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Sample records for medical ethical challenges

  1. Children in Medical Research : Ethical challenges

    NARCIS (Netherlands)

    W. Bos (Wendy)

    2017-01-01

    markdownabstractPaediatric research ethics evolves around a central dilemma. Either one has to accept that many childhood diseases cannot be (properly) treated and that many children receive treatments that are not (properly) tested in children, or one has to accept that children, i.e. vulnerable

  2. Pediatric palliative care and pediatric medical ethics: opportunities and challenges.

    Science.gov (United States)

    Feudtner, Chris; Nathanson, Pamela G

    2014-02-01

    The fields of pediatric palliative care (PPC) and pediatric medical ethics (PME) overlap substantially, owing to a variety of historical, cultural, and social factors. This entwined relationship provides opportunities for leveraging the strong communication skills of both sets of providers, as well as the potential for resource sharing and research collaboration. At the same time, the personal and professional relationships between PPC and PME present challenges, including potential conflict with colleagues, perceived or actual bias toward a palliative care perspective in resolving ethical problems, potential delay or underuse of PME services, and a potential undervaluing of the medical expertise required for PPC consultation. We recommend that these challenges be managed by: (1) clearly defining and communicating clinical roles of PPC and PME staff, (2) developing questions that may prompt PPC and PME teams to request consultation from the other service, (3) developing explicit recusal criteria for PPC providers who also provide PME consultation, (4) ensuring that PPC and PME services remain organizationally distinct, and (5) developing well-defined and broad scopes of practice. Overall, the rich relationship between PPC and PME offers substantial opportunities to better serve patients and families facing difficult decisions.

  3. Screening for depression in medical research: ethical challenges and recommendations

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    Sheehan Aisling M

    2013-01-01

    Full Text Available Abstract Background Due to the important role of depression in major illnesses, screening measures for depression are commonly used in medical research. The protocol for managing participants with positive screens is unclear and raises ethical concerns. The aim of this article is to identify and critically discuss the ethical issues that arise when a positive screen for depression is detected, and offer some guidance on managing these issues. Discussion Deciding on whether to report positive screens to healthcare practitioners is both an ethical and a pragmatic dilemma. Evidence suggests that reporting positive depression screens should only be considered in the context of collaborative care. Possible adverse effects, such as the impact of false-positive results, potentially inappropriate labelling, and potentially inappropriate treatment also need to be considered. If possible, the psychometric properties of the selected screening measure should be determined in the target population, and a threshold for depression that minimises the rate of false-positive results should be chosen. It should be clearly communicated to practitioners that screening scores are not diagnostic for depression, and they should be informed about the diagnostic accuracy of the measure. Research participants need to be made aware of the consequences of the detection of high scores on screening measures, and to be fully informed about the implications of the research protocol. Summary Further research is needed and the experiences of researchers, participants, and practitioners need to be collated before the value of reporting positive screens for depression can be ascertained. In developing research protocols, the ethical challenges highlighted should be considered. Participants must be agreeable to the agreed protocol and efforts should be made to minimise potentially adverse effects.

  4. Ethical Challenges in Teaching Genetics for Medical Students

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    Erika Nagle

    2014-09-01

    Full Text Available Although inclusion of ethics as a study course in medical students' curricula is a common practice, special approaches in teaching ethics in the context of genetics should be considered. In the realm of genomics, there are several ethically sensitive topics such as diagnosis of genetic diseases, in vitro fertilization, and identification of genetic susceptibility to common diseases. In addition, in communication with the general public, genetic terms should be used with caution. Demonstration of the phenotypes of affected individuals should be regarded as a particular aspect of teaching genetics. In a description of a patient’s phenotype, not only is it necessary to provide scientifically precise characteristics of a patient; voice timbre, facial expression, and body language should also be carefully controlled. Furthermore, in medicine, the theory–practice gap is a problematic aspect, and students often find it difficult to apply knowledge on ethical issues to real situations in clinics. For this purpose, clinical cases are presented during classes and their analysis requires a very respectful attitude on the part of both students and lecturers. For many genetic diseases, evaluation of minor anomalies such as a curved fifth finger, low situated ears, or missing of some teeth is required. Some minor anomalies are found in healthy individuals too, and interpretation of such features must therefore be considered carefully. This article describes our experiences in teaching genetics at Riga Stradiņš University, ethical problems faced while teaching genetics, and their solutions.

  5. Introducing the Medical Ethics Bowl.

    Science.gov (United States)

    Merrick, Allison; Green, Rochelle; Cunningham, Thomas V; Eisenberg, Leah R; Hester, D Micah

    2016-01-01

    Although ethics is an essential component of undergraduate medical education, research suggests that current medical ethics curricula face considerable challenges in improving students' ethical reasoning. This article discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised: the Medical Ethics Bowl (MEB). Finally, we suggest the pedagogical advantages of the MEB when compared to other ethics curricula.

  6. Ethical challenges for medical professionals in middle manager positions: a debate article.

    Science.gov (United States)

    Schnoor, Joerg; Heyde, Christoph-Eckhard; Ghanem, Mohamed

    2015-01-01

    Demographic changes increase the financing needs of all social services. This change also generates new and complex demands on the medical staff. Accordingly, medical professionals in middle management positions hold a characteristic sandwich position between top management and the operational core. This sandwich position often constitutes new challenges. In the industrial field, the growing importance of the middle management for the company's success has already been recognized. Accordingly, the growing demand on economy urges an analysis for the medical field. While there are nearly no differences in the nature of the tasks of medical middle manager in the areas of strategy, role function, performance pressure and qualifications compared to those tasks of the industrial sector, there are basic differences as well. Especially the character of "independence" of the medical profession and its ethical values justifies these differences. Consequently, qualification of medical professionals may not be solely based on medical academic career. It is also based on the personal ability or potential to lead and to manage. Above all, the character of "independence" of the medical profession and its ethical values justifies medical action that is based on the patient's well-being and not exclusively on economic outcomes. In the future, medical middle managers are supposed to achieve an optimized balance between a patient-centered medicine and economic measures. It will be a basic requirement that middle managers accept their position and the resultant tasks putting themselves in a more active position. Because of that, middle managers can become "value-added bridge-builders".

  7. [Medical ethics as professional ethics].

    Science.gov (United States)

    Kwon, Ivo

    2012-09-25

    Contemporary medical ethics is far from the traditional concept of "In-Sul (benevolent art)" or "Yul-Li (倫, ethics), which emphasizes so much the personality or the character of a doctor. Nowadays, medical ethics should be considered as "professional ethics" which regulates the acts and medical practices of ordinary doctors in their daily practice. The key concepts of the professional ethics are "autonomy", "integrity", and "professional standard" established by medical organizations such as medical societies or associations. Most of Korean doctors have not been familiar with the concept of professional ethics or professionalism, which is due to the modern history of Korea. However, the concept of professional ethics is really critical to Korean doctors from the perspective of professional dignity and social respect to this profession. The current healthcare system of Korea is suffering from many problems of both private and public sector. Nonetheless, the professional ethics is urgently demanded for that very reason.

  8. The major medical ethical challenges facing the public and healthcare providers in Saudi Arabia

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    Abdulaziz F Alkabba

    2012-01-01

    Full Text Available Background: Despite the relatively high expenditure on healthcare in Saudi Arabia, its health system remains highly centralized in the main cities with its primary focus on secondary and tertiary care rather than primary care. This has led to numerous ethical challenges for the healthcare providers. This article reports the results of a study conducted with a panel of practitioners, and non-clinicians, in Saudi Arabia, in order to identify the top ten ethical challenges for healthcare providers, patients, and their families. Materials and Methods: The study design was a cross-sectional, descriptive, and qualitative one. The participants were asked the question: "What top ten ethical challenges are Saudis likely to face in health care?" The participants were asked to rank the top ten ethical challenges throughout a modified Delphi process, using a ranking Scale. A consensus was reached after three rounds of questions and an experts′ meeting. Results: The major 10 ethical issues, as perceived by the participants in order of their importance, were: (1 Patients′ Rights, (2 Equity of resources, (3 Confidentiality of the patients, (4 Patient Safety, (5 Conflict of Interests, (6 Ethics of privatization, (7 Informed Consent, (8 Dealing with the opposite sex, (9 Beginning and end of life, and (10 Healthcare team ethics. Conclusion: Although many of the challenges listed by the participants have received significant public and specialized attention worldwide, scant attention has been paid to these top challenges in Saudi Arabia. We propose several possible steps to help address these key challenges.

  9. The challenge of promoting professionalism through medical ethics and humanities education.

    Science.gov (United States)

    Doukas, David J; McCullough, Laurence B; Wear, Stephen; Lehmann, Lisa S; Nixon, Lois LaCivita; Carrese, Joseph A; Shapiro, Johanna F; Green, Michael J; Kirch, Darrell G

    2013-11-01

    Given recent emphasis on professionalism training in medical schools by accrediting organizations, medical ethics and humanities educators need to develop a comprehensive understanding of this emphasis. To achieve this, the Project to Rebalance and Integrate Medical Education (PRIME) II Workshop (May 2011) enlisted representatives of the three major accreditation organizations to join with a national expert panel of medical educators in ethics, history, literature, and the visual arts. PRIME II faculty engaged in a dialogue on the future of professionalism in medical education. The authors present three overarching themes that resulted from the PRIME II discussions: transformation, question everything, and unity of vision and purpose.The first theme highlights that education toward professionalism requires transformational change, whereby medical ethics and humanities educators would make explicit the centrality of professionalism to the formation of physicians. The second theme emphasizes that the flourishing of professionalism must be based on first addressing the dysfunctional aspects of the current system of health care delivery and financing that undermine the goals of medical education. The third theme focuses on how ethics and humanities educators must have unity of vision and purpose in order to collaborate and identify how their disciplines advance professionalism. These themes should help shape discussions of the future of medical ethics and humanities teaching.The authors argue that improvement of the ethics and humanities-based knowledge, skills, and conduct that fosters professionalism should enhance patient care and be evaluated for its distinctive contributions to educational processes aimed at producing this outcome.

  10. [Ethics in medical journals.

    Science.gov (United States)

    Lifshitz, Alberto

    2013-01-01

    The title of this reflection evokes several contents that may encompass from ethics in research; fraud in science; ethics in medical advertising and relations between sponsors and science; and, finally, papers related to ethic content. This paper is limited to the ethic responsibilities of the medical writers or "scriptwriters."

  11. [Destiny-zapping--medical education, students' world view and the ethical challenge].

    Science.gov (United States)

    Johansson, K A; Ohldieck, C; Aase, M; Schei, E

    2001-05-20

    Three medical students describe their search for professional and personal identity midway through medical school. The article focuses on their concrete experience of human suffering and vulnerability, which is set against elements from the relational ethics of Danish philosopher KE Løgstrup. Løgstrup's ontology is based on a relational understanding of being human, and implicitly opposes the strongly objectivating and individualised view of human existence promoted through the experiences of everyday medical education.

  12. Machine medical ethics

    CERN Document Server

    Pontier, Matthijs

    2015-01-01

    The essays in this book, written by researchers from both humanities and sciences, describe various theoretical and experimental approaches to adding medical ethics to a machine in medical settings. Medical machines are in close proximity with human beings, and getting closer: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. In such contexts, machines are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for e...

  13. Teaching and learning of ethics in Malaysian Medical Schools: The challenges

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    Verasingam Kumarasamy

    2012-01-01

    Full Text Available There is a widespread demand coming from the publicand the medical fraternity for physicians not only to becompetent in their chosen field but to exhibit the higheststandards of ethical behavior. Physicians are constantlyunder public scrutiny and any misdemeanor actual orperceived hog the headlines of the public media. Theproblem is compounded by the democratization ofmedical education, fuelled by the increasing marketdemand for physicians and the corporatisation ofmedical education and practice in Malaysia.

  14. Teaching and learning of ethics in Malaysian Medical Schools: The challenges

    OpenAIRE

    Verasingam Kumarasamy

    2012-01-01

    There is a widespread demand coming from the publicand the medical fraternity for physicians not only to becompetent in their chosen field but to exhibit the higheststandards of ethical behavior. Physicians are constantlyunder public scrutiny and any misdemeanor actual orperceived hog the headlines of the public media. Theproblem is compounded by the democratization ofmedical education, fuelled by the increasing marketdemand for physicians and the corporatisation ofmedical education and pract...

  15. The Medical Ethics Curriculum in Medical Schools: Present and Future.

    Science.gov (United States)

    Giubilini, Alberto; Milnes, Sharyn; Savulescu, Julian

    2016-01-01

    In this review article we describe the current scope, methods, and contents of medical ethics education in medical schools in Western English speaking countries (mainly the United Kingdom, the United States, and Australia). We assess the strengths and weaknesses of current medical ethics curricula, and students' levels of satisfaction with different teaching approaches and their reported difficulties in learning medical ethics concepts and applying them in clinical practice. We identify three main challenges for medical ethics education: counteracting the bad effects of the "hidden curriculum," teaching students how to apply ethical knowledge and critical thinking to real cases in clinical practice, and shaping future doctors' right character through ethics education. We suggest ways in which these challenges could be addressed. On the basis of this analysis, we propose practical guidelines for designing, implementing, teaching, and assessing a medical ethics program within a four-year medical course.

  16. MEDICAL LAW AND ETHICS

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    Sunčica Ivanović

    2013-09-01

    Full Text Available The subject of interest in this article is the importance of knowing and connecting medical ethics and medical law for the category of health workers. The author believes that knowledge of bioethics which as a discipline deals with the study of ethical issues and health care law as a legal discipline, as well as medical activity in general, result in the awareness of health professionals of human rights, and since the performance of activities of health workers is almost always linked to the question of life and death, then the lack of knowledge of basic legal acts would not be justified at all. The aim of the paper was to present the importance of medical ethics and medical law among the medical staff. A retrospective analysis of the medical literature available on the indexed base KOBSON for the period 2005-2010 was applied. Analysis of all work leads to the conclusion that the balance between ethical principles and knowledge of medical law, trust and cooperation between the two sides that appear over health care can be considered a goal that every health care worker should strive for. This study supports the attitude that lack of knowledge and non-compliance with the ethical principles and medical law when put together can only harm the health care worker. In a way, this is the message to health care professionals that there is a need for the adoption of ethical principles and knowledge of medical law, because the most important position of all health workers is their dedication to the patient as a primary objective and the starting point of ethics.

