Sample records for making ethical decisions
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DEFF Research Database (Denmark)
Lauesen, Linne Marie
2012-01-01
of the interaction between a corporation and its stakeholders. Methodology/approach: This paper offers a theoretical 'Organic Stakeholder Model' based on decision making theory, risk assessment and adaption to a rapidly changing world combined with appropriate stakeholder theory for ethical purposes in decision...... applicable): The Model is based on case studies, but the limited scope of the length of the paper did not leave room to show the empirical evidence, but only the theoretical study. Originality / value of a paper: The model offers a new way of combining risk management with ethical decision-making processes...... by the inclusion of multiple stakeholders. The conceptualization of the model enhances business ethics in decision making by managing and balancing stakeholder concerns with the same concerns as the traditional risk management models does – for the sake of the wider social responsibilities of the businesses...
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Ethical decision-making, passivity and pharmacy.
Cooper, R J; Bissell, P; Wingfield, J
2008-06-01
Increasing interest in empirical ethics has enhanced understanding of healthcare professionals' ethical problems and attendant decision-making. A four-stage decision-making model involving ethical attention, reasoning, intention and action offers further insights into how more than reasoning alone may contribute to decision-making. To explore how the four-stage model can increase understanding of decision-making in healthcare and describe the decision-making of an under-researched professional group. 23 purposively sampled UK community pharmacists were asked, in semi-structured interviews, to describe ethical problems in their work and how they were resolved. Framework analysis of transcribed interviews utilised the four decision-making stages, together with constant comparative methods and deviant-case analysis. Pharmacists were often inattentive and constructed problems in legal terms. Ethical reasoning was limited, but examples of appeals to consequences, the golden rule, religious faith and common-sense experience emerged. Ethical intention was compromised by frequent concern about legal prosecution. Ethical inaction was common, typified by pharmacists' failure to report healthcare professionals' bad practices, and ethical passivity emerged to describe these negative examples of the four decision-making stages. Pharmacists occasionally described more ethically active decision-making, but this often involved ethical uncertainty. The four decision-making stages are a useful tool in considering how healthcare professionals try to resolve ethical problems in practice. They reveal processes often ignored in normative theories, and their recognition and the emergence of ethical passivity indicates the complexity of decision-making in practice. Ethical passivity may be deleterious to patients' welfare, and concerns emerge about improving pharmacists' ethical training and promoting ethical awareness and responsibility.
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Ethical decision-making, passivity and pharmacy
Cooper, R.J.; Bissell, P.; Wingfield, J.
2008-01-01
Background: Increasing interest in empirical ethics has enhanced understanding of healthcare professionals' ethical problems and attendant decision-making. A four-stage decision-making model involving ethical attention, reasoning, intention and action offers further insights into how more than reasoning alone may contribute to decision-making.\\ud \\ud Aims: To explore how the four-stage model can increase understanding of decision-making in healthcare and describe the decision-making of an und...
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Zsolnai, László
2011-01-01
The self-centeredness of modern organizations leads to environmental destruction and human deprivation. The principle of responsibility developed by Hans Jonas requires caring for the beings affected by our decisions and actions. Ethical decision-making creates a synthesis of reverence for ethical norms, rationality in goal achievement, and respect for the stakeholders. The maximin rule selects the "least worst alternative" in the multidimensional decision space of deontologica...
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Ethical aspect price decision making
Directory of Open Access Journals (Sweden)
Grubor Aleksandar
2007-01-01
Full Text Available Price decision making in a marketing program framework creatings is a complicated and delicated part of marketing management, especially to keep in sight culminating of mass external factors. In a market economies price policy as a marketing mix instrument rarely is regulated by the law, which opening the ethical aspect questions of price decision making process. The ethics in the price decision making means consideration of the inner law of the individual (marketing managers and/or consumers, whose irreverence does not entail any juridical sanctions, rather its application is sanctioned by the self - awareness. The acception and stability of the ethical aspect price decision making are determined by the characteristic of selected marketing environment.
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Nonrational processes in ethical decision making.
Rogerson, Mark D; Gottlieb, Michael C; Handelsman, Mitchell M; Knapp, Samuel; Younggren, Jeffrey
2011-10-01
Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasilegal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior, including context, perceptions, relationships, emotions, and heuristics. For example, a large body of behavioral research has demonstrated the importance of automatic intuitive and affective processes in decision making and judgment. These processes profoundly affect human behavior and lead to systematic biases and departures from normative theories of rationality. Their influence represents an important but largely unrecognized component of ethical decision making. We selectively review this work; provide various illustrations; and make recommendations for scientists, trainers, and practitioners to aid them in integrating the understanding of nonrational processes with ethical decision making.
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School Counselors and Ethical Decision Making
West, Dana R.
2016-01-01
Students and their parents/guardians rely on school counselors to provide counseling services based on ethically sound principles. However, there is a lack of empirical evidence about what influences a school counselor's ethical decision making. Ethical decision making for this study was defined as the degree to which decisions pertaining to…
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Moral and Ethical Decision Making: Literature Review
2005-08-08
exploration and elaboration of both rational and intuitive decision making processes. In addition, emotions may also play an important role in...More specifically, it suggests that both rational and intuitive decision making processes are likely to play an important role in ethical decision ...and military literature related to ethical decision making more generally. Specifically, it suggests that both rational and intuitive decision making
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Making ethical choices: a comprehensive decision-making model for Canadian psychologists.
Hadjistavropoulos, T; Malloy, D C
2000-05-01
This paper proposes a theoretical augmentation of the seven-step decision-making model outlined in the Canadian Code of Ethics for Psychologists. We propose that teleological, deontological, and existential ethical perspectives should be taken into account in the decision-making process. We also consider the influence of individual, issue-specific, significant-other, situational, and external factors on ethical decision-making. This theoretical analysis demonstrates the richness and complexity of ethical decision-making.
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Ethical decision making in clinical practice.
Fowler, M D
1989-12-01
Contemporary nursing ethics education focuses on the use of an analytical model of ethical decision making for both its process and its content. Perhaps this is the case because it bears some resemblance to the nursing process, which is taught in a similar fashion. Thus, a deductivist method of ethical decision making fits within the same general schema of the hypotheticodeductive method of decision making that is taught for nursing diagnosis. Ethics requires that nurses respect persons, inform patients and secure their consent, not inflict harm, preserve the patient's quality of life, prevent harm and remove harmful conditions, do good for patients, and minimize risk to themselves. These are among the norms of obligation that guide ethical analysis and judgment in nursing practice and are the substance of the analytical model of ethical decision making. Nursing's ethics has established high ideals and strong demands for nurses. These are demands which nurses have met and ideals which have often been realized. Whatever the strength of our science, nursing is an inherently moral endeavor and is only as strong as its commitment to its ethical obligations and values. Between the grinding edges of the forces that affect it, nursing must establish its priorities among the aspects of its environment that it attempts to control. Ethics must be chief among those priorities.
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Sensemaking Strategies for Ethical Decision-making.
Caughron, Jay J; Antes, Alison L; Stenmark, Cheryl K; Thiel, Chaise E; Wang, Xiaoqian; Mumford, Michael D
2011-01-01
The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision-making. Using a sample of 163 undergraduates, a low fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision-making. A mediated model is presented which suggests that environmental factors influence reasoning strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision-making. Findings were mixed but generally supported the hypothesized model. Interestingly, framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies.
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Moral and Ethical Decision Making
2007-07-01
rational ones (i.e. Kohlberg’s influential model of decision making ). However, non- rational elements, such as affect, risk perception, risk preference...dread or anxiety) play a strong role in many types of decisions , and that the addition of decision makers’ emotions to models of choice may make ...White, 1994) agree that emotions are an integral part of ethical decision making as well. Emotions arise in the context of interpersonal
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Consumer recycling: An ethical decision-making process
DEFF Research Database (Denmark)
Culiberg, Barbara; Bajde, Domen
2013-01-01
Although recycling is often experienced as a moral dilemma, studies that systematically approach this issue from an ethical perspective are scarce. Moreover, previous studies have explored recycling by mainly using single ethical constructs, such as moral norms, values or obligations, rarely...... approaching it as an ethical decision-making process. Our study takes a more holistic approach and integrates the recycling literature with business ethics theory in order to develop a conceptual model of ethical decision making involved in recycling. The model is based on Jones' issue-contingent model...... using structural equation modelling. The results of our study confirmed the relationships between three key facets of ethical decision making: moral recognition, moral judgment and moral intention. Higher levels of moral recognition were found to lead to more positive moral judgments, which in turn...
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The nursing contribution to ethical decision making
Directory of Open Access Journals (Sweden)
Barbara Dinten-Schmid
2016-11-01
Full Text Available Background: In the neonatal care units of the University Hospitals of Zurich and Bern, the nurse´s role in ethical decision-making is well established. However, nurses often reported uncertainty with regard to introducing the premature infant’s situation from the nursing perspective in ethics rounds. Aims: To empower neonatal nurses in fulfilling their role in the multiprofessional decision-making process, we performed a practice development project. On the basis of the Iowa model we developed a checklist for presenting the nursing history of premature infants in an ethically competent and responsible way. Conclusions: The ‘checklist for nursing assessment in the context of ethical decision-making’, equips nurses for their professional contribution to ethics rounds, making them better prepared to present the nursing perspective in a structured and thorough manner. Implications for practice: The Iowa model supports practice development even with limited data availability The instrument invigorates the neonatal nurse´s role in the multiprofessional ethical decision-making process It is crucial to involve peers in practice development
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Nonrational Processes in Ethical Decision Making
Rogerson, Mark D.; Gottlieb, Michael C.; Handelsman, Mitchell M.; Knapp, Samuel; Younggren, Jeffrey
2011-01-01
Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasi-legal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior,…
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Ethical decision-making in forensic psychology
Directory of Open Access Journals (Sweden)
M. Swanepoel
2010-07-01
Full Text Available The purpose of this article is to develop a comprehensive process for identifying and addressing primarily ethical issues related to the psychology profession in South Africa. In fulfilling this purpose, research was conducted of relevant ethical and to a lesser extent, legal aspects pertaining to the psychology profession. In an attempt to prevent unprofessional conduct claims against psychologists from succeeding and to alert psychologists to the concurrent ethical problems that may lead to malpractice suits, this article offers material on some important issues – in the context of forensic psychology – such as ethical decision-making and principles, professional ethics, the regulation of psychology as a profession, the Ethical Code of Professional Conduct to which a psychologist should adhere, ethical aspects and issues pertaining to forensic psychology in general, some ethical issues pertaining to child forensic psychology, summary guidelines for ethical decision-making and some steps to follow to ensure sound ethical decisionmaking.
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George Williams in Thailand: An Ethical Decision-Making Exercise
James, Constance R.; Smith, J. Goosby
2007-01-01
This article presents a classroom ethical decision-making exercise designed to help students make reasoned ethical decisions while gaining insight into their own and others' ethical decision-making strategies. During the exercise, students individually analyze an original mini-case, then meet in small groups to reach consensus on the advice and…
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Neurofunctional correlates of ethical, food-related decision-making.
Cherry, J Bradley C; Bruce, Jared M; Lusk, Jayson L; Crespi, John M; Lim, Seung-Lark; Bruce, Amanda S
2015-01-01
For consumers today, the perceived ethicality of a food's production method can be as important a purchasing consideration as its price. Still, few studies have examined how, neurofunctionally, consumers are making ethical, food-related decisions. We examined how consumers' ethical concern about a food's production method may relate to how, neurofunctionally, they make decisions whether to purchase that food. Forty-six participants completed a measure of the extent to which they took ethical concern into consideration when making food-related decisions. They then underwent a series of functional magnetic resonance imaging (fMRI) scans while performing a food-related decision-making (FRDM) task. During this task, they made 56 decisions whether to purchase a food based on either its price (i.e., high or low, the "price condition") or production method (i.e., with or without the use of cages, the "production method condition"), but not both. For 23 randomly selected participants, we performed an exploratory, whole-brain correlation between ethical concern and differential neurofunctional activity in the price and production method conditions. Ethical concern correlated negatively and significantly with differential neurofunctional activity in the left dorsolateral prefrontal cortex (dlPFC). For the remaining 23 participants, we performed a confirmatory, region-of-interest (ROI) correlation between the same variables, using an 8-mm3 volume situated in the left dlPFC. Again, the variables correlated negatively and significantly. This suggests, when making ethical, food-related decisions, the more consumers take ethical concern into consideration, the less they may rely on neurofunctional activity in the left dlPFC, possibly because making these decisions is more routine for them, and therefore a more perfunctory process requiring fewer cognitive resources.
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[Kairos. Decision-making in medical ethics].
Jousset, David
2014-06-01
This paper assesses the decision making patterns in medical ethics: the formalized pattern of decision science, the meditative pattern of an art of judgement and lastly the still-to-be-elaborated pattern of kairology or sense of the right time. The ethical decision is to be thought out in the conditions of medical action while resorting to the philosophical concepts that shed light on the issue. And it is precisely where medicine and philosophy of human action meet that the Greek notion of kairos, or "propitious moment", evokes the critical point where decision has to do with what is vital. Reflection shows that this kairos can be thought out outside the sacrificial pattern (deciding comes down to killing a possibility) by understanding the opportune moment as a sign of ethical action, as the condition for the formation of the subject (making a decision) and finally as a new relationship to time, including in the context of medical urgency. Thus with an approach to clinical ethics centred on the relation to the individual, the focus is less on the probabilistic knowledge of the decidable than on the meaning of the decision, and the undecidable comes to be accepted as an infinite dimension going beyond the limits of our acts, which makes the contingency and the grandeur of human responsibility.
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Factors that impact on emergency nurses' ethical decision-making ability.
Alba, Barbara
2016-11-10
Reliance on moral principles and professional codes has given nurses direction for ethical decision-making. However, rational models do not capture the emotion and reality of human choice. Intuitive response must be considered. Supporting intuition as an important ethical decision-making tool for nurses, the aim of this study was to determine relationships between intuition, years of worked nursing experience, and perceived ethical decision-making ability. A secondary aim explored the relationships between rational thought to years of worked nursing experience and perceived ethical decision-making ability. A non-experimental, correlational research design was used. The Rational Experiential Inventory measured intuition and rational thought. The Clinical Decision Making in Nursing Scale measured perceived ethical decision-making ability. Pearson's r was the statistical method used to analyze three primary and two secondary research questions. A sample of 182 emergency nurses was recruited electronically through the Emergency Nurses Association. Participants were self-selected. Approval to conduct this study was obtained by the Adelphi University Institutional Review Board. A relationship between intuition and perceived ethical decision-making ability (r = .252, p = .001) was a significant finding in this study. This study is one of the first of this nature to make a connection between intuition and nurses' ethical decision-making ability. This investigation contributes to a broader understanding of the different thought processes used by emergency nurses to make ethical decisions. © The Author(s) 2016.
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Teaching Empathy and Ethical Decision Making in Business Schools
Baker, Diane F.
2017-01-01
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…
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Evaluating the Intervention of an Ethics Class in Students' Ethical Decision-Making
Walker, Marquita
2011-01-01
In this pilot study, the author evaluated the impact of an ethics class in terms of students' ethical decision-making. The research compares aggregate responses from scenario-based pre- and post-survey open-ended survey questions designed to elicit changes in ethical decision-making by comparing students' cognitive and affective perceptions about…
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The influence of emotions on trust in ethical decision making
Lee, Wing-Shing; Selart, Marcus
2014-01-01
This paper attempts to delineate the interaction between trust, emotion, and ethical decision making. The authors first propose that trust can either in cite an individual toward ethical decisions or drag him or her away from ethical decisions, depending on different situations. The authors then postulate that the feeling of guilt is central in understanding how trust affects the ethical decision making process. Several propositions based on these assumptions are in...
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Ethical Decision Making and Effective Leadership
Kaucher, Ellie
2010-01-01
The problem. Educational leaders face challenges in the 21st century, make numerous decisions daily, and have the choice to make decisions based on ethics. Educational leaders may follow a corporate model regarding expenses and revenues while ignoring the best interests of children and their academic achievement. The alternative to the corporate…
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Directory of Open Access Journals (Sweden)
Bernie Brenner
2007-06-01
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
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Miller, Keith W; Wolf, Marty J; Grodzinsky, Frances
2017-04-01
In this paper we address the question of when a researcher is justified in describing his or her artificial agent as demonstrating ethical decision-making. The paper is motivated by the amount of research being done that attempts to imbue artificial agents with expertise in ethical decision-making. It seems clear that computing systems make decisions, in that they make choices between different options; and there is scholarship in philosophy that addresses the distinction between ethical decision-making and general decision-making. Essentially, the qualitative difference between ethical decisions and general decisions is that ethical decisions must be part of the process of developing ethical expertise within an agent. We use this distinction in examining publicity surrounding a particular experiment in which a simulated robot attempted to safeguard simulated humans from falling into a hole. We conclude that any suggestions that this simulated robot was making ethical decisions were misleading.
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Woodward, Belle; Davis, Diane C.; Hodis, Flaviu A.
2007-01-01
This study examined undergraduate information technology (IT) students' (N = 122) level of ethical reasoning and decision making at a Midwestern university. The purpose was to determine whether IT students' level of ethical reasoning provided information about the degree of their ethical decision making. The Defining Issues Test-2 (DIT-2) was used…
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Martin, April; Bagdasarov, Zhanna; Connelly, Shane
2015-04-01
Although various models of ethical decision making (EDM) have implicitly called upon constructs governed by working memory capacity (WMC), a study examining this relationship specifically has not been conducted. Using a sense making framework of EDM, we examined the relationship between WMC and various sensemaking processes contributing to EDM. Participants completed an online assessment comprised of a demographic survey, intelligence test, various EDM measures, and the Automated Operation Span task to determine WMC. Results indicated that WMC accounted for unique variance above and beyond ethics education, exposure to ethical issues, and intelligence in several sensemaking processes. Additionally, a marginally significant effect of WMC was also found with reference to EDM. Individual differences in WMC appear likely to play an important role in the ethical decision-making process, and future researchers may wish to consider their potential influences.
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Principals’ Moral Agency and Ethical Decision-Making: Toward a Transformational Ethics
Directory of Open Access Journals (Sweden)
Sabre Lynn Cherkowski
2015-11-01
Full Text Available This descriptive study provides a rich portrait of moral agency and ethical decision-making processes among a sample of Canadian school principals. Using an ethical responsibility framework linking moral agency and transformational leadership, the researchers found that 1 modeling moral agency is important for encouraging others to engage their own moral agency in the best interests of all children; 2 despite efforts to engage in collaborative decision-making, principals are often faced with the reality that they are the ones to absorb the cost of decisions; and 3 moral agents need to become wide-awake to the ethical issues and challenges that permeate their day-to-day work lives.
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Ethical decision making within the bureaucratic context: a case study.
Desai, Kathryn
2003-01-01
Balancing the polarized notions of quality and quantity of service and care is a challenge for the 21st century health and social service system. The expectation of transparent decision making at both the policy and the practice level of case management has forced practitioners to seek guidance in ethical decision making. Case management, as a system, has potential to lead this new practice approach by incorporating the principles of ethical decision making in planning and coordinating care. A recent case study of ethical decision making within the bureaucratic context offers some insight and learning and may help inform future practice.
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Priming and Organizational Level Effects on Ethical Decision Making.
Lautenschlager, Gary; Morris, Debbie
The study of ethical decision making has gained considerable interest among organizational scientists due to the widespread occurrence of wrongdoing in business, industry, government and various other institutions. This study examined the effects of priming and organizational level manipulation on an individual's ethical decision-making behavior.…
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A Contingency Model for Ethical Decision-Making by Educational Leaders
Green, James; Walker, Keith
2009-01-01
While numerous philosophical essays offer speculative explanations of how persons should make ethical decisions, empirical investigations of the phenomenon of ethical decision-making are limited to just a few studies in the discipline of business management. This investigation focused on the ethical dilemmas confronted by educators, with emphasis…
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Mendoza, Mary Elizabeth
2010-01-01
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...
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Ethical Decision-Making Accounting Competencies: Practitioners' Perspectives
Meador, Gwendolyn Parrish
2017-01-01
Recent accounting and corporate scandals call into question the ethicality of accounting practice, likewise accounting graduates. Advances in ethical accounting education are not emphasized in today's business schools leaving accounting graduates lacking necessary ethical accounting competencies to make ethical accounting decisions (Abend, 2013;…
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Ethical behavior of nurses in decision-making in Iran
Ebrahimi, Hossein; Nikravesh, Mansoure; Oskouie, Fatemeh; Ahmadi, Fazlollah
2015-01-01
Background: Ethical caring is an essential in nursing practice. Nurses are confronted with complex situations in which they are expected to autonomously make decisions in delivering good care to patients. Although a wide range of studies have examined ethical behavior of nurses, there are still many issues requiring further investigation. The aim of this article is to describe the ethical behavior of nurses in decision-making in patients? care in Iran. Materials and Methods: This study was co...
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Doing what's right: A grounded theory of ethical decision-making in occupational therapy.
VanderKaay, Sandra; Letts, Lori; Jung, Bonny; Moll, Sandra E
2018-04-20
Ethical decision-making is an important aspect of reasoning in occupational therapy practice. However, the process of ethical decision-making within the broader context of reasoning is yet to be clearly explicated. The purpose of this study was to advance a theoretical understanding of the process by which occupational therapists make ethical decisions in day-to-day practice. A constructivist grounded theory approach was adopted, incorporating in-depth semi-structured interviews with 18 occupational therapists from a range of practice settings and years of experience. Initially, participants nominated as key informants who were able to reflect on their decision-making processes were recruited. Theoretical sampling informed subsequent stages of data collection. Participants were asked to describe their process of ethical decision-making using scenarios from clinical practice. Interview transcripts were analyzed using a systematic process of initial then focused coding, and theoretical categorization to construct a theory regarding the process of ethical decision-making. An ethical decision-making prism was developed to capture three main processes: Considering the Fundamental Checklist, Consulting Others, and Doing What's Right. Ethical decision-making appeared to be an inductive and dialectical process with the occupational therapist at its core. Study findings advance our understanding of ethical decision-making in day-to-day clinical practice.
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An assessment of faculty and dental student decision-making in ethics.
Behar-Horenstein, Linda S; Catalanotto, Frank A; Garvan, Cynthia Wilson; Hudson-Vassell, Charisse
2014-01-01
This study reports and compares dental student and dental faculty scores to national norms for the Defining Issues Test 2, a measure of ethical decision-making competency. The findings showed that dental students and faculty tend to make decisions that promote self-interest, paralleling the ethical orientation of business professionals. Differences associated with gender, language, and norms from previous studies were observed. The findings underscore the importance of raising dental faculty and student awareness of their own ethical decision-making approaches. More importantly, the findings highlight the need to ensure that dental faculty have both the knowledge and skills to train dental students about the central role that ethical decision-making must play in patient care.
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Walker, Marquita
2013-01-01
This summative evaluation is the result of two years' of data reflecting the impact of an ethics class in terms of students' ethical decision-making. The research compares aggregate responses from scenario-based pre- and post-survey open-ended survey questions designed to measure changes in ethical decision-making by comparing students' cognitive…
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Kert, Serhat Bahadir; Uz, Cigdem; Gecu, Zeynep
2014-01-01
This study examined the effectiveness of an electronic performance support system (EPSS) on computer ethics education and the ethical decision-making processes. There were five different phases to this ten month study: (1) Writing computer ethics scenarios, (2) Designing a decision-making framework (3) Developing EPSS software (4) Using EPSS in a…
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GM ethical decision making in practice
Directory of Open Access Journals (Sweden)
Donald Bruce
2002-09-01
Full Text Available Celia Deane-Drummond's case for wisdom as an approach to ethical decision making and her doubts about case-oriented methodology are critiqued with reference to the SRT Project's Engineering Genesis study. Its approach is explored in practical decisions on various real life examples of genetic modification in crops and animals. It involved both intrinsic and consequential approaches, and identified key value positions behind different policies and stakeholders. The paper also clarifies the relationship between reactive (cost-benefit and precautionary risk assessment, explaining their strengths and limitations, and the role of underlying values in both forms of risk decision making.
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Patient decision-making: medical ethics and mediation.
Craig, Y J
1996-01-01
A review of medical ethics literature relating to the importance of the participation of patients in decision-making introduces the role of rights-based mediation as a voluntary process now being developed innovatively in America. This is discussed in relation to the theory of communicative ethics and moral personhood. References are then made to the work of medical ethics committees and the role of mediation within these. Finally it is suggested that mediation is part of an eirenic ethic alr...
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Risk informed decision-making and its ethical basis
International Nuclear Information System (INIS)
Ersdal, Gerhard; Aven, Terje
2008-01-01
In decision-making under uncertainty there are two main questions that need to be evaluated: (i) What are the future consequences and associated uncertainties of an action, and (ii) what is a good (or right) decision or action. Philosophically these issues are categorized as epistemic questions (i.e. questions of knowledge) and ethical questions (i.e. questions of moral and norms). This paper discusses the second issue, and evaluates different risk management approaches for establishing good decisions, using different ethical theories as a basis. These theories include the utilitarian ethics of Bentley and Mills, and deontological ethics of Kant, Rawls and Habermas. The risk management approaches include cost-benefit analysis (CBA), minimum safety criterion, the ALARP principle and the precautionary principle
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Risk informed decision-making and its ethical basis
Energy Technology Data Exchange (ETDEWEB)
Ersdal, Gerhard [University of Stavanger (Norway)], E-mail: gerhard.ersdal@ptil.no; Aven, Terje [University of Stavanger (Norway)
2008-02-15
In decision-making under uncertainty there are two main questions that need to be evaluated: (i) What are the future consequences and associated uncertainties of an action, and (ii) what is a good (or right) decision or action. Philosophically these issues are categorized as epistemic questions (i.e. questions of knowledge) and ethical questions (i.e. questions of moral and norms). This paper discusses the second issue, and evaluates different risk management approaches for establishing good decisions, using different ethical theories as a basis. These theories include the utilitarian ethics of Bentley and Mills, and deontological ethics of Kant, Rawls and Habermas. The risk management approaches include cost-benefit analysis (CBA), minimum safety criterion, the ALARP principle and the precautionary principle.
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Ethical implications and decision making in care education process
Directory of Open Access Journals (Sweden)
Layse Kelle Silva
2014-07-01
Full Text Available Objective. To determine ethical implications for nursing practice at the point of decision making by nursing professors in practice area. Methodology. A qualitative method was adopted, with use of semistructured interviews with sixteen nursing professors who delivered care at a teaching hospital in Salvador, Bahia, from May to June 2011. The methodological reference used was the discourse of the collective subject (DCS by Lefévre and Lefévre. Results. In response to DCSs, the following subjects appeared: "Ethics is fundamental and of vital importance in the decision making process," "searching for knowledge and research to identify problems and solutions, including alternatives and support for decisions," and "to act in the best way." Conclusion. Professors who provide education about patient care also delivered care. They have the responsibility to consider the ethical implications of decision making because they stimulate fundamental reflection and could positively influence future nursing professionals.
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Using Gaming Technology to Teach Ethical Decision-Making
Sloane, Sharon; Holmes, Elizabeth
2009-01-01
The authors describe the steps in the ethical decision-making process and show how employers and educators are addressing ethical gray areas using innovative simulations in order to better prepare employees and other personnel to face ethical challenges head-on. The model outlined in this article can be used as a teaching and training tool to…
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Principals' Moral Agency and Ethical Decision-Making: Toward a Transformational Ethics
Cherkowski, Sabre; Walker, Keith D.; Kutsyuruba, Benjamin
2015-01-01
This descriptive study provides a rich portrait of moral agency and ethical decision-making processes among a sample of Canadian school principals. Using an ethical responsibility framework linking moral agency and transformational leadership, the researchers found that (1) modeling moral agency is important for encouraging others to engage their…
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Making the hard decisions: Ethical care decisions in wartime nursing practice.
Agazio, Janice; Goodman, Petra
Codes of ethics set forth standards of ethical conduct for nurses. However, nurses involved in wartime operations, or disasters, may often have their moral compass challenged by the patient care decisions necessary under adverse conditions. Reverse triage, resource allocation, and promotion of patient autonomy present multiple challenges to meeting commonly applied ethical principles. The purpose of this study was to use the International Council of Nursing code of ethics as a framework to organize the ethical issues emerging from wartime nursing. This article represents a secondary analysis of two studies using thematic analysis to identify ethical issues encountered by military nurses during the recent conflicts in Iraq and Afghanistan. Data were collected from nurses deployed from 2002 to 2015 and from 111 military nurses during focused interviews. Across both studies, issues such as resource allocation, patient triage, cultural differences, and equitable treatment for all emerged as challenges within the wartime environment. Nurses were at a loss at times as to how best to manage the situations and recommended that more education is needed in ethical decision making before, during, and after deployment as a debriefing strategy. Similar issues have been documented in military and disaster literature indicating that such challenges are not limited to the recent conflicts but cross time and location. By better understanding how nurses define, assess, and manage the ethical situations they encounter in wartime nursing practice, military nurses can better prepare for future conflicts, provide mentorship and targeted education to hopefully reducing any feelings of moral distress, and promote ethical decision making that will best promote outcomes in accordance with nursing's ethical codes. Copyright © 2017 Elsevier Inc. All rights reserved.
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Rebera, Andrew P; Rafalowski, Chaim
2014-09-01
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".
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The Role of Principles, Character, and Professional Values in Ethical Decision-Making
Humphrey, Elaine; Janosik, Steven M.; Creamer, Don G.
2004-01-01
The role of ethical principles, character traits, and professional values in ethical decision-making is examined and depicted through an integrated and comprehensive model. A case study provides an illustration of improved decision-making when using the model.
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Virtue Ethics in School Counseling: A Framework for Decision Making
Wilczenski, Felicia L.; Cook, Amy L.
2011-01-01
Virtue ethics focus on the motives that guide ethical decision making and action, and as such, are critical to the competent application of the counseling profession's ethical codes. Knowledge of virtue ethics deepens understanding of moral responsibilities and ethical reasoning in professional practice. This paper is an overview of virtue ethics…
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Do ethical Guidelines make a difference to decision-making?
Osborn, M; Day, R; Komesaroff, P; Mant, A
2009-12-01
The different levels of knowledge and understanding of attitudes to and use by physicians of the Royal Australasian College of Physicians (RACP) Guidelines for ethical relationships between physicians and the pharmaceutical industry are unknown. The aim of this study was to explore how physician Fellows of the RACP relate to and use the ethical Guidelines of the RACP regarding relationships with the pharmaceutical industry. Focus group discussions and in-depth face-to-face interviews were used to gather information from physicians who responded to invitations placed in electronic newsletters or through word of mouth. Five focus groups and eight in-depth interviews were conducted with 56 practising physicians in Australia and New Zealand. Most physicians were aware of the RACP ethical Guidelines (3rd edition, 2006), but only a few used them to resolve ethical dilemmas or to influence their decision-making in relation to interacting with the pharmaceutical industry. Ethical standards used or approaches to decision-making practices related to interactions with the pharmaceutical industry were most likely to have been developed through past experiences, peer pressure or decisions that were considered to be 'in the best interests of their patients'. There were strong opinions expressed about relationships with the pharmaceutical industry and how these relationships often lead to feelings of humiliation. Some felt they were prostituting themselves for the sake of acquiring funding for staff positions, medical devices, research or attendance at conferences. Very few physicians recollected having any assistance on how to deal with the pharmaceutical industry during their training, and those few who did recollect such input through their curricula and education felt they did not benefit. RACP Guidelines on ethical guidance for relating to the pharmaceutical industry have not been used by most physicians, and very few had read or referred to the Guidelines. Reliance on
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Ethically-based clinical decision-making in physical therapy: process and issues.
Finch, Elspeth; Geddes, E Lynne; Larin, Hélène
2005-01-01
The identification and consideration of relevant ethical issues in clinical decision-making, and the education of health care professionals (HCPs) in these skills are key factors in providing quality health care. This qualitative study explores the way in which physical therapists (PTs) integrate ethical issues into clinical practice decisions and identifies ethical themes used by PTs. A purposive sample of eight PTs was asked to describe a recent ethically-based clinical decision. Transcribed interviews were coded and themes identified related to the following categories: 1) the integration of ethical issues in the clinical decision-making process, 2) patient welfare, 3) professional ethos of the PT, and 4) health care economics and business practices. Participants readily described clinical situations involving ethical issues but rarely identified specific conflicting ethical issues in their description. Ethical dilemmas were more frequently resolved when there were fewer emotional sequelae associated with the dilemma, and the PT had a clear understanding of professional ethos, valued patient autonomy, and explored a variety of alternative actions before implementing one. HCP students need to develop a clear professional ethos and an increased understanding of the economic factors that will present ethical issues in practice.
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Pandemic influenza preparedness: an ethical framework to guide decision-making
Directory of Open Access Journals (Sweden)
Gibson Jennifer L
2006-12-01
Full Text Available Abstract Background Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on values because science alone cannot tell us how to prepare for a public health crisis. Discussion In this paper, we present an ethical framework for pandemic influenza planning. The ethical framework was developed with expertise from clinical, organisational and public health ethics and validated through a stakeholder engagement process. The ethical framework includes both substantive and procedural elements for ethical pandemic influenza planning. The incorporation of ethics into pandemic planning can be helped by senior hospital administrators sponsoring its use, by having stakeholders vet the framework, and by designing or identifying decision review processes. We discuss the merits and limits of an applied ethical framework for hospital decision-making, as well as the robustness of the framework. Summary The need for reflection on the ethical issues raised by the spectre of a pandemic influenza outbreak is great. Our efforts to address the normative aspects of pandemic planning in hospitals have generated interest from other hospitals and from the governmental sector. The framework will require re-evaluation and refinement and we hope that this paper will generate feedback on how to make it even more robust.
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Social Decision Making Social Dilemmas, Social Values, and Ethical Judgments
Kramer, Roderick M; Bazerman, Max H
2009-01-01
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
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Enhancing Perception in Ethical Decision Making: A Method to Address Ill-Defined Training Domains
2010-08-01
Development Ethical Decision Making Qualitative Methods Applications of Gestalt Theory Decision Making Experiences Mixed-Method...U.S. Army Research Institute for the Behavioral and Social Sciences Research Report 1932 Enhancing Perception in Ethical...TYPE Final 3. DATES COVERED (from. . . to) April 2009 to May 2010 4. TITLE AND SUBTITLE Enhancing Perception in Ethical Decision Making: A
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Feminist ethics and menopause: autonomy and decision-making in primary medical care.
Murtagh, Madeleine J; Hepworth, Julie
2003-04-01
The construction of menopause as a long-term risk to health and the adoption of discourses of prevention has made necessary a decision by women about medical treatment; specifically regarding the use of hormone replacement therapy. In a study of general practitioners' accounts of menopause and treatment in Australia, women's 'choice', 'informed decision-making' and 'empowerment' were key themes through which primary medical care for women at menopause was presented. These accounts create a position for women defined by the concept of individual choice and an ethic of autonomy. These data are a basis for theorising more generally in this paper. We critically examine the construct of 'informed decision-making' in relation to several approaches to ethics including bioethics and a range of feminist ethics. We identify the intensification of power relations produced by an ethic of autonomy and discuss the ways these considerations inform a feminist ethics of decision-making by women. We argue that an 'ethic of autonomy' and an 'offer of choice' in relation to health care for women at menopause, far from being emancipatory, serves to intensify power relations. The dichotomy of choice, to take or not to take hormone replacement therapy, is required to be a choice and is embedded in relations of power and bioethical discourse that construct meanings about what constitutes decision-making at menopause. The deployment of the principle of autonomy in medical practice limits decision-making by women precisely because it is detached from the construction of meaning and the self and makes invisible the relations of power of which it is a part.
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Effectiveness of a Case-Based Computer Program on Students' Ethical Decision Making.
Park, Eun-Jun; Park, Mihyun
2015-11-01
The aim of this study was to test the effectiveness of a case-based computer program, using an integrative ethical decision-making model, on the ethical decision-making competency of nursing students in South Korea. This study used a pre- and posttest comparison design. Students in the intervention group used a computer program for case analysis assignments, whereas students in the standard group used a traditional paper assignment for case analysis. The findings showed that using the case-based computer program as a complementary tool for the ethics courses offered at the university enhanced students' ethical preparedness and satisfaction with the course. On the basis of the findings, it is recommended that nurse educators use a case-based computer program as a complementary self-study tool in ethics courses to supplement student learning without an increase in course hours, particularly in terms of analyzing ethics cases with dilemma scenarios and exercising ethical decision making. Copyright 2015, SLACK Incorporated.
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Oliveira, Arnaldo
2007-01-01
This paper examines rational and psychological decision-making models. Descriptive and normative methodologies such as attribution theory, schema theory, prospect theory, ambiguity model, game theory, and expected utility theory are discussed. The definition of culture is reviewed, and the relationship between culture and decision making is also highlighted as many organizations use a cultural-ethical decision-making model.
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Wilson, Vernesia Bracey
2010-01-01
As ethical dilemmas arise in community colleges, administrators make decisions that require sensitivity to the organizational, political, and environmental factors surrounding their particular institutional climates and locales. The moral reasoning and ethical decision-making of community college administrators were examined in this study. In…
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On the ethical analysis of value issues in public decision-making ...
African Journals Online (AJOL)
South African Journal of Philosophy ... What difference can such an ethical analysis make to public decision-making? ... value and ethical questions cannot be settled in a rational manner ... values and ethics are so intertwined with emotions and biases that one cannot take them seriously in ... AJOL African Journals Online.
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A Multidimensional Ethics Scale for Indian Managers' Moral Decision Making
Gupta, Seema
2010-01-01
This paper analyses the role of traditional moral theories in managers’ moral decision making using the multidimensional ethics scale (MES) developed and refined by Reidenbach and Robin (1988, 1990). This study extends their work by examining the applicability of the scale to subjects from India, other than the country in which the scale was developed. The research question is: what kind of ethical dimensions do Indian managers reveal when they are making moral decisions. Factor analysis is d...
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Ethical behavior of nurses in decision-making in Iran.
Ebrahimi, Hossein; Nikravesh, Mansoure; Oskouie, Fatemeh; Ahmadi, Fazlollah
2015-01-01
Ethical caring is an essential in nursing practice. Nurses are confronted with complex situations in which they are expected to autonomously make decisions in delivering good care to patients. Although a wide range of studies have examined ethical behavior of nurses, there are still many issues requiring further investigation. The aim of this article is to describe the ethical behavior of nurses in decision-making in patients' care in Iran. This study was conducted through grounded theory method. Participants were 17 Iranian nurses, employed in Tabriz University of Medical Sciences hospitals. Unstructured, semi-structured, and in-depth interviews were used for data gathering. Interviews were transcribed and coded according to Strauss and Corbin method in open, axial, and selective coding. Nurses showed three major approaches in ethical behavior: Beyond the legal duty and protection of the patients, which includes dedication and full availability to nurses' job and the client, spending time for the patients and delayed exit from the workplace, and arbitrary practice; legal duty and the protection of patients and nurses, which includes caretaking for the patient, responding to the client, and implementing the physician's prescription; and below the legal duty and the protection of one's self, that is, finding evidence and having witness in case of false documentation, and shortcoming, negligence, and mistake. Because of the importance of the ethical behavior of nurses in decision-making, it is necessary to find ways to promote moral reasoning and moral development of nurses. Empowerment of nurses, nurse educators, and nursing students to acquire knowledge and develop ethical behavior skills is important.
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The effect of an ethical decision-making training on young athletes’ attitudes toward doping
DEFF Research Database (Denmark)
Elbe, Anne-Marie; Brand, Ralf
2016-01-01
This article examines whether a training program in ethical decision making can change young athletes’ doping attitudes. Fifty-two young elite athletes were randomly assigned to either an ethical decision-making training group or a standard-knowledge-based educational program group. Another 17 yo...... could be an indication that the ethical decision-making training was successful in breaking up the athletes’ stereotypical style of reasoning about doping....
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Avoiding bias in medical ethical decision-making. Lessons to be learnt from psychology research.
Albisser Schleger, Heidi; Oehninger, Nicole R; Reiter-Theil, Stella
2011-05-01
When ethical decisions have to be taken in critical, complex medical situations, they often involve decisions that set the course for or against life-sustaining treatments. Therefore the decisions have far-reaching consequences for the patients, their relatives, and often for the clinical staff. Although the rich psychology literature provides evidence that reasoning may be affected by undesired influences that may undermine the quality of the decision outcome, not much attention has been given to this phenomenon in health care or ethics consultation. In this paper, we aim to contribute to the sensitization of the problem of systematic reasoning biases by showing how exemplary individual and group biases can affect the quality of decision-making on an individual and group level. We are addressing clinical ethicists as well as clinicians who guide complex decision-making processes of ethical significance. Knowledge regarding exemplary group psychological biases (e.g. conformity bias), and individual biases (e.g. stereotypes), will be taken from the disciplines of social psychology and cognitive decision science and considered in the field of ethical decision-making. Finally we discuss the influence of intuitive versus analytical (systematical) reasoning on the validity of ethical decision-making.
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Beyond Relativism to Ethical Decision-Making
Walker, Keith D.; Donlevy, J. Kent
2006-01-01
This article examines the ethical conundrum of educational decision makers when faced with a plethora of conflicting value-based decisions. It offers an analysis of a well-known fable as the foil to demonstrate the problematic nature of ethical relativism and postmodern ethics in resolving that conundrum, while advocating the use of five core…
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Catacutan, Maria Rosario G.; de Guzman, Allan B.
2015-01-01
Ethical decision-making in school administration has received considerable attention in educational leadership literature. However, most research has focused on principals working in secondary school settings while studies that explore ethical reasoning processes of academic deans have been significantly few. This qualitative study aims to…
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Preaching What We Practice: Teaching Ethical Decision-Making to Computer Security Professionals
Fleischmann, Kenneth R.
The biggest challenge facing computer security researchers and professionals is not learning how to make ethical decisions; rather it is learning how to recognize ethical decisions. All too often, technology development suffers from what Langdon Winner terms technological somnambulism - we sleepwalk through our technology design, following past precedents without a second thought, and fail to consider the perspectives of other stakeholders [1]. Computer security research and practice involves a number of opportunities for ethical decisions. For example, decisions about whether or not to automatically provide security updates involve tradeoffs related to caring versus user autonomy. Decisions about online voting include tradeoffs between convenience and security. Finally, decisions about routinely screening e-mails for spam involve tradeoffs of efficiency and privacy. It is critical that these and other decisions facing computer security researchers and professionals are confronted head on as value-laden design decisions, and that computer security researchers and professionals consider the perspectives of various stakeholders in making these decisions.
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THE CONTRIBUTION OF PHILOSOPHY AND PSYCHOLOGY IN THE ETHICAL DECISION MAKING PROCESS
Directory of Open Access Journals (Sweden)
DANIELA LIVIA DOLTU
2010-11-01
Full Text Available This article aims to explore the relationship between morality and organizational culture with reference to the process of ethical decision making and to the cooperation between philosopher and psychologist for the improvement of ethical climate within a public institution. Firstly, we introduce the notion of organizational culture emphasizing the importance of moral values and their role in building a true ethical climate. Secondly, we focus on the study of ethical decision making. The process is examined from the perspective of the interaction between human personality and different elements of organizational culture. Philosophy and psychology differently approach this problem. Our intention is to bridge the gap between the two perspectives, by demonstrating their belonging to the same continuum as well as the need for knowledge from both fields in order to have a complete overview of its internal mechanisms. Deontological and utilitarian theories fail to explain by themselves the decision making process and so psychology does: moral development theories, the leadership type, and emotions have on their basis a personal moral philosophy. We will also consider the influence of social groups on individual decision making.
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Ethical case deliberation and decision making.
Gracia, Diego
2003-01-01
During the last thirty years different methods have been proposed in order to manage and resolve ethical quandaries, specially in the clinical setting. Some of these methodologies are based on the principles of Decision-making theory. Others looked to other philosophical traditions, like Principlism, Hermeneutics, Narrativism, Casuistry, Pragmatism, etc. This paper defends the view that deliberation is the cornerstone of any adequate methodology. This is due to the fact that moral decisions must take into account not only principles and ideas, but also emotions, values and beliefs. Deliberation is the process in which everyone concerned by the decision is considered a valid moral agent, obliged to give reasons for their own points of view, and to listen to the reasons of others. The goal of this process is not the reaching of a consensus but the enrichment of one's own point of view with that of the others, increasing in this way the maturity of one's own decision, in order to make it more wise or prudent. In many cases the members of a group of deliberation will differ in the final solution of the case, but the confrontation of their reasons will modify the perception of the problem of everyone. This is the profit of the process. Our moral decisions cannot be completely rational, due to the fact that they are influenced by feelings, values, beliefs, etc., but they must be reasonable, that is, wise and prudent. Deliberation is the main procedure to reach this goal. It obliges us to take others into account, respecting their different beliefs and values and prompting them to give reasons for their own points of view. This method has been traditional in Western clinical medicine all over its history, and it should be also the main procedure for clinical ethics.
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Davidrajuh, Reggie
2008-01-01
This paper proposes a conceptual model for ethical business decision-making. The purpose of this model is to explore the ethical implications of personal relationship in business exchanges. Firstly, this paper introduces personal relationship in business exchanges. Secondly, three normative theories of ethics that are relevant to the business environment are presented. Thirdly, a literature study on the existing models and frameworks for ethical business decision-making is pres...
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Framework for ethical decision-making based on mission, vision and values of the institution.
Kotalik, Jaro; Covino, Cathy; Doucette, Nadine; Henderson, Steve; Langlois, Michelle; McDaid, Karen; Pedri, Louisa M
2014-06-01
The authors led the development of a framework for ethical decision-making for an Academic Health Sciences Centre. They understood the existing mission, vision, and values statement (MVVs) of the centre as a foundational assertion that embodies an ethical commitment of the institution. Reflecting the Patient and Family Centred Model of Care the institution is living, the MVVs is a suitable base on which to construct an ethics framework. The resultant framework consists of a set of questions for each of the MVVs. Users of the framework are expected to identify two or more possible decisions to address the issue at hand and then, by applying the provided sequence of questions to each, examine these options and determine the overall ethically preferable decision. The construction of such a framework requires the creative involvement of the institution's staff. Thus the development of the framework can represent a training process in ethical decision-making as well as advance the ethical atmosphere of the institution. This novel approach has the advantage of placing the MVVs on active duty, at the centre of ethical decision-making, and lifts it from its otherwise relative obscurity in most institutions.
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A Model for Making Decisions about Ethical Dilemmas in Student Assessment
Johnson, Robert L.; Liu, Jin; Burgess, Yin
2017-01-01
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…
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A Review of Contemporary Ethical Decision-Making Models for Mental Health Professionals
Francis, Perry C.
