gestation, gave birth to a healthy baby boy weighted 1,130 gr. The patient died after four months because she suffered from an extremely aggressive tumor with brain and diffused spinal metastatic infiltrations and also from the appearance of paraneoplastic disorders like Lambert-Eaton myasthenic syndrome. Conclusions The
Most accounts of the ethical problems facing researchers across a broad spectrum of research fields come from ethicists, ethics committees and specialists committed to the study of ethics in human research. In contrast, this study reports on the ethical questions that researchers, themselves, report facing in their everyday practice. Fifty-five Swedish researchers contributed 109 examples of ethical dilemmas, conflicts and problems in research. They were all researchers at the post-doctoral l...
Even though principles to guide practice are crucial, there are no hard-and-fast rules for resolving ethical issues--dilemmas that are not easily resolvable because they present opposing values and outcomes that may harm to certain groups of people if not properly considered. This article describes a number of ethical dilemmas faced as a workplace…
Greene, C. H.; Kammen, D. M.
For over 200 years, fossil fuels have been the basis for an industrial revolution that has delivered a level of prosperity to modern society unimaginable during the previous 5000 years of human civilization. However, society's dependence on fossil fuels is coming to an end for two reasons. The first reason is because our fossil fuel reserves are running out, oil in this century, natural gas during the next century, and coal a few centuries later. The second reason is because fossil fuels are having a devastating impact on the habitability of our planet, disrupting our climate system and acidifying our oceans. So the question is not whether we will discontinue using fossil fuels, but rather whether we will stop using them before they do irreparable damage to the Earth's life-support systems. Within our geoscience community, climate scientists have determined that a majority of existing fossil fuel reserves must remain unburned if dangerous climate change and ocean acidification are to be avoided. In contrast, Exxon-Mobil, Shell, and other members of the fossil fuel industry are pursuing a business model that assumes all of their reserves will be burned and will not become stranded assets. Since the geosciences have had a long and mutually beneficial relationship with the fossil fuel industry, this inherent conflict between climate science and industrial interests presents an ethical dilemma for many geoscientists. This conflict is further heightened by the fossil fuel divestment movement, which is underway at over 400 college and university campuses around the world. This presentation will explore some of the ethical and financial issues being raised by the divestment movement from a geoscientist's perspective.
With the growth of research collaborations, the average number of authors per article and the phenomenon of equally important authorships have increased. The essence of the phenomenon of equally important authorships is the approximately equal importance of authors, both because of the difficulties in comparing authors' contributions to a paper and some actual research evaluation practices, which (approximately) give full paper credit only to the most important authors. A mechanism for indicating that various authors contributed equally is required to maintain and strengthen collaboration. However, the phenomenon of multiple important authors can cause unfair comparisons among the research contributions and abilities of authors of different papers. This loophole may be exploited. Normalizing the credit assigned to a given paper's authors is an easy way to solve this ethical dilemma. This approach enables fair comparisons of the contributions by the authors of different articles and suppresses unethical behaviour in author listings. Bibliometric researchers have proposed mature methods of normalized paper credit assignment that would be easy to use given the current level of computer adoption.
Marcus, Brian S; Carlson, Jestin N; Hegde, Gajanan G; Shang, Jennifer; Venkat, Arvind
We sought to evaluate whether health care professionals' viewpoints differed on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas based on practice location. We conducted a survey study from December 21, 2013 to March 15, 2014 of health care professionals at six hospitals (one tertiary care academic medical center, three large community hospitals and two small community hospitals). The survey consisted of eight clinical ethics cases followed by statements on whether there was a role for the ethics committee or hospital in their resolution, what that role might be and case specific queries. Respondents used a 5-point Likert scale to express their degree of agreement with the premises posed. We used the ANOVA test to evaluate whether respondent views significantly varied based on practice location. 240 health care professionals (108-tertiary care center, 92-large community hospitals, 40-small community hospitals) completed the survey (response rate: 63.6 %). Only three individual queries of 32 showed any significant response variations across practice locations. Overall, viewpoints did not vary across practice locations within question categories on whether the ethics committee or hospital had a role in case resolution, what that role might be and case specific queries. In this multicenter survey study, the viewpoints of health care professionals on the role of ethics committees or hospitals in the resolution of clinical ethics cases varied little based on practice location.
Gomez, Margarita Victoria
The objective of this work is a reflection on the ethics of education on the net as a contribution to the face-to-face interaction in the virtual world. We think the ethics is a result of a process of responsible interchange with others. Two important thinkers of the last few decades, Emmanuel Levinas e Paulo Freire contribute each one with one's…
Castleberry, Stephen B.
As a marketing analyst, Eric is faced with several ethical dilemmas. When asked to engage in unethical and illegal behavior, Eric must decide whether to obey his boss and fudge the numbers (the counts of product purchased in order to get reimbursed more from the manufacturer during special sales) or take the ethical route. The case consists of two…
Francisco José Castilhos Karam
Full Text Available This work intends to locate and to explore the complexities of
some classical moral dilemmas in human history considering two
paradigms as references: Antigone’s, created by Sophocles; and
Gacel Sayah’s, created by Vázquez-Figueroa. The work situates
both historical and contemporary dilemmas of journalism and
points out examples furnished by professionals in activity and
academic 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
Full Text Available This work intends to locate and to explore the complexities of some classical moral dilemmas in human history considering two paradigms as references: Antigone’s, created by Sophocles; and Gacel Sayah’s, created by Vázquez-Figueroa. The work situates both historical and contemporary dilemmas of journalism and points out examples furnished by professionals in activity and academic 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.
This article focuses on the measure of involuntary treatment of mental patients in the community, not only with regard to human rights and more specifically those of persons with mental disorders, but also with regard to ethics and deontology in mental healthcare delivery service. In this light, the important role of informed consent in psychiatry with regard to the psychiatric act is examined. Informed consent of mental patients in treatment when they are in need of voluntary or involuntary hospitalization is further examined, while emphasis is being put on the case of involuntary treatment. The Convention for Human Rights and Biomedicine (Convention of Οviedo), the European Convention of Human Rights, other documents of International Organizations (UN) and specialized national legislation (A. 2071/1992, Chapter vi, Greek law) constitute basic reference and interpretation points. The examination of consent and the demarcation of the exceptions are important issues that need to be approached. More particularly, our interest lies with the article 7 of the Convention for Human Rights and Biomedicine, which specifically refers to the protection of person who suffers from a mental disorder. The opinion that informed consent in psychiatric treatment and involuntary treatment are concepts and processes which are distinct but not always mutually exclusive is enhanced. In any case, involuntary treatment causes major dilemmas as far as informed consent in the psychiatric act is concerned, as it raises issues that affect the autonomy of the person. Today, however, there are many factors which influence public politics towards the adoption of the measure of involuntary treatment within the community. How is it that this paradoxical link is legitimized and justified: involuntary treatment and community? The enactment of the above mentioned measure in many European and North American countries has created new paths in the practice of contemporary psychiatry. Nonetheless, it
Phua, Kai-Lit; Hue, J W
Scientists and policy makers issuing predictions and warnings of impending natural disaster are faced with two major challenges, that is, failure to warn and issuing a false alarm. The consequences of failure to warn can be serious for society overall, for example, significant economic losses, heavy infrastructure and environmental damage, large number of human casualties, and social disruption. Failure to warn can also have serious for specific individuals, for example, legal proceedings against disaster research scientists, as in the L'Aquila earthquake affair. The consequences of false alarms may be less serious. Nevertheless, false alarms may violate the principle of nonmaleficence (do no harm), affect individual autonomy (eg, mandatory evacuations), and may result in the "cry wolf" effect. Other ethical issues associated with natural disasters include the promotion of global justice through international predisaster technical assistance and postdisaster aid. Social justice within a particular country is promoted through greater postdisaster aid allocation to the less privileged.
Wanyonyi, Sikolia; Muriithi, Francis G
Vaginal birth after Caesarean section (VBAC) has long been practised in low resource settings using unconventional methods. This not only poses danger to the woman and her baby, but could also have serious legal and ethical implications. The adoption of this practice has been informed by observational studies with many deficiencies; this is so despite other studies from settings in which the standard of care is much better that show that elective repeat Caesarean section (ERCS) may actually be safer than VBAC. This raises questions about whether we should insist on a dangerous practice when there are safer alternatives. We highlight some of the challenges faced in making this decision, and discuss why the fear of ERCS may not be justified after all in low resource settings. Since a reduction in rates of Caesarean section may not be applicable in these regions, because their rates are already low, the emphasis should instead be on adequate birth spacing and safer primary operative delivery.
'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.
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. © 2011 Blackwell Publishing Ltd.
Oppenheim, Daniel; Brugières, Laurence; Corradini, Nadège; Vivant, Florence; Hartmann, Olivier
The increasing complexity of present day medicine--with highly effective and yet risky treatments, individual and collective expectations, and evolving ideological and cultural landmarks--often gives rise to difficult ethical problems. Specific meetings are valuable for understanding such problems, acquiring the relevant skills and for gaining and transmitting experience on how to solve them. Parents and doctors may disagree about what is the best treatment. Such a difference of opinion is not rare but usually a solution can easily be found. This is not the case when the child is treated for a severe illness and when there is no clearly defined or satisfactory treatment for him\\her. We present how a dramatic conflict arose between the parents and the doctors faced with such a case (mostly because the staff failed to understand early enough the psychological factors at the root of the father's demands), how clinical, institutional and ethical problems were analysed during a meeting, and how they were solved.
Murray, C G
to cope with the operative demands and financial burden of resolving their deteriorating dental situation and so complex implant-born structures and precision removable prostheses should probably be avoided for those individuals contemplating entering a care situation. Therefore, the timing of the provision of complex dentistry poses an ethical dilemma. © 2015 Australian Dental Association.
Business ethics is a company's soft power. After an analysis of business ethics and its significance, and the dilemma of its development, principles and ways to improve business ethics and tackle the dilemma are proposed from the perspective of business and society, which aims to offer some theoretical guidance for business ethics development.%摘要：企业道德是企业的一种软实力。在对企业道德建设的涵义和意义、企业道德建设的企业与社会困境分析基础上，提出了破解企业道德建设困局的原则和方法，以期对企业道德提升提供理论指导。
Bernthal, Elizabeth M; Draper, H J A; Henning, J; Kelly, J C
To identify and explore features of ethical issues that senior clinicians faced as deployed medical directors (DMDs) to the British Field Hospital in Afghanistan as well as to determine the ethical training requirements for future deployments. A qualitative study in two phases conducted from November 2014 to June 2015. Phase 1 analysed 60 vignettes of cases that had generated ethical dilemmas for DMDs. Phase 2 included focus groups and an interview with 13 DMDs. Phase 1 identified working with limited resources, dual conflict of meeting both clinical and military obligations and consent of children as the most prevalent ethical challenges. Themes found in Phase 2 included sharing clinical responsibilities with clinicians from other countries and not knowing team members' ways of working, in addition to the themes from Phase 1. This study has drawn together examples of scenarios to form a repository that will aid future training. Recommendations included undertaking ethics training together as a team before, during and after deployment which must include all nationalities who are assigned to the same operational tour, so that different ethical views can be explored beforehand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Gombert, Karolina; Douglas, Flora; McArdle, Karen; Carlisle, Sandra
This article reflects on ethical limitations and dilemmas encountered during fieldwork of the Foodways and Futures project (2013-2016). Foodways and Futures is a qualitative action research project aimed at exploring the food choices of former homeless young people (aged 16-25) in Aberdeenshire. In Scotland, where over 13,000 young people become…
Kenia Lara Silva
Full Text Available We sought to analyze, from the perspective of professors and students, the reasons and consequences of the expansion of undergraduate courses in nursing, discussing the dilemmas and the contradictions confronting the labor market. It was a qualitative study with data obtained from focus groups, conducted in 18 undergraduate nursing courses in the state of Minas Gerais, during the period of February to October of 2011. The narratives were submitted to critical discourse analysis. The results indicated that the education of the nurse was permeated by insecurity as to the future integration into the labor market. The insecurity translates into dilemmas that referred to employability and the precariousness of the working conditions. In this context, employment in the family health strategy emerges as a mirage. One glimpses the need for a political agenda with the purpose of discussion about education, the labor market and the determinants of these processes.
当前大学生道德实践教育遭遇严峻挑战，这与社会层面的功利主义、实用主义等思想的侵蚀和个人境界的层次、自律性不强等主客观方面原因都有内在关联。可通过道德教育目标的崇高定位、道德教育内容的德性培育和道德教育方式的体验养成等途径来加以完善。%The practical ethics education for college students is facing a severe challenge which shares a connection with objective and subjective factors such as,social utilitarianism,the influence of pragmatism,personal ideological level, lacking of self-discipline, etc. The dilemma can be enhanced by aiming at a higher target in ethical education, fostering the ethical characters of ethical education,and the acquirement of experiencing ethical teaching methods.
Driscoll, Andrea; Currey, Judy; Worrall-Carter, Linda; Stewart, Simon
To examine the impact and obstacles that individual Institutional Research Ethics Committee (IRECs) had on a large-scale national multi-centre clinical audit called the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study. Multi-centre research is commonplace in the health care system. However, IRECs continue to fail to differentiate between research and quality audit projects. The National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes study used an investigator-developed questionnaire concerning a clinical audit for heart failure programmes throughout Australia. Ethical guidelines developed by the National governing body of health and medical research in Australia classified the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study as a low risk clinical audit not requiring ethical approval by IREC. Fifteen of 27 IRECs stipulated that the research proposal undergo full ethical review. None of the IRECs acknowledged: national quality assurance guidelines and recommendations nor ethics approval from other IRECs. Twelve of the 15 IRECs used different ethics application forms. Variability in the type of amendments was prolific. Lack of uniformity in ethical review processes resulted in a six- to eight-month delay in commencing the national study. Development of a national ethics application form with full ethical review by the first IREC and compulsory expedited review by subsequent IRECs would resolve issues raised in this paper. IRECs must change their ethics approval processes to one that enhances facilitation of multi-centre research which is now normative process for health services. The findings of this study highlight inconsistent ethical requirements between different IRECs. Also highlighted are the obstacles and delays that IRECs create when undertaking multi-centre clinical audits
Lawler, Patricia Ann
Continuing professional education practitioners often face ethical dilemmas regarding their obligations to multiple stakeholders and issues arising in new arenas such as the workplace, distance education, and collaboration with business. Codes of ethics can guide practice, but practitioners should also identify their personal core values system…
McDonald, Kimberly S.; Wood, George S., Jr.
An Indiana survey of 113 of 248 adult basic educators, 113 of 117 trainers, and 23 of 29 continuing educators identified ethical dilemmas they face. Fifty-two percent believed a code of ethics should be created and enforced by professional associations, covering broad issues. Those who had experience with codes were positive about them. (SK)
Mishara, Brian L.; Weisstub, David N.
The ethical basis of suicide prevention is illustrated by contrasting helpline emergency rescue policies of the Samaritans and the AAS and the U.S. National Suicide Prevention Lifeline network. We contrast moralist, relativist, and libertarian ethical premises and question whether suicide can be rational. Samaritans respect a caller's right to…
Kvalnes, Øyvind; Øverenget, Einar
Business leaders frequently face dilemmas, circumstances where whatever course of action they choose, something of important value will be offended. How can an organisation prepare its decision makers for such situations? This article presents a pedagogical approach to dilemma training for business leaders and managers. It has evolved through ten years of experience with human resource development, where ethics has been an integral part of programs designed to help individuals to become excel...
Neonatal intensive care has greatly improved the survival chances of a very sick infant. At the same time, it has also given rise to serious ethical problems. In all circumstances, however, parents and paediatricians and other healthcare team workers should continuously evaluate together what is in
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.
Sevilla-Godínez, Héctor Tiburcio
The paper is a reflection on an ethical proposal of death. Death is seen as a natural part in the process of life. There are different ideas focusing on the useless suffering in patients, physician's frustrations and unfair indignation from patients' families. Also questioned is the traditional way to understand the right to live versus the right to a life with quality, understanding the last as the most important. The article concludes with a critical point of view about euthanasia and its implications generated by health professionals in their daily practices.
Veatch, R M
Characteristics of ethical evaluations as they apply to the dilemmas faced by the pharmacist in the workplace are described, and the general principles and theories of Western normative ethics are discussed. Because ethical dilemmas are commonplace in pharmacy practice, pharmacists must develop a working knowledge of formal and systematic ethical analysis, as well as learn to distinguish ethical issues from social, psychological, political, and legal issues. Ethical evaluations are distinguished by three characteristics: They are ultimate, they possess universality, and they treat the good of everyone alike. Ethical analyses can be thought of as having four different and successive stages. The first stage is ensuring that all parties understand the facts of the specific case. If controversy remains after the facts are clear, parties to the dispute can proceed through three successive stages of general moral reflection: (1) the level of moral rules, (2) the level of ethical principles, and (3) the level of ethical theories. Specific moral rules cover groups of cases, and they generally are regarded as being derived from a shorter list of abstract moral principles. An ethical theory is a systematic position about which principles are morally significant, how the principles relate to each other, and how they should be tested. Pursuit of ethical dilemmas through the full hierarchy of levels of analysis exposes simplistic or irrational moral decisions and clarifies the nature of disputes.
Seen in the general frame of environmental impact, the problem of nuclear waste disposal seems of minor importance. As a model, however, for early consideration of long-term ethical aspects it deserves our full attention. From the ethical point of view, the waste storage should not be irreversible. It must be left to future generations to decide how to deal with the nuclear material. (orig.) [de
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.
Christen, Markus; Müller, Sabine
Understanding how the "brain produces behavior" is a guiding idea in neuroscience. It is thus of no surprise that establishing an interrelation between brain pathology and antisocial behavior has a long history in brain research. However, interrelating the brain with moral agency--the ability to act in reference to right and wrong--is tricky with respect to therapy and rehabilitation of patients affected by brain lesions. In this contribution, we outline the complexity of the relationship between the brain and moral behavior, and we discuss ethical issues of the neuroscience of ethics and of its clinical consequences. First, we introduce a theory of moral agency and apply it to the issue of behavioral changes caused by brain lesions. Second, we present a typology of brain lesions both with respect to their cause, their temporal development, and the potential for neural plasticity allowing for rehabilitation. We exemplify this scheme with case studies and outline major knowledge gaps that are relevant for clinical practice. Third, we analyze ethical pitfalls when trying to understand the brain-morality relation. In this way, our contribution addresses both researchers in neuroscience of ethics and clinicians who treat patients affected by brain lesions to better understand the complex ethical questions, which are raised by research and therapy of brain lesion patients.