  17. ETHICAL CHALLENGES IN AESTHETIC DENTISTRY

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    Marius NEAGU

    2015-12-01

    Full Text Available Aesthetic dentistry is a branch of dentistry which aims primarily at improving patient’s physical appearance and, to a lesser extent, the functionality of teeth. This field raises particular ethical dilemmas and requires a careful evaluation of patient’s needs and wishes versus his/her clinical best interests. In this article, the authors discuss the main ethical challenges in the field of aesthetic dentistry in the light of the four “classical” principles of bioethics: autonomy, beneficence, non-maleficence and justice. The authors conclude that the principles of medical ethics should be at the very foundation of the field of aesthetic dentistry, for establishing a patient-physician relationship which could lead to optimum clinical outcomes, while respecting the wishes of the patient and promoting his/her best interests.

  18. [Medical ethics in residency training].

    Science.gov (United States)

    Civaner, Murat; Sarikaya, Ozlem; Balcioğlu, Harun

    2009-04-01

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

  19. MEDICAL GENETICS AND ETHICS

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    Vladimir TRAJKOVSKI

    1999-05-01

    Full Text Available Fast development of medical genetics and it’s subdisciplines is noticed in last thirty years. Modern diagnostic methods made possible to establish human genome and its impairment. In human genetics, ethic is main principle in working. Ethic is science about biggest goodness for human or society, and its aim pro­tecting human health.Today's conditions for leaving and science development open a wide way for ethical approaches, but also for non-ethical manipulations with human even before his conception. We must keep to attitude that without law, with our behavior will must conduct our conscience. It is best to have neutral eugenetic attitude, which allows free ethical choice of each individual, in any case, for the well being of man.

  20. Policy makers ignoring science and scientists ignoring policy: the medical ethical challenges of heroin treatment

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    Small Dan

    2006-05-01

    Full Text Available Abstract A decade of research in Switzerland, The Netherlands, Germany, and Spain now constitutes a massive body of work supporting the use of heroin treatment for the most difficult patients addicted to opiates. These trials concur on this method's safety and efficacy and are now serving as a prelude to the institution of heroin treatment in clinical practice throughout Europe. While the different sampling and research protocols for heroin treatment in these studies were important to the academic claims about specific results and conclusions that could be drawn from each study, the overall outcomes were quite clear – and uniformly positive. They all find that the use of prescribed pharmaceutical heroin does exactly what it is intended to do: it reaches a treatment refractory group of addicts by engaging them in a positive healthcare relationship with a physician, it reduces their criminal activity, improves their health status, and increases their social tenure through more stable housing, employment, and contact with family. The Canadian trial (NAOMI, now underway for over a year, but not yet completed, now faces a dilemma about what to do with its patients who have successfully completed 12 months of heroin and must be withdrawn from heroin and transferred to other treatments in accordance with the research protocol approved by Government of Canada, federal granting body and host institutions. The problem is that the principal criterion for acceptance to NAOMI was their history of repeated failure in these very same treatment programs to which they will now be referred. The existence of the results from abroad (some of which were not yet available when NAOMI was designed and initiated now raises a very important question for Canada: is it ethical to continue to prohibit the medical use of heroin treatment that has already been shown to be feasible and effective in numerous medical studies throughout the world? And while this is being worked

  1. [Ethics, medical ethics, and occupational medicine: is their dialogue possible?].

    Science.gov (United States)

    Buzzi, Elisa

    2016-01-20

    Today's medicine faces some critical moral challenges, yet the medical class suffers from an increasingly evident malaise: a growing dissatisfaction with an ethical demand often perceived as a cumbersome burden of rules and prohibitions, which risk to erode the fiduciary relations with patients. Such a negative appraisal is partly due to a narrow interpretation of the meaning of ethics, a misconception whose roots are in the positivistic stance that permeates our culture, and in its almost exclusively technological bent. This radical orientation of our culture shows itself in the vanishing of the idea of an intrinsic ethical dimension of medicine and consequent eclipse of traditional medical ethics, currently all but assimilated by bioethics. Maintaining a clear distinction between medical ethics and bioethics is a fundamental condition for guaranteeing an original ethical reflection in medicine, thereby fostering a constructive dialogue between philosophical and medical ethics. In this sense, occupational medicine holds a very propitious position, at the cross-roads to some of the most important dimensions in human life and society: health, work, environment. In a milieu which is too often inclined to efface the living human being and the deepest needs of humanity, the moral commitment of medical profession to the care of the integral reality of the embodied human person is one of the most important ethical challenges facing occupational medicine and a most valuable contribution to the current ethical debate.

  2. [Crisis in medical ethics].

    Science.gov (United States)

    Stellamor, K

    1996-01-01

    There is a disproportion between diagnostic and therapeutic medical achievements and the doctor/patient relationship. Are we allowed to do everything we are able to do in medicine? People are concerned and worried (genetic technology, invasive medicine, embryos in test tubes etc.). The crisis of ethics in medicine is evident. The analysis of the situation shows one of the causes in the shift of the paradigma-modern times to postmodern following scientific positivism-but also a loss of ethics in medicine due to an extreme secularism and to modern philosophical trends (Hans Jonas and the responsibility for the future and on the other hand modern utilitarism).

  3. Justice and medical ethics.

    Science.gov (United States)

    Gillon, R

    1985-07-20

    Justice, in the sense of fair adjudication between conflicting claims, is held to be relevant to a wide range of issues in medical ethics. Several differing concepts of justice are briefly described, including Aristotle's formal principle of justice, libertarian theories, utilitarian theories, Marxist theories, the theory of John Rawls, and the view--held, for example, by W.D. Ross--that justice is essentially a matter of reward for individual merit.

  4. Paternalism and medical ethics.

    Science.gov (United States)

    Gillon, R

    1985-06-29

    In one of a series of articles on philosophical medical ethics, Gillon considers various moral arguments in support of medical paternalism. He maintains that the utilitarian principle of maximizing happiness by improving health, minimizing suffering, and prolonging life is not promoted by granting physicians the authority to deceive patients or to make decisions for them in areas of moral and subjective choice. If one wants to do good for a patient, one generally needs to find out what the patient wants one to do. Gillon concludes that many utilitarians agree with deontologists that respect for autonomy is required if human welfare really is to be maximized.

  5. Religion and medical ethics.

    Science.gov (United States)

    Green, Ronald M

    2013-01-01

    Religious traditions of medical ethics tend to differ from more secular approaches by stressing limitations on autonomous decision-making, by more positively valuing the experience of suffering, and by drawing on beliefs and values that go beyond empiric verification. I trace the impact of these differences for some of the world's great religious traditions with respect to four issues: (1) religious conscientious objection to medical treatments; (2) end-of life decision-making, including euthanasia, physician-assisted suicide, and the withholding or withdrawing of life-sustaining treatments; (3) definitions of moral personhood (defining life's beginning and end); and (4) human sexuality.

  6. Ethics and Challenge by Choice.

    Science.gov (United States)

    Nussbaum, Gary

    1996-01-01

    An experiential practitioner discusses the foundations of his ethical perspective on challenge by choice--participant choice within adventure activities. These foundations include existential and experiential philosophy, leisure theory, and the adventure-based counseling model. The ethics of choice and informed consent is discussed in relation to…

  7. Islamic medical ethics: a primer.

    Science.gov (United States)

    Padela, Aasim I

    2007-03-01

    Modern medical practice is becoming increasingly pluralistic and diverse. Hence, cultural competency and awareness are given more focus in physician training seminars and within medical school curricula. A renewed interest in describing the varied ethical constructs of specific populations has taken place within medical literature. This paper aims to provide an overview of Islamic Medical Ethics. Beginning with a definition of Islamic Medical Ethics, the reader will be introduced to the scope of Islamic Medical Ethics literature, from that aimed at developing moral character to writings grounded in Islamic law. In the latter form, there is an attempt to derive an Islamic perspective on bioethical issues such as abortion, gender relations within the patient-doctor relationship, end-of-life care and euthanasia. It is hoped that the insights gained will aid both clinicians and ethicists to better understand the Islamic paradigm of medical ethics and thereby positively affect patient care.

  8. 77 FR 2556 - Ethical and Regulatory Challenges in the Development of Pediatric Medical Countermeasures; Public...

    Science.gov (United States)

    2012-01-18

    ... workshop will be held at the Rockville Hilton Hotel, 1750 Rockville Pike, Rockville, MD 20852. Contact...) leveraging new technologies to develop pediatric medical countermeasures; and (4) risk communication related... at the cost of 10 cents per page. A transcript of the public workshop will be available on the...

  9. Teaching medical ethics and law.

    Science.gov (United States)

    Parker, Malcolm

    2012-03-01

    The teaching of medical ethics is not yet characterised by recognised, standard requirements for formal qualifications, training and experience; this is not surprising as the field is still relatively young and maturing. Under the broad issue of the requirements for teaching medical ethics are numerous more specific questions, one of which concerns whether medical ethics can be taught in isolation from considerations of the law, and vice versa. Ethics and law are cognate, though distinguishable, disciplines. In a practical, professional enterprise such as medicine, they cannot and should not be taught as separate subjects. One way of introducing students to the links and tensions between medical ethics and law is to consider the history of law via its natural and positive traditions. This encourages understanding of how medical practice is placed within the contexts of ethics and law in the pluralist societies in which most students will practise. Four examples of topics from medical ethics teaching are described to support this claim. Australasian medical ethics teachers have paid less attention to the role of law in their curricula than their United Kingdom counterparts. Questions like the one addressed here will help inform future deliberations concerning minimal requirements for teaching medical ethics.

  10. Research ethics consultation: ethical and professional practice challenges and recommendations.

    Science.gov (United States)

    Sharp, Richard R; Taylor, Holly A; Brinich, Margaret A; Boyle, Mary M; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

    2015-05-01

    The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical and Translational Science Award Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: (1) managing multiple institutional roles and responsibilities, (2) managing sensitive information, and (3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services.

  11. Research Ethics Consultation: Ethical and Professional Practice Challenges and Recommendations

    Science.gov (United States)

    Sharp, Richard R.; Taylor, Holly A.; Brinich, Margaret A.; Boyle, Mary M.; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

    2015-01-01

    The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include: assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical Translational Science Award (CTSA) Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: 1) managing multiple institutional roles and responsibilities, 2) managing sensitive information, and 3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services. PMID:25607942

  12. Antibiotic resistance: An ethical challenge.

    Science.gov (United States)

    Littmann, Jasper; Buyx, Alena; Cars, Otto

    2015-10-01

    In this paper, we argue that antibiotic resistance (ABR) raises a number of ethical problems that have not yet been sufficiently addressed. We outline four areas in which ethical issues that arise in relation to ABR are particularly pressing. First, the emergence of multidrug-resistant and extensively drug-resistant infections exacerbates traditional ethical challenges of infectious disease control, such as the restriction of individual liberty for the protection of the public's health. Second, ABR raises issues of global distributive justice, both with regard to the overuse and lack of access to antibiotics. Third, the use of antibiotics in veterinary medicine raises serious concerns for animal welfare and sustainable farming practices. Finally, the diminishing effectiveness of antibiotics leads to questions about intergenerational justice and our responsibility for the wellbeing of future generations. We suggest that current policy discussions should take ethical conflicts into account and engage openly with the challenges that we outline in this paper.

  13. Should AAPL enforce its ethics? Challenges and solutions.

    Science.gov (United States)

    Candilis, Philip J; Dike, Charles C; Meyer, Donald J; Myers, Wade C; Weinstock, Robert

    2014-01-01

    Ethics enforcement in psychiatry occurs at the district branch and American Psychiatric Association (APA) levels under the guidance of American Medical Association (AMA) and APA ethics documents. Subspecialty ethics consequently have no formal role in the enforcement process. This reality challenges practitioners to work according to guidelines that may not be sufficiently relevant and challenges ethics reviewers to apply frameworks not intended for the subspecialties. This article offers the theoretical and practical support to amend APA Procedures to permit formal consideration of subspecialty ethics during ethics complaints and to include forensic practitioners on panels reviewing them. This is the first step toward an integration of two conflicting models of ethics enforcement, regulatory and aspirational, that bring together specialty and subspecialty ethics.

  14. Engineering ethics challenges and opportunities

    CERN Document Server

    Bowen, W Richard

    2014-01-01

    Engineering Ethics: Challenges and Opportunities aims to set a new agenda for the engineering profession by developing a key challenge: can the great technical innovation of engineering be matched by a corresponding innovation in the acceptance and expression of ethical responsibility?  Central features of this stimulating text include:   ·         An analysis of engineering as a technical and ethical practice providing great opportunities for promoting the wellbeing and agency of individuals and communities. ·         Elucidation of the ethical opportunities of engineering in three key areas:             - Engineering for Peace, emphasising practical amelioration of the root causes of    conflict rather than military solutions.             - Engineering for Health, focusing on close collaboration with healthcare professionals      for both the promotion and restoration of health.             - Engineering for Development, providing effective solution...

  15. Medical ethics in the media.

    Science.gov (United States)

    Raman, Usha

    2009-01-01

    The mass media function both as reflector and a shaper of a society's attitudes and values and as such represent a forum within which one may understand and influence public opinion. While questions of medical ethics may be largely confined to academic and scientific spaces, their importance to society at large cannot be denied, and how issues of medical ethics play out--if at all--in the media could tell us how society understands and processes these questions. This paper uses the techniques of framing analysis and textual analysis to examine how the print media, represented by two major Indian newspapers, cover medical ethics. The study looked at all articles related to medical research over a three-month period (January-March 2007) and considered how the story was framed, what were the key threads followed, and the dominant themes focused on. The ethical frame is notable by its absence, even in articles related to controversial themes such as drug research and genetics. Discussion of ethics appears to be problematic given the adherence to traditional "news values" when covering science and medicine. The research community and the media need to pay more attention to explicitly focusing on ethics in their interactions.

  16. Drugs and medical ethics.

    Science.gov (United States)

    Somogyi, E

    1993-01-01

    Naturopathy has received considerable interest all over the world recently. The use of its methods and its consequences have raised legal and ethical problems. This article reports on the use of two 'oncolytic' drugs. Neither of them was produced by cancer researchers and neither passed the analytic examination required in pharmaceutical research. During their use--they were prescribed and applied by physicians--conventional treatment was withdrawn. The ethical responsibility of doctors using fringe medicine drugs is dealt with. Naturopathy may, however, have a role in official medicine in certain cases.