2015-01-01
Mental health professionals are faced with increasingly complex ethical decisions that are impacted by culture, personal and professional values, and the contexts in which they and their clients inhabit. This article presents the reasons for developing and implementing multiple ethical decision making models and reviews four models that address…
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Teaching ethics to engineers: ethical decision making parallels the engineering design process.
Bero, Bridget; Kuhlman, Alana
2011-09-01
In order to fulfill ABET requirements, Northern Arizona University's Civil and Environmental engineering programs incorporate professional ethics in several of its engineering courses. This paper discusses an ethics module in a 3rd year engineering design course that focuses on the design process and technical writing. Engineering students early in their student careers generally possess good black/white critical thinking skills on technical issues. Engineering design is the first time students are exposed to "grey" or multiple possible solution technical problems. To identify and solve these problems, the engineering design process is used. Ethical problems are also "grey" problems and present similar challenges to students. Students need a practical tool for solving these ethical problems. The step-wise engineering design process was used as a model to demonstrate a similar process for ethical situations. The ethical decision making process of Martin and Schinzinger was adapted for parallelism to the design process and presented to students as a step-wise technique for identification of the pertinent ethical issues, relevant moral theories, possible outcomes and a final decision. Students had greatest difficulty identifying the broader, global issues presented in an ethical situation, but by the end of the module, were better able to not only identify the broader issues, but also to more comprehensively assess specific issues, generate solutions and a desired response to the issue.
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Stakeholder Risk Management in Ethical Decision Making
DEFF Research Database (Denmark)
Lauesen, Linne Marie
evidence from hybrid organizations as Publicly Owned Enterprises (POEs) mixed of private corporations and political administration. The model offers a new way of combining risk management with ethical decisionmaking processes by the inclusion of multiple stakeholders. Not only does the model apply...... to these kinds of hybrid organizations, but it is easily adopted and tested for other private business models too. The findings and the conceptualization of the model enhances business ethics in decision making by managing and balancing stakeholder concerns with the same concerns as the traditional risk......Stakeholder management has for the last three decades been concerned either with strategic business management or business ethics, values and quality. Many models have been developed, but recently the literature asks for more dynamic models instead of the staticism that characterizes some models...
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Caswell, Shane V; Gould, Trenton E
2008-01-01
Ethics research in athletic training is lacking. Teaching students technical skills is important, but teaching them how to reason and to behave in a manner that befits responsible health care professionals is equally important. To expand ethics research in athletic training by (1) describing undergraduate athletic training students' and educators' individual moral philosophies and ethical decision-making abilities and (2) investigating the effects of sex and level of education on mean composite individual moral philosophies and ethical decision-making scores. Stratified, multistage, cluster-sample correlational study. Mailed survey instruments were distributed in classroom settings at 30 institutions having Commission on Accreditation of Allied Health Education Programs (CAAHEP)-accredited athletic training programs. Undergraduate students and educators (n = 598: 373 women, 225 men; mean age = 23.5 +/- 6.3 years) from 25 CAAHEP-accredited athletic training programs. We used the Ethics Position Questionnaire and the Dilemmas in Athletic Training Questionnaire to compute participants' mean composite individual moral philosophies (idealism and relativism) and ethical decision-making scores, respectively. Three separate 2 (sex: male, female) x 3 (education level: underclass, upper class, educator) between-subjects factorial analyses of variance using idealism, relativism, and ethical decision-making scores as dependent measures were performed. Respondents reported higher idealism scores (37.57 +/- 4.91) than relativism scores (31.70 +/- 4.80) (response rate = 83%). The mean ethical decision-making score for all respondents was 80.76 +/- 7.88. No significant interactions were revealed. The main effect for sex illustrated that men reported significantly higher relativism scores ( P = .0014, eta (2) = .015) than did women. The main effect for education level revealed significant differences between students' and educators' idealism ( P = .0190, eta (2) = .013), relativism
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Xabier ETXEBERRIA MAULEON
2016-01-01
The text deals with the existing ethical tension between decision-making on behalf of people with intellectual disabilities and substitute decision-making, and the duty-bound respect for the person’s autonomy. The work begins by distinguishing decision- making on behalf of someone and substitute decision-making, consequently favoring the latter, as well as relating autonomy to interdependence. This first clarification leads to the construction of a basic and general criterion for substitute d...
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Assessing ethical problem solving by reasoning rather than decision making.
Tsai, Tsuen-Chiuan; Harasym, Peter H; Coderre, Sylvain; McLaughlin, Kevin; Donnon, Tyrone
2009-12-01
The assessment of ethical problem solving in medicine has been controversial and challenging. The purposes of this study were: (i) to create a new instrument to measure doctors' decisions on and reasoning approach towards resolving ethical problems; (ii) to evaluate the scores generated by the new instrument for their reliability and validity, and (iii) to compare doctors' ethical reasoning abilities between countries and among medical students, residents and experts. This study used 15 clinical vignettes and the think-aloud method to identify the processes and components involved in ethical problem solving. Subjects included volunteer ethics experts, postgraduate Year 2 residents and pre-clerkship medical students. The interview data were coded using the instruments of the decision score and Ethical Reasoning Inventory (ERI). The ERI assessed the quality of ethical reasoning for a particular case (Part I) and for an individual globally across all the vignettes (Part II). There were 17 Canadian and 32 Taiwanese subjects. Based on the Canadian standard, the decision scores between Taiwanese and Canadian subjects differed significantly, but made no discrimination among the three levels of expertise. Scores on the ERI Parts I and II, which reflect doctors' reasoning quality, differed between countries and among different levels of expertise in Taiwan, providing evidence of construct validity. In addition, experts had a greater organised knowledge structure and considered more relevant variables in the process of arriving at ethical decisions than did residents or students. The reliability of ERI scores was 0.70-0.99 on Part I and 0.75-0.80 on Part II. Expertise in solving ethical problems could not be differentiated by the decisions made, but could be differentiated according to the reasoning used to make those decisions. The difference between Taiwanese and Canadian experts suggests that cultural considerations come into play in the decisions that are made in the
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Moral Development and Social Worker Ethical Decision-Making
Groessl, Joan
2013-01-01
This study examined both the moral development levels using the Defining Issues Test-2 (DIT--2) and ethical decision-making using the Professional Opinion Scale (POS) of social workers who provide field supervision to students within accredited social work programs in Wisconsin. Using the moral development theory of Kohlberg (1981) which defined…
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Ethical decision-making in the dilemma of the intersex infant.
Lathrop, Breanna L; Cheney, Teresa B; Hayman, Annette B
2014-03-01
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.
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The Mediating Role of Anticipated Guilt in Consumers’ Ethical Decision-Making
S. STEENHAUT; P. VAN KENHOVE
2006-01-01
In this paper we theorize that the anticipation of guilt plays an important role in ethically questionable consumer situations. We propose an ethical decision-making framework incorporating anticipated guilt as partial mediator between consumers’ ethical beliefs (anteceded by ethical ideology) and intentions. In a first study we compared several models using structural equation modeling and found empirical support for our research model. A second experiment was set up to illustrate how retail...
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Applying an ethical decision-making tool to a nurse management dilemma.
Toren, Orly; Wagner, Nurith
2010-05-01
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.
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The history of ethical decision making in neonatal intensive care.
Placencia, Frank X; McCullough, Laurence B
2011-01-01
Neonatal ethics has focused on 2 questions: is withholding potentially live-saving treatment from neonates ethically justified? and if so, who has the authority to decide? This article details how these questions developed and provides a description of the possible answers. In the first section, we review a selection of seminal articles by noted authors in the fields of ethics, medicine, and law. The second section provides a detailed account of the development of the Baby Doe Regulations and the impact they had on neonatal ethics, with particular attention to the emergence of the Best Interest Standard as a guideline for decision making. In the last section, we review the landmark position statements by the American Academy of Pediatric (AAP), and the focus on evidence-based decision making. We conclude that forgoing life-saving treatment is ethically justified. However, this requires a rigorous evidence-based process and is limited by the Best Interest Standard. The second question is more difficult to answer, but we feel that in light of legal limitations, physicians acting as both the infant advocate and a proxy for the state, decide what falls in the range of acceptable treatment options, with the parents free to choose within that range.
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Ethical Decision-Making: The Role of Self-Monitoring, Future Orientation, and Social Networks
Directory of Open Access Journals (Sweden)
Ana Carla Bon
2017-02-01
Full Text Available This study examines the influence of individual factors (self monitoring, temporal orientation on social networking, and their relationship with unethical decision-making. The study used surveys to measure the unethical intentions and social network data of 129 professionals. Data were analyzed using confirmatory factor analysis and structural equation modeling. The findings provided evidence that individual factors influence the development of social networks and, along with self-monitoring, the likelihood of unethical decision-making. In particular, being in positions of lower network centrality increased individuals’ risk of unethical intention. One explanation stems from the need for high situation control to reduce risk and ensure the success of an event, which only a closed network can provide. However, ethical low self-monitor women were also found to have low centrality, so social networks alone do not explain ethical decision-making. This research represents a step forward in our understanding of ethical decision-making through the adoption of multiple and simultaneous factors, proposing an integrated theory of individual and situational factors influencing unethical options.
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Perceived Possibility of Disclosure and Ethical Decision Making in an Information Technology Context
Directory of Open Access Journals (Sweden)
A. Bolhari
2017-04-01
Full Text Available To date, substantial research studies have been conducted in the field of ethical decision making in many disciplines. However, ethical efforts in the context of information technology have been limited. In this research, a focus has been put on modeling ethical decision making in cyberspace with emphasis on business intelligence scenarios. The model is comprised of six exogenous and two endogenous constructs, among them seven were delicately selected from valid and empirically tested ethical models and the eighth one is developed by the authors. After pre-testing the model by experts, reliability, convergent and discriminant validities were approved. Data were collected from 188 IT personnel in the banking industry of Iran. Results revealed that the perceived importance of an IT ethical issue, ethical judgment, ethical obligation, perceived possibility of disclosure, ego strength, and locus of control directly impact ethical intention. However, no impact from law on ethical obligation and codes of ethics on ethical intention was observed. As shown, a higher possibility on acting unethically occurs when the person feels confident that his/her actions will go unnoticed.
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Antes, Alison L; Wang, Xiaoqian; Mumford, Michael D; Brown, Ryan P; Connelly, Shane; Devenport, Lynn D
2010-03-01
To examine the effects that existing courses on the responsible conduct of research (RCR) have on ethical decision making by assessing the ethicality of decisions made in response to ethical problems and the underlying processes involved in ethical decision making. These processes included how an individual thinks through ethical problems (i.e., meta-cognitive reasoning strategies) and the emphasis placed on social dimensions of ethical problems (i.e., social-behavioral responses). In 2005-2007, recruitment announcements were made, stating that a nationwide, online study was being conducted to examine the impact of RCR instruction on the ethical decision making of scientists. Recruitment yielded contacts with over 200 RCR faculty at 21 research universities and medical schools; 40 (20%) RCR instructors enrolled their courses in the current study. From those courses, 173 participants completed an ethical decision-making measure. A mixed pattern of effects emerged. The ethicality of decisions did not improve as a result of RCR instruction and even decreased for decisions pertaining to business aspects of research, such as contract bidding. Course participants improved on some meta-cognitive reasoning strategies, such as awareness of the situation and consideration of personal motivations, but declined for seeking help and considering others' perspectives. Participants also increased their endorsement of detrimental social-behavioral responses, such as deception, retaliation, and avoidance of personal responsibility. These findings indicated that RCR instruction may not be as effective as intended and, in fact, may even be harmful. Harmful effects might result if instruction leads students to overstress avoidance of ethical problems, be overconfident in their ability to handle ethical problems, or overemphasize their ethical nature. Future research must examine these and other possible obstacles to effective RCR instruction.
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Levin, Lia; Schwartz-Tayri, Talia
2017-06-01
Partnerships between service users and social workers are complex in nature and can be driven by both personal and contextual circumstances. This study sought to explore the relationship between social workers' involvement in shared decision making with service users, their attitudes towards service users in poverty, moral standards and health and social care organizations' policies towards shared decision making. Based on the responses of 225 licensed social workers from health and social care agencies in the public, private and third sectors in Israel, path analysis was used to test a hypothesized model. Structural attributions for poverty contributed to attitudes towards people who live in poverty, which led to shared decision making. Also, organizational support in shared decision making, and professional moral identity, contributed to ethical behaviour which led to shared decision making. The results of this analysis revealed that shared decision making may be a scion of branched roots planted in the relationship between ethics, organizations and Stigma. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.
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Hozien, Wafa Ismail
2012-01-01
The purpose of this study is to explore and describe individual Pennsylvania rural elementary principals' experiences of ethical decision-making in a complex era. Ethical dilemma, in this case, is the term used to depict an incident which calls for a decision to be made when moral values or ethical principles were in conflict. Also, to learn how…
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Meyer-Zehnder, Barbara; Albisser Schleger, Heidi; Tanner, Sabine; Schnurrer, Valentin; Vogt, Deborah R; Reiter-Theil, Stella; Pargger, Hans
2017-02-23
As the implementation of new approaches and procedures of medical ethics is as complex and resource-consuming as in other fields, strategies and activities must be carefully planned to use the available means and funds responsibly. Which facilitators and barriers influence the implementation of a medical ethics decision-making model in daily routine? Up to now, there has been little examination of these factors in this field. A medical ethics decision-making model called METAP was introduced on three intensive care units and two geriatric wards. An evaluation study was performed from 7 months after deployment of the project until two and a half years. Quantitative and qualitative methods including a questionnaire, semi-structured face-to-face and group-interviews were used. Sixty-three participants from different professional groups took part in 33 face-to-face and 9 group interviews, and 122 questionnaires could be analysed. The facilitating factors most frequently mentioned were: acceptance and presence of the model, support given by the medical and nursing management, an existing or developing (explicit) ethics culture, perception of a need for a medical ethics decision-making model, and engaged staff members. Lack of presence and acceptance, insufficient time resources and staff, poor inter-professional collaboration, absence of ethical competence, and not recognizing ethical problems were identified as inhibiting the implementation of the METAP model. However, the results of the questionnaire as well as of explicit inquiry showed that the respondents stated to have had enough time and staff available to use METAP if necessary. Facilitators and barriers of the implementation of a medical ethics decision-making model are quite similar to that of medical guidelines. The planning for implementing an ethics model or guideline can, therefore, benefit from the extensive literature and experience concerning the implementation of medical guidelines. Lack of time and
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Wood, J. Luke; Hilton, Adriel A.
2012-01-01
This article encourages community college leaders to employ ethical paradigms when constructing and considering alternative courses of action in decision-making processes. The authors discuss four previously articulated paradigms (e.g., ethic of justice, ethic of critique, ethic of care, and ethic of the profession) and propose an additional…
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Ethical decision-making: the doctrine of sin and grace
Directory of Open Access Journals (Sweden)
S. P. Giles
2009-07-01
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?
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Bagdasarov, Zhanna; Thiel, Chase E; Johnson, James F; Connelly, Shane; Harkrider, Lauren N; Devenport, Lynn D; Mumford, Michael D
2013-09-01
Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sense making processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed.
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Celuch, Kevin; Saxby, Carl
2013-01-01
The present study extends understanding of the self-regulatory aspects of ethical decision making by integrating and exploring relationships among counterfactual thinking, attribution, anticipatory emotions, and ethical decision-making constructs and processes. Specifically, we examine the effects of a manipulation designed to stimulate a…
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Rosenthal, Sara A; Nolan, Marie T
2013-07-01
To synthesize the existing qualitative literature about parent ethical decision making in the neonatal intensive care unit (NICU) and to investigate the potential impact of culture on parents' decision making experiences. PubMed, CINAHL plus, and PsychInfo using the search terms parental decision making, culture, race, decision making, and parental decisions. Qualitative research studies investigating decision making for infants in the NICU from the parents' perspective were included. Studies involving older pediatric populations were excluded. Ten primary qualitative research articles were included. The primary author read all manuscripts and tabulated themes related to parents' ethical decision making. Study findings were synthesized using meta-ethnography involving translating concepts of separate studies into one another, exploring contradictions, and organizing these concepts into new theories. Key themes included parent involvement in decision making, parental role, necessity of good information, need for communication, desire for hope and compassion conveyed by providers, decision making satisfaction, and trust in caregiving team. A preliminary theoretical framework of ethical parent decision making was modeled based on the proposed relationships between the themes. Parent preferences for their involvement in decision making, their perceptions of communication with providers, and their relationships with providers are all important factors in the experience of making decisions for their infants. Needs of parents were the same regardless the ethnic or racial diversity of study participants. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
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The four principles: can they be measured and do they predict ethical decision making?
Page, Katie
2012-05-20
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.
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The four principles: Can they be measured and do they predict ethical decision making?
Directory of Open Access Journals (Sweden)
Page Katie
2012-05-01
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.
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The four principles: Can they be measured and do they predict ethical decision making?
2012-01-01
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
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Berggren, Ingela; Severinsson, Elisabeth
2003-03-01
The aim of the study was to explore the decision-making style and ethical approach of nurse supervisors by focusing on their priorities and interventions in the supervision process. Clinical supervision promotes ethical awareness and behaviour in the nursing profession. A focus group comprised of four clinical nurse supervisors with considerable experience was studied using qualitative hermeneutic content analysis. The essence of the nurse supervisors' decision-making style is deliberations and priorities. The nurse supervisors' willingness, preparedness, knowledge and awareness constitute and form their way of creating a relationship. The nurse supervisors' ethical approach focused on patient situations and ethical principles. The core components of nursing supervision interventions, as demonstrated in supervision sessions, are: guilt, reconciliation, integrity, responsibility, conscience and challenge. The nurse supervisors' interventions involved sharing knowledge and values with the supervisees and recognizing them as nurses and human beings. Nurse supervisors frequently reflected upon the ethical principle of autonomy and the concept and substance of integrity. The nurse supervisors used an ethical approach that focused on caring situations in order to enhance the provision of patient care. They acted as role models, shared nursing knowledge and ethical codes, and focused on patient related situations. This type of decision-making can strengthen the supervisees' professional identity. The clinical nurse supervisors in the study were experienced and used evaluation decisions as their form of clinical decision-making activity. The findings underline the need for further research and greater knowledge in order to improve the understanding of the ethical approach to supervision.
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Energy Technology Data Exchange (ETDEWEB)
Cotton, Matthew [Univ. of East Anglia, Norwich (United Kingdom). Centre for Environmental Risk
2006-09-15
In the UK and internationally, there is widespread recognition that decision-making processes over long-term radioactive waste management are subject to a broad array of inherent technical, political, social, psychological and ethical issues. This paper seeks to specifically address the ethical aspects of long-term radioactive waste management and siting by proposing a framework for evaluating and integrating stakeholders' ethical values into a political decision-making process. Evaluation and integration of the ethical issues and related values takes place within the context of a comprehensive program of stakeholder engagement; a process necessary in fostering support amongst stakeholder groups and potentially affected communities - allowing legitimate and defensible political decisions to be made. In pluralistic democracies such as the UK, there is a recognition that a broad array of ethical values are held by the affected stakeholder groups, and the tools used to integrate ethical values into a stakeholder engagement process must be designed to reflect this pattern of moral diversity. This paper outlines the implications of this diversity for participatory decision making and addresses it by outlining a 'tool' or procedure for stakeholder deliberation as part of a broader 'toolbox' of deliberative methods: a tool that allows not only the elicitation of stakeholders' moral values, but also a critical re-evaluation of those values in light of ethical principles agreed upon by the participants themselves. Drawing upon the theoretical framework of ethical pragmatism, the goal is to turn what philosopher John Rawls has termed an ethical 'reflective equilibrium' into a practical procedure for stakeholder deliberation. The paper describes how the model of reflective equilibrium can be used as a basis for designing this deliberative procedure, in a way that is multi-staged and iterative in nature; with a goal to providing the
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International Nuclear Information System (INIS)
Cotton, Matthew
2006-01-01
In the UK and internationally, there is widespread recognition that decision-making processes over long-term radioactive waste management are subject to a broad array of inherent technical, political, social, psychological and ethical issues. This paper seeks to specifically address the ethical aspects of long-term radioactive waste management and siting by proposing a framework for evaluating and integrating stakeholders' ethical values into a political decision-making process. Evaluation and integration of the ethical issues and related values takes place within the context of a comprehensive program of stakeholder engagement; a process necessary in fostering support amongst stakeholder groups and potentially affected communities - allowing legitimate and defensible political decisions to be made. In pluralistic democracies such as the UK, there is a recognition that a broad array of ethical values are held by the affected stakeholder groups, and the tools used to integrate ethical values into a stakeholder engagement process must be designed to reflect this pattern of moral diversity. This paper outlines the implications of this diversity for participatory decision making and addresses it by outlining a 'tool' or procedure for stakeholder deliberation as part of a broader 'toolbox' of deliberative methods: a tool that allows not only the elicitation of stakeholders' moral values, but also a critical re-evaluation of those values in light of ethical principles agreed upon by the participants themselves. Drawing upon the theoretical framework of ethical pragmatism, the goal is to turn what philosopher John Rawls has termed an ethical 'reflective equilibrium' into a practical procedure for stakeholder deliberation. The paper describes how the model of reflective equilibrium can be used as a basis for designing this deliberative procedure, in a way that is multi-staged and iterative in nature; with a goal to providing the means for stakeholder participants to
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Professional Decision Making and Personal Ethics.
Black, Jay; Steele, Robert
1991-01-01
Discusses ethics regarding the journalism and mass communications professoriate. Suggests a schema or audit to positively address such issues as accountability and loyalty, values, and principles. Offers eight questions for a personal ethics audit which attempt to join good intentions with good decisions, and shift the enterprise to a positive…
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Tveit, Anne Dorthe; Sunde, Annikken Louise
2016-01-01
The purpose of this paper is to explore how different insights from a variety of theories might help ethical decision making in educational counselling and highlight the need for reflection. A framework for ethical decision making based on basic features of counselling, namely the interlocutors' practice or "acts", is proposed. There are…
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Indhraratana, Apinya; Kaemkate, Wannee
2012-01-01
The aim of this paper is to develop a reliable and valid tool to assess ethical decision-making ability of nursing students using rubrics. A proposed ethical decision making process, from reviewing related literature was used as a framework for developing the rubrics. Participants included purposive sample of 86 nursing students from the Royal…
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A Social Constructivism Model of Ethical Decision Making in Counseling.
Cottone, R. Rocco
2001-01-01
Examines social constructivism as an intellectual movement in the mental health field that directs a social consensual interpretation of reality. Presents a social constructivism approach to counseling which redefines the ethical decision-making process as an interactive rather than individual or intrapsychic process. Explores how the process…
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Institute of Scientific and Technical Information of China (English)
陈英
2011-01-01
目的 提高急诊科护士的伦理决策能力.方法 通过伦理决策过程,由护理团体对以往在急诊救治中的护理困境作出最佳伦理决策.结果使护士知晓伦理相关的理论,掌握应对护理实践中的护理伦理困惑的方法,提高护理伦理决策能力.结论 通过应用团体伦理决策法,培养和提高急诊科护士的伦理决策能力,有效地减少了护患医疗纠纷.%Objective: To increase the ethical decision - making capacity of nurses of emergency department. Method: Optimal ethical decisions are made by nursing group s discussion of the experience gathered from past ethical predicaments in emergency nursing. Result; Nurses are equipped with relevant ethical theories, measures of coping with possible ethical predicaments in future nursing practice, and increased capacity of nursing ethical decision - making. Conclusion: The ethical decision - making capacity of nurses of emergency department has been cultivated and increased by the approach of group ethical decision - making, resulting in a decrease in medical disputes between nurses and doctors.
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Rottig, Daniel; Heischmidt, Kenneth A.
2007-01-01
Based on three independent samples from Germany and the United States, this exploratory, cross-cultural study examines empirically the importance of ethical training for the improvement of ethical decision-making. The results of the study reveal a significant difference in the use of corporate codes of conduct and ethical training, as well as…
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Greenfield, Bruce H; West, Charles Robert
2012-11-01
Ethical issues present a challenge for health care professionals working with athletes of sports teams. Health care professionals-including the team physician, the physical therapist, and the athletic trainer-are faced with the challenge of returning an athlete to competition as quickly as possible but as safely as possible. Conflicts of interest arise due to conflicting obligations of the team physician to the athlete and other members of the sports organization, including coaches and the team owner. The multiple stakeholders involved in sports teams challenge the traditional notion of confidentiality and autonomy. The aims of this article are to explicate the ethics of sports medicine, highlight the ethical issues, and provide some strategies and suggestions for ethical decision making.
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Health Care Decisions at the End of Life: Theological and Ethical Foundations for Decision Making.
Allegretti, Joseph G.
This paper provides a framework for making sense of perplexing problems surrounding issues of death and dying by exploring the theological and ethical background to health care decision making at the end of life. The paper first examines several of the basic principles that theologians and secular ethicists employ when analyzing such questions.…
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YANG, SHU-TING
2008-01-01
In this study, first, the discrepancy between consumers'ethical belief and ethical intention was reported in the ethical context of whether to use plastic carrier bags in supermarkets. Second, the anticipated guilt and consumers'acceptance of neutralization techniques were found to play the important roles in ethical consumers'decision making process. A framework, based on the theory of planned behavior, incorporated anticipated guilt as a mediator between consumers' neutralization and ethic...
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Making Responsible Academic Ethical Decisions.
Reynolds, Charles H.
1996-01-01
Sound ethical decisions depend on clear problem definition, careful review of alternatives, consideration of consequences, and thoughtful application of relevant principles of responsibility. Often they also require a willingness to receive corrective insight and to check judgments with moral intuitions. Higher education has a special…
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Unicriterion Model: A Qualitative Decision Making Method That Promotes Ethics
Directory of Open Access Journals (Sweden)
Fernando Guilherme Silvano Lobo Pimentel
2011-06-01
Full Text Available Management decision making methods frequently adopt quantitativemodels of several criteria that bypass the question of whysome criteria are considered more important than others, whichmakes more difficult the task of delivering a transparent viewof preference structure priorities that might promote ethics andlearning and serve as a basis for future decisions. To tackle thisparticular shortcoming of usual methods, an alternative qualitativemethodology of aggregating preferences based on the rankingof criteria is proposed. Such an approach delivers a simpleand transparent model for the solution of each preference conflictfaced during the management decision making process. Themethod proceeds by breaking the decision problem into ‘two criteria– two alternatives’ scenarios, and translating the problem ofchoice between alternatives to a problem of choice between criteriawhenever appropriate. The unicriterion model method is illustratedby its application in a car purchase and a house purchasedecision problem.
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The development of the CoRE-Values framework as an aid to ethical decision-making.
Manson, Helen M
2012-01-01
Ethical analysis frameworks can help to identify the ethical dimensions to clinical care and provide a method for justifying clinical decisions. Published frameworks, however, have some limitations to easy, practical use. The aim was to identify a comprehensive yet easy-to-use framework that clarifies ethical decision-making, suitable for use by medical learners and clinical educators. A literature search identified published frameworks that define the components of ethical clinical decision-making. On this basis, a new framework, the 'CoRE-Values Compass and Grid' was constructed. This was formally evaluated during a medical school interprofessional teaching session. For 88% of 228 medical and nursing students, the new framework was easy to understand; 85% reported it as easy to use. The framework improved awareness of the ethical dimensions to a clinical scenario for 97% of students and the ability to systematically identify ethical aspects for 83%. Students and instructors reported that the framework helped to link ethics theory with clinical practice. The framework was described as a useful educational tool by 85% of students and 95% of instructors. The 'CoRE-Values Compass and Grid' is a new framework, shown to aid the systematic identification and consideration of ethical aspects to clinical cases.
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Greeff, Minrie; Rennie, Stuart
2016-04-01
Health researchers conducting research in the community are often faced with unanticipated ethical issues that arise in the course of their research and that go beyond the scope of ethical approval by the research ethics committee. Eight expert researchers were selected through extreme intensity purposive sampling, because they are representative of unusual manifestations of the phenomenon related to their research in the community. They were selected to take part in a semi-structured focus group discussion on whether practical wisdom (phronesis) is used as a decision-making skill to solve unanticipated ethical issues during research in the community. Although the researchers were not familiar with the concept phronesis, it became obvious that it formed an integral part of their everyday existence and decision making during intervention research. They could balance research ethics with practical considerations. The capacity of practical wisdom as a crucial decision-making skill should be assimilated into a researcher's everyday reality, and also into the process of mentoring young researchers to become phronimos. Researchers should be taught this skill to handle unanticipated ethical issues. © The Author(s) 2016.
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Ethical analysis to improve decision-making on health technologies
DEFF Research Database (Denmark)
Saarni, Samuli I; Hofmann, Bjørn; Lampe, Kristian
2008-01-01
Health technology assessment (HTA) is the multidisciplinary study of the implications of the development, diffusion and use of health technologies. It supports health-policy decisions by providing a joint knowledge base for decision-makers. To increase its policy relevance, HTA tries to extend...... beyond effectiveness and costs to also considering the social, organizational and ethical implications of technologies. However, a commonly accepted method for analysing the ethical aspects of health technologies is lacking. This paper describes a model for ethical analysis of health technology...... to only analyse the ethical consequences of a technology, but also the ethical issues of the whole HTA process must be considered. Selection of assessment topics, methods and outcomes is essentially a value-laden decision. Health technologies may challenge moral or cultural values and beliefs...
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Using an ecological ethics framework to make decisions about the relocation of wildlife.
McCoy, Earl D; Berry, Kristin
2008-12-01
Relocation is an increasingly prominent conservation tool for a variety of wildlife, but the technique also is controversial, even among conservation practitioners. An organized framework for addressing the moral dilemmas often accompanying conservation actions such as relocation has been lacking. Ecological ethics may provide such a framework and appears to be an important step forward in aiding ecological researchers and biodiversity managers to make difficult moral choices. A specific application of this framework can make the reasoning process more transparent and give more emphasis to the strong sentiments about non-human organisms held by many potential users. Providing an example of the application of the framework may also increase the appeal of the reasoning process to ecological researchers and biodiversity managers. Relocation as a conservation action can be accompanied by a variety of moral dilemmas that reflect the interconnection of values, ethical positions, and conservation decisions. A model that is designed to address moral dilemmas arising from relocation of humans provides/demonstrates/illustrates a possible way to apply the ecological ethics framework and to involve practicing conservationists in the overall decision-making process.
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Loyens, Kim|info:eu-repo/dai/nl/370525086; Maesschalck, Jeroen
Much research has been done on the way in which individuals in organizations deal with their discretion. This article focuses on the literature on street-level bureaucracy and the literature on ethical decision making. Despite their shared attempt to explain individual behavior and decision making,
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Säve-Söderbergh, Jenny
2005-01-01
Recent economics literature has devoted attention towards motives beyond the typical selfish norm for economic decision-making. Yet, it still remains a puzzle who allows such considerations to govern their behavior. This paper contributes by empirically identifying some features which differentiate individuals who choose to bear the cost of ethically guided economic decision-making from others. Using unique Swedish data on individual pension portfolio choices, we find that education, the choi...
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Ethical decision making in organizations: the role of leadership stress
Selart, Marcus; Johansen, Svein Tvedt
2011-01-01
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...
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The Influence of Counterfactual Thinking and Regret on Ethical Decision Making
Celuch, Kevin; Saxby, Carl; Oeding, Jill
2015-01-01
The authors explore the influence of counterfactual thoughts in triggering the emotions of regret and disappointment in ethical decision making. Counterfactual thinking involves examining possible outcomes to events and is often explored in what-if scenarios. Findings support that subjects were able to transfer regret (but not disappointment)…
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Leaders on the Front Line--Managing Emotion for Ethical Decision Making
Tenuto, Penny L.; Gardiner, Mary E.; Yamamoto, Julie K.
2016-01-01
To build capacity for students in educational leadership programs, we developed a teaching case study focused on managing emotion for ethical decision making in supervision of personnel. The case offers troubling encounters between a secondary assistant principal and a novice teacher, a veteran teacher, and a veteran administrator. Scenarios…
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Arar, Khalid; Haj, Ibrahim; Abramovitz, Ruth; Oplatka, Izhar
2016-01-01
Purpose: The purpose of this paper is to investigate ethical leadership in the context of the Arab educational system in Israel. It questions the relations of ethical leadership dimensions with decision making as well as background characteristics of the educational leaders. Design/methodology/approach: Arab educational leaders (n=150) from…
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[The ethical reflection approach in decision-making processes in health institutes].
Gruat, Renaud
2015-12-01
Except in the specific case of end-of-life care, the law says nothing about the way in which health professionals must carry out ethical reflection regarding the treatment of their patients. A problem-solving methodology called the "ethical reflection approach" performed over several stages can be used. The decision-making process involves the whole team and draws on the ability of each caregiver to put forward a reasoned argument, in the interest of the patient. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
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[Ethical and philosophical dimensions of decision-making in public health].
Grémy, F
2008-01-01
Decisions in public health, or in individual health care, are taken by people (individuals or collective) for other people (individuals or collective). Human values, that is to say what is connected to Ethics, should be to the fore, de jure. Too often, under the pretext that they refer to subjectivity, they appear only after very many technical considerations. The latter, in a scientist society, are supposed to deserve a claim to objectivity, this being of course illusory. The author, placing himself in the line of Levinas, Ricoeur, and also of Kant, for whom the "What must I do?" is the most fundamental question any human being has to face, develops four reasons which plead for the pre-eminence of ethics as the foundation of decisions in a policy for public health. 1) He reminds us the intangible values, which are on one side uniqueness and universality of mankind, and on the other side the singularity of the human person. 2) He insists on the ethical wreck which threatens the whole health- and healthcare systems. 3) He sets out some results of modern neurophysiological research (AR Damasio's work), joining an intuition of Aristoteles: the decision making process implies two phases: deliberation the aim of which is to list the different possible actions to undertake, then the choice between those actions. Damasio shows that the lack of emotions inhibits the choice, especially when decision implies human values. 4) Finally, he insists, after E. Morin, on the practical and theoretical difficulties in taking a "good" decision, and on what Morin calls "ecology of action". The results of a decision may completely escape from the decision-makers aims, very often for unexpected social and psychological reasons.
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Riemenschneider, Cynthia K.; Leonard, Lori N. K.; Manly, Tracy S.
2011-01-01
Business educators have increased the focus on ethics in the classroom. In order for students to become ethical professionals, they must first be held to an ethical standard as students. As information technology continues to permeate every aspect of students' lives, it becomes increasingly important to understand student decision-making in this…
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Higgins, S S
2001-10-01
Parents of children with complex or terminal heart conditions often face agonizing decisions about cardiac transplantation. There are differences in the level of involvement that parents prefer when making such decisions. The purpose of this study was to identify and describe parents' preferences for their roles in decisions related to cardiac transplantation. A prospective ethnographic method was used to study 24 parents of 15 children prior to their decision of accepting or rejecting the transplant option for their children. Findings revealed that the style of parent decision making ranged from a desire to make an independent, autonomous choice to a wish for an authoritarian, paternalistic choice. Nurses and physicians can best support families in this situation, showing sensitivity to the steps that parents use to make their decisions. An ethical model of decision making is proposed that includes respect for differences in beliefs and values of all persons involved in the transplantation discussion. Copyright 2001 by W.B. Saunders Company
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Ethical safety of deep brain stimulation: A study on moral decision-making in Parkinson's disease.
Fumagalli, Manuela; Marceglia, Sara; Cogiamanian, Filippo; Ardolino, Gianluca; Picascia, Marta; Barbieri, Sergio; Pravettoni, Gabriella; Pacchetti, Claudio; Priori, Alberto
2015-07-01
The possibility that deep brain stimulation (DBS) in Parkinson's disease (PD) alters patients' decisions and actions, even temporarily, raises important clinical, ethical and legal questions. Abnormal moral decision-making can lead to ethical rules violations. Previous experiments demonstrated the subthalamic (STN) activation during moral decision-making. Here we aim to study whether STN DBS can affect moral decision-making in PD patients. Eleven patients with PD and bilateral STN DBS implant performed a computerized moral task in ON and OFF stimulation conditions. A control group of PD patients without DBS implant performed the same experimental protocol. All patients underwent motor, cognitive and psychological assessments. STN stimulation was not able to modify neither reaction times nor responses to moral task both when we compared the ON and the OFF state in the same patient (reaction times, p = .416) and when we compared DBS patients with those treated only with the best medical treatment (reaction times: p = .408, responses: p = .776). Moral judgment is the result of a complex process, requiring cognitive executive functions, problem-solving, anticipations of consequences of an action, conflict processing, emotional evaluation of context and of possible outcomes, and involving different brain areas and neural circuits. Our data show that STN DBS leaves unaffected moral decisions thus implying relevant clinical and ethical implications for DBS consequences on patients' behavior, on decision-making and on judgment ability. In conclusion, the technique can be considered safe on moral behavior. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Zydziunaite, V; Suominen, T
2014-09-21
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.
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Testing the Intercultural Model of Ethical Decision Making with Counselor Trainees
Luke, Melissa; Goodrich, Kristopher M.; Gilbride, Dennis D.
2013-01-01
A training intervention using the Intercultural Model of Ethical Decision Making was tested with a sample of 48 counselor trainees enrolled in 3 counseling courses across 2 universities. Postintervention data indicated students' scores increased significantly on 5 of 6 evaluation criteria as well as on the overall total score. Although…
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Leadership styles in ethical dilemmas when head nurses make decisions.
Zydziunaite, V; Lepaite, D; Suominen, T
2013-06-01
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.
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Ethical Decision Making: A Teaching and Learning Model for Graduate Students and New Professionals
McDonald, William M.; Ebelhar, Marcus Walker; Orehovec, Elizabeth R.; Sanderson, Robyn H.
2006-01-01
Student affairs practitioners are inundated with a variety of ethical considerations when making day-to-day decisions regarding the welfare of students and colleagues. There is every reason to believe that confronting ethical issues will be an increasingly difficult issue for student affairs professionals in the future. This article provides a…
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Teixeira, Carla; Ribeiro, Orquídea; Fonseca, António M; Carvalho, Ana Sofia
2014-02-01
Ethical decision making in intensive care is a demanding task. The need to proceed to ethical decision is considered to be a stress factor that may lead to burnout. The aim of this study is to explore the ethical problems that may increase burnout levels among physicians and nurses working in Portuguese intensive care units (ICUs). A quantitative, multicentre, correlational study was conducted among 300 professionals. The most crucial ethical decisions made by professionals working in ICU were related to communication, withholding or withdrawing treatments and terminal sedation. A positive relation was found between ethical decision making and burnout in nurses, namely, between burnout and the need to withdraw treatments (p=0.032), to withhold treatments (p=0.002) and to proceed to terminal sedation (p=0.005). This did not apply to physicians. Emotional exhaustion was the burnout subdimension most affected by the ethical decision. The nurses' lack of involvement in ethical decision making was identified as a risk factor. Nevertheless, in comparison with nurses (6%), it was the physicians (34%) who more keenly felt the need to proceed to ethical decisions in ICU. Ethical problems were reported at different levels by physicians and nurses. The type of ethical decisions made by nurses working in Portuguese ICUs had an impact on burnout levels. This did not apply to physicians. This study highlights the need for education in the field of ethics in ICUs and the need to foster inter-disciplinary discussion so as to encourage ethical team deliberation in order to prevent burnout.
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Using an ecological ethics framework to make decisions about the relocation of wildlife
McCoy, E.D.; Berry, K.
2008-01-01
Relocation is an increasingly prominent conservation tool for a variety of wildlife, but the technique also is controversial, even among conservation practitioners. An organized framework for addressing the moral dilemmas often accompanying conservation actions such as relocation has been lacking. Ecological ethics may provide such a framework and appears to be an important step forward in aiding ecological researchers and biodiversity managers to make difficult moral choices. A specific application of this framework can make the reasoning process more transparent and give more emphasis to the strong sentiments about non-human organisms held by many potential users. Providing an example of the application of the framework may also increase the appeal of the reasoning process to ecological researchers and biodiversity managers. Relocation as a conservation action can be accompanied by a variety of moral dilemmas that reflect the interconnection of values, ethical positions, and conservation decisions. A model that is designed to address moral dilemmas arising from relocation of humans provides/demonstrates/illustrates a possible way to apply the ecological ethics framework and to involve practicing conservationists in the overall decision-making process. ?? 2008 Springer Science+Business Media B.V.
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A Lay Ethics Quest for Technological Futures: About Tradition, Narrative and Decision-Making.
van der Burg, Simone
2016-01-01
Making better choices about future technologies that are being researched or developed is an important motivator behind lay ethics interventions. However, in practice, they do not always succeed to serve that goal. Especially authors who have noted that lay ethicists sometimes take recourse to well-known themes which stem from old, even 'archetypical' stories, have been criticized for making too little room for agency and decision-making in their approach. This paper aims to contribute to a reflection on how lay ethics can acquire more practical relevance. It will use resources in narrative ethics to suggest that in order to be relevant for action, facilitators of lay ethics interventions need to invite participants to engage in a narrative quest. As part of a quest, lay ethicists should be asked to (1) reflect on a specific question or choice, (2) use diverse (imaginative) input which is informative about the heterogeneity of viewpoints that are defended in society and (3) argue for their standpoints.
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The Use of Touch in Counseling: An Ethical Decision-Making Model
Calmes, Stephanie A.; Piazza, Nick J.; Laux, John M.
2013-01-01
Although some counselors have advocated for the limited use of touch in counseling, others have argued that touch has no place within the counseling relationship. Despite the controversy, the use of touch has been shown to have a number of therapeutic benefits; however, there are few ethical decision-making models that are appropriate for…
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The Effect of Moral Intensity on Ethical Decision Making in Accounting
Yang, Hui-Ling; Wu, Wei-Pang
2009-01-01
The purpose of this study was to examine the dimensionality of a moral intensity construct in four ethical accounting scenarios and how the dimensions directly affect the specific processes of moral decision making of accounting students. A survey was conducted with 233 accounting students enrolled in the school of accounting in a university of…
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Casali, Gian Luca; Day, Gary E
2010-03-01
This paper explores the interplay between individual values, espoused organisational values and the values of the organisational culture in practice in light of a recent Royal Commission in Queensland, Australia, which highlighted systematic failures in patient care. The lack of congruence among values at these levels impacts upon the ethical decision making of health managers. The presence of institutional ethics regimes such as the Public Sector Ethics Act 1994 (Qld) and agency codes of conduct are not sufficient to counteract the negative influence of informal codes of practice that undermine espoused organisational values and community standards. The ethical decision-making capacity of health care managers remains at the front line in the battle against unethical and unprofessional practice.
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Directory of Open Access Journals (Sweden)
Ali Reza Salar
2016-05-01
Full Text Available The nursing occupation is considered among those sciences which have had and will also have numerous ethical and exemplary aspects. The results of the studies performed regarding ethics indicate the weak nature of the nurses’ ethical decision making. Therefore, it was felt that there is a need to perform a study aiming at the ethical sensitivity level in decision making of the nurses working in training hospitals belonging to Zahedan medical sciences universities. The current study is a descriptive-analytical research performed on 140 nurses who were selected based on a randomized clustering method. To collect the information there was made use of a questionnaire comprising of two parts, the first part of which is related to the demographic characteristics and the second part pertains to a standard questionnaire of nurses’ ethical sensitivity in decision making. Finally after the questionnaires were collected they were analyzed by the use of SPSS 19 and descriptive statistics, Pierson correlation test, variance analysis and independent t-test. Nurses’ average age was 28.56 ± 6.48 and of the total population 123 individuals were women of whom 68 people had participated in ethics seminars and 53 of them were single. The overall ethical sensitivity mean among the nurses was 59.82 ± 17.50 which was ranked as intermediate according to the classification of the questionnaire, and in each of the dimensions of the ethical sensitivity the following scores were obtained respectively, in respect for the help-seeker independence the score was 10.71 ± 4.00, in the dimension if ethical problems and challenges the score obtained was 11.35 ± 4.21, in the dimension of application of the ethical concepts in decision making the score was 12.49 ± 3.82 and in the dimension of honesty and benevolence the obtained score was 4.73 ± 1.70, the professional knowledge dimension scored 13.49 ± 4.50 and the dimension of awareness of the nurses’ treating style
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Consumer Ethical Decision Making: Intensity, Self-Consciousness and Neutralization Techniques
Syed Afzal Moshadi Shah; Shehla Amjad
2017-01-01
The purpose of the study is to examine the effect of moral intensity on self-conscious emotions and neutralization techniques in the context of ethical decision making among consumers. A sample of 388 shopping mall retail consumers was recruited through self-administered survey technique. Descriptive statistics, exploratory factor analysis, correlation was carried out in SPSS whereas the measurement model and structural relationships were estimated using AMOS. Results indicate ...
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Ethical analysis to improve decision-making on health technologies.
Saarni, Samuli I; Hofmann, Bjørn; Lampe, Kristian; Lühmann, Dagmar; Mäkelä, Marjukka; Velasco-Garrido, Marcial; Autti-Rämö, Ilona
2008-08-01
Health technology assessment (HTA) is the multidisciplinary study of the implications of the development, diffusion and use of health technologies. It supports health-policy decisions by providing a joint knowledge base for decision-makers. To increase its policy relevance, HTA tries to extend beyond effectiveness and costs to also considering the social, organizational and ethical implications of technologies. However, a commonly accepted method for analysing the ethical aspects of health technologies is lacking. This paper describes a model for ethical analysis of health technology that is easy and flexible to use in different organizational settings and cultures. The model is part of the EUnetHTA project, which focuses on the transferability of HTAs between countries. The EUnetHTA ethics model is based on the insight that the whole HTA process is value laden. It is not sufficient to only analyse the ethical consequences of a technology, but also the ethical issues of the whole HTA process must be considered. Selection of assessment topics, methods and outcomes is essentially a value-laden decision. Health technologies may challenge moral or cultural values and beliefs, and their implementation may also have significant impact on people other than the patient. These are essential considerations for health policy. The ethics model is structured around key ethical questions rather than philosophical theories, to be applicable to different cultures and usable by non-philosophers. Integrating ethical considerations into HTA can improve the relevance of technology assessments for health care and health policy in both developed and developing countries.