Full Text Available Abstract The controversy about the use of data from human volunteer studies involving experimental exposure to pesticides as part of regulatory risk assessment has been widely discussed, but the complex and interrelated scientific and ethical issues remain largely unresolved. This discussion paper, generated by authors who comprised a workgroup of the ICOH Scientific Committee on Rural Health, reviews the use of human experimental studies in regulatory risk assessment for pesticides with a view to advancing the debate as to when, if ever, such studies might be ethically justifiable. The discussion is based on three elements: (a a review of discussion papers on the topic of human testing of pesticides and the positions adopted by regulatory agencies in developed countries; (b an analysis of published and unpublished studies involving human testing with pesticides, both in the peer-reviewed literature and in the JMPR database; and (c application of an ethical analysis to the problem. The paper identifies areas of agreement which include general principles that may provide a starting point on which to base criteria for judgements as to the ethical acceptability of such studies. However, the paper also highlights ongoing unresolved differences of opinion inherent in ethical analysis of contentious issues, which we propose should form a starting point for further debate and the development of guidelines to achieve better resolution of this matter.
London, Leslie; Coggon, David; Moretto, Angelo; Westerholm, Peter; Wilks, Martin F; Colosio, Claudio
The controversy about the use of data from human volunteer studies involving experimental exposure to pesticides as part of regulatory risk assessment has been widely discussed, but the complex and interrelated scientific and ethical issues remain largely unresolved. This discussion paper, generated by authors who comprised a workgroup of the ICOH Scientific Committee on Rural Health, reviews the use of human experimental studies in regulatory risk assessment for pesticides with a view to advancing the debate as to when, if ever, such studies might be ethically justifiable. The discussion is based on three elements: (a) a review of discussion papers on the topic of human testing of pesticides and the positions adopted by regulatory agencies in developed countries; (b) an analysis of published and unpublished studies involving human testing with pesticides, both in the peer-reviewed literature and in the JMPR database; and (c) application of an ethical analysis to the problem. The paper identifies areas of agreement which include general principles that may provide a starting point on which to base criteria for judgements as to the ethical acceptability of such studies. However, the paper also highlights ongoing unresolved differences of opinion inherent in ethical analysis of contentious issues, which we propose should form a starting point for further debate and the development of guidelines to achieve better resolution of this matter.
The controversy about the use of data from human volunteer studies involving experimental exposure to pesticides as part of regulatory risk assessment has been widely discussed, but the complex and interrelated scientific and ethical issues remain largely unresolved. This discussion paper, generated by authors who comprised a workgroup of the ICOH Scientific Committee on Rural Health, reviews the use of human experimental studies in regulatory risk assessment for pesticides with a view to advancing the debate as to when, if ever, such studies might be ethically justifiable. The discussion is based on three elements: (a) a review of discussion papers on the topic of human testing of pesticides and the positions adopted by regulatory agencies in developed countries; (b) an analysis of published and unpublished studies involving human testing with pesticides, both in the peer-reviewed literature and in the JMPR database; and (c) application of an ethical analysis to the problem. The paper identifies areas of agreement which include general principles that may provide a starting point on which to base criteria for judgements as to the ethical acceptability of such studies. However, the paper also highlights ongoing unresolved differences of opinion inherent in ethical analysis of contentious issues, which we propose should form a starting point for further debate and the development of guidelines to achieve better resolution of this matter. PMID:20718963
During disasters, clinicians may be forced to play dual roles, as both a provider and an allocator of scarce resources. At present, a clear framework to govern resource stewardship at the bedside is lacking. Clinicians who find themselves practicing in this ethical gap between clinical and public health ethics can experience significant moral distress. One provider describes her experience allocating an oxygen tank in the intensive care unit at a hospital in Port-au-Prince, Haiti, immediately following the 2010 earthquake. Using a clinical vignette and reflective narrative she attempts to identify the factors that influenced her allocation decision, opening up the factors for commentary and debate by an ethicist. A better paradigm for the ethical care of patients during disasters is needed to better guide provider choices in the future.
Full Text Available Infectious diseases—including emerging and re-emerging diseases such as Ebola and tuberculosis—continue to be important causes of morbidity and mortality in the globalizing, contemporary world. This article discusses the ethical issues associated with protecting the rights of individuals versus the protection of the health of populations in the case of infectious diseases. The discussion uses the traditional medical ethics approach together with the public health approach presented by Faden and Shebaya. 3 Infectious diseases such as Ebola hemorrhagic fever, Nipah virus and HIV/AIDS (together with tuberculosis will be used to illustrate particular points in the discussion.
Magalhães-Sant'Ana, M.; More, S. J.; Morton, D. B.; Hanlon, A.
Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. PMID:27613779
Addison, Courtney Page
. However, social scientists have yet to devote much attention to this ethically contentious and medically complex field. This project aimed to identify and explore social and ethical factors shaping gene therapy practice in clinical settings. It is based on six months of participant observation in a London...... children’s hospital (the UKCH), thirty-two interviews with key actors in the gene therapy field, and scientific and policy document analysis. One of the main interests of this research is with the politics of ethics. The thesis shows that ‘ethical boundary work’ was central to establishing the credibility...... of gene therapy, and the authority of its practitioners. The politics of ethics can also be discerned in practice: the UK research ethics system structures scientific work but cannot account for the various, complex, and on-going ethical dilemmas that patients and practitioners face when undertaking gene...
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.
2000. A cover letter attached to the five page questionnaire explained the nature and scope of the study, informed the providers of voluntary ... euthanasia , rather than the application of ethics (theories, principles, concepts, rules) to clinical practice (Msyer, Kerridge & Mitchell, 1995). Not
Mitchell, Jennifer M.; Yordy, Eric D.
This article describes a model that aims to create a greater ability to recognize the negative aspects of making unethical decisions. To this end, the authors developed an ethical decision-making model to aid students through the process of analyzing these situations--a model that is easy to remember and apply. Through this model, the COVER model,…
Basile, Michael L.
This paper explores Max Weber's study of the origins of the secularization of the Puritan work ethic and examines the hybridized category of secular science expert. The hybrid construct provides an opening for the critical analysis of the concrete activity of development from two perspectives, the structural and the individual. The individual…
Alfandre, David; Clever, Sarah; Farber, Neil J; Hughes, Mark T; Redstone, Paul; Lehmann, Lisa Soleymani
The care of Very Important Patients (VIPs) is different from other patients because they may receive greater access, attention, and resources from health care staff. Although the term VIP is used regularly in the medical literature and is implicitly understood, in practice it constitutes a wide and heterogeneous group of patients that have a strong effect on health care providers. We define a VIP as a very influential patient whose individual attributes and characteristics (eg, social status, occupation, position), coupled with their behavior, have the potential to significantly influence a clinician's judgment or behavior. Physicians, celebrities, the politically powerful, and philanthropists, may all become VIPs in the appropriate context. The quality of care may be inferior because health care professionals may deviate from standard practices when caring for them. Understanding the common features among what may otherwise be very different groups of patients can help health care providers manage ethical concerns when they arise. We use a series of vignettes to demonstrate how VIPs behavior and status can influence a clinician's judgment or actions. Appreciating the ethical principles in these varied circumstances provides health care professionals with the tools to manage ethical conflicts that arise in the care of VIPs. We conclude each vignette with guidance for how health care providers and administrators can manage the ethical concern. Published by Elsevier Inc.
Kimber, Megan; Campbell, Marilyn
Acting in the best interests of students is central to the moral and ethical work of schools. Yet tensions can arise between principals and school counsellors as they work from at times opposing professional paradigms. In this article we report on principals' and counsellors' responses to scenarios covering confidentiality and the law,…
Newman, Anne; Glass, Ronald David
This essay examines several ethical and epistemological issues that arise when philosophers conduct empirical research focused on, or in collaboration with, community groups seeking to bring about systemic change. This type of research can yield important policy lessons about effective community-driven reform and how to incorporate the voices of…
Pedigo, Kerry; Marshall, Verena
Globalisation has seen diverse cultures becoming increasingly entwined and interdependent as business organisations operate in a borderless world. When organisations operate internationally they often find that countries differ in what is considered wrong or right. The objectives of the research were to identify cross-cultural ethical dilemmas…
Bush, Victoria D.; Smith, Rachel Korthage; Bush, Alan J.
A large body of pedagogical research exists on developing curricula and ethics training tools to prepare college graduates for entering the workforce. However, many college students are "already" in the workforce while they attend school. Many of these jobs are entry-level or frontline employee positions in retail or service industries,…
Kauffman, James M.; Hallahan, Daniel P.
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…
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.
Speck, Bruce W.
Describes a method for helping students evaluate ethical issues in a systematic way, based on Lawrence Kohlberg's stages of moral development. Recommends the case-study approach for creating social constructs in which students face ethical dilemmas, and outlines a case-study ethics unit using Kohlberg's model. (MM)
Most (71.6%; n=63) intensivists cited availability of an intensive care unit (ICU) bed ... 1 Department of Family Medicine, School of Nursing and Public Health, Nelson ..... Patient B − 24 years, drug overdose, respiratory depression and seizures.
Intensivists comprising 26.8% (n=22) of the total group rated as probably important or least important the 'resources available'; 'bed used to the prejudice of another patient' was stated by 16.4% (n=14); and 'policy of the intensive care unit' by 17% (n=14). Nearly two-thirds (65.9%; n=58) would respect an informed refusal of ...
Kirschen, Matthew P; Friedlander, Joel A
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.
Oocyte donations have increased with improvements in oocyte cryopreservation procedures in recent years. Women with medical conditions that require chemotherapy or radiotherapy have begun to opt for oocyte cryo¬preservation prior to their treatment or to enroll in an oocyte donation program. Alternatively, some women apply for "third-party" oocyte donation programs for nonmedical reasons such as delayed childbearing. Although society seems to accept oocyte donations for medical reasons, it appears that there are still some moral issues surrounding nonmedical oocyte donations. In this review, the ethical aspects of oocyte donations and donors' perspectives are discussed. With developing technologies, the genetic screening of donors has expanded to include diseases. This review explores the ethical issues involved in genetic screening of gamete donors.
Sarah D. Stanwick; Peter A. Stanwick
In response to ethical dilemmas faced by companies around the globe, companies are developing or refining their ethical codes. Many of these companies communicate these codes to their stakeholders through the companys corporate social responsibility (CSR) report. This paper examines the ethics codes of the top 100 companies (based on market capitalization) in the United Kingdom. A sample of CSR reports for these companies is examined to determine if the company includes its ethical code in th...
Mendoza, Mary Elizabeth
In the course of their work, sign language interpreters are faced with ethical dilemmas that require prioritizing competing moral beliefs and views on professional practice. There are several decision-making models, however, little research has been done on how sign language interpreters learn to identify and make ethical decisions. Through surveys and interviews on ethical decision-making, this study investigates how expert and novice interpreters discuss their ethical decision-making proces...
Umeora, Ouj; Chukwuneke, Fn
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.
Moatti, J P; Souville, M; Obadia, Y; Morina, M; Sebbah, R; Gamby, T; Gallais, H; Gastaut, J A
A survey was carried out in May-June 1992, in the city of Marseille (South-Eastern France), to analyze attitudes towards ethical issues associated with the care of HIV-infected patients in a random sample of general practitioners (GPs) (telephone interviews; answer rate = 78.6%; n = 313). A total of 70.6% were consulted by HIV carriers and 48.9% regularly took care of these patients over the past year. Multi-dimensional analysis showed that support for HIV mandatory screening was related to lack of knowledge and experience with HIV infection, high perception of risks associated with HIV care, and the individual characteristics of GPs, such as religious beliefs and intolerance to uncertain situations. GPs with experience of regular care of HIV carriers had the same opinions than the rest of the sample about 'creation of specialized hospitals for AIDS patients' and similar attitudes toward HIV testing 'without patients' consent' or breaching of confidentiality of HIV diagnosis. Debates on ethical issues among GPs cannot be reduced to a simplistic division of a 'liberal group' highly involved in prevention and HIV care and a 'conservative' majority more or less inclined to stigmatize HIV-infected patients. Ambiguous messages on these issues from health authorities and professional ethical bodies may have very negative impacts on the attitudes of primary care physicians regarding the acceptability of HIV-infected patients.
Full Text Available To The Editor: Brain death that refers to the irreversible end of all brain activity, including involuntary activity necessary to sustain life, due to total necrosis of the cerebral neurons following loss of blood flow and oxygenation [1,2]. Using brain-death criteria, the medical community can declare a person legally dead even if life support equipment keeps the body's metabolic processes working. However, putting an end to someone’s life createsmany ethical dilemmas. Many patients perceive death as a natural part of life, or relief from pain and they may express a wish to diequickly and painlessly. They often ask the treating physician and their family to be taken home and allowed to die peacefully. However,the next of kin may want the patient to be actively treated and kept alive. The physician hopes that the patient will survive and resortsto technical means to keep the patient alive. Who should decide; the patient, the family or the physician?
Crawshaw, Marilyn A; Glaser, Adam W; Pacey, Allan A
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.
Full Text Available Museums are part of a wider cultural and entertainment environment, which is ruled by highly demanding visitors who seek immersive experiences (edutainment and time-saving arrangement. This has encouraged and, in some opinions, forced museums to turn their focus from collections to visitors. In addition, museums have faced competition and new technologies in the form of virtual museums and virtual reality. This has emphasized the need to accept marketing as a survival tool and to make it into a link between museums and visitors. This article attempts to give current insights into museum marketing as part of the arts marketing field. Its aim is also to identify and explain some of the major challenges and opportunities facing everyday museum business, in order to provide insight into the complex world of museum marketing. Former findings about the development of museum marketing and its biggest changes and challenges are presented, summarized and analyzed.
Museums are part of a wider cultural and entertainment environment, which is ruled by highly demanding visitors who seek immersive experiences (edutainment) and time-saving arrangement. This has encouraged and, in some opinions, forced museums to turn their focus from collections to visitors. In addition, museums have faced competition and new technologies in the form of virtual museums and virtual reality. This has emphasized the need to accept marketing as a survival tool and to make it int...
Todd, E Michelle; Watts, Logan L; Mulhearn, Tyler J; Torrence, Brett S; Turner, Megan R; Connelly, Shane; Mumford, Michael D
Despite the growing body of literature on training in the responsible conduct of research, few studies have examined the effectiveness of delivery formats used in ethics courses (i.e., face-to-face, online, hybrid). The present effort sought to address this gap in the literature through a meta-analytic review of 66 empirical studies, representing 106 ethics courses and 10,069 participants. The frequency and effectiveness of 67 instructional and process-based content areas were also assessed for each delivery format. Process-based contents were best delivered face-to-face, whereas contents delivered online were most effective when restricted to compliance-based instructional contents. Overall, hybrid courses were found to be most effective, suggesting that ethics courses are best delivered using a blend of formats and content areas. Implications and recommendations for future development of ethics education courses in the sciences are discussed.
Roberto Israel Rodríguez Soriano
Full Text Available This essay is a reflection on some of the political elements embedded in the ethical problems of medically assisted suicide and euthanasia. The thesis work is that political theoretical foundations of modern nations are aimed to protect the lives of people, a fact that responds to a series of historical processes of the very development of modern political theory. These fundamentals directly affect the cultural and political positions for the refusal to accept the legalization or regulation of the two practices in question, thus denying the right of self-determination in human decision making on the own life and death.
Able, Harriet; West, Tracey A.; Lim, Chih Ing
Ethical considerations are integral to our professional lives when we are faced with difficult choices regarding services and supports for children and families. Often, the right choice in service delivery for young children with disabilities ages birth to 5 years is unclear due to a myriad of factors potentially creating ethical dilemmas. This…
Vrecar, Irena; Peterlin, Borut; Teran, Natasa; Lovrecic, Luca
Over the last few years, many private companies are advertising direct-to-consumer genetic testing (DTC GT), mostly with no or only minor clinical utility and validity of tests and without genetic counselling. International professional community does not approve provision of DTC GT and situation in some EU countries has been analysed already. The aim of our study was to analyse current situation in the field of DTC GT in Slovenia and related legal and ethical issues. Information was retrieved through internet search, performed independently by two authors, structured according to individual private company and the types of offered genetic testing. Five private companies and three Health Insurance Companies offer DTC GT and it is provided without genetic counselling. Available tests include testing for breast cancer, tests with other health-related information (complex diseases, drug responses) and other tests (nutrigenetic, ancestry, paternity). National legislation is currently being developed and Council of Experts in Medical Genetics has issued an opinion about Genetic Testing and Commercialization of Genetic Tests in Slovenia. Despite the fact that Slovenia has signed the Additional protocol to the convention on human rights and biomedicine, concerning genetic testing for health purposes, DTC GT in Slovenia is present and against all international recommendations. There is lack of or no medical supervision, clinical validity and utility of tests and inappropriate genetic testing of minors is available. There is urgent need for regulation of ethical, legal, and social aspects. National legislation on DTC GT is being prepared.
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.
A physician-patient relationship is essential for the well-being of the patient, for without a strong and trusting relationship between both individuals, the patient may not receive the best care that they deserve. There are many legal policies and ethical principles a physician must follow when caring for a patient. It is both the legal and moral duty of the physician to act in the best interests of their patients, while making sure to respect them regardless of background and personal behaviours. The relationship is secured with both trust and respect, for without trust, the patient may hold back from stating their conditions which will result in the physician not providing them with all the care they require. Sometimes, lack of some of these key characteristics of the physician-patient relationship and other circumstances, may cause either the patient or the physician to terminate the relationship. Termination of a relationship creates a difficult situation for the patient, and therefore there are only specific situations where a physician may have permission to follow through and terminate their relationship. Both the law and ethical principles play a role in the decisions made by the physician in regards to their relationship with the patient, but regardless, the physician has the obligation to make sure their patient is receiving care by one means or another.
Neely, Erica L
Additive manufacturing has spread widely over the past decade, especially with the availability of home 3D printers. In the future, many items may be manufactured at home, which raises two ethical issues. First, there are questions of safety. Our current safety regulations depend on centralized manufacturing assumptions; they will be difficult to enforce on this new model of manufacturing. Using current US law as an example, I argue that consumers are not capable of fully assessing all relevant risks and thus continue to require protection; any regulation will likely apply to plans, however, not physical objects. Second, there are intellectual property issues. In combination with a 3D scanner, it is now possible to scan items and print copies; many items are not protected from this by current intellectual property laws. I argue that these laws are ethically sufficient. Patent exists to protect what is innovative; the rest is properly not protected. Intellectual property rests on the notion of creativity, but what counts as creative changes with the rise of new technologies.