  17. Biomedical research - opportunities and ethical challenges.

    Science.gov (United States)

    Rogozea, Liliana; Purcaru, Daniel; Leaşu, Florin; Nemet, Condruţa

    2014-01-01

    The principal purpose of this paper is to analyze the main opportunities and challenges in biomedical research, thus contributing to improving compliance with ethical norms within the context of continuously expanding research, such as to ensure better quality of patient care and reduce the risk of research not observing the totality of patient rights. Since antiquity finding ways to give care to people has represented not only an opportunity, but also a challenge materialized in experimenting and self-experimenting - a constant part of caregivers' activity. Medical research, whether fundamental or applied, is not only essential to evolution in medicine, but also the way towards increasing the quality of individual lives. The article undertakes to analyze the main ethical norms governing medical research, starting from historical experience and literature search. The growing number of people engaged in medical research over the last years has turned bioethics into an increasingly applicative science, capable of developing practical standards to ensure the moral advancement of the medical profession. The bioethics of the last years has been more and more tied to the reality of medical practice, as well as to that of scientific research, contributing increasingly to the integration of moral elements into medical activity and to the development of research in interdisciplinary bioethics. Bioethics and more so bioethical education need to be correlated with the transition from research itself for the purpose of publishing and career advancement to research based on altruism and the desire to contribute to the wellbeing of patients.

  18. Moral fictions and medical ethics.

    Science.gov (United States)

    Miller, Franklin G; Truog, Robert D; Brock, Dan W

    2010-11-01

    Conventional medical ethics and the law draw a bright line distinguishing the permitted practice of withdrawing life-sustaining treatment from the forbidden practice of active euthanasia by means of a lethal injection. When clinicians justifiably withdraw life-sustaining treatment, they allow patients to die but do not cause, intend, or have moral responsibility for, the patient's death. In contrast, physicians unjustifiably kill patients whenever they intentionally administer a lethal dose of medication. We argue that the differential moral assessment of these two practices is based on a series of moral fictions - motivated false beliefs that erroneously characterize withdrawing life-sustaining treatment in order to bring accepted end-of-life practices in line with the prevailing moral norm that doctors must never kill patients. When these moral fictions are exposed, it becomes apparent that conventional medical ethics relating to end-of-life decisions is radically mistaken. © 2009 Blackwell Publishing Ltd.

  19. Medical employee ethics: a staff training tool.

    Science.gov (United States)

    Hills, Laura Sachs

    2009-01-01

    Ethics is a critical part of medical employee education and is a subject that requires frequent and regular consideration and attention. This article defines ethics particularly as it applies to an individual who works in a medical practice and explores five core ethical values for all medical practice personnel. It suggests the benefits of basing management practices and decisions on ethical core values and explores specific ways that ethics can affect an individual's emotional and physical well being. This article also offers ethical guidelines specifically for medical practice employees regarding the use of their time at work and their workplace communications. Finally, this article offers a set of questions a medical practice employee can use when working through an ethical dilemma and dispels six common myths about medical practice ethics.

  20. Needs and necessities of medical ethics education

    Directory of Open Access Journals (Sweden)

    Bagher Larijani

    2006-03-01

    Full Text Available In the recent years, new medical technologies and their probable misuses have emerged public concerns about medical ethics. Medical ethics is a practical discipline that provides a structured approach for identifying, analyzing, and resolving ethical issues in clinical medicine. "nIn this study we reviewed some new methods of teaching medical ethics in other countries by searching in internet and literature. "nTwo key features related to the teaching of medical ethics are active involvement of students in the learning process instead of merely lecturing about the ethical principles and assessing how students apply their knowledge of ethical principles in simulated and actual situations. In many countries such as Iran, medical schools attempted to address medical ethics issues in formal ethics classes. "nIt is clear that the traditional method is no longer sufficient to meet the needs of practitioners and societies and new methods particularly those emphasize on active learning, individual participation, group interactions, and a process - based approach, should be developed and implemented. In addition, a concerted effort to improve education in medical ethics will benefit the medical profession and services to patients. Therefore, we recommend policy makers of medical ethics education to change the traditional methods to the modern methods; which are used now in the world.

  1. Transcendental (Motaalieh Methodology in Medical Ethics

    Directory of Open Access Journals (Sweden)

    Lotfollah Dezhkam

    2016-12-01

    Full Text Available Introduction: The main role model of medical ethics is to explain and clarify the proper conducts appropriate to those involved in the profession of medicine. In other words, one can say that through the methodologies of medical ethics, new conclusions and inferences are to be reached and achieved to describe and explain the end aims of this approach towards the moral and ethical aspects of medical sciences. So the different roles and responsibilities in this field can be classified as follows: 1. To present ways and methods whereby and ethical and moral framework can be attained and achieved. 2. To present and show ways by which this framework can be implemented and applicable. 3. To face challenges and remove obstacles in the absence of this framework. Methods:This investigation on medical ethics has been dealt with on a library, descriptive and analytic basis, and the subject has been described, analyzed and clarified on the basis of transcendental philosophy presented by Mulla Sadra. Results: Different methodologies concerning medical ethics have been forwarded, classified and grouped as empirical, religious, philosophy, legal and allegorical methods in view of ethical theories based on Islamic teachings and customs and traditions practiced in medical sciences. Having all the above-mentioned points in mind, a researcher in this field can succeed in achieving their goals if the Islamic medical ethics is taken into consideration. By following the philosophical example belonging to Mulla Sadra, an Islamic- Iranian methodology in this field can be based and founded whereby the relationships between different sciences can be firstly explained and clarified, in an appropriate manner and secondly there will be no contrasts and contradictions in regard to the principles of religion in a way that the position of the Islamic laws and jurisprudence will be rightly presented, respected and put into practice. Conclusion:It can be worth while, here, to

  2. Six Challenges for Ethical Conduct in Science.

    Science.gov (United States)

    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.

  3. MEDICAL ETHICS COURSE IMPROVES MEDICAL PROFESSIONALISM: MEDICAL STUDENTS´ OPINIONS

    Directory of Open Access Journals (Sweden)

    Abdolreza Sotoodeh Jahromi

    2014-01-01

    Full Text Available Training physicians who are expert in many medical aspects is the most improtant mission of medical universities. One of these aspects, is professional behavior achievement. One of the important goals in training of ethics, is recognition of conflicts in different parts of ethics and having logical viewpoint for resolving and analyzing these conflicts. This descriptive and analytical study was done to evaluate the efficacy of medical ethics education in medical students´ professional attitudes improvement. One hundred and two medical students were selected randomly in different steps of education and were questioned and their opinions correlation with stage of education and gender were evaluated. There was a significant difference between female viewpoint (in roles of ethic course which is presented in preclinical step in professional attitude improvement (P = 0.009 and also a significant difference was seen in the viewpoint score between student stage with intern stage (P = 0.031. Medical students in educational student stage believe ethic course improve medical professionalism. Since there is no special course to train medical students in professionalism, some interventions are required in this field to improve this aspect of physicians' professional life.

  4. Neuroethics: the pursuit of transforming medical ethics in scientific ethics.

    Science.gov (United States)

    Figueroa, Gustavo

    2016-02-20

    Ethical problems resulting from brain research have given rise to a new discipline termed neuroethics, representing a new kind of knowledge capable of discovering the neural basis for universal ethics. The article (1) tries to evaluate the contributions of neuroethics to medical ethics and its suitability to outline the foundations of universal ethics, (2) critically analyses the process of founding this universal ethic. The potential benefits of applying neuroimaging, psychopharmacology and neurotechnology have to be carefully weighed against their potential harm. In view of these questions, an intensive dialogue between neuroscience and the humanities is more necessary than ever.

  5. New advances and prospects of medical ethics

    Directory of Open Access Journals (Sweden)

    Fang YANG

    2011-09-01

    Full Text Available Objective To review and summarize the latest advances and achievements in medical ethics research since "the Eleventh Five-Year Plan",and to infer the possible developmental prospects of medical ethics in "the Twelfth Five-Year Plan".Methods Bibliographical methods were employed to retrieve the academic achievements and dynamic developments in medical ethics since 2006 to obtain a brief overview and to conduct an in-depth study.Results Since "the Eleventh Five-Year Plan",a series of achievements in medical ethics,especially on the upgrade of the themes,the expansion of the scope,and the renovation of the methods,have been achieved.Research on medical ethics carried out in the army,such as the research on military medical ethics,bioethics,and disaster and epidemic ethics,also yielded several new achievements and played leading roles in the military and practical fields.Conclusions In the period of "the Twelfth Five-Year Plan",the localization of medical ethics research should be promoted,the level of original research should be improved,and the academic contingent and platform should be strenuously constructed.In terms of research direction,continuously strengthening basic and general research of bioethics,highlighting the characteristics and superiority of military medical ethics,enhancing non-combat and combat operation research,and strengthening ethics research for the application of advanced biotechnology in the military field are necessary.

  6. Teaching Ethically: Challenges and Opportunities

    Science.gov (United States)

    Landrum, R. Eric, Ed.; McCarthy, Maureen A., Ed.

    2012-01-01

    Educators work within a fluid academic and social landscape that requires frequent examination and re-examination of what constitutes ethical practice. In this book, editors R. Eric Landrum and Maureen McCarthy identify four broad areas of concern in the ethical teaching of undergraduate psychology: pedagogy, student behavior, faculty behavior…

  7. Teaching Ethically: Challenges and Opportunities

    Science.gov (United States)

    Landrum, R. Eric, Ed.; McCarthy, Maureen A., Ed.

    2012-01-01

    Educators work within a fluid academic and social landscape that requires frequent examination and re-examination of what constitutes ethical practice. In this book, editors R. Eric Landrum and Maureen McCarthy identify four broad areas of concern in the ethical teaching of undergraduate psychology: pedagogy, student behavior, faculty behavior…

  8. The Challenge of Social Ethics

    DEFF Research Database (Denmark)

    Larsen, Øjvind

    Modern global society has seen dramatic changes that throw us into impenetrable ethical problems of a kind never before witnessed in history. By this means, ethical problems constitute the locus of our confrontation with our own life situation. It is this condition that I take to be of fundamental...... importance when one undertakes to reflect upon the meaning of ethics today. If we approach the issue from the point of view of the history of ideas, we find that throughout the whole of the history of philosophy there have been a series of different attempts to articulate an ethics. Most of them address our...... concerns about how a human being ought to act in order to realise his or her life in the best or most correct way. I will return to the array of suggestions that have been offered in this regard. What is important for my purposes, meanwhile, is that there is some-thing that precedes ethical considerations...

  9. An Ethics Challenge for School Counselors

    Science.gov (United States)

    Froeschle, Janet G.; Crews, Charles

    2010-01-01

    Ethical issues arise more often for school counselors than for those who work in other settings (Remley, 2002). The challenge of working not only with minors but also with other stakeholders including parents, teachers, school administrators, and community members sets the stage for potential legal and ethical dilemmas. Awareness and adherence to…

  10. Technology in Art Therapy: Ethical Challenges

    Science.gov (United States)

    Alders, Amanda; Beck, Liz; Allen, Pat B.; Mosinski, Barbara

    2011-01-01

    As technology advances, art therapy practices are adapting to the demands of a new cultural climate. Art therapists face a number of ethical challenges as they interact with increasingly diverse populations and employ new media. This article addresses some of the ethical and professional issues related to the use of technology in clinical…

  11. Technology in Art Therapy: Ethical Challenges

    Science.gov (United States)

    Alders, Amanda; Beck, Liz; Allen, Pat B.; Mosinski, Barbara

    2011-01-01

    As technology advances, art therapy practices are adapting to the demands of a new cultural climate. Art therapists face a number of ethical challenges as they interact with increasingly diverse populations and employ new media. This article addresses some of the ethical and professional issues related to the use of technology in clinical…

  12. Ethical Challenges Scenario: Youth Involvement in Evaluation

    Science.gov (United States)

    Cooksy, Leslie J.

    2007-01-01

    All evaluators face the challenge of striving to adhere to the highest possible standards of ethical conduct. Translating the AEA's Guiding Principles and the Joint Committee's Program Evaluation Standards into everyday practice, however, can be a complex, uncertain, and frustrating endeavor. Moreover, acting in an ethical fashion can require…

  13. The healing philosopher: John Locke's medical ethics.

    Science.gov (United States)

    Short, Bradford William

    2004-01-01

    This article examines a heretofore unexplored facet of John Locke's philosophy. Locke was a medical doctor and he also wrote about medical issues that are controversial today. Despite this, Locke's medical ethics has yet to be studied. An analysis of Locke's education and his teachers and colleagues in the medical profession, of the 17th century Hippocratic Oath, and of the reaction to the last recorded outbreak of the bubonic plague in London, shines some light on the subject of Locke's medical ethics. The study of Locke's medical ethics confirms that he was a deontologist who opposed all suicide and abortion through much of pregnancy.

  14. Two concepts of medical ethics and their implications for medical ethics education.

    Science.gov (United States)

    Rhodes, Rosamond

    2002-08-01

    People who discuss medical ethics or bioethics come to very different conclusions about the levels of agreement in the field and the implications of consensus among health care professionals. In this paper I argue that these disagreements turn on a confusion of two distinct senses of medical ethics. I differentiate (1) medical ethics as a subject in applied ethics from (2) medical ethics as the professional moral commitments of health care professions. I then use the distinction to explain its significant implications for medical ethics education. Drawing on the recent work of John Rawls, I also show the centrality of philosophy in medical ethics by illustrating how contemporary philosophy can be used to construct an ethical framework for the medical professions.