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Emerging Adult Religiosity and Spirituality: Linking Beliefs, Values, and Ethical Decision-Making
Directory of Open Access Journals (Sweden)
Patricia Snell Herzog
2018-03-01
Full Text Available This paper challenges the “spiritual but not religious” (SBNR category as a methodological artifact caused by interacting two closed-ended survey items into binary combinations. Employing a theoretically rich approach, this study maps the multiple ways in which the religious and the spiritual combine for emerging adults. Results indicate that most emerging adults have a tacit sense of morality, displaying limited cognitive access to how moral reasoning relates to religious and spiritual orientations. This longitudinal study investigates efforts to raise moral awareness through: exposure to diverse religious and spiritual orientations, personal reflection, and collective discussion. Relative to control groups, emerging adults in this study display increases in moral awareness. We combine the results of these studies to formulate a theoretical framework for the ways in which beliefs, values, and ethical decision-making connect in expressing plural combinations of religiosity and spirituality. The implication is that direct attention to religiosity and spirituality — not avoidance of — appears to facilitate ethical decision-making.
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RPA Field Simulations:Dilemma Training for Legal and Ethical Decision Making
2015-11-07
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
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Truth-telling, decision-making, and ethics among cancer patients in nursing practice in China.
Ling, Dong-Lan; Yu, Hong-Jing; Guo, Hui-Ling
2017-01-01
Truth-telling toward terminally ill patients is a challenging ethical issue in healthcare practice. However, there are no existing ethical guidelines or frameworks provided for Chinese nurses in relation to decision-making on truth-telling of terminal illness and the role of nurses thus is not explicit when encountering this issue. The intention of this paper is to provide ethical guidelines or strategies with regards to decision-making on truth-telling of terminal illness for Chinese nurses. This paper initially present a case scenario and then critically discuss the ethical issue in association with ethical principles and philosophical theories. Instead of focusing on attitudes toward truth disclosure, it aims to provide strategies regarding this issue for nurses. It highlights and discusses some of the relevant ethical assumptions around the perceived role of nurses in healthcare settings by focusing on nursing ethical virtues, nursing codes of ethics, and philosophical perspectives. And Confucian culture is discussed to explicate that deontology does not consider family-oriented care in China. Treating each family individually to explore the family's beliefs and values on this issue is essential in healthcare practice and nurses should tailor their own approach to individual needs regarding truth-telling in different situations. Moreover, the Chinese Code of Ethics should be modified to be more specific and applicable. Finally, a narrative ethics approach should be applied and teamwork between nurses, physicians and families should be established to support cancer patients and to ensure their autonomy and hope. Ethical considerations: This paper was approved by the Ethics Committee of The Second Affiliated Hospital of Guangzhou Medical University. The authors have obtained consent to use the case study and it has been anonymised to preserve the patient's confidentiality.
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Ethical Decision-Making in College: Choosing Between Right, Wrong, and the Space in Between
Fanny P.F. Yeung and Jennifer R. Keup
2009-01-01
It is important to understand how students’ changing belief structures influence their values and behaviors, including their ethical beliefs and decision-making patterns. As such, this study will address the following research questions: 1) what are students’ ethical beliefs and their perceptions of students’ ethical behaviors; and 2) how do students’ personal values and perceptions of behaviors differ? Using data from the 2006 University of California Undergraduate Experience Survey,...
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The Role of Ethics Committees and Ethics Consultation in Allocation Decisions
Strech, Daniel; Hurst, Samia; Danis, Marion
2013-01-01
Background Decisions about the allocation and rationing of medical interventions likely occur in all health care systems worldwide. So far very little attention has been given to the question of what role ethics consultation and ethics committees could or should play in questions of allocation at the hospital level. Objectives and Methods This article argues for the need for ethics consultation in rationing decisions using empirical data about the status quo and the inherent nature of bedside rationing. Subsequently, it introduces a 4-stage process for establishing and conducting ethics consultation in rationing questions with systematic reference to core elements of procedural justice. Results Qualitative and quantitative findings show a significant demand for ethics consultation expressed directly by doctors, as well as additional indirect evidence of such a need as indicated by ethically challenging circumstances of inconsistent and structurally disadvantaging rationing decisions. To address this need, we suggest 4 stages for establishing and conducting ethics consultation in rationing questions we recommend: (1) training, (2) identifying actual scarcity-related problems at clinics, (3) supporting decision-making, and (4) evaluation. Conclusion This process of ethics consultation regarding rationing decisions would facilitate the achievement of several practical goals: (i) encouragement of an awareness and understanding of ethical problems in bedside rationing, (ii) encouragement of achieving efficiency along with rationing, (iii) reinforcement of consistency in inter- and intraindvidual decision-making, (iv) encouragement of explicit reflection and justification of the prioritization criteria taken into consideration, (v) improvement in internal (in-house) and external transparency, and (vi) prevention of the misuse of the corresponding consulting structures. PMID:20706163
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Nill, Alexander; Schibrowsky, John A.
2005-01-01
An experiment was conducted to study how marketing students' ethical decision making was influenced by their perceived moral intensity (PMI), corporate culture, and the reward system. The findings indicate that levels of awareness of the ethical consequences of a decision, the corporate culture, and the reward system all significantly affect…
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Guest Editors’ Introduction On Understanding Ethical Behavior and Decision Making
D. de Cremer (David); D.M. Mayer (David); M. Schminke (Marshall)
2010-01-01
textabstractBehavioral ethics is an emerging field that takes an empirical, social scientific approach to the study of business ethics. In this special issue, we include six articles that fall within the domain of behavioral ethics and that focus on three themes—moral awareness, ethical decision
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Ethical decision-making near the end of life.
Finucane, T E; Harper, M
1996-05-01
For ethical decision-making near the end of life, autonomy is the moral North Star. At the same time, for some treatments, the burdens so clearly outweigh benefits that physicians may make a judgment not to offer the treatment. This is often clearer in surgery. A person with colon cancer and metastases may not insist on resection of the metastases. For some reason, some treatments have escaped these logical constraints. Attempted resuscitation of a dying patient is a good example. The circumstances in which a physician may make choices on behalf of a competent, terminally-ill patient without consent, and even without notification, are hotly debated, but data suggest that physicians do so frequently. Patients who lack capacity present even more difficult challenges. Advance directives, when available, can be extremely helpful, but even with them difficult problems can remain. If advance directives have not been established, family and close friends are an obvious source of guidance. Their legal role varies in different jurisdictions; in practice, they are crucial in bedside decision-making. Guardianship and alternatives to it remain a poor last resort. Euthanasia is a very difficult problem. We believe it is semantically misleading to lump under the term "passive euthanasia" those circumstances where potentially life-sustaining treatment is withheld or withdrawn. The tension between patient autonomy and medical common sense remains unresolved within the "futility" controversy. The authors believe it serves no purpose to discuss carefully with dying patients propositions that are nonsense. At the same time, physicians must not confuse decisions about quality of life with judgements about treatment effectiveness. We believe that what many, although not all, dying patients want are physicians with intelligent compassion who can take care of them through the dying process.
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The ethical health lawyer: an empirical assessment of moral decision making.
Perry, Joshua E; Moore, Ilene N; Barry, Bruce; Clayton, Ellen Wright; Carrico, Amanda R
2009-01-01
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.
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The ethical basis of the precautionary principle in health care decision making
International Nuclear Information System (INIS)
Meulen, Ruud H.J. ter
2005-01-01
This article explores the relation between the precautionary and health care decision making. Decision making in medical practice as well as health policy is characterized by uncertainty. On the level of clinical practice for example, one never knows in advance whether one has made the right diagnosis or has opted for the right treatment. Though medical decisions have a risk on serious harms and burdens, the precautionary principle is not applicable to health care. This principle holds that one should not act when there is no scientific proof that no harms will result from a medical act or a policy decision. However, in clinical practice there is a duty to act. Physicians have an obligation to do good to their patients and have to weigh the benefits against possible harms and burdens. The basis virtue of medical decision making is not avoidance of risks, as stated in the precautionary principle, but the prudent assessment of benefits, burdens, and harms, in relation to other ethical principles like respect for autonomy and justice. The precautionary principle does play a role in health care, but it should never rule medical decision making as an absolute principle. This is not only true for clinical decision making, but also for the area of health policy. Physicians and other health care decision makers need to have knowledge about the possible effects of treatments or the precision of diagnostic procedures in order to reduce harm and promote well-being. Evidence-based medicine may contribute to the wisdom of health care decision makers, but this evidence-based wisdom should always be applied under the guidance of prudence, which is the central virtue of health care decision making
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Substance use disorder and compulsory commitment to care: a care-ethical decision-making framework.
Nicolini, Marie; Vandenberghe, Joris; Gastmans, Chris
2017-11-29
In the era of deinstitutionalisation of psychiatric patients, steady or even increasing rates of compulsory commitment to care (CCC) are an intriguing phenomenon to analyse. From a clinical, legal and ethical perspective, CCC continues to be a controversial practice in psychiatry, and perhaps even more so when applied to patients with severe substance use disorder (SUD). Several reasons make it controversial. The lack of consensus about the benefits of CCC and professional disagreement about what mental illness and autonomy mean in the case of SUD make it difficult to apply ethically sound clinical decision-making in CCC. Also, the medico-legal framework underlying CCC use sometimes appears to foster the use of reductionist clinical evaluation. Layered on top of these issues is how stakeholders view coercion. There is a discrepancy between clinicians' and patients' perception of coercion, which leads to clinician-patient differences on whether CCC is necessary. Moreover, the way in which the evaluation is typically carried out influences patients' perception of coercion and subsequently their motivation for participating fully in treatment. In this article, we explore the value of care ethics, often applied to care practices such as nursing, when applied to more procedural medical practices, such as decision-making regarding CCC. The care-ethical approach views decision-making as part of a dynamic care process, within which the lived experience, interpretative dialogue and promotion of dignity are core features. Embracing this new framework means a paradigm shift in when the therapeutic relationship begins, namely, investing in it occurs while conducting an evaluation for a possible CCC procedure. Unlike in current typical evaluations, early cultivation of the therapeutic relationship enables the patient to participate in the definition of his needs, reduces perceived coercion and negative emotions and enhances treatment motivation. Finally, implications of this
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Ethical Decision-Making for Homeland Security
2013-09-01
PhD Thesis Co-Advisor Anders Strindberg, PhD Thesis Co-Advisor Mohammed Hafez, PhD Chair, Department of National Security Affairs...expectations may be deleterious in the long-term, emotionally, psychologically , spiritually , and socially (what we label as moral injury)” (Litz 2009). They...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited ETHICAL DECISION
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Van den Bulcke, Bo; Piers, Ruth; Jensen, Hanne Irene; Malmgren, Johan; Metaxa, Victoria; Reyners, Anna K; Darmon, Michael; Rusinova, Katerina; Talmor, Daniel; Meert, Anne-Pascale; Cancelliere, Laura; Zubek, Làszló; Maia, Paolo; Michalsen, Andrej; Decruyenaere, Johan; Kompanje, Erwin J O; Azoulay, Elie; Meganck, Reitske; Van de Sompel, Ariëlla; Vansteelandt, Stijn; Vlerick, Peter; Vanheule, Stijn; Benoit, Dominique D
2018-02-23
Literature depicts differences in ethical decision-making (EDM) between countries and intensive care units (ICU). To better conceptualise EDM climate in the ICU and to validate a tool to assess EDM climates. Using a modified Delphi method, we built a theoretical framework and a self-assessment instrument consisting of 35 statements. This Ethical Decision-Making Climate Questionnaire (EDMCQ) was developed to capture three EDM domains in healthcare: interdisciplinary collaboration and communication; leadership by physicians; and ethical environment. This instrument was subsequently validated among clinicians working in 68 adult ICUs in 13 European countries and the USA. Exploratory and confirmatory factor analysis was used to determine the structure of the EDM climate as perceived by clinicians. Measurement invariance was tested to make sure that variables used in the analysis were comparable constructs across different groups. Of 3610 nurses and 1137 physicians providing ICU bedside care, 2275 (63.1%) and 717 (62.9%) participated respectively. Statistical analyses revealed that a shortened 32-item version of the EDMCQ scale provides a factorial valid measurement of seven facets of the extent to which clinicians perceive an EDM climate: self-reflective and empowering leadership by physicians; practice and culture of open interdisciplinary reflection; culture of not avoiding end-of-life decisions; culture of mutual respect within the interdisciplinary team; active involvement of nurses in end-of-life care and decision-making; active decision-making by physicians; and practice and culture of ethical awareness. Measurement invariance of the EDMCQ across occupational groups was shown, reflecting that nurses and physicians interpret the EDMCQ items in a similar manner. The 32-item version of the EDMCQ might enrich the EDM climate measurement, clinicians' behaviour and the performance of healthcare organisations. This instrument offers opportunities to develop tailored ICU
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Frize, Monique; Yang, Lan; Walker, Robin C; O'Connor, Annette M
2005-06-01
This research is built on the belief that artificial intelligence estimations need to be integrated into clinical social context to create value for health-care decisions. In sophisticated neonatal intensive care units (NICUs), decisions to continue or discontinue aggressive treatment are an integral part of clinical practice. High-quality evidence supports clinical decision-making, and a decision-aid tool based on specific outcome information for individual NICU patients will provide significant support for parents and caregivers in making difficult "ethical" treatment decisions. In our approach, information on a newborn patient's likely outcomes is integrated with the physician's interpretation and parents' perspectives into codified knowledge. Context-sensitive content adaptation delivers personalized and customized information to a variety of users, from physicians to parents. The system provides structuralized knowledge translation and exchange between all participants in the decision, facilitating collaborative decision-making that involves parents at every stage on whether to initiate, continue, limit, or terminate intensive care for their infant.
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DEFF Research Database (Denmark)
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...
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An analysis of medical decision making
International Nuclear Information System (INIS)
Lusted, L.B.
1977-01-01
Medical decision-making studies continue to focus on two questions: How do physicians make decisions and how should physicians make decisions. Researchers pursuing the first question emphasize human cognitive processes and the programming of symbol systems to model the observed human behaviour. Those researchers concentrating on the second question assume that there is a standard of performance against which physicians' decisions can be judged, and to help the physician improve his performance an array of tools is proposed. These tools include decision trees, Bayesian analysis, decision matrices, receiver operating characteristic (ROC) analysis, and cost-benefit considerations including utility measures. Both questions must be answered in an ethical context where ethics and decision analysis are intertwined. (author)
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Reproductive Ethics in Commercial Surrogacy: Decision-Making in IVF Clinics in New Delhi, India.
Tanderup, Malene; Reddy, Sunita; Patel, Tulsi; Nielsen, Birgitte Bruun
2015-09-01
As a neo-liberal economy, India has become one of the new health tourism destinations, with commercial gestational surrogacy as an expanding market. Yet the Indian Assisted Reproductive Technology (ART) Bill has been pending for five years, and the guidelines issued by the Indian Council of Medical Research are somewhat vague and contradictory, resulting in self-regulated practices of fertility clinics. This paper broadly looks at clinical ethics in reproduction in the practice of surrogacy and decision-making in various procedures. Through empirical research in New Delhi, the capital of India, from December 2011 to November 2012, issues of decision-making on embryo transfer, fetal reduction, and mode of delivery were identified. Interviews were carried out with doctors in eighteen ART clinics, agents from four agencies, and fourteen surrogates. In aiming to fulfil the commissioning parents' demands, doctors were willing to go to the greatest extent possible in their medical practice. Autonomy and decision-making regarding choice of the number of embryos to transfer and the mode of delivery lay neither with commissioning parents nor surrogate mothers but mostly with doctors. In order to ensure higher success rates, surrogates faced the risk of multiple pregnancy and fetal reduction with little information regarding the risks involved. In the globalized market of commercial surrogacy in India, and with clinics compromising on ethics, there is an urgent need for formulation of regulative law for the clinical practice and maintenance of principles of reproductive ethics in order to ensure that the interests of surrogate mothers are safeguarded.
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Directory of Open Access Journals (Sweden)
Sule Tomkinson
2014-11-01
Full Text Available By drawing on eighteen months of ethnographic fieldwork and my field diaries in refugee decision-making in Canada, I make three arguments in this article. First, the binary of research in closed vs. open settings may have contributed to overlooking of ethical challenges of research in state organizations in democratic settings. We have to overcome this binary by opening a dialogue among ethnographers. Second, despite well-developed and diverse nature of scholarship on Research Ethics' Board's (REB formal practices and their negative impact on ethnographers' research proposals, the scarcity of scholarship on "ethics in practice" or "everyday ethics" show that we seem to forget that ethnographers, after receiving research ethics approval, still have to do considerable interpretation for what "being ethical" means. Finally, paying attention to "ethically important moments" during research practice may help us bridge the gap between principles of formal ethics and ethics in practice. Using field diaries in these reflections instead of more sanitized subsequent accounts illustrates the immediacy and importance of ethical concerns during research practice. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs150168
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Ethical analysis to improve decision-making on health technologies
DEFF Research Database (Denmark)
Saarni, Samuli I; Hofmann, Bjørn; Lampe, Kristian
2008-01-01
beyond effectiveness and costs to also considering the social, organizational and ethical implications of technologies. However, a commonly accepted method for analysing the ethical aspects of health technologies is lacking. This paper describes a model for ethical analysis of health technology...... that is easy and flexible to use in different organizational settings and cultures. The model is part of the EUnetHTA project, which focuses on the transferability of HTAs between countries. The EUnetHTA ethics model is based on the insight that the whole HTA process is value laden. It is not sufficient...... to only analyse the ethical consequences of a technology, but also the ethical issues of the whole HTA process must be considered. Selection of assessment topics, methods and outcomes is essentially a value-laden decision. Health technologies may challenge moral or cultural values and beliefs...
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Institute of Scientific and Technical Information of China (English)
李晓明; 傅小兰; 王新超
2012-01-01
本研究基于Hunt和Vitell（1986）所提出的市场营销领域的道德通用理论模型，随机选取129名MBA学生为被试，采用Reidenbach和Robin（1988，1990）的多维道德量表和情景研究法，旨在考察个体在应对企业决策中的道德问题时，不同道德评价取向对道德决策（整体性道德判断和道德意图阶段）的预测作用。结果表明：1）与对道德判断的单项目测量相比，多维道德量表对道德意图具有更高的预测效度；2）道德公平、功利主义和契约主义对整体道德判断具有显著预测作用；3）道德公平和相对主义对自我和他人道德意图具有显著预测作用。%As a general model of ethical decision making and behavior in marketing, the Hunt-Vitell theory illustrates how ethical deci- sions are predicated not only upon estimations of potential benefits or outcomes, but also by deontological evaluations which invoke norms and values. The former studies used to apply one item " ethical/unethical" to measure ethical judgment. But the single item measure was questionable due to reliability issues. Reidenbach & Robin (1988, 1990) began to develop the multidimensional ethics scale to explore how the individuals make ethical evaluation from different ethical philosophies. Thus, the multidimensional nature of the scale can provide information as to why a particular business activity is unethically judged. This study aimed at investigating the role of ethical evaluation on ethical decision-making ( ethical judgment and ethical intention) using the multidimensional ethics scale in China. The present paper reported the results of a vignette- and questionnaire-based research project. The study selected 129 MBA students as participants. Every participant was presented with two scenarios. Each scenario was followed by items assessing ethical evaluation (Moral Equity, Egoism, Relativism, Utilitarianism and Contractualism) from Reidenbach and Robin
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Klose, Laurie McGarry; Lasser, Jon; Reardon, Robert F.
2012-01-01
This preliminary, exploratory study examines the impact of select social psychological phenomena on school-based ethical decision-making of school psychologists. Responses to vignettes and hypothetical statements reflecting several social psychological phenomena were collected from 106 practicing school psychologists. Participants were asked to…
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论技术决策的伦理参与模式%Discussion on the ethical model of technology decision-making
Institute of Scientific and Technical Information of China (English)
高杨帆
2012-01-01
现代社会的许多风险是由于技术决策过程中伦理缺位所引起的。把伦理思想融入技术决策过程是当代技术面临的重大课题。尽管人们的技术决策总是有意或者无意受到某种伦理的指引,但有意识地在技术决策中植入伦理则至少有三种伦理模式,即价值观模式、功利主义模式和道义主义模式。它们因侧重点不同而适应于不同层次的技术决策,没有一种模式能普遍适用所有的技术决策,但选择一种最合适的伦理模式则是必要的,也是可行的。对于大型技术决策,则必须采取基于上述三种伦理模式的综合模式。%Many risks in modern society are due to the lack of ethic joining during the prohess of technical decision-making. How to embody he ethical thought into the technology decision-making process is a major issue faced by the contemporary technology. Despite the technical deci- sion making always is influenced intentionally or accidentally by certain ethical guidelines, but consciously implanting ethics in technology deci- sion-making has at least three ethical pattern, namely model of values, model of utilitarianism and model of deontology. They are different and are suitable for different levels of technical decision-making, not one model can be generally applicable to all technical decision-making, but to choose an appropriate ethical model is necessary and feasible. For oversized technical decision-making, taken on these three kinds of ethical model integrated model is necessary.
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Yang, Jianfeng; Ming, Xiaodong; Wang, Zhen; Adams, Susan M
2017-02-01
A meta-analysis of 143 studies was conducted to explore how the social desirability response bias may influence sex effects on ratings on measures of ethical decision-making. Women rated themselves as more ethical than did men; however, this sex effect on ethical decision-making was no longer significant when social desirability response bias was controlled. The indirect questioning approach was compared with the direct measurement approach for effectiveness in controlling social desirability response bias. The indirect questioning approach was found to be more effective.
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Uncertainty and equipoise: at interplay between epistemology, decision making and ethics.
Djulbegovic, Benjamin
2011-10-01
In recent years, various authors have proposed that the concept of equipoise be abandoned because it conflates the practice of clinical care with clinical research. At the same time, the equipoise opponents acknowledge the necessity of clinical research if there are unresolved uncertainties about the effects of proposed healthcare interventions. As equipoise represents just 1 measure of uncertainty, proposals to abandon equipoise while maintaining a requirement for addressing uncertainties are contradictory and ultimately not valid. As acknowledgment and articulation of uncertainties represent key scientific and moral requirements for human experimentation, the concept of equipoise remains the most useful framework to link the theory of human experimentation with the theory of rational choice. In this article, I show how uncertainty (equipoise) is at the intersection between epistemology, decision making and ethics of clinical research. In particular, I show how our formulation of responses to uncertainties of hoped-for benefits and unknown harms of testing is a function of the way humans cognitively process information. This approach is based on the view that considerations of ethics and rationality cannot be separated. I analyze the response to uncertainties as it relates to the dual-processing theory, which postulates that rational approach to (clinical research) decision making depends both on analytical, deliberative processes embodied in scientific method (system II), and good human intuition (system I). Ultimately, our choices can only become wiser if we understand a close and intertwined relationship between irreducible uncertainty, inevitable errors and unavoidable injustice.
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Matching the 'Knowing what to do' and the 'Doing what you Know' in Ethical Decision-making
Directory of Open Access Journals (Sweden)
Chang-Yuan Loh
2009-06-01
Full Text Available Corporate events in the past decades have contributed to a continued interest in the ethicaldecision-making of individuals in accounting. Much of the research in ethics and educationhave relied on the assumption that the individual’s level of ethical development is related tohis/her ethical behavior. Adapting a simplified version of Thorne’s (2000prescriptive/deliberative reasoning in a cheat-to-gain business scenario, a survey of accountingstudents suggest that ethical development may not be related to behavior. In addition,consistent with Thorne (2001, results suggest that even if individuals may ‘know what to do’for the ideal ethical decision, they may not always actually choose that path or ‘doing whatthey know’.
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Using an ethical decision-making model to determine consequences for student plagiarism.
Kiehl, Ermalynn M
2006-06-01
The incidence of plagiarism, intentional or unintentional, in the professional nursing arena has increased in recent years, as has the occurrence of plagiarism among nursing students. Strategies for cheating have become very sophisticated with the use of aids such as personal digital assistants, camera phones, and instant messaging. Cheating on written papers has also increased. The Internet provides students with ready-made research and academic papers, and access to Web sites on a plethora of topics. In this article, I describe my experience with plagiarism of ethics papers during students' final semester before graduation. How I discovered the plagiarized work and used the A-B-C-D-E ethical decision-making model in determining the student consequences for the event are presented.
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Resnik, David B; Miller, Frank
2010-09-01
Populations recruited to participate in sham surgery clinical trials sometimes include patients with cognitive impairments that affect decision-making capacity. In this commentary we examine arguments for and against including these patients in sham surgery clinical trials. We argue that patients with cognitive impairments that affect decision-making capacity should not be excluded from a sham surgery clinical trial if there are scientific reasons for including them in the study and basic ethical requirements for clinical research are met. Published by Elsevier Inc.
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Towards ethical decision support and knowledge management in neonatal intensive care.
Yang, L; Frize, M; Eng, P; Walker, R; Catley, C
2004-01-01
Recent studies in neonatal medicine, clinical nursing, and cognitive psychology have indicated the need to augment current decision-making practice in neonatal intensive care units with computerized, intelligent decision support systems. Rapid progress in artificial intelligence and knowledge management facilitates the design of collaborative ethical decision-support tools that allow clinicians to provide better support for parents facing inherently difficult choices, such as when to withdraw aggressive treatment. The appropriateness of using computers to support ethical decision-making is critically analyzed through research and literature review. In ethical dilemmas, multiple diverse participants need to communicate and function as a team to select the best treatment plan. In order to do this, physicians require reliable estimations of prognosis, while parents need a highly useable tool to help them assimilate complex medical issues and address their own value system. Our goal is to improve and structuralize the ethical decision-making that has become an inevitable part of modern neonatal care units. The paper contributes to clinical decision support by outlining the needs and basis for ethical decision support and justifying the proposed development efforts.
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Huckel Schneider, Carmen; Negin, Joel
2016-01-01
The engagement of the for-profit private sector in health, social and humanitarian services has become a topic of keen interest. It is particularly contentious in those instances where for-profit organizations have become recipients of public funds, and where they become key decision-makers in terms of how, and to whom, services are provided. We put forward a framework for identifying and organizing the ethical questions to be considered when contracting government services to the for-profit sector, specifically in those areas that have traditionally remained in the public or not-for-profit spheres. The framework is designed to inform both academic debate and practical decision-making regarding the acceptability, feasibility and legitimacy of for-profit organizations carrying out humanitarian work. First, we outline the importance of posing ethical questions in government contracting for-profit vs. not-for-profit organizations. We then outline five key areas to be considered before then examining the extent to which ethics concerns are warranted and how they may be safeguarded.
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Ethical Frameworks in Public Health Decision-Making: Defending a Value-Based and Pluralist Approach.
Grill, Kalle; Dawson, Angus
2017-12-01
A number of ethical frameworks have been proposed to support decision-making in public health and the evaluation of public health policy and practice. This is encouraging, since ethical considerations are of paramount importance in health policy. However, these frameworks have various deficiencies, in part because they incorporate substantial ethical positions. In this article, we discuss and criticise a framework developed by James Childress and Ruth Bernheim, which we consider to be the state of the art in the field. Their framework distinguishes aims, such as the promotion of public health, from constraints on the pursuit of those aims, such as the requirement to avoid limitations to liberty, or the requirement to be impartial. We show how this structure creates both theoretical and practical problems. We then go on to present and defend a more practical framework, one that is neutral in avoiding precommitment to particular values and how they ought to be weighted. We believe ethics is at the very heart of such weightings and our framework is developed to reflect this belief. It is therefore both pluralist and value-based. We compare our new framework to Childress and Bernheim's and outline its advantages. It is justified by its impetus to consider a wide range of alternatives and its tendency to direct decisions towards the best alternatives, as well as by the information provided by the ranking of alternatives and transparent explication of the judgements that motivate this ranking. The new framework presented should be useful to decision-makers in public health, as well as being a means to stimulate further reflection on the role of ethics in public health.
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Behavioral Ethics and Teaching Ethical Decision Making
Drumwright, Minette; Prentice, Robert; Biasucci, Cara
2015-01-01
Business education often renders students less likely to act ethically. An infusion of liberal learning in the form of behavioral ethics could improve this situation by prompting students to develop higher levels of professionalism that encompass ethics, social responsibility, self-critical reflection, and personal accountability. More…
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Evaluating Ethical Responsibility in Inverse Decision Support
Directory of Open Access Journals (Sweden)
Ahmad M. Kabil
2012-01-01
Full Text Available Decision makers have considerable autonomy on how they make decisions and what type of support they receive. This situation places the DSS analyst in a different relationship with the client than his colleagues who support regular MIS applications. This paper addresses an ethical dilemma in “Inverse Decision Support,” when the analyst supports a decision maker who requires justification for a preconceived selection that does not correspond to the best option that resulted from the professional resolution of the problem. An extended application of the AHP model is proposed for evaluating the ethical responsibility in selecting a suboptimal alternative. The extended application is consistent with the Inverse Decision Theory that is used extensively in medical decision making. A survey of decision analysts is used to assess their perspective of using the proposed extended application. The results show that 80% of the respondents felt that the proposed extended application is useful in business practices. 14% of them expanded the usability of the extended application to academic teaching of the ethics theory. The extended application is considered more usable in a country with a higher Transparency International Corruption Perceptions Index (TICPI than in a country with a lower one.
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Yeung, Fanny P. F.; Keup, Jennifer R.
2009-01-01
It is important to understand how students' changing belief structures influence their values and behaviors, including their ethical beliefs and decision-making patterns. As such, this study will address the following research questions: (1) what are students' ethical beliefs and their perceptions of students' ethical behaviors; and (2) how do…
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Kimball, Bob
2007-01-01
Educators and marketing professionals agree that course-work must address interpersonal communication skills and ethical decision making in addition to traditional business functions and skills. This article describes an innovative approach to teaching the professional selling course in which students enhance their competency in these areas…
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Universal prescriptivism: traditional moral decision-making theory revisited.
Crigger, N J
1994-09-01
Universal prescriptivism is a recently developed moral decision-making theory that combines utilitarian and Kantian theories with two levels of moral thinking. A combined approach offers a creative solution to the weaknesses inherent in traditional moral theories. The paper describes the theory and discusses important implications for nursing education, practical ethical decision-making, and research. The relationship of an ethical theory of caring to traditional moral theory is discussed.
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Goksoy, Asli; Alayoglu, Nihat
2013-01-01
Ethics in decision making has been an issue for academics, practitioners, and governmental regulators for decades. In the last decade, numerous scandals and consequently many corporate crises in the global business world have added credence to the criticisms of business ethics. Therefore, it is vital to understand the factors affecting employees'…
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Nelson, Johnathan; Smith, Lola B.; Hunt, Clifford Steven
2014-01-01
Many academicians are asking the following question: "Are we ill-preparing our business students if we fail to offer future business professionals the opportunity to engage in a greater understanding of the ethical decision making process?" The authors provide a current review of the literature on the state of ethics education in…
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Does everyone have a price? On the role of payoff magnitude for ethical decision making.
Hilbig, Benjamin E; Thielmann, Isabel
2017-06-01
Most approaches to dishonest behavior emphasize the importance of corresponding payoffs, typically implying that dishonesty might increase with increasing incentives. However, prior evidence does not appear to confirm this intuition. However, extant findings are based on relatively small payoffs, the potential effects of which are solely analyzed across participants. In two experiments, we used different multi-trial die-rolling paradigms designed to investigate dishonesty at the individual level (i.e., within participants) and as a function of the payoffs at stake - implementing substantial incentives exceeding 100€. Results show that incentive sizes indeed matter for ethical decision making, though primarily for two subsets of "corruptible individuals" (who cheat more the more they are offered) and "small sinners" (who tend to cheat less as the potential payoffs increase). Others ("brazen liars") are willing to cheat for practically any non-zero incentive whereas still others ("honest individuals") do not cheat at all, even for large payoffs. By implication, the influence of payoff magnitude on ethical decision making is often obscured when analyzed across participants and with insufficiently tempting payoffs. Copyright © 2017 Elsevier B.V. All rights reserved.
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Husted, BW; Allen, DB
2008-01-01
In this paper, we explore the impact of individualism and collectivism on three basic aspects of ethical decision making – the perception of moral problems, moral reasoning, and behavior. We argue that the inclusion of business practices within the moral domain by the individual depends partly upon individualism and collectivism. We also propose a pluralistic approach to post-conventional moral judgment that includes developmental paths appropriate for individualist and collectivist cultures....
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Cunningham, Thomas V
2016-01-01
Three common ethical principles for establishing the limits of parental authority in pediatric treatment decision-making are the harm principle, the principle of best interest, and the threshold view. This paper considers how these principles apply to a case of a premature neonate with multiple significant co-morbidities whose mother wanted all possible treatments, and whose health care providers wondered whether it would be ethically permissible to allow him to die comfortably despite her wishes. Whether and how these principles help in understanding what was morally right for the child is questioned. The paper concludes that the principles were of some value in understanding the moral geography of the case; however, this case reveals that common bioethical principles for medical decision-making are problematically value-laden because they are inconsistent with the widespread moral value of medical vitalism.
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J. de Boer (Coby)
2015-01-01
markdownabstractAbstract This thesis assesses the effectiveness of structured multi-professional medical ethical decision-making in diminishing problems experienced around medical ethical decisionmaking in the Erasmus MC NICU. Besides, it gives an overview of the patients discussed from 2009 to
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Ethical Decisions in Experience-Based Training and Development Programs.
Gass, Michael A.; Wurdinger, Scott
1993-01-01
Illustrates how principle and virtue ethics can be applied to decision-making processes in experience-based training and development programs. Principle ethics is guided by predetermined rules and assumes that issues being examined are somewhat similar in context, whereas virtue ethics assumes that "correct behavior" is determined from…
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Celuch, Kevin; Dill, Andy
2011-01-01
The moral conduct of organizations is ultimately dependent on the discrete actions of individuals. The authors address the scholarly and managerial imperative of how individuals combine various cognitions in their ethical decision making. The study extends the understanding of ethical decision making by exploring relationships among Theory of…
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Common-sense ethics in administrative decision making. Part I, Preparatory steps.
Sullivan, P A; Brown, T
1991-10-01
This is Part 1 of two articles demonstrating the relevance of business ethics to nurse administrators as they confront value-laden issues such as the advantages and disadvantages of 10-12-hour scheduling patterns, understaffing, emerging registered nurse partnerships, and other administrative problems. Common-sense ethics can serve as the basis of just administrative decisions. The authors present a model of preparatory attitudes and behaviors. The steps that they propose do not guarantee success, but if implemented, they may facilitate the nurse administrator's management of diverse ethical issues.
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Nudge or Grudge? Choice Architecture and Parental Decision-Making.
Blumenthal-Barby, Jennifer; Opel, Douglas J
2018-03-01
Richard Thaler and Cass Sunstein define a nudge as "any aspect of the choice architecture that alters people's behavior in a predictable way without forbidding any options or significantly changing their economic incentives." Much has been written about the ethics of nudging competent adult patients. Less has been written about the ethics of nudging surrogates' decision-making and how the ethical considerations and arguments in that context might differ. Even less has been written about nudging surrogate decision-making in the context of pediatrics, despite fundamental differences that exist between the pediatric and adult contexts. Yet, as the field of behavioral economics matures and its insights become more established and well-known, nudges will become more crafted, sophisticated, intentional, and targeted. Thus, the time is now for reflection and ethical analysis regarding the appropriateness of nudges in pediatrics. We argue that there is an even stronger ethical justification for nudging in parental decision-making than with competent adult patients deciding for themselves. We give three main reasons in support of this: (1) child patients do not have autonomy that can be violated (a concern with some nudges), and nudging need not violate parental decision-making authority; (2) nudging can help fulfill pediatric clinicians' obligations to ensure parental decisions are in the child's interests, particularly in contexts where there is high certainty that a recommended intervention is low risk and of high benefit; and (3) nudging can relieve parents' decisional burden regarding what is best for their child, particularly with decisions that have implications for public health. © 2018 The Hastings Center.
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Ethical Decisions in Turbulent Times
Shapiro, Joan Poliner; Gross, Steven Jay; Shapiro, Susan H.
2008-01-01
Education leaders make difficult ethical decisions each day. Using the story of a preschool director in lower Manhattan on September 11, 2001, the authors detail a series of paradigms to help educational leaders navigate rationally through challenging and complex circumstances when they are under considerable emotional stress. One approach which…
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Zhu, Qin; Jesiek, Brent K
2017-06-01
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.
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Male Pragmatism in Ethical Decision Making
Kray, Laura J.; Haselhuhn, Michael P.
2011-01-01
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 men’s ethicality...
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End-of-life decisions in Malaysia: Adequacies of ethical codes and developing legal standards.
Kassim, Puteri Nemie Jahn; Alias, Fadhlina
2015-06-01
End-of-life decision-making is an area of medical practice in which ethical dilemmas and legal interventions have become increasingly prevalent. Decisions are no longer confined to clinical assessments; rather, they involve wider considerations such as a patient's religious and cultural beliefs, financial constraints, and the wishes and needs of family members. These decisions affect everyone concerned, including members of the community as a whole. Therefore it is imperative that clear ethical codes and legal standards are developed to help guide the medical profession on the best possible course of action for patients. This article considers the relevant ethical, codes and legal provisions in Malaysia governing certain aspects of end-of-life decision-making. It highlights the lack of judicial decisions in this area as well as the limitations with the Malaysian regulatory system. The article recommends the development of comprehensive ethical codes and legal standards to guide end-of-life decision-making in Malaysia.
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Realism and Impartiality: Making Sustainability Effective in Decision-Making.
Bastons, Miquel; Armengou, Jaume
2017-08-01
There is both individual and collective widespread concern in society about the impact of human activity and the effects of our decisions on the physical and social environment. This concern is included within the idea of sustainability. The meaning of the concept is still ambiguous and its practical effectiveness disputed. Like many other authors, this article uses as a starting point the definition proposed by the World Commission on Environment and Development (Our common future, Oxford University Press, Oxford, 1987), considering it to be a proposal for changing the assessment of the effects of decisions, from at least two perspectives: (1) what effects we should consider and (2) how we should assess them. Based on this double perspective, sustainability is explored as a method for decision-making which both expands the assessment of the consequences, and also provides an objective criterion for such assessment. It will be argued that the idea of sustainability, seen from this perspective, brings to decision-making two qualities which had been partially lost: realism and impartiality. In turn, the criteria for realism and impartiality in decision-making can be used to identify the limitations of some partial approaches to sustainability, which suffer from insufficient realism (emotional altruism), insufficient impartiality (tactical altruism) or both phenomena at once (egoism). The article concludes by demonstrating how realism and impartiality provide the basis for a new form of sustainable decision-making (ethical sustainability), which is dependent on the development of two moral virtues, prudence and benevolence, and which brings practical effectiveness and ethical sense to the concept of sustainability.
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Motives for Ethical Decision-Making.
Singletary, Michael W.; And Others
1990-01-01
Uses Q-analysis to study the motives that reporters and mass communication students bring to the resolution of ethical issues. Finds that most were "mainstream" ethicists, whose ethical concerns centered on credibility, their personal sense of morality, the public's need to know, and the standards of their field and their employer. (SR)
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Strategy and skills for moral decision-making in business
G.J. Rossouw
1997-01-01
Business Ethics is a truly interdisciplinary field of study. The specific issue of moral decision-making within the field of business ethics testifies to this. Recently some have made important contributions in this regard - contributions in which they emphasised that moral theory is not sufficient for moral decision-making. What is needed besides moral theory is problem-solving ability. In this article the same point is argued, but from a philosophical perspective. It is further indicated th...
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Autonomy and couples' joint decision-making in healthcare.
Osamor, Pauline E; Grady, Christine
2018-01-11
Respect for autonomy is a key principle in bioethics. However, respecting autonomy in practice is complex because most people define themselves and make decisions influenced by a complex network of social relationships. The extent to which individual autonomy operates for each partner within the context of decision-making within marital or similar relationships is largely unexplored. This paper explores issues related to decision-making by couples (couples' joint decision-making) for health care and the circumstances under which such a practice should be respected as compatible with autonomous decision-making. We discuss the concept of autonomy as it applies to persons and to actions, human interdependency and gender roles in decision-making, the dynamics and outcomes of couples' joint decision-making, and the ethics of couples' joint decision-making. We believe that the extent to which couples' joint decision-making might be deemed ethically acceptable will vary depending on the context. Given that in many traditional marriages the woman is the less dominant partner, we consider a spectrum of scenarios of couples' joint decision-making about a woman's own health care that move from those that are acceptably autonomous to those that are not consistent with respecting the woman's autonomous decision-making. To the extent that there is evidence that both members of a couple understand a decision, intend it, and that neither completely controls the other, couples' joint decision-making should be viewed as consistent with the principle of respect for the woman's autonomy. At the other end of the spectrum are decisions made by the man without the woman's input, representing domination of one partner by the other. We recommend viewing the dynamics of couples' joint decision-making as existing on a continuum of degrees of autonomy. This continuum-based perspective implies that couples' joint decision-making should not be taken at face value but should be assessed against
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It's money that matters: the financial context of ethical decision-making in modern biomedicine.
Hedgecoe, Adam M
2006-09-01
While the importance of patient autonomy is widely acknowledged and discussed in the bioethics literature, clinicians' autonomy, their ability to make the best choices about patients' care free from outside interference, is far less debated. This paper takes one form of external influence over clinical decisions - the cost of drugs - and applies it to a specific case, that of HER2 positive breast cancer and the use of the drug Herceptin in the UK. Drawing on interviews with clinicians, researchers and policymakers, I explore the way financial decisions about Herceptin shape clinicians' autonomy, and how clinicians as individuals and as professional groups respond to these limits and seek to provide treatment to the highest number of the most deserving patients they can. The point of this paper is not to castigate bioethicists for misguidedly focusing on patient autonomy but point out that clinicians' autonomy may be so circumscribed by external factors that it may make no sense to speak of their actions as stemming from ethical decisions. At the same time, I suggest that financial constraints create areas at the margin of clinical practice which are deserving of bioethical consideration.
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A communication model of shared decision making: accounting for cancer treatment decisions.
Siminoff, Laura A; Step, Mary M
2005-07-01
The authors present a communication model of shared decision making (CMSDM) that explicitly identifies the communication process as the vehicle for decision making in cancer treatment. In this view, decision making is necessarily a sociocommunicative process whereby people enter into a relationship, exchange information, establish preferences, and choose a course of action. The model derives from contemporary notions of behavioral decision making and ethical conceptions of the doctor-patient relationship. This article briefly reviews the theoretical approaches to decision making, notes deficiencies, and embeds a more socially based process into the dynamics of the physician-patient relationship, focusing on cancer treatment decisions. In the CMSDM, decisions depend on (a) antecedent factors that have potential to influence communication, (b) jointly constructed communication climate, and (c) treatment preferences established by the physician and the patient.
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Strategy and skills for moral decision-making in business
Directory of Open Access Journals (Sweden)
G.J. Rossouw
1997-03-01
Full Text Available Business Ethics is a truly interdisciplinary field of study. The specific issue of moral decision-making within the field of business ethics testifies to this. Recently some have made important contributions in this regard - contributions in which they emphasised that moral theory is not sufficient for moral decision-making. What is needed besides moral theory is problem-solving ability. In this article the same point is argued, but from a philosophical perspective. It is further indicated that problem-solving ability entails more than merely a strategy fo r making moral decisions. It should also include the development of the thinking skills which are demanded by the strategy chosen fo r problem resolution.
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International Nuclear Information System (INIS)
Oughton, Deborah; Bay, Ingrid; Forsberg, Ellen-Marie; Kaiser, Matthias
2003-01-01
Experience after the Chernobyl accident has shown that restoration strategies need to consider a wide range of different issues to ensure the long-term sustainability of large and varied contaminated areas. Thus, the criteria by which we evaluate countermeasures needs to be extended from simple cost benefit effectiveness and radiological protection standards to a more integrated, holistic approach, including social and ethical aspects. Within the EU STRATEGY project, the applicability of many countermeasures is being critically assessed using a wide range of criteria, such as practicability, environmental side-effects, public perceptions of risk, communication and dialogue, and ethical aspects such as informed consent and the fair distribution of costs and doses. Although such socio-ethical factors are now the subject of a substantial field of research, there has been little attempt to integrate them in a practical context for decision makers. Within this paper, we suggest practical means by which these can be taken into account in the decision making process, proposing use of an ethical matrix to ensure transparent and systematic consideration of values in selection of a restoration strategy. in selection of a restoration strategy
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Advancing an Ethic of Embodied Relational Sexuality to Guide Decision-Making in Dementia Care.
Grigorovich, Alisa; Kontos, Pia
2018-03-19
Sexuality and intimacy are universal needs that transcend age, cognitive decline, and disability; sexuality is a fundamental aspect of the human experience. However, supporting sexuality in long-term residential care presents ethical challenges as this setting is both a home environment for residents and a workplace for health practitioners. This is particularly complex in the case of residents with dementia given the need to balance protection from harm and freedom of self-determination. Despite such complexity, this challenge has received limited critical theoretical attention. The dominant approach advocated to guide ethical reasoning is the bioethical four principles approach. However, the application of this approach in the context of dementia and long-term care may set the bar for practitioners' interference excessively high, restricting assentual (i.e., voluntary) sexual expression. Furthermore, it privileges cognitive and impartial decision-making, while disregarding performative, embodied, and relational aspects of ethical reasoning. With an interest in addressing these limitations, we explicate an alternative ethic of embodied relational sexuality that is grounded in a model of citizenship that recognizes relationality and the agential status of embodied self-expression. This alternative ethic broadens ethical reasoning from the exclusive duty to protect individuals from harm associated with sexual expression, to the duty to also uphold and support their rights to experience the benefits of sexual expression (e.g., pleasure, intimacy). As such it has the potential to inform the development of policies, organizational guidelines, and professional curricula to support the sexuality of persons with dementia, and thereby ensure more humane practices in long-term residential care settings.
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Individual decision making, group decision making and deliberation
Directory of Open Access Journals (Sweden)
Radovanović Bojana
2012-01-01
Full Text Available Each of us makes a number of decisions, from the less important to those with far-reaching consequences. As members of different groups, we are also actors of group decision making. In order to make a rational decision, a choice-making procedure must satisfy a number of assumptions (conditions of rationality. In addition, when it comes to group decisions, those procedures should also be “fair.” However, it is not possible to define a procedure of choice-making that would transform individual orders of alternatives based on preferences of perfectly rational individuals into a single social order and still meet conditions of rationality and ethics. The theory of deliberative democracy appeared in response to the impossibility of Social Choice theory. The basic assumption of deliberative democracy is that individuals adjust their preferences taking into account interests of the community. They are open for discussion with other group members and are willing to change their attitudes in order to achieve common interests. Ideally, group members come to an agreement during public discussion (deliberation. Still, this concept cannot completely overcome all the difficulties posed by the theory of social choice. Specifically, there is no solution for strategic and manipulative behavior of individuals. Also, the concept of deliberative democracy faces certain problems particular to this approach, such as, to name but a few, problems with the establishment of equality of participants in the debate and their motivation, as well as problems with the organization of public hearings. [Projekat Ministarstva nauke Republike Srbije, br. 47009: Evropske integracije i društveno-ekonomske promene privrede Srbije na putu ka EU i br. 179015: Izazovi i perspektive strukturnih promena u Srbiji: Strateški pravci ekonomskog razvoja i usklađivanje sa zahtevima EU
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Making sense of adolescent decision-making: challenge and reality.