Lemieux-Charles, L; Meslin, E M; Aird, C; Baker, R; Leatt, P
This article explores the ethical issues faced by clinicians with management responsibilities (clinician/managers) when making decisions related to resource allocation and utilization at a Canadian teaching hospital. Using a focus group method, 28 individuals participated in four homogeneous groups that included nurse managers, managers from other professional groups, and physician managers. Ethical issues that recurred throughout the discussions included fairness, concern with preventing harm, consumer/patient choice, balancing needs of different groups of patients, conflict between financial incentives and patient needs, and professional autonomy. The particular issue of conflict is analyzed from two perspectives--a theory of professional-bureaucratic roles and of obligation--that illustrate how both management and philosophical issues are related. The findings suggest that decentralizing resource allocation and utilization decisions does raise ethical issues for clinician/managers and that a better understanding of these issues can be obtained using an interdisciplinary perspective.
Ciobanu, Ionela Elisabeta; Rusu, Darian; Stratul, Stefan-Ioan; Didilescu, Andreea Cristina; Cristache, Corina Marilena
Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur.
Casey, Murray Joseph; O'Brien, Richard; Rendell, Marc; Salzman, Todd
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.
Löfström, Erika; Pyhältö, Kirsi
This study focused on exploring students' and supervisors' perceptions of ethical problems in doctoral supervision in the natural sciences. Fifteen supervisors and doctoral students in one research community in the natural sciences were interviewed about their practices and experiences in the doctoral process and supervision. We explored to what extent doctoral students and supervisors experienced similar or different ethical challenges in the supervisory relationship and analyzed how the experiences of ethical dilemmas in supervision could be understood in light of the structure and practices of natural science research groups. The data were analyzed by theory-driven content analysis. Five ethical principles, namely non-maleficence, beneficence, autonomy, fidelity and justice, were used as a framework for identifying ethical issues. The results show that one major question that appears to underpin many of the emerging ethical issues is that the supervisors and students have different expectations of the supervisory role. The second important observation is that doctoral students primarily described their own experiences, whereas the supervisors described their activities as embedded in a system and elaborated on the causes and consequences at a system level.
symptoms. However, she agrees to meet with the community treatment team. How are they to act? Should they accept her refusal of antipsychotic medication, though they see it as the best treatment? This dilemma is analysed and described according to Beauchamps and Childress four fundamental principles: 1......Through the presentation of a concrete ethical dilemma, this article presents the praxis of a clinical ethics committee in Denmark. The dilemma was analysed in the clinical ethics committee of psychiatry in the region of Southern Denmark. The dilemma is well known in psychiatry; it concerns....... the non-maleficence principle, 2. the beneficence principle, 3.the principle of autonomy and 4. the principle of justice. Common values in Danish psychiatry; respect, proficiency and responsibility are included in the description....
Abbasi, Imran Naeem
Peaceful protests and strikes are a basic human right as stated in the United Nations' universal declaration on human rights. But for doctors, their proximity to life and death and the social contract between a doctor and a patient are stated as the reasons why doctors are valued more than the ordinary beings. In Pakistan, strikes by doctors were carried out to protest against lack of service structure, security and low pay. This paper discusses the moral and ethical concerns pertaining to the strikes by medical doctors in the context of Pakistan. The author has carefully tried to balance the discussion about moral repercussions of strikes on patients versus the circumstances of doctors working in public sector hospitals of a developing country that may lead to strikes. Doctors are envisaged as highly respectable due to their direct link with human lives. Under Hippocrates oath, care of the patient is a contractual obligation for the doctors and is superior to all other responsibilities. From utilitarian perspective, doctors' strikes are justifiable only if there is evidence of long term benefits to the doctors, patients and an improvement in service delivery. Despite that, it is hard to justify such benefits against the risks to the patients. Harms that may incur to the patients include: prolongation of sufferings, irreversible damage to health, delay in treatment, death, loss of work and waste of financial resources.In a system of socialized medicine, government owing to greater control over resources and important managerial decisions should assume greater responsibility and do justice to all stakeholders including doctors as well as patients. If a doctor is underpaid, has limited options for career growth and is forced to work excessively, then not only quality of medical care and ability to act in the best interests of patients is adversely affected, it may also lead to brain drain. There is no single best answer against or in favor of doctors' industrial
Background Peaceful protests and strikes are a basic human right as stated in the United Nations’ universal declaration on human rights. But for doctors, their proximity to life and death and the social contract between a doctor and a patient are stated as the reasons why doctors are valued more than the ordinary beings. In Pakistan, strikes by doctors were carried out to protest against lack of service structure, security and low pay. This paper discusses the moral and ethical concerns pertaining to the strikes by medical doctors in the context of Pakistan. The author has carefully tried to balance the discussion about moral repercussions of strikes on patients versus the circumstances of doctors working in public sector hospitals of a developing country that may lead to strikes. Discussion Doctors are envisaged as highly respectable due to their direct link with human lives. Under Hippocrates oath, care of the patient is a contractual obligation for the doctors and is superior to all other responsibilities. From utilitarian perspective, doctors’ strikes are justifiable only if there is evidence of long term benefits to the doctors, patients and an improvement in service delivery. Despite that, it is hard to justify such benefits against the risks to the patients. Harms that may incur to the patients include: prolongation of sufferings, irreversible damage to health, delay in treatment, death, loss of work and waste of financial resources. In a system of socialized medicine, government owing to greater control over resources and important managerial decisions should assume greater responsibility and do justice to all stakeholders including doctors as well as patients. If a doctor is underpaid, has limited options for career growth and is forced to work excessively, then not only quality of medical care and ability to act in the best interests of patients is adversely affected, it may also lead to brain drain. Summary There is no single best answer against or
Sharif, Thikra; Bugo, John
The cultural background, religion and societal norms have a huge influence on the decision making process for physicians, patients and their families, when faced with medical ethical dilemmas. While the medical professionals, through their training, can rely on the principles of autonomy, justice, beneficence and non-maleficence to guide them, the patients can only draw from their personal and cultural experiences. To explore some of the challenges that face physicians when presented with ethical dilemmas. A review of the literature on the principles of medical ethics and the cultural practices of the Maasai tribe, as well as, interview, interaction and observation of the patients and family during patient. management. In the Maasai community in Kenya, where family is the center of all attention and decision-making, the listed ethical principles and rules have a very different understanding of the self-determination, and autonomy becomes collective rather than individualistic. Medical practitioners when faced with ethical medical dilemmas are neither comfortable in adopting the conventional bioethical guidelines, nor in offering a health care purely based on cultural and historical practice. In our set up, developing culturally relevant principles of bioethics appears to be the most effective solution in addressing medical ethical dilemmas.
In the efforts to develop a vaccine for human immunodeficiency virus (HIV), attention has focused on sub-Saharan Africa, where large populations at risk for HIV infection could be studied easily. Cross cultural bioethics must be examined to address the ethical implications and cultural obstacles of such research. Autonomy and informed consent are difficult to achieve in cultures with limited personal choice. In some cultures, individual personhood is secondary to social relationships in the tribe or village. Language barriers, illiteracy, and the lack of knowledge about modern science all make it difficult to adequately inform participants. While the Helsinki Declaration emphasizes that a subject's well-being takes precedence over the interests of science and society, health policy decisions in nonautonomous populations often place state interests over the individual. Political sensitivities have been aroused by attempts to attribute the origin of AIDS to western or central Africa, leading political controversy and discrimination against Africans. Foreign researchers often exclude African participation once they have obtained the body fluid samples for study. Without joint collaboration and education, human research in developing countries can easily become exploitative. Justice dictates that research subjects be chosen for scientific reasons, not due to easy availability or ability to be manipulated. In vaccine development, Africans should not experience a disproportionate amount of risk without an equal share in the benefits. Furthermore, malnutrition, malaria, tuberculosis, and many other diseases present more urgent health problems to the developing world than AIDS. The health care priorities of the developing nations must be considered.
Gasparyan, Armen Yuri; Yessirkepov, Marlen; Diyanova, Svetlana N; Kitas, George D
Publishing scholarly articles in traditional and newly-launched journals is a responsible task, requiring diligence from authors, reviewers, editors, and publishers. The current generation of scientific authors has ample opportunities for publicizing their research. However, they have to selectively target journals and publish in compliance with the established norms of publishing ethics. Over the past few years, numerous illegitimate or predatory journals have emerged in most fields of science. By exploiting gold Open Access publishing, these journals paved the way for low-quality articles that threatened to change the landscape of evidence-based science. Authors, reviewers, editors, established publishers, and learned associations should be informed about predatory publishing practices and contribute to the trustworthiness of scholarly publications. In line with this, there have been several attempts to distinguish legitimate and illegitimate journals by blacklisting unethical journals (the Jeffrey Beall's list), issuing a statement on transparency and best publishing practices (the Open Access Scholarly Publishers Association's and other global organizations' draft document), and tightening the indexing criteria by the Directory of Open Access Journals. None of these measures alone turned to be sufficient. All stakeholders of science communication should be aware of multiple facets of unethical practices and publish well-checked and evidence-based articles.
Devor, Marshall; Rappaport, Isabelle; Rappaport, Z Harry
Pain has variously been used as a means of punishment, extracting information, or testing commitment, as a tool for education and social control, as a commodity for sacrifice, and as a draw for sport and entertainment. Attitudes concerning these uses have undergone major changes in the modern era. Normative convictions on what is right and wrong are generally attributed to religious tradition or to secular-humanist reasoning. Here, we elaborate the perspective that ethical choices concerning pain have much earlier roots that are based on instincts and brain-seated empathetic responses. They are fundamentally a function of brain circuitry shaped by processes of Darwinian evolution. Social convention and other environmental influences, with their idiosyncrasies, are a more recent, ever-changing overlay. We close with an example in which details on the neurobiology of pain processing, specifically the question of where in the brain the experience of pain is generated, affect decision making in end-of-life situations. By separating innate biological substrates from culturally imposed attitudes (memes), we may arrive at a more reasoned approach to a morality of pain prevention. © 2014 World Institute of Pain.
James D. Harrison
Full Text Available The aim of this study was to identify global health ethical issues that health professional trainees may encounter during electives or placements in resource-limited countries. We conducted a qualitative study involving focus groups and an interview at the University of California San Francisco. Participants were multi-professional from the Schools of Medicine, Nursing and Pharmacy and had experience working, or teaching, as providers in resource-limited countries. Eighteen participants provided examples of ethical dilemmas associated with global-health outreach work. Ethical dilemmas fell into four major themes relating to (1 cultural differences (informed consent, truth-telling, autonomy; (2 professional issues (power dynamics, training of local staff, corruption; (3 limited resources (scope of practice, material shortages; (4 personal moral development (dealing with moral distress, establishing a moral compass, humility and self awareness. Three themes (cultural differences, professional issues, limited resources were grouped under the core category of “external environmental and/or situational issues” that trainees are confronted when overseas. The fourth theme, moral development, refers to the development of a moral compass and the exercise of humility and self-awareness. The study has identified case vignettes that can be used for curriculum content for global-health ethics training.
Harrison, James D.; Logar, Tea; Le, Phuoc; Glass, Marcia
The aim of this study was to identify global health ethical issues that health professional trainees may encounter during electives or placements in resource-limited countries. We conducted a qualitative study involving focus groups and an interview at the University of California San Francisco. Participants were multi-professional from the Schools of Medicine, Nursing and Pharmacy and had experience working, or teaching, as providers in resource-limited countries. Eighteen participants provided examples of ethical dilemmas associated with global-health outreach work. Ethical dilemmas fell into four major themes relating to (1) cultural differences (informed consent, truth-telling, autonomy); (2) professional issues (power dynamics, training of local staff, corruption); (3) limited resources (scope of practice, material shortages); (4) personal moral development (dealing with moral distress, establishing a moral compass, humility and self awareness). Three themes (cultural differences, professional issues, limited resources) were grouped under the core category of “external environmental and/or situational issues” that trainees are confronted when overseas. The fourth theme, moral development, refers to the development of a moral compass and the exercise of humility and self-awareness. The study has identified case vignettes that can be used for curriculum content for global-health ethics training. PMID:27417631
Ismail, Heba M; Rincon, Marielisa
Our objective is to present the first case report of X-linked adrenal hypoplasia congenita in a child conceived by a donated egg and which also presented atypically, with initial mineralocorticoid deficiency. Case report with literature review. A late preterm fraternal twin male, conceived by in vitro fertilization of donated eggs, presented shortly after birth with feeding intolerance, hyponatremia, and hyperkalemia. Testing revealed a low aldosterone level, high plasma renin activity, normal cortisol level, and normal 17-hydroxyprogesterone level. He was diagnosed with 18-hydroxylase deficiency based on low 18-hydroxycorticosterone levels and was treated with mineralocorticoid successfully for 17 months. At age 18 months, he presented with dehydration secondary to herpetic gingivostomatitis and was found to be hypoglycemic, hyponatremic, hyperkalemic, and acidotic, with a low serum cortisol level. An adrenocorticotropic hormone (ACTH) stimulation test revealed low levels of all adrenal cortex products, with an elevated ACTH level. He was started on glucocorticoids. Genetic testing confirmed X-linked adrenal hypoplasia congenita (AHC). His asymptomatic fraternal twin underwent genetic testing and the results were negative. The fertility center records indicated that the mother had donated eggs to other families, but none of the children were known to have this disorder. The egg donor was informed but did not pursue genetic testing. We report a case of X-linked AHC presenting in the context of extraordinary ethical considerations. Our case raises a question unique to the era of assisted reproduction: should routine genetic screening of gamete donors be done for rare but potentially life-threatening conditions?
What is a security dilemma? What are the consequences of security dilemmas in international politics?......What is a security dilemma? What are the consequences of security dilemmas in international politics?...
Resnik, David B.; MacDougall, D. Robert; Smith, Elise M.
Various U.S. laws, such as the Clean Air Act and the Food Quality Protection Act, require additional protections for susceptible subpopulations who face greater environmental health risks. The main ethical rationale for providing these protections is to ensure that environmental health risks are distributed fairly. In this article, we (1) consider how several influential theories of justice deal with issues related to the distribution of environmental health risks; (2) show that these theories often fail to provide specific guidance concerning policy choices; and (3) argue that an approach to public decision making known as accountability for reasonableness can complement theories of justice in establishing acceptable environmental health risks for the general population and susceptible subpopulations. Since accountability for reasonableness focuses on the fairness of the decision-making process, not the outcome, it does not guarantee that susceptible subpopulations will receive a maximum level of protection, regardless of costs or other morally relevant considerations. PMID:29466133
Dijkstra, Jacob; van Assen, Marcel A.L.M.
We develop a new paradigm to study social dilemmas, called exchange dilemmas. Exchange dilemmas arise from externalities of exchanges with third parties, and many real-life social dilemmas are more accurately modeled as exchange dilemmas rather than prisoner's dilemmas. Building on focusing and
Dijkstra, J.; van Assen, M.A.L.M.
We develop a new paradigm to study social dilemmas, called exchange dilemmas. Exchange dilemmas arise from externalities of exchanges with third parties, and many real-life social dilemmas are more accurately modeled as exchange dilemmas rather than prisoner's dilemmas. Bulding on focusing and
McCormick, Donald W.
Discusses ethical dilemmas that professors face in the classroom, drawing on three examples involving students: (1) discussing the illegal activities of an employer; (2) participating in politically controversial military activities; and (3) making racist comments. Argues that academic and professional organizations should issue codes of ethics…
Full Text Available Business leaders frequently face dilemmas, circumstances where whatever course of action they choose, something of important value will be offended. How can an organisation prepare its decision makers for such situations? This article presents a pedagogical approach to dilemma training for business leaders and managers. It has evolved through ten years of experience with human resource development, where ethics has been an integral part of programs designed to help individuals to become excellent in their professional roles. The core element in our approach is The Navigation Wheel, a figure used to keep track of relevant decision factors. Feedback from participants indicates that dilemma training has helped them to recognise the ethical dimension of leadership. They respond that the tools and concepts are highly relevant in relation to the challenges that occur in the working environment they return to after leadership training.http://dx.doi.org/10.5324/eip.v6i1.1778
Blanco, Pedro J.; Sheely-Moore, Angela I.
Child-centered play therapists are often confronted with the challenge of receiving gifts from clients. This article highlights recommended strategies when faced with gift receiving, exemplified by actual ethical dilemmas encountered by child-centered play therapists. Ethical and therapeutic considerations of therapist gift giving to child clients…
Discusses some of the ethical dilemmas faced by writers who prepare marketing materials in engineering organizations. Describes social, political, economic, and legal changes in the professions during the last 30 years and the growing influence of market-driven decisions on ethical decision making. (PRA)
Dijkstra, J.; van Assen, M.A.L.M.
We develop a new paradigm to study social dilemmas, called exchange dilemmas. Exchange dilemmas arise from externalities of exchanges with third parties, and many real-life social dilemmas are more accurately modeled as exchange dilemmas rather than prisoner's dilemmas. Bulding on focusing and framing research we predict that defection is omnipresent in exchange dilemmas, which is corroborated in to very different experiments. Our results suggest that the fundamental problem of cooperation in...
Rabadán, Alejandra T; Tripodoro, Vilma A
In healthcare, an ethical concern that arises during the decision making process is considered to be a bioethical dilemma. It is often the case that in the absence of proper deliberation, the problem is transferred to a bioethics committee, not even representing precisely a dilemma. Bioethics emerged as a discipline in the mid-20th century. It is defined as a support to decision-making in ethical dilemmas centered on two aspects: ethics of clinical investigation, focused on protecting the rights of research subjects, and bioethics in medical practice, of an advisory nature. To recognize the difference among difficult or complex clinical circumstances and ethical dilemmas could allow knowing when it is necessary to request for advice of a committee. It is not so much a question of deciding what is right or wrong, but which is the most advisable solution to a problem. We review the history of Bioethics Committees in Argentina that are facing today the challenge of promoting social responsibility and opening deliberations to community and health professionals. In the 20th century two historical moments are recognized: a pioneering and slow first period, and a second one of legal regulatory framework. Considering deliberation as a method of ethics, this article proposes a case analysis procedure and the deliberative method to elucidate dilemmas, with or without the help of a Committee.
Alejandra T Rabadán
Full Text Available In healthcare, an ethical concern that arises during the decision making process is considered to be a bioethical dilemma. It is often the case that in the absence of proper deliberation, the problem is transferred to a bioethics committee, not even representing precisely a dilemma. Bioethics emerged as a discipline in the mid-20th century. It is defined as a support to decision-making in ethical dilemmas centered on two aspects: ethics of clinical investigation, focused on protecting the rights of research subjects, and bioethics in medical practice, of an advisory nature. To recognize the difference among difficult or complex clinical circumstances and ethical dilemmas could allow knowing when it is necessary to request for advice of a committee. It is not so much a question of deciding what is right or wrong, but which is the most advisable solution to a problem. We review the history of Bioethics Committees in Argentina that are facing today the challenge of promoting social responsibility and opening deliberations to community and health professionals. In the 20th century two historical moments are recognized: a pioneering and slow first period, and a second one of legal regulatory framework. Considering deliberation as a method of ethics, this article proposes a case analysis procedure and the deliberative method to elucidate dilemmas, with or without the help of a Committee.