  15. Medical and nursing ethics: never the twain?

    Science.gov (United States)

    Gallagher, A

    1995-06-01

    Since the publication of Carol Gilligan's In a different voice in 1982, there has been much discussion about masculine and feminine approaches to ethics. It has been suggested that an ethics of care, or a feminine ethics, is more appropriate for nursing practice, which contrasts with the 'traditional, masculine' ethics of medicine. It has been suggested that Nel Noddings' version of an 'ethics of care' (or feminine ethics) is an appropriate model for nursing ethics. The 'four principles' approach has become a popular model for medical or health care ethics. It will be suggested in this article that, whilst Noddings presents an interesting analysis of caring and the caring relationship, this has limitations. Rather than acting as an alternative to the 'four principles' approach, the latter is necessary to provide a framework to structure thinking and decision-making in health care. Further, it will be suggested that ethical separatism (that is, one ethics for nurses and one for doctors) in health care is not a progressive step for nurses or doctors. Three recommendations are made: that we promote a health care ethics that incorporates what is valuable in a 'traditional, masculine ethics', the why (four principles approach) and an 'ethics of care', the 'how' (aspects of Noddings' work and that of Urban Walker); that we encourage nurses and doctors to participate in the 'shared learning' and discussion of ethics; and that our ethical language and concerns are common to all, not split into unhelpful dichotomies.

  16. Ethical Challenges in Psychiatric Administration and Leadership.

    Science.gov (United States)

    Moffic, H Steven; Saeed, Sy Atezaz; Silver, Stuart; Koh, Steve

    2015-09-01

    As with all professional ethical principles, those in psychiatry have to evolve over time and societal changes. The current ethical challenges for psychiatric administration and leadership, especially regarding for-profit managed care, need updated solutions. One solution resides in the development by the American Association of Psychiatric Administrators (AAPA) of the first set of ethical principles designed specifically for psychiatric administrators. These principles build on prior Psychological Theories of leadership, such as those of Freud, Kernberg, and Kohut. Supplementing these theories are the actual real life models of psychiatrist leadership as depicted in the memoirs of various psychiatrists. Appreciating these principles, theories, and models may help emerging leaders to better recognize the importance of ethical challenges. A conclusion is that psychiatrists should have the potential to assume more successful leadership positions once again. In such positions, making the skills and well-being of all in the organization seems now to be the foremost ethical priority.

  17. Medical Ethics in Nephrology: A Jewish Perspective

    Directory of Open Access Journals (Sweden)

    Allon J. Friedman

    2016-04-01

    Full Text Available Jewish medical ethics is arguably the oldest recorded system of bioethics still in use. It should be of interest to practicing nephrologists because of its influence on the ethical systems of Christianity, Islam, and Western secular society; because of the extensive written documentation of rabbinical response in addressing a broad range of bioethical dilemmas; and in understanding the values of patients who choose to adhere to religious Jewish law. The goal of this review is to provide a brief overview of the basic principles underlying mainstream traditional Jewish medical ethics, apply them to common clinical scenarios experienced in nephrology practice, and contrast them with that of secular medical ethics.

  18. ETHICAL CONSIDERATIONS IN MEDICAL PRACTICE AND RESEARCH

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    Rajeev

    2016-01-01

    Full Text Available Ethics is governed by moral principles that define human conduct for an individual, group or society. Role of ethics has become extremely important in medical practice and research. Medical practice or any scientific act related to human participation in research should be carefully calibrated safeguarding the ethical interest of the patient/participant. The philosophy of medical intervention should be to integrate a transparent health care system that focuses on consistent delivery of evidence based care at the right time in the right environment and in right manner. In futuristic healthcare sector, upcoming professionals should be adequately sensitized to protect and respect the ethical interest of the patients.

  19. Medical Ethics in Nephrology: A Jewish Perspective.

    Science.gov (United States)

    Friedman, Allon N

    2016-04-19

    Jewish medical ethics is arguably the oldest recorded system of bioethics still in use. It should be of interest to practicing nephrologists because of its influence on the ethical systems of Christianity, Islam, and Western secular society; because of the extensive written documentation of rabbinical response in addressing a broad range of bioethical dilemmas; and in understanding the values of patients who choose to adhere to religious Jewish law. The goal of this review is to provide a brief overview of the basic principles underlying mainstream traditional Jewish medical ethics, apply them to common clinical scenarios experienced in nephrology practice, and contrast them with that of secular medical ethics.

  20. Modern medical research ethics - bioethics

    Directory of Open Access Journals (Sweden)

    Vásquez Abanto J. E.

    2015-01-01

    Full Text Available For today, the medical association came to common opinion, that a doctor-scientist cannot be higher than the universal values. At a decision-making, equally with the scientific interests, which, undoubtedly, will bring to development of the theoretical and practical medicine, a doctor must take into account moral values. The doctrine of the informed consent of patient that is examined as a necessary condition of any medical interference became ethic basis of experiment with participation of human. An observance of confidentiality of the results of the studies is also very important. The present development of the biomedical knowledge supposes realization of human research in a good cause, after the conducted tests on the animals and the other models. A clinical test on human must take place only then, when the risk does not exceed the benefit. Carrying out of the biomedical studies is considered as illegal, unconscionable, amoral and even criminal action. If the regulations and the norms of the law are not observed, it entails penal offence. This article provides the basic foundations of medical activities rather moral standards of medical and research activity, which in the different periods underwent the changes dictated by moral requirements of an era and society are analyzed.

  1. Vulnerable participants in health research: methodological and ethical challenges

    DEFF Research Database (Denmark)

    Nordentoft, Helle Merete; Kappel, Nanna

    2011-01-01

    . The guidelines appear to be instrumental and over-simplistic representations of the often ‘messy’ realities surrounding the research process that is often guided by relational and local negotiations of ethical solutions. Vulnerable participants, for instance, challenge both professional and research ethics......, leaving both professionals and researchers in ethical and moral dilemmas. In this article, we specifically focus on the methodological challenges of obtaining informed consent from drug users and terminally ill cancer patients in our PhD research. The question is how to illuminate the needs and problems......Ethical guidelines for conducting research are embedded in the Helsinki Declaration of 1964. We contend that these abstract and intentionally universal guidelines need to be appropriated for social and healthcare research, in which purpose and methods often deviate from medical research...

  2. Vulnerable participants in health research: methodological and ethical challenges

    DEFF Research Database (Denmark)

    Nordentoft, Helle Merete; Kappel, Nanna

    2011-01-01

    , leaving both professionals and researchers in ethical and moral dilemmas. In this article, we specifically focus on the methodological challenges of obtaining informed consent from drug users and terminally ill cancer patients in our PhD research. The question is how to illuminate the needs and problems......Ethical guidelines for conducting research are embedded in the Helsinki Declaration of 1964. We contend that these abstract and intentionally universal guidelines need to be appropriated for social and healthcare research, in which purpose and methods often deviate from medical research....... The guidelines appear to be instrumental and over-simplistic representations of the often ‘messy’ realities surrounding the research process that is often guided by relational and local negotiations of ethical solutions. Vulnerable participants, for instance, challenge both professional and research ethics...

  3. Ultimate justification: Wittgenstein and medical ethics.

    Science.gov (United States)

    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.

  4. Argument-based medical ethics: a formal tool for critically appraising the normative medical ethics literature.

    Science.gov (United States)

    McCullough, Laurence B; Coverdale, John H; Chervenak, Frank A

    2004-10-01

    Although there are critical appraisal tools for other genres of the medical literature, there currently is no formal tool for physicians to use in their critical appraisal of the normative medical ethics literature. We present a formal assessment tool for the critical appraisal of the normative medical ethics literature that incorporates the intellectual standards of argument-based medical ethics and evidence-based medicine. We draw on the intellectual standards of argument-based ethics, ethical analysis and argument, and the literature on evidence-based medicine. The tool involves 4 questions about normative medical ethics papers: (1) Does the article address a focused ethics question? (2) Are the arguments that support the results of the article valid? (3) What are the results? (4) Will the results help me in clinical practice? Obstetrician-gynecologists can use this tool to appraise the normative literature of ethics in obstetrics and gynecology formally.

  5. Nutrition: ethical issues and challenges.

    Science.gov (United States)

    Rucker, Robert B; Rucker, Michael R

    2016-11-01

    For nutrition and its associated disciplines, ethical considerations related to research are often complicated by factors that range from the use of experimental research designs that are overly holistic to inextricable links between nutrition research and marketing. As a consequence, there is the need for constant vigilance to assess and deal with apparent conflicts of interest. Also, there are few scientific disciplines that are defined by cultural, religious, or political codifications as is nutrition. Accordingly, examples of historical, cultural, and political events are described that have influenced ethical approaches related to nutrition research. Furthermore, nutrition research questions are often multifaceted and require dealing with complex variables. In this regard, ethical principles and perspectives that have relevance to data acquisition, the publication and translation of nutrition research, and the marketing of nutritional products and concepts are highlighted.

  6. The agency problem and medical acting: an example of applying economic theory to medical ethics.

    Science.gov (United States)

    Langer, Andreas; Schröder-Bäck, Peter; Brink, Alexander; Eurich, Johannes

    2009-03-01

    In this article, the authors attempt to build a bridge between economic theory and medical ethics to offer a new perspective to tackle ethical challenges in the physician-patient encounter. They apply elements of new institutional economics to the ethically relevant dimensions of the physician-patient relationship in a descriptive heuristic sense. The principal-agent theory can be used to analytically grasp existing action problems in the physician-patient relationship and as a basis for shaping recommendations at the institutional level. Furthermore, the patients' increased self-determination and modern opportunities for the medical laity to inform themselves lead to a less asymmetrical distribution of information between physician and patient and therefore require new interaction models. Based on the analysis presented here, the authors recommend that, apart from the physician's necessary individual ethics, greater consideration should be given to approaches of institutional ethics and hence to incentive systems within medical ethics.

  7. New Ethical Challenges for Anthropologists

    Science.gov (United States)

    Fluehr-Lobban, Carolyn

    2008-01-01

    The first code of ethics by the American Anthropological Association, adopted in 1971, was forged during the Vietnam War, years after revelations that anthropologists had engaged in counterinsurgency research in Southeast Asia. Now, in response to issues raised by the war in Iraq, the author advocates that it is time for a new code. Members of the…

  8. Cultural context in medical ethics: lessons from Japan

    Directory of Open Access Journals (Sweden)

    Powell Tia

    2006-04-01

    Full Text Available Abstract This paper examines two topics in Japanese medical ethics: non-disclosure of medical information by Japanese physicians, and the history of human rights abuses by Japanese physicians during World War II. These contrasting issues show how culture shapes our view of ethically appropriate behavior in medicine. An understanding of cultural context reveals that certain practices, such as withholding diagnostic information from patients, may represent ethical behavior in that context. In contrast, nonconsensual human experimentation designed to harm the patient is inherently unethical irrespective of cultural context. Attempts to define moral consensus in bioethics, and to distinguish between acceptable and unacceptable variation across different cultural contexts, remain central challenges in articulating international, culturally sensitive norms in medical ethics.

  9. Translational ethics? The theory-practice gap in medical ethics.

    Science.gov (United States)

    Cribb, Alan

    2010-04-01

    Translational research is now a critically important current in academic medicine. Researchers in all health-related fields are being encouraged not only to demonstrate the potential benefits of their research but also to help identify the steps through which their research might be 'made practical'. This paper considers the prospects of a corresponding movement of 'translational ethics'. Some of the advantages and disadvantages of focusing upon the translation of ethical scholarship are reviewed. While emphasising the difficulties of crossing the gap between scholarship and practice, the paper concludes that a debate about the business of translation would be useful for medical ethics.

  10. Medical Ethics in Contemporary Clinical Practice

    Directory of Open Access Journals (Sweden)

    John R. Williams

    2005-11-01

    Full Text Available This review article describes and analyzes ethical issues in medical practice, particularly those issues encountered by physicians in their relationships with their patients. These relationships often involve ethical conflicts between 2 or more interests, which physicians need to recognize and resolve. The article deals with 4 topics in clinical practice in which ethical conflicts occur: physicians' duty of confidentiality in a digital environment, their responsibilities for dealing with abuses of the human rights of patients, their role in clinical research, and their relationships with commercial enterprises. The ethical policies of the World Medical Association provide the basis for determining appropriate physician conduct on these matters. The article concludes with reflections on the need for international standards of medical ethics.

  11. The development of computer ethics: contributions from business ethics and medical ethics.

    Science.gov (United States)

    Wong, K; Steinke, G

    2000-04-01

    In this essay, we demonstrate that the field of computer ethics shares many core similarities with two other areas of applied ethics. Academicians writing and teaching in the area of computer ethics, along with practitioners, must address ethical issues that are qualitatively similar in nature to those raised in medicine and business. In addition, as academic disciplines, these three fields also share some similar concerns. For example, all face the difficult challenge of maintaining a credible dialogue with diverse constituents such as academicians of various disciplines, professionals, policymakers, and the general public. Given these similarities, the fields of bioethics and business ethics can serve as useful models for the development of computer ethics.

  12. Medical ethics in the Neurosciences

    Directory of Open Access Journals (Sweden)

    Pandya S

    2003-07-01

    Full Text Available Doctors in India are heirs to a long tradition of ethics from their own forebears and from those from the West. This paper discusses ethical aspects of topics of relevance to neurological scientists such as brain death, neural transplant and whole brain transplant. Many other topics such as ethics in research, patients with AIDS, patients in a persistent vegetative state and euthanasia deserve similar consideration and debate.

  13. The Medical Ethics of Cognitive Neuroenhancement

    Directory of Open Access Journals (Sweden)

    Erick H. Cheung

    2015-07-01

    Full Text Available Prescription stimulant medications have been sought for cognitive “neuroenhancement”, the practice of enhancing ostensibly normal cognitive function such as attention span, focus, and memory. This trend, particularly studied in college students, has driven a debate about many ethical aspects related to cognitive enhancement; however, the central role of physicians and the medical ethics of this practice have been minimally investigated. In this paper, a clinical case serves as the focal point to review the current state of prescription stimulant use for enhancement, beginning with the medical and legal problems related to the surreptitious, yet common, behaviors of diversion and malingering. In contrast, there may be a growing trend for individuals to seek prescription stimulants “openly” (without malingering or diversion as a direct request from their physician, which leads to complex ethical questions. A model of clinical-ethical decision making (the “four-box model” from Jonsen et al. is applied to analyze the factors that a physician must consider when deciding whether to engage in the open prescribing of a stimulant neuroenhancer to otherwise healthy, autonomous adults. Four domains are explored in depth: medical indications, quality of life/beneficence, patient preferences, and contextual factors. Relevant experiences from the medical disciplines involved in athletic enhancement and cosmetic enhancement are discussed. Although an overall ethical framework for neuroenhancement continues to evolve, from a perspective of medical ethics there are presently significant reasons to be wary of cognitive neuroenhancement with stimulant medications.