Unguru, Yoram
2011-08-01
Few topics in pediatric bioethics are as vexing as decision-making. Decision-making in pediatrics presents challenges for children, parents, and physicians alike. The related, yet distinct, concepts of assent and consent are central to pediatric decision-making. Although informed consent is largely regarded as a worthwhile adult principle, assent has been, and continues to be, mired in debate. Controversial subjects include a meaningful definition of assent; how old children should be to assent; who should be included in the assent process; parental permission; how to resolve disputes between children and their parents; the relationship between assent and consent; the quantity and quality of information to disclose to children and their families; how much and what information children desire and need; the necessity and methods for assessing both children's understanding of disclosed information and of the assent process itself; reconciling ethical and legal attitudes toward assent; and finally, an effective, practical, and realistically applicable decision-making model.
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Nursing informatics, ethics and decisions: implications for translational research
DEFF Research Database (Denmark)
Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Dowie, Jack
Nursing informatics, ethics and decisions: implications for translational research Objective: To introduce, in the multi-disciplinary contexts of clinical decision making and policy formation, a theory-based decision-analytic framework for the transparent forward translation of research......-calculation with evidence-based ratings for option performance on those criteria to produce a preference-sensitive assessment or opinion. Results: The first example shows the framework connecting nursing informatics and nursing ethics in the clinical context of a nurse’s decision to disclose or not disclose information......, satisfaction, Quality of Life), organization-related (staff and work environment, internal and external communication and relationships) and economics-related (start-up costs, financial implications and externalities)). Conclusion: Web-based decision support can provide nursing with a template, technique...
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On ethical (in)decisions experienced by parents of infants in neonatal intensive care.
van Manen, Michael A
2014-02-01
This study was a phenomenological investigation of ethical decisions experienced by parents of newborns in neonatal intensive care. I explore the lived meanings of thematic events that speak to the variable ways that ethical situations may be experienced: a decision that was never a choice; a decision as looking for a way out; a decision as thinking and feeling oneself through the consequences; a decision as indecision; and a decision as something that one falls into. The concluding recommendations spell out the need for understanding the experiences of parents whose children require medical care and underscore the tactful sensitivities required of the health care team during moral-ethical decision making.
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Sanchini, Virginia
2016-01-01
This book offers an overview of the main questions arising when biomedical decision-making intersects ethical decision-making. It reports on two ethical decision-making methodologies, one addressing the patients, the other physicians. It shows how patients’ autonomous choices can be empowered by increasing awareness of ethical deliberation, and at the same time it supports healthcare professionals in developing an ethical sensitivity, which they can apply in their daily practice. The book highlights the importance and relevance of practicing bioethics in the age of personalized medicine. It presents concrete cases studies dealing with cancer and genetic diseases, where difficult decisions need to be made by all the parties involved: patients, physicians and families. Decisions concern not only diagnostic procedures and treatments, but also moral values, religious beliefs and ways of seeing life and death, thus adding further layers of complexity to biomedical decision-making. This book, which is strongly ro...
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Yeung, Fanny P.F.; Keup, Jennifer R.
2009-01-01
It is important to understand how students' changing belief structures influence their values and behaviors, including their ethical beliefs and decision-making patterns. As such, this study will address the following research questions: 1) what are students' ethical beliefs and their perceptions of students' ethical behaviors; and 2) how do…
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Ethical decision-making in forensic psychology
M. Swanepoel
2010-01-01
The purpose of this article is to develop a comprehensive process for identifying and addressing primarily ethical issues related to the psychology profession in South Africa. In fulfilling this purpose, research was conducted of relevant ethical and to a lesser extent, legal aspects pertaining to the psychology profession. In an attempt to prevent unprofessional conduct claims against psychologists from succeeding and to alert psychologists to the concurrent ethical problems that may lead to...
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Chinese business managers' moral decision-making
LIN, NASA
2011-01-01
The topic of this thesis is about moral decision-making, and the main objective of this study is to research the moral decision-making of Chinese business managers based on the analysis of data. The study adopts systematic literature of qualitative research method and is constructed by means of qualitative analysis of 64 data articles. The 64 data articles are the journals from the Database of Chinese Academic Journals, Journal of Business Ethics and other leading business journals from the y...
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Calculus formation: nurses' decision-making in abortion-related care.
McLemore, Monica R; Kools, Susan; Levi, Amy J
2015-06-01
Nurses routinely provide care to patients in ethically challenging situations. To explore the continuum between conscientious objectors and designated staff in the provision of care to women seeking abortions, the aim of this study was to thickly describe decision-making, using abortion as the clinical context to elucidate how nurses approach ethically challenging work. A purposive sample of 25 nurses who worked in abortion clinics, emergency departments, intensive care units, labor, and delivery, operating rooms, and post anesthesia care units were interviewed. Qualitative description and thematic analysis were used to identify the cognitive, emotional, and behavioral processes in nurses' decisions to care for women needing abortions. Nurses developed and used multifaceted, real-time calculi when making decisions about their participation in emergent or routine abortion care. Nurses tacked back and forth between the personal and professional and/or held multiple contradictory positions simultaneously. Nurses weighed the role and opinion of others to determine if they know how to or know why they would provide abortion care to women, particularly in the elective abortion context. The parameters of the nurse-patient relationship were complex and specific to the experiences of both the nurse and patient. Findings from this study further develop the science of ethically challenging decision-making and expand our understanding of factors that influence how nurses develop relationships to ethically challenging work. © 2015 Wiley Periodicals, Inc.
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Convey, Helen; Holt, Janet; Summers, Barbara
2018-03-08
This study explored the feasibility of using Construal Level Theory to analyse proxy decision maker thinking about a hypothetical ethical dilemma, relating to a person who has dementia. Proxy decision makers make decisions on behalf of individuals who are living with dementia when dementia affects that individual's decision making ability. Ethical dilemmas arise because there is a need to balance the individual's past and contemporary values and views. Understanding of how proxy decision makers respond is incomplete. Construal Level Theory contends that individuals imagine reactions and make predications about the future by crossing psychological distance. This involves abstract thinking, giving meaning to decisions. There is no empirical evidence of Construal Level Theory being used to analyse proxy decision maker thinking. Exploring the feasibility of using Construal Level Theory to understand dementia carer thinking regarding proxy decisions may provide insights which inform the support given. Descriptive qualitative research with semi-structured interviews. Seven participants were interviewed using a hypothetical dementia care scenario in February 2016. Interview transcripts were analysed for themes. Construal Level Theory was applied to analyse participant responses within themes using the Linguistic Category Model. Participants travelled across psychological distance, using abstract thinking to clarify goals and provide a basis for decisions. When thinking concretely participants established boundaries regarding the ethical dilemma. Construal Level Theory gives insight into proxy decision maker thinking and the levels of abstraction used. Understanding what dementia carers think about when making proxy decisions may help nurses to understand their perspectives and to provide appropriate support. © 2018 John Wiley & Sons Ltd.
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Decision making in neonatologia.
Paterlini, G; Tagliabue, P
2010-06-01
The field of neonatology presents a fascinating context in which hugely important decisions have to be made on the basis of physicians' assessments of the long term consequences of various possible choices. In many cases such assessments cannot be derived from a consensual professional opinion; the situation is characterized by a high level of uncertainty. A sample of neonatologists in different countries received a questionnaire including vignette cases for which no clear consensus exists regarding the (probabilistic) prognosis. They were asked to (I) assess the probability of various outcomes (death, severe impairment) and (II) choose a treatment to be offered to the parents. Information on the physicians' professional and socio-demographic characteristics and their ethical "values" was also collected. The goal of this international survey is to understand the prognosis and to analyze decision making by professionals in the context of life and death in medicine. The availability of an identical technology in different social and institutional contexts should help identifying the convergences and differences under consideration. Seventy percent of those invited responded to the questionnaire (International 60-80%). Italian neonatologists seem to be quite pessimistic about the prognosis of infants at high risk of death or long term disabilities, they show a pro-life attitude, but in a certain proportion are willing to change their minds if requested by parents. Furthermore personal opinions predominate in the decision-making process and the contribution of team meeting and/or ethic consultation seem not significantly modify the decisions.
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Decision making regarding multifetal reduction.
Maifeld, Michelle; Hahn, Sandra; Titler, Marita G; Mullen, Meredithe
2003-01-01
To identify salient variables that influence decision making regarding multifetal reduction (MFR) and describe their effect on individuals over time. Prospective, exploratory, descriptive design, using qualitative and quantitative methods. Midwestern tertiary care center. A convenience sample of 11 consecutive consenting couples with triplet or higher-order pregnancies who elected to undergo MFR. Semistructured audiotaped telephone interviews at three points: (a) 2 weeks postreduction, (b) 6 weeks postpartum, and (c) 6 months postpartum; a demographic and marital adjustment questionnaire. Themes identified by content analysis and compared via matrix analysis between males and females and at three points in time; trends in marital adjustment. Dominant variables influencing MFR decision making were risks associated with higher-order pregnancies and preservation of infants' and mothers' health. Most participants identified emotional issues, including moral and ethical dilemmas, as the most difficult aspect of reduction. Over time, participants reported feeling more positive about their decision; nonetheless, negative feelings emerged progressively. Risk aversion favored MFR decision making. Yet, both making and living with the decision were emotionally difficult for this sample. Interventions are needed to assist couples with this decision and its consequences.
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Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria.
Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho
2016-11-01
End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees' roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery.
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Equity trade-offs in conservation decision making.
Law, Elizabeth A; Bennett, Nathan J; Ives, Christopher D; Friedman, Rachel; Davis, Katrina J; Archibald, Carla; Wilson, Kerrie A
2018-04-01
Conservation decisions increasingly involve multiple environmental and social objectives, which result in complex decision contexts with high potential for trade-offs. Improving social equity is one such objective that is often considered an enabler of successful outcomes and a virtuous ideal in itself. Despite its idealized importance in conservation policy, social equity is often highly simplified or ill-defined and is applied uncritically. What constitutes equitable outcomes and processes is highly normative and subject to ethical deliberation. Different ethical frameworks may lead to different conceptions of equity through alternative perspectives of what is good or right. This can lead to different and potentially conflicting equity objectives in practice. We promote a more transparent, nuanced, and pluralistic conceptualization of equity in conservation decision making that particularly recognizes where multidimensional equity objectives may conflict. To help identify and mitigate ethical conflicts and avoid cases of good intentions producing bad outcomes, we encourage a more analytical incorporation of equity into conservation decision making particularly during mechanistic integration of equity objectives. We recommend that in conservation planning motivations and objectives for equity be made explicit within the problem context, methods used to incorporate equity objectives be applied with respect to stated objectives, and, should objectives dictate, evaluation of equity outcomes and adaptation of strategies be employed during policy implementation. © 2017 Society for Conservation Biology.
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Ethical factors influencing decisions
International Nuclear Information System (INIS)
Feldhaus, S.
1993-01-01
Ethics are determined by weighing risks against benefits, pros against cons, but also by evasion. Whenever decisions are taken, the side effects and risks to be accepted must be weighed. In law, this is called the principle of commensurability implying that ethical compromises are made. Too much emphasis on ethical principles leads to an evasion of realistic action. In consensus discussions it is often seen that the positions adopted by science and technology are incommensurable with those of philosophy, psychology, and theology. Any decision requires that the risk be evaluated in a spirit of responsibility. (orig.) [de
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Whole mind and shared mind in clinical decision-making.
Epstein, Ronald Mark
2013-02-01
To review the theory, research evidence and ethical implications regarding "whole mind" and "shared mind" in clinical practice in the context of chronic and serious illnesses. Selective critical review of the intersection of classical and naturalistic decision-making theories, cognitive neuroscience, communication research and ethics as they apply to decision-making and autonomy. Decision-making involves analytic thinking as well as affect and intuition ("whole mind") and sharing cognitive and affective schemas of two or more individuals ("shared mind"). Social relationships can help processing of complex information that otherwise would overwhelm individuals' cognitive capacities. Medical decision-making research, teaching and practice should consider both analytic and non-analytic cognitive processes. Further, research should consider that decisions emerge not only from the individual perspectives of patients, their families and clinicians, but also the perspectives that emerge from the interactions among them. Social interactions have the potential to enhance individual autonomy, as well as to promote relational autonomy based on shared frames of reference. Shared mind has the potential to result in wiser decisions, greater autonomy and self-determination; yet, clinicians and patients should be vigilant for the potential of hierarchical relationships to foster coercion or silencing of the patient's voice. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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Career Decision-Making and Corporate Responsibility
Sainty, Rosemary
2008-01-01
This paper seeks to investigate the extent of influence of corporate (or organisational) responsibility on university students' career decision-making. It reports on a pilot study conducted at the University of Sydney which aims to: explore students' ethical, professional and social understanding regarding corporate responsibility; determine the…
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Judging Managerial Actions as Ethical or Unethical: Decision Bias and Domain Relevant Experience
Directory of Open Access Journals (Sweden)
Jeffrey J. Bailey, Ph.D.
2013-07-01
Full Text Available This is an empirical study comparing the susceptibility of managers and students to a decision-making bias when making judgments about ethical business practices. The managers and students read through vignettes and made judgments about how ethical they perceived the described business actions to be. Half of the participants (half of the managers and half of the students were exposed to three situations in which the actions being judged were clearly unethical. The other half of each group was exposed to situations in which the actions being judged were clearly ethical. All were exposed to the same fourth situation of a business decision. In this ambiguous situation it was not clear if the business decision being evaluated was ethical or unethical. The decision bias examined here addressed the question of ‘to what extent does exposure to prior unethical (or ethical actions influence one’s evaluation of how ethical a particular business decision is when it is not a clearly right or wrong action. The results demonstrated that students’ ethical judgments about the action in the fourth scenario (the same scenario for everyone differed depending on what they were previously exposed to. Significant assimilation effects were found in the student sample suggesting support for the perceptual readiness models. The managerial sample yielded differences in the opposite direction, one of a contrast effect, but these did not reach statistical significance. Assimilation effects occurred in the sample without domain relevant experience and contrast effects occurred with the experienced sample. Implications are discussed.
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Kaufert, Joseph; Schwartz, Karen; Wiebe, Rhonda; Derksen, Jim; Lutfiyya, Zana M; Richert, Dean
2013-04-01
The objectives of this article are, first, to document a unique process of research knowledge translation (KT), which the authors describe as the creation of "ethical safe space," and, second, to document the narratives of forum participants and describe their interaction in a dialogue about vulnerability, the authority of physicians, and the perspective of people with disabilities on the policy. Narrative data from qualitative interviews with individual key informants and focus groups were used to identify speakers with specific expertise on policy, disability perspectives, and bioethical issues, who were invited to participate in the Forum on Ethical Safe Space. The planning workgroup adopted a model for enabling representative participation in the public forum designed to reduce the impact of physical, sensory, financial, language, and professional status barriers. Using the transcripts and keynote speakers' printed texts, primary themes and patterns of interaction were identified reflecting the alternative perspectives. Through the development of a workshop on ethical, legal, and disability-related implications of professional policy guidelines developed by the College of Physicians and Surgeons of Manitoba, we provided a qualitative analysis of the discourse involving experts and disability community members supporting alternative positions on the impact of the policy statement, and discuss ethical, legal, and disability rights issues identified in the public debate. Contested policy and ethical frameworks for making decisions about withdrawing and withholding life supporting treatment may influence both the perspectives of palliative care providers and patients referred to palliative care facilities. An innovative model for KT using a public forum that enabled stakeholders with conflicting perspectives to engage with ethical and professional policy issues asserting the physician's authority in contested decisions involving withdrawing or withholding life
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Consumer Ethical Decision Making: Intensity, Self-Consciousness and Neutralization Techniques
Directory of Open Access Journals (Sweden)
Syed Afzal Moshadi Shah
2017-03-01
Full Text Available The purpose of the study is to examine the effect of moral intensity on self-conscious emotions and neutralization techniques in the context of ethical decision making among consumers. A sample of 388 shopping mall retail consumers was recruited through self-administered survey technique. Descriptive statistics, exploratory factor analysis, correlation was carried out in SPSS whereas the measurement model and structural relationships were estimated using AMOS. Results indicate that moral intensity positively influences consumer’s self-consciousness, neutralization techniques and behavioural intention. Self-consciousness negatively influence consumer’s defence mechanism i.e. neutralization techniques. Neither self-consciousness nor neutralization techniques is found to have an impact on consumers’ behavioural intention. Only self-consciousness is found to complementary mediate the relationship of moral intensity and neutralization. The limitations associated with field survey and crosssectional research design are inevitable. The study offers some relevant practical implications for government, marketing professionals and academia. The study is among the pioneer studies that theoretically links and empirically examines Issue Contingent Model, theory of neutralization and self-consciousness. The study develops and tested an Urdu language version of the questionnaire for retail consumers.
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Chiarello, Elizabeth
2013-12-01
Social science studies of bioethics demonstrate that ethics are highly contextual, functioning differently across local settings as actors make daily decisions "on the ground." Sociological studies that demonstrate the key role organizations play in shaping ethical decision-making have disproportionately focused on physicians and nurses working in hospital settings where they contend with life and death issues. This study broadens our understanding of the contexts of ethical decision-making by empirically examining understudied healthcare professionals - pharmacists - working in two organizational settings, retail and hospital, where they act as gatekeepers to regulated goods and services as they contend with ethical issues ranging from the serious to the mundane. This study asks: How do organizations shape pharmacists' identification, negotiation, and resolution of ethical challenges; in other words, how do organizations shape pharmacists' gatekeeping processes? Based on 95 semi-structured interviews with U.S. pharmacists practicing in retail and hospital pharmacies conducted between September 2009 and May 2011, this research finds that organizations influence ethical decision-making by shaping how pharmacists construct four gatekeeping processes: medical, legal, fiscal, and moral. Each gatekeeping process manifests differently across organizations due to how these settings structure inter-professional power dynamics, proximity to patients, and means of accessing information. Findings suggest new directions for theorizing about ethical decision-making in medical contexts by drawing attention to new ethical actors, new organizational settings, an expanded definition of ethical challenges, and a broader conceptualization of gatekeeping. Copyright © 2012 Elsevier Ltd. All rights reserved.
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An integrated ethical approach to bioethical decision-making: A proposed model for ministers
Directory of Open Access Journals (Sweden)
Magdalena C. de Lange
2012-10-01
Full Text Available This article outlined a model for guidance in ‘doing’ bioethics in a Reformed context. The proposed model suggested that in order to arrive at responsible ethical decisions, one must refer to both contextual elements and theory. The theoretical grounding for this model was based on the integration of a deontological and virtue ethics approach, arguing that virtue enables persons to know and desire the right moral ends and motivates them to carry out appropriate action toward achieving these ends. An integrative model opens up the possibility whereby bioethics as a systematic tool provides the individual decision-maker with the critical-reflective skills and justification for the ultimate choice that is lacking in the general decision-making processes. This could lead to clearer thinking and increased confidence in the justification of decisions within the Reformed tradition. The proposed hermeneutical perspective on ethical decision-making represents a shift in views about the nature of knowledge and the process of how we come to know. The key to this hermeneutical approach is to acknowledge the dialectic between the universal and the subjectivity of human relations. Working in specific religious communities, one needs to take cognisance of the fact that knowledge is situated in the context of human relationships in which the interpreter participates when articulating the meaning of bioethical experiences. Another aspect that is anticipated lies in the realisation that people struggling with bioethical dilemmas should not be viewed as isolated individuals, but as members of a broader faith community. ‘n Geïntegreerde etiese benadering tot bioetiese besluitneming: Voorgestelde model vir predikante. Hierdie artikel het ‘n model geskets wat moontlike riglyne aantoon vir die beoefening van bioetiek binne ‘n Gereformeerde konteks. Die voorgestelde model argumenteer dat verwysing na beide kontekstuele elemente en teorie
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Decision Making for Democratic Leadership in a Guided Internship
Klinker, JoAnn Franklin; Hoover, J. Duane; Valle, Fernando; Hardin, Fred
2014-01-01
Experience in problem-based learning, authentic experiences, on-the-job decision making, and critical reflection on decisions made formed the conceptual framework of an internship to develop democratic leadership as a professional ethic in interns. Interns in an on-the-job guided internship examined decisions over a 13-week period as they…
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Comparativism and the Grounds for Person-Centered Care and Shared Decision Making.
Herlitz, Anders
2017-01-01
This article provides a new argument and a new value-theoretical ground for person-centered care and shared decision making that ascribes to it the role of enabling rational choice in situations involving clinical choice. Rather than referring to good health outcomes and/or ethical grounds such as patient autonomy, it argues that a plausible justification and ground for person-centered care and shared decision making is preservation of rationality in the face of comparative non-determinacy in clinical settings. Often, no alternative treatment will be better than or equal to every other alternative. In the face of such comparative non-determinacy, Ruth Chang has argued that we can make rational decisions by invoking reasons that are created through acts of willing. This article transfers this view to clinical decision making and argues that shared decision making provides a solution to non-determinacy problems in clinical settings. This view of the role of shared decision making provides a new understanding of its nature, and it also allows us to better understand when caregivers should engage in shared decision making and when they should not. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.
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How to make the best decision. Philosophical aspects of clinical decision theory.
Wulff, H R
1981-01-01
An attempt is made to discuss some of the philosophical implications of the use of decision-analytic techniques. The probabilities of a decision analysis are subjective measures of belief, and it is concluded that clinicians base their subjective beliefs on both recorded observations and theoretical knowledge. The clinical decision maker also evaluates the consequences of his actions, and therefore clinical decision theory transcends medical science. A number of different schools of normative ethics are mentioned to illustrate the complexity of everyday decision making. The philosophical terminology is useful for the analysis of clinical problems, and it is argued that clinical decision making has both a teleological and a deontological component. The results of decision-analytic studies depend on such factors as the wealth of the country, the organization of the health service, and cultural norms.
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End-of-life decision making in the ICU.
Siegel, Mark D
2009-03-01
A large proportion of deaths, particularly in the developed world, follows admission to an ICU. Therefore, end-of life decision making is an essential facet of critical care practice. For intensivists, managing death in the critically ill has become a key professional skill. They must be thoroughly familiar with the ethical framework that guides end-of-life decision making. Decisions should generally be made collaboratively by clinicians partnering with patients' families. Treatment choices should be crafted to meet specific, achievable goals. A rational, empathic approach to working with families should encourage appropriate, mutually satisfactory outcomes.
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When families cannot "let go": ethical decision-making at the bedside.
Thomas, J E; Latimer, E J
1989-09-01
Shared decision-making at the bedside is now a regular feature of medical practice. When disagreements arise between a patient and family members caregivers sometimes find themselves caught in a complex tangle of human relationships that strains monochrome ethical thinking. The patient's expressed wishes are often compromised for the sake of the family's needs. Conversely, a unilateral appeal for patient autonomy may prove insensitive to the hurt and the needs of the family. We describe a relatively unsuccessful attempt by a patient's caregivers to buy time to maximize the interests of the patient and her family and discuss the way in which the family dynamics militated against the rather obvious solution of promoting the patient's right to refuse treatment. The purpose of this article is not to evoke sympathy for health care professionals in dealing with such conflicts but rather to heighten awareness of the issues at stake and to stimulate thinking about ways and means to bring about a more favourable outcome than the one described here.
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Le Coz, Pierr; Tassy, Sebastien
2007-08-01
The present investigation looks for a solution to the problem of the influence of feelings and emotions on our ethical decisions. This problem can be formulated in the following way. On the one hand, emotions (fear, pity and so on) can alter our sense of discrimination and lead us to make our wrong decisions. On the other hand, it is known that lack of sensitivity can alter our judgment and lead us to sacrifice basic ethical principles such as autonomy, beneficence, non-maleficence and justice. Only emotions can turn a decision into an ethical one, but they can also turn it into an unreasonable one. To avoid this contradiction, suggest integrating emotions with the decisional factors of the process of "retrospective thinking". During this thinking, doctors usually try to identify the nature and impact of feelings on the decision they have just made. In this retrospective moment of analysis of the decision, doctors also question themselves on the feelings they did not experience. They do this to estimate the consequences of this lack of feeling on the way they behaved with the patient.
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Institute of Scientific and Technical Information of China (English)
杨建锋; 明晓东
2017-01-01
Although most business ethical decisions are made by teams rather than individuals,only a few studies have focused on team ethical decision making,which remain on comparing the results of individual and team ethical decision-making directly without much aid of theories.Based on studies of individual ethical decision-making,group decision-making,and Chinese cultural characteristics (reflection,zhongyong,authoritarian leadership,et al.),we intend to explore the mechanism of team ethical decision making process and the effect pattern of its antecedents.Specifically,it will include four sub-studies in two aspects via multiple methods.First,a process mechanism model is developed to look at the mechanism of team ethical decision-making process.Second,based on social decision scheme theory,an opinion integration mechanism is set up to integrate the opinions out of team ethical decision-making when focusing on the core differences between team and individual ethical decision-making.The other two are about member and leadership with regard to the effect pattern of antecedents:to study the mechanism of how member diversity influences team ethical decision-making via information processing and team conflict;to study the mechanism of how leadership features affects team ethical decision-making by information sampling model.%尽管绝大多数商业伦理决策都是由团队而非个人所做出的,但目前对团队伦理决策的研究还很少,尤其缺乏基于理论的深入研究.在前人研究的基础上,借鉴个体伦理决策和团队决策方面的研究成果,结合中国文化强调反省、中庸、威权领导等特点,我们对团队伦理决策的过程机制及影响因素的作用模式展开理论驱动的深入研究.具体来讲,将综合利用多种方法来进行两个方面的4项子研究.在
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论直觉、偏差和情绪在伦理决策中的作用%The role of intuition, heuristics, and emotion in ethical decision-making
Institute of Scientific and Technical Information of China (English)
伍如昕
2015-01-01
Ethical decision-making is an important issue in the field of ethics research especially of the business ethics. Currently, most ethical decision-making models treat the process of ethical decision-making as a logical and reasoned process, sitting on assumptions of rational, conscious, and quasilegal reasoning. Such models are predominate despite the fact that they could not fully explain the complexity of the ethical thinking and the dilemmas in the practice. In fact, many irrational elements affect the processes in the ethical decision-making. The essay selectively reviews the effects of intuition, heuristics, and emotion, which profoundly affect human behavior and lead to systematic biases and departures from normative theories of rationality.%伦理决策是伦理学尤其是商业伦理研究领域中的重要议题。现有大多数伦理决策模型基于理性、意识和准合法的前提假设，将伦理决策视为逻辑和理性的过程。尽管这些模型在目前伦理决策的研究中占有主导地位，然而这些模型往往难以完全解释伦理思维和实践困境中的复杂性。事实上，许多非理性因素对伦理决策存在影响。通过回顾、梳理现有伦理决策中直觉、偏差和情绪对伦理决策影响的相关研究说明，这些非理性因素从根本上影响着人类伦理决策，并且导致对理性的标准化伦理决策理论的偏离。
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Langlais, Philip J
2012-09-01
Despite the importance of scientific integrity to the well-being of society, recent findings suggest that training and mentoring in the responsible conduct of research are not very reliable or effective inhibitors of research misbehavior. Understanding how and why individual scientists decide to behave in ways that conform to or violate norms and standards of research is essential to the development of more effective training programs and the creation of more supportive environments. Scholars in business management, psychology, and other disciplines have identified many important factors that affect ethical behavior, including individual, contextual, and organizational factors. Surprisingly little research has been conducted to examine the role of these factors in either the development of ethical decision-making skills, or their applicability to ethical issues commonly encountered in research and other scholarly and professional activities. Interdisciplinary approaches combined with research and discipline relevant paradigms should greatly enhance understanding of the individual contextual and organizational factors involved in ethical and unethical research conduct. Such studies will inform and facilitate the development of more effective ethics education programs in the sciences and engineering professions.
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Evidence, values, guidelines and rational decision-making.
Barrett, Bruce
2012-02-01
Medical decision-making involves choices, which can lead to benefits or to harms. Most benefits and harms may or may not occur, and can be minor or major when they do. Medical research, especially randomized controlled trials, provides estimates of chance of occurrence and magnitude of event. Because there is no universally accepted method for weighing harms against benefits, and because the ethical principle of autonomy mandates informed choice by patient, medical decision-making is inherently an individualized process. It follows that the practice of aiming for universal implementation of standardized guidelines is irrational and unethical. Irrational because the possibility of benefits is implicitly valued more than the possibility of comparable harms, and unethical because guidelines remove decision making from the patient and give it instead to a physician, committee or health care system. This essay considers the cases of cancer screening and diabetes management, where guidelines often advocate universal implementation, without regard to informed choice and individual decision-making.
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Kon, Alexander A; Davidson, Judy E; Morrison, Wynne; Danis, Marion; White, Douglas B
2016-01-01
Shared decision making is endorsed by critical care organizations; however, there remains confusion about what shared decision making is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define shared decision making, recommend when shared decision making should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. The American College of Critical Care Medicine and American Thoracic Society Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of American College of Critical Care Medicine and American Thoracic Society were included in the statement. Six recommendations were endorsed: 1) DEFINITION: Shared decision making is a collaborative process that allows patients, or their surrogates, and clinicians to make healthcare decisions together, taking into account the best scientific evidence available, as well as the patient's values, goals, and preferences. 2) Clinicians should engage in a shared decision making process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their "default" approach a shared decision making process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable, including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making
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12 CFR 367.16 - Ethics Counselor decisions.
2010-01-01
... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Ethics Counselor decisions. 367.16 Section 367... POLICY SUSPENSION AND EXCLUSION OF CONTRACTOR AND TERMINATION OF CONTRACTS § 367.16 Ethics Counselor... disputed material facts, the Ethics Counselor shall base the decision on the facts as found, together with...
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Life and Death Decision Making, by Baruch A. Brody.
Veatch, Robert M
1989-04-01
Veatch considers the pluralistic casuistry theory advocated by Baruch Brody in his 1988 book, Life and Death Decision Making, to be an important contribution to the secular medical ethics literature. The casuistic and pluralistic elements of Brody's new model are described as intriguing but controversial because Brody both excludes several ethical appeals (i.e., classical Hippocratic ethics, virtue theory) and/or limits other questionable appeals (i.e., consequences for families and others in society, the virtue of integrity) without accounting for these decisions. Veatch also questions Brody's use of intuitional judgment to determine what ought to be done after examination of various appeals and their significance because Brody's approach raises serious problems about how various appeals are counted. Veatch does affirm the rich assessment of medical ethical problems made possible by Brody's pluralistic approach but notes the difficulties it raises.
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Beyond Bioethics: A Child Rights-Based Approach to Complex Medical Decision-Making.
Wade, Katherine; Melamed, Irene; Goldhagen, Jeffrey
2016-01-01
This analysis adopts a child rights approach-based on the principles, standards, and norms of child rights and the U.N. Convention on the Rights of the Child (CRC)-to explore how decisions could be made with regard to treatment of a severely impaired infant (Baby G). While a child rights approach does not provide neat answers to ethically complex issues, it does provide a framework for decision-making in which the infant is viewed as an independent rights-holder. The state has obligations to develop the capacity of those who make decisions for infants in such situations to meet their obligations to respect, protect, and fulfill their rights as delineated in the CRC. Furthermore, a child rights approach requires procedural clarity and transparency in decision-making processes. As all rights in the CRC are interdependent and indivisible, all must be considered in the process of ethical decision-making, and the reasons for decisions must be delineated by reference to how these rights were considered. It is also important that decisions that are made in this context be monitored and reviewed to ensure consistency. A rights-based framework ensures decision-making is child-centered and that there are transparent criteria and legitimate procedures for making decisions regarding the child's most basic human right: the right to life, survival, and development.
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Directory of Open Access Journals (Sweden)
Vanessa Russo
2017-12-01
Full Text Available The development of the web, in the last 20 years, has opened new areas of analysis and new phenomena sociologically relevant for social research. However, the research work in digital space presents a series of ethical and deontological problems. In this context the members of the Association of Internet Researchers (AOIR have composed and edited a document with a series of ethical guidelines for social research. The work of the AOIR group not include Italian researchers; for this reason, the aim of this paper is propose a commented translation of the contents of Ethical decision-making and Internet research for make the ethical factor one of the main tools for computational sociology.
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DEFF Research Database (Denmark)
Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn
2016-01-01
of each option, as a contribution to enhanced deliberation. As proof of concept and method an exemplar aid adds veracity and confidentiality to beneficence, non-maleficence, autonomy and justice, as the criteria, with case-based reasoning supplying the necessary inputs for the decision of whether a nurse......An interactive decision support tool based on Multi-Criteria Decision Analysis (MCDA) can help health professionals integrate the principlist (principle-based) and casuist (case-based) approaches to ethical decision making in both their training and practice. MCDA can incorporate generic ethical...
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Surrogate decision making and intellectual virtue.
Bock, Gregory L
2014-01-01
Patients can be harmed by a religiously motivated surrogate decision maker whose decisions are contrary to the standard of care; therefore, surrogate decision making should be held to a high standard. Stewart Eskew and Christopher Meyers proposed a two-part rule for deciding which religiously based decisions to honor: (1) a secular reason condition and (2) a rationality condition. The second condition is based on a coherence theory of rationality, which they claim is accessible, generous, and culturally sensitive. In this article, I will propose strengthening the rationality condition by grounding it in a theory of intellectual virtue, which is both rigorous and culturally sensitive. Copyright 2014 The Journal of Clinical Ethics. All rights reserved.
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Schwerdt, R
2005-08-01
The intraprofessional discourse about economical aspects in nursing from an ethical point of view has not taken place yet. To cope with the increasing restriction of resources, some preconditions have to be met: It is necessary to communicate issues in rationalizing and rationing in nursing openly. Person-oriented criteria in the nursing process indicate a high level of competence and user-oriented quality in nursing care. But nursing professionals do not decide in favor or against resources to perform this task on a high or poor quality level. Democratic decision-making on providing nursing services depends on a continuous societal discourse about allocation criteria.
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The role of depression pharmacogenetic decision support tools in shared decision making.
Arandjelovic, Katarina; Eyre, Harris A; Lenze, Eric; Singh, Ajeet B; Berk, Michael; Bousman, Chad
2017-10-29
Patients discontinue antidepressant medications due to lack of knowledge, unrealistic expectations, and/or unacceptable side effects. Shared decision making (SDM) invites patients to play an active role in their treatment and may indirectly improve outcomes through enhanced engagement in care, adherence to treatment, and positive expectancy of medication outcomes. We believe decisional aids, such as pharmacogenetic decision support tools (PDSTs), facilitate SDM in the clinical setting. PDSTs may likewise predict drug tolerance and efficacy, and therefore adherence and effectiveness on an individual-patient level. There are several important ethical considerations to be navigated when integrating PDSTs into clinical practice. The field requires greater empirical research to demonstrate clinical utility, and the mechanisms thereof, as well as exploration of the ethical use of these technologies.
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Ethics in Librarianship: A Management Model.
Du Mont, Rosemary Ruhig
1991-01-01
Presents a management model of ethical decision making in librarianship. Highlights include a definition of ethics; ethical concerns in information professions; the concept of social responsibility; ethical dimensions of decision making, including access to information and hiring decisions; ethical considerations for managers; and strategies for…
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Institute of Scientific and Technical Information of China (English)
李晓明; 傅小兰; 王新超
2012-01-01
本研究将一种重要的道德情绪——移情引入问题权变模型中，以探讨移情因素在道德强度对企业道德决策影响中的作用。本研究基于情景研究法，随机选取256名MBA学生为被试，要求被试基于所提供情景中假想参与者的行为，回答随后测量道德决策（道德识别、道德判断和道德意图）、移情反应、主观道德强度及移情特质的问题。结果发现，1）移情反应在道德强度对企业道德决策的影响中具有中介作用；2）移情关怀特质会通过影响主观道德强度和移情反应而作用于企业道德决策；3）结果大小、社会舆论和效应可能性对道德判断和道德意图的影响机制各有特点。%Jones ( 1991 ) postulated 'moral intensity' of an issue as a starting point in the ethical decision making process. The Jones' study mainly explored the relationship between moral intensity and ethical decision making, but ignored investigating the influencing mechanism. The present study tried to include empathy into the Issue - Contingent Model to explore the mechanism of the influence of moral intensity on ethical decision making in business. The present paper reported the results of a vignette - and questionnaire -based research project. One scenario about the employee's health was created allowing independent manipulation of the four MI components ( magnitude of consequences, probability of effect, social consensus, proximity) as high or low moral intensity. All possible combinations were utilized, resulting in 16 different versions. The participants were presented with one version of the scenario. The scenario was followed by items assessing ethical perception, ethical judgment and ethical intention, empathic response, perceived moral intensity, dispositional empathy (including empathic concern and perspective - taking). The study selected 256 MBA students as participants. LISREL 8.51 was used to make the structural equation
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End-of-life decision making is more than rational.
Eliott, Jaklin A; Olver, Ian N
2005-01-01
Most medical models of end-of-life decision making by patients assume a rational autonomous adult obtaining and deliberating over information to arrive at some conclusion. If the patient is deemed incapable of this, family members are often nominated as substitutes, with assumptions that the family are united and rational. These are problematic assumptions. We interviewed 23 outpatients with cancer about the decision not to resuscitate a patient following cardiopulmonary arrest and examined their accounts of decision making using discourse analytical techniques. Our analysis suggests that participants access two different interpretative repertoires regarding the construct of persons, invoking a 'modernist' repertoire to assert the appropriateness of someone, a patient or family, making a decision, and a 'romanticist' repertoire when identifying either a patient or family as ineligible to make the decision. In determining the appropriateness of an individual to make decisions, participants informally apply 'Sanity' and 'Stability' tests, assessing both an inherent ability to reason (modernist repertoire) and the presence of emotion (romanticist repertoire) which might impact on the decision making process. Failure to pass the tests respectively excludes or excuses individuals from decision making. The absence of the romanticist repertoire in dominant models of patient decision making has ethical implications for policy makers and medical practitioners dealing with dying patients and their families.
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营销伦理决策测量研究述评与展望%Review and Prospect of Studies on Marketing Ethical Decision Making Measurement
Institute of Scientific and Technical Information of China (English)
田虹; 王汉瑛
2015-01-01
The recent high-profile business ethics scandals are drawing the attention of the theoretical and practical circles on the topic of ethical decision making. Marketing is one of the high-risk areas that easy to trigger ethical dilemmas, in the process of frequent contact between marketers and various stakeholders, a variety of interest groups and values conflict and end up with triggering ethical dilemmas. The studies on marketing ethical decision making in the West start earlier, while the domestic research in this field is only in its infancy. To promote the validation and development of the relevant theoretical and empirical researches, the paper focuses on systematically sorting out and analyzing the theoretical models, measurement scales of marketing ethical decision making in the West,so as to find out the drawbacks of the existing researches and the future research directions.%商业伦理丑闻的频发引起了国内外理论界和实践界对伦理决策问题的关注。市场营销是伦理困境高发领域之一，在营销人员与各个利益相关者频繁接触的过程中，各种利益集团和价值观相互冲突，容易触发伦理困境。西方对营销伦理决策的研究较早，而中国的相关研究还只处于起步阶段。为推进相关理论和实证研究在中国的验证和拓展，文章对西方营销伦理决策的理论模型、测量量表进行了系统的梳理和分析，以发现现有研究的不足和未来研究的方向。
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Midwives׳ decision making about transfers for 'slow' labour in rural New Zealand.
Patterson, Jean; Skinner, Joan; Foureur, Maralyn
2015-06-01
Midwives who provided Lead Maternity Care (LMC) to women in rural areas were invited to share their experiences of decision making around transfer in labour. Ethics approval was obtained from the NZ National Ethics Committee. to explore midwives׳ decision making processes when making transfer decisions for slow labour progress from rural areas to specialist care. individual and group interviews were conducted with a purposive sample of rural midwives. The recalled decision processes of the midwives were subjected to a content and thematic analysis to expose experiences in common and to highlight aspects of probabilistic (normative), heuristic (behavioural), and group decision making theory within the rural context. New Zealand. 15 midwives who provided LMC services to women in their rural areas. 'making the mind shift', 'sitting on the boundary', 'timing the transfer' and 'the community interest' emerged as key themes. The decision processes were also influenced by the woman׳s preferences and the distance and time involved in the transfer. the findings contribute insights into the challenge of making transfer decisions in rural units; particularly for otherwise well women who were experiencing slow labour progress. Knowledge of the fallibility of our heuristic decision making strategies may encourage the practitioner to step back and take a more deliberative, probabilistic view of the situation. In addition to the clinical picture, this process should include the relational and aspirational aspects for the woman, and any logistical challenges of the particular rural context. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Roman, Gabriel; Enache, Angela; Pârvu, Andrada; Gramma, Rodica; Moisa, Ştefana Maria; Dumitraş, Silvia; Ioan, Beatrice
2013-08-01
Medical communication in Western-oriented countries is dominated by concepts of shared decision-making and patient autonomy. In interactions with Roma patients, these behavioral patterns rarely seem to be achieved because the culture and ethnicity have often been shown as barriers in establishing an effective and satisfying doctor-patient relationship. The study aims to explore the Roma's beliefs and experiences related to autonomy and decision-making process in the case of a disease with poor prognosis. Forty-eight Roma people from two Romanian counties participated in semi-structured interviews, conducted by a research team from the University of Medicine and Pharmacy of Iasi. Participants were recruited among the chronically ill patients and caregivers. The Roma community opposes informing the terminal patients about their condition, the "silence conspiracy" being widely practiced. The family fully undertakes the right of decision making, thus minimizing the patient's autonomy. We identified ethical dilemmas concerning autonomy, lack of patients' real decision-making power, and paternalistic attitudes exerted firstly by the family and, on demand, by the physician. Instead, the Roma patient benefits from a very active support network, being accompanied at the hospital by numerous relatives. The patient's right to make autonomous decisions promoted in the Western countries and stipulated by the Romanian law has diminished value in the Roma community. For the Roma, the understanding of dignity is not simply individual and personal, but it is closely related to their cultural particularities. Ignoring their cultural values could create conflicts between healthcare providers and community.
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Ethical issues faced by clinician/managers in resource-allocation decisions.
Lemieux-Charles, L; Meslin, E M; Aird, C; Baker, R; Leatt, P
1993-01-01
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.
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When Organizational Identification Elicits Moral Decision-Making: A Matter of the Right Climate
S. van Gils (Suzanne); M.A. Hogg (Michael A.); N. van Quaquebeke (Niels); D.L. van Knippenberg (Daan)
2017-01-01
textabstractTo advance current knowledge on ethical decision-making in organizations, we integrate two perspectives that have thus far developed independently: the organizational identification perspective and the ethical climate perspective. We illustrate the interaction between these perspectives
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Implementing shared decision-making: consider all the consequences
Elwyn, G.; Frosch, D.L.; Kobrin, S.
2016-01-01
BACKGROUND: The ethical argument that shared decision-making is "the right" thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and
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Risk perception, safety goals and regulatory decision-making
International Nuclear Information System (INIS)
Hoegberg, Lars
1998-01-01
Deciding on 'how safe is safe enough?' includes value judgements with implications of an ethical and political nature. As regulators are accountable to governments, parliaments and the general public, regulatory decision-making should be characterized by transparency with respect to how such value judgements are reflected in risk assessments and regulatory decisions. Some approaches in this respect are discussed in the paper, based on more than fifteen years of experience in nuclear regulatory decision-making. Issues discussed include: (1) risk profiles and safety goals associated with severe reactor accidents--individual health risks, societal risks and risk of losing investments; (2) risk profile-based licensing of the Swedish SFR final disposal facility for low and intermediate level radioactive waste
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Marckmann, G; In der Schmitten, J
2014-05-01
Under the current conditions in the health care system, physicians inevitably have to take responsibility for the cost dimension of their decisions on the level of single cases. This article, therefore, discusses the question how physicians can integrate cost considerations into their clinical decisions at the microlevel in a medically rational and ethically justified way. We propose a four-step model for "ethical cost-consciousness": (1) forego ineffective interventions as required by good evidence-based medicine, (2) respect individual patient preferences, (3) minimize the diagnostic and therapeutic effort to achieve a certain treatment goal, and (4) forego expensive interventions that have only a small or unlikely (net) benefit for the patient. Steps 1-3 are ethically justified by the principles of beneficence, nonmaleficence, and respect for autonomy, step 4 by the principles of justice. For decisions on step 4, explicit cost-conscious guidelines should be developed locally or regionally. Following the four-step model can contribute to ethically defensible, cost-conscious decision-making at the microlevel. In addition, physicians' rationing decisions should meet basic standards of procedural fairness. Regular cost-case discussions and clinical ethics consultation should be available as decision support. Implementing step 4, however, requires first of all a clear political legitimation with the corresponding legal framework.
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Is problem-based learning an ideal format for developing ethical decision skills?
Directory of Open Access Journals (Sweden)
Peter H. Harasym
2013-10-01
Full Text Available Ethical decision making is a complex process, which involves the interaction of knowledge, skills, and attitude. To enhance the teaching and learning on ethics reasoning, multiple teaching strategies have to be applied. A medical ethical reasoning (MER model served as a framework of the development of ethics reasoning and their suggested instructional strategies. Problem-based learning (PBL, being used to facilitate students' critical thinking, self-directed learning, collaboration, and communication skills, has been considered effective on ethics education, especially when incorporated with experiential experience. Unlike lecturing that mainly disseminates knowledge and activates the left brain, PBL encourages “whole-brain” learning. However, PBL has several disadvantages, such as its inefficiency, lack of adequately trained preceptors, and the in-depth, silo learning within a relatively small number of cases. Because each school tends to utilize PBL in different ways, either the curriculum designer or the learning strategy, it is important to maximize the advantages of a PBL session, PBL then becomes an ideal format for refining students' ethical decisions and behaviors.