Loh, Winnie Y; Butow, Phyllis N; Brown, Richard F; Boyle, Frances
Informed consent has been proposed as the optimal method for ensuring the ethical entry of patients into clinical trials. However, it is known that problems with informed consent exist from the perspective of both patients and physicians. This has led to the suggestion that a third party, such as a research nurse or data manager, should be responsible for obtaining informed consent. The objective of this study was to explore the views of data managers concerning the nature, challenges, and rewards of their role and the similarities and differences between their role and that of physicians in obtaining informed consent. Four focus groups in three large teaching hospitals were conducted. Twenty-one data managers who were involved in cancer or pain clinical trials participated. The focus groups were audiotaped, transcribed, and subjected to content analysis to identify themes. Data managers identified three primary roles complementary to that of physicians: information provision, quality assurance of the informed consent process, and ongoing support during the trial. Despite expressed concern that medical and drug company interests may lead to subtle coercion of the patient, participants did not support the notion that they may be solely responsible for the consent process. Participants described a range of ethical dilemmas they confronted, including patients asking them for medical details they could not provide and situations in which they felt that informed consent was compromised in some way, for example, dealing with situations in which the patient appeared to be entering the trial for the wrong reasons due to misunderstanding, need, or passivity. Effective functioning of the multidisciplinary team assisted data managers in performing their role. A range of training needs were identified, particularly communication skills training and trial start-up briefing. The issues raised by these data managers have important implications for the successful conduct of
Garcia, E.; Timmermans, D.R.; Leeuwen, E. van
In contrast to most Western countries, routine offer of prenatal screening is considered problematic in the Netherlands. The main argument against offering it to every pregnant woman is that women would be brought into a moral dilemma when deciding whether to use screening or not. This paper
Dukewich, Kristie R.; Wood, Suzanne
Educators are regularly confronted with moral dilemmas for which there are no easy solutions. Increasing course sizes and program enrolments, coupled with a new consumerist attitude towards education, have only further exacerbated the quantity and quality of students' requests for special academic consideration (Macfarlane, 2004). Extensions, late…
Garcia Gonzalez, M.E.; Timmermans, D.R.M.; Leeuwen, van E.
In contrast to most Western countries, routine offer of prenatal screening is considered problematic in the Netherlands. The main argument against offering it to every pregnant woman is that women would be brought into a moral dilemma when deciding whether to use screening or not. This paper
Peirce, Anne Griswold; Smith, Jennifer A
Ethical questions dealt with by nurses who have Doctor of Nursing Practice (DNP) degrees include traditional bioethical questions, but also business and legal ethics. Doctorally prepared nurses are increasingly in positions to make ethical decisions rather than to respond to decisions made by others. The traditional master's-degree advanced practice nursing curriculum does not address the extended expertise and decision-making skills needed by DNP practitioners as they face these new types of ethical dilemmas. We propose that a curricular framework that addresses clinical, research, business, and legal ethics is needed by all DNP students.
Bellver Capella, Vicente
If the prediction of some scientists comes true, then we are only few years away from the appearance of the first generation of human beings who will be able to add one year to each remaining year of life expectancy. Faced with this possibility, it seems appropriate to give thought to the public policies that should be adopted. It is better to anticipate the various future scenarios than react to a reality which is a fait accompli. To date, the debate has mainly focused on the ethical question: is it good or bad for us humans to achieve immortal life? Until now, neither legal guidelines at State level nor those of international organisations which deal with bioethical issues have concerned themselves with this matter. But before discussing policies, two other matters should be addressed: first, to show how the prolongation of human life can be as much the unwanted outcome of legitimate efforts in search of healthy aging, as one of the aims of the post-humanist project; second, to present the most consistent and shared ethical reasons for rejecting the human immortality project.
Behavioral big data (BBD) refers to very large and rich multidimensional data sets on human and social behaviors, actions, and interactions, which have become available to companies, governments, and researchers. A growing number of researchers in social science and management fields acquire and analyze BBD for the purpose of extracting knowledge and scientific discoveries. However, the relationships between the researcher, data, subjects, and research questions differ in the BBD context compared to traditional behavioral data. Behavioral researchers using BBD face not only methodological and technical challenges but also ethical and moral dilemmas. In this article, we discuss several dilemmas, challenges, and trade-offs related to acquiring and analyzing BBD for causal behavioral research.
Rolando Montero Díaz
Full Text Available A review on the ethical dilemmas in the diagnosis of hypertension and some elements in the emergence of the bioethics concept was performed. Ethical conflicts that appear at each stage of diagnosis of hypertension: at the time of providing the information, at the point of indication and performance of diagnostic tests, when communicating the diagnosis and during subsequent decision making were identified. We conclude that technological development will introduce new ethical decisions in the diagnosis of hypertension that will increasingly involve the interests of society and create, in one way or another, ethical and moral conflict in the decision making process.Se realizó una revisión sobre los dilemas éticos en el diagnóstico de la hipertensión arterial, así como de algunos elementos en el surgimiento del concepto de bioética. Se identificaron los conflictos éticos que aparecen en cada etapa del diagnóstico de la hipertensión arterial: en el momento de suministrar la información, en el instante de la indicación y realización de las pruebas diagnósticas, en la comunicación del diagnóstico y en la toma de decisiones posteriores. Se concluye que el desarrollo tecnológico va a introducir nuevas decisiones éticas en el diagnóstico de la hipertensión arterial que van a involucrar cada vez más los intereses de la sociedad y crear de una manera u otra conflictos éticos y morales en la toma de decisiones.
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 principles where the foundation for ethical conduct is either emotion or reason. The article investigates the ethical potential of bureaucracy and aims to contribute to sociological debates about e...
Practitioner impairment occurs when a physical, mental or substance-related disorder interferes with his or her ability to engage in professional activities competently and safely. The Health Professions Council of South Africa makes reporting of impaired colleagues and students mandatory. The ethical dilemma faced by ...
Shivneil Kumar Raj
Full Text Available Decisions are made daily in businesses and individuals do encounter situations where they are faced with ethical issues. The subject is how one evaluates whether an act is ethical or unethical. This research article discusses real life ethical dilemmas that could be faced in accounting or business environment and applicability of various theories of ethics that were taught in accounting theory course in the undergraduate accounting program. The researcher employs a number of case studies highlighting the stories related to ethics that have been experienced in the past working life. Teleological and deontological theories are being used to explain how one could identify that a particular act is ethical or unethical. The work of accountants requires them to maintain high level of ethics to ensure integrity of the profession.
Campbell, Madeleine L H
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. Copyright © 2013 The Author. Published by Elsevier Ltd.. All rights reserved.
Manning, S S
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.
Van Niekerk, Leesa Micole; Martin, Frances
A survey of 1,015 Australian registered nurses found that those who felt adequately consulted by physicians were significantly more likely to initiate consultation. Nurses dissatisfied with their relationship with physicians were more likely to experience ethical conflicts related to pain management. Level of satisfaction with this relationship…
Cameron, Robyn Ann; O'Leary, Conor
Ethical instruction is critical in accounting education. However, does accounting ethics teaching actually instil core ethical values or simply catalogue how students should act when confronted with typical accounting ethical dilemmas? This study extends current literature by distinguishing between moral/ethical and legal/ethical matters and then…
Sessums, Laura L; Collen, Jacob F; O'Malley, Patrick G; Jackson, Jeffery L; Roy, Michael J
The Global War on Terrorism brings significant ethical challenges for military physicians. From Abu Ghraib to Guantanamo Bay, the actions of health care providers have come under considerable scrutiny. Military providers have dual roles as military officers and medical professionals, which have the potential to come into conflict. Often they are inadequately prepared to manage this conflict. We review pertinent historical precedents, applicable laws, ethical guidelines, and military regulations. We also present examples of ethical challenges deployed clinicians have faced and their ethical solution. Finally, we propose a practical strategy to educate physicians on how to manage complex ethical dilemmas in war time settings.
Solihu, Abdul Kabir Hussain; Ambali, Abdul Rauf
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.
Nurse administrators are in a position to encounter ethical dilemmas when evaluating philanthropic proposals. Nurses may have little formal training in ethics, or they may be most experienced with ethical frameworks that apply primarily to clinical patient encounters. Gifts of goods, services, education, or other benefits to nurses may create ethical dilemmas. Philanthropic ethics and potential dilemmas are discussed in nonnursing professions such as medicine and nonprofit administration but rarely explored in the nursing administration context. Nurse administrators in a position to evaluate generous offers of philanthropy should identify key components to fully assess the ethics of their receipt. A survey of several resources is done to provide nurse administrators with the foundation to develop policies related to philanthropy if they are absent, preferably in advance of the offer. Recommendations for assessment and evaluation of philanthropic proposals are provided to aid nurse administrators in their synthesis and application of ethical principles from multiple sources.
Habgood, J S
All ethics has a religious dimension. This paper considers how specific Christian insights concerning death, suffering, human nature and human creatureliness can help to expose more fully the moral issues at stake in some of the dilemmas faced by doctors. It ends by acknowledging the crushing burden of decision-making which rests on many in the medical profession, and indicates the importance of religious resources in dealing with this. PMID:3981562
Cedo, Kelli M.; Dickerson, William E.
This case study creates a dilemma that many school districts face. Public education is under-funded. Principals are expected to be the instructional leaders and are held accountable for student achievement. Is it appropriate then for public schools to have local businesses as benefactors when teaching personnel are involved? The conflict between…
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.
Jacob Dahl Rendtorff
Full Text Available Recently, the developments of ethics and politics in the Arctic region have again become an issue for international discussion. One main issue is the problem of climate change and sustainability of the Arctic region. This problem is linked to the issue of exploitation of natural resources in the Arctic region, not at least in Greenland. Indeed, the general issue is how we should define ethics of the environment and sustainability as a general principle for the Arctic region. It is important to discuss what is at stake and how we define the problem in relation to the different participating stakeholders. This paper deals with these problems as a case for global ethics and it proposes a vision of ethical and political responsibility for sustainable development in order to deal with such problems.
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
Kramer, Shira; Soskolne, Colin L
This review integrates historical developments and key events in bringing ethics into epidemiology in general and into environmental epidemiology in particular. The goal is to provide context for and discern among the various approaches and motivations that drive the need for ethical conduct in support of the public interest. The need for ethics guidelines in epidemiology is different from developments in other biomedical-related fields by virtue of its focus on populations rather than on individuals. The need for ethics guidelines in environmental epidemiology as a subspecialty of epidemiology stems from the larger scale of its mission than that of epidemiology per se. Ethics guidelines in the field of environmental epidemiology have been established. They articulate not only the profession's core values and mission, but more specifically, they address the environmental epidemiologist's obligations to the participants in research, to colleagues, and to employers. They are the product of consensus, scholarship, and diligent stewardship over several decades. The next challenge is ensuring their value and impact. The forces that support professional and institutional success, and the power of special interests, are the major threats to achieving the goals of ethical conduct and research for the public good. In environmental epidemiology, these threats have global implications.
The continuous inclusion of new technologies in organizations challenges business ethics and creates new problematics in work life. Managers in particular are challenged insofar as they must learn how to adapt general technological hardware to local organizational needs and work habits. Based......? Using a techno-human practice approach—which takes into account both human and non-human entities as the basis of moral judgment—the new technologically-induced ethical dilemmas faced by managers are discussed. A typology of techno-ethics is introduced, which presents situated ways of engaging...... with technologies in businesses. By employing multiple ethics connected to the use of technologies in organizations might make managers more ethically responsible in decisions concerning technologies....
Pillalamarri, Sudarshan Kumar; Holm, Claus
that novice accounting students cannot differentiate between these two types of reasoning, but would exhibit order effects while making ethical decisions. One hundred forty graduate accounting students from universities in Denmark respond to an audit-specific DIT instrument, measuring prescriptive...... investigates the order effects of presentation of dilemmas on ethical decision making ability of novice and experienced accounting students. Rest (1979, 1983, 1991) categorizes moral reasoning into prescriptive reasoning i.e. consideration of what should ideally be done to resolve a particular ethical dilemma...... and deliberative reasoning i.e. consideration of what would actually be done in resolving ethical dilemmas. Because of lack of work experience, novice accounting students often do not face scenarios where there is a difference between their prescriptive and deliberative reasoning. This study hypothesizes...
Mortensen, Kristine Køhler; Brotherton, Chloe
for the face the be put into action. Based on an ethnographic study of Danish teenagers’ use of SnapChat we demonstrate how the face is used as a central medium for interaction with peers. Through the analysis of visual SnapChat messages we investigate how SnapChat requires the sender to put an ‘ugly’ face...... already secured their popular status on the heterosexual marketplace in the broad context of the school. Thus SnapChat functions both as a challenge to beauty norms of ‘flawless faces’ and as a reinscription of these same norms by further manifesting the exclusive status of the popular girl...
Kuhnert, Barbara; Lindner, Felix; Bentzen, Martin Mose
We introduce causal agency models as a modeling technique for representing and reasoning about ethical dilemmas. We find that ethical dilemmas, although they look similar on the surface, have very different causal structures. Based on their structural properties, as identified by the causal agency...... models, we cluster a set of dilemmas in Type 1 and Type 2 dilemmas. We observe that for Type 2 dilemmas but not for Type 1 dilemmas a utilitarian action dominates the possibility of refraining from action. Hence, we hypothesize, based on the model, that Type 2 dilemmas are perceived as less difficult...
The changing context of medical practice--bureaucratic, political, or economic--demands that doctors have the knowledge and skills to face these new realities. Such changes impose obstacles on doctors delivering ethical care to vulnerable patient populations. Modern medical ethics education requires a focus upon the knowledge and skills necessary to close the gap between the theory and practice of ethical care. Physicians and doctors-in-training must learn to be morally sensitive to ethical dilemmas on the wards, learn how to make professionally grounded decisions with their patients and other medical providers, and develop the leadership, dedication, and courage to fulfill ethical values in the face of disincentives and bureaucratic challenges. A new core focus of medical ethics education must turn to learning how to put ethics into practice by teaching physicians to realistically negotiate the new institutional maze of 21st-century medicine.
Fox-Wolfgramm, Susan J.
This paper presentation will focus on the application of self leadership and strategic management concepts to help make sense of the current global financial crisis and its critical connection with our future business professionals' perceptions of ethical behavior. The author will explore ideas that lead to the strengthening of business students'…
Silva, Terezinha Nunes da; Freire, Maria Eliane Moreira; Vasconcelos, Monica Ferreira de; Silva Junior, Sergio Vital da; Silva, Wilton José de Carvalho; Araújo, Patrícia da Silva; Eloy, Allan Victor Assis
to investigate nursing professionals' understanding concerning the Code of Ethics; to assess the relevance of the Code of Ethics of the nursing profession and its use in practice; to identify how problem-solving is performed when facing ethical dilemmas in professional practice. exploratory descriptive study, conducted with 34 (thirty-four) nursing professionals from a teaching hospital in João Pessoa, PB - Brazil. four thematic categories emerged: conception of professional ethics in nursing practice; interpretations of ethics in the practice of care; use of the Code of Ethics in the professional practice; strategies for solving ethical issues in the professional practice. some of the nursing professionals comprehend the meaning coherently; others have a limited comprehension, based on jargon. Therefore, a deeper understanding of the text contained in this code is necessary so that it can be applied into practice, aiming to provide a quality care that is, above all, ethical and legal.
Prock, Valencia N., Ed.; And Others
A variety of ethical issues confronting the nursing profession are examined in these proceedings. The following papers are presented: (1) "Ethics: Care & Conflict," by Leah Curtin; (2) "The Interface of Politics and Ethics in Nursing," by Mila Aroskar; (3) "Pluralistic Ethical Decision-Making," by Rita Payton; (4)…
Muñoz, Yupanqui J.; El-Hani, Charbel N.
Video games, as technological and cultural artifacts of considerable influence in the contemporary society, play an important role in the construction of identities, just as other artifacts (e.g., books, newspapers, television) played for a long time. In this paper, we discuss this role by considering video games under two concepts, othering and technopoly, and focus on how these concepts demand that we deepen our understanding of the ethics of video games. We address here how the construction of identities within video games involves othering process, that is, processes through which, when signifying and identifying `Ourselves', we create and marginalize `Others'. Moreover, we discuss how video games can play an important role in the legitimation of the technopoly, understood as a totalitarian regime related to science, technology and their place in our societies. Under these two concepts, understanding the ethics of video games goes beyond the controversy about their violence. The main focus of discussion should lie in how the ethics of video games is related to their part in the formation of the players' citizenship. Examining several examples of electronic games, we consider how video games provide a rich experience in which the player has the opportunity to develop a practical wisdom ( phronesis), which can lead her to be a virtuous being. However, they can be also harmful to the moral experiences of the subjects when they show unethical contents related to othering processes that are not so clearly and openly condemned as violence, as in the cases of sexism, racism or xenophobia. Rather than leading us to conclude that video games needed to be banned or censored, this argument makes us highlight their role in the (science) education of critical, socially responsible, ethical, and politically active citizens, precisely because they encompass othering processes and science, technology, and society relationships.
Altınörs, Nur; Haberal, Mehmet
The aim of this study was to review and discuss the great variety of ethical issues related to organ donation, organ procurement, transplant activities, and new ethical problems created as a result of technologic and scientific developments. An extensive literature survey was made, and expert opinions were obtained. The gap between demand and supply of organs for transplant has yielded to organ trafficking, organ tourism, and commercialism. This problem seems to be the most important issue, and naturally there are ethical dilemmas related to it. A wide number of ideas have been expressed on the subject, and different solutions have been proposed. The struggle against organ trafficking and commercialism should include legislation, efforts to increase deceased-donor donations, and international cooperation. China's policy to procure organs from prisoners sentenced to death is unethical, and the international community should exert more pressure on the Chinese government to cease this practice. Each particular ethical dilemma should be taken separately and managed.
Leever, Martin G.; DeCiani, Gina; Mulaney, Ellen; Hasslinger, Heather; Gambrill, Eileen
Noting that child welfare professionals can improve the quality and integrity of the services they provide if they develop ethical decision making skills, this book provides child welfare administrators and caseworkers with a framework for assessing ethical dilemmas, making sound ethical decisions, and delivering services with integrity to…
Bon, Susan C.; Bigbee, Adam J.