  14. The foundations and the development of modern medical ethics.

    Science.gov (United States)

    Steinberg, A

    1995-09-01

    Modern bioethics is based on a pluralistic and multidisciplinary approach, deriving its sources from medicine, biology, philosophy, law, theology, social and behavioral sciences, and history. The moral foundation of modern biomedical ethics is based upon four prima facie principles: respect of autonomy, beneficence, nonmaleficence, justice. This approach, however, has been seriously criticized and challenged. A wide range of issues is discussed and debated in biomedical ethics. Several causes have intensified the recent flourishing of medical ethics: The enormous advancements in scientific and technological knowledge; the intense and widespread interest in bioethics by professionals as well as by the public at large; and the wide sociocultural and economic changes in western society, and in the conduct of medicine. The objectives of clinical medical ethics is outlined in the article.

  15. Ethics in Medical Research and Publication

    Directory of Open Access Journals (Sweden)

    Izet Masic

    2014-01-01

    Full Text Available To present the basic principles and standards of Ethics in medical research and publishing, as well as the need for continuing education in the principles and ethics in science and publication in biomedicine. An analysis of relevant materials and documents, sources from the published literature. Investing in education of researches and potential researches, already in the level of medical schools. Educating them on research ethics, what constitutes research misconduct and the seriousness of it repercussion is essential for finding a solution to this problem and ensuring careers are constructed on honesty and integrity.

  16. Innovation in surgical technology and techniques: Challenges and ethical issues.

    Science.gov (United States)

    Geiger, James D; Hirschl, Ronald B

    2015-06-01

    The pace of medical innovation continues to increase. The deployment of new technologies in surgery creates many ethical challenges including how to determine safety of the technology, what is the timing and process for deployment of a new technology, how are patients informed before undergoing a new technology or technique, how are the outcomes of a new technology evaluated and how are the responsibilities of individual patients and society at large balanced. Ethical considerations relevant to the implementation of ECMO and robotic surgery are explored to further discussion of how we can optimize the delicate balance between innovation and regulation.

  17. Medicine beyond borders: the legal and ethical challenges.

    Science.gov (United States)

    Kassim, Puteri Nemie J

    2009-09-01

    The ease and affordability of international travel has contributed to the rapid growth of the healthcare industry where people from all around the world are traveling to other countries to obtain medical, dental, and surgical care while at the same time touring, vacationing and fully experiencing the attractions of the countries that they are visiting. A combination of many factors has led to the recent increase in popularity of medical tourism such as exorbitant costs of healthcare in industrialized nations, favorable currency exchange rates in the global economy, rapidly improving technology in many countries of the world and most importantly proven safety of healthcare in selected foreign nations. Nevertheless, the development of medical tourism has certainly awakened many ethical and legal issues, which must be addressed. Issues pertaining to malpractice, consumer protection, organ trafficking, alternative medicine and telemedicine need comprehensive legal regulatory framework to govern them. Ethical issues are also been raised by the promotion of medical tourism in particular those pertaining to doctor and patient relationship. A future, where medical law is subsumed into various legal and ethical dimensions, poses serious challenges for the practice and ethics of medicine.

  18. Ethical Challenges Regarding Globalization of Higher Education

    Science.gov (United States)

    Olivier, Bert

    2011-01-01

    This paper places the question of ethical challenges in relation to the process of globalization concerning international education and the mobility of international students worldwide. It focuses on five areas of justice, namely, social and political justice, administrative justice, distributive justice, cultural justice and ecological justice.…

  19. Social and ethical challenges for metallurgical companies

    Directory of Open Access Journals (Sweden)

    Gajdzik, B.

    2008-01-01

    Full Text Available The subject of this article is an analysis of one of the most crucial aspects of the contemporary business, which is corporate social responsibility and ethical business. The notion of a socially responsible business signifies the business obligation to contribute to the sustainable economical development by way of working with employees and their families, local communities and the society as a whole in order to improve the quality of their lives. Ethical business means following the principles and standards determining a manner of conducting a given business from the moral point of view. The article contains examples of such challenges that are realised by Arcelor Mittal.

  20. Virtue ethics - an old answer to a new dilemma? Part 1. Problems with contemporary medical ethics.

    Science.gov (United States)

    Misselbrook, David

    2015-02-01

    The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis. © The Royal Society of Medicine.

  1. A two-decade Review of Medical Ethics in Iran

    Directory of Open Access Journals (Sweden)

    F Zahedi

    2009-03-01

    Full Text Available "nThe growing developments in science and technology have raised ethical challenges which should practically be addressed by scientists, regulatory bodies and policy makers. Likewise, challenging issues of medical ethics have also drawn a great deal of academic attention in Iran. In other words, recent decades have been an occasion of considerable development for contemporary bioethics in Iran. At first, the ongoing initiatives to arrange the national and regional research ethics commit­tees and to compile the national strategic plan for medical ethics is worth mentioning. Currently, research ethics committees are actively established in the universities and research centers across the country. Furthermore, the subject of ethics in dif­ferent fields of science, which was followed in a traditional approach previously, is an important object of discussion cur­rently. Much research is now being undertaken in various areas of bioethics nationwide. Consequently, during the period under review, considerable articles and books have been published in the emerging subjects of bioethics. Several educa­tional workshops and courses have been frequently taken place in the universities and research centers. Foundation of aca­demic courses and fellowship in bioethics are also among the recent activities in the realm of medical ethics education in Iran. Likewise, considering several areas of bioethics that need legislation or reconsideration of previous regulations; the authorities, policy-makers, and scientists have carried out some endeavors to prepare appropriate law, codes, and guidelines. This report summarizes the bioethical activities and achievements in different fields of policy-making, organizing, teaching, and putting ethics into practice in our country during two recent decades.

  2. Ethics in the marketing of medical services.

    Science.gov (United States)

    Latham, Stephen R

    2004-09-01

    This paper deals with the ethics of marketing medical services by physicians, medical groups, hospitals and other mainstream medical caregivers in the United States. It does not deal with pharmaceutical marketing, since that raises a number of special issues, some of them legal and some having to do with the unique culture of pharmaceutical marketing, which really ought to be dealt with separately. Nor does it touch on the little-explored field of marketing alternative and complementary medicine. It begins with a general description of what is included in "the marketing process." It then briefly tours some of the difficulties faced by those who would market medical services ethically, and ends with some comments on the relevance of professionalism to ethical marketing.

  3. Medical Schools, Clinical Research, and Ethical Leadership

    Science.gov (United States)

    Makarushka, Julia L.; Lally, John J.

    1974-01-01

    Recent discussion of the ethical problems of biomedical human experimentation has drawn attention to the responsibility of the medical schools for training new clinical investigators and for safeguarding the rights and welfare of the subjects of clinical research conducted in the medical schools and their affiliated hospitals. (Author)

  4. Medical performance : Ethical and conceptual issues

    NARCIS (Netherlands)

    Widder, J

    1996-01-01

    Following an introductory criticism of the Hippocratic Oath and a health-maximizing principle as ethical basis for health care, an evaluation of medical performance is presented according to 3 underlying concepts, namely 1) the act of performing medical procedures itself, 2) effectiveness and 3) eff

  5. Ethical challenges and how to develop ethics support in primary health care.

    Science.gov (United States)

    Lillemoen, Lillian; Pedersen, Reidar

    2013-02-01

    Ethics support in primary health care has been sparser than in hospitals, the need for ethics support is probably no less. We have, however, limited knowledge about how to develop ethics support that responds to primary health-care workers' needs. In this article, we present a survey with a mixture of closed- and open-ended questions concerning: How frequent and how distressed various types of ethical challenges make the primary health-care workers feel, how important they think it is to deal with these challenges better and what kind of ethics support they want. Five primary health-care institutions participated. Ethical challenges seem to be prominent and common. Most frequently, the participants experienced ethical challenges related to scarce resources and lack of knowledge and skills. Furthermore, ethical challenges related to communication and decision making were common. The participants welcomed ethics support responding to their challenges and being integrated in their daily practices.

  6. Ethics committees in Japanese medical schools.

    Science.gov (United States)

    Saito, T

    1992-01-01

    The present features and functions of ethics committees in 80 Japanese medical schools were surveyed by employing questionnaires. Seventy-nine schools had already established committees on each campus (however, the ethics committee at Kitasato Medical University was formally established after the completion of this survey). The major role of Japanese ethics committees may be said roughly to correspond to that of Institutional Review Boards (IRB) in the U.S., although ethics committees have other functions as well. Among the ethics committees' many problems, two significant weaknesses should be underscored. The first is the inappropriate composition of the membership of the committees: more non-campus members, younger professionals, and women should be invited to participate. The second concern is the committees' essentially closed review process: this process has not been adequately open to the public even in cases in which the issue of the patient's confidentiality does not arise. However, several schools are now preparing to open their meetings to non-members and this policy should improve the present situation. It is fortunate, however, that the ethics committees in Japan's medical schools were established by members from each campus and not as a response to national directives or legislation.

  7. Ethical issues associated with medical tourism in Africa

    Science.gov (United States)

    Mogaka, John J. O.; Mupara, Lucia; Tsoka-Gwegweni, Joyce M

    2017-01-01

    ABSTRACT Global disparities in medical technologies, laws, economic inequities, and social–cultural differences drive medical tourism (MT), the practice of travelling to consume healthcare that is either too delayed, unavailable, unaffordable or legally proscribed at home. Africa is simultaneously a source and destination for MT. MT however, presents a new and challenging health ethics frontier, being largely unregulated and characterized by policy contradictions, minority discrimination and conflict of interest among role-players. This article assesses the level of knowledge of MT and its associated ethical issues in Africa; it also identifies critical research gaps on the subject in the region. Exploratory design guided by Arksey and O’Malley’s (2005) framework was used. Key search terms and prior determined exclusion/inclusion criteria were used to identify relevant literature sources. Fifty-seven articles met the inclusion criteria. Distributive justice, healthcare resource allocation, experimental treatments and organ transplant were the most common ethical issues of medical tourism in Africa. The dearth of robust engagement of MT and healthcare ethics, as identified through this review, calls for more rigorous research on this subject. Although the bulk of the medical tourism industry is driven by global legal disparities based on ethical considerations, little attention has been given to this subject. PMID:28740618

  8. Ethical issues associated with medical tourism in Africa.

    Science.gov (United States)

    Mogaka, John J O; Mupara, Lucia; Tsoka-Gwegweni, Joyce M

    2017-01-01

    Global disparities in medical technologies, laws, economic inequities, and social-cultural differences drive medical tourism (MT), the practice of travelling to consume healthcare that is either too delayed, unavailable, unaffordable or legally proscribed at home. Africa is simultaneously a source and destination for MT. MT however, presents a new and challenging health ethics frontier, being largely unregulated and characterized by policy contradictions, minority discrimination and conflict of interest among role-players. This article assesses the level of knowledge of MT and its associated ethical issues in Africa; it also identifies critical research gaps on the subject in the region. Exploratory design guided by Arksey and O'Malley's (2005) framework was used. Key search terms and prior determined exclusion/inclusion criteria were used to identify relevant literature sources. Fifty-seven articles met the inclusion criteria. Distributive justice, healthcare resource allocation, experimental treatments and organ transplant were the most common ethical issues of medical tourism in Africa. The dearth of robust engagement of MT and healthcare ethics, as identified through this review, calls for more rigorous research on this subject. Although the bulk of the medical tourism industry is driven by global legal disparities based on ethical considerations, little attention has been given to this subject.

  9. Epistemological and Pedagogical Challenges of Teaching International Business Ethics Courses

    Science.gov (United States)

    Dion, Michel

    2015-01-01

    International business ethics courses imply four basic epistemological and pedagogical challenges: (a) understanding various perceptions of ethics and values/virtues; (b) identifying ethical maxims among religious/spiritual traditions; (c) designing international business ethics courses as dialogical experiences; and (d) deepening our personal…

  10. Epistemological and Pedagogical Challenges of Teaching International Business Ethics Courses

    Science.gov (United States)

    Dion, Michel

    2015-01-01

    International business ethics courses imply four basic epistemological and pedagogical challenges: (a) understanding various perceptions of ethics and values/virtues; (b) identifying ethical maxims among religious/spiritual traditions; (c) designing international business ethics courses as dialogical experiences; and (d) deepening our personal…

  11. Medical ethics, bioethics and research ethics education perspectives in South East Europe in graduate medical education.

    Science.gov (United States)

    Mijaljica, Goran

    2014-03-01

    Ethics has an established place within the medical curriculum. However notable differences exist in the programme characteristics of different schools of medicine. This paper addresses the main differences in the curricula of medical schools in South East Europe regarding education in medical ethics and bioethics, with a special emphasis on research ethics, and proposes a model curriculum which incorporates significant topics in all three fields. Teaching curricula of Medical Schools in Bulgaria, Bosnia and Herzegovina, Croatia, Serbia, Macedonia and Montenegro were acquired and a total of 14 were analyzed. Teaching hours for medical ethics and/or bioethics and year of study in which the course is taught were also analyzed. The average number of teaching hours in medical ethics and bioethics is 27.1 h per year. The highest national average number of teaching hours was in Croatia (47.5 h per year), and the lowest was in Serbia (14.8). In the countries of the European Union the mean number of hours given to ethics teaching throughout the complete curriculum was 44. In South East Europe, the maximum number of teaching hours is 60, while the minimum number is 10 teaching hours. Research ethics topics also show a considerable variance within the regional medical schools. Approaches to teaching research ethics vary, even within the same country. The proposed model for education in this area is based on the United Nations Educational, Scientific and Cultural Organization Bioethics Core Curriculum. The model curriculum consists of topics in medical ethics, bioethics and research ethics, as a single course, over 30 teaching hours.