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Hernández-Marrero, Pablo; Pereira, Sandra Martins; Carvalho, Ana Sofia
2016-09-01
Ethical decisions are part of contemporary practices in palliative care. The need of making such decisions is associated to higher burnout levels and other work related problems among healthcare professionals. As part of the project entitled "Decisions in End-of-Life Care in Spain and Portugal" (DELiCaSP), this study aims to (i) identify the most common ethical decisions made by Portuguese palliative care teams and (ii) understand how the making of such decisions relates to burnout. A mixed methods study was conducted with 9 palliative care teams, using (i) questionnaires of socio-demographic and professional variables, work-related experiences, (ii) the Maslach Burnout Inventory, (iii) interviews and (iv) observations. These teams were geographically dispersed across the country, covering the North, Centrum and South regions, and heterogeneous: Five palliative care units for inpatients; three home care teams; and one hospital support team. A total of 20 interviews and 240 hours of observations were completed until reaching saturation. The most common ethical decisions were related to communication issues (information disclosure of the diagnosis and prognosis), forgoing treatment and sedation. Although perceived as stressful, emotionally demanding and challenging, ethical decisions were not significantly associated with burnout. Making ethical decisions is not associated with higher burnout levels among professionals working in Portuguese palliative care teams. This can be explained by the interprofessional decision-making process followed by these teams, which promotes a sense of shared-decision and team-based empowerment; and by the advanced level of interdisciplinary education in palliative care that these professionals have. © The Author(s) 2015.
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A moral compass for management decision making: a healthcare CEO's reflections.
Donnellan, John J
2013-01-01
Ethical behavior is good for business in any organization. In healthcare, it results in better patient care, a more committed and satisfied staff, more efficient care delivery, and increased market share. But it requires leaders who have a broad view of the role that ethics programs--and an effective, sustained ethical culture--play. Ethical organizations have integrated and shared ethical values and practices, an effective ethics infrastructure, ongoing ethics education for staff at every level, ethical and morally courageous leaders, and a culture that is consistent with the organization's values. The mission, vision, and values statements of these organizations have been successfully translated into a set of shared values--a moral compass that guides behavior and decision making.
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Herlitz, Anders; Munthe, Christian; Törner, Marianne; Forsander, Gun
2016-08-01
This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy.
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Patient engagement in healthcare: pathways for effective medical decision making
Directory of Open Access Journals (Sweden)
Serena Barello
2015-04-01
Full Text Available Making patients protagonists of decisions about their care is a primacy in the 21st century medical ethics. Precisely, to favor shared treatment decisions potentially enables patients’ autonomy and self-determination, and protects patients’ rights to make decisions about their own future care. To fully accomplish this goal, medicine should take into account the complexity of the healthcare decision making processes: patients may experience dilemmas when having to take decisions that not only concern their patient role/identity but also involve the psychosocial impact of treatments on their overall life quality. A deeper understanding of the patients’ expected role in the decision making process across their illness journey may favor the optimal implementation of this practice into the day-to-day medical agenda. In this paper, authors discuss the value of assuming the Patient Health Engagement Model to sustain successful pathways for effective medical decision making throughout the patient’s illness course. This model and its relational implication for the clinical encounter might be the base for an innovative “patient-doctor relational agenda” able to sustain an “engagement-sensitive” medical decision making.
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Ethical Child Welfare Practice.
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…
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Mind the Gap: A Case Study of Values-Based Decision Making in a Nonprofit Organization
Craft, Jana L.
2013-01-01
Using an exploratory case study approach, this research examined the consistency between espoused and enacted values within a large nonprofit organization known as an ethical leader in the human services industry. This research explored ethical business culture, ethical decision making, deontological and utilitarian moral paradigms and learning…
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Ethical Issues and Decision Making in Collaborative Financial Therapy
Directory of Open Access Journals (Sweden)
D. Bruce Ross
2016-09-01
Full Text Available The purpose of this article is to introduce potential ethical challenges that may arise when a financial and mental health professional collaborate to provide financial therapy and recommendations on how to effectively address these concerns. The development of ethical and professional practices requires extensive dialogue from practitioners in the emerging field of financial therapy; however, it is important to first develop an awareness and sensitivity to the ethical and professional issues across disciplines. This article examines the differences and similarities between the codes of ethics of different financial and mental health disciplines, and addresses six core ethical and professional issues: dual relationships, confidentiality, collaborating with other professionals, fee management, use of technology, and attending to federal and state regulatory laws. In working through the complexity of different disciplines’ regulatory environments, a discussion of how to address these ethical questions in order to progress the financial therapy field is presented.
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Energy decisions reframed as justice and ethical concerns
Sovacool, Benjamin; Heffron, Raphael J.; McCauley, Darren; Goldthau, Andreas
2016-01-01
All too often, energy policy and technology discussions are limited to the domains of engineering and economics. Many energy consumers, and even analysts and policymakers, confront and frame energy and climate risks in a moral vacuum, rarely incorporating broader social justice concerns. Here, to remedy this gap, we investigate how concepts from justice and ethics can inform energy decision-making by reframing five energy problems — nuclear waste, involuntary resettlement, energy pollution, e...
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Psychological Peculiarities of Judge Professional Activity and Decision-Making
Uspanov, Zholdybai T.; Turabayeva, Dana S.
2016-01-01
The article considers the psychological peculiarities of judge professional activity and decision-making, judge's mental set and requirements to ethical and moral requirements and quality. Moreover, this work offers original job analysis and competency model of judge professional activity. The authors have studied the problems concerning the…
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Palazzo, Salvatore; Filice, Aldo; Mastroianni, Candida; Biamonte, Rosalbino; Conforti, Serafino; Liguori, Virginia; Turano, Salvatore; De Simone, Rosanna; Rovito, Antonio; Manfredi, Caterina; Minardi, Stefano; Vilardo, Emmanuelle; Loizzo, Monica; Oriolo, Carmela
2016-04-01
Clinical decision making in oncology is based so far on the evidence of efficacy from high-quality clinical research. Data collection and analysis from experimental studies provide valuable insight into response rates and progression-free or overall survival. Data processing generates valuable information for medical professionals involved in cancer patient care, enabling them to make objective and unbiased choices. The increased attention of many scientific associations toward a more rational resource consumption in clinical decision making is mirrored in the Choosing Wisely campaign against the overuse or misuse of exams and procedures of little or no benefit for the patient. This cultural movement has been actively promoting care solutions based on the concept of "value". As a result, the value-based decision-making process for cancer care should not be dissociated from economic sustainability and from ethics of the affordability, also given the growing average cost of the most recent cancer drugs. In support of this orientation, the National Comprehensive Cancer Network (NCCN) has developed innovative and "complex" guidelines based on values, defined as "evidence blocks", with the aim of assisting the medical community in making overall sustainable choices.
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Supporting decision-making processes for evidence-based mental health promotion.
Jané-Llopis, Eva; Katschnig, Heinz; McDaid, David; Wahlbeck, Kristian
2011-12-01
The use of evidence is critical in guiding decision-making, but evidence from effect studies will be only one of a number of factors that will need to be taken into account in the decision-making processes. Equally important for policymakers will be the use of different types of evidence including implementation essentials and other decision-making principles such as social justice, political, ethical, equity issues, reflecting public attitudes and the level of resources available, rather than be based on health outcomes alone. This paper, aimed to support decision-makers, highlights the importance of commissioning high-quality evaluations, the key aspects to assess levels of evidence, the importance of supporting evidence-based implementation and what to look out for before, during and after implementation of mental health promotion and mental disorder prevention programmes.
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Clint Parker, J; Goldberg, Daniel S
2016-03-01
The central claim of this paper is that American states' use of so-called "triggering conditions" to regulate surrogate decision-making authority in end-of-life care leaves unresolved a number of important ethical and legal considerations regarding the scope of that authority. The paper frames the issue with a case set in a jurisdiction in which surrogate authority to withdraw life-sustaining treatment is triggered by two specific clinical conditions. The case presents a quandary insofar as the clinical facts do not satisfy the triggering conditions, and yet both the appropriate surrogates and the care team agree that withdrawal of life-sustaining treatment is in the best interest of the patient. The paper surveys applicable law across the 50 states and weighs the arguments for and against the inclusion of such triggering conditions in relevant legal regimes. The paper concludes by assessing the various legal and policy options states have for regulating surrogate decision-making authority in light of the moral considerations (including epistemic difficulties), and notes the possibility for conflict within ethics teams arising from the potential tension between prudence, risk-aversion, and moral obligation.
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DEFF Research Database (Denmark)
Douglas-Jones, Rachel
2017-01-01
This article examines the work that goes in to ‘making room’ for ethics, literally and figuratively. It follows the activities of a capacity building Asia-Pacific NGO in training and recognising ethics review committees, using multi-sited field materials collected over 12 months between 2009...
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Implementing shared decision making in routine mental health care.
Slade, Mike
2017-06-01
Shared decision making (SDM) in mental health care involves clinicians and patients working together to make decisions. The key elements of SDM have been identified, decision support tools have been developed, and SDM has been recommended in mental health at policy level. Yet implementation remains limited. Two justifications are typically advanced in support of SDM. The clinical justification is that SDM leads to improved outcome, yet the available empirical evidence base is inconclusive. The ethical justification is that SDM is a right, but clinicians need to balance the biomedical ethical principles of autonomy and justice with beneficence and non-maleficence. It is argued that SDM is "polyvalent", a sociological concept which describes an idea commanding superficial but not deep agreement between disparate stakeholders. Implementing SDM in routine mental health services is as much a cultural as a technical problem. Three challenges are identified: creating widespread access to high-quality decision support tools; integrating SDM with other recovery-supporting interventions; and responding to cultural changes as patients develop the normal expectations of citizenship. Two approaches which may inform responses in the mental health system to these cultural changes - social marketing and the hospitality industry - are identified. © 2017 World Psychiatric Association.
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Kon, Alexander A.; Davidson, Judy E.; Morrison, Wynne; Danis, Marion; White, Douglas B.
2015-01-01
Objectives Shared decision-making (SDM) is endorsed by critical care organizations, however there remains confusion about what SDM is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define SDM, recommend when SDM should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. Methods The American College of Critical Care Medicine (ACCM) and American Thoracic Society (ATS) Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of ACCM and ATS were included in the statement. Main Results Six recommendations were endorsed: 1) Definition: Shared decision-making is a collaborative process that allows patients, or their surrogates, and clinicians to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values, goals, and preferences. 2) Clinicians should engage in a SDM process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their “default” approach a SDM process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making strategies. Conclusions Patient and surrogate preferences for decision-making roles regarding value
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Voglmayr, Elisabeth; Widder, Joachim
2006-05-01
By means of a case report on a 44-year-old female patient, we show how, with changing personnel and places of care, decisions as well as the kind of decision-making during illness influence the quality of care. The patient was receiving immunosuppressive therapy after kidney transplantation and then suffered from a carcinomatous ovary. At first she refused postoperative chemotherapy, but then returned with a very advanced state of metastatic growth. The lack of continuity, a missing overall interdisciplinary concept of medical case, as well as the failure to document decision processes and the patient's attitude to life and suffering made it difficult for the caring team to accompany her in the last weeks of life. A possible solution to such a complex problem will be the introduction of ethical case deliberation.
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Delayed clarification: information, clarification and ethical decisions in critical care in Norway.
Bunch, E H
2000-12-01
Following the analysis of about 150 hours of field observation on a critical care unit in Norway a theory was generated to explain the actual ethical decision-making process. This was grounded in the empirical reality of physicians, nurses and family. The core theme in this study was a delayed clarification in assessing the prognosis of accident victims with neurosurgical traumas. The physicians, nurses and family had to wait for the clinical picture to clarify, during which time there was an exchange and emergence of information. Exchanging information, a subprocess to delayed clarification, involved a continuous flow of collecting and dispersing information about the clinical status of the patient. The nurses engaged in two useful strategies: grading information to family when the patient prognosis was poor, and providing grieving strategies for themselves, colleagues and family members. The core variable, delayed clarification has three dimensions: clinical, psychological and ethical. The nurses participated in the decision-making process to discontinue treatment as passive participants, they did not engage in collegial deliberations with the physicians. Ethical dilemmas were end of life questions, resource allocations, and questions of justice and organ transplants.
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Domke, David; Shah, Dhavan V.
1995-01-01
Finds that voters who ascribed an ethical interpretation to issues were more likely to use a noncompensatory decision-making strategy, which focuses on one or two key issues in the decision-making process, than voters who ascribed a societal interpretation to issues. (SR)
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Lone ranger decision making versus consensus decision making: Descriptive analysis
Maite Sara Mashego
2015-01-01
Consensus decision making, concerns group members make decisions together with the requirement of reaching a consensus that is all members abiding by the decision outcome. Lone ranging worked for sometime in a autocratic environment. Researchers are now pointing to consensus decision-making in organizations bringing dividend to many organizations. This article used a descriptive analysis to compare the goodness of consensus decision making and making lone ranging decision management. This art...
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Sacrifice: an ethical dimension of caring that makes suffering meaningful.
Helin, Kaija; Lindström, Unni A
2003-07-01
This article is intended to raise the question of whether sacrifice can be regarded stituting a deep ethical structure in the relationship between patient and carer. The significance of sacrifice in a patient-carer relationship cannot, however, be fully understood from the standpoint of the consistently utilitarian ethic that characterizes today's ethical discourse. Deontological ethics, with its universal principles, also does not provide a suitable point of departure. Ethical recommendations and codices are important and serve as general sources of knowledge when making decisions, but they should be supplemented by an ethic that takes into consideration contextual and situational factors that make every encounter between patient and carer unique. Caring science research literature presents, on the whole, general agreement on the importance of responsibility and devotian with regard to sense of duty, warmth and genuine engagement in caring. That sacrifice may also constitute an important ethical element in the patient-carer relationship is, however, a contradictory and little considered theme. Caring literature that deals with sacrifice/self-sacrifice indicates contradictory import. It is nevertheless interesting to notice that both the negative and the positive aspects bring out importance of the concept for the professional character of caring. The tradition of ideas in medieval Christian mysticism with reference to Lévinas' ethic of responsibility offers a deeper perspective in which the meaningfulness of sacrifice in the caring relationship can be sought. The theme of sacrifice is not of interest merely as a carer's ethical outlook, but sacrifice can also be understood as a potential process of transformation health. The instinctive or conscious experience of sacrifice on the part of the individual patient can, on a symbolic level, be regarded as analogous to the cultic or religious sacrifice aiming at atonement. Sacrifice appears to the patient as an act of
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Martins Pereira, Sandra; Fradique, Emília; Hernández-Marrero, Pablo
2018-05-01
End-of-life decisions (ELDs) are embedded in clinical, sociocultural, political, economic, and ethical concerns. In 2014, the Council of Europe (CoE) through its Committee on Bioethics launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations," aiming at improving decision-making processes and empowering professionals in making ELDs. To analyze if end-of-life decision making in palliative care (PC) is consistent with this Guide and to identify if disputed/controversial issues are part of current ELDs. Qualitative secondary analysis. Four qualitative datasets, including 44 interviews and 9 team observation field notes from previous studies with PC teams/professionals in Portugal. An analysis grid based on the abovementioned guide was created considering three dimensions: ethical and legal frameworks, decision-making process, and disputed/controversial issues. The majority of the professionals considered the ethical principle of autonomy paramount in end-of-life decision making. Justice and beneficence/nonmaleficence were also valued. Although not mentioned in the Guide, the professionals also considered other ethical principles when making ELDs, namely, responsibility, integrity, and dignity. Most of the interviewees and field notes referred to the collective interprofessional dimension of the decision-making process. Palliative sedation and the wish to hasten death were the most mentioned disputed/controversial issues. The nature, limitations, and benefits of qualitative secondary analysis are discussed. End-of-life decision-making processes made by Portuguese PC teams seem to be consistent with the guidelines of the CoE. Further research is needed about disputed/controversial issues and the actual use, effectiveness, and impact of ethical guidelines for end-of-life decision making on professionals' empowerment and for all parties involved.
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Clinical decision-making and secondary findings in systems medicine.
Fischer, T; Brothers, K B; Erdmann, P; Langanke, M
2016-05-21
Systems medicine is the name for an assemblage of scientific strategies and practices that include bioinformatics approaches to human biology (especially systems biology); "big data" statistical analysis; and medical informatics tools. Whereas personalized and precision medicine involve similar analytical methods applied to genomic and medical record data, systems medicine draws on these as well as other sources of data. Given this distinction, the clinical translation of systems medicine poses a number of important ethical and epistemological challenges for researchers working to generate systems medicine knowledge and clinicians working to apply it. This article focuses on three key challenges: First, we will discuss the conflicts in decision-making that can arise when healthcare providers committed to principles of experimental medicine or evidence-based medicine encounter individualized recommendations derived from computer algorithms. We will explore in particular whether controlled experiments, such as comparative effectiveness trials, should mediate the translation of systems medicine, or if instead individualized findings generated through "big data" approaches can be applied directly in clinical decision-making. Second, we will examine the case of the Riyadh Intensive Care Program Mortality Prediction Algorithm, pejoratively referred to as the "death computer," to demonstrate the ethical challenges that can arise when big-data-driven scoring systems are applied in clinical contexts. We argue that the uncritical use of predictive clinical algorithms, including those envisioned for systems medicine, challenge basic understandings of the doctor-patient relationship. Third, we will build on the recent discourse on secondary findings in genomics and imaging to draw attention to the important implications of secondary findings derived from the joint analysis of data from diverse sources, including data recorded by patients in an attempt to realize their
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Edwards, Ian; Delany, Clare M; Townsend, Anne F; Swisher, Laura Lee
2011-11-01
This is the second of 2 companion articles in this issue. The first article explored the clinical and ethical implications of new emphases in physical therapy codes of conduct reflecting the growing evidence regarding the importance of social determinants of health, epidemiological trends for health service delivery, and the enhanced participation of physical therapists in shaping health care reform in a number of international contexts. The first article was theoretically oriented and proposed that a re-thinking of ethical frameworks expressed in codes of ethics could both inform and underpin practical strategies for working in primary health care. A review of the ethical principle of "justice," which, arguably, remains the least consensually understood and developed principle in the ethics literature of physical therapy, was provided, and a more recent perspective-the capability approach to justice-was discussed. The current article proposes a clinical and ethical decision-making framework, the ethical reasoning bridge (ER bridge), which can be used to assist physical therapy practitioners to: (1) understand and implement the capability approach to justice at a clinical level; (2) reflect on and evaluate both the fairness and influence of beliefs, perspectives, and context affecting health and disability through a process of "wide reflective equilibrium" and assist patients to do this as well; and (3) nurture the development of moral agency, in partnership with patients, through a transformative learning process manifest in a mutual "crossing" and "re-crossing" of the ER bridge. It is proposed that the development and exercise of moral agency represent an enacted justice that is the result of a shared reasoning and learning experience on the part of both therapists and patients.
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Goethals, S; Dierckx de Casterlé, B; Gastmans, C
2013-05-01
The increasing vulnerability of patients in acute elderly care requires constant critical reflection in ethically charged situations such as when employing physical restraint. Qualitative evidence concerning nurses' decision making in cases of physical restraint is limited and fragmented. A thorough understanding of nurses' decision-making process could be useful to understand how nurses reason and make decisions in ethically laden situations. The aims of this study were to explore and describe nurses' decision-making process in cases of physical restraint. We used a qualitative interview design inspired by the Grounded Theory approach. Data analysis was guided by the Qualitative Analysis Guide of Leuven. Twelve hospitals geographically spread throughout the five provinces of Flanders, Belgium. Twenty-one acute geriatric nurses interviewed between October 2009 and April 2011 were purposively and theoretically selected, with the aim of including nurses having a variety of characteristics and experiences concerning decisions on using physical restraint. In cases of physical restraint in acute elderly care, nurses' decision making was never experienced as a fixed decision but rather as a series of decisions. Decision making was mostly reasoned upon and based on rational arguments; however, decisions were also made routinely and intuitively. Some nurses felt very certain about their decisions, while others experienced feelings of uncertainty regarding their decisions. Nurses' decision making is an independent process that requires nurses to obtain a good picture of the patient, to be constantly observant, and to assess and reassess the patient's situation. Coming to thoughtful and individualized decisions requires major commitment and constant critical reflection. Copyright © 2012 Elsevier Ltd. All rights reserved.
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The Case of the Lost Ethic: Making Moral Decisions.
Martin, C. June
1988-01-01
Discusses the necessity of journalism leaders and educators fighting the group-think morality movement. Suggests that courses in both applied ethics and ethical theory should be offered to graduate and undergraduate journalism students. (JK)
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DEFF Research Database (Denmark)
2017-01-01
The video gives examples, where the social educator in the very situations in the kindergartens has to make ethical decisions when using digital media in a kindergarten.......The video gives examples, where the social educator in the very situations in the kindergartens has to make ethical decisions when using digital media in a kindergarten....
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Dow, Mirah J.; Boettcher, Carrie A.; Diego, Juana F.; Karch, Marziah E.; Todd-Diaz, Ashley; Woods, Kristine M.
2015-01-01
The purpose of this mixed methods study is to determine the effectiveness of case-based pedagogy in teaching basic principles of information ethics and ethical decision making. Study reports results of pre- and post-assessment completed by 49 library and information science (LIS) graduate students at a Midwestern university. Using Creswell's…
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Teaching Business Ethics or Teaching Business Ethically?
Stablein, Ralph
2003-01-01
Notes that one of the most important contexts for ethical decision-making is the nature and operation of "contemporary capitalisms." Suggests that rather than issuing a call for teaching business ethics, the author emphasizes the need for more ethical business teaching. (SG)
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White, Eleanor Bantry; Montgomery, Paul
2014-03-01
Electronic tracking through GPS (global positioning system) is being used to monitor and locate people with dementia who are vulnerable to becoming lost. Through a review of the literature and an original study, this article examined ethical issues associated with use in a domestic setting. The qualitative study consisted of in-depth interviews with 10 carers who were using electronic tracking. The study explored the values, beliefs and contextual factors that motivated carers to use electronic tracking. It examined the extent of involvement of the person with dementia in decision-making and it explored the various ethical dilemmas encountered by carers when introducing the tracking system. As an issue that emerged from the interviews, specific attention was paid to exploring covert usage. From the study findings, recommendations have been made for research and practice about the use of electronic tracking in dementia care.
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Ethical Awareness and Ethical Orientation of Turkish Teachers
Gökçe, Asiye Toker
2013-01-01
This study inquires ethical evaluation of teachers, investigating their moral reasoning to ethical decision making, in Turkey. Specifically three hypotheses were tested: Overall ethical awareness of teachers is high; Teachers will identify reasons for ethical evaluation related to philosophical values such as justice, deontology, utilitarianism,…
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Value Application in Radiation Protection Decision-Making
International Nuclear Information System (INIS)
Bombaerts, G.; Hardeman, F.; Braeckman, J.
2001-01-01
Full text: The radiation protection (RP) community is looking for a sound philosophical basis to support their actions. The utilitarianism-egalitarianism debate of the nineties is a reference here. These ethical theories are well elaborated in philosophy throughout the past ages, making it very difficult for RP decision-makers to use these systems in all their sensitivities. Furthermore, the debate's polarisation obstructs dealing with the essence: how can concerned people be given their say? A theory of core values gives a firm basis. Cost Benefit Analysis is another common decision-making tool in RP, often reducing values to economic numbers when it is used. A 'collective willingness to pay (CWP) principle' is proposed and it avoids this reduction. The new principle can be brought in accordance with risk perception analysis. The existing cost-effectiveness differences in RP measures will be illustrated and explained. Nevertheless, there are limitations to CWP applications. A third philosophical foundation (post-materialism) is presented to state that decision-making procedures have to balance between top-down functionality and bottom-up participation. To make sure the latter has full play, the RP officers have to put out special receptors to detect the societal important core values. This mechanism is illustrated with a few examples (Doel, Belgium; ...). (author)
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Edwards, Kyle T
2014-07-01
In recent years, liberal democratic societies have struggled with the question of how best to balance expertise and democratic participation in the regulation of emerging technologies. This study aims to explain how national deliberative ethics committees handle the practical tension between scientific expertise, ethical expertise, expert patient input, and lay public input by explaining two institutions' processes for determining the legitimacy or illegitimacy of reasons in public policy decision-making: that of the United Kingdom's Human Fertilisation and Embryology Authority (HFEA) and the United States' American Society for Reproductive Medicine (ASRM). The articulation of these 'methods of legitimation' draws on 13 in-depth interviews with HFEA and ASRM members and staff conducted in January and February 2012 in London and over Skype, as well as observation of an HFEA deliberation. This study finds that these two institutions employ different methods in rendering certain arguments legitimate and others illegitimate: while the HFEA attempts to 'balance' competing reasons but ultimately legitimizes arguments based on health and welfare concerns, the ASRM seeks to 'filter' out arguments that challenge reproductive autonomy. The notably different structures and missions of each institution may explain these divergent approaches, as may what Sheila Jasanoff (2005) terms the distinctive 'civic epistemologies' of the US and the UK. Significantly for policy makers designing such deliberative committees, each method differs substantially from that explicitly or implicitly endorsed by the institution. Copyright © 2014 Elsevier Ltd. All rights reserved.
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The Just War Tradition: A Model for Healthcare Ethics.
Connolly, Chaplain John D
2018-06-01
Healthcare ethics committees, physicians, surgeons, nurses, families, and patients themselves are constantly under pressure to make appropriate medically ethical decisions concerning patient care. Various models for healthcare ethics decisions have been proposed throughout the years, but by and large they are focused on making the initial ethical decision. What follows is a proposed model for healthcare ethics that considers the most appropriate decisions before, during, and after any intervention. The Just War Tradition is a model that is thorough in its exploration of the ethics guiding a nation to either engage in or refuse to engage in combatant actions. In recent years, the Just War Tradition has expanded beyond the simple consideration of going to war or not to include how the war is conducted and what the post-war phase would look like ethically. This paper is an exploration of a healthcare ethics decision making model using the tenets of the Just War Tradition as a framework. It discusses the initial consult level of decision making prior to any medical intervention, then goes further in considering the ongoing ethical paradigm during medical intervention and post intervention. Thus, this proposal is a more holistic approach to healthcare ethics decision making that encourages healthcare ethics committees to consider alternate models and ways of processing so that ultimately what is best for patient, family, staff, and the environment is all taken into consideration.
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Behavioral Economics: A New Lens for Understanding Genomic Decision Making.
Moore, Scott Emory; Ulbrich, Holley H; Hepburn, Kenneth; Holaday, Bonnie; Mayo, Rachel; Sharp, Julia; Pruitt, Rosanne H
2018-05-01
This article seeks to take the next step in examining the insights that nurses and other healthcare providers can derive from applying behavioral economic concepts to support genomic decision making. As genomic science continues to permeate clinical practice, nurses must continue to adapt practice to meet new challenges. Decisions associated with genomics are often not simple and dichotomous in nature. They can be complex and challenging for all involved. This article offers an introduction to behavioral economics as a possible tool to help support patients', families', and caregivers' decision making related to genomics. Using current writings from nursing, ethics, behavioral economic, and other healthcare scholars, we review key concepts of behavioral economics and discuss their relevance to supporting genomic decision making. Behavioral economic concepts-particularly relativity, deliberation, and choice architecture-are specifically examined as new ways to view the complexities of genomic decision making. Each concept is explored through patient decision making and clinical practice examples. This article also discusses next steps and practice implications for further development of the behavioral economic lens in nursing. Behavioral economics provides valuable insight into the unique nature of genetic decision-making practices. Nurses are often a source of information and support for patients during clinical decision making. This article seeks to offer behavioral economic concepts as a framework for understanding and examining the unique nature of genomic decision making. As genetic and genomic testing become more common in practice, it will continue to grow in importance for nurses to be able to support the autonomous decision making of patients, their families, and caregivers. © 2018 Sigma Theta Tau International.
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Frick, William C.
2009-01-01
Purpose: This research seeks to explore the inevitable internal struggle experienced by school leaders when making ethically-informed judgments. The study acquired principals' intimate reflections about professional decision making in response to personal versus organizational and/or professional value discrepancy as identified in the ethic of the…
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Steenhaut, Sarah
2006-01-01
In sum, we may conclude that – although many questions are still to be resolved – the present dissertation contributes to a better understanding of unethical consumer behavior by further enhancing the theory development of consumers’ ethical decision-making processes by conceiving and testing (1) additional individual characteristics, (2) situational circumstances, and (3) emotional experiences (along with other issue-related influences), and considering the potential mediating and moderating...
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Directory of Open Access Journals (Sweden)
Pier Luigi Baldi
2006-06-01
Full Text Available This article points out some conditions which significantly exert an influence upon decision and compares decision making and problem solving as interconnected processes. Some strategies of decision making are also examined.
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Using an Ethical Decision-Making Model to Address Ethical Dilemmas in School Counseling
Brown, Timothy; Armstrong, Stephen A.; Bore, Samuel; Simpson, Chris
2017-01-01
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…
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Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne
2013-01-01
Dealing with socio-scientific issues in science classes enables students to participate productively in controversial discussions concerning ethical topics, such as sustainable development. In this respect, well-structured decision-making processes are essential for elaborate reasoning. To foster decision-making competence, a computer-based…
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When concretized emotion-belief complexes derail decision-making capacity.
Halpern, Jodi
2012-02-01
There is an important gap in philosophical, clinical and bioethical conceptions of decision-making capacity. These fields recognize that when traumatic life circumstances occur, people not only feel afraid and demoralized, but may develop catastrophic thinking and other beliefs that can lead to poor judgment. Yet there has been no articulation of the ways in which such beliefs may actually derail decision-making capacity. In particular, certain emotionally grounded beliefs are systematically unresponsive to evidence, and this can block the ability to deliberate about alternatives. People who meet medico-legal criteria for decision-making capacity can react to health and personal crises with such capacity-derailing reactions. One aspect of this is that a person who is otherwise cognitively intact may be unable to appreciate her own future quality of life while in this complex state of mind. This raises troubling ethical challenges. We cannot rely on the current standard assessment of cognition to determine decisional rights in medical and other settings. We need to understand better how emotionally grounded beliefs interfere with decision-making capacity, in order to identify when caregivers have an obligation to intervene. © 2010 Blackwell Publishing Ltd.
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Directory of Open Access Journals (Sweden)
Louise Kretzschmar
2013-02-01
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.
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[Clinical decision making and critical thinking in the nursing diagnostic process].
Müller-Staub, Maria
2006-10-01
The daily routine requires complex thinking processes of nurses, but clinical decision making and critical thinking are underestimated in nursing. A great demand for educational measures in clinical judgement related with the diagnostic process was found in nurses. The German literature hardly describes nursing diagnoses as clinical judgements about human reactions on health problems / life processes. Critical thinking is described as an intellectual, disciplined process of active conceptualisation, application and synthesis of information. It is gained through observation, experience, reflection and communication and leads thinking and action. Critical thinking influences the aspects of clinical decision making a) diagnostic judgement, b) therapeutic reasoning and c) ethical decision making. Human reactions are complex processes and in their course, human behavior is interpreted in the focus of health. Therefore, more attention should be given to the nursing diagnostic process. This article presents the theoretical framework of the paper "Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies".
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Stiggelbout, A.M.; Vries, M. de; Scherer, L.; Keren, G.; Wu, G.
2016-01-01
This chapter presents an overview of the field of medical decision making. It distinguishes the levels of decision making seen in health-care practice and shows how research in judgment and decision making support or improve decision making. Most of the research has been done at the micro level,
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Directory of Open Access Journals (Sweden)
Enrique Benjamín Franklin Fincowsky
2011-06-01
Full Text Available People and organizations make better or get wrong as consequence of making decisions. Sometimes making decisions is just a trial and error process. Some others, decisions are good and the results profitable with a few of mistakes, most of the time because it’s considered the experience and the control of a specific field or the good intention of who makes them. Actually, all kinds of decisions bring learning. What is important is the intention, the attitude and the values considered in this process. People from different scenes face many facts and circumstances—almost always out of control—that affect the making decisions process. There is not a unique way to make decisions for all companies in many settings. The person who makes a decision should identify the problem, to solve it later using alternatives and solutions. Even though, follow all the steps it’s not easy as it seems. Looking back the conditions related to the decisions, we can mention the followings: uncertainty, risk and certainty. When people identify circumstances and facts, as well as its effects in a possible situation, they will make decisions with certainty. As long as the information decreases and it becomes ambiguous the risk becomes an important factor in the making decisions process because they are connected to probable objectives (clear or subjective (opinion judgment or intuition. To finish, uncertainty, involves people that make a decision with no or little information about circumstances or criteria with basis
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Jerpseth, Heidi; Dahl, Vegard; Nortvedt, Per; Halvorsen, Kristin
2017-11-01
Decisions regarding whether or not to institute mechanical ventilation during the later stages of chronic obstructive pulmonary disease is challenging both ethically, emotionally and medically. Caring for these patients is a multifaceted process where nurses play a crucial role. Research question and design: We have investigated how nurses experienced their own role in decision-making processes regarding mechanical ventilation in later stages of chronic obstructive pulmonary disease and how they consider the patients' role in these processes. We applied a qualitative approach, with six focus-group interviews of nurses (n = 26). Ethical considerations: The Regional Committees for Medical and Health Research Ethics approved the study. Voluntary informed consent was obtained. The nurses found themselves operating within a cure-directed treatment culture wherein they were unable to stand up for the caring values. They perceived their roles and responsibilities in decision-making processes regarding mechanical ventilation to patients as unclear and unsatisfactory. They also experienced inadequate interdisciplinary cooperation. Lack of communication skills, the traditional hierarchical hospital culture together with operating in a medical-orientated treatment culture where caring values is rated as less important might explain the nurses' absence in participation in the decision about mechanical ventilation. To be able to advocate for the patients' and their own right to be included in decision-making processes, nurses need an awareness of their own responsibilities. This requires personal courage, leadership who are capable of organising common interpersonal meetings and willingness on the part of the physicians to include and value the nurses' participation in decision-making processes.
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Ethics and rationality in information-enriched decisions: A model for technical communication
Dressel, S. B.; Carlson, P.; Killingsworth, M. J.
1993-12-01
In a technological culture, information has a crucial impact upon decisions, but exactly how information plays into decisions is not always clear. Decisions that are effective, efficient, and ethical must be rational. That is, we must be able to determine and present good reasons for our actions. The topic in this paper is how information relates to good reasons and thereby affects the best decisions. A brief sketch of a model for decision-making, is presented which offers a synthesis of theoretical approaches to argument and to information analysis. Then the model is applied to a brief hypothetical case. The main purpose is to put the model before an interested audience in hopes of stimulating discussion and further research.
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Justice and care: decision making by medical school student promotions committees.
Green, Emily P; Gruppuso, Philip A
2017-06-01
The function of medical school entities that determine student advancement or dismissal has gone largely unexplored. The decision making of 'academic progress' or student promotions committees is examined using a theoretical framework contrasting ethics of justice and care, with roots in the moral development work of theorists Kohlberg and Gilligan. To ascertain promotions committee members' conceptualisation of the role of their committee, ethical orientations used in member decision making, and student characteristics most influential in that decision making. An electronic survey was distributed to voting members of promotions committees at 143 accredited allopathic medical schools in the USA. Descriptive statistics were calculated and data were analysed by gender, role, institution type and class size. Respondents included 241 voting members of promotions committees at 55 medical schools. Respondents endorsed various promotions committee roles, including acting in the best interest of learners' future patients and graduating highly qualified learners. Implementing policy was assigned lower importance. The overall pattern of responses did not indicate a predominant orientation toward an ethic of justice or care. Respondents indicated that committees have discretion to take individual student characteristics into consideration during deliberations, and that they do so in practice. Among the student characteristics with the greatest influence on decision making, professionalism and academic performance were paramount. Eighty-five per cent of participants indicated that they received no training. Promotions committee members do not regard orientations of justice and care as being mutually exclusive and endorse an array of statements regarding the committee's purpose that may conflict with one another. The considerable variance in the influence of student characteristics and the general absence of committee member training indicate a need for clear delineation of the
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Capacity for Preferences: Respecting Patients with Compromised Decision-Making.
Wasserman, Jason Adam; Navin, Mark Christopher
2018-05-01
When a patient lacks decision-making capacity, then according to standard clinical ethics practice in the United States, the health care team should seek guidance from a surrogate decision-maker, either previously selected by the patient or appointed by the courts. If there are no surrogates willing or able to exercise substituted judgment, then the team is to choose interventions that promote a patient's best interests. We argue that, even when there is input from a surrogate, patient preferences should be an additional source of guidance for decisions about patients who lack decision-making capacity. Our proposal builds on other efforts to help patients who lack decision-making capacity provide input into decisions about their care. For example, "supported," "assisted," or "guided" decision-making models reflect a commitment to humanistic patient engagement and create a more supportive process for patients, families, and health care teams. But often, they are supportive processes for guiding a patient toward a decision that the surrogate or team believes to be in the patient's medical best interests. Another approach holds that taking seriously the preferences of such a patient can help surrogates develop a better account of what the patient's treatment choices would have been if the patient had retained decision-making capacity; the surrogate then must try to integrate features of the patient's formerly rational self with the preferences of the patient's currently compromised self. Patients who lack decision-making capacity are well served by these efforts to solicit and use their preferences to promote best interests or to craft would-be autonomous patient images for use by surrogates. However, we go further: the moral reasons for valuing the preferences of patients without decision-making capacity are not reducible to either best-interests or (surrogate) autonomy considerations but can be grounded in the values of liberty and respect for persons. This has
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Making an Ethical Decision: A Utilitarian Strategy.
Price, Sandra J.
1992-01-01
By identifying and weighing the effects of an act on each constituency, a matrix based on John Stuart Mill's theories of utilitarianism illuminates and helps resolve complex ethical dilemmas. Application of the approach is illustrated with a simulated case study concerning the issue of reputation in a small private college. (Author/MSE)
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Chambers, David W
2011-01-01
A decision is a commitment of resources under conditions of risk in expectation of the best future outcome. The smart decision is always the strategy with the best overall expected value-the best combination of facts and values. Some of the special circumstances involved in decision making are discussed, including decisions where there are multiple goals, those where more than one person is involved in making the decision, using trigger points, framing decisions correctly, commitments to lost causes, and expert decision makers. A complex example of deciding about removal of asymptomatic third molars, with and without an EBD search, is discussed.
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Anderson, Natalie E; Gott, Merryn; Slark, Julia
2017-04-01
When faced with an out-of-hospital cardiac arrest patient, prehospital and emergency resuscitation providers have to decide when to commence, continue, withhold or terminate resuscitation efforts. Such decisions may be made difficult by incomplete information, clinical, resourcing or scene challenges and ethical dilemmas. This systematic integrative review identifies all research papers examining resuscitation providers' perspectives on resuscitation decision-making for out-of-hospital cardiac arrest patients. A total of 14 studies fulfilled the inclusion criteria: nine quantitative, four qualitative and one mixed-methods design. Five themes were identified, describing factors informing resuscitation provider decision-making: the arrest event; patient characteristics; the resuscitation scene; resuscitation provider perspectives; and medicolegal concerns. Established prognostic factors are generally considered important, but there is a lack of resuscitation provider consensus on other factors, indicating that decision-making is influenced by the perspective of resuscitation providers themselves. Resuscitation decision-making research typically draws conclusions from evaluation of cardiac arrest registry data or clinical notes, but these may not capture all salient factors. Future research should explore resuscitation provider perspectives to better understand these important decisions and the clinical, ethical, emotional and cognitive demands placed on resuscitation providers.
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Shared decision making in endocrinology: present and future directions.
Rodriguez-Gutierrez, Rene; Gionfriddo, Michael R; Ospina, Naykky Singh; Maraka, Spyridoula; Tamhane, Shrikant; Montori, Victor M; Brito, Juan P
2016-08-01
In medicine and endocrinology, there are few clinical circumstances in which clinicians can accurately predict what is best for their patients. As a result, patients and clinicians frequently have to make decisions about which there is uncertainty. Uncertainty results from limitations in the research evidence, unclear patient preferences, or an inability to predict how treatments will fit into patients' daily lives. The work that patients and clinicians do together to address the patient's situation and engage in a deliberative dialogue about reasonable treatment options is often called shared decision making. Decision aids are evidence-based tools that facilitate this process. Shared decision making is a patient-centred approach in which clinicians share information about the benefits, harms, and burden of different reasonable diagnostic and treatment options, and patients explain what matters to them in view of their particular values, preferences, and personal context. Beyond the ethical argument in support of this approach, decision aids have been shown to improve patients' knowledge about the available options, accuracy of risk estimates, and decisional comfort. Decision aids also promote patient participation in the decision-making process. Despite accumulating evidence from clinical trials, policy support, and expert recommendations in endocrinology practice guidelines, shared decision making is still not routinely implemented in endocrine practice. Additional work is needed to enrich the number of available tools and to implement them in practice workflows. Also, although the evidence from randomised controlled trials favours the use of this shared decision making in other settings, populations, and illnesses, the effect of this approach has been studied in a few endocrine disorders. Future pragmatic trials are needed to explore the effect and feasibility of shared decision making implementation into routine endocrinology and primary care practice. With the
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Decision making on organ donation: the dilemmas of relatives of potential brain dead donors.
de Groot, Jack; van Hoek, Maria; Hoedemaekers, Cornelia; Hoitsma, Andries; Smeets, Wim; Vernooij-Dassen, Myrra; van Leeuwen, Evert
2015-09-17
This article is part of a study to gain insight into the decision-making process by looking at the views of the relatives of potential brain dead donors. Alongside a literature review, focus interviews were held with healthcare professionals about their role in the request and decision-making process when post-mortal donation is at stake. This article describes the perspectives of the relatives. A content-analysis of 22 semi-structured in-depth interviews with relatives involved in an organ donation decision. Three themes were identified: 'conditions', 'ethical considerations' and 'look back'. Conditions were: 'sense of urgency', 'incompetence to decide' and 'agreement between relatives'. Ethical considerations result in a dilemma for non-donor families: aiding people or protecting the deceased's body, especially when they do not know his/her preference. Donor families respect the deceased's last will, generally confirmed in the National Donor Register. Looking back, the majority of non-donor families resolved their dilemma by justifying their decision with external arguments (lack of time, information etc.). Some non-donor families would like to be supported during decision-making. The discrepancy between general willingness to donate and the actual refusal of a donation request can be explained by multiple factors, with a cumulative effect. Firstly, half of the participants (most non-donor families) stated that they felt that they were not competent to decide in such a crisis and they seem to struggle with utilitarian considerations against their wish to protect the body. Secondly, non-donor families refused telling that they did not know the deceased's wishes or contesting posthumous autonomy of the eligible. Thirdly, the findings emphasise the importance of Donor Registration, because it seems to prevent dilemmas in decision-making, at least for donor families. Discrepancies between willingness to consent to donate and refusal at the bedside can be attributed
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Ethical Dilemmas when Diagnosing Hypertension
Directory of Open Access Journals (Sweden)
Sandra Santana López
2012-12-01
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.
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Medlin, E. Lander
2010-01-01
Ethics is defined as a set of guidelines and/or rules for the conduct of individual behavior in an organization or civil society. This ethical code of conduct is intended to guide policies, practices, and decision-making for employees on behalf of the organization. This article explores the importance of ethics, the basis for making ethical…
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When Organizational Identification Elicits Moral Decision-Making:A Matter of the Right Climate
Gils, Suzanne Van; A HOGG, Michael; Van Quaquebeke, N; Van Knippenberg, Daniel L
2015-01-01
textabstractTo advance current knowledge on ethical decision-making in organizations, we integrate two perspectives that have thus far developed independently: the organizational identification perspective and the ethical climate perspective. We illustrate the interaction between these perspectives in two studies (Study 1, N = 144, US sample; and Study 2, N = 356, UK sample), in which we presented participants with moral business dilemmas. Specifically, we found that organizational identifica...
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Directory of Open Access Journals (Sweden)
Leon R. Sütfeld
2017-07-01
Full Text Available Self-driving cars are posing a new challenge to our ethics. By using algorithms to make decisions in situations where harming humans is possible, probable, or even unavoidable, a self-driving car's ethical behavior comes pre-defined. Ad hoc decisions are made in milliseconds, but can be based on extensive research and debates. The same algorithms are also likely to be used in millions of cars at a time, increasing the impact of any inherent biases, and increasing the importance of getting it right. Previous research has shown that moral judgment and behavior are highly context-dependent, and comprehensive and nuanced models of the underlying cognitive processes are out of reach to date. Models of ethics for self-driving cars should thus aim to match human decisions made in the same context. We employed immersive virtual reality to assess ethical behavior in simulated road traffic scenarios, and used the collected data to train and evaluate a range of decision models. In the study, participants controlled a virtual car and had to choose which of two given obstacles they would sacrifice in order to spare the other. We randomly sampled obstacles from a variety of inanimate objects, animals and humans. Our model comparison shows that simple models based on one-dimensional value-of-life scales are suited to describe human ethical behavior in these situations. Furthermore, we examined the influence of severe time pressure on the decision-making process. We found that it decreases consistency in the decision patterns, thus providing an argument for algorithmic decision-making in road traffic. This study demonstrates the suitability of virtual reality for the assessment of ethical behavior in humans, delivering consistent results across subjects, while closely matching the experimental settings to the real world scenarios in question.
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Sütfeld, Leon R; Gast, Richard; König, Peter; Pipa, Gordon
2017-01-01
Self-driving cars are posing a new challenge to our ethics. By using algorithms to make decisions in situations where harming humans is possible, probable, or even unavoidable, a self-driving car's ethical behavior comes pre-defined. Ad hoc decisions are made in milliseconds, but can be based on extensive research and debates. The same algorithms are also likely to be used in millions of cars at a time, increasing the impact of any inherent biases, and increasing the importance of getting it right. Previous research has shown that moral judgment and behavior are highly context-dependent, and comprehensive and nuanced models of the underlying cognitive processes are out of reach to date. Models of ethics for self-driving cars should thus aim to match human decisions made in the same context. We employed immersive virtual reality to assess ethical behavior in simulated road traffic scenarios, and used the collected data to train and evaluate a range of decision models. In the study, participants controlled a virtual car and had to choose which of two given obstacles they would sacrifice in order to spare the other. We randomly sampled obstacles from a variety of inanimate objects, animals and humans. Our model comparison shows that simple models based on one-dimensional value-of-life scales are suited to describe human ethical behavior in these situations. Furthermore, we examined the influence of severe time pressure on the decision-making process. We found that it decreases consistency in the decision patterns, thus providing an argument for algorithmic decision-making in road traffic. This study demonstrates the suitability of virtual reality for the assessment of ethical behavior in humans, delivering consistent results across subjects, while closely matching the experimental settings to the real world scenarios in question.
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... page: //medlineplus.gov/ency/patientinstructions/000877.htm Shared decision making To use the sharing features on this page, ... treatment you both support. When to use Shared Decision Making Shared decision making is often used when you ...
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Buddhist ethics and end-of-life care decisions.