Special education teachers who also serve as case managers for students with disabilities are in unique leadership positions in which they face complex ethical dilemmas and are called on to make decisions that involve multiple competing interests and pressures. The purpose of this study was to explore how special education leaders identify ethical…
Yang, Jin; Arant, David
This study compares how American and Chinese journalism students view the importance of various journalistic roles and the difficulties of ethical dilemmas faced by journalists. Chinese students perceive greater difficulty in resolving conflict of interests and making a fair representation of the news while American students find greater…
Voepel-Lewis, Terri; Zikmund-Fisher, Brian J; Smith, Ellen Lavoie; Zyzanski, Sarah; Tait, Alan R
Despite parents' stated desire to treat pain in their children, recent studies have critiqued their underuse of prescribed analgesics to treat pain in their children after painful procedures. Parents' analgesic preferences, including their perceived importance of providing pain relief or avoiding adverse drug effects may have important implications for their analgesic decisions, yet no studies have evaluated the influence of preferences on decisions to withhold prescribed opioids for children. We prospectively explored how parents' preferences influenced decisions to withhold prescribed opioids when faced with hypothetical dilemmas and after hospital discharge. Prospective Observational Study Design: Phase 1 included hypothetical analgesic decisions and Phase 2, real analgesic decisions after hospital discharge. Large tertiary care pediatric hospital in the Midwest of the United States. Five-hundred seven parents whose children underwent a painful surgical procedure requiring an opioid prescription were included. At baseline, parents completed surveys assessing their pain relief preference (i.e., their rated importance of pain relief relative to adverse drug event avoidance), preferred treatment thresholds (i.e., pain level at which they would give an opioid), adverse drug event understanding, and hypothetical trade-off decisions (i.e., scenarios presenting variable pain and adverse drug event symptoms in a child). After discharge, parents recorded all analgesics they gave their child as well as pain scores at the time of administration. Higher preference to provide pain relief (over avoid analgesic risk) lessened the likelihood that parents would withhold the prescribed opioid when adverse drug event symptoms were present together with high pain scores in the hypothetical scenarios. Additionally, higher preferred treatment thresholds increased the likelihood of parents withholding opioids during their hypothetical decision-making as well as at home. The strong
Benninga, Jacques S.
Although ethical dilemmas are a constant in teachers' lives, the profession has offered little in the way of training to help teachers address such issues. This paper presents a framework, based on developmental theory, for resolving professional ethical dilemmas. The Four-Component Model of Moral Maturity, when used in conjunction with a…
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. 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. 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. 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.
Fullerton, Jami A.; Kendrick, Alice; McKinnon, Lori Melton
A national survey of 1,045 advertising students measured opinions about the ethical nature of advertising and ethical dilemmas in the advertising business. More than nine out of ten students agreed that working for a company with high ethical standards was important. Students rated all twelve workplace dilemmas presented as somewhat unethical. For…
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)
Pellegrino, Edmund D
In this brief annual review of ethical issues in medicine, Pellegrino focuses on two issues, AIDS and surrogate mothers. The AIDS epidemic has generated debate over public health needs vs. individual rights, modification of sexual practices, screening programs to detect infected persons, confidentiality of test results, experimental therapies, and the duty of physicians to care for AIDS patients. Surrogate motherhood arrangements have become one of the more controversial of the new reproductive technologies. The publicity that accompanied the custody battle over New Jersey's "Baby M" intensified debate over the commercialization of childbearing and the regulation of reproduction. Pellegrino concludes that physicians, along with ethicists and policymakers, have an obligation to "lead society in careful and judicious deliberation" of the ethical issues raised by AIDS and by reproductive technologies.
We discuss the governing forces for analytics, especially concerning citizens' behaviours and their transactions, that depend on which of three spheres of operation an institution is in (corporate, public sector/government and academic). We argue that aspirations and missions also differ by sphere even as digital spaces have drawn these spheres ever closer together. We propose that citizens' expectations and implicit permissions for any exploitation of their data require the perception of a fair balance of benefits, which should be transparent (accessible to citizens) and justifiable. We point out that within the corporate sphere most analytics does not concern identity, targeted marketing nor any direct interference with individual citizens; but instead it supports strategic decision-making, where the data are effectively anonymous. With the three spheres we discuss the nature of models deployed in analytics, including 'black-box' modelling uncheckable by a human mind, and the need to track the provenance and workings or models. We also examine the recent evolution of personal data, where some behaviours, or tokens, identifying individuals (unique and yet non-random) are partially and jointly owned by other individuals that are themselves connected. We consider the ability of heavily and lightly regulated sectors to increase access or to stifle innovation. We also call for clear and inclusive definitions of 'data science and analytics', avoiding the narrow claims of those in technical sub-sectors or sub-themes. Finally, we examine some examples of unethical and abusive practices. We argue for an ethical responsibility to be placed upon professional data scientists to avoid abuses in the future.This article is part of the themed issue 'The ethical impact of data science'. © 2016 The Author(s).
Zhu, Qin; Jesiek, Brent K
This paper begins by reviewing dominant themes in current teaching of professional ethics in engineering education. In contrast to more traditional approaches that simulate ethical practice by using ethical theories to reason through micro-level ethical dilemmas, this paper proposes a pragmatic approach to ethics that places more emphasis on the practical plausibility of ethical decision-making. In addition to the quality of ethical justification, the value of a moral action also depends on its effectiveness in solving an ethical dilemma, cultivating healthy working relationships, negotiating existing organizational cultures, and achieving contextual plausibility in everyday professional practice. This paper uses a cross-cultural ethics scenario to further elaborate how a pragmatic approach can help us rethink ethical reasoning, as well as ethics instruction and assessment. This paper is expected to be of interest to educators eager to improve the ability of engineers and other professional students to effectively and appropriately deal with the kinds of everyday ethical issues they will likely face in their careers.
Dauchy, Sarah; Charles, Cécile; Vérotte, Nelly; Block, Véronique; Adam, Virginie
Caregivers can find themselves faced with a refusal of nursing care. A number of questions are then raised. While it is firstly important to understand the reasons for this refusal and what is at stake for the patient, there are a number of nursing strategies in place, not least of all dialogue and analysis. The role of the multi-disciplinary team is essential in such situations. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Scaturo, Douglas J
The transtheoretical nature of fundamental dilemmas in contemporary psychotherapy is explored. The basic distinction between technical and ethical dilemmas in clinical practice is discussed, as well as the ramifications for the psychotherapist. Clinical dilemmas identified by survey research studies and interviews with master psychotherapists are reviewed. In addition to dilemmas relevant to circumscribed areas of psychotherapy, such as brief therapy, managed mental health care, sexual questions, feminist therapy, dilemmas fundamental to the psychotherapeutic process as a whole are examined. Finally, clinical examples are provided that include such issues as hospitalization of the suicidal patient, dealing with known contraindications, treating the intractable patient, and self-care of the psychotherapist.
Based on the analysis of the various immoral phenomena caused by some people′s ill-treatment towards good deeds,starting from the moral options of utilitarianism as well as the ineffectiveness of the moral law,the paper critically analyzed the ethical dilemma in contemporary society,and proposed relevant measures to solve current moral problems.%分析各种＂善有恶报＂的不道德现象,从功利主义的道德选择和道德律令的失效着手,深入剖析当今社会的伦理困境,在此基础上提出解决现存道德问题的相应对策。
Most forensic psychiatrists occasionally face complex situations in forensic work in which ethics dilemmas cause discomfort. They want to determine the most ethical action, but the best choice is unclear. Fostering justice is primary in forensic roles, but secondary duties such as traditional biomedical ethics and personal values like helping society, combating racism, and being sensitive to cultural issues can impinge on or even outweigh the presumptive primary duty in extreme cases. Similarly, in treatment the psychiatrists' primary duty is to patients, but that can be outweighed by secondary duties such as protecting children and the elderly or maintaining security. The implications of one's actions matter. In forensic work, if the psychiatrist determines that he should not assist the party who wants to hire him, despite evidence clearly supporting its side, the only ethical option becomes not to accept the case at all, because the evidence does not support the better side. Sometimes it can be ethical to accept cases only for one side. In ethics-related dilemmas, I call the method of prioritizing and balancing all types of conflicting principles, duties, and personal and societal values in a dialectic to resolve conflicts among them dialectical principlism. This approach is designed to help determine the most ethical action. It is aspirational and is not intended to get the psychiatrist into trouble. © 2015 American Academy of Psychiatry and the Law.
Diane E. Hoffmann
On September 12, 2003, the University of Maryland School of Law's Intellectual Property and Law & Health Care Programs jointly sponsored and convened a roundtable discussion on the future public policy and ethical issues that will likely face the agricultural and microbial genomics sectors of the biotechnology industry. As this industry has developed over the last two decades, societal concerns have moved from what were often local issues, e.g., the safety of laboratories where scientists conducted recombinant DNA research on transgenic microbes, animals and crops, to more global issues. These newer issues include intellectual property, international trade, risks of genetically engineered foods and microbes, bioterrorism, and marketing and labeling of new products sold worldwide. The fast paced nature of the biotechnology industry and its new developments often mean that legislators, regulators and society, in general, must play ''catch up'' in their efforts to understand the issues, the risks, and even the benefits, that may result from the industry's new ways of conducting research, new products, and novel methods of product marketing and distribution. The goal of the roundtable was to develop a short list of the most significant public policy and ethical issues that will emerge as a result of advances in these sectors of the biotechnology industry over the next five to six years. More concretely, by ''most significant'' the conveners meant the types of issues that would come to the attention of members of Congress or state legislators during this time frame and for which they would be better prepared if they had well researched and timely background information. A concomitant goal was to provide a set of focused issues for academic debate and scholarship so that policy makers, industry leaders and regulators would have the intellectual resources they need to better understand the issues and concerns at stake. The
Ethical dilemmas experienced by nurses presented in nursing publications Dilemas éticos vivenciados por enfermeros y presentados en publicaciones de enfermería Dilemas éticos vivenciados por enfermeiros apresentados em publicações de enfermagem
Maria Adelane Alves Monteiro
Full Text Available This systematic literature review used nursing studies about "ethics" published in the SCIELO database. The objective was to identify the ethical dilemmas of nursing, based on a literature review of nursing publications between 2002 and 2006. Forty publications were found, of which seventeen were selected. The analysis of the articles permitted the organization of the following categories: ethics, the health system and nursing practice; ethics and nursing teaching-learning; ethics and nursing care. We noticed that the authors attributed a multidimensional approach to ethical issues. However, we considered it necessary to pay closer attention to the ethical aspects involved in nursing practice. There is a clear need for further studies, showing new ethical dilemmas experienced by nurses, so that they can contribute to a change in attitude, with outcomes for professional practice.Se trata de una revisión sistemática de la literatura, realizada en artículos del área de la enfermería, contenidos en el banco de datos SCIELO, y que abordaron el tema "ética". El estudio tuvo como objetivo identificar los dilemas éticos de la enfermería a partir de una revisión de la literatura en publicaciones sobre esa área, en el período de 2002 a 2006. Se localizaron cuarenta publicaciones, de las cuales fueron seleccionadas diecisiete. El análisis de los artículos permitió la organización de las categorías en: ética, el sistema de salud y la práctica de enfermería, ética y la enseñanza-aprendizaje en la enfermería y, ética y el cuidado de enfermería. Se percibió que los autores realizaron, sobre las cuestiones éticas, un abordaje multidimensional, entretanto, se consideró necesario, en este estudio, dar mayor atención a los aspectos éticos que se encuentran frecuentemente en la práctica de enfermería. Quedó clara la necesidad de realizar otros estudios que pongan en evidencia nuevos dilemas éticos vivenciados por enfermeros, en el
Wu, Yijin; Elliott, Robert; Li, Linzi; Yang, Tongwei; Bai, Yusen; Ma, Wen
In this paper, we will discuss several ethical issues concerning cadaveric organ donation from the perspective of sociocultural factors that are unique to China under the condition that China has ended the use of executed prisoner's organs for transplants. It is found that though great developments have been made in organ transplantation, the ethical issues relating to organ transplantation still face dilemmas in China. It is argued that organ donation and transplantation in China could make further progress if the ethical issues proposed in this paper can be carefully considered.
卓越医学人才教育是实现精英医学教育的一种途径.目前,卓越医学人才医德素质培养面临着医德认识教育单向度、医德情感培养缺乏人文关怀、医德意志培养功利化、医德实践形式化的困境.因此,高等医学院校应该改革传统课程设置体系,丰富校园文化活动,制定科学的人才培养模式,提高卓越医学人才医德素质.%The excellent medical talents education is a path of elite medical education .At present , the cultiva-tion of medical ethics quality of excellent medical talents is facing with the unidirectional medical ethics cognition education ,lacking humanistic care in the cultivation of medical ethics emotion , the utilitarian tendency of the culti-vation of medical ethics will and the formalization of the medical ethics practice .Therefore , medical colleges can improve medical ethics quality of excellent medical talents with reforming the traditional curriculum system , enric-hing the campus cultural activities and formulating scientific personnel training mode .
This paper explores ethical dilemmas in situated fieldwork ethics concerning ethnographic studies of adolescent students. While consequentialist and deontological ethics form the basis of the ethical stances shared by ethnographers and research ethics committees, the interpretation of those principles may diverge in school-based ethnography with adolescent students because of the particular role of the adult ethnographer vis-à-vis developmentally immature adolescents not held legally responsible for many of their actions. School ethnographers attempt to build trust with adolescent participants in order to learn about their hidden cultural worlds, which may involve activities that are very harmful to the youths involved. They face many difficult and sometimes unexpected choices, including whether to intervene and how to represent events and adolescents in published findings. Scenarios with examples drawn from research conducted in public high schools are used to illustrate and explicate dilemmas in formal research and latent insider/outsider roles and relations involving harmful adolescent behaviors, advocacy, and psychological trauma. Also examined are analytical procedures used to construct interpretations leading to representations of research participants in the resulting publication.
On the spot ethical decision-making in CBRN (chemical, biological, radiological or nuclear event) response: approaches to on the spot ethical decision-making for first responders to large-scale chemical incidents.
Rebera, Andrew P; Rafalowski, Chaim
First responders to chemical, biological, radiological, or nuclear (CBRN) events face decisions having significant human consequences. Some operational decisions are supported by standard operating procedures, yet these may not suffice for ethical decisions. Responders will be forced to weigh their options, factoring-in contextual peculiarities; they will require guidance on how they can approach novel (indeed unique) ethical problems: they need strategies for "on the spot" ethical decision making. The primary aim of this paper is to examine how first responders should approach on the spot ethical decision-making amid the stress and uncertainty of a CBRN event. Drawing on the long-term professional CBRN experience of one of the authors, this paper sets out a series of practical ethical dilemmas potentially arising in the context of a large-scale chemical incident. We propose a broadly consequentialist approach to on the spot ethical decision-making, but one which incorporates ethical values and rights as "side-constraints".
MacLeod, Rod D; Wilson, Donna M; Malpas, Phillipa
Assisting or hastening death is a dilemma with many ethical as well as practical issues facing healthcare practitioners in most countries worldwide now. Various arguments for and against assisted dying have been made over time but the call from the public for the legalisation of euthanasia and assisted suicide has never been stronger. While some studies have documented the reluctance of medical and other healthcare 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 hastening death. This paper explores salient practical and ethical considerations for healthcare practitioners associated with assisting death, including 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. PMID:23121745
Full Text Available This article explores how Applied Ethics, especially Business Ethics, is taught at the University of South Africa (Unisa. This discussion refers to the content of a particular Unisa module, Theoretical and Applied Ethics, which serves as an introduction to Bio-medical Ethics, Business Ethics and Environmental Ethics. The fundamentals of this course are: defining ethics; providing methods for moral decision-making; describing the role of ethics in a particular field and addressing common dilemmas in a specific context. The intention is to empower students to identify issues they are likely to face in the workplace, and to grow in confidence in their ability to make sound moral decisions when required to do so. The aim of this article is to contribute to the ongoing discussion between tertiary institutions about how the teaching of Business Ethics can be promoted, how moral decision-making in the workplace can be encouraged and what role theological ethics can play in this regard.
Resnik, David B; Elliott, Kevin C
Social responsibility is an essential part of the responsible conduct of research that presents difficult ethical questions for scientists. Recognizing one's social responsibilities as a scientist is an important first step toward exercising social responsibility, but it is only the beginning, since scientists may confront difficult value questions when deciding how to act responsibly. Ethical dilemmas related to socially responsible science fall into at least three basic categories: 1) dilemmas related to problem selection, 2) dilemmas related to publication and data sharing, and 3) dilemmas related to engaging society. In responding to these dilemmas, scientists must decide how to balance their social responsibilities against other professional commitments and how to avoid compromising their objectivity. In this article, we will examine the philosophical and ethical basis of social responsibility in science, discuss some of the ethical dilemmas related to exercising social responsibility, and make five recommendations to help scientists deal with these issues.
Aim: The overall aim of this study is to contribute to ethical theory and literature by demonstrating how employees’ ethical perceptions and behaviour shape the strategic orientations of the business. To achieve this aim, the study sought to: (1 establish the typical ethical dilemmas that employees of these retail firms faced in their daily tasks, (2 assess how they responded to these ethical challenges, (3 ascertain whether demographic factors such as age, level of education, gender and their position in the organisational hierarchy influence their reaction to ethical dilemmas; and (4 determine these employees’ overall perceptions of ethical issues within their organisations. Setting: The study was conducted on employees of an indigenous-owned fast-food firm operating in two cities in Zimbabwe. Methods: A survey was conducted on 108 employees working in two cities. A structured questionnaire was developed and administered to the employees. Results: The results suggested that a majority of the respondents were ethically conscious and could make ethical choices. In addition, most respondents deemed the ethical scenarios presented to them as morally wrong, suggesting that the surveyed employees wished to engage in ethical behaviour. However, while the respondents were deemed to be ethically astute in their individual capacities, they seemed to lack an in-depth knowledge of the ethical policies of their organisation. Conclusion: The study concludes that owners and managers of small firms should provide interventions to cascade ethical policy to the lower ranks of the organisation to enhance the ethical perception amongst employees of these firms. The study implication is that an institutional top-down approach is critical to embedding ethical sensitivity into employees without which employees may continue to speculate about the business ethics of their organisation.
Krstev, Dejan; Krstev, Aleksandar; Minovski, Robert; Krstev, Boris
This article describes how the systems archetype ‘Drifting Goals’ can be used in the classroom to explore ethical dilemmas. Systems archetypes are systems thinking tool that provide a framework that shifts the focus from seeing ethical dilemmas as stemming from the acts of individuals to a focus on the systemic interrelationships and interactions within the organization. The use of the ‘Drifting Goals’ archetype provides a pedagogical approach that exposes students to innovative ways of think...
Roughly 6.5 billion people inhabit the earth, but over 1 billion people regularly go hungry. This food shortfall poses an ethical dilemma for agriculture, and Agriculture's Ethical Horizon grapples with this dilemma. It argues that agricultural productivity has been the quintessential value of agr...