  12. Students’ medical ethics rounds: a combinatorial program for medical ethics education

    Science.gov (United States)

    Beigy, Maani; Pishgahi, Ghasem; Moghaddas, Fateme; Maghbouli, Nastaran; Shirbache, Kamran; Asghari, Fariba; Abolfat-h Zadeh, Navid

    2016-01-01

    It has long been a common goal for both medical educators and ethicists to develop effective methods or programs for medical ethics education. The current lecture-based courses of medical ethics programs in medical schools are demonstrated as insufficient models for training “good doctors’’. In this study, we introduce an innovative program for medical ethics education in an extra-curricular student-based design named Students’ Medical Ethics Rounds (SMER). In SMER, a combination of educational methods, including theater-based case presentation, large group discussion, expert opinions, role playing and role modeling were employed. The pretest-posttest experimental design was used to assess the impact of interventions on the participants’ knowledge and attitude regarding selected ethical topics. A total of 335 students participated in this study and 86.57% of them filled the pretest and posttest forms. We observed significant improvements in the knowledge (P attitude (P < 0.0001) of participants. Interestingly, 89.8% of participants declared that their confidence regarding how to deal with the ethical problems outlined in the sessions was increased. All of the applied educational methods were reported as helpful. We found that SMER might be an effective method of teaching medical ethics. We highly recommend the investigation of the advantages of SMER in larger studies and interdisciplinary settings. PMID:27471586

  13. Teaching medical ethics to meet the realities of a changing health care system.

    Science.gov (United States)

    Millstone, Michael

    2014-06-01

    The changing context of medical practice--bureaucratic, political, or economic--demands that doctors have the knowledge and skills to face these new realities. Such changes impose obstacles on doctors delivering ethical care to vulnerable patient populations. Modern medical ethics education requires a focus upon the knowledge and skills necessary to close the gap between the theory and practice of ethical care. Physicians and doctors-in-training must learn to be morally sensitive to ethical dilemmas on the wards, learn how to make professionally grounded decisions with their patients and other medical providers, and develop the leadership, dedication, and courage to fulfill ethical values in the face of disincentives and bureaucratic challenges. A new core focus of medical ethics education must turn to learning how to put ethics into practice by teaching physicians to realistically negotiate the new institutional maze of 21st-century medicine.

  14. [Bioethics is dead. Long live medical ethics!].

    Science.gov (United States)

    Barrio Maestre, José María

    2015-01-01

    The purpose of this paper is to show a paradigmatic crisis in academic bioethics. Since an important part of bioethicists began to relativize the ethical prohibition of killing an innocent human being, one way or another they began to ally with the death industry: the business of abortion, and then that of euthanasia. The thesis of this paper is that by crossing that Rubicon bioethics has been corrupted and has lost its connection to the ethical, political and legal discourse. One can only hope that it will revive from its ashes if it retakes the ″taboo″ of the sacredness of human life, something for which medical ethics could provide invaluable help, because it still keeps the notion that ″a doctor should not kill″, although in an excessively ″discreet″ and somehow ″ashamed″ way. However, conscientious doctors know more about ethics than most bioethicists.

  15. Ethics and Continuing Professional Education: Today's Challenges, Tomorrow's Solutions.

    Science.gov (United States)

    Lawler, Patricia A.

    2001-01-01

    If continuing professional education is to make a difference and meet challenges, ethics and its place in professional life must be moved to the forefront. Educators should continually renew the ethics discourse, drawing on the resources of adult education. (JOW)

  16. Medical ethics and human rights in wartime

    African Journals Online (AJOL)

    2015-03-09

    Mar 9, 2015 ... Dr Wouter Basson was charged with violating this medical ethics norm during the ... a criminal trial, with a higher standard of proof than a civil trial ... cannot escape responsibility by relying on a military order; that as long as a ...

  17. A Theoretical Framework for Human and Veterinary Medical Ethics Education

    Science.gov (United States)

    Magalhães-Sant'Ana, Manuel

    2016-01-01

    In their practice, physicians and veterinarians need to resort to an array of ethical competences. As a teaching topic, however, there is no accepted gold standard for human medical ethics, and veterinary medical ethics is not yet well established. This paper provides a reflection on the underlying aims of human and veterinary medical ethics…

  18. Ethical Challenges in Infant Feeding Research.

    Science.gov (United States)

    Binns, Colin; Lee, Mi Kyung; Kagawa, Masaharu

    2017-01-11

    Infants have a complex set of nutrient requirements to meet the demands of their high metabolic rate, growth, and immunological and cognitive development. Infant nutrition lays the foundation for health throughout life. While infant feeding research is essential, it must be conducted to the highest ethical standards. The objective of this paper is to discuss the implications of developments in infant nutrition for the ethics of infant feeding research and the implications for obtaining informed consent. A search was undertaken of the papers in the medical literature using the PubMed, Science Direct, Web of Knowledge, Proquest, and CINAHL databases. From a total of 9303 papers identified, the full text of 87 articles that contained discussion of issues in consent in infant feeding trials were obtained and read and after further screening 42 papers were included in the results and discussion. Recent developments in infant nutrition of significance to ethics assessment include the improved survival of low birth weight infants, increasing evidence of the value of breastfeeding and evidence of the lifelong importance of infant feeding and development in the first 1000 days of life in chronic disease epidemiology. Informed consent is a difficult issue, but should always include information on the value of preserving breastfeeding options. Project monitoring should be cognisant of the long term implications of growth rates and early life nutrition.

  19. Understanding doctors' ethical challenges as role virtue conflicts.

    Science.gov (United States)

    McDougall, Rosalind

    2013-01-01

    This paper argues that doctors' ethical challenges can be usefully conceptualised as role virtue conflicts. The hospital environment requires doctors to be simultaneously good doctors, good team members, good learners and good employees. I articulate a possible set of role virtues for each of these four roles, as a basis for a virtue ethics approach to analysing doctors' ethical challenges. Using one junior doctor's story, I argue that understanding doctors' ethical challenges as role virtue conflicts enables recognition of important moral considerations that are overlooked by other approaches to ethical analysis.

  20. [Kairos. Decision-making in medical ethics].

    Science.gov (United States)

    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.

  1. [Ethics in articles published in medical journals].

    Science.gov (United States)

    Reyes, Humberto; Palma, Joaquín; Andresen, Max

    2007-04-01

    Authors of clinical articles have similar motivations and rules than authors in other scientific fields. In addition, medical research must obey specific ethical rules that apply to studies involving human subjects, including biological samples, tissues, cellular or sub cellular samples obtained from them. When submitting their reports for publication, authors must declare that they have followed such ethical rules and also should declare any possible conflict of interest that may have arisen. External peer reviewers and the editors should also conform to limitations by eventual conflicts of interest. Authors should respect specific ethical norms that apply to the process of submitting, publishing and reproducing their manuscripts. In recent years, the editors of Revista Médica de Chile have become aware of five instances of misconduct committed by authors of articles submitted or already published. Four correspond to redundant publications and one exhibits overt plagiarism in the text and syntax. Appropriate actions have been taken following recommendations published by the International Committee of Medical Journal Editors, the World Association of Medical Editors and other groups. The present article stresses that authors and their sponsoring institutions must be aware of the importance of following ethical rules when reporting scientific work.

  2. Ethical Challenges of Medicine and Health on the Internet: A Review

    Science.gov (United States)

    2001-01-01

    Knowledge and capabilities, particularly of a new technology or in a new area of study, frequently develop faster than the guidelines and principles needed for practitioners to practice ethically in the new arena; this is particularly true in medicine. The blending of medicine and healthcare with e-commerce and the Internet raises many questions involving what sort of ethical conduct should be expected by practitioners and developers of the medical Internet. Some of the early pioneers in medical and healthcare Web sites pushed the ethical boundaries with questionable, even unethical, practices. Many involved with the medical Internet are now working to reestablish patient and consumer trust by establishing guidelines to determine how the fundamentals of the medical code of ethical conduct can best be adapted for the medical/healthcare Internet. Ultimately, all those involved in the creation, maintenance, and marketing of medical and healthcare Web sites should be required to adhere to a strict code of ethical conduct, one that has been fairly determined by an impartial international organization with reasonable power to regulate the code. This code could also serve as a desirable, recognizable label-of-distinction for ethical Web sites within the medical and healthcare Internet community. One challenge for those involved with the medical and healthcare Internet will be to determine what constitutes "Medical Internet Ethics" or "Healthcare Internet Ethics," since the definition of medical ethics can vary from country to country. Therefore, the emerging field of Medical/ Healthcare Internet Ethics will require careful thought and insights from an international collection of ethicists in many contributing areas. This paper is a review of the current status of the evolving field of Medical/Healthcare Internet Ethics, including proposed definitions and identification of many diverse areas that may ultimately contribute to this multidisciplinary field. The current role

  3. Ethical challenges of medicine and health on the Internet: a review.

    Science.gov (United States)

    Dyer, K A

    2001-01-01

    Knowledge and capabilities, particularly of a new technology or in a new area of study, frequently develop faster than the guidelines and principles needed for practitioners to practice ethically in the new arena; this is particularly true in medicine. The blending of medicine and healthcare with e-commerce and the Internet raises many questions involving what sort of ethical conduct should be expected by practitioners and developers of the medical Internet. Some of the early pioneers in medical and healthcare Web sites pushed the ethical boundaries with questionable, even unethical, practices. Many involved with the medical Internet are now working to reestablish patient and consumer trust by establishing guidelines to determine how the fundamentals of the medical code of ethical conduct can best be adapted for the medical/healthcare Internet. Ultimately, all those involved in the creation, maintenance, and marketing of medical and healthcare Web sites should be required to adhere to a strict code of ethical conduct, one that has been fairly determined by an impartial international organization with reasonable power to regulate the code. This code could also serve as a desirable, recognizable label-of-distinction for ethical Web sites within the medical and healthcare Internet community. One challenge for those involved with the medical and healthcare Internet will be to determine what constitutes "Medical Internet Ethics" or "Healthcare Internet Ethics," since the definition of medical ethics can vary from country to country. Therefore, the emerging field of Medical/ Healthcare Internet Ethics will require careful thought and insights from an international collection of ethicists in many contributing areas. This paper is a review of the current status of the evolving field of Medical/Healthcare Internet Ethics, including proposed definitions and identification of many diverse areas that may ultimately contribute to this multidisciplinary field. The current role

  4. A Monotheistic Look at Medical Ethics

    Directory of Open Access Journals (Sweden)

    Amir Ahmad Shojaei

    2016-09-01

    Full Text Available Introduction: Medical ethics in a reductive look can be handed to physician’s ethics and then call a physician who adheres to medical ethics attributed to the moral virtues. Moral virtues are counted to be about one hundred and fifty in the teachings of Shiite most of which are not related to the practice of medicine but nearly eighty virtues are linked to the to the practice of medicine. This number is too much to be handled in a paper and analyzed by verses and hadiths. Therefore, we should take two steps: - limit therapeutic virtues - analyze therapeutic virtues METHODOLOGY: Factor analysis method was used and therapeutic virtues were limited to thirteen virtues. Then library study and focus group discussions were used to analyze the selected therapeutic virtues. Results: believe and practice the virtues emphasized in the teachings of Shiite leads to a monotheistic look to the practice of medicine and provides physicians with a different and transcendental worldview.This insight that stood upon the teachings of the Qur'an and hadiths by Imams (AS first knows the practice of medicine a divine relation and then shows the communication between a physician and others. The current paper analyzes the divine relation of the physician and its impact to the practice of medicine. The practical conclusions is that if we consider medical ethics practice based on virtue, and define and interpret virtues based on the teachings of Shiite, then we will get to a monotheistic view in the practice of medicine that distinguishes Shiite medical ethics monotheistic feature and the secular one, and helps to link between faith and morals.

  5. The ethics of reality medical television.

    Science.gov (United States)

    Krakower, Thalia Margalit; Montello, Martha; Mitchell, Christine; Truog, Robert D

    2013-01-01

    Reality medical television, an increasingly popular genre, depicts private medical moments between patients and healthcare providers. Journalists aim to educate and inform the public, while the participants in their documentaries-providers and patients-seek to heal and be healed. When journalists and healthcare providers work together at the bedside, moral problems precipitate. During the summer of 2010, ABC aired a documentary, Boston Med, featuring several Boston hospitals. We examine the ethical issues that arise when journalism and medicine intersect. We provide a framework for evaluating the potential benefits and harms of reality medical television, highlighting critical issues such as informed consent, confidentiality, and privacy.

  6. Ethical challenges when reading aesthetic rape scenes

    NARCIS (Netherlands)

    E.M. Koopman (Emy)

    2011-01-01

    textabstractBoth the issue of the ethics of representation and the issue of the ethics of reading are particularly important when it comes to representations of suffering and violence. This chapter addresses the ethics of representing and the ethics of reading rape, with a focus on the latter. Depic

  7. How virtue ethics informs medical professionalism.

    Science.gov (United States)

    McCammon, Susan D; Brody, Howard

    2012-12-01

    We argue that a turn toward virtue ethics as a way of understanding medical professionalism represents both a valuable corrective and a missed opportunity. We look at three ways in which a closer appeal to virtue ethics could help address current problems or issues in professionalism education-first, balancing professionalism training with demands for professional virtues as a prerequisite; second, preventing demands for the demonstrable achievement of competencies from working against ideal professionalism education as lifelong learning; and third, avoiding temptations to dismiss moral distress as a mere "hidden curriculum" problem. As a further demonstration of how best to approach a lifelong practice of medical virtue, we will examine altruism as a mean between the extremes of self-sacrifice and selfishness.

  8. Intragastric balloon: ethics, medical need and cosmetics.

    Science.gov (United States)

    Kotzampassi, Katerina; Shrewsbury, Anne D

    2008-01-01

    The development of the intragastic balloon as a safe, noninvasive, alternative method to weight reduction raises all the ethical questions routinely faced by practitioners of other forms of cosmetic surgery. In the case of the morbidly, severely or merely obese, the surgeon is faced with a medical decision in a situation defined by medical parameters. The case of the overweight or normal may, however, create an ethical dilemma in which the doctor is forced to make decisions of a nonmedical nature, for which his training has not prepared him, and relating essentially to his personal attitudes and moral beliefs, culture and the recognition that 'if I don't, somebody else--possibly less competent--will'.

  9. 'Medical ethics'--an alternative approach.