McCormick, Andrew J
2013-01-01
Buddhism has grown in the United States in the past 50 years. Immigrants come following long traditions. American converts are more eclectic. The first Buddhist precept prohibiting harm to living things, the virtue of compassion, and the goal of a peaceful death provide guidance for ethical decision making regarding organ donation, withholding and withdrawing life-sustaining treatment, voluntary cessation of eating, physician aid in dying, and euthanasia. Concepts and views from three Buddhist traditions and views of master practitioners are presented. Case examples illustrate some of the differences within Buddhism. Suggestions for social workers are provided.
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Sisti, Dominic A; Baum-Baicker, Cynthia
2012-01-01
Comments on the original article, "Nonrational processes in ethical decision making" by M. D. Rogerson et al (see record 2011-19198-001). The current authors suggest that Rogerson, Gottlieb, Handelsman, Knapp, and Younggren (October 2011) presumed that the only ethical theories available for grounding decision-making models are of the rational, neoliberal variety. Rogerson et al stated, "Contextual, interpersonal, and intuitive factors are inextricably linked and inexorably influential in the process of ethical decision making. Ethical theory would benefit from encompassing these subtle yet powerful forces" (Rogerson et al., 2011, p. 616). They sought to augment these models with a cluster of contextual considerations, appending to them accounts of emotion, context, and intuition. First, notwithstanding the theories attributed to (the caricature of) Kant and his ilk, there are several ethical theories that include an account of what Rogerson et al. (2011) consider to be "nonrational" processes. From feminist theories to narrative ethics, sophisticated contextual theories have been developed and are readily available. Second, we question whether thick contextual considerations can simply be tacked on to extant models of decision making originally built upon a philosophical foundation that assumes a rational, autonomous agent who deliberates independently and logically.
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Teaching Ethics Informed by Neuroscience
Sayre, Molly Malany
2016-01-01
New findings about the brain are explicating how we make moral and ethical decisions. The neuroscience of morality is relevant to ethical decision making in social work because of a shared biopsychosocial perspective and the field's explanatory power to understand possible origins of universally accepted morals and personal attitudes at play in…
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Handbook on Decision Making Vol 2 Risk Management in Decision Making
Lu, Jie; Zhang, Guangquan
2012-01-01
This book presents innovative theories, methodologies, and techniques in the field of risk management and decision making. It introduces new research developments and provides a comprehensive image of their potential applications to readers interested in the area. The collection includes: computational intelligence applications in decision making, multi-criteria decision making under risk, risk modelling,forecasting and evaluation, public security and community safety, risk management in supply chain and other business decision making, political risk management and disaster response systems. The book is directed to academic and applied researchers working on risk management, decision making, and management information systems.
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Azria, E; Tsatsaris, V; Moriette, G; Hirsch, E; Schmitz, T; Cabrol, D; Goffinet, F
2007-05-01
Extreme premature child's long-term prognostic is getting better and better known, and if a resuscitation procedure is possible at birth, it won't guarantee survival or a survival free of disability. Incertitude toward individual prognosis and outcome for those children remains considerable. In this field, we are at the frontier of medical knowledge and the answer to the question, "how to decide the ante and postnatal care" is crucial. This work is focused on this problematic of decision-making in the context of extreme prematurity. It attempts to deconstruct this concept and to explicit its stakes. Thus, with the support of the medical sources and of philosophical debates, we tried to build a decision-making procedure that complies with the ethical requirements of medical care, accuracy, justice and equity. This decision-making procedure is primarily concerned with the singularity of each decision situation and it intends to link it closely to the notions of rationality and responsibility.
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Jung, Insung
2009-01-01
Assuming that ICT ethics are influenced by both moral and circumstantial factors, the study investigates Japanese college students' ethical judgments and behavioral intentions in three scenarios involving ICT-related ethical problems and explores why they make such decisions, relying on five moral philosophies: moral equity, relativism,…
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[HEALTH ECONOMIC ANALYSIS AND FAIR DECISION MAKING].
Jeantet, Marine; Lopez, Alain
2015-09-01
Health technology assessment consists in evaluating the incremental cost-benefit ratio of a medicine, a medical device, a vaccine, a health strategy, in comparison to alternative health technologies. This form of socio-eoonomic evaluation aims at optimizing resource allocation within the health system. By setting the terms of valid alternatives, it is useful to highlight public choices, but it cannot in itself make the decision as regards the public funding of patient's access to the considered technology. The decision to include such technology in the basket of health goods and sercices covered, the levels and conditions of the coverage, also result from budget constraints, from economic situation and from a political vision about health policy, social protection and public expenditure. Accordingly, health economic analysis must be implemented on specific and targeted topics. The decision making process, with its health, economic and ethical stakes, calls for a public procedure and debate, based on shared information and argument. Otherwise, health system regulation, confronted with radical and costly innovations in the coming years, will become harder to handle. This requires the development of health economic research teams able to contribute to this assessment exercise.
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Roman concept of mental capacity to make end-of-life decisions.
Mendelson, Danuta
2007-01-01
When assessing decisional competence of patients, psychiatrists have to balance the patients' right to personal autonomy, their condition and wishes against principles of medical ethics and professional discretion. This article explores the age-old legal and ethical dilemmas posed by refusal of vital medical treatment by patients and their mental capacity to make end-of-life decisions against the background of philosophical, legal and medical approaches to these issues in the time of the Younger Pliny (c62-c113 CE). Classical Roman discourse regarding mental competency and "voluntary death" formed an important theme of the vast corpus of Greco-Roman writings, which was moulded not only by legal permissibility of suicide but also by philosophical (in modern terms, moral or ethical) considerations. Indeed, the legal and ethical issues of evaluating the acceptability of end of life decisions discussed in the Letters are as pertinent today as they were 2000 years ago. We may gain valuable insights about our own methodologies and frames of reference in this area of the law and psychiatry by examining Classical Roman approaches to evaluating acceptability of death-choices as described in Pliny's Letters and the writings of some of his peers.
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Creativity and Ethics: The Relationship of Creative and Ethical Problem-Solving.
Mumford, Michael D; Waples, Ethan P; Antes, Alison L; Brown, Ryan P; Connelly, Shane; Murphy, Stephen T; Devenport, Lynn D
2010-02-01
Students of creativity have long been interested in the relationship between creativity and deviant behaviors such as criminality, mental disease, and unethical behavior. In the present study we wished to examine the relationship between creative thinking skills and ethical decision-making among scientists. Accordingly, 258 doctoral students in the health, biological, and social sciences were asked to complete a measure of creative processing skills (e.g., problem definition, conceptual combination, idea generation) and a measure of ethical decision-making examining four domains, data management, study conduct, professional practices, and business practices. It was found that ethical decision-making in all four of these areas was related to creative problem-solving processes with late cycle processes (e.g., idea generation and solution monitoring) proving particularly important. The implications of these findings for understanding the relationship between creative and deviant thought are discussed.
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Zubir, S. N. A.; Thiruchelvam, S.; Mustapha, K. N. M.; Che Muda, Z.; Ghazali, A.; Hakimie, H.
2017-12-01
For the past few years, natural disaster has been the subject of debate in disaster management especially in flood disaster. Each year, natural disaster results in significant loss of life, destruction of homes and public infrastructure, and economic hardship. Hence, an effective and efficient flood disaster management would assure non-futile efforts for life saving. The aim of this article is to examine the relationship between approach, decision maker, influence factor, result, and ethic to decision making for flood disaster management in Malaysia. The key elements of decision making in the disaster management were studied based on the literature. Questionnaire surveys were administered among lead agencies at East Coast of Malaysia in the state of Kelantan and Pahang. A total of 307 valid responses had been obtained for further analysis. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were carried out to analyse the measurement model involved in the study. The CFA for second-order reflective and first-order reflective measurement model indicates that approach, decision maker, influence factor, result, and ethic have a significant and direct effect on decision making during disaster. The results from this study showed that decision- making during disaster is an important element for disaster management to necessitate a successful collaborative decision making. The measurement model is accepted to proceed with further analysis known as Structural Equation Modeling (SEM) and can be assessed for the future research.
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Ombud's corner: Use of sensemaking* in ethical decisions
Vincent Vuillemin
2012-01-01
In this series, the Bulletin aims to explain the role of the Ombuds at CERN by presenting practical examples of misunderstandings that could have been resolved by the Ombuds if he had been contacted earlier. Please note that, in all the situations we present, the names are fictitious and used only to improve clarity. Taking ethical decisions can often be a dilemma - one that requires recognition and proper representation of multiple pieces of complex information, as well as an intuitive judgment about potential consequences. Pressure is particularly placed on organizational leaders, who are tasked with projects, partnerships and individuals. Constraining forces - be they personal, situational or environmental - can negatively influence any decision by decreasing ethical awareness, ethical sensitivity and ethical judgment. By creating mental compensatory models, the Sensemaking* technique serves to counteract these constraining forces that narrow the search and evaluation of&nbs...
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Decision Making with Imperfect Decision Makers
Guy, Tatiana Valentine; Wolpert, David H
2012-01-01
Prescriptive Bayesian decision making has reached a high level of maturity and is well-supported algorithmically. However, experimental data shows that real decision makers choose such Bayes-optimal decisions surprisingly infrequently, often making decisions that are badly sub-optimal. So prevalent is such imperfect decision-making that it should be accepted as an inherent feature of real decision makers living within interacting societies. To date such societies have been investigated from an economic and gametheoretic perspective, and even to a degree from a physics perspective. However, lit
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Game Theory - Its Applications to Ethical Decision Making
Directory of Open Access Journals (Sweden)
Cavagnetto Stefano
2014-01-01
Full Text Available The application of game theory according to Hargreaves-Heap and Varonfakis (1995 to understand human behaviour, and in particular ethical behaviour, is a valuable development, as game theory has gradually become one of the key frameworks to assist us in the understanding of social sciences. Esther (1982 and Aumann and Hart (1992 show that there are several studies that indicate the importance of a game theoretic framework in advancing our understanding of social behaviour and evolutionary sciences. Although the application of game theory in the above areas has largely been not formalised, its application in the fields of ethical conduct and human behaviour is at present developed in several respects with the gradual assistance of advances in related areas such as evolutionary biology and our understanding of group social behaviour.
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The rational choice model in family decision making at the end of life.
Karasz, Alison; Sacajiu, Galit; Kogan, Misha; Watkins, Liza
2010-01-01
Most end-of-life decisions are made by family members. Current ethical guidelines for family decision making are based on a hierarchical model that emphasizes the patient's wishes over his or her best interests. Evidence suggests that the model poorly reflects the strategies and priorities of many families. Researchers observed and recorded 26 decision-making meetings between hospital staff and family members. Semi-structured follow-up interviews were conducted. Transcriptions were analyzed using qualitative techniques. For both staff and families, consideration of a patient's best interests generally took priority over the patient's wishes. Staff generally introduced discussion of the patient's wishes for rhetorical purposes, such as persuasion. Competing moral frameworks, which de-emphasized the salience of patients' autonomy and "right to choose," played a role in family decision making. The priority given to the patients' wishes in the hierarchical model does not reflect the priorities of staff and families in making decisions about end-of-life care.
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The Role of Intuition in Risk/Benefit Decision-Making in Human Subjects Research.
Resnik, David B
2017-01-01
One of the key principles of ethical research involving human subjects is that the risks of research to should be acceptable in relation to expected benefits. Institutional review board (IRB) members often rely on intuition to make risk/benefit decisions concerning proposed human studies. Some have objected to using intuition to make these decisions because intuition is unreliable and biased and lacks transparency. In this article, I examine the role of intuition in IRB risk/benefit decision-making and argue that there are practical and philosophical limits to our ability to reduce our reliance on intuition in this process. The fact that IRB risk/benefit decision-making involves intuition need not imply that it is hopelessly subjective or biased, however, since there are strategies that IRBs can employ to improve their decisions, such as using empirical data to estimate the probability of potential harms and benefits, developing classification systems to guide the evaluation of harms and benefits, and engaging in moral reasoning concerning the acceptability of risks.
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A conceptual and computational model of moral decision making in human and artificial agents.
Wallach, Wendell; Franklin, Stan; Allen, Colin
2010-07-01
Recently, there has been a resurgence of interest in general, comprehensive models of human cognition. Such models aim to explain higher-order cognitive faculties, such as deliberation and planning. Given a computational representation, the validity of these models can be tested in computer simulations such as software agents or embodied robots. The push to implement computational models of this kind has created the field of artificial general intelligence (AGI). Moral decision making is arguably one of the most challenging tasks for computational approaches to higher-order cognition. The need for increasingly autonomous artificial agents to factor moral considerations into their choices and actions has given rise to another new field of inquiry variously known as Machine Morality, Machine Ethics, Roboethics, or Friendly AI. In this study, we discuss how LIDA, an AGI model of human cognition, can be adapted to model both affective and rational features of moral decision making. Using the LIDA model, we will demonstrate how moral decisions can be made in many domains using the same mechanisms that enable general decision making. Comprehensive models of human cognition typically aim for compatibility with recent research in the cognitive and neural sciences. Global workspace theory, proposed by the neuropsychologist Bernard Baars (1988), is a highly regarded model of human cognition that is currently being computationally instantiated in several software implementations. LIDA (Franklin, Baars, Ramamurthy, & Ventura, 2005) is one such computational implementation. LIDA is both a set of computational tools and an underlying model of human cognition, which provides mechanisms that are capable of explaining how an agent's selection of its next action arises from bottom-up collection of sensory data and top-down processes for making sense of its current situation. We will describe how the LIDA model helps integrate emotions into the human decision-making process, and we
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Dean, Peter J.
1994-01-01
Discussion of ethics focuses on the role of human performance technology professionals in helping corporate ethicists. Highlights include definitions of ethics, morals, values, and business ethics; ethics in academia and in business; and application of the knowledge of ethics to decision-making. (Contains 18 references.) (LRW)
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Pratt, Cornelius B.
1994-01-01
Links ethical theories to the management of the product recall of the Perrier Group of America. Argues for a nonsituational theory-based eclectic approach to ethics in public relations to enable public relations practitioners, as strategic communication managers, to respond effectively to potentially unethical organizational actions. (SR)
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Medical decision-making in children and adolescents: developmental and neuroscientific aspects.
Grootens-Wiegers, Petronella; Hein, Irma M; van den Broek, Jos M; de Vries, Martine C
2017-05-08
Various international laws and guidelines stress the importance of respecting the developing autonomy of children and involving minors in decision-making regarding treatment and research participation. However, no universal agreement exists as to at what age minors should be deemed decision-making competent. Minors of the same age may show different levels of maturity. In addition, patients deemed rational conversation-partners as a child can suddenly become noncompliant as an adolescent. Age, context and development all play a role in decision-making competence. In this article we adopt a perspective on competence that specifically focuses on the impact of brain development on the child's decision-making process. We believe that the discussion on decision-making competence of minors can greatly benefit from a multidisciplinary approach. We adopted such an approach in order to contribute to the understanding on how to deal with children in decision-making situations. Evidence emerging from neuroscience research concerning the developing brain structures in minors is combined with insights from various other fields, such as psychology, decision-making science and ethics. Four capacities have been described that are required for (medical) decision-making: (1) communicating a choice; (2) understanding; (3) reasoning; and (4) appreciation. Each capacity is related to a number of specific skills and abilities that need to be sufficiently developed to support the capacity. Based on this approach it can be concluded that at the age of 12 children can have the capacity to be decision-making competent. However, this age coincides with the onset of adolescence. Early development of the brain's reward system combined with late development of the control system diminishes decision-making competence in adolescents in specific contexts. We conclude that even adolescents possessing capacities required for decision-making, may need support of facilitating environmental factors
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Reyna, Valerie F.; Nelson, Wendy L.; Han, Paul K.; Pignone, Michael P.
2015-01-01
We review decision-making along the cancer continuum in the contemporary context of informed and shared decision making, in which patients are encouraged to take a more active role in their health care. We discuss challenges to achieving informed and shared decision making, including cognitive limitations and emotional factors, but argue that understanding the mechanisms of decision making offers hope for improving decision support. Theoretical approaches to decision making that explain cogni...
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DEFF Research Database (Denmark)
Veissier, I.; Jensen, Karsten Klint; Botreau, R.
2011-01-01
dimension of scoring and labelling does not mean that we should reject them, but it does mean that we need to make the normative and ethical background explicit. The Welfare Quality® scoring system is used as a case study in order to highlight the role of underlying value-based decisions. In this scoring......, but the rules governing the assignment of an animal unit to a category take into account what had been observed on European farms. The scientists behind Welfare Quality® are keen to make the value-based choices underlying assessments of animal welfare transparent. This is essential to allow stakeholder groups......All systems of scoring animal units (groups, farms, slaughter plants, etc.) according to the level of the animals’ welfare are based inevitably on normative decisions. Similarly, all methods of labelling, in terms of acceptability, are based on choices reflecting ethical values. The evaluative...
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Directory of Open Access Journals (Sweden)
Bernabe Rosemarie D L C
2012-04-01
Full Text Available Abstract Background Research ethics committees (RECs are tasked to assess the risks and the benefits of a trial. Currently, two procedure-level approaches are predominant, the Net Risk Test and the Component Analysis. Discussion By looking at decision studies, we see that both procedure-level approaches conflate the various risk-benefit tasks, i.e., risk-benefit assessment, risk-benefit evaluation, risk treatment, and decision making. This conflation makes the RECs’ risk-benefit task confusing, if not impossible. We further realize that RECs are not meant to do all the risk-benefit tasks; instead, RECs are meant to evaluate risks and benefits, appraise risk treatment suggestions, and make the final decision. Conclusion As such, research ethics would benefit from looking beyond the procedure-level approaches and allowing disciplines like decision studies to be involved in the discourse on RECs’ risk-benefit task.
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[Refusal of care in the intensive care: how makes decision?].
Borel, M; Veber, B; Villette-Baron, K; Hariri, S; Dureuil, B; Hervé, C
2009-11-01
Decision-making bringing to an admission or not in intensive care is complex. The aim of this study is to analyze with an ethical point of view the making decision process leading to the refusal and its consequences. It is proposed a setting in prospect through the principles of beneficence, non-maleficience, respect for autonomy, justice, and the Leonetti law. Prospective study in surgical reanimation at the University Hospital of Rouen over 9 months (November 2007-September 2008). Systematic collection for each non-admitted patient of the general characters, the methods of decision making, immediate becoming and within 48 h Constitution of two groups: patients for whom an admission in intensive care could be an unreasonable situation of obstinacy, and patients for whom an admission in reanimation would not be about unreasonable if it occurred. One hundred and fifty situations were analyzed. The potentially unreasonable character of an admission does not involve necessarily a refusal of care in intensive care. The question of the lack of place and equity in the access to the care is real but relative according to the typology of the patients. The research of the respect of the autonomy of the patient is difficult but could be facilitated. The Leonetti law does not appear to be able to be a framework with the situation of refusal of care in intensive care. It is not a question of going towards a systematic admission in intensive care of any patient proposed, but to make sure that so if there is a refusal, it is carried out according to a step ethically acceptable.
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Ethical challenges related to elder care. High level decision-makers' experiences
Directory of Open Access Journals (Sweden)
Kihlgren Mona
2007-04-01
Full Text Available Abstract Background Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. Methods A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Results Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Conclusion Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to
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Ethical challenges related to elder care. High level decision-makers' experiences.
Mamhidir, Anna-Greta; Kihlgren, Mona; Sorlie, Venke
2007-04-10
Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health
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ASCA Ethical Standards and the Relevance of Eastern Ethical Theories
Cook, Amy L.; Houser, Rick A.
2009-01-01
As schools become increasingly diverse through immigration and growth of minority groups, it is important that school counselors incorporate culturally sensitive ethical decision-making in their practice. The use of Western ethical theories in the application of professional codes of ethics provides a specific perspective in ethical…
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Narrative Interest Standard: A Novel Approach to Surrogate Decision-Making for People With Dementia.
Wilkins, James M
2017-06-17
Dementia is a common neurodegenerative process that can significantly impair decision-making capacity as the disease progresses. When a person is found to lack capacity to make a decision, a surrogate decision-maker is generally sought to aid in decision-making. Typical bases for surrogate decision-making include the substituted judgment standard and the best interest standard. Given the heterogeneous and progressive course of dementia, however, these standards for surrogate decision-making are often insufficient in providing guidance for the decision-making for a person with dementia, escalating the likelihood of conflict in these decisions. In this article, the narrative interest standard is presented as a novel and more appropriate approach to surrogate decision-making for people with dementia. Through case presentation and ethical analysis, the standard mechanisms for surrogate decision-making for people with dementia are reviewed and critiqued. The narrative interest standard is then introduced and discussed as a dementia-specific model for surrogate decision-making. Through incorporation of elements of a best interest standard in focusing on the current benefit-burden ratio and elements of narrative to provide context, history, and flexibility for values and preferences that may change over time, the narrative interest standard allows for elaboration of an enriched context for surrogate decision-making for people with dementia. More importantly, however, a narrative approach encourages the direct contribution from people with dementia in authoring the story of what matters to them in their lives.
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Sisti, Dominic A.; Baum-Baicker, Cynthia
2012-01-01
This article represents comments on the original article, "Nonrational processes in ethical decision making" by M. D. Rogerson et al (EJ945176). The current authors suggest that Rogerson, Gottlieb, Handelsman, Knapp, and Younggren (October 2011) presumed that the only ethical theories available for grounding decision-making models are of the…
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Cultural Effects on Business Students' Ethical Decisions: A Chinese versus American Comparison
Li, Sherry F.; Persons, Obeua S.
2011-01-01
The authors used a corporate code of ethics to create 18 scenarios for examining cultural effects on ethical decisions of Chinese versus American business students. Four cultural differences were hypothesized to contribute to overall less ethical decisions of Chinese students. The results support the hypothesis and indicate strong cultural effects…
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The ethics curriculum for doctor of nursing practice programs.
Peirce, Anne Griswold; Smith, Jennifer A
2008-01-01
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.
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Categorization = Decision Making + Generalization
Seger, Carol A; Peterson, Erik J.
2013-01-01
We rarely, if ever, repeatedly encounter exactly the same situation. This makes generalization crucial for real world decision making. We argue that categorization, the study of generalizable representations, is a type of decision making, and that categorization learning research would benefit from approaches developed to study the neuroscience of decision making. Similarly, methods developed to examine generalization and learning within the field of categorization may enhance decision making research. We first discuss perceptual information processing and integration, with an emphasis on accumulator models. We then examine learning the value of different decision making choices via experience, emphasizing reinforcement learning modeling approaches. Next we discuss how value is combined with other factors in decision making, emphasizing the effects of uncertainty. Finally, we describe how a final decision is selected via thresholding processes implemented by the basal ganglia and related regions. We also consider how memory related functions in the hippocampus may be integrated with decision making mechanisms and contribute to categorization. PMID:23548891
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Moral disengagement in ethical decision making: a study of antecedents and outcomes.
Detert, James R; Treviño, Linda Klebe; Sweitzer, Vicki L
2008-03-01
This article advances understanding of the antecedents and outcomes of moral disengagement by testing hypotheses with 3 waves of survey data from 307 business and education undergraduate students. The authors theorize that 6 individual differences will either increase or decrease moral disengagement, defined as a set of cognitive mechanisms that deactivate moral self-regulatory processes and thereby help to explain why individuals often make unethical decisions without apparent guilt or self-censure (Bandura, 1986). Results support 4 individual difference hypotheses, specifically, that empathy and moral identity are negatively related to moral disengagement, while trait cynicism and chance locus of control orientation are positively related to moral disengagement. Two additional locus of control orientations are not significantly related to moral disengagement. The authors also hypothesize and find that moral disengagement is positively related to unethical decision making. Finally, the authors hypothesize that moral disengagement plays a mediating role between the individual differences they studied and unethical decisions. Their results offer partial support for these mediating hypotheses. The authors discuss the implications of these findings for future research and for practice. Copyright 2008 APA
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Medical ethics and ethical dilemmas.
Iyalomhe, G B S
2009-01-01
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.
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Race and Ethical Reasoning: The Importance of Race to Journalistic Decision Making.
Coleman, Renita
2003-01-01
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)
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ONE SIZE FITS ALL? ON PATIENT AUTONOMY, MEDICAL DECISION-MAKING, AND THE IMPACT OF CULTURE.
Gilbar, Roy; Miola, José
2015-01-01
While both medical law and medical ethics have developed in a way that has sought to prioritise patient autonomy, it is less clear whether it has done so in a way that enhances the self-determination of patients from non-western backgrounds. In this article, we consider the desire of some patients from non-western backgrounds for family involvement in decision-making and argue that this desire is not catered for effectively in either medical law or medical ethics. We examine an alternative approach based on relational autonomy that might serve both to allow such patients to exercise their self-determination while still allowing them to include family members in the decision-making process. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.
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Implementing shared decision-making: consider all the consequences.
Elwyn, Glyn; Frosch, Dominick L; Kobrin, Sarah
2016-08-08
The ethical argument that shared decision-making is "the right" thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and efficiency. It is helpful, therefore, when evaluating new approaches such as shared decision-making to conceptualize potential consequences in a way that is broad, long-term, and as relevant as possible to multiple stakeholders. Yet, so far, evaluation metrics for shared decision-making have been mostly focused on short-term outcomes, such as cognitive or affective consequences in patients. The goal of this article is to hypothesize a wider set of consequences, that apply over an extended time horizon, and include outcomes at interactional, team, organizational and system levels, and to call for future research to study these possible consequences. To date, many more studies have evaluated patient decision aids rather than other approaches to shared decision-making, and the outcomes measured have typically been focused on short-term cognitive and affective outcomes, for example knowledge and decisional conflict. From a clinicians perspective, the shared decision-making process could be viewed as either intrinsically rewarding and protective, or burdensome and impractical, yet studies have not focused on the impact on professionals, either positive or negative. At interactional levels, group, team, and microsystem, the potential long-term consequences could include the development of a culture where deliberation and collaboration are regarded as guiding principles, where patients are coached to assess the value of interventions, to trade-off benefits versus harms, and assess their burdens-in short, to new social norms in the clinical workplace. At organizational levels, consistent shared decision-making might boost patient experience evaluations and lead to fewer complaints and legal
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Chattopadhyay, Subrata; Simon, Alfred
2008-06-01
Culture creates the context within which individuals experience life and comprehend moral meaning of illness, suffering and death. The ways the patient, family and the physician communicate and make decisions in the end-of-life care are profoundly influenced by culture. What is considered as right or wrong in the healthcare setting may depend on the socio-cultural context. The present article is intended to delve into the cross-cultural perspectives in ethical decision making in the end-of-life scenario. We attempt to address the dynamics of the roles of patient, family and physician therein across two countries from East and West, namely, India and Germany. In India, where illness is more a shared family affair than an individual incident, a physician is likely to respect the family's wishes and may withhold the [Symbol: see text]naked truth' about the diagnosis of a fatal disease to the patient. In Germany, a physician is legally required to inform the patient about the disease. In India, advance directive being virtually non-existent, the family acts as the locus of the decision-making process, taking into account the economic cost of available medical care. In Germany, advance directive is regarded as mandatory and healthcare is covered by insurance. Family and the physician appear to play larger roles in ethical decision making for patients in India than for those in Germany, who place greater emphasis on autonomy of the individual patient. Our study explicates how culture matters in ethical decision-making and why the bioethical discourse is necessary in the concrete realities of the socio-cultural context. To explore the possibility of finding a common ground of morality across different cultures while acknowledging and respecting cultural diversity, thus remains a formidable challenge for the bioethicists.
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Reyna, Valerie F; Nelson, Wendy L; Han, Paul K; Pignone, Michael P
2015-01-01
We review decision making along the cancer continuum in the contemporary context of informed and shared decision making in which patients are encouraged to take a more active role in their health care. We discuss challenges to achieving informed and shared decision making, including cognitive limitations and emotional factors, but argue that understanding the mechanisms of decision making offers hope for improving decision support. Theoretical approaches to decision making that explain cognition, emotion, and their interaction are described, including classical psychophysical approaches, dual-process approaches that focus on conflicts between emotion versus cognition (or reason), and modern integrative approaches such as fuzzy-trace theory. In contrast to the earlier emphasis on rote use of numerical detail, modern approaches emphasize understanding the bottom-line gist of options (which encompasses emotion and other influences on meaning) and retrieving relevant social and moral values to apply to those gist representations. Finally, research on interventions to support better decision making in clinical settings is reviewed, drawing out implications for future research on decision making and cancer. PsycINFO Database Record (c) 2015 APA, all rights reserved.
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Anderson, Albert
Intended for professionals and others in the field of philanthropy, this book applies ethics and ethical decision-making to fund raising. Its primary aim is to enhance the level of ethical fund raising throughout the nonprofit sector by equipping those involved with frameworks for understanding and taking principled actions and preventing…
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Perspective Taking and Decision-Making in Educational Game Play: A Mixed-Methods Study
Hilliard, Lacey J.; Buckingham, Mary H.; Geldhof, G. John; Gansert, Patricia; Stack, Caroline; Gelgoot, Erin S.; Bers, Marina U.; Lerner, Richard M.
2018-01-01
Video games have the potential to be contexts for moral learning. We investigated whether "Quandary," a video game designed to promote ethical thinking and moral considerations for decision-making, would help promote positive skills such as perspective taking and empathy in adolescents. We examined the effect of playing…
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Principals' Decision Making in Discipline Policy Implementation: The Lutheran Schools' Perspective
Brandon, Katherine J.
2013-01-01
This quantitative study examines the relationship of philosophical beliefs of administrators of Lutheran schools and the influence of those beliefs on discipline decision-making styles, job satisfaction, and other factors. The study patterns the survey work from William Perry (1999) and other theorists regarding philosophy and ethics. A…
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Energy decisions reframed as justice and ethical concerns
Sovacool, Benjamin K.; Heffron, Raphael J.; McCauley, Darren; Goldthau, Andreas
2016-05-01
All too often, energy policy and technology discussions are limited to the domains of engineering and economics. Many energy consumers, and even analysts and policymakers, confront and frame energy and climate risks in a moral vacuum, rarely incorporating broader social justice concerns. Here, to remedy this gap, we investigate how concepts from justice and ethics can inform energy decision-making by reframing five energy problems — nuclear waste, involuntary resettlement, energy pollution, energy poverty and climate change — as pressing justice concerns. We conclude by proposing an energy justice framework centred on availability, affordability, due process, transparency and accountability, sustainability, equity and responsibility, which highlights the futurity, fairness and equity dimensions of energy production and use.
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Institute of Scientific and Technical Information of China (English)
杨继平; 王兴超
2012-01-01
All over the world, growing concern over business and marketing has led to intensified research efforts in the relevant area. Albert Bandura＇ s theory of moral disengagement was developed to explain why certain people are able to engage in unethical decision making or inhumane conduct without apparent distress. It is also important to consider whether ethical leadership can influence the ethical quality of follower decisions. In the present study, we investigated the moderating role of ethical leadership played in the linkages between moral disengagement and ethical decision making in the context of Chinese organizations. A structured questionnaire was employed as the research instrument for this study. It consisted of five scales designed to measure the variables of moral disengagement, moral recognition, moral judgment, moral intent, and ethical leadership. Data were collected from 819 full-time employees who came from enterprises and institutions located in Beijing, Shanxi, Shandong, Henan, Hebei, Liaoning and Jilin. Cronbach＇ s alpha coefficients for the above measures were from . 83 to . 91, showing a good measurement reliability. A confirmatory factor analysis of the questionnaire was done with the software LISREL 8.70. Hierarchical regression modeling was utilized to analyze the data for testing the hypotheses proposed. All the data were analyzed with the software SPSS 16.0 and LISREL 8.70, and the main statistics methods were correlation analysis and hierarchical regression modeling. The results showed that moral disengagement positively correlated with moral judgment and moral intent, but negatively correlated with moral recognition and moral ethic. Moral ethic also positively correlated with moral recognition, but negatively correlated with moral judgment and moral intent. In line with predictions, the results of hierarchical regression modeling analysis suggested ethical leadership significantly moderated the relationship between moral disengagement
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Ethical considerations in geriatric neuropsychology.
Martin, Thomas A; Bush, Shane S
2008-01-01
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.
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Decision Making Under Uncertainty
2010-11-01
A sound approach to rational decision making requires a decision maker to establish decision objectives, identify alternatives, and evaluate those...often violate the axioms of rationality when making decisions under uncertainty. The systematic description of such observations may lead to the...which leads to “anchoring” on the initial value. The fact that individuals have been shown to deviate from rationality when making decisions
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Orasanu, Judith; Statler, Irving C. (Technical Monitor)
1994-01-01
The importance of decision-making to safety in complex, dynamic environments like mission control centers and offshore installations has been well established. NASA-ARC has a program of research dedicated to fostering safe and effective decision-making in the manned spaceflight environment. Because access to spaceflight is limited, environments with similar characteristics, including aviation and nuclear power plants, serve as analogs from which space-relevant data can be gathered and theories developed. Analyses of aviation accidents cite crew judgement and decision making as causes or contributing factors in over half of all accidents. A similar observation has been made in nuclear power plants. Yet laboratory research on decision making has not proven especially helpful in improving the quality of decisions in these kinds of environments. One reason is that the traditional, analytic decision models are inappropriate to multidimensional, high-risk environments, and do not accurately describe what expert human decision makers do when they make decisions that have consequences. A new model of dynamic, naturalistic decision making is offered that may prove useful for improving decision making in complex, isolated, confined and high-risk environments. Based on analyses of crew performance in full-mission simulators and accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation. Effective crew decision making and overall performance are mediated by crew communication. Communication
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Sun, Jing-Ping
2011-01-01
For three decades, the scholars in the area of values in educational administration and the moral dimension of leadership have conceptually argued for and empirically explored the centrality of values to educational administration. This centrality may be expressed as the roles and nature of values in decision-making and conflict resolution.…
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Decision-making: Theory and practice
SM Turpin; MA Marais
2004-01-01
This paper compares a number of theoretical models of decision-making with the way in which senior managers make decisions in practice. Six prominent decision-makers were interviewed about their own decision-making style, as well as their use of decision support technology. Significant variation was found in personal decision-making styles. However, some central themes emerged, such as the importance of sensitivity to the decision-making context, attention to the presentation of information, ...
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Verdonschot, E.H.A.M.; Liem, S.L.; Palenstein Helderman, W.H. van
2003-01-01
By conducting an oral examination, during radiographic examination and in treatment planning procedures dentists make numerous decisions. A dentist will be required to make his decisions explicit. Decision trees and decision analyses may play an important role. In a decision analysis, the
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The Relations between Decision Making in Social Relationships and Decision Making Styles
Sari, Enver
2008-01-01
The research reported in this paper aimed to examine the relationships between decisiveness in social relationships, and the decision-making styles of a group of university students and to investigate the contributions of decision-making styles in predicting decisiveness in social relationship (conflict resolution, social relationship selection…
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Research on self-esteem in decision-making and decision-making styles in orienteering athletes
Directory of Open Access Journals (Sweden)
Eroğlu Başak
2016-01-01
Full Text Available The aim of this study is to examine the self-esteem in decision making and decision-making styles of orienteering athletes in terms of different variables. 157 male and 43 female orienteering athletes, making a total of 200 athletes that joined the 3rd Level of Turkey Championship in 2015 have participated in this study which is in a survey model. The data collection tools were the Melbourne Decision-making. Quastionnaire I-II and the Personal Information Form which were adapted into Turkish by Deniz (2004. In the data analysis, descriptive statics, anova, t test and Tukey test have been utilized. There is a significant difference between athletes’ marital status, age groups, experiences in orienteering sports and self-esteem in decision making, decision making styles (p<0.05. According to the research results, it has been determined that married orienteering athletes prefer both self-esteem in decision making and vigilance decision-making style more often than the single athletes that mostly prefer procrastination decision-making style. Also, it has been found out that as the athletes’ age and experiences in sports increase, selfesteem and decision-making styles are affected more positively as well.
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Assessing the Decision-Making Capacity of Terminally Ill Patients with Cancer.
Kolva, Elissa; Rosenfeld, Barry; Saracino, Rebecca
2018-05-01
Despite the clinical, ethical, and legal magnitude of end-of-life decision-making, the capacity of terminally ill patients to make the medical decisions they often face is largely unknown. In practice, clinicians are responsible for determining when their patients are no longer competent to make treatment decisions, yet the accuracy of these assessments is unclear. The purpose of this study was to explore decision-making capacity and its assessment in terminally ill cancer patients. Fifty-five patients with advanced cancer receiving inpatient palliative care and 50 healthy adults were administered the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) to evaluate decision-making capacity with regard to the four most commonly used legal standards: Choice, Understanding, Appreciation, and Reasoning. Participants made a hypothetical treatment decision about whether to accept artificial nutrition and hydration for treatment of cachexia. Participants' physicians independently rated their decision-making capacity. Terminally ill participants were significantly more impaired than healthy adults on all MacCAT-T subscales. Most terminally ill participants were able to express a treatment choice (85.7%), but impairment was common on the Understanding (44.2%), Appreciation (49.0%), and Reasoning (85.4%) subscales. Agreement between physician-rated capacity and performance on the MacCAT-T subscales was poor. The use of the MacCAT-T revealed high rates of decisional impairment in terminally ill participants. Participants' physicians infrequently detected impairment identified by the MacCAT-T. The findings from the present study reinforce the need for engagement in advance care planning for patients with advanced cancer. Copyright © 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
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Gillespie, Mary
2010-11-01
Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Assessing Patient Participation in Health Policy Decision-Making in Cyprus
Directory of Open Access Journals (Sweden)
Kyriakos Souliotis
2016-08-01
Full Text Available Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA. PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI, an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients’ involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus.
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Assessing Patient Participation in Health Policy Decision-Making in Cyprus.
Souliotis, Kyriakos; Agapidaki, Eirini; Peppou, Lily Evangelia; Tzavara, Chara; Samoutis, George; Theodorou, Mamas
2016-06-20
Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA). PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI), an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH) as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA) procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients' involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus. © 2016 by Kerman University of Medical Sciences.
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Medical futility in children's nursing: making end-of-life decisions.
Brien, Irene O; Duffy, Anita; Shea, Ellen O
Caring for infants at end of life is challenging and distressing for parents and healthcare professionals, especially in relation to making decisions regarding withholding or withdrawal of treatment. The concept of medical futility must be considered under these circumstances. Parents and healthcare professionals should be involved together in making these difficult decisions. However, for some parents, emotions and guilt often are unbearable and, understandably, parents can be reluctant to make a decision. Despite the recognition of parental autonomy, if parents disagree with a decision made by medical staff, the case will be referred to and solved by the courts. The courts' decisions are often based on the best interest of the child. In this article, the authors discuss the concepts of 'parental autonomy' and 'the child's best interests' when determining medical futility for infants or neonates. The role of the nurse when caring for the dying child and their family is multifaceted. While nurses do not have a legitimate role in decision making at the end of life, it is often nurses who, through their advocacy role, inform doctors about parents' wishes and it is often nurses who support parents during this difficult time. Furthermore, nurses caring for dying children should be familiar to the family, experienced in end-of-life care and comfortable talking to parents about death and dying and treatment choices. Children's nurses therefore require advanced communication skills and an essential understanding of the ethical and legal knowledge relating to medical futility in end-of-life children's nursing.
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Medical futility in children's nursing: making end-of-life decisions.
LENUS (Irish Health Repository)
Brien, Irene O
2012-02-01
Caring for infants at end of life is challenging and distressing for parents and healthcare professionals, especially in relation to making decisions regarding withholding or withdrawal of treatment. The concept of medical futility must be considered under these circumstances. Parents and healthcare professionals should be involved together in making these difficult decisions. However, for some parents, emotions and guilt often are unbearable and, understandably, parents can be reluctant to make a decision. Despite the recognition of parental autonomy, if parents disagree with a decision made by medical staff, the case will be referred to and solved by the courts. The courts\\' decisions are often based on the best interest of the child. In this article, the authors discuss the concepts of \\'parental autonomy\\' and \\'the child\\'s best interests\\' when determining medical futility for infants or neonates. The role of the nurse when caring for the dying child and their family is multifaceted. While nurses do not have a legitimate role in decision making at the end of life, it is often nurses who, through their advocacy role, inform doctors about parents\\' wishes and it is often nurses who support parents during this difficult time. Furthermore, nurses caring for dying children should be familiar to the family, experienced in end-of-life care and comfortable talking to parents about death and dying and treatment choices. Children\\'s nurses therefore require advanced communication skills and an essential understanding of the ethical and legal knowledge relating to medical futility in end-of-life children\\'s nursing.
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Beyond a code of ethics: phenomenological ethics for everyday practice.
Greenfield, Bruce; Jensen, Gail M
2010-06-01
Physical therapy, like all health-care professions, governs itself through a code of ethics that defines its obligations of professional behaviours. The code of ethics provides professions with a consistent and common moral language and principled guidelines for ethical actions. Yet, and as argued in this paper, professional codes of ethics have limits applied to ethical decision-making in the presence of ethical dilemmas. Part of the limitations of the codes of ethics is that there is no particular hierarchy of principles that govern in all situations. Instead, the exigencies of clinical practice, the particularities of individual patient's illness experiences and the transformative nature of chronic illnesses and disabilities often obscure the ethical concerns and issues embedded in concrete situations. Consistent with models of expert practice, and with contemporary models of patient-centred care, we advocate and describe in this paper a type of interpretative and narrative approach to moral practice and ethical decision-making based on phenomenology. The tools of phenomenology that are well defined in research are applied and examined in a case that illustrates their use in uncovering the values and ethical concerns of a patient. Based on the deconstruction of this case on a phenomenologist approach, we illustrate how such approaches for ethical understanding can help assist clinicians and educators in applying principles within the context and needs of each patient. (c) 2010 John Wiley & Sons, Ltd.
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Preferences for autonomy in end-of-life decision making in modern Korean society.
Kim, Su Hyun
2015-03-01
The demand for autonomy in medical decision making is increasing among Korean people, but it is not well known why some people prefer autonomy in decision making but others do not. The aim of this study was to determine the extent to which Korean adults wished to exercise autonomy in the process of decision making regarding end-of-life treatment and to determine whether economic issues and family functioning, in particular, were associated with preferences for participation in decision making in Korean people. This study was a cross-sectional correlational study using a survey. Data were collected using structured questionnaires from 354 patients or their families who visited ambulatory departments at two general hospitals in South Korea, recruited by the proportionate quota sampling method. Data analysis was performed using multinomial logistic regression analyses. The study was approved by the hospitals' directors and the ethics committee of Kyungpook National University Hospital. Written informed consent was given by all participants. A majority of Korean people wanted to make autonomous decisions regarding treatment at the end of life. Preferences for autonomous decision making regarding end-of-life treatment, rather than relying on family, showed a significant increase in association with poor family functioning and low income. Results of this study suggested the necessity for development of alternatives to a dominant traditional "family-centered" approach in Korean people, in order to enhance end-of-life decision making for people who wish to take an active role in the decision-making process. Healthcare providers need to examine not only patients' preferred decision-making style but also any reasons for their choice, in particular, family conflict and financial burden. © The Author(s) 2014.
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[Interoception and decision-making].
Ohira, Hideki
2015-02-01
We sometimes make decisions relying not necessarily on deliberative thoughts but on intuitive and emotional processes in uncertain situations. The somatic marker hypothesis proposed by Damasio argued that interoception, which means bodily responses such as sympathetic activity, can be represented in the insula and anterior cingulate cortex and can play critical roles in decision-making. Though this hypothesis has been criticized in its theoretical and empirical aspects, recent studies are expanding the hypothesis to elucidate multiple bodily responses including autonomic, endocrine, and immune activities that affect decision-making. In addition, cumulative findings suggest that the anterior insula where the inner model of interoception is represented can act as an interface between the brain and body in decision-making. This article aims to survey recent findings on the brain-body interplays underlying decision-making, and to propose hypotheses on the significance of the body in decision-making.
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Making longevity in an aging society: linking Medicare policy and the new ethical field.
Kaufman, Sharon R
2010-01-01
Life-extending interventions for older persons are changing medical knowledge and societal expectations about longevity. Today's consciousness about growing older is partly shaped by a new form of ethics, constituted by and enabled through the routines and institutions that comprise ordinary clinical care. Unlike bioethics, whose emphasis is on clinical decision-making in individual situations, this new form of ethics is exceptionally diffuse and can be characterized as an ethical field. It is located in and shaped by health-care policies, standard technologies, and clinical evidence, and it emerges in what patients and families come to need and want. Three developments illustrate this ethical field at work: the changing nature of disease, especially the ascent of risk awareness and risk-based strategies for life extension; the role of technology in reshaping the ends of medicine; and the role of Medicare policy in creating need and ethical necessity. Medicare's expanding criteria for payment coverage of liver transplantation and implantable cardiac devices illustrate the pervasive logic of this new form of ethics. The powerful connection between the technological imperative and its ethical necessity is rarely mentioned in Medicare reform debates.
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Azria, E; Tsatsaris, V; Moriette, G; Hirsch, E; Schmitz, T; Cabrol, D; Goffinet, F
2007-05-01
Extreme premature child's long-term prognostic is getting better and better known, and if a resuscitation procedure is possible at birth, it won't guarantee survival or a survival free of disability. Incertitude toward individual prognosis and outcome for those childs remains considerable. In this field, we are at the frontier of medical knowledge and the answer to the question, "how to decide the ante and postnatal care?" is crucial. This work is focused on this problematic of decision making in the context of extreme prematurity. It attempts to deconstruct this concept and to explicit its stakes. Thus, with the support of the medical sources and of philosophical debates, we tried to build a decision-making procedure that complies with the ethical requirements of medical care, accuracy, justice and equity. This decision-making procedure is primarily concerned with the singularity of each decision situation and it intends to link it closely to the notions of rationality and responsibility.
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Learning by Doing: Teaching Decision Making through Building a Code of Ethics.
Hawthorne, Mark D.
2001-01-01
Notes that applying abstract ethical principles to the practical business of building a code of applied ethics for a technical communication department teaches students that they share certain unarticulated or unconscious values that they can translate into ethical principles. Suggests that combining abstract theory with practical policy writing…
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Impact of Ethics Codes on Judgments by Journalists: A Natural Experiment.
Pritchard, David; Morgan, Madelyn Peroni
1989-01-01
Investigates whether ethics codes help shape the decisions journalists make in situations that raise ethical issues. Finds no evidence that ethics codes directly influence journalists' decisions. (RS)
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Organizational decision making
Grandori, Anna
2015-01-01
Approved for public release; distribution is unlimited This thesis develops a heuristic approach to organizational decision-making by synthesizing the classical, neo-classical and contingency approaches to organization theory. The conceptual framework developed also integrates the rational and cybernetic approaches with cognitive processes underlying the decision-making process. The components of the approach address the role of environment in organizational decision-maki...