Bell, Sue Ellen
This article describes the ethical conflicts that a sample of US nurse utilization reviewers faced in their work, and also each nurse's self-reported ethical orientation that was used to resolve the dilemmas. Data were collected from a sample of 97 registered nurses who were working at least 20 hours per week as utilization reviewers. Respondents were recruited from three managed care organizations that conduct utilization reviews in a large midwestern city. A cross-sectional survey design was used to collect demographic data and to ask closed-response, short-answer and open-ended questions. Ethical conflicts reported by nurses were similar across utilization review settings and many were justice orientated. Self-reported ethical orientations were similar across organizations, with beneficence dominating. Implications of these findings are discussed.
Ho, Anita; MacDonald, Lisa Mei-Hwa; Unger, David
Healthcare institutions have been making increasing efforts to standardize consultation methodology and to accredit both bioethics training programs and the consultants accordingly. The focus has traditionally been on the ethics consultation as the relevant unit of ethics intervention. Outcome measures are studied in relation to consultations, and the hidden assumption is that consultations are the preferred or best way to address day-to-day ethical dilemmas. Reflecting on the data from an internal quality improvement survey and the literature, we argue that having general ethics education as a key function of ethics services may be more important in meeting the contemporaneous needs of acute care settings. An expanded and varied ethics education, with attention to the time constraints of healthcare workers' schedules, was a key recommendation brought forward by survey respondents. Promoting ethical reflection and creating a culture of ethics may serve to prevent ethical dilemmas or mitigate their effects.
Declaring nuclear preparedness 'immoral' helps to recreate the pacifism of 50 years ago. War itself is a dilemma, not the weapons with which it is waged. We must ask of the anti-war proposals: whom do they benefit. On the whole people concerned are ordinary citizens who are fearful of nuclear incineration. But marching with them is a spectrum of forces with other motivations and purposes. In a real life situation of international tension or crises, numbers of weapons in combination with their particular charateristics could mean the difference between peace and outbreak of war.
Di Nucci, Ezio
Ethics Without Intention tackles the questions raised by difficult moral dilemmas by providing a critical analysis of double effect and its most common ethical and political applications. The book discusses the philosophical distinction between intended harm and foreseen but unintended harm...... of our time. An engaging and comprehensive introduction to the doctrine of double effect. - See more at: http://www.bloomsbury.com/uk/ethics-without-intention-9781472525796/#sthash.NKISOPL8.dpuf...
Feldt-Rasmussen, Ulla; Dobrovolny, Robert; Nazarenko, Irina
Fabry disease, an X-linked lysosomal storage disorder, results from the deficient activity of a-galactosidase A (a-Gal A). In affected males, the clinical diagnosis is confirmed by the markedly decreased a-Gal A activity. However, in female heterozygotes, the a-Gal A activity can range from low t...... on enzyme replacement therapy. Thus, gene dosage analyses can detect large deletions (>50bp) in suspect heterozygotes for X-linked and autosomal dominant diseases that are "sequencing cryptic," resolving molecular diagnostic dilemmas....... to normal due to random X-chromosomal inactivation, and diagnostic confirmation requires identification of the family's a-Gal A gene mutation. In a young female who had occasional acroparesthesias, corneal opacities, and 15 to 50% of the lower limit of normal leukocyte a-Gal A activity, a-Gal A sequencing...... in two expert laboratories did not identify a confirmatory mutation, presenting a diagnostic dilemma. A renal biopsy proved diagnostic and renewed efforts to detect an a-Gal A mutation. Subsequent gene dosage analyses identified a large a-Gal A deletion confirming her heterozygosity, and she was started...
Mukadder Boydak Özan
Full Text Available The main objective of this study is to determine the degree of ethical leadership behaviours of school administrators according to teachers’ opinions. As a quantitative research, this study was carried out in the academic year of 2010-2011 with 371 teachers who were employed in elementary schools. Ethical Leadership Questionnaire developed by Langlois (2007 has been used in the research. Findings of study reveal that as the year of seniority increases, more teachers think that administrators act within the ethical standards. Teachers’ opinions about school administrators’ ethical leadership behaviours do not differentiate according to the teachers’ gender variable. However; in terms of branch variable, a significant difference is observed in teachers’ opinions about their school administrators’ ethical leadership behaviours when they faced with an ethical problem. Class teachers’ opinions are more positive than branch teachers’ opinions regarding school administrators’ ethical leadership behaviours. Results indicate that teachers think that their school administrators often faced with an ethical dilemma while deciding upon personnel issues. This study concludes that establishing written ethical codes for school administrators may help them to make decisions with integrity, fairness, and in a more ethical manner especially about personnel issues.
Löfström, Erika; Pyhältö, Kirsi
This study focused on exploring students' and supervisors' perceptions of ethical problems in doctoral supervision in the natural sciences. Fifteen supervisors and doctoral students in one research community in the natural sciences were interviewed about their practices and experiences in the doctoral process and supervision. We explored to what…
Burger, Marc J C
This paper covers the main findings of the doctoral research that was concerned with seeking to extend aspects of dilemma theory. In professional practice, the Trompenaars Hampden-Turner Dilemma Reconciliation Process(TM) is a vehicle delivering dilemma theory in application. It informs a manager or leader on how to explore the dilemmas they face, how to reconcile the tensions that result, and how to structure the action steps for implementing the reconciled solutions. This vehicle forms the professional practice of the author who seeks to bring more rigor to consulting practice and thereby also contribute to theory development in the domain. The critical review of dilemma theory reveals that previous authors are inconsistent and variously invalid in their use of the terms 'dilemma theory,' 'dilemma methodology,' 'dilemma process,' 'dilemma reconciliation,' etc., and therefore an attempt is made to resolve these inconsistencies by considering whether 'dilemmaism' at the meta-level might be positioned as a new paradigm of inquiry for (management) research that embodies ontological, epistemological, and methodical premises that frame an approach to the resolution of real world business problems in (multi) disciplinary; (multi) functional and (multi) cultural business environments. This research offers contributions to knowledge, professional practice and theory development from the exploration of the SPID model as a way to make the elicitation of dilemmas more rigorous and structured and in the broader context of exploring 'dilemmaism' as a new paradigm of inquiry.
Magelssen, Morten; Pedersen, Reidar; Førde, Reidun
When clinical ethics committee members discuss a complex ethical dilemma, what use do they have for normative ethical theories? Members without training in ethical theory may still contribute to a pointed and nuanced analysis. Nonetheless, the knowledge and use of ethical theories can play four important roles: aiding in the initial awareness and identification of the moral challenges, assisting in the analysis and argumentation, contributing to a sound process and dialogue, and inspiring an attitude of reflexivity. These four roles of ethical theory in clinical ethics consultation are described and their significance highlighted, while an example case is used as an illustration throughout.
Hasle, Peter; Limborg, Hans Jørgen
A discussion of the ethical dilemmas confronting occupational health and safety professionals when they are involved in workplace interventions. Case stories from the Danish occupational health service are used as the emperical point of departure for paper.......A discussion of the ethical dilemmas confronting occupational health and safety professionals when they are involved in workplace interventions. Case stories from the Danish occupational health service are used as the emperical point of departure for paper....
Investigates the effects of race of news subjects on student journalists' ethical reasoning. Explains that journalism students were presented with four ethical dilemmas that working journalists might encounter. Concludes that the race of the people in the ethical dilemmas presented had a significant impact on ethical reasoning. (PM)
Pauline, Jeffrey S; Pauline, Gina A; Johnson, Scott R; Gamble, Kelly M
Exercise psychology encompasses the disciplines of psychiatry, clinical and counseling psychology, health promotion, and the movement sciences. This emerging field involves diverse mental health issues, theories, and general information related to physical activity and exercise. Numerous research investigations across the past 20 years have shown both physical and psychological benefits from physical activity and exercise. Exercise psychology offers many opportunities for growth while positively influencing the mental and physical health of individuals, communities, and society. However, the exercise psychology literature has not addressed ethical issues or dilemmas faced by mental health professionals providing exercise psychology services. This initial discussion of ethical issues in exercise psychology is an important step in continuing to move the field forward. Specifically, this article will address the emergence of exercise psychology and current health behaviors and offer an overview of ethics and ethical issues, education/training and professional competency, cultural and ethnic diversity, multiple-role relationships and conflicts of interest, dependency issues, confidentiality and recording keeping, and advertisement and self-promotion.
Tengilimoglu, Dilaver; Kisa, Adnan; Ekiyor, Aykut
In many developed countries, the physician/pharmaceutical sales representative relationship has increasingly become the focus of ethical questions. Given this context, the purpose of the present study was to determine the ethical dilemmas faced by pharmaceutical sales representatives in Turkey in their relations with physicians, and to identify possible solutions. Through an investigator-designed questionnaire, the ethical problems perceived by 215 pharmaceutical sales representatives were quantitatively analyzed. Nearly all of the participants (96.7%) reported that they had faced ethical dilemmas in marketing drugs to physicians. The most commonly reported problems included paramedical requests (for free lab test kits, etc.) and the necessity of bargaining with physicians over the use of their firm's drugs by offering gifts and sponsorships. The participants in the study felt that physicians were the primary source of ethical problems in the marketing of drugs, and the participants' most highly ranked potential solution to these ethical problems was a better understanding, on the part of physicians, of the role of pharmaceutical sales representatives. At the end of this study, suggestions are given with a view to helping health policy makers understand and address the current controversies involving drug company representatives and physicians.
Full Text Available Research Question (RQ: Future managers are faced daily with a variety of ethical dilemmas in traffic that need to be balanced by the interests of all participants. The question is whether a new innovative model of ethical principles could be developed that would increase road safety.Purpose: The a im is to raise the level of social responsibility and relationship of participants in traffic as well as warn all participants on the importance of safety. In addition, the purpose is to share suggestions to other researchers for further research studies in the area of increasing traffic safety.Method: We carried out a quantitative study (survey among first year post-graduate students studying at a higher education school focused on quality management in south-eastern Slovenia. The article presents five different ethical scenarios.Results: The participants have very similar views on judging individual ethical dilemmas. The desire to increase road safety, have led to new useful suggestions for further study of innovative new ethical principles in the field of safety, such as: no death victims annually, adequate road infrastructure, improved vehicle technology, video surveillance systems, and so on.Organization: Relevant authorities should promote models of ethical thinking and the introduction of codes of conduct at an early age. As such, the state, police, rescuers, fire departments, hospitals, and so on, would have fewer deaths due to serious traffic accidents.Society: By taking these results and further research suggestions into account, society would gain a new model that would be based on zero accidents annually.Originality: Research in the field of ethics and innovative ethical principles of traffic safety is limited. The article presents practical examples of ethical and moral decision-making that we encounter in daily traffic. But nothing much is done to make it better ("every day the same story".Limitations/Future Research: The research study
Buxton, Margaret; Phillippi, Julia C; Collins, Michelle R
The importance of ethical conduct in health care was acknowledged as early as the fifth century in the Hippocratic Oath and continues to be an essential element of clinical practice. Providers face ethical dilemmas that are complex and unfold over time, testing both practitioners' knowledge and communication skills. Students learning to be health care providers need to develop the knowledge and skills necessary to negotiate complex situations involving ethical conflict. Simulation has been shown to be an effective learning environment for students to learn and practice complex and overlapping skills sets. However, there is little guidance in the literature on constructing effective simulation environments to assist students in applying ethical concepts. This article describes realistic simulations with trained, standardized patients that present ethical problems to graduate-level nurse-midwifery students. Student interactions with the standardized patients were monitored by faculty and peers, and group debriefing was used to help explore students' emotions and reactions. Student feedback postsimulation was exceedingly positive. This simulation could be easily adapted for use by health care education programs to assist students in developing competency with ethics. © 2014 by the American College of Nurse-Midwives.
Sexual harassment within the marine sciences and the ethical dilemmas of collaboration: a case study in the education and reportino methods available to scientists, students, and staff on board a federal research vessel
Within the Science, technology, engineering, and math (STEM) disciplines, a disparity between male and female involvement persists on the order of about 3:1. While roughly 40% of men with STEM degrees go on to pursue STEM jobs, just 26% of women with STEM degrees hold jobs within the STEM field. There are a number of contributing factors to these disparities, but one pernicious factor is the issue of sexual harassment and discrimination. For the marine sciences this is an especially concerning issue because our field research frequently takes place hundreds of miles offshore. Despite education and policy initiatives, sexual harassment pervades many research vessels and is often never addressed, discouraging female involvement and limiting the opportunities available to women. Ethical dilemmas develop when administrators do not want to risk limited field schedules and funding while investigations are conducted and harassment issues resolved. Additionally, scientists and staff often collaborate between institutions, benefitting science but blurring the lines of responsibility. In one such case, administrators within a federal research office declined to report sexual harassment taking place between contracted crew members on their research vessel. The lengthy review process and lack of culpability discourages reporting of sexual harassment and allows problematic situations to occur. This case study reviews the reporting mechanisms currently in place, the barriers to reporting, and the proposed methods for more effectively resolving discriminatory workplaces. Collaboration within marine science is an absolute necessity, and our research benefits from diverse working groups. As marine scientists we have an ethical responsibility to ensure safe working environments for both the scientists and the staff who make our research possible.
Bouas, Kelly S.; Komorita, S. S.
Face-to-face discussion has been shown to increase cooperation behavior in social dilemmas. Two general explanations of this effect were tested: group identity and perception of consensus. Female undergraduate students (N=160) participated in four-person groups in one of four experimental conditions. Findings indicate the most plausible…
Iliakis, Theodoros; Papadopoulou, Vasiliki; Diamantopoulos, Panagiotis T; Panayiotidis, Panayiotis; Zervakis, Konstantinos; Giannakopoulou, Nefeli; Tilimidos, Gerassimos; Angelopoulou, Maria; Siakantaris, Marina P; Pangalis, Gerassimos; Mantzourani, Marina; Variami, Eleni; Viniou, Nora Athina
Tyrosine kinase inhibitors (TKIs), namely imatinib mesylate (IM) and recently approved second-generation TKIs dasatinib and nilotinib, are currently considered the treatment of choice for newly-diagnosed chronic phase chronic myelogenous leukemia (CP-CML). Although treatment with TKIs has not yet been proven curative, it certainly accomplishes a sustained control of the disease in the vast majority of patients. More than a decade after the successful launching of IM in first-line treatment of CP-CML and the subsequent introduction of second-generation TKIs in this setting, the question of the possibility of TKI cessation in a specific subset of patients has emerged. Side-effects of TKIs, along with some patients' wish to abandon the drugs and the rising financial burden upon healthcare systems, have led to the dilemma whether IM can be safely withdrawn after achieving deep molecular remissions and which patients are suitable for this discontinuation. We examined the data of our patients with CML in search of potential canditates for cessation of TKI therapy and identified their characteristics. We also performed a thorough review of the relevant literature. Eight out of fifty patients were discriminated on grounds of sustained complete molecular response (CMR) exceeding 12 months, most of them with a low or intermediate Sokal score at diagnosis. The median interval from IM initiation to CMR was almost 2 years and the median duration of detected CMR reached 6.5 years. Based on the promising results of prospective clinical trials reporting successful cessation of treatment with TKIs on selected subgroups of patients, we decided to proceed to interruption of therapy in the specific subset of our patients and closely monitor their response.
Perry, Joshua E; Moore, Ilene N; Barry, Bruce; Clayton, Ellen Wright; Carrico, Amanda R
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.
Huhtala, Mari; Kinnunen, Ulla; Feldt, Taru
We investigated school psychologists' experiences of ethical strain (the frequency of ethical dilemmas at work and the stress caused by these dilemmas) and dilemma-related rumination outside working hours. Individual latent profiles were estimated at the study baseline based on these three dimensions. The psychologists' weekly well-being (vigor,…
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.
Payment of research participants helps to increase recruitment for research studies, but can pose ethical dilemmas. Research ethics committees (RECs) have a centrally important role in guiding this practice, but standardisation of the ethical approval process in Ireland is lacking.
Ethical dilemma: offering short-term extracorporeal membrane oxygenation support for terminally ill children who are not candidates for long-term mechanical circulatory support or heart transplantation.
Shankar, Venkat; Costello, John P; Peer, Syed M; Klugman, Darren; Nath, Dilip S
The use of extracorporeal membrane oxygenation (ECMO) in terminally ill pediatric patients who are not candidates for long-term mechanical circulatory support or heart transplantation requires careful deliberation. We present the case of a 16-year-old female with a relapse of acute lymphoid leukemia and acute-on-chronic cardiomyopathy who received short-term ECMO therapy. In addition, we highlight several ethical considerations that were crucial to this patient's family-centered care and demonstrate that this therapy can be accomplished in a manner that respects patient autonomy and family wishes.
Christoffersen, Mette Buhl; Boukaouit, Dounia; Hervit, Weeke; Helmer, Benjamin; Winther Brødreskift, Ditte; Makilä, Riia Marette; Vogel, Pingel; Elisa, Klara; Wolter Strate, Simon
With the opportunities for anonymity and free expression on the Internet it is it is not inconceivable that moral and ethical dilemmas occur. To give examples of this, we have chosen to analyse two case studies that are concerned with ethical dilemmas. The first case concerns the hacker group “Anonymous” which revealed personal information and accused two men of being paedophiles. The second case deals with the violation of privacy based on the famous meme “Scumbag Steve”. The two dimensions ...
This chapter intends to lay out some essential ethics questions that might frame the next step of space exploration. In this, I undertake two sorts of tasks. The first is to respond to the core ethic question: Is it ethical to travel in space? The second, assuming for the moment that I can convince you that the first premise can be justified, is to comment on what ethical challenges will face us there. It is appropriate to have a philosopher comment on this at the fortieth anniversary celebration, since it was also in 1962 that the National Academy of Science first convened a panel of philosophers to comment on space travel. They asked at that time whether it was indeed a worthwhile pursuit to travel in space and what might be expected of such an effort. What is at stake in any such boundary crossing is how the changing of essential human perimeters changes our own moral status. Will such boundary crossing worsen our human condition, or will it enhance it? In this way, the geopolitical quest is then linked to the quest for ontology, Pisarro hunting for the fountain of youth, for gold, and for territory. What follows are a series of ethical claims that link the problem of discovery in the larger world and the attendant ethical dilemmas of our explorations, as well as how this exploration alters our concepts of life on Earth. In this, the role of the ethicist is to function as both a skeptic and a stranger, aware of the optimism of science and the pessimism of philosophy.
Bennett, Katelyn G; Bonawitz, Steven C; Vercler, Christian J
Facial photography presents a unique ethical dilemma, as faces are difficult to deidentify for publication. We performed a review of the literature to examine current guidelines for the publication of facial photographs. We also reviewed societies' websites, journal requirements, and ethical and legal aspects of confidentiality. Most articles emphasized the importance of consent for photography and publication. Masking is not appropriate, but some journals continue to allow masking. Most legislation allows patients to restrict the uses of photographs. In the end, it is imperative to protect patient privacy by obtaining consent for photograph publication after full disclosure of risks, and specific recommendations are provided regarding a comprehensive consent process.