    Science.gov (United States)

    Haldane, J J

    1986-09-01

    Contemporary medical ethics is generally concerned with the application of ethical theory to medico-moral dilemmas and with the critical analysis of the concepts of medicine. This paper presents an alternative programme: the development of a medical philosophy which, by taking as its starting point the two questions: what is man? and, what constitutes goodness in life? offers an account of health as one of the primary concepts of value. This view of the subject resembles that implied by ancient theories of goodness, and in later sections of the paper it is shown how Aristotle points us towards a coherent theory of human nature as psycho-physical, which overcomes the inadequacies of dualism and physicalist reductionism. What is on offer therefore, is the prospect of an integrated account of human nature and of what constitutes its flourishing: to be healthy is to be an active unity-of-parts in equilibrium.

  10. Life and Medical Ethics in Pediatric Neurosurgery

    Science.gov (United States)

    YAMASAKI, Mami

    2017-01-01

    Ethical issues in the field of pediatric neurosurgery, including prenatal diagnosis, palliative care for children with an intractable serious disease, and medical neglect, are discussed. An important role of medicine is to offer every possible treatment to a patient. However, it also is the responsibility of medicine to be conscious of its limitations, and to help parents love and respect a child who suffers from an incurable disease. When dealing with cases of medical neglect and palliative care for an incurable disease, it is critical to diagnose the child’s condition accurately and evaluate the outcome. However, to treat or not to treat also depends on the medical resources and social-economic status of the community, the parents’ religion and philosophy, the policies of the institutions involved, and the limits of medical science. Moral dilemmas will continue to be addressed as medical progress yields treatments for untreatable diseases in the future. PMID:28025426

  11. Challenges to ethics and professionalism facing the contemporary neurologist.

    Science.gov (United States)

    Bernat, James L

    2014-09-30

    Challenges to ethics and professionalism that can harm neurologists and their patients include the commercialization of medicine, poorly designed Medicare regulations, conflicts of interest, physician employment by hospitals, faulty measurement of medical quality care, electronic health records, electronic communications with patients, and the demotion of the role of physician beneficence. These threats can lead to inaccurate medical record-keeping, unnecessary medical care, a decline in the primacy of patients' interests, and damage to the sanctity of the patient-physician relationship. The increasing frequency of physician burnout can be attributed at least partially to unmitigated stresses on practicing physicians, particularly the growing time pressures for patient visits, the mounting daily requirements of documentation, and the increasing burden of time-consuming but unproductive tasks. Recommended correctives include reforming billing documentation regulations, improving electronic health records, designing proper quality indicators integrating physician wellness, and incorporating reasonable physician workflows in the design of accountable care organizations.

  12. The Ethics of Infection Challenges in Primates.

    Science.gov (United States)

    Barnhill, Anne; Joffe, Steven; Miller, Franklin G

    2016-07-01

    In the midst of the recent Ebola outbreak, scientific developments involving infection challenge experiments on nonhuman primates (NHPs) sparked hope that successful treatments and vaccines may soon become available. Yet these studies pose a stark ethical quandary. On the one hand, they represent an important step in developing novel therapies and vaccines for Ebola and the Marburg virus, with the potential to save thousands of human lives and to protect whole communities from devastation; on the other hand, they intentionally expose sophisticated animals to severe suffering and a high risk of death. Other studies that infect NHPs with a lethal disease in order to test interventions that may prove beneficial for humans pose the same ethical difficulty. Some advocates have argued that all research on primates should be phased out, and ethicists have questioned whether a moral justification of primate research is possible. A 2010 European Union directive banned virtually all research on great apes, and 2013 guidelines from the National Institutes of Health (NIH), based upon recommendations in an influential 2011 Institute of Medicine (IOM) report, eliminated most biomedical research with chimpanzees in the United States. But studies involving other NHPs face no comparable restrictions. Should research on NHPs other than great apes be subject to tighter restrictions than it currently is? In this article, we explore this general question in the context of one particular type of biomedical research: infection challenge studies. We advocate a presumptive prohibition on infection challenge experiments in NHPs, but we also argue that exceptions to this prohibition are permissible, subject to strict substantive and procedural safeguards, when necessary to avert substantial loss of human life or severe morbidity for a substantial number of people.

  13. Ethical and public policy challenges for pharmacogenomics.

    Science.gov (United States)

    Gershon, Elliot S; Alliey-Rodriguez, Ney; Grennan, Kay

    2014-12-01

    It is timely to consider the ethical and social questions raised by progress in pharmacogenomics, based on the current importance of pharmacogenomics for avoidance of predictable side effects of drugs, and for correct choice of medications in certain cancers. It has been proposed that the entire population be genotyped for drug-metabolizing enzyme polymorphisms, as a measure that would prevent many untoward and dangerous drug reactions. Pharmacologic treatment targeting based on genomics of disease can be expected to increase greatly in the coming years. Policy and ethical issues exist on consent for large-scale genomic pharmacogenomic data collection, public vs corporate ownership of genomic research results, testing efficacy and safety of drugs used for rare genomic indications, and accessibility of treatments based on costly research that is applicable to relatively few patients. In major psychiatric disorders and intellectual deficiency, rare and de novo deletion or duplication of chromosomal segments (copy number variation), in the aggregate, are common causes of increased risk. This implies that the policy problems of pharmacogenomics will be particularly important for the psychiatric disorders.

  14. Ethical and medical dilemmas of space tourism

    Science.gov (United States)

    Marsh, Melinda

    Space tourism is an important new venture, however it raises several issues that must be addressed; namely, the medical implications associated with space flight and potential for ethical problems surrounding the safety of such travel. It seems highly likely that businesses involved in space tourism could find themselves liable for any passenger deaths or injuries, if they are found to have been negligent. This paper, therefore, discusses such issues as the medical facilities that need to be made available on board a space facility, and the companies' duty to disclose to potential passengers the risks associated with microgravity and the likelihood of space sickness, loss of bone density, disease, and pregnancy.

  15. Changes in moral reasoning and the teaching of medical ethics

    DEFF Research Database (Denmark)

    Holm, S; Norup, M; Vegner, A

    1995-01-01

    Courses in medical ethics are becoming an integral part of many medical school curricula in Europe. At the medical school of the University of Copenhagen, a course on philosophy of medicine has been compulsory for all medical students since 1988. The effect of such courses on the ethical awareness...

  16. Avoiding Evasion: Medical Ethics Education and Emotion Theory

    National Research Council Canada - National Science Library

    C. Leget

    2004-01-01

    .... It is argued that in order to avoid an attitude of evasion in medical ethics teaching, a philosophical theory of emotions is needed that is able to clarify on a conceptual level the ethical importance of emotions...

  17. Ethical challenges in designing and conducting medicine quality surveys

    OpenAIRE

    Tabernero, P; Parker, M.; Ravinetto, R; Phanouvong, S; Yeung, S; Kitutu, FE; Cheah, PY; MAYXAY, M; Guerin, PJ; Newton, PN

    2016-01-01

    ObjectivesIn this paper we discuss the main ethical challenges related to the conduct of medicine quality surveys and make suggestions on how to address them. MethodMost evidence-based information regarding medicine quality derives from surveys. However, existing research ethical guidelines do not provide specific guidance for medicine quality surveys. Hence, those conducting surveys are often left wondering how to judge what counts as best practice. A list of the main ethical challenges in t...

  18. The essential role of medical ethics education in achieving professionalism: the Romanell Report.

    Science.gov (United States)

    Carrese, Joseph A; Malek, Janet; Watson, Katie; Lehmann, Lisa Soleymani; Green, Michael J; McCullough, Laurence B; Geller, Gail; Braddock, Clarence H; Doukas, David J

    2015-06-01

    This article-the Romanell Report-offers an analysis of the current state of medical ethics education in the United States, focusing in particular on its essential role in cultivating professionalism among medical learners. Education in ethics has become an integral part of medical education and training over the past three decades and has received particular attention in recent years because of the increasing emphasis placed on professional formation by accrediting bodies such as the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education. Yet, despite the development of standards, milestones, and competencies related to professionalism, there is no consensus about the specific goals of medical ethics education, the essential knowledge and skills expected of learners, the best pedagogical methods and processes for implementation, and optimal strategies for assessment. Moreover, the quality, extent, and focus of medical ethics instruction vary, particularly at the graduate medical education level. Although variation in methods of instruction and assessment may be appropriate, ultimately medical ethics education must address the overarching articulated expectations of the major accrediting organizations. With the aim of aiding medical ethics educators in meeting these expectations, the Romanell Report describes current practices in ethics education and offers guidance in several areas: educational goals and objectives, teaching methods, assessment strategies, and other challenges and opportunities (including course structure and faculty development). The report concludes by proposing an agenda for future research.

  19. Moral forces: interpreting ethical challenges in military operations

    NARCIS (Netherlands)

    Graaff, de Miriam Carla

    2017-01-01

    The studies presented in this dissertation reveal three broad types of ethical challenges during military operations at an individual level that are caused by social interactions of military personnel, regardless of rank. The first encompasses ethical challenges related to encounters with other indi

  20. Moral forces: interpreting ethical challenges in military operations

    NARCIS (Netherlands)

    de Graaff, Miriam

    2017-01-01

    The studies presented in this dissertation reveal three broad types of ethical challenges during military operations at an individual level that are caused by social interactions of military personnel, regardless of rank. The first encompasses ethical challenges related to encounters with other

  1. [Medical research ethics 50 years after Nuremberg].

    Science.gov (United States)

    Ruyter, K W

    1997-12-10

    50 years ago, in Nuremberg, 23 German doctors were accused of crimes against humanity. The anniversary is a solemn reminder of the dark origins of medical research ethics. Many researchers today believe that the medical experiments carried out under Hitler "vaccinated" postwar researchers against abuse. A review of the practices of postwar research shows that the "vaccination" had limited effect and that there is no reason to believe that the events which took place under Hitler were unique and will never happen again. After the war various measures were introduced to protect research subjects: informed consent, self regulation and independent research ethics committees. The measures have undoubtedly limited the abuse of subjects substantially. Nevertheless, in the Armed Forces, where abuse has been most rampant after the war, informed consent is not always practised and independent review is seldom carried out. With the support of grant institutions, journals and industry the protection of research subjects can be improved. It is recommended that medical faculties arrange an annual commemoration of the victims of medical research in order to raise consciousness and awareness among teachers and students.

  2. Are medical ethics universal or culture specific

    Institute of Scientific and Technical Information of China (English)

    Furqaan; Ahmed

    2013-01-01

    In our society and culture where family is of utmost importance,sometimes I wonder how much of a doctor’s duty is to the patient and how much is to the whole family.As a medical student,I remember being told by my professors that we should treat the patient as a whole and not focus on just one problem or organ system.Similarly when practicing medicine in Pakistan,one cannot treat the patient alone and ignore the family.How much should relatives’ wishes be taken into account when dealing with a patient? Don’t patients have a right to their medical information? When,how,and by whom can that right be waived? What role does culture play when debating medical ethics?

  3. Following professional codes of practice and military orders in austere military environments: a controversial debate on ethical challenges.

    Science.gov (United States)

    Kelly, Janet

    2015-12-01

    In 2004, the World Medical Association's International Code of Ethics claimed that 'medical ethics in armed conflict is identical to medical ethics in times of peace'. This paper challenges this notion and suggests that the hostile, austere and diverse environments in which military doctors and nurses serve are significantly more problematic and different to a civilian healthcare environment. It debates that there may be some incompatibility and challenges between following military orders such as the protocols written down in a Medical Rules of Eligibility matrix and professional codes of practice in these environments. This is either where fighting takes place or where the mission is for humanitarian purposes.

  4. An Analysis of Student Choices in Medical Ethical Dilemmas.

    Science.gov (United States)

    Woloshin, Phyllis Lerman

    This report describes a study undertaken to assess student choices in medical ethical dilemmas. Medical ethical dilemmas are interpreted to include problems such as abortion, euthanasia, sterilization, experimentation on humans, allocation of scarce medical resources, and physician and health personnel training. The major purpose of the study was…

  5. An Analysis of Student Choices in Medical Ethical Dilemmas.

    Science.gov (United States)

    Woloshin, Phyllis Lerman

    This report describes a study undertaken to assess student choices in medical ethical dilemmas. Medical ethical dilemmas are interpreted to include problems such as abortion, euthanasia, sterilization, experimentation on humans, allocation of scarce medical resources, and physician and health personnel training. The major purpose of the study was…

  6. [Specialist and lay ethical expertise in public health: issues and challenges for discourse ethics].

    Science.gov (United States)

    Massé, Raymond

    2012-01-01

    In recent decades, both public health professionals and the populations targeted by prevention and health promotion programs have shown an increasing interest in ethical issues since some interventions have been seen as impinging on fundamental rights and values. Insofar as bioethics is not adapted to population interventions and community health issues, a specific expertise in public health ethics is now required. However, ethical expertise in this area faces many challenges. The purpose of this paper is to examine four of these challenges. The first three challenges concern professional or specialist expertise. The paper suggests that expertise in public health ethics should go beyond the search for greater sophistication in defining ethical principles. Experts in public health ethics also need to identify appropriate strategies to include public health professionals in ethical analysis and to adopt a critical and reflexive approach to the status of moral experts and moral expertise. However, the main challenge is to identify appropriate ways of reconciling lay and specialist ethical expertise. The paper argues that secular morality and common morality represent two key sources of lay ethics expertise and that the fundamental values that inform discourse ethics should be derived from both forms of expertise.

  7. The ethics of an ordinary medical technology.

    Science.gov (United States)

    van Manen, Michael A

    2015-07-01

    Some routinely applied hospital technologies may have unintended consequences for patients and their families. The neonatal cardiorespiratory monitor, a computer-like display used to show an infant's vital functions, is one such technology that may become part of a parent's day-to-day being with his or her hospitalized child. In this phenomenological study, I explored how the monitor may mediate parental sensibilities, reshaping the contact of parent and child. This exploration speaks to understanding the relational ethics of even the seemingly most ordinary of medical technologies in clinical contexts.