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Teachers' Grading Decision Making
Isnawati, Ida; Saukah, Ali
2017-01-01
This study investigated teachers' grading decision making, focusing on their beliefs underlying their grading decision making, their grading practices and assessment types, and factors they considered in grading decision making. Two teachers from two junior high schools applying different curriculum policies in grade reporting in Indonesian…
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Review of patient decision-making factors and attitudes regarding preimplantation genetic diagnosis.
Genoff Garzon, M C; Rubin, L R; Lobel, M; Stelling, J; Pastore, L M
2017-11-09
The increasing technical complexity and evolving options for repro-genetic testing have direct implications for information processing and decision making, yet the research among patients considering preimplantation genetic diagnosis (PGD) is narrowly focused. This review synthesizes the literature regarding patient PGD decision-making factors, and illuminates gaps for future research and clinical translation. Twenty-five articles met the inclusion criteria for evaluating experiences and attitudes of patients directly involved in PGD as an intervention or considering using PGD. Thirteen reports were focused exclusively on a specific disease or condition. Five themes emerged: (1) patients motivated by prospects of a healthy, genetic-variant-free child, (2) PGD requires a commitment of time, money, energy and emotions, (3) patients concerned about logistics and ethics of discarding embryos, (4) some patients feel sense of responsibility to use available technologies, and (5) PGD decisions are complex for individuals and couples. Patient research on PGD decision-making processes has very infrequently used validated instruments, and the data collected through both quantitative and qualitative designs have been inconsistent. Future research for improving clinical counseling is needed to fill many gaps remaining in the literature regarding this decision-making process, and suggestions are offered. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Eveslage, Thomas; D'Angelo, Paul
1994-01-01
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…
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Informed Consent Decision-Making in Deep Brain Stimulation.
Mandarelli, Gabriele; Moretti, Germana; Pasquini, Massimo; Nicolò, Giuseppe; Ferracuti, Stefano
2018-05-11
Deep brain stimulation (DBS) has proved useful for several movement disorders (Parkinson’s disease, essential tremor, dystonia), in which first and/or second line pharmacological treatments were inefficacious. Initial evidence of DBS efficacy exists for refractory obsessive-compulsive disorder, treatment-resistant major depressive disorder, and impulse control disorders. Ethical concerns have been raised about the use of an invasive surgical approach involving the central nervous system in patients with possible impairment in cognitive functioning and decision-making capacity. Most of the disorders in which DBS has been used might present with alterations in memory, attention, and executive functioning, which may have an impact on the mental capacity to give informed consent to neurosurgery. Depression, anxiety, and compulsivity are also common in DBS candidate disorders, and could also be associated with an impaired capacity to consent to treatment or clinical research. Despite these issues, there is limited empirical knowledge on the decision-making levels of these patients. The possible informed consent issues of DBS will be discussed by focusing on the specific treatable diseases.
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Informed Consent Decision-Making in Deep Brain Stimulation
Directory of Open Access Journals (Sweden)
Gabriele Mandarelli
2018-05-01
Full Text Available Deep brain stimulation (DBS has proved useful for several movement disorders (Parkinson’s disease, essential tremor, dystonia, in which first and/or second line pharmacological treatments were inefficacious. Initial evidence of DBS efficacy exists for refractory obsessive-compulsive disorder, treatment-resistant major depressive disorder, and impulse control disorders. Ethical concerns have been raised about the use of an invasive surgical approach involving the central nervous system in patients with possible impairment in cognitive functioning and decision-making capacity. Most of the disorders in which DBS has been used might present with alterations in memory, attention, and executive functioning, which may have an impact on the mental capacity to give informed consent to neurosurgery. Depression, anxiety, and compulsivity are also common in DBS candidate disorders, and could also be associated with an impaired capacity to consent to treatment or clinical research. Despite these issues, there is limited empirical knowledge on the decision-making levels of these patients. The possible informed consent issues of DBS will be discussed by focusing on the specific treatable diseases.
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Hospice decision making: diagnosis makes a difference.
Waldrop, Deborah P; Meeker, Mary Ann
2012-10-01
This study explored the process of decision making about hospice enrollment and identified factors that influence the timing of that decision. This study employed an exploratory, descriptive, cross-sectional design and was conducted using qualitative methods. In-depth in-person semistructured interviews were conducted with 36 hospice patients and 55 caregivers after 2 weeks of hospice care. The study was guided by Janis and Mann's conflict theory model (CTM) of decision making. Qualitative data analysis involved a directed content analysis using concepts from the CTM. A model of hospice enrollment decision making is presented. Concepts from the CTM (appraisal, surveying and weighing the alternatives, deliberations, adherence) were used as an organizing framework to illustrate the dynamics. Distinct differences were found by diagnosis (cancer vs. other chronic illness, e.g., heart and lung diseases) during the pre-encounter phase or before the hospice referral but no differences emerged during the post-encounter phase. Differences in decision making by diagnosis suggest the need for research about effective means for tailored communication in end-of-life decision making by type of illness. Recognition that decision making about hospice admission varies is important for clinicians who aim to provide person-centered and family-focused care.
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Prinsloo, Paul
2017-01-01
In the socio-technical imaginary of higher education, algorithmic decision-making offers huge potential, but we also cannot deny the risks and ethical concerns. In fleeing from Frankenstein's monster, there is a real possibility that we will meet Kafka on our path, and not find our way out of the maze of ethical considerations in the nexus between…
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Doty, Ed; Tomkiewicz, Joe; Bass, Kenneth
2005-01-01
This study is an empirical examination of possible differences between female and male accounting majors' managerial motivational traits, perceptions of ethical issues, ethical judgments, and ethical behavioral intentions regarding ethically equivocal business situations. Subjects were presented with two scales to measure their motivational…
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Decision-making: Theory and practice
Directory of Open Access Journals (Sweden)
SM Turpin
2004-12-01
Full Text Available This paper compares a number of theoretical models of decision-making with the way in which senior managers make decisions in practice. Six prominent decision-makers were interviewed about their own decision-making style, as well as their use of decision support technology. Significant variation was found in personal decision-making styles. However, some central themes emerged, such as the importance of sensitivity to the decision-making context, attention to the presentation of information, and the use of intuition. In terms of the use of decision support technology, the use of self-help tools, such as office software, was clearly favoured.
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Assessing an Adolescent's Capacity for Autonomous Decision-Making in Clinical Care.
Michaud, Pierre-André; Blum, Robert Wm; Benaroyo, Lazare; Zermatten, Jean; Baltag, Valentina
2015-10-01
The purpose of this article is to provide policy guidance on how to assess the capacity of minor adolescents for autonomous decision-making without a third party authorization, in the field of clinical care. In June 2014, a two-day meeting gathered 20 professionals from all continents, working in the field of adolescent medicine, neurosciences, developmental and clinical psychology, sociology, ethics, and law. Formal presentations and discussions were based on a literature search and the participants' experience. The assessment of adolescent decision-making capacity includes the following: (1) a review of the legal context consistent with the principles of the Convention on the Rights of the Child; (2) an empathetic relationship between the adolescent and the health care professional/team; (3) the respect of the adolescent's developmental stage and capacities; (4) the inclusion, if relevant, of relatives, peers, teachers, or social and mental health providers with the adolescent's consent; (5) the control of coercion and other social forces that influence decision-making; and (6) a deliberative stepwise appraisal of the adolescent's decision-making process. This stepwise approach, already used among adults with psychiatric disorders, includes understanding the different facets of the given situation, reasoning on the involved issues, appreciating the outcomes linked with the decision(s), and expressing a choice. Contextual and psychosocial factors play pivotal roles in the assessment of adolescents' decision-making capacity. The evaluation must be guided by a well-established procedure, and health professionals should be trained accordingly. These proposals are the first to have been developed by a multicultural, multidisciplinary expert panel. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
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Everyday ethics: ethical issues and stress in nursing practice.
Ulrich, Connie M; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine
2010-11-01
This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. © 2010 Blackwell Publishing Ltd.
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Applied Ethics in Nowadays Society
Tomita CIULEI
2013-01-01
This special issue is dedicated to Nowadays Applied Ethics in Society, and falls in the field of social sciences and humanities, being hosted both theoretical approaches and empirical research in various areas of applied ethics. Applied ethics analyzes of a series of morally concrete situations of social or professional practice in order to make / adopt decisions. In the field of applied ethics are integrated medical ethics, legal ethics, media ethics, professional ethics, environmental ethic...
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Human factors influencing decision making
Jacobs, Patricia A.
1998-01-01
This report supplies references and comments on literature that identifies human factors influencing decision making, particularly military decision making. The literature has been classified as follows (the classes are not mutually exclusive): features of human information processing; decision making models which are not mathematical models but rather are descriptive; non- personality factors influencing decision making; national characteristics influencing decision makin...
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Riedel, Annette
2015-01-01
Alongside the central focus on the persons requiring nursing care in professional nursing practice, the perspective of the sustainability of interventions and the use of materials (for example, nursing aids and hygiene articles) is gaining prominence in nursing decision-making processes. This contribution makes the principle of sustainability concrete and delineates its importance in the context of professional nursing practice and decision-making. It further suggests the development of an ethical policy in order to systematically ensure that sustainability has a place in ethical reflection and decision-making, and describes the elements involved. Finally, a synthesis is made between the importance of the principle of sustainability, suggested ethical policies (system of ethical reflection) as they affect nursing practice and professional reflection, decision-making, and practice. PMID:27417590
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Ethical issues in neurogenetics.
Uhlmann, Wendy R; Roberts, J Scott
2018-01-01
Many neurogenetic conditions are inherited and therefore diagnosis of a patient will have implications for the patient's relatives and can raise ethical issues. Predictive genetic testing offers asymptomatic relatives the opportunity to determine their risk status for a neurogenetic condition, and professional guidelines emphasize patients' autonomy and informed, voluntary decision making. Beneficence and nonmaleficence both need to be considered when making decisions about disclosure and nondisclosure of genetic information and test results. There can be disclosure concerns and challenges in determining whose autonomy to prioritize when a patient makes a genetic testing decision that can reveal the genetic status of a relative (e.g., testing an adult child when the at-risk parent has not been tested). Ethical issues are prominent when genetic testing for neurogenetic conditions is requested prenatally, on minors, adoptees, adult children at 25% risk, and for individuals with psychiatric issues or cognitive impairment. Neurogenetic conditions can result in cognitive decline which can affect decisional capacity and lead to ethical challenges with decision making, informed consent, and determining the patient's ability to comprehend test results. The ethical implications of genetic testing and emerging issues, including direct-to-consumer genetic testing, disclosure of secondary findings from genomic sequencing, and use of apolipoprotein E testing in clinical and research settings, are also discussed. Resources for information about genetic testing practice guidelines, insurance laws, and directories of genetics clinics are included. Copyright © 2018 Elsevier B.V. All rights reserved.
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Torke, Alexia M; Petronio, Sandra; Sachs, Greg A; Helft, Paul R; Purnell, Christianna
2012-04-01
To build a conceptual model of the role of communication in decision making, based on literature from medicine, communication studies and medical ethics. We proposed a model and described each construct in detail. We review what is known about interpersonal and patient-physician communication, described literature about surrogate-clinician communication, and discussed implications for our developing model. The communication literature proposes two major elements of interpersonal communication: information processing and relationship building. These elements are composed of constructs such as information disclosure and emotional support that are likely to be relevant to decision making. We propose these elements of communication impact decision making, which in turn affects outcomes for both patients and surrogates. Decision making quality may also mediate the relationship between communication and outcomes. Although many elements of the model have been studied in relation to patient-clinician communication, there is limited data about surrogate decision making. There is evidence of high surrogate distress associated with decision making that may be alleviated by communication-focused interventions. More research is needed to test the relationships proposed in the model. Good communication with surrogates may improve both the quality of medical decisions and outcomes for the patient and surrogate. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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Virtue vs utility: Alternative foundations for computer ethics
Energy Technology Data Exchange (ETDEWEB)
Artz, J.M. [George Washington Univ., Washington, DC (United States)
1994-12-31
Ethical decisions within the field of computers and information systems are made at two levels by two distinctly different groups of people. At the level of general principles, ethical issues are debated by academics and industry representatives in an attempt to decide what is proper behavior on issues such as hacking, privacy, and copying software. At another level, that of particular situations, individuals make ethical decisions regarding what is good and proper for them in their particular situation. They may use the general rules provided by the experts or they may decide that these rules do not apply in their particular situation. Currently, the literature on computer ethics provides some opinions regarding the general rules, and some guidance for developing further general rules. What is missing is guidance for individuals making ethical decisions in particular situations. For the past two hundred years, ethics has been dominated by conduct based ethical theories such as utilitarianism which attempt to describe how people must be behave in order to be moral individuals. Recently, weaknesses in conduct based approaches such as utilitarianism have led moral philosophers to reexamine character based ethical theories such as virtue ethics which dates back to the Greek philosophers Plato and Aristotle. This paper will compare utilitarianism and virtue ethics with respect to the foundations they provide for computer ethics. It will be argued that the very nature of computer ethics and the need to provide guidance to individuals making particular moral decisions points to the ethics of virtue as a superior philosophical foundation for computer ethics. The paper will conclude with the implications of this position for researchers, teachers and writers within the field of computer ethics.
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Dementia, Decision Making, and Capacity.
Darby, R Ryan; Dickerson, Bradford C
After participating in this activity, learners should be better able to:• Assess the neuropsychological literature on decision making and the medical and legal assessment of capacity in patients with dementia• Identify the limitations of integrating findings from decision-making research into capacity assessments for patients with dementia ABSTRACT: Medical and legal professionals face the challenge of assessing capacity and competency to make medical, legal, and financial decisions in dementia patients with impaired decision making. While such assessments have classically focused on the capacity for complex reasoning and executive functions, research in decision making has revealed that motivational and metacognitive processes are also important. We first briefly review the neuropsychological literature on decision making and on the medical and legal assessment of capacity. Next, we discuss the limitations of integrating findings from decision-making research into capacity assessments, including the group-to-individual inference problem, the unclear role of neuroimaging in capacity assessments, and the lack of capacity measures that integrate important facets of decision making. Finally, we present several case examples where we attempt to demonstrate the potential benefits and important limitations of using decision-making research to aid in capacity determinations.
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Curtis, Rob
1987-01-01
Advises directors of ways to include day care workers in the decision-making process. Enumerates benefits of using staff to help focus and direct changes in the day care center and discusses possible pitfalls in implementation of a collective decision-making approach to management. (NH)
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Rennie, Sarah C; van Rij, Andre M; Jaye, Chrystal; Hall, Katherine H
2011-06-01
Decision making is a key competency of surgeons; however, how best to assess decisions and decision makers is not clearly established. The aim of the present study was to identify criteria that inform judgments about surgical trainees' decision-making skills. A qualitative free text web-based survey was distributed to recognized international experts in Surgery, Medical Education, and Cognitive Research. Half the participants were asked to identify features of good decisions, characteristics of good decision makers, and essential factors for developing good decision-making skills. The other half were asked to consider these areas in relation to poor decision making. Template analysis of free text responses was performed. Twenty-nine (52%) experts responded to the survey, identifying 13 categories for judging a decision and 14 for judging a decision maker. Twelve features/characteristics overlapped (considered, informed, well timed, aware of limitations, communicated, knowledgeable, collaborative, patient-focused, flexible, able to act on the decision, evidence-based, and coherent). Fifteen categories were generated for essential factors leading to development of decision-making skills that fall into three major themes (personal qualities, training, and culture). The categories compiled from the perspectives of good/poor were predominantly the inverse of each other; however, the weighting given to some categories varied. This study provides criteria described by experts when considering surgical decisions, decision makers, and development of decision-making skills. It proposes a working definition of a good decision maker. Understanding these criteria will enable clinical teachers to better recognize and encourage good decision-making skills and identify poor decision-making skills for remediation.
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Bollig, Georg; Schmidt, Gerda; Rosland, Jan Henrik; Heller, Andreas
2015-12-01
Many ethical problems exist in nursing homes. These include, for example, decision-making in end-of-life care, use of restraints and a lack of resources. The aim of the present study was to investigate nursing home staffs' opinions and experiences with ethical challenges and to find out which types of ethical challenges and dilemmas occur and are being discussed in nursing homes. The study used a two-tiered approach, using a questionnaire on ethical challenges and systematic ethics work, given to all employees of a Norwegian nursing home including nonmedical personnel, and a registration of systematic ethics discussions from an Austrian model of good clinical practice. Ninety-one per cent of the nursing home staff described ethical problems as a burden. Ninety per cent experienced ethical problems in their daily work. The top three ethical challenges reported by the nursing home staff were as follows: lack of resources (79%), end-of-life issues (39%) and coercion (33%). To improve systematic ethics work, most employees suggested ethics education (86%) and time for ethics discussion (82%). Of 33 documented ethics meetings from Austria during a 1-year period, 29 were prospective resident ethics meetings where decisions for a resident had to be made. Agreement about a solution was reached in all 29 cases, and this consensus was put into practice in all cases. Residents did not participate in the meetings, while relatives participated in a majority of case discussions. In many cases, the main topic was end-of-life care and life-prolonging treatment. Lack of resources, end-of-life issues and coercion were ethical challenges most often reported by nursing home staff. The staff would appreciate systematic ethics work to aid decision-making. Resident ethics meetings can help to reach consensus in decision-making for nursing home patients. In the future, residents' participation should be encouraged whenever possible. © 2015 The Authors. Scandinavian Journal of Caring
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2016-06-15
laws and ethical principles above private gain. (2) Employees shall not hold financial interests that conflict with the conscientious...applying ethical principles to decision-making. We analyze the DA ethics training courses, policies, and procedures. The project explores the...leveraging the Enterprises buying power to obtain goods and services more efficiently. Ms. Lyons earned her Bachelor of Science degree in Accounting in
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Six Challenges for Ethical Conduct in Science.
Niemi, Petteri
2016-08-01
The realities of human agency and decision making pose serious challenges for research ethics. This article explores six major challenges that require more attention in the ethics education of students and scientists and in the research on ethical conduct in science. The first of them is the routinization of action, which makes the detection of ethical issues difficult. The social governance of action creates ethical problems related to power. The heuristic nature of human decision making implies the risk of ethical bias. The moral disengagement mechanisms represent a human tendency to evade personal responsibility. The greatest challenge of all might be the situational variation in people's ethical behaviour. Even minor situational factors have a surprisingly strong influence on our actions. Furthermore, finally, the nature of ethics itself also causes problems: instead of clear answers, we receive a multitude of theories and intuitions that may sometimes be contradictory. All these features of action and ethics represent significant risks for ethical conduct in science. I claim that they have to be managed within the everyday practices of science and addressed explicitly in research ethics education. I analyse them and suggest some ways in which their risks can be alleviated.
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Integrating Ethics across the Curriculum: A Pilot Study to Assess Students' Ethical Reasoning
Willey, Susan L.; Mansfield, Nancy Reeves; Sherman, Margaret B.
2012-01-01
At Georgia State University (GSU), undergraduate and graduate business students are introduced to ethical theory and decision making in the required legal environment of business course, but ethics instruction in the functional areas is sporadic and uncoordinated. After a broad overview of the history of ethics in the business curriculum in Part…
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Ultimate justification: Wittgenstein and medical ethics.
Hughes, J
1995-02-01
Decisions must be justified. In medical ethics various grounds are given to justify decisions, but ultimate justification seems illusory and little considered. The philosopher Wittgenstein discusses the problem of ultimate justification in the context of general philosophy. His comments, nevertheless, are pertinent to ethics. From a discussion of Wittgensteinian notions, such as 'bedrock', the idea that 'ultimate' justification is grounded in human nature as such is derived. This discussion is relevant to medical ethics in at least five ways: it shows generally what type of certainty there is in practical ethics; it seems to imply some objective foundation to our ethical judgements; it squares with our experience of making ethical decisions; it shows something of the nature of moral arguments; and, finally, it has implications for teaching medicine and ethics.
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[The role of epidemiology in the process of decision-making].
Prost, A
1997-01-01
Epidemiology is the method of choice for quantifying and interpreting health phenomena, placing them into perspective to allow trend analysis and projections. It is a tool for analysis, evaluation and forecasting and is thus indispensable in the decision-making process. However, this comprehensive technique has its limitations since health is the result of complex interactions: individual requirements do not always correspond to the overall needs of the community; consideration has to be given to solidarity and the necessity for cost-sharing; and the decision process is strongly influenced by social, cultural, religious and political factors which defy quantification and, on occasion, any rational course of action. Each indicator only takes into account one aspect of the situation and the pertinent indicator should therefore be carefully selected. At the same time, any choice implicitly signifies value judgements-often unnoticed-which need to be balanced and validated in relation to the ethical values of the community in order to be of any assistance to decision-making. Decision-making is a qualitative political process which, although based on the quantitative analysis supplied by epidemiology, cannot be limited to it. Each approach enhance the other, but they should not be confused if freedom to act is to be preserved from being locked into some kind of mechanical process that is unacceptable both to man and to society.
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Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne
2013-10-01
Dealing with socio-scientific issues in science classes enables students to participate productively in controversial discussions concerning ethical topics, such as sustainable development. In this respect, well-structured decision-making processes are essential for elaborate reasoning. To foster decision-making competence, a computer-based programme was developed that trains secondary school students (grades 11-13) in decision-making strategies. The main research question is: does training students to use these strategies foster decision-making competence? In addition, the influence of meta-decision aids was examined. Students conducted a task analysis to select an appropriate strategy prior to the decision-making process. Hence, the second research question is: does combining decision-making training with a task analysis enhance decision-making competence at a higher rate? To answer these questions, 386 students were tested in a pre-post-follow-up control-group design that included two training groups (decision-making strategies/decision-making strategies combined with a task analysis) and a control group (decision-making with additional ecological information instead of strategic training). An open-ended questionnaire was used to assess decision-making competence in situations related to sustainable development. The decision-making training led to a significant improvement in the post-test and the follow-up, which was administered three months after the training. Long-term effects on the quality of the students' decisions were evident for both training groups. Gains in competence when reflecting upon the decision-making processes of others were found, to a lesser extent, in the training group that received the additional meta-decision training. In conclusion, training in decision-making strategies is a promising approach to deal with socio-scientific issues related to sustainable development.
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Decision Making in the Airplane
Orasanu, Judith; Shafto, Michael G. (Technical Monitor)
1995-01-01
The Importance of decision-making to safety in complex, dynamic environments like mission control centers, aviation, and offshore installations has been well established. NASA-ARC has a program of research dedicated to fostering safe and effective decision-making in the manned spaceflight environment. Because access to spaceflight is limited, environments with similar characteristics, including aviation and nuclear power plants, serve as analogs from which space-relevant data can be gathered and theories developed. Analyses of aviation accidents cite crew judgement and decision making as causes or contributing factors in over half of all accidents. Yet laboratory research on decision making has not proven especially helpful In improving the quality of decisions in these kinds of environments. One reason is that the traditional, analytic decision models are inappropriate to multi-dimensional, high-risk environments, and do not accurately describe what expert human decision makers do when they make decisions that have consequences. A new model of dynamic, naturalistic decision making is offered that may prove useful for improving decision making in complex, isolated, confined and high-risk environments. Based on analyses of crew performance in full-mission simulators and accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation. Effective crew decision making and overall performance are mediated by crew communication. Communication contributes to performance because it assures that
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The Idea of 'Ethical Accounting' for a Livestock Farm
DEFF Research Database (Denmark)
Jensen, Karsten Klint; Sørensen, Jan Tind
1998-01-01
This paper presents the idea of a decision-support system for a livestock farm, called “ethical accounting”, to be used as an extension of traditional cost accounting. “Ethical accounting” seeks to make available to the farmer information about how his decisions affect the interests of farm animals......, consumers and future generations. Furthermore, “ethical accounting” involves value-based planning. Thus, the farmer should base his choice of production plan on reflections as to his fundamental objectives, and he should make his final decision only after having seriously considered the various consequences...
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Decision Making Styles and Progress in Occupational Decision Making.
Phillips, Susan D.; And Others
1984-01-01
Examined the role of rational, intuitive, and dependent decisional strategies in facilitating decisions about postcollege occupation among college students (N=71). Results indicated that the use of a dependent decision-making style was the single most powerful predictor of progress. (LLL)
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Directory of Open Access Journals (Sweden)
Leonardo Yuji Tamura
2016-04-01
Full Text Available Quantum Electronics was a Brazilian startup in the 1990's that was acquired by an American equity fund in 2012. They are currently the largest manufacturer of vehicle tracking and infotainment systems. The company was founded by three college friends, who are currently executives at the company: Camilo Santos, Pedro Barbosa and Luana Correa. Edward Hutter was sent by the equity fund to take over the company’s finances, but is having trouble making organizational decisions with his colleagues. As a consultant, I was called to help them improve their decision making process and project prioritization. I adapted and deployed our firm's methodology, but, in the end, its adequacy is shown to be very much in question. The author of this case study intends to explore how actual organizational decisions rely on different decision models and their assumptions, .as well as demonstrate that a decision model is neither absolutely good nor bad as its quality is context dependent.
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Rule-based decision making model
International Nuclear Information System (INIS)
Sirola, Miki
1998-01-01
A rule-based decision making model is designed in G2 environment. A theoretical and methodological frame for the model is composed and motivated. The rule-based decision making model is based on object-oriented modelling, knowledge engineering and decision theory. The idea of safety objective tree is utilized. Advanced rule-based methodologies are applied. A general decision making model 'decision element' is constructed. The strategy planning of the decision element is based on e.g. value theory and utility theory. A hypothetical process model is built to give input data for the decision element. The basic principle of the object model in decision making is division in tasks. Probability models are used in characterizing component availabilities. Bayes' theorem is used to recalculate the probability figures when new information is got. The model includes simple learning features to save the solution path. A decision analytic interpretation is given to the decision making process. (author)
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Photovoltaics in agriculture: A case study on decision making of farmers
International Nuclear Information System (INIS)
Brudermann, Thomas; Reinsberger, Kathrin; Orthofer, Anita; Kislinger, Martin; Posch, Alfred
2013-01-01
This paper aims to identify the success factors, incentives, barriers and challenges in the adoption process of photovoltaics (PV) in the agricultural sector, with particular focus placed on decision making of individual farmers and network effects. We investigated a successful case of an Austrian farmers' association that set up a community power plant concept and a society for facilitating PV adoption among farmers. We found that PV adoption decisions are driven by economic and environmental considerations and that while ethical considerations are relatively strong among farmers, they cannot be used as predictors in the decision making process. Results furthermore suggest that while adoption of PV increases belief in technological progress as a solution to environmental problems, it may simultaneously lead to a weakening in the belief that underlying lifestyle changes are necessary. Our conclusions address crucial aspects of PV adoption in agriculture, and implications for policy measures related to respective community initiatives. - Highlights: • Study on successful community PV adoption case in agriculture. • Bottom-up emergence of institutional agreements as reaction to public subsidies. • Economic and environmental considerations guide decision making of farmers. • PV adoption might change perception of environmental problems. • Policy measures required to cope with potential added-value of private initiatives
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Making the Monday Connection: Teaching Business Ethics in the Congregation.
Van Buren, Harry J., III
1998-01-01
Discusses three factors that have contributed to the decline of eccelsiastical influences on the ethical decisions of Christians in the workplace. Considers the components of a business-ethics curriculum. Outlines one model for both teaching theological/philosophical bases for moral action and providing support groups for business people…
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Spector, J. Michael
2016-01-01
This special issue of "ETR&D" is devoted to ethics in the broad domain of educational technology. Many ethical issues arise involving the study and use of educational technologies. A well-known issue involves the digital divide and the degree to which the introduction of new technologies is increasing the digital divide and…
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Gallagher, Ann; Bousso, Regina Szylit; McCarthy, Joan; Kohlen, Helen; Andrews, Tom; Paganini, Maria Cristina; Abu-El-Noor, Nasser Ibrahim; Cox, Anna; Haas, Margit; Arber, Anne; Abu-El-Noor, Mysoon Khalil; Baliza, Michelle Freire; Padilha, Katia Grillo
2015-04-01
Intensive care units (ICUs) focus on treatment for those who are critically ill and interventions to prolong life. Ethical issues arise when decisions have to be made regarding the withdrawal and withholding of life-sustaining treatment and the shift to comfort and palliative care. These issues are particularly challenging for nurses when there are varying degrees of uncertainty regarding prognosis. Little is known about nurses' end-of-life (EoL) decision-making practice across cultures. To understand nurses' EoL decision-making practices in ICUs in different cultural contexts. We collected and analysed qualitative data using Grounded Theory. Interviews were conducted with experienced ICU nurses in university or hospital premises in five countries: Brazil, England, Germany, Ireland and Palestine. Semi-structured interviews were conducted with 51 nurses (10 in Brazil, 9 in England, 10 in Germany, 10 in Ireland and 12 nurses in Palestine). They were purposefully and theoretically selected to include nurses having a variety of characteristics and experiences concerning end-of-life (EoL) decision-making. The study used grounded theory to inform data collection and analysis. Interviews were facilitated by using key questions. The comparative analysis of the data within and across data generated by the different research teams enabled researchers to develop a deeper understanding of EoL decision-making practices in the ICU. Ethical approval was granted in each of the participating countries and voluntary informed consent obtained from each participant. The core category that emerged was 'negotiated reorienting'. Whilst nurses do not make the 'ultimate' EoL decisions, they engage in two core practices: consensus seeking (involving coaxing, information cuing and voice enabling); and emotional holding (creating time-space and comfort giving). There was consensus regarding the core concept and core practices employed by nurses in the ICUs in the five countries. However
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Decision-Making under Criteria Uncertainty
Kureychik, V. M.; Safronenkova, I. B.
2018-05-01
Uncertainty is an essential part of a decision-making procedure. The paper deals with the problem of decision-making under criteria uncertainty. In this context, decision-making under uncertainty, types and conditions of uncertainty were examined. The decision-making problem under uncertainty was formalized. A modification of the mathematical decision support method under uncertainty via ontologies was proposed. A critical distinction of the developed method is ontology usage as its base elements. The goal of this work is a development of a decision-making method under criteria uncertainty with the use of ontologies in the area of multilayer board designing. This method is oriented to improvement of technical-economic values of the examined domain.
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Management and ethical responsibility
Directory of Open Access Journals (Sweden)
Gašović Milan
2004-01-01
Full Text Available Most authors believe that ethics is set of moral principles and values which leads a person or a group toward what is good or bad. Ethics sets the standards about what is good, and what is bad in behaving and decision making. Principles are the rules or the laws that create ethical codex.
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Hansson, Sven Ove
2017-02-01
Ethicists have investigated ethical problems in other disciplines, but there has not been much discussion of the ethics of their own activities. Research in ethics has many ethical problems in common with other areas of research, and it also has problems of its own. The researcher's integrity is more precarious than in most other disciplines, and therefore even stronger procedural checks are needed to protect it. The promotion of some standpoints in ethical issues may be socially harmful, and even our decisions as to which issues we label as "ethical" may have unintended and potentially harmful social consequences. It can be argued that ethicists have an obligation to make positive contributions to society, but the practical implications of such an obligation are not easily identified. This article provides an overview of ethical issues that arise in research into ethics and in the application of such research. It ends with a list of ten practical proposals for how these issues should be dealt with.
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Nurses' ethical reasoning in cases of physical restraint in acute elderly care: a qualitative study.
Goethals, Sabine; Dierckx de Casterlé, Bernadette; Gastmans, Chris
2013-11-01
In their practice, nurses make daily decisions that are ethically informed. An ethical decision is the result of a complex reasoning process based on knowledge and experience and driven by ethical values. Especially in acute elderly care and more specifically decisions concerning the use of physical restraint require a thoughtful deliberation of the different values at stake. Qualitative evidence concerning nurses' decision-making in cases of physical restraint provided important insights in the complexity of decision-making as a trajectory. However a nuanced and refined understanding of the reasoning process in terms of ethical values is still lacking. A qualitative interview design, inspired by the Grounded Theory approach, was carried out to explore nurses' reasoning process in terms of ethical values. We interviewed 21 acute geriatric nurses from 12 hospitals in different regions in Flanders, Belgium in the period October 2009-April 2011. The Qualitative Analysis Guide of Leuven was used to analyse interview data. Nurses' decision-making is characterized as an ethical deliberation process where different values are identified and where the process of balancing these values forms the essence of ethical deliberation. Ethical decision-making in cases of physical restraint implies that nurses have to choose which values receive priority in the process, which entails that not all values can be respected to the same degree. As a result, decision making can be experienced as difficult, even as a dilemma. Driven by the overwhelming goal of protecting physical integrity, nurses took into account the values of dignity and justice more implicitly and less dominantly.
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Getting public health ethics into practice
Maeckelberghe, Els
2015-01-01
Background Ethics is the philosophical discipline that advises on decision making criteria when difficult choices are to be made. Research has shown over the last years that public health researchers and practitioners ‘must confront numerous ethical choices' but they ‘often feel ill-prepared to make
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S?tfeld, Leon R.; Gast, Richard; K?nig, Peter; Pipa, Gordon
2017-01-01
Self-driving cars are posing a new challenge to our ethics. By using algorithms to make decisions in situations where harming humans is possible, probable, or even unavoidable, a self-driving car's ethical behavior comes pre-defined. Ad hoc decisions are made in milliseconds, but can be based on extensive research and debates. The same algorithms are also likely to be used in millions of cars at a time, increasing the impact of any inherent biases, and increasing the importance of getting it ...
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Burden of Disease Study and Priority Setting in Korea: an Ethical Perspective.
Park, So Youn; Kwon, Ivo; Oh, In Hwan
2016-11-01
When thinking about priority setting in access to healthcare resources, decision-making requires that cost-effectiveness is balanced against medical ethics. The burden of disease has emerged as an important approach to the assessment of health needs for political decision-making. However, the disability adjusted life years approach hides conceptual and methodological issues regarding the claims and value of disabled people. In this article, we discuss ethical issues that are raised as a consequence of the introduction of evidence-based health policy, such as economic evidence, in establishing resource allocation priorities. In terms of ethical values in health priority setting in Korea, there is no reliable rationale for the judgment used in decision-making as well as for setting separate and distinct priorities for different government bodies. An important question, therefore, is which ethical values guiding the practice of decision-making should be reconciled with the economic evidence found in Korean healthcare. The health technology assessment core model from the European network for Health Technology Assessment (EUnetHTA) project is a good example of incorporating ethical values into decision-making. We suggest that a fair distribution of scarce healthcare resources in South Korea can be achieved by considering the ethical aspects of healthcare.
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Cognitive-emotional decision making (CEDM): a framework of patient medical decision making.
Power, Tara E; Swartzman, Leora C; Robinson, John W
2011-05-01
Assistance for patients faced with medical decisions has largely focussed on the clarification of information and personal values. Our aim is to draw on the decision research describing the role of emotion in combination with health behaviour models to provide a framework for conceptualizing patient decisions. A review of the psychological and medical decision making literature concerned with the role of emotion/affect in decision making and health behaviours. Emotion plays an influential role in decision making. Both current and anticipated emotions play a motivational role in choice. Amalgamating these findings with that of Leventhal's (1970) SRM provide a framework for thinking about the influence of emotion on a patient medical decision. Our framework suggests that a patient must cope with four sets of elements. The first two relate to the need to manage the cognitive and emotional aspects of the health threat. The second set relate to the management of the cognitive and emotional elements of the decision, itself. The framework provides a way for practitioners and researchers to frame thinking about a patient medical decision in order to assist the patient in clarifying decisional priorities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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Collective Decision Making as the Actualization of Decision Potential
Directory of Open Access Journals (Sweden)
Andrej Ule
2009-12-01
Full Text Available This paper presents some characteristics and dilemmas of collective decision making. Collective decision making could be presented as the process of successive crystallization of dominant alternatives under the influence of different decision contexts from primary given decision potentials. This process is presented as the many-phased process of the acting of contextually dependent “energizing factors” of the collective decision making on the “attractiveness matrix” of outcomes of collective decisions. The attractiveness matrix determines the attractiveness for each alternative of decision, and the most attractive alternative in the given situation presents the rational decision in the given situation. In the final phase of decision making holds a context which gets a simplified attractiveness matrix. It corresponds to the common decision for one of the alternatives.
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Tools for collaborative decision-making
Zaraté, Pascale
2013-01-01
Decision-making has evolved recently thanks to the introduction of information and communication technologies in many organizations, which has led to new kinds of decision-making processes, called "collaborative decision-making", at the organizational and cognitive levels. This book looks at the development of the decision-making process in organizations. Decision-aiding and its paradigm of problem solving are defined, showing how decision-makers now need to work in a cooperative way. Definitions of cooperation and associated concepts such as collaboration and coordination are given and a framework of cooperative decision support systems is presented, including intelligent DSS, cooperative knowledge-based systems, workflow, group support systems, collaborative engineering, integrating with a collaborative decision-making model in part or being part of global projects. Several models and experimental studies are also included showing that these new processes have to be supported by new types of tools, several ...
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Directory of Open Access Journals (Sweden)
Jane Wilcock
2015-06-01
Full Text Available Aim: To create sustained improvements in medical students’ critical thinking skills through short teaching interventions in pharmacology. Method: The ability to make professional decisions was assessed by providing year-4 medical students at a UK medical school with a novel medical scenario (antenatal pertussis vaccination. Forty-seven students in the 2012 cohort acted as a pretest group, answering a questionnaire on this novel scenario. To improve professional decision-making skills, 48 students from the 2013 cohort were introduced to three commonly used medications, through tutor-led 40-min teaching interventions, among six small groups using a structured presentation of evidence-based medicine and ethical considerations. Student members then volunteered to peer-teach on a further three medications. After a gap of 8 weeks, this cohort (post-test group was assessed for professional decision-making skills using the pretest questionnaire, and differences in the 2-year groups analysed. Results: Students enjoyed presenting on medications to their peers but had difficulty interpreting studies and discussing ethical dimensions; this was improved by contextualising information via patient scenarios. After 8 weeks, most students did not show enhanced clinical curiosity, a desire to understand evidence, or ethical questioning when presented with a novel medical scenario compared to the previous year group who had not had the intervention. Students expressed a high degree of trust in guidelines and expert tutors and felt that responsibility for their own actions lay with these bodies. Conclusion: Short teaching interventions in pharmacology did not lead to sustained improvements in their critical thinking skills in enhancing professional practice. It appears that students require earlier and more frequent exposure to these skills in their medical training.
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Wilcock, Jane; Strivens, Janet
2015-01-01
Aim To create sustained improvements in medical students’ critical thinking skills through short teaching interventions in pharmacology. Method The ability to make professional decisions was assessed by providing year-4 medical students at a UK medical school with a novel medical scenario (antenatal pertussis vaccination). Forty-seven students in the 2012 cohort acted as a pretest group, answering a questionnaire on this novel scenario. To improve professional decision-making skills, 48 students from the 2013 cohort were introduced to three commonly used medications, through tutor-led 40-min teaching interventions, among six small groups using a structured presentation of evidence-based medicine and ethical considerations. Student members then volunteered to peer-teach on a further three medications. After a gap of 8 weeks, this cohort (post-test group) was assessed for professional decision-making skills using the pretest questionnaire, and differences in the 2-year groups analysed. Results Students enjoyed presenting on medications to their peers but had difficulty interpreting studies and discussing ethical dimensions; this was improved by contextualising information via patient scenarios. After 8 weeks, most students did not show enhanced clinical curiosity, a desire to understand evidence, or ethical questioning when presented with a novel medical scenario compared to the previous year group who had not had the intervention. Students expressed a high degree of trust in guidelines and expert tutors and felt that responsibility for their own actions lay with these bodies. Conclusion Short teaching interventions in pharmacology did not lead to sustained improvements in their critical thinking skills in enhancing professional practice. It appears that students require earlier and more frequent exposure to these skills in their medical training. PMID:26051556
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Regulating professional behavior: codes of ethics or law? Suggested criteria.
Libman, Liron A
2013-09-01
This paper suggests considering a few parameters when making policy decisions as to the proper "tool" to regulate professional behavior: law or professional ethics. This is done on the background of understanding the place of codes of professional ethics between "pure" ethics and law. Suggested criteria are then illustrated using a few examples. Further discourse may reveal additional factors to support a more rational process of decision-making in this field.
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Viewpoint: Decision-making in committees
Li Hao; Wing Suen
2009-01-01
This article reviews recent developments in the theory of committee decision-making. A committee consists of self-interested members who make a public decision by aggregating imperfect information dispersed among them according to a pre-specified decision rule. We focus on costly information acquisition, strategic information aggregation, and rules and processes that enhance the quality of the committee decision. Seeming inefficiencies of the committee decision-making process such as over-cau...
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Tactical decision making under stress (TADMUS) decision support system
Morrison, Jeffrey G.; Kelly, Richard T.; Moore, Ronald A.; Hutchins, Susan G.
1996-01-01
A prototype decision support system (DSS) was developed to enhance Navy tactical decision making based on naturalistic decision processes. Displays were developed to support critical decision making tasks through recognition-primed and explanation-based reasoning processes and cognitive analysis of the decision making problems faced by Navy tactical officers in a shipboard Combat Information Center. Baseline testing in high intensity, peace keeping, littoral scenarios indicated...
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Ethical Issues in Public Health Practice in Michigan
Gollust, Sarah E.; Goold, Susan D.; Jacobson, Peter D.
2009-01-01
Objectives. We sought to ascertain the types of ethical challenges public health practitioners face in practice and to identify approaches used to resolve such challenges. Methods. We conducted 45 semistructured interviews with public health practitioners across a range of occupations (e.g., health officers, medical directors, sanitarians, nurses) at 13 health departments in Michigan. Results. Through qualitative analysis, we identified 5 broad categories of ethical issues common across occupations and locations: (1) determining appropriate use of public health authority, (2) making decisions related to resource allocation, (3) negotiating political interference in public health practice, (4) ensuring standards of quality of care, and (5) questioning the role or scope of public health. Participants cited a variety of values guiding their decision-making that did not coalesce around core values often associated with public health, such as social justice or utilitarianism. Public health practitioners relied on consultations with colleagues to resolve challenges, infrequently using frameworks for decision-making. Conclusions. Public health practitioners showed a nuanced understanding of ethical issues and navigated ethical challenges with minimal formal assistance. Decision-making guides that are empirically informed and tailored for practitioners might have some value. PMID:19059850
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de Groot, Niels; Antonsson, Jimmy
2012-01-01
Business ethics is a fragmented and well covered scientific field. This Master thesis study concerns two type of organizations, namely family businesses (FB’s) and venture capital firms (VCF’s), in relation to the ethical decision-making process, which is a relatively undiscovered field. The study is conducted in the way it sheds a light on the influences on a manager when taking decisions concerning ethical considerations. Important scholars such as Colby and Kohlberg (1987) and Rest et al. ...
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Leadership and Moral Imagination: Beyond the Decision-making Context
Directory of Open Access Journals (Sweden)
Alan Preti
2014-12-01
Full Text Available Moral imagination is often viewed as a necessary condition for ethical leadership on account of its role in managerial decision-making and organizational management. This article argues that an extension of the notion beyond this limited context sheds light on recent reconceptualizations of the nature of business and the relation of business and society proffered by several well-known business leaders. It is suggested that an account of moral imagination which takes into consideration its contribution to the development of a morally deeper and broader perspective and its bearing on character is of particular value for business leaders.
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A basic decision-making approach to common ethical issues in consultation-liaison psychiatry.
Wright, Mark T; Roberts, Laura Weiss
2009-06-01
Ethical dilemmas are found throughout the daily work of C-L psychiatrists. Unfortunately, most psychiatrists have no more training in ethics than their nonpsychiatric colleagues. Psychiatric consults spurred by ethical dilemmas can provoke anxiety in psychiatrists and leave anxious colleagues without the clear recommendations they seek. C-L psychiatrists, and probably all psychiatrists, need more training in clinical ethics. C-L psychiatrists do not need to become clinical ethicists, but competence in handling the ethical issues most commonly seen in C-L work is needed. The 2008 ABPN guidelines for specialists in psychosomatic medicine mention specific ethics topics important in C-L work, and ways of attaining competence in these areas have been discussed in the C-L literature. The four cases discussed here illustrate the high level of complexity often seen in situations in which ethical dilemmas arise in C-L psychiatry. Given the sometimes furious pace of hospital work, it can be easy for C-L psychiatrists to be seduced by the idea of the quick, focused consult that simply responds to a simple question with a simple answer. Because cases involving ethical dilemmas often involve multiple stakeholders, each with his or her own set of concerns, a brief consult focused only on the patient often leads to errors of omission. A wider approach, such as that suggested by the Four Topics Method, is needed to successfully negotiate ethical dilemmas. Busy C-L psychiatry services may struggle at first to find the time to do the type of global evaluations discussed here, but increasing familiarity with approaches such as the Four Topics Method should lead to quicker ways of gathering and processing the needed information.
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From Career Decision-Making Styles to Career Decision-Making Profiles: A Multidimensional Approach
Gati, Itamar; Landman, Shiri; Davidovitch, Shlomit; Asulin-Peretz, Lisa; Gadassi, Reuma
2010-01-01
Previous research on individual differences in career decision-making processes has often focused on classifying individuals into a few types of decision-making "styles" based on the most dominant trait or characteristic of their approach to the decision process (e.g., rational, intuitive, dependent; Harren, 1979). In this research, an…
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Ethics and Ethical Theories from an Islamic Perspective
Directory of Open Access Journals (Sweden)
AL-HASAN AL-AIDAROS
2013-12-01
Full Text Available With the collapse of many organizations, many researchers are increasingly paying attention to such phenomenon. But ethical issues are not always clear cut; there are many grey areas that need to be threaded with care by organizations. To determine whether an action or decision is ethically carried out, ethical theories, developed mainly by Western scholars, are the current theoretical framework organizations have at their disposal. Theories such as relativism, utilitarianism, egoism, deontology, the divine command theory, and the virtue ethics, are all products of Western understanding of what ethics are and how they are applicable to help one’s decision making process. Despite their utility, this paper intends to argue that the Western concepts and understanding of what ethics are limited and incomprehensive in explaining what is right and what is wrong. In its place, this paper argues that to understand the concepts of ethics that can extend beyond time and space. It has to be analysed from an Islamic perspective. Toward this purpose, this paper will compare and contrast between Islamic and Western perspectives of ethics, and highlight the main weaknesses and limitations of the former. Then, an argument on why Islam can provide the best understanding of ethics will be made.
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Implications of Decision Making Research for Decision Support and Displays
Morrison, Jeffrey G.; Kelly, Richard T.; Moore, Ronald A.; Hutchins, Susan G.