Lyons, Rachel; Reinisch, Courtney
Social media is a growing and popular means of communication. It is understandable that health care providers may not share identifying information on patients through these sources. Challenges arise when patients and family members wish to record the care provided in the emergency department. The health care provider may be faced with an ethical and possibly legal dilemma when social media is present in the emergency department. This article seeks to discuss the legal and ethical principles surrounding social media in the emergency department.
The Ethics of Setting Course Expectations to Manipulate Student Evaluations of Teaching Effectiveness in Higher Education: An Examination of the Ethical Dilemmas Created by the Use of SETEs and a Proposal for Further Study and Analysis
Neal, Catherine S.; Elliott, Teressa
Because student evaluations of teaching effectiveness (SETEs) are an important and widely used tool used in the evaluation and reward systems for faculty members in higher education, a discussion and analysis of the ethical problems that may arise as a result of the conflict created by expectations of performance is provided. This discussion…
Kirby, L C; Banerjee, A; Augustine, T; Douglas, J F
Malignant melanoma is a high-risk skin cancer that, in potential transplant recipients, is considered a substantial contraindication to solid organ transplantation due to significant risk of recurrence with immunosuppression. Current guidelines stipulate waiting between 3 and 10 years after melanoma diagnosis. However, in young patients with end-stage organ failure and malignant melanoma, complex ethical and moral issues arise. Assessment of the true risk associated with transplantation in these patients is difficult due to lack of prospective data, but an autonomous patient can make a decision that clinicians may perceive to be high risk. The national and worldwide shortage of available organs also has to be incorporated into the decision to maximize the net benefit and minimize the risk of graft failure and mortality. The incidence of malignant melanoma worldwide is increasing faster than that of any other cancer and continues to pose ethically challenging decisions for transplant specialists evaluating recipients for solid organ transplantation. © 2016 British Association of Dermatologists.
Full Text Available Do information and communications technology (ICT professionals who have ICT qualifications believe that the ethics education they received as part of their ICT degrees helped them recognise ethical problems in the workplace and address them? If they do, are they also influenced by their personal ethics? What else helps them recognise ethical problems in the workplace and address them? And what are their views in relation to the impact of ethics education on professionalism in the ICT workplace? A quantitative survey of 2,315 Australian ICT professionals revealed that participants who reported having various levels of qualifications found ethics education or training, to a small degree, helpful for recognising ethical problems and addressing them; although it is those with Non-ICT qualifications, not those with ICT degrees, who were influenced more by ethics education or training. This suggests that educators need to consider how to better prepare ICT graduates for the workplace challenges and the types of situations they subsequently experience. The survey also found that participants who reported having various levels of qualifications were not influenced by their personal ethics or indeed any other factor making ethics education or training important for developing professionalism. The quantitative survey was followed by qualitative interviews with 43 Australian ICT professionals in six Australian capital cities. These interviews provided further empirical evidence that ethics education is crucial for enabling ICT professionals to recognise ethical problems and resolve them and that educators need to consider how to better prepare ICT graduates for the types of moral dilemmas that they are likely going to face in the workforce.
Paris, ethics is not a science,1 nor is it an institutionalised system of regulations. ... are they important? Ethical dilemmas and moral challenges in occupational health. ..... CARE RISK WASTE. Waste Treatment & Disposal is our business.
Full Text Available Karl Widerquist has recently argued that libertarians face two dilemmas. The first dilemma arises because, contrary to what Widerquist takes libertarians to suggest, there is no conceptual link between robust property rights and the libertarian state. Private property rights can legitimately yield non-libertarian states. Libertarians must thus remain committed either to robust property rights or the libertarian state. I call this the “Conceptual Dilemma.”The second dilemma is empirical in nature. Libertarians can try to undermine state property rights by showing that the means by which all present states came to have their property was unjust. However, doing so would presumably undermine almost all the property claims of private individuals. So the dilemma is that libertarians can undermine state property rights only by undermining individual property rights, on the one hand. On the other, libertarians can vindicate private property rights of individuals only by vindicating state property rights. I call this the “Empirical Dilemma.”I attempt to diffuse both of these dilemmas here. I argue that the Conceptual Dilemma relies on a misunderstanding of the libertarian’s commitments. In particular, I show that libertarians need not think robust property rights can yield states more extensive than Nozick’s minimal state. I then argue that Widerquist ignores libertarian scholarship aimed at meeting the Empirical Dilemma. Many libertarians have attempted to demonstrate that there are legitimate private property rights which are illegitimately disregarded by current states. The upshot of this discussion is that there are no genuine dilemmas posed by Widerquist’s “A Dilemma for Libertarians.”
Faced with the diversity-efficiency dilemma, private companies apply "mass customization" strategies to add diversity without adding costs. As schools are urged to become more "customer oriented" they also face a diversity-efficiency dilemma. This article asks how Dutch secondary schools cope with this dilemma and to what…
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.
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. PMID:22606995
Lassen, Lars Christian; Thomsen, Mads Krogsgaard
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.
S. P. Giles
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?
Full Text Available The ethics is the inner law of the individual. Its application is controlled and sacked by the self-awareness and the surrounding (by ethical codecs. The self-awareness is the inner law produced by everyday life, and is therefore changeable and adaptable to the outer reality. The ethics is a common field of marketing research, within the processes of ethical dilemmas and the marketing research process itself (identified target segments: the public the consumer, the subject ordering marketing research and marketing researchers.
Wildy, Helen; Louden, William
The complexity of principals' work may be characterized according to three dilemmas: accountability, autonomy, and efficiency. Narrative vignettes of 74 Australian principals revealed that principals were fair and inclusive. When faced with restructuring dilemmas, however, they favored strong over shared leadership, efficiency over collaboration,…
Female Leadership Dilemmas in Primary Schools: A Case Study of Primary Schools in Harare Province in Zimbabwe. ... Zimbabwe Journal of Educational Research ... The study sought to explore dilemmas faced by female school leaders in primary schools in Kambuzuma, Warren Park and Kuwadzana areas of Harare ...
Dilemmas in SEA Application: The DK Energy SectorIvar Lyhne - firstname.lastname@example.org. Based on three years of collaborative research, this paper outlines dilemmas in the application of SEA in the strategic development of the Danish energy sector. The dilemmas are based on concrete examples from practice...
Kwaadsteniet, Erik Willem de
This dissertation focuses on social dilemmas, and more specifically, on environmental uncertainty in these dilemmas. Real-life social dilemma situations are often characterized by uncertainty. For example, fishermen mostly do not know the exact size of the fish population (i.e., resource size
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
Mara Ambrosina de Oliveira Vargas
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.
Kray, Laura J.; Haselhuhn, Michael P.
Why do men have more lenient ethical standards than women? To address this question, we test the male pragmatism hypothesis, which posits that men rely on their social and achievement motivations to set ethical standards more so than women. Across two studies, motivation was both manipulated and measured before examining ethicality judgments. Study 1 manipulated identification with two parties in an ethical dilemma and found that men were more egocentric than women. Whereas menâ€™s ethicality...
Lierville, Anne-Lise; Grou, Christine; Pelletier, Jean-François
In terms of health and social services, the territory of the province of Quebec is covered by four large 'integrated university health networks,' which are involved in the coordination of care delivery and medical training. The francophone components of the public mental health system for Montreal are thus primarily linked to the Integrated University Health Network of University of Montreal. In 2010, the Faculty of Medicine of the University of Montreal has included in its development strategy a firm commitment to the development and implementation of the 'patient partner expertise' in research, training and care in order to make this expertise no less than the brand of the Faculty. This commitment applies to all medical specialties that are taught at University of Montreal, including in psychiatry. More recently, the Institut universitaire en santé mentale de Montréal (IUSMM) has endorsed a new clinical vision that promotes full citizenship, which implies that service users and carers are considered as full partners with a specific expertise to be fully deployed. The objective of this paper is to examine, from an ethical point of view, the challenges that may be associated with involving such lay persons in various levels of mental health care planning and delivery, and in research. This study is mainly based on a review of the institutional processes that are in place at the IUSMM to promote service users' participation in care planning and delivery, and in research. The focus is on the practicalities and conditions for the exercise of such an active participation, as some questions and concerns emerged through a series of interviews with different stakeholders. These issues are addressed and discussed through the lenses of the ethical values that were formalized at IUSMM. Despite a firm institutional commitment at IUSMM to implement its new citizenship-oriented clinical vision through greater service users' involvement, little is known about the possible
Reviewed by Yavuz AKBULUT
233Rapid developments in information andcommunication technologies have created newsecurity threats along with ethical dilemmas. Thesedevelopments have been so fast that appropriatesecurity precautions and ethical codes fail to keeppace with the technological developments. In thisrespect, education of both professionals andordinary citizens regarding information technologyethics carries utmost importance. Encyclopedia ofInformation Ethics and Security serves as anauthentic and comprehensive r...
Full Text Available The tourism industry is one of the largest industries in the world, and despite recent events that have made its operating environment more complex, the industry continues to grow [Theobald, 2005, Global Tourism, 3rdedn., Butterworth-Heinemann/Elsevier]. Commensurate to the size of the industry is a growth in the number of students pursuing degree courses in tourism around the world. Despite an increasingly sophisticated literature, the relative recency of the industry and its study has meant little attention has been paid in the ethics literature to the dilemmas facing tourism managers and its students. Based on interviews with senior members of the tourism industry six scenarios are developed with pertinence to the challenges faced by industry practitioners today.
This study attempts to describe Jewish teachers' perceptions about their ethical dilemmas based on stories derived from the Bible. Sixty teachers were asked to submit descriptions of their ethical dilemmas to the study website; submissions were then discussed in focus groups. The findings were grouped by the ATLAS.ti into five categories: Telling…
Jotkowitz, Alan B; Clarfield, A Mark; Glick, Shimon
Patients with dementia and their families can face many difficult and agonizing ethical dilemmas over the course of the illness. An awareness of the Jewish ethical response to some of these issues can help clinicians in treating patients of the Jewish faith and also serve as an example of how one ethical system addresses these questions. The Jewish response is grounded in a profound respect and value for human life in all its forms and man's responsibility to preserve it, but Judaism rejects unproven therapies and recognizes the limitations of modern medicine. Jewish law also codifies normative obligations that children have toward their elderly parents. With these principles in the forefront, this article analyzes a Jewish ethical response to various problems in the care of the demented patient such as truth telling, transfer to a nursing home, artificial nutrition, and end-of-life care, taking into account modern concepts of the doctor-patient relationship and ancient Jewish tradition.
.... Those faced with this dilemma have included the Romans, Byzantines, and the British Empire. Studying these nations in their struggle to maintain control revealed tactics and techniques that proved effective...
Whittaker, James K.
The professional helping person faces multiple dilemmas today that challenge his own value system. Article presented some of the particular problems and pitfalls confronted by the professional helper. (Author/RK)
Nielsen, Thomas Galasz; Buhl, Kenneth Øhlenschlæger
and save military lives. However, this opens up for discussions about ethical dilemmas about machines that autonomously are able to kill humans: What is an autonomous weapons system? What laws covers the use of fully autonomous weapons systems? Should it apply to International Humanitarian Law?...
Fisher, Celia B; True, Gala; Alexander, Leslie; Fried, Adam L
The role of front-line researchers, those whose responsibilities include face-to-face contact with participants, is critical to ensuring the responsible conduct of community-based drug use research. To date, there has been little empirical examination of how front-line researchers perceive the effectiveness of ethical procedures in their real-world application and the moral stress they may experience when adherence to scientific procedures appears to conflict with participant protections. This study represents a first step in applying psychological science to examine the work-related attitudes, ethics climate, and moral dilemmas experienced by a national sample of 275 front-line staff members whose responsibilities include face-to-face interaction with participants in community-based drug-use research. Using an anonymous Web-based survey we psychometrically evaluated and examined relationships among six new scales tapping moral stress (frustration in response to perceived barriers to conducting research in a morally appropriate manner); organizational ethics climate; staff support; moral practice dilemmas (perceived conflicts between scientific integrity and participant welfare); research commitment; and research mistrust. As predicted, front-line researchers who evidence a strong commitment to their role in the research process and who perceive their organizations as committed to research ethics and staff support experienced lower levels of moral stress. Front-line researchers who were distrustful of the research enterprise and frequently grappled with moral practice dilemmas reported higher levels of moral stress. Applying psychometrically reliable scales to empirically examine research ethics challenges can illuminate specific threats to scientific integrity and human subjects protections encountered by front-line staff and suggest organizational strategies for reducing moral stress and enhancing the responsible conduct of research.
Davidson, Patricia; Rushton, Cynda Hylton; Kurtz, Melissa; Wise, Brian; Jackson, Debra; Beaman, Adam; Broome, Marion
To develop a framework to enable discussion, debate and the formulation of interventions to address ethical issues in nursing practice. Social, cultural, political and economic drivers are rapidly changing the landscape of health care in our local environments but also in a global context. Increasingly, nurses are faced with a range of ethical dilemmas in their work. This requires investigation into the culture of healthcare systems and organisations to identify the root causes and address the barriers and enablers of ethical practice. The increased medicalisation of health care; pressures for systemisation; efficiency and cost reduction; and an ageing population contribute to this complexity. Often, ethical issues in nursing are considered within the abstract and philosophical realm until a dilemma is encountered. Such an approach limits the capacity to tangibly embrace ethical values and frameworks as pathways to equitable, accessible, safe and quality health care and as a foundation for strengthening a supportive and enabling workplace for nurses and other healthcare workers. Conceptual framework development. A comprehensive literature review was undertaken using the social-ecological framework as an organising construct. This framework views ethical practice as the outcome of interaction among a range of factors at eight levels: individual factors (patients and families); individual factors (nurses); relationships between healthcare professionals; relationships between patients and nurses; organisational healthcare context; professional and education regulation and standards; community; and social, political and economic. Considering these elements as discrete, yet interactive and intertwined forces can be useful in developing interventions to promote ethical practice. We consider this framework to have utility in policy, practice, education and research. Nurses face ethical challenges on a daily basis, considering these within a social-ecological framework can
This paper examines the ethical nature of nursing. Examples are taken from coronary care units. A critical view is taken whereby it is felt that nursing models do not truly reflect this nature. It is suggested that nurses make most ethical decisions without dilemma using intuition. The traditions behind using this intuition are examined. Such normative traditions may be summarized as teleological, deontological and axiological. Lastly, it is suggested that nurses would benefit in several ways from some education in ethics.
Ramos, Flávia Regina Souza; Brehmer, Laura Cavalcanti de Farias; Vargas, Mara Ambrosina; Trombetta, Ana Paula; Silveira, Luciana Ramos; Drago, Laila
Nursing students on clinical placements as part of their professional training are routinely faced with situations involving ethical conflicts. The initial act of perceiving a situation as causing an ethical dilemma is the result of both the students' personal values, drawn from their culture and families, and of the professional knowledge and values that they have acquired through training and experience. Nursing students' experiences on clinical placements in primary care settings were investigated in order to identify situations that they perceived as involving ethical conflict and describe the elements they took into consideration during their decision-making processes in these situations. The research design was qualitative descriptive case study. Around 50 students from three different intakes to a nursing degree answered a questionnaire and discussed it in focus groups. The study was designed in accordance with the principles guiding research with human beings and was approved by the Human Research Ethics Committee. Synthesised into two principal axes: (a) ethical conflicts in primary care, linked with the domains of working processes, professional nursing ethics and human and social rights and (b) students' decision-making processes - realisation, reflection and intervention. The student nurses saw themselves both as actors and spectators in situations involving ethical problems and demanding moral deliberation, demonstrating the ability to base their arguments soundly. They tended to emphasise the possibilities offered by dialogue and that different ethical values must be respected to find fair solutions to ethical problems. © The Author(s) 2014.
Gundersen, David E.; Capozzoli, Ernest A.; Rajamma, Rajasree K.
The authors analyzed the reactions of various academic-level respondent groups to 14 short scenarios reflecting ethical dilemmas in higher education and research. As the authors hypothesized, groups differed in their views of the dilemmas presented. The results did not support a 2nd hypothesis predicting a linear relationship between academic…
Herschel, Richard T.; Andrews, Patricia Hayes
Explores ethical issues heightened by use of technology, and examines a means for managing these ethical concerns. Argues that ethical problems are not inherent in technological advances, but rather it is how human beings choose to use these new tools that may lead to ethical dilemmas in business contexts. (SR)
Humbarger, Michele; DeVaney, Sharon A.
It is important to understand the ethical values of college students because they will be the leaders of the future. As part of an undergraduate honors project, a survey was developed that consisted of eight cases depicting ethical dilemmas in the classroom. Each case included a choice of four actions ranging from most ethical to least ethical.…
Qualters, Donna M.; McDaniels, Melissa; Cohen, Perrin
Although universities often teach ethics courses, they do not always teach students how to apply ethical course content to ethical dilemmas they encounter on a day-to-day basis. The Awareness-Investigation-Responding (AIR) model of ethical inquiry bridges this gap by scaffolding the reflective process and empowering students to make more caring,…
Pettit, John D., Jr.; And Others
Outlines a theoretical framework of ethics, power, and communication in the workplace, which provides a backdrop for viewing ethical decisions. Explains that business managers are often caught in a dilemma between job pressures and personal ethical codes. Proposes communication as a means of fostering more ethical organizational behavior. (SG)
Baker, Diane F.
Researchers in behavioral ethics seek to understand how individuals respond to the ethical dilemmas in their lives. In any given situation, multiple social and psychological variables interact to influence ethical decision making. The purpose of this article is to explore how one such variable, empathy, affects the ethical decision-making process…
Global Ethics Applied’ in four volumes is a reader of 88 selected articles from the author on 13 domains: Vol. 1 Global Ethics, Economic Ethics; Vol. 2 Environmental Ethics; Vol. 3 Development Ethics, Political Ethics, Dialogue and Peace Ethics, Innovation and Research Ethics, Information and Communication Ethics; Vol. 4 Bioethics and Medical Ethics, Family Ethics and Sexual Ethics, Leadership Ethics, Theological Ethics and Ecclesiology, Methods of Ethics. It concludes with the extended Bibli...
Martin, Thomas A; Bush, Shane S
The practice of geriatric neuropsychology demands specialized training and experience that enables the practitioner to appreciate the unique challenges and opportunities that are encountered when working with older adults. In addition to maintaining advanced knowledge regarding medical and psychological conditions, assessment issues, and treatment needs specific to older persons, clinicians working with older adults must be prepared to recognize and confront ethical dilemmas that arise. For example, ethical challenges related to professional competence, informed consent, assessment, and privacy and confidentiality may be prominent when working with older persons. Maintaining an emphasis on "positive ethics" and utilizing an ethical decision-making model will promote the practitioner's ability to avoid, identify, and resolve ethical challenges. The present article reviews (1) the concept of positive ethics, (2) a comprehensive ethical decision-making model, and (3) ethical issues that are commonly encountered by geriatric neuropsychologists. A case vignette is presented to illustrate the application of the aforementioned tools to promote ethical practice.