  8. Teaching communication skills and medical ethics to undergraduate medical student

    Directory of Open Access Journals (Sweden)

    SADIA AHSIN

    2013-07-01

    Full Text Available Introduction: The purpose of this study was to improve communication skills and knowledge of bioethics of last year medical students doing clerkship and to evaluate the effectiveness of using workshops for this purpose from students’ point of view, in order to continue such programs in future. Methods: After Ethical approval for the study a two-day workshop on teaching effective communication skills and principles of medical ethics was planned and conducted by the department of Medical Education through multidisciplinary faculty of Foundation University Medical College, Pakistan. A total of 102 last year medical students participated in this workshop. The students were divided into 8 groups each containing 12 students. A team of pre trained facilitators for each group conducted the group activities. Teaching strategies including interactive discussions on basic principles of doctor-patient relationship, power point presentations, day to day case scenarios, video clips and presentations involving students in role plays were used. Pre and post workshop self evaluation proformas about knowledge and skills of communication and medical ethics were rated (0=none, 1=below average, 2=average, 3=above average, 4=very good, 5=excellent by the students. Results: 89 out of 102 participants returned the proformas. A significant percentage of students (%82 showed improvement in their knowledge and skills of appreciating bioethical issues like valid informed consent, patient confidentiality, end of life issues and breaking bad news by rating as “very good” after participation in the workshop. More than %70 students recommended this activity for other students. Conclusion: Teaching through interactive workshops was found to be an effective method as reflected by students’ feedback. Therefore, the program will be continued in future.

  9. Medical Students’ and Interns’ Attitudes toward Medical Ethics Education in a Thai Medical School

    Directory of Open Access Journals (Sweden)

    Sakda Sathirareuangchai

    2016-03-01

    Full Text Available Background: Medical ethics has been accepted as part of every accredited medical curriculum for the past 40 years. Medical students’ attitudes have an important role for development and improvement of the curriculum. Faculty of Medicine Siriraj Hospital is the oldest and largest medical school in Thailand, and has been teaching medical ethics since 1907. Objective: To determine attitudes among medical students and interns toward medical ethics education and understand the factors influencing their attitudes. Methods: Mixed quantitative and qualitative research was conducted with early 6th year medical students and interns. A questionnaire was adapted from previous studies and included some original items. Results: Of the 550 questionnaires distributed, 386 were returned (70.2% response rate. Males (n=180 made up 46.63 % of the sample. Interns (n=219, 56.74 % tended to have more positive attitudes toward ethics learning than did medical students (n = 167, 43.26 %. Male participants tended to agree more with negative statements about ethics learning than did females. There was no statistically significant effect of hometown (Bangkok versus elsewhere or grade point average on attitudes. The main problem cited with medical ethics education was lack of engaging methods. Conclusion: Because clinical experience has an effect on learners’ attitudes towards ethics education, medical ethics should be taught at the appropriate time and with proper techniques, such as drawing explicit ties between ethical principles and real-life situations. Attention to the more detailed aspects of these data should also facilitate improvements to curriculum content, thereby ensuring better educational outcomes.

  10. [Non-medical applications for brain MRI: Ethical considerations].

    Science.gov (United States)

    Sarrazin, S; Fagot-Largeault, A; Leboyer, M; Houenou, J

    2015-04-01

    The recent neuroimaging techniques offer the possibility to better understand complex cognitive processes that are involved in mental disorders and thus have become cornerstone tools for research in psychiatry. The performances of functional magnetic resonance imaging are not limited to medical research and are used in non-medical fields. These recent applications represent new challenges for bioethics. In this article we aim at discussing the new ethical issues raised by the applications of the latest neuroimaging technologies to non-medical fields. We included a selection of peer-reviewed English medical articles after a search on NCBI Pubmed database and Google scholar from 2000 to 2013. We screened bibliographical tables for supplementary references. Websites of governmental French institutions implicated in ethical questions were also screened for governmental reports. Findings of brain areas supporting emotional responses and regulation have been used for marketing research, also called neuromarketing. The discovery of different brain activation patterns in antisocial disorder has led to changes in forensic psychiatry with the use of imaging techniques with unproven validity. Automated classification algorithms and multivariate statistical analyses of brain images have been applied to brain-reading techniques, aiming at predicting unconscious neural processes in humans. We finally report the current position of the French legislation recently revised and discuss the technical limits of such techniques. In the near future, brain imaging could find clinical applications in psychiatry as diagnostic or predictive tools. However, the latest advances in brain imaging are also used in non-scientific fields raising key ethical questions. Involvement of neuroscientists, psychiatrists, physicians but also of citizens in neuroethics discussions is crucial to challenge the risk of unregulated uses of brain imaging. Copyright © 2014 L’Encéphale, Paris. Published by

  11. Ethics in medical curriculum; Ethics by the teachers for students and society.

    Science.gov (United States)

    Rameshkumar, Karuna

    2009-07-01

    There are many ethical issues involved in the practice of modern medicine. It can be a simple one-on-one issue with complex ramifications. The training of medical ethics should be a continuous process. The ideal time to introduce ethics is a subject of many debates. Though it has to be introduced during the undergraduate curriculum, it requires reinforcing during specialty training also. The teaching of medical ethics can utilize various methodologies. There should be a proper evaluation of the ethical aspects learned.

  12. Telemedicine: medical, legal and ethical perspectives.

    Science.gov (United States)

    Clark, Peter A; Capuzzi, Kevin; Harrison, Joseph

    2010-12-01

    Technological innovations in medical care have led to the development of telemedicine programs in both rural and urban environments. The necessity for telemedicine has increased immensely as more cost-effective treatment options have become available for both patients and physicians through the addition of telecommunication technologies to medical practice. The development of telemedicine systems began as a means of providing access to health care resources for individuals living in isolated rural areas, grew into advanced medical intervention techniques for soldiers on the battlefield, and have become prevalent in urban medical centers both as a resource to the underserved populations and as a platform for physicians off-site to conduct patient consults remotely. Urban telemedicine systems, as monitored in the Mercy Health System (Philadelphia, Pennsylvania) and AtlantiCare Regional Medical Center (Atlantic City, New Jersey), display the enormous benefits of telemedicine as a form of preliminary analysis of patients for the treatment of various medical conditions including chronic disease, mental health disorders and stroke. However, the initiation of telemedicine programs requires new protocols and safeguards to be initiated to protect patient confidentiality/privacy, ensure the appropriate licensure of physicians practicing across state borders, and educate patients on the use of new technological systems. Telemedicine represents the progression of medicine in the presence of improving communication technologies and should be instituted in all urban medical centers. This conclusion is based upon the ethical responsibility to treat all persons with dignity and respect, which in this case, mandates the provision of the most cost-effective, beneficial medical care for all populations.

  13. Ethical challenges in surgery as narrated by practicing surgeons

    Directory of Open Access Journals (Sweden)

    Nordam Ann

    2005-02-01

    Full Text Available Abstract Background The aim of this study was to explore the ethical challenges in surgery from the surgeons' point of view and their experience of being in ethically difficult situations. Methods Five male and five female surgeons at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in such situations. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. Results No differences in ethical reasoning between male and female surgeons were found. They reasoned in both action and relational ethical perspectives. Surgeons focused on their relationships with patients and colleagues and their moral self in descriptions of the ethical challenges in their work. Dialogue and personal involvement were important in their relationships with patients. The surgeons emphasized the importance of open dialogue, professional recognition, and an inclusive and accepting environment between colleagues. Conclusion The surgeons are personally challenged by the existential realities of human life in their relationships with patients. They realized that ethical challenges are an inherent part of performing surgery and of life itself, and say that they have to learn to "live with" these challenges in a way that is confirmed both socially and by their inner moral self. This means accepting their personal and professional limitations, being uncertain, being fallible, and being humble. Living with the ethical challenges of surgery seems to contribute to the surgeons' confidence and vulnerability in their professional identity.

  14. Ethical challenges for the life sciences

    NARCIS (Netherlands)

    Korthals, M.J.J.A.A.

    2004-01-01

    In this book we will first discuss broader issues of ethics of the life sciences, which enable us later on to focus on the more specific issues. Therefore, we begin with two contributions on the ethical issues of working in organizations. A fruitful side effect of this start is that it gives a good

  15. Ethical challenges for the life sciences

    NARCIS (Netherlands)

    Korthals, M.J.J.A.A.

    2004-01-01

    In this book we will first discuss broader issues of ethics of the life sciences, which enable us later on to focus on the more specific issues. Therefore, we begin with two contributions on the ethical issues of working in organizations. A fruitful side effect of this start is that it gives a good

  16. The ethical challenges of animal research.

    Science.gov (United States)

    Ferdowsian, Hope R; Gluck, John P

    2015-10-01

    In 1966, Henry K. Beecher published an article entitled "Ethics and Clinical Research" in the New England Journal of Medicine, which cited examples of ethically problematic human research. His influential paper drew attention to common moral problems such as inadequate attention to informed consent, risks, and efforts to provide ethical justification. Beecher's paper provoked significant advancements in human research policies and practices. In this paper, we use an approach modeled after Beecher's 1966 paper to show that moral problems with animal research are similar to the problems Beecher described for human research. We describe cases that illustrate ethical deficiencies in the conduct of animal research, including inattention to the issue of consent or assent, incomplete surveys of the harms caused by specific protocols, inequitable burdens on research subjects in the absence of benefits to them, and insufficient efforts to provide ethical justification. We provide a set of recommendations to begin to address these deficits.

  17. Using Challenge Course Activities to Teach Organizational Ethics

    Science.gov (United States)

    Goltz, Sonia M.; Hietapelto, Amy B.

    2006-01-01

    Few learning experiences give students immediate feedback on ethical and unethical behaviors and provide opportunities to repeatedly practice effective behaviors. This article describes how the authors have used challenge course activities to stimulate students to observe their own and others' ethical and unethical behaviors. Specifically, these…

  18. Ethics for medical educators: An overview and fallacies

    Directory of Open Access Journals (Sweden)

    Singh Arjun

    2010-01-01

    Full Text Available Ethics is the rule of right conduct or practice in a profession. The basic principles of ethics are beneficence, justice and autonomy or individual freedom. There is very minor demarcation between ethics and the law. The ethics is promulgated by the professional bodies. All are expected to guide the medical professional in their practice. Medical educators have dual ethical obligations: firstly, to the society at large which expects us to produce competent health professionals, and secondly, to the students under our care. The students observe and copy what their teacher does and his/her role modelling can be a gateway to a student′s character building. Due to rapid increase in the number of medical colleges, privatization, and capitalism, ethical issue has become much more relevant and needs to discuss in detail. The present paper discusses the ethics for medical educators in detail with, basic principles, common breaches of ethics and fallacies due to wrong application of ethical principles, and the approach to ethics and methods by which we can prevent and avoid breach of ethics.

  19. Ethics for medical educators: an overview and fallacies.

    Science.gov (United States)

    Singh, Arjun

    2010-07-01

    Ethics is the rule of right conduct or practice in a profession. The basic principles of ethics are beneficence, justice and autonomy or individual freedom. There is very minor demarcation between ethics and the law. The ethics is promulgated by the professional bodies. All are expected to guide the medical professional in their practice. Medical educators have dual ethical obligations: firstly, to the society at large which expects us to produce competent health professionals, and secondly, to the students under our care. The students observe and copy what their teacher does and his/her role modelling can be a gateway to a student's character building. Due to rapid increase in the number of medical colleges, privatization, and capitalism, ethical issue has become much more relevant and needs to discuss in detail. The present paper discusses the ethics for medical educators in detail with, basic principles, common breaches of ethics and fallacies due to wrong application of ethical principles, and the approach to ethics and methods by which we can prevent and avoid breach of ethics.

  20. Surgical ethics and the challenge of surgical innovation.

    Science.gov (United States)

    Angelos, Peter

    2014-12-01

    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  1. Ethical Guidelines and Practices for US Military Medical Professionals

    Science.gov (United States)

    2015-03-03

    JS. Utilitarianism . Hackett Publishing Company; 1979. 143. Thomasma DC, Marshall PA. Clinical medical ethics : cases and reading. New York, NY: New...Defense Health Board Defense Health Board Ethical Guidelines and Practices for U.S. Military Medical Professionals March 3, 2015 [This page...22042-5101 DEFENSE HEALTH BOARD MEMORANDUM FOR ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS SUBJECT: Ethical Guidelines and Practices for

  2. Devotion, Diversity, and Reasoning: Religion and Medical Ethics.

    Science.gov (United States)

    Dahnke, Michael D

    2015-12-01

    Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethics, including fields of professional ethics like medical ethics. This assertion, of course, implicitly refers to ethical reasoning, but there is much more to the ethical life and the practice of ethics-especially professional ethics-than reasoning. It is no surprise that teachers of practical ethics, myself included, often focus on reasoning to the exclusion of other aspects of the ethical life. Especially for those with a philosophical background, reasoning is the most patent and pedagogically controllable aspect of the ethical life-and the most easily testable. And whereas there may be powerful reasons for the limitation of religion in this aspect of ethics, there are other aspects of the ethical life in which recognition of religious belief may arguably be more relevant and possibly even necessary. I divide the ethical life into three areas-personal morality, interpersonal morality, and rational morality-each of which I explore in terms of its relationship to religion, normatively characterized by the qualities of devotion, diversity, and reasoning, respectively.

  3. [Ethical challenge in palliative support of intensive care patients].

    Science.gov (United States)

    Salomon, Fred

    2015-01-01

    Intensive care medicine and palliative care medicine were considered for a long time to be contrasting concepts in therapy. While intensive care medicine is directed towards prolonging life and tries to stabilize disordered body functions, palliative care medicine is focused upon the relief of disturbances to help patients in the face of death. Today both views have become congruent. Palliative aspects are equally important in curative therapy. In the course of illness or in respect of the patient's will, the aim of therapy may change from curative to palliative. Two examples are presented to illustrate the ethical challenges in this process. They follow from the medical indication, attention to the patient's will, different opinions in the team, truth at the bedside and from what must be done in the process of withdrawing therapy.

  4. Against medical ethics: opening the can of worms.

    Science.gov (United States)

    Cassell, J

    1998-02-01

    In a controversial paper, David Seedhouse argues that medical ethics is not and cannot be a distinct discipline with it own field of study. He derives this claim from a characterization of ethics, which he states but does not defend. He claims further that the project of medical ethics as it exists and of moral philosophy do not overlap. I show that Seedhouse's views on ethics have wide implications which he does not declare, and in the light of this argue that Seedhouse owes us a defence of his characterization of ethics. Further, I show that his characterization of ethics, which he uses to attack medical ethics, is a committed position within moral philosophy. As a consequence of this, it does not allow the relation between moral philosophy and medical ethics to be discussed without prejudice to its outcome. Finally, I explore the relation between Seedhouse's position and naturalism, and its implications for medical epistemology. I argue that this shows us