1998-01-01
To appear in J. A. Cannon-Bowers & E. Salas (Eds.), Decision Making Under Stress: Implications for Training and Simulation. A prototype decision support system (DSS) was developed to enhance Navy tactical decision making based on naturalistic decision processes. Displays were developed to support critical decision making tasks through recognition-primed and explanation-based reasoning processes, and cognitive analysis was conducted of the decision making problems faced by Navy ...
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The amygdala and decision-making.
Gupta, Rupa; Koscik, Timothy R; Bechara, Antoine; Tranel, Daniel
2011-03-01
Decision-making is a complex process that requires the orchestration of multiple neural systems. For example, decision-making is believed to involve areas of the brain involved in emotion (e.g., amygdala, ventromedial prefrontal cortex) and memory (e.g., hippocampus, dorsolateral prefrontal cortex). In this article, we will present findings related to the amygdala's role in decision-making, and differentiate the contributions of the amygdala from those of other structurally and functionally connected neural regions. Decades of research have shown that the amygdala is involved in associating a stimulus with its emotional value. This tradition has been extended in newer work, which has shown that the amygdala is especially important for decision-making, by triggering autonomic responses to emotional stimuli, including monetary reward and punishment. Patients with amygdala damage lack these autonomic responses to reward and punishment, and consequently, cannot utilize "somatic marker" type cues to guide future decision-making. Studies using laboratory decision-making tests have found deficient decision-making in patients with bilateral amygdala damage, which resembles their real-world difficulties with decision-making. Additionally, we have found evidence for an interaction between sex and laterality of amygdala functioning, such that unilateral damage to the right amygdala results in greater deficits in decision-making and social behavior in men, while left amygdala damage seems to be more detrimental for women. We have posited that the amygdala is part of an "impulsive," habit type system that triggers emotional responses to immediate outcomes. Copyright © 2010 Elsevier Ltd. All rights reserved.
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The Ethics of Archival Research
McKee, Heidi A.; Porter, James E.
2012-01-01
What are the key ethical issues involved in conducting archival research? Based on examination of cases and interviews with leading archival researchers in composition, this article discusses several ethical questions and offers a heuristic to guide ethical decision making. Key to this process is recognizing the person-ness of archival materials.…
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van Otterlo, Martijn
2017-01-01
Ethics of algorithms is an emerging topic in various disciplines such as social science, law, and philosophy, but also artificial intelligence (AI). The value alignment problem expresses the challenge of (machine) learning values that are, in some way, aligned with human requirements or values. In this paper I argue for looking at how humans have formalized and communicated values, in professional codes of ethics, and for exploring declarative decision-theoretic ethical programs (DDTEP) to fo...
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Kretzschmar, Louise; Bentley, Wessel
2013-01-01
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 dile...
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Ethics in Christianity and health care: can "character" be defined in this interdisciplinary course?
Broeseker, A E
1999-04-01
To describe a unique interdisciplinary ethics course that incorporates elements of character into a decision-making model. The Ethics in Christianity and Health Care course is divided into two sections: ethics in Christianity and ethics in health care. The first section comprises the initial 30% of the course, and the second portion spans the latter 70%. Character traits of ethical persons are described in the second section of the course and are then used in an adapted decision-making model. A scenario from a nontraditional Doctor of Pharmacy student is included to illustrate this decision-making process. Texts, assignments, and assessments are also discussed briefly. This course provides a framework within which ethical relationships are described and discussed. The character traits delineated in the article offer a logical approach when solving ethical dilemmas.
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Knowledge, decision making, and uncertainty
International Nuclear Information System (INIS)
Fox, J.
1986-01-01
Artificial intelligence (AI) systems depend heavily upon the ability to make decisions. Decisions require knowledge, yet there is no knowledge-based theory of decision making. To the extent that AI uses a theory of decision-making it adopts components of the traditional statistical view in which choices are made by maximizing some function of the probabilities of decision options. A knowledge-based scheme for reasoning about uncertainty is proposed, which extends the traditional framework but is compatible with it
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Modelling decision-making by pilots
Patrick, Nicholas J. M.
1993-01-01
Our scientific goal is to understand the process of human decision-making. Specifically, a model of human decision-making in piloting modern commercial aircraft which prescribes optimal behavior, and against which we can measure human sub-optimality is sought. This model should help us understand such diverse aspects of piloting as strategic decision-making, and the implicit decisions involved in attention allocation. Our engineering goal is to provide design specifications for (1) better computer-based decision-aids, and (2) better training programs for the human pilot (or human decision-maker, DM).
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Breaking Bad: The Efficacy of Ethics Education in Air Force Officer PME
2015-02-12
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
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Nurses' contributions to the resolution of ethical dilemmas in practice.
Barlow, Nichola Ann; Hargreaves, Janet; Gillibrand, Warren P
2018-03-01
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
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Self-Esteem in Decision Making and Decision-Making Styles of Teachers
Temel, Veysel; Birol, Sefa Sahan; Nas, Kazim; Akpinar, Selahattin; Tekin, Murat
2015-01-01
The aim of the study was to examine the self-esteem in decision-making and decision-making styles of the teachers in various branches of Çat town of Erzurum Province, Turkey in terms of some variables in 2014-2015 year. A total of 153 teachers (84 females and 69 males) (age (? = 1.6536 ± 0.72837) from different departments participated in the…
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Shared decision-making in neonatology: an utopia or an attainable goal?
D'Aloja, Ernesto; Floris, Laura; Muller, Mima; Birocchi, Francesca; Fanos, Vassilios; Paribello, Francesco; Demontis, Roberto
2010-10-01
Medical decision making is sometimes considered as a relatively simple process in which a decision may be made by the physician, by the patient, or by both patient and physician working together. There are three main models of decision making--paternalism, patient informed choice, and shared decision-making (SDM), having each one of these drawbacks and limitations. Historically, the most adopted one was the paternalism (strongly 'Doctor knows best'), where the professional made the decision based on what he/she considered to be as the patient's best interest, not necessarily contemplating patient's will and wishes. Currently, at the antipodes, the patient informed choice, where the patient makes his/her decision based on information received from the physician with no possible interference of professional's own preferences, seems to be the preferred relationship standard. SDM represents an intermediate approach between the two above-mentioned opposite models, being a medical process that involves actively the doctor and the patient who both bring their own facts and preferences to reach an agreement on the decision on if, when and how to treat a disease. This model, being characterized by elements pertaining to both the others, is gaining popularity in several medical and surgical scenarios whenever a competent patient is able to actively participate into the decisional process. On this basis can this model be implemented also in a Neonatology Intensive Care Unit where little patients are--by nature--incompetent, being the diagnostic/therapeutic choices taken by parents? We focused on this complex item considering four possible different scenarios and it seems to us that it could be possible to introduce such an approach, providing that parents' empowerment, a good physician's communication skill and consideration of all cultural, religious, economic, and ethic values of every single actor have been fairly taken into account.
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Ethical Issues in the Mental Health Treatment of Gender Dysphoric Adolescents.
Swann, Stephanie; Herbert, Sarah E.
1999-01-01
Examines ethical dilemmas arising when treating adolescents with gender dysphoria, discussing ethical and legal issues pertinent to treating any adolescent and highlighting gender dysphoric adolescents. Reviews legal decisions, existing data on adolescent decision making, and ethical principles for resolving complex situations. Illustrates ethical…
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Decision-Making Based on Emotional Images
Katahira, Kentaro; Fujimura, Tomomi; Okanoya, Kazuo; Okada, Masato
2011-01-01
The emotional outcome of a choice affects subsequent decision making. While the relationship between decision making and emotion has attracted attention, studies on emotion and decision making have been independently developed. In this study, we investigated how the emotional valence of pictures, which was stochastically contingent on participants’ choices, influenced subsequent decision making. In contrast to traditional value-based decision-making studies that used money or food as a reward...
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Decision making based on emotional images
Kentaro eKatahira; Kentaro eKatahira; Kentaro eKatahira; Tomomi eFujimura; Tomomi eFujimura; Kazuo eOkanoya; Kazuo eOkanoya; Kazuo eOkanoya; Masato eOkada; Masato eOkada; Masato eOkada
2011-01-01
The emotional outcome of a choice affects subsequent decision making. While the relationship between decision making and emotion has attracted attention, studies on emotion and decision making have been independently developed. In this study, we investigated how the emotional valence of pictures, which was stochastically contingent on participants’ choices, influenced subsequent decision making. In contrast to traditional value-based decision-making studies that used money or food as a reward...
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Supportive Care: Communication Strategies to Improve Cultural Competence in Shared Decision Making.
Brown, Edwina A; Bekker, Hilary L; Davison, Sara N; Koffman, Jonathan; Schell, Jane O
2016-10-07
Historic migration and the ever-increasing current migration into Western countries have greatly changed the ethnic and cultural patterns of patient populations. Because health care beliefs of minority groups may follow their religion and country of origin, inevitable conflict can arise with decision making at the end of life. The principles of truth telling and patient autonomy are embedded in the framework of Anglo-American medical ethics. In contrast, in many parts of the world, the cultural norm is protection of the patient from the truth, decision making by the family, and a tradition of familial piety, where it is dishonorable not to do as much as possible for parents. The challenge for health care professionals is to understand how culture has enormous potential to influence patients' responses to medical issues, such as healing and suffering, as well as the physician-patient relationship. Our paper provides a framework of communication strategies that enhance crosscultural competency within nephrology teams. Shared decision making also enables clinicians to be culturally competent communicators by providing a model where clinicians and patients jointly consider best clinical evidence in light of a patient's specific health characteristics and values when choosing health care. The development of decision aids to include cultural awareness could avoid conflict proactively, more productively address it when it occurs, and enable decision making within the framework of the patient and family cultural beliefs. Copyright © 2016 by the American Society of Nephrology.
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Shared decision making in Brazil: history and current discussion.
Abreu, Mirhelen Mendes de; Battisti, Raphael; Martins, Rachel Samhan; Baumgratz, Thiago Dias; Cuziol, Mirella
2011-01-01
There is no SDM in clinical practice in Brazil. The first steps have been taken towards research and tool development recently. Likewise, our society is starting to get involved with decision making in health care. This paper aims to offer an overview of the Brazilian health system history, its values, and its influence on SDM. The participative social control concept is introduced as a result of the movement against the dictatorship era. In addition, the influence of social changes on the Medical Ethical Code is delineated. SDM state of the art in Brazil is also discussed and the challenges to implement it on clinical practice are described. Regardless the challenges, it is possible to make a positive assessment of SDM in Brazil. 2011. Published by Elsevier GmbH.
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Perceived risks around choice and decision making at end-of-life: a literature review.
Wilson, F; Gott, M; Ingleton, C
2013-01-01
the World Health Organization identifies meeting patient choice for care as central to effective palliative care delivery. Little is known about how choice, which implies an objective balancing of options and risks, is understood and enacted through decision making at end-of-life. to explore how perceptions of 'risk' may inform decision-making processes at end-of-life. an integrative literature review was conducted between January and February 2010. Papers were reviewed using Hawker et al.'s criteria and evaluated according to clarity of methods, analysis and evidence of ethical consideration. All literature was retained as background data, but given the significant international heterogeneity the final analysis specifically focused on the UK context. the databases Medline, PsycINFO, Assia, British Nursing Index, High Wire Press and CINAHL were explored using the search terms decision*, risk, anxiety, hospice and palliative care, end-of-life care and publication date of 1998-2010. thematic analysis of 25 papers suggests that decision making at end-of-life is multifactorial, involving a balancing of risks related to caregiver support; service provider resources; health inequalities and access; challenges to information giving; and perceptions of self-identity. Overall there is a dissonance in understandings of choice and decision making between service providers and service users. the concept of risk acknowledges the factors that shape and constrain end-of-life choices. Recognition of perceived risks as a central factor in decision making would be of value in acknowledging and supporting meaningful decision making processes for patients with palliative care needs and their families.
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Constraint programming and decision making
Kreinovich, Vladik
2014-01-01
In many application areas, it is necessary to make effective decisions under constraints. Several area-specific techniques are known for such decision problems; however, because these techniques are area-specific, it is not easy to apply each technique to other applications areas. Cross-fertilization between different application areas is one of the main objectives of the annual International Workshops on Constraint Programming and Decision Making. Those workshops, held in the US (El Paso, Texas), in Europe (Lyon, France), and in Asia (Novosibirsk, Russia), from 2008 to 2012, have attracted researchers and practitioners from all over the world. This volume presents extended versions of selected papers from those workshops. These papers deal with all stages of decision making under constraints: (1) formulating the problem of multi-criteria decision making in precise terms, (2) determining when the corresponding decision problem is algorithmically solvable; (3) finding the corresponding algorithms, and making...
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Fischer, Sophia; Soyez, Katja; Gurtner, Sebastian
2015-05-01
Research testing the concept of decision-making styles in specific contexts such as health care-related choices is missing. Therefore, we examine the contextuality of Scott and Bruce's (1995) General Decision-Making Style Inventory with respect to patient choice situations. Scott and Bruce's scale was adapted for use as a patient decision-making style inventory. In total, 388 German patients who underwent elective joint surgery responded to a questionnaire about their provider choice. Confirmatory factor analyses within 2 independent samples assessed factorial structure, reliability, and validity of the scale. The final 4-dimensional, 13-item patient decision-making style inventory showed satisfactory psychometric properties. Data analyses supported reliability and construct validity. Besides the intuitive, dependent, and avoidant style, a new subdimension, called "comparative" decision-making style, emerged that originated from the rational dimension of the general model. This research provides evidence for the contextuality of decision-making style to specific choice situations. Using a limited set of indicators, this report proposes the patient decision-making style inventory as valid and feasible tool to assess patients' decision propensities. © The Author(s) 2015.
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Research on self-esteem in decision-making and decision-making styles in orienteering athletes
Eroğlu Başak; Özkan Zekiye; Eroğlu Arif Kaan; Bilgin Şakire
2016-01-01
The aim of this study is to examine the self-esteem in decision making and decision-making styles of orienteering athletes in terms of different variables. 157 male and 43 female orienteering athletes, making a total of 200 athletes that joined the 3rd Level of Turkey Championship in 2015 have participated in this study which is in a survey model. The data collection tools were the Melbourne Decision-making. Quastionnaire I-II and the Personal Information Form which were adapted into Turkish ...
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Role of affect in decision making.
Bandyopadhyay, Debarati; Pammi, V S Chandrasekhar; Srinivasan, Narayanan
2013-01-01
Emotion plays a major role in influencing our everyday cognitive and behavioral functions, including decision making. We introduce different ways in which emotions are characterized in terms of the way they influence or elicited by decision making. This chapter discusses different theories that have been proposed to explain the role of emotions in judgment and decision making. We also discuss incidental emotional influences, both long-duration influences like mood and short-duration influences by emotional context present prior to or during decision making. We present and discuss results from a study with emotional pictures presented prior to decision making and how that influences both decision processes and postdecision experience as a function of uncertainty. We conclude with a summary of the work on emotions and decision making in the context of decision-making theories and our work on incidental emotions. Copyright © 2013 Elsevier B.V. All rights reserved.
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Directory of Open Access Journals (Sweden)
Jonathan D. Santoro
2018-04-01
Full Text Available Background: This manuscript reviews unique aspects of end of life decision-making in pediatrics. Methods: A narrative literature review of pediatric end of life issues was performed in the English language. Results: While a paternalistic approach is typically applied to children with life-limiting medical prognoses, the cognitive, language, and physical variability in this patient population is wide and worthy of review. In end of life discussions in pediatrics, the consideration of a child’s input is often not reviewed in depth, although a shared decision-making model is ideal for use, even for children with presumed limitations due to age. This narrative review of end of life decision-making in pediatric care explores nomenclature, the introduction of the concept of death, relevant historical studies, limitations to the shared decision-making model, the current state of end of life autonomy in pediatrics, and future directions and needs. Although progress is being made toward a more uniform and standardized approach to care, few non-institutional protocols exist. Complicating factors in the lack of guidelines include the unique facets of pediatric end of life care, including physical age, paternalism, the cognitive and language capacity of patients, subconscious influencers of parents, and normative values of death in pediatrics. Conclusions: Although there have been strides in end of life decision-making in pediatrics, further investigation and research is needed in this field.
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Santoro, Jonathan D; Bennett, Mariko
2018-04-26
Background: This manuscript reviews unique aspects of end of life decision-making in pediatrics. Methods: A narrative literature review of pediatric end of life issues was performed in the English language. Results: While a paternalistic approach is typically applied to children with life-limiting medical prognoses, the cognitive, language, and physical variability in this patient population is wide and worthy of review. In end of life discussions in pediatrics, the consideration of a child’s input is often not reviewed in depth, although a shared decision-making model is ideal for use, even for children with presumed limitations due to age. This narrative review of end of life decision-making in pediatric care explores nomenclature, the introduction of the concept of death, relevant historical studies, limitations to the shared decision-making model, the current state of end of life autonomy in pediatrics, and future directions and needs. Although progress is being made toward a more uniform and standardized approach to care, few non-institutional protocols exist. Complicating factors in the lack of guidelines include the unique facets of pediatric end of life care, including physical age, paternalism, the cognitive and language capacity of patients, subconscious influencers of parents, and normative values of death in pediatrics. Conclusions: Although there have been strides in end of life decision-making in pediatrics, further investigation and research is needed in this field.
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Narrative ethics for narrative care.
Baldwin, Clive
2015-08-01
Narrative permeates health care--from patients' stories taken as medical histories to the development of health policy. The narrative approach to health care has involved the move from narratives in health care as objects of study to the lens through which health care is studied and, more recently, to narrative as a form of care. In this paper, I argue that narrative care requires a move in the field of ethics--from a position where narratives are used to inform ethical decision making to one in which narrative is the form and process of ethical decision making. In other words, I argue for a narrative ethics for narrative care. The argument is relatively straightforward. If, as I argue, humans are narrative beings who make sense of themselves, others, and the world in and through narrative, we need to see our actions as both narratively based and narratively contextual and thus understanding the nature, form, and content of the narratives of which we are a part, and the process of narrativity, provides an intersubjective basis for ethical action. Copyright © 2015 Elsevier Inc. All rights reserved.
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The Self in Decision Making and Decision Implementation.
Beach, Lee Roy; Mitchell, Terence R.
Since the early 1950's the principal prescriptive model in the psychological study of decision making has been maximization of Subjective Expected Utility (SEU). This SEU maximization has come to be regarded as a description of how people go about making decisions. However, while observed decision processes sometimes resemble the SEU model,…
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Who should make the decision on the use of GPS for people with dementia?
Landau, Ruth; Auslander, Gail K; Werner, Shirli; Shoval, Noam; Heinik, Jeremia
2011-01-01
In recent years advanced technologies, such as Global Positioning Systems (GPS), allow for tracking of human spatial activity and provide the ability to intervene to manage that activity. The purpose of this study is to examine the issue of who should decide about the use of electronic tracking using GPS for people with dementia. Based on quantitative data collected from 296 participants comprising cognitively intact elderly, family caregivers of people with dementia, social workers, other professionals, and social work students, study participants were asked to rate nine different potential decision-makers to make this decision. The results show that figures inside the family, particularly the spouse or the most involved family caregiver, were perceived more important in the decision-making process than figures outside the family, whereas the person with dementia was ranked third in the order of the figures. Since the decision to use GPS for tracking raises the ethical dilemma of personal safety versus autonomy and privacy of people with dementia, the findings seem to indicate that the reluctance of professional caregivers to assist family caregivers to make this decision is experienced as frustrating. The findings imply that in order to reach a balance between the wishes and interests of both people with dementia and their family caregivers, there is a need for more active involvement of the professional caregivers to facilitate the family decision-making process.
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Dall, Sasha R. X.; Gosling, Samuel; Gordon D.A., Brown,; Dingemanse, Niels; Ido, Erev,; Martin, Kocher,; Laura, Schulz,; Todd, Peter M; Weissing, Franz; Wolf, Max; Hammerstein, Peter; Stevens, Jeffrey R.
2012-01-01
Variation in how organisms allocate their behavior over their lifetimes is key to determining Darwinian fitness., and thus the evolution of human and nonhuman decision making. This chapter explores how decision making varies across biologically and societally significant scales and what role such
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The Evolution of Social Work Ethics.
Reamer, Frederic G.
1998-01-01
Traces the evolution of ethical norms, principles, and standards in social work during four stages in the profession's history: (1) morality period, (2) values period, (3) ethical theory and decision-making period, and (4) ethical standards and risk-management period. Recent developments in the profession include complex conceptual frameworks and…
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Current Debates on Variability in Child Welfare Decision-Making: A Selected Literature Review
Directory of Open Access Journals (Sweden)
Emily Keddell
2014-11-01
Full Text Available This article considers selected drivers of decision variability in child welfare decision-making and explores current debates in relation to these drivers. Covering the related influences of national orientation, risk and responsibility, inequality and poverty, evidence-based practice, constructions of abuse and its causes, domestic violence and cognitive processes, it discusses the literature in regards to how each of these influences decision variability. It situates these debates in relation to the ethical issue of variability and the equity issues that variability raises. I propose that despite the ecological complexity that drives decision variability, that improving internal (within-country decision consistency is still a valid goal. It may be that the use of annotated case examples, kind learning systems, and continued commitments to the social justice issues of inequality and individualisation can contribute to this goal.
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The Effect of Decision-Making Skill Training Programs on Self-Esteem and Decision-Making Styles
Colakkadioglu, Oguzhan; Celik, D. Billur
2016-01-01
Problem Statement: Decision making is a critical cognitive process in every area of human life. In this process, the individuals play an active role and obtain outputs with their functional use of decision-making skills. Therefore, the decision-making process can affect the course of life, life satisfaction, and the social relations of an…
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Directory of Open Access Journals (Sweden)
Szymaniec-Mlicka Karolina
2017-05-01
Full Text Available The decisions made in the organization determine its success, therefore, conducting studies in the scope of decision-making seems important both for theory and practice. The aim of the studies was to identify the type of decision-making process in public medical entities with the use of typology developed by P. Nutt. For this purpose we used qualitative methods. Interviews with 8 directors of hospitals were conducted and the reconstruction was made on the basis of the decision-making process, which enabled the assignment of the model of decision-making process to the organization. The research indicated that four organizations use the historical decision-making model, three organizations represent the model of generating solutions, and one organization uses the model of available solutions.
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CRITICAL ANALYSIS OF THE RELIABILITY OF INTUITIVE MORAL DECISIONS
Directory of Open Access Journals (Sweden)
V. V. Nadurak
2017-06-01
Full Text Available Purpose of the research is a critical analysis of the reliability of intuitive moral decisions. Methodology. The work is based on the methodological attitude of empirical ethics, involving the use of findings from empirical research in ethical reflection and decision making. Originality. The main kinds of intuitive moral decisions are identified: 1 intuitively emotional decisions (i.e. decisions made under the influence of emotions that accompanies the process of moral decision making; 2 decisions made under the influence of moral risky psychological aptitudes (unconscious human tendencies that makes us think in a certain way and make decisions, unacceptable from the logical and ethical point of view; 3 intuitively normative decisions (decisions made under the influence of socially learned norms, that cause evaluative feeling «good-bad», without conscious reasoning. It was found that all of these kinds of intuitive moral decisions can lead to mistakes in the moral life. Conclusions. Considering the fact that intuition systematically leads to erroneous moral decisions, intuitive reaction cannot be the only source for making such decisions. The conscious rational reasoning can compensate for weaknesses of intuition. In this case, there is a necessity in theoretical model that would structure the knowledge about the interactions between intuitive and rational factors in moral decisions making and became the basis for making suggestions that would help us to make the right moral decision.
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Energy Technology Data Exchange (ETDEWEB)
Korff, W
1979-01-01
The investigation was born by a concrete challenge. In the decision conflict regarding the project in Wyhl/Oberrhein, the theologic ethic was asked for his opinion. As the present ethical theory has only few strategies concerning efficiency and performance, the author turned to the traditional models to find some points of view there. Here is the main point of the investigation: in the emphasizing of general criteria which make a reasonable, i.e. controllable decision possible; not really in the concrete individual results to which the application from the preconditions taken into consideration leads.
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A New Interlink Decision Making Index for Making Multi-criteria Decision
Directory of Open Access Journals (Sweden)
Eric Hu
2012-11-01
Full Text Available Multi-criteria decisions usually require measurement or evaluation of performance in different units and their mix by application of weighting factors. This approach lads to potential manipulation of the results as a direct consequence of the applied weightings. In this paper a mechanism that is the brain child of the authors, has been proposed to overcome this problem. It is known as the Interlink Decision Making Index (IDMI and has all the desired features: simple, interlink (all criteria and automatically guaranteed dominant influence of critical criteria (i.e. no human weighting needed. The IDMI is capable of reflecting the total merits of a particular option once the normal decision making criteria and (up to two critical criteria have been chosen. Then, without arbitrarily weighting criteria, comparison and selection of the best possible option can be made. Simple software has been developed to do this numerical transfer and graphic presentation. Two hypothetical examples are presented in the paper to demonstrate the application of the IDMI concept and its advantages over the traditional "tabular and weightingmethod" in the decision making process.
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Ethical decision-making climate in the ICU
DEFF Research Database (Denmark)
Van den Bulcke, Bo; Piers, Ruth; Jensen, Hanne Irene
2018-01-01
measurement of seven facets of the extent to which clinicians perceive an EDM climate: self-reflective and empowering leadership by physicians; practice and culture of open interdisciplinary reflection; culture of not avoiding end-of-life decisions; culture of mutual respect within the interdisciplinary team...
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Optimising Transport Decision Making using Customised Decision Models and Decision Conferences
DEFF Research Database (Denmark)
Barfod, Michael Bruhn
The subject of this Ph.D. thesis entitled “Optimising Transport Decision Making using Customised Decision Models and Decision Conferences” is multi-criteria decision analysis (MCDA) and decision support in the context of transport infrastructure assessments. Despite the fact that large amounts...... is concerned with the insufficiency of conventional cost-benefit analysis (CBA), and proposes the use of MCDA as a supplementing tool in order to also capture impacts of a more strategic character in the appraisals and hence make more use of the often large efforts put in the preliminary examinations. MCDA...... and rail to bike transport projects. Two major concerns have been to propose an examination process that can be used in situations where complex decision problems need to be addressed by experts as well as non-experts in decision making, and to identify appropriate assessment techniques to be used...
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Collaborative Decision Making in METOC
2002-01-01
desired effect (Eagly, & Chaiken, 1993). Arguably, artificial intelligence is representative of the best of approaches in rational decision - making ...2001), The quantum of social action and the function of emotion in decision - making , Emotional and Intelligent II: The Tangled Knot of Social...Collaborative decision making in METOC W.F. Lawless Paine College, Departments of Mathematics and Psychology Augusta, GA 30901-3182 ph: 706
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Perez, Maya; Gati, Itamar
2017-01-01
We tested the associations among the career decision-making difficulties, the career decision status, and either (a) the career decision-making profiles of 575 young adults, or (b) the coping strategies of 379 young adults. As hypothesized, a more advanced decision status was negatively associated with both career decision-making difficulties…
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Relationship between ethical ideology and moral judgment: Academic nurse educators' perception.
Abou Hashish, Ebtsam Aly; Ali Awad, Nadia Hassan
2017-01-01
Ascertaining the relationship between ethical ideology, moral judgment, and ethical decision among academic nurse educators at work appears to be a challenge particularly in situations when they are faced with a need to solve an ethical problem and make a moral decision. This study aims to investigate the relationship between ethical ideology, moral judgment, and ethical decision as perceived by academic nurse educators. A descriptive correlational research design was conducted at Faculty of Nursing, Alexandria University. All academic nurse educators were included in the study (N = 220). Ethical Position Questionnaire and Questionnaire of Moral Judgment and Ethical Decisions were proved reliable to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects' informed consent. This study reveals a significant positive moderate correlation between idealism construct of ethical ideology and moral judgment in terms of recognition of the behavior as an ethical issue and the magnitude of emotional consequences of the ethical situation (p relativism construct of ethical ideology and overall moral judgment (p = 0.010). Approximately 3.5% of the explained variance of overall moral judgment is predicted by idealism together with relativism. The findings suggest that variations in ethical position and ideology are associated with moral judgment and ethical decision. Organizations of academic nursing education should provide a supportive work environment to help their academic staff to develop their self-awareness and knowledge of their ethical position and promoting their ethical ideologies and, in turn, enhance their moral judgment as well as develop ethical reasoning and decision-making capability of nursing students. More emphasis in nursing curricula is needed on ethical concepts for developing nursing
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Decision-making: Theory and Practice
CSIR Research Space (South Africa)
Turpin, SM
2004-01-01
Full Text Available of decision support technology. Much variation was found in people’s personal decision-making styles. However, some central themes emerged, such as the importance of sensitivity to the decision-making context, attention to the presentation of information...
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Serotonin and decision making processes.
Homberg, Judith R
2012-01-01
Serotonin (5-HT) is an important player in decision making. Serotonergic antidepressant, anxiolytic and antipsychotic drugs are extensively used in the treatment of neuropsychiatric disorders characterized by impaired decision making, and exert both beneficial and harmful effects in patients. Detailed insight into the serotonergic mechanisms underlying decision making is needed to strengthen the first and weaken the latter. Although much remains to be done to achieve this, accumulating studies begin to deliver a coherent view. Thus, high central 5-HT levels are generally associated with improved reversal learning, improved attentional set shifting, decreased delay discounting, and increased response inhibition, but a failure to use outcome representations. Based on 5-HT's evolutionary role, I hypothesize that 5-HT integrates expected, or changes in, relevant sensory and emotional internal/external information, leading to vigilance behaviour affecting various decision making processes. 5-HT receptor subtypes play distinctive roles in decision making. 5-HT(2A) agonists and 5-HT2c antagonists decrease compulsivity, whereas 5-HT(2A) antagonists and 5-HT(2C) agonists decrease impulsivity. 5-HT(6) antagonists univocally affect decision making processes. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Nuclear regulatory decision making
International Nuclear Information System (INIS)
2005-01-01
The fundamental objective of all nuclear safety regulatory bodies is to ensure that nuclear utilities operate their plants at all times in an acceptably safe manner. In meeting this objective, the regulatory body should strive to ensure that its regulatory decisions are technically sound, consistent from case to case, and timely. In addition, the regulator must be aware that its decisions and the circumstances surrounding those decisions can affect how its stakeholders, such as government policy makers, the industry it regulates, and the public, view it as an effective and credible regulator. In order to maintain the confidence of those stakeholders, the regulator should make sure that its decisions are transparent, have a clear basis in law and regulations, and are seen by impartial observers to be fair to all parties. Based on the work of a Nuclear Energy Agency (NEA) expert group, this report discusses some of the basic principles and criteria that a regulatory body should consider in making decisions and describes the elements of an integrated framework for regulatory decision making. (author)
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Increasing Effectiveness in Teaching Ethics to Undergraduate Business Students.
Lampe, Marc
1997-01-01
Traditional approaches to teaching business ethics (philosophical analysis, moral quandaries, executive cases) may not be effective in persuading undergraduates of the importance of ethical behavior. Better techniques include values education, ethical decision-making models, analysis of ethical conflicts, and role modeling. (SK)
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Entrepreneurs` Cognitive and Decision Making Styles
Directory of Open Access Journals (Sweden)
Mahmoud Motvaseli
2015-12-01
Full Text Available The main purpose of this study is to explore the relation between decision-making styles which are measured by the General decision-making style (GDMS test and information processing styles which are often termed cognitive styles and are, in this study, measured by Cognitive Style Inventory. The authors directed a survey research on 162 Iranian students. Structural equation modeling techniques were used to measure the impact of cognitive styles on decision-making styles. The authors found that cognitive styles have a positive impact on decision-making styles. In spite of the abundant research on factors that affect decision-making styles, few researches have tested the relationship between cognitive styles and decision-making styles. This study examines the impact of cognitive styles on decision-making styles in Iran. This study, like most research paper studies, cannot easily be generalized. Furthermore, the results of this study could be affected by economic conditions.
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Decision making on fitness landscapes
Arthur, R.; Sibani, P.
2017-04-01
We discuss fitness landscapes and how they can be modified to account for co-evolution. We are interested in using the landscape as a way to model rational decision making in a toy economic system. We develop a model very similar to the Tangled Nature Model of Christensen et al. that we call the Tangled Decision Model. This is a natural setting for our discussion of co-evolutionary fitness landscapes. We use a Monte Carlo step to simulate decision making and investigate two different decision making procedures.
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Decision Making on Fitness Landscapes
DEFF Research Database (Denmark)
Arthur, Rudy; Sibani, Paolo
2017-01-01
We discuss fitness landscapes and how they can be modified to account for co-evolution. We are interested in using the landscape as a way to model rational decision making in a toy economic system. We develop a model very similar to the Tangled Nature Model of Christensen et. al. that we call...... the Tangled Decision Model. This is a natural setting for our discussion of co-evolutionary fitness landscapes. We use a Monte Carlo step to simulate decision making and investigate two different decision making procedures....
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Using Gaming To Help Nursing Students Understand Ethics.
Metcalf, Barbara L.; Yankou, Dawn
2003-01-01
An ethics game involves nursing students in defending actions in ethics-based scenarios. Benefits include increased confidence, ability to see multiple perspectives, values clarification, and exposure to decision-making models, professional responsibilities, ethical principles, social expectations, and legal requirements. Difficulties include…
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New Ways to Cut through Ethical Gordian Knots.
Howe, Edmund G
2017-01-01
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.
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Neither Pollyanna nor Chicken Little: Thoughts on the Ethics of Automation
Holloway, C. Michael; Knight, John C.; McDermid, John A.
2014-01-01
This paper has raised issues concerning the ethics of automation in aviation systems, and outlined ways of thinking about the issues that may help in ethical decision making. It is very easy to be carried along by technology and the Pollyanna view, but just because we can do something, doesn't mean we should - which is perhaps a little milder than the Chicken Little view. Both views have merits, and we would view ethical decisions as ones that more appropriately balance or reconcile these conflicting viewpoints. We have set out some of the background to the problems of automation in aviation systems, but are aware that there is much more that could be said (considering military UAS, for example). We hope, however, that the brief introduction provides a foundation for the ethical questions that we have set out. The underlying aim in proposing ESCs is to make understanding ethical issues easier so that ethically-informed decisions can be made. Whilst we have not linked the discussion directly back to specific ethical decisions, we believe that making explicit those issues on which such judgments are based is a contribution to ethically informed decision making. We also believe that the four principles set out by the RAEng are reflected in this approach. We acknowledge that what we have set out, especially the ideas of ESC, goes some way beyond current practice and principles and there are significant technical issues to resolve before such an approach could be implemented. It is hoped, however, that the ideas will help improve the production and presentation of safety cases in a range of industries not just aviation - a Pollyanna view, of course!
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Decision Making in Adults with ADHD
Montyla, Timo; Still, Johanna; Gullberg, Stina; Del Missier, Fabio
2012-01-01
Objectives: This study examined decision-making competence in ADHD by using multiple decision tasks with varying demands on analytic versus affective processes. Methods: Adults with ADHD and healthy controls completed two tasks of analytic decision making, as measured by the Adult Decision-Making Competence (A-DMC) battery, and two affective…
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A Case Study in Ethical Decision Making Regarding Remote Mitigation of Botnets
Dittrich, David; Leder, Felix; Werner, Tillmann
It is becoming more common for researchers to find themselves in a position of being able to take over control of a malicious botnet. If this happens, should they use this knowledge to clean up all the infected hosts? How would this affect not only the owners and operators of the zombie computers, but also other researchers, law enforcement agents serving justice, or even the criminals themselves? What dire circumstances would change the calculus about what is or is not appropriate action to take? We review two case studies of long-lived malicious botnets that present serious challenges to researchers and responders and use them to illuminate many ethical issues regarding aggressive mitigation. We make no judgments about the questions raised, instead laying out the pros and cons of possible choices and allowing workshop attendees to consider how and where they would draw lines. By this, we hope to expose where there is clear community consensus as well as where controversy or uncertainty exists.
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Stokman, Frans N.; Assen, Marcel A.L.M. van; Knoop, Jelle van der; Oosten, Reinier C.H. van
2000-01-01
This paper introduces a methodology for strategic intervention in collective decision making.The methodology is based on (1) a decomposition of the problem into a few main controversial issues, (2) systematic interviews of subject area specialists to obtain a specification of the decision
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Giannunzio, Valeria; Degortes, Daniela; Tenconi, Elena; Collantoni, Enrico; Solmi, Marco; Santonastaso, Paolo; Favaro, Angela
2018-07-01
Patients with anorexia nervosa (AN) often report difficulties in decision making, which may interfere with treatment. The aim of this study was to investigate decision making in a large sample of adolescent and adult patients with AN, by using the Iowa gambling task. Participants were 611 female individuals (310 patients and 301 controls) who underwent neuropsychological and clinical assessment. Significantly poorer decision-making performance was observed in adult patients, whereas no difference emerged between affected and nonaffected adolescents. Both adolescent and adult patients were characterized by trends for higher levels of attention to losses in comparison with healthy controls. Although healthy adult women exhibited better decision-making performance than healthy adolescents, in AN, there was no improvement of decision making with age. A cluster analysis identified 2 different styles of decision making in both patients and controls: a conservative style and an impulsive style. Our study provides evidence of dysfunctional decision making in adult patients with AN and reveals an association between poor decision making and excessive punishment sensitivity in AN. The clinical and scientific implications of these findings merit further exploration. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.
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Guay, Frederic
2005-01-01
The purpose of the present research was to develop and validate a measure of motivation toward career decision-making activities, the Career Decision-Making Autonomy Scale (CDMAS). The CDMAS is designed to assess the constructs of intrinsic motivation, identified regulation, introjected regulation, and external regulation. A longitudinal study was…
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Fosmire, Michael
2017-01-01
Engineering designers must make evidence-based decisions when applying the practical tools and techniques of their discipline to human problems. Information literacy provides a structure for determining information gaps, locating appropriate and relevant information, applying that information effectively, and documenting and managing the knowledge…
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Goeree, Ron; Levin, Les; Chandra, Kiran; Bowen, James M; Blackhouse, Gord; Tarride, Jean-Eric; Burke, Natasha; Bischof, Matthias; Xie, Feng; O'Reilly, Daria
2009-05-01
Health care expenditures continue to escalate, and pressures for increased spending will continue. Health care decision makers from publicly financed systems, private insurance companies, or even from individual health care institutions, will continue to be faced with making difficult purchasing, access, and reimbursement decisions. As a result, decision makers are increasingly turning to evidence-based platforms to help control costs and make the most efficient use of existing resources. Most tools used to assist with evidence-based decision making focus on clinical outcomes. Health technology assessment (HTA) is increasing in popularity because it also considers other factors important for decision making, such as cost, social and ethical values, legal issues, and factors such as the feasibility of implementation. In some jurisdictions, HTAs have also been supplemented with primary data collection to help address uncertainty that may still exist after conducting a traditional HTA. The HTA process adopted in Ontario, Canada, is unique in that assessments are also made to determine what primary data research should be conducted and what should be collected in these studies. In this article, concerns with the traditional HTA process are discussed, followed by a description of the HTA process that has been established in Ontario, with a particular focus on the data collection program followed by the Programs for Assessment of Technology in Health Research Institute. An illustrative example is used to show how the Ontario HTA process works and the role value of information analyses plays in addressing decision uncertainty, determining research feasibility, and determining study data collection needs.
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Shared decision-making and patient autonomy.
Sandman, Lars; Munthe, Christian
2009-01-01
In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice.
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Ferrie, Suzie
2006-04-01
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.
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Rough multiple objective decision making
Xu, Jiuping
2011-01-01
Rough Set TheoryBasic concepts and properties of rough sets Rough Membership Rough Intervals Rough FunctionApplications of Rough SetsMultiple Objective Rough Decision Making Reverse Logistics Problem with Rough Interval Parameters MODM based Rough Approximation for Feasible RegionEVRMCCRMDCRM Reverse Logistics Network Design Problem of Suji Renewable Resource MarketBilevel Multiple Objective Rough Decision Making Hierarchical Supply Chain Planning Problem with Rough Interval Parameters Bilevel Decision Making ModelBL-EVRM BL-CCRMBL-DCRMApplication to Supply Chain Planning of Mianyang Co., LtdStochastic Multiple Objective Rough Decision Multi-Objective Resource-Constrained Project Scheduling UnderRough Random EnvironmentRandom Variable Stochastic EVRM Stochastic CCRM Stochastic DCRM Multi-Objective rc-PSP/mM/Ro-Ra for Longtan Hydropower StationFuzzy Multiple Objective Rough Decision Making Allocation Problem under Fuzzy Environment Fuzzy Variable Fu-EVRM Fu-CCRM Fu-DCRM Earth-Rock Work Allocation Problem.
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Shahand, Assadullah
2010-01-01
Growing incidences of corporate ethical misconducts have revived the debate over ethical reasoning and moral development of corporate managers. The role of information technology (IT) in the ethical dilemmas is becoming more evident as virtual environments become increasingly popular, organizations adopt digital form of record keeping, and the…
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Ethical Leadership and Moral Literacy: Incorporating Ethical Dilemmas in a Case-Based Pedagogy
Jenlink, Patrick M.; Jenlink, Karen Embry
2015-01-01
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…
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Negotiating end-of-life decision making: a comparison of Japanese and U.S. residents' approaches.
Gabbay, Baback B; Matsumura, Shinji; Etzioni, Shiri; Asch, Steven M; Rosenfeld, Kenneth E; Shiojiri, Toshiaki; Balingit, Peter P; Lorenz, Karl A
2005-07-01
To compare Japanese and U.S. resident physicians' attitudes, clinical experiences, and emotional responses regarding making disclosures to patients facing incurable illnesses. From September 2003 to June 2004, the authors used a ten-item self-administered anonymous questionnaire in a cross-sectional survey of 103 internal medicine residents at two U.S. sites in Los Angeles, California, and 244 general medical practice residents at five Japanese sites in Central Honshu, Kyushu, Okinawa, Japan. The Japanese residents were more likely to favor including the family in disclosing diagnosis (95% versus 45%, pguilt about these behaviors. The residents' approaches to end-of-life decision making reflect known cultural preferences related to the role of patients and their families. Although Japanese trainees were more likely to endorse the role of the family, they expressed greater uncertainty about their approach. Difficulty and uncertainty in end-of-life decision making were common among both the Japanese and U.S. residents. Both groups would benefit from ethical training to negotiate diverse, changing norms regarding end-of-life decision making.
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Siddiqui, Shahla; Chuan, Voo Teck
2018-06-28
This paper will discuss why and how social network sites ought to be used in surrogate decision making (SDM), with focus on a context like Singapore in which substituted judgment is incorporated as part of best interest assessment for SDM, as guided by the Code of Practice for making decisions for those lacking mental capacity under the Mental Capacity Act (2008). Specifically, the paper will argue that the Code of Practice already supports an ethical obligation, as part of a patient-centred care approach, to look for and appraise social network site (SNS) as a source of information for best interest decision making. As an important preliminary, the paper will draw on Berg's arguments to support the use of SNS information as a resource for SDM. It will also supplement her account for how SNS information ought to be weighed against or considered alongside other evidence of patient preference or wishes, such as advance directives and anecdotal accounts by relatives. © Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.
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Making the Connection between Environmental Science and Decision Making
Woodhouse, C. A.; Crimmins, M.; Ferguson, D. B.; Garfin, G. M.; Scott, C. A.
2011-12-01
As society is confronted with population growth, limited resources, and the impacts of climate variability and change, it is vital that institutions of higher education promote the development of professionals who can work with decision-makers to incorporate scientific information into environmental planning and management. Skills for the communication of science are essential, but equally important is the ability to understand decision-making contexts and engage with resource managers and policy makers. It is increasingly being recognized that people who understand the linkages between science and decision making are crucial if science is to better support planning and policy. A new graduate-level seminar, "Making the Connection between Environmental Science and Decision Making," is a core course for a new post-baccalaureate certificate program, Connecting Environmental Science and Decision Making at the University of Arizona. The goal of the course is to provide students with a basic understanding of the dynamics between scientists and decision makers that result in scientific information being incorporated into environmental planning, policy, and management decisions. Through readings from the environmental and social sciences, policy, and planning literature, the course explores concepts including scientific information supply and demand, boundary organizations, co-production of knowledge, platforms for engagement, and knowledge networks. Visiting speakers help students understand some of the challenges of incorporating scientific information into planning and decision making within institutional and political contexts. The course also includes practical aspects of two-way communication via written, oral, and graphical presentations as well as through the interview process to facilitate the transfer of scientific information to decision makers as well as to broader audiences. We aspire to help students develop techniques that improve communication and
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Teaching versus Living: Managerial Decision Making in the Gray
Soltes, Eugene
2017-01-01
Preparing students for the consequential ethical decisions that they will face in their careers is among the most difficult tasks of management education. I describe some of these challenges based on my book "Why They Do It: Inside the Mind of the White-Collar Criminal" and recent work in behavioral ethics. I explore why some decisions…
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Electroencephalogy (EEG) Feedback in Decision-Making
2015-08-26
Electroencephalogy ( EEG ) Feedback In Decision- Making The goal of this project is to investigate whether Electroencephalogy ( EEG ) can provide useful...feedback when training rapid decision-making. More specifically, EEG will allow us to provide online feedback about the neural decision processes...Electroencephalogy ( EEG ) Feedback In Decision-Making Report Title The goal of this project is to investigate whether Electroencephalogy ( EEG ) can provide useful
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Managerial Decision Making in Traffic
Directory of Open Access Journals (Sweden)
Teodor Perić
2003-11-01
Full Text Available Decision-making is defined as a selection of a certain actionamong several alternatives. It is the essence of planning, asin the managerial sense there is no plan until a decision of engagementof resources, reputation and direction of activities ismade. Decision-making is, in fact, only a step in planning, evenwhen it is performed quickly and without special consideration.It is what we all experience every day. It is one of the most fascinatingbiological activities and the subject of frightening implicationsfor the whole human race. Since various techniques improvethe system and the quality of managerial decision-making,they are classified into three assumptions: risk analysis, decision-making trees, and the theory of revealed preference. Allof these are based on the interaction of a certain number of importantvariables out of which many contain the elements ofuncertainty, but maybe also high level of probability.
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GROUPS DECISION MAKING WITHIN THE ORGANIZATION
Directory of Open Access Journals (Sweden)
Anca Stan
2008-12-01
Full Text Available In a highly global market, organizations that have the ability to analyze and rapidly respond to the constantly changing marketplace will have the greatest chance of remaining competitive and profitable. Group decision making is the process of arriving at a judgment based upon the feedback of multiple individuals. Due to the importance of the group decision making process, decision making models can be used to establish a systematic means of developing effective group decision making. Once a decision has been made, the members of the group should be willing to accept it and support its implementations.