Kwaadsteniet, Erik Willem de
This dissertation focuses on social dilemmas, and more specifically, on environmental uncertainty in these dilemmas. Real-life social dilemma situations are often characterized by uncertainty. For example, fishermen mostly do not know the exact size of the fish population (i.e., resource size uncertainty). Several researchers have therefore asked themselves the question as to how such uncertainty influences people’s choice behavior. These researchers have repeatedly concluded that uncertainty...
As the traditional definition of "medical ethics" has recently changed markedly with advances in medical knowledge and technology, medical doctors and researchers in Japan are required to understand and apply both research and clinical ethics. Quite frequently, ethical problems in clinical settings cannot be addressed by the simple application of good will, hard work, and perseverance by medical personnel. The Ministry of Health, Labour and Welfare (MHLW) and the Ministry of Education, Culture, Sports, Science and Technology (MEXT) have jointly published "Ethical Guidelines for Clinical Studies;" however, clear guidelines (legal, ministerial, or governmental) outlining the expectations regarding clinical ethics do not exist. All medical personnel face deep ethical dilemmas. In these instances, if the fulfillment of 'ethics' relies solely on the capacity of personnel to apply their own individual moral efforts, the result will be burn-out among these workers who have a strong sense of responsibility. In order to avoid this, a system which comprises multiple physicians, nurses, and other personnel must be established, allowing collaboration when an appropriate response is required. A major factor supporting this approach is the offering of Clinical Ethics Consultations.
Gössling, Stefan; Metzler, Daniel
Germany has one of the most ambitious climate policy goals worldwide, having pledged to reduce national emissions by 40% by 2020, and 80–95% by 2050 (base year: 1990). 2015 data suggests that progress on decarbonisation has slowed, also because emissions from the transport sector have grown. Road transport, which is contributing 20.5% to Germany's CO_2 emissions, has become a major obstacle to achieving the country's policy goals. This paper analyses energy use from road transport in order to provide a better understanding of emissions from this sub-sector. Data is derived from representative longitudinal household surveys as well as mobility and fuel diaries for the period 2002–2015. Analysis reveals significant growth in energy-inefficient car choices, as well as considerable differences in mobility patterns (distances driven, driving styles) and actual fuel consumption between car segments. Findings suggest that German transport policies will fail to deliver significant emission reductions if complexities in car model choices and use patterns are ignored. Both command-and-control and market-based measures will be needed to align the transport sector with climate goals, while persisting policy inconsistencies will also have to be addressed. Findings are of central relevance for EU-wide and global climate policy in the transport sector. - Highlights: • Emissions from German road transport have remained constant between 1990 and 2015. • Non-progress on transport decarbonisation is barrier to national mitigation goals. • Analysis shows that wide range of complexities are overlooked by government. • Policies need to consider car fleet segmentation and driving patterns. • Command-and-control as well as market-based measures needed.
Howe, Edmund G
Clinicians and ethicists routinely encounter complex ethical dilemmas that seem intractable, which have been described as ethical Gordian knots. How can they best assist patients and surrogate decision makers who are entangled in struggles around the capacity to make life-or-death treatment decisions? In this article I describe unconventional and unorthodox approaches to help slice through these dilemmas. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.
Knudsen, Fabienne; Ergle, Andra
The workshop will be formed as an occasion to reflect upon the ethical dimensions of our practice as professional in maritime occupational health. The point of departure for this reflection will consist of dilemmas we have encountered - or may encounter - in our daily work. Dilemmas have often th...
Terezinha Nunes da Silva
Full Text Available ABSTRACT Objective: to investigate nursing professionals' understanding concerning the Code of Ethics; to assess the relevance of the Code of Ethics of the nursing profession and its use in practice; to identify how problem-solving is performed when facing ethical dilemmas in professional practice. Method: exploratory descriptive study, conducted with 34 (thirty-four nursing professionals from a teaching hospital in João Pessoa, PB - Brazil. Results: four thematic categories emerged: conception of professional ethics in nursing practice; interpretations of ethics in the practice of care; use of the Code of Ethics in the professional practice; strategies for solving ethical issues in the professional practice. Final considerations: some of the nursing professionals comprehend the meaning coherently; others have a limited comprehension, based on jargon. Therefore, a deeper understanding of the text contained in this code is necessary so that it can be applied into practice, aiming to provide a quality care that is, above all, ethical and legal.
Eveslage, Thomas; D'Angelo, Paul
Suggests that publications advisors have sound, practical reasons for addressing ethical decision making. Presents a brief review of the Supreme Court's message in "Hazelwood." Surveys staffs and advisors of award-winning high school newspapers concerning ethical issues facing the student press. Finds that advisors believe ethics to be…
Kang, Peter B
The field of neurogenetics is moving so rapidly that new discoveries are announced almost weekly. The tools available for the diagnosis of neurogenetic disorders have become powerful and complex, and raise new ethical dilemmas that did not exist just a few years ago. In addition to previous concerns about presymptomatic genetic testing and carrier testing, the widening availability of next-generation sequencing raises concerns about the reporting of incidental findings of unclear significance. Genetically targeted therapies have now been proven to be efficacious for a few neurogenetic diseases, and it is likely that gene therapies and cell-based therapies will soon be applied to other neurologic disorders. These therapies are generally quite expensive compared to other treatments. Given the cost constraints that will be needed in the healthcare system in the United States and other countries, and the likelihood that new genetically targeted therapies will be introduced, society will face difficult questions regarding its obligations to fund expensive therapies both for large populations and for small numbers of patients with rare diseases. Potential conflicts of interest involving both individuals and institutions will need ongoing vigilance. Scientific advances will continue to raise consequential ethical questions in the field of neurogenetics. © 2013 Elsevier B.V. All rights reserved.
For most of its existence, the field of computer science has been lucky enough to avoid ethical dilemmas by virtue of its relatively benign nature. The subdisciplines of programming methodology research, microprocessor design, and so forth have little room for the greater questions of human harm. Other, more recently developed sub-disciplines, such as data mining, social network analysis, behavioral profiling, and general computer security, however, open the door to abuse of users by practitioners and researchers. It is therefore the duty of the men and women who chart the course of these fields to set rules for themselves regarding what sorts of actions on their part are to be considered acceptable and what should be avoided or handled with caution out of ethical concerns. This paper deals solely with the issues faced by computer security researchers, be they vulnerability analysts, privacy system designers, malware experts, or reverse engineers.
MUHAMMAD NUMAN ALI KHAN; DANISH JAMIL,
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.
Edwards, Ian; Jones, Mark; Thacker, Michael; Swisher, Laura Lee
There has been a widespread call for an ethics in the management of patients with chronic pain which is patient centered and takes into account the lived experience of the patient. It has been argued in literature that current "duty" or principlist-based models of ethics (so-called 3rd person ethics) have not adequately addressed the needs of either patients or practitioners in this area. Two strands of literature within phenomenology were reviewed: the literature of interpretative phenomenological analysis and the study of the lived experience of the person with chronic pain; and the contribution of phenomenology in neo-Aristotelian virtue ethics (1st person ethics). Patients experience chronic pain in existential and moral terms in addition to their biomedical issues, facing dilemmas in understanding their own self-identity and in attempting to recover a sense of moral worth and agency. We outline a patient-centered ethics to underpin contemporary collaborative, multimodal approaches in the management of chronic pain. We firstly describe an agency-oriented, neo-Aristotelian 1st person ethics and then outline a hermeneutic relationship with extant "duty-based," 3rd person bioethics. The utility of the ethics model we propose (the ethical reasoning bridge) lies in its capacity for developing a sense of moral agency for both practitioner and patient, resonating with the current emphasis of seeking active engagement of patients in management. Wiley Periodicals, Inc.
Singer, Dani; Hunter, Myra
... Psychological therapy and counselling with individuals and families after donor conception Sharon A Pettle Chapter 9 182 Policy development in third party reproduction: an international perspective...
Russell, Vanessa Tamara
Although all teachers are expected to be "role models," discursive trajectories reaching back to the West's gay liberation pressure queer teachers to be role models in specific ways--by "coming out" and helping queer students out of their "time of difficulty." Paradoxically, discourses that construct children as…
All too often, those patients who complain are thought to be unreasonable. Healthcare professionals often feel that patients do not have an understanding of the pressures and hardships that they struggle with on a day-to-day basis. When a patient complains, it is seen by the professional complained about as a wholly negative event, leading to loss of confidence and leaving that professional feeling demoralized. Often complaints are due to a breakdown in communication. Sometimes a patient is unhappy with a treatment charge or simply there is a perception that he/she has been poorly treated. The General Dental Council and Primary Care Trusts (and now their successors) take a dim view of dental practitioners who deal with complaints poorly. This article sets out to offer a different perspective on complaints, so that the complaint system can be used to build trust between dental professionals and patients, instead of instilling demoralization and fear of litigation into those on the receiving end of a complaint. This article is relevant to all dental professionals as complaints are an inevitability of practice.
Shuaib, Waqas; Beatrice, Cristina; Abazid, Ahmad G
Acute altered mental status can be caused by a broad range of etiologies, including cerebrovascular, neurologic, traumatic, metabolic, infectious, psychiatric, medications, etc. We present a case of a 53-year-old healthcare professional with an acute altered mental status after a trip to Africa. The patient was extensively worked up for infectious, cardiovascular, and neurologic etiologies, and all results were within normal limits. Further history revealed an overdose of a self-medicated hypnotic (zolpidem) for insomnia. The patient was conservatively managed and discharged on trazadone for insomnia.
This article argues that the English legislative regime is ineffective in regulating international surrogacy, particularly with regard to commercial payments. It suggests that if English law views surrogacy as exploitative, we have a responsibility to protect women both in England and abroad, and the only way to do so effectively is to create a domestic system of regulation that caters adequately for the demand in this country. This requires a system of authorisation for surrogacy before it is undertaken; ex-post facto examinations of agreements completed in other jurisdictions, after the child is already living with the commissioning parents, cannot be seen as an acceptable compromise, as authorisation will inevitably be granted in the child's best interests. © The Author 2016. Published by Oxford University Press; all rights reserved. For Permissions, please email: email@example.com.
Kim, Hye Won
This paper explores the challenges and dilemmas raised by my own experience of researching an immigrant Korean child at an ethnic Sunday School where I taught. I review the ethical and methodological challenges raised in my interactions with the child as an insider researcher from the ways I approached consent forms through to interview…
Martins, Julia; Fortmüller, Richard; Powell, Owen
Economics and business students regularly behave less prosocially than others. Can ethics training reverse this tendency? Results from a repeated public goods experiment reveal that it can. Students who attend an interactive lecture on social dilemmas show significantly more cooperation than others. However, the lecture does not appear to increase…
Frisque, Deloise A.; Lin, Hong; Kolb, Judith A.
Ethics is very much in the news today and on the minds of those who teach and/or train current and future professionals to work successfully in today's workplaces. While there seems to be agreement that organizations need to address the topic of ethics, there is also a concern about how best to proceed. Ethics and compliance offices, professional…
Vyskocilová, Jana; Prasko, Jan
Theories of ethics and ethical reflection may be applied to both theory and practice in psychotherapy. There is a natural affinity between ethics and psychotherapy. Psychotherapy practice is concerned with human problems, dilemmas and emotions related to both one's own and other people's values. Ethics is also concerned with dilemmas in human thinking and with how these dilemmas reflect other individuals' values. Philosophical reflection itself is not a sufficient basis for the ethics of psychotherapy but it may aid in exploring attitudes related to psychotherapy, psychiatry and health care. PubMed, Web of Science and Scopus databases were searched for articles containing the keywords "psychotherapy", "ethics", "therapeutic relationship" and "supervision". The search was conducted by repeating the terms in various combinations without language or time restrictions. Also included were data from monographs cited in reviews. The resulting text is a review with conclusions concerning ethical aspects of psychotherapy. The ability to behave altruistically, sense for justice and reciprocity and mutual help are likely to be genetically determined as dispositions to be later developed by upbringing or to be formed or deformed by upbringing. Early experiences lead to formation of ethical attitudes which are internalized and then applied to both one's own and other people's behavior. Altruistic behavior has a strong impact on an individual's health and its acceptance may positively influence the pathophysiological mechanisms underlying numerous diseases. Ethical theory and reflection, however, may be applied to both theory and practice of psychotherapy in a conscious, targeted and thoughtful manner. In everyday practice, psychotherapists and organizations must necessarily deal with conscious conflicts between therapeutic possibilities, clients' wishes, their own as well as clients' ideas and the real world. Understanding one's own motives in therapy is one of the aims of a
of Teaching Ethics in the Military?” in Ethics Education in the Military, eds. Paul Robinson, Nigel De Lee, and Don Carrick (Burlington, VT: Ashgate...Decision Making: Social Dilemmas, Social Values, and Ethical Judgments, (New York, NY: Taylor and Francis Group, 2010), 288. 25. Ronald F. Duska and...Decision Making: Social Dilemmas, Social Values, and Ethical Judgments. (New York, NY: Taylor and Francis Group, 2010), 259. 41. Jones and Ryan, “The
Pressure ulcers represent a considerable cost, both in terms of healthcare spending and quality of life. They are increasingly viewed in terms of patient harm. For clinicians involved in pressure ulcer prevention, ethical issues surrounding accountability may arise from both policy and practice perspectives. It may be useful for clinicians to refer to ethical theories and principles to create frameworks when addressing ethical dilemmas. However, such theories and principles have been criticised for their simplicity and over-generalisation. Alternative theories, for example, virtue ethics and experiential learning, can provide more comprehensive guidance and promote a pluralistic approach to tackling ethical dilemmas.
This article reports on face-to-face and online qualitative research conducted with 25 teachers from 8 schools in Australia that explored their experience of mindfulness and reflection in relation to a self-identified relational dilemma with a student, colleague, or parent who was causing them concern at work. The aim of this study was to find out…
McCarthy, Robert L.; Perrolle, Judith A.
The current and potential impact of computerization on pharmacy practice is discussed, focusing on ethical dilemmas in the pharmacist-patient relationship, confidentiality of records, and the role of artificial intelligence in decision making about drug therapy. Case studies for use by teachers of pharmaceutical ethics are provided. (Author/MSE)
Weidman, Justin; Coombs, Dawan
Students had just participated in an experiential learning exercise where they played dodgeball using marshmallows, but the unique context of the game introduced ethical dilemmas that integrated ethics education into a technical education classroom setting. Research shows that "Engineering curriculum and activities at the K-12 level should be…
A new interactive computer simulation designed to teach sales ethics is described. Simulation learner objectives include gaining a better understanding of legal issues in selling; realizing that ethical dilemmas do arise in selling; realizing the need to be honest when selling; seeing that there are conflicting demands from a salesperson's…
Maddock, James W.
Notes that working with marital and family problems complicates the concept of therapeutic responsibility. Discusses several societal contributors to ethical dilemmas in contemporary family therapy and summarizes an ecological framework for therapy on the basis of which a profile of the ethical family therapist is derived. (Author/NB)
Froeschle, Janet G.; Crews, Charles
Ethical issues arise more often for school counselors than for those who work in other settings (Remley, 2002). The challenge of working not only with minors but also with other stakeholders including parents, teachers, school administrators, and community members sets the stage for potential legal and ethical dilemmas. Awareness and adherence to…
Porter, Russell; Broussard, Amelia; Duckett, Todd
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…
Selart, Marcus; Johansen, Svein Tvedt
Across two studies the hypotheses were tested that stressful situations affect both leadership ethical acting and leaders’ recognition of ethical dilemmas. In the studies, decision makers recruited from 3 sites of a Swedish multinational civil engineering company provided personal data on stressful situations, made ethical decisions, and answered to stress-outcome questions. Stressful situations were observed to have a greater impact on ethical acting than on the recognition of ethical dil...
Merrick, Allison; Green, Rochelle; Cunningham, Thomas V; Eisenberg, Leah R; Hester, D Micah
Although ethics is an essential component of undergraduate medical education, research suggests that current medical ethics curricula face considerable challenges in improving students' ethical reasoning. This article discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised: the Medical Ethics Bowl (MEB). Finally, we suggest the pedagogical advantages of the MEB when compared to other ethics curricula.
Miriam Debieux Rosa
Full Text Available Procura-se demonstrar como os discursos a que são expostos os sujeitos do capitalismo avançado indicam um modo de laço que empurra o sujeito violentamente ao gozo, seja sob a forma de consumo e lucro, seja sob a forma de sofrimento. Sua estratégia é propor aos sujeitos uma realidade posta (imposta, que os abstém dos dilemas éticos, o que gera, para além do mal-estar, violências. Ressituar o sujeito e a ética como elementos indissociáveis aponta para uma política de resistência à instrumentalização social do gozo.The article demonstrates how the speach of post-capitalist subjects underpins a type of social bond in which they see themselves immersed in a culture that violently thrusts them toward enjoyment (jouissance in the form of either consumption and profit or suffering. Its strategy relies on proposing the suspension of ethical dilemmas to subjects submitted to the posed (imposed reality. Besides discontents, that results in violence. Resituating both subjects and ethics as indissoluble elements points to a resistance policy to the social instrumentalization of enjoyment.
Reta CONDEI; Ioana NICULAE; Petrica STEFAN; Agatha POPESCU
Management ethics, the determination at what means “fair”, ”correct” and “just” in decisions and action that affect the others, passes the simple problems like corruption, steal and swindle. It is focused on human interrelations such as between employers and employees, sellers and clients, shareholders, creditors, distributors, community members. The solving of the ethics dilemmas in management do not represent just a delimitation between good and bad, correct and incorrect, but also it is a ...
This paper is part of a larger study designed to explore the effects of ethnicity, nationality, and gender on responses to a variety of business ethical dilemmas in Central Asia. The data were collected in spring 2010 from MBA students at an American-style business school located in Kazakhstan. The findings are discussed in terms of their relevance to the conceptual categories of western philosophies of ethics (utilitarianism, deontology, individual rights, justice, etc.). Possible implica...
Full Text Available The spread of digital technology, which allows anyone (in theory to disseminate in-formation on the Internet, is the greatest and a dramatic new ethical question of the modern world. It is especially true for the principles that traditionally have guided journalism. This article addresses some of the central dilemmas that journalism faces in this new context, and poses questions regarding possible limits to what should be made pub-lic, in view of the loss of this control historically applied through journalism and the everpresent hypothesis of anonymity on the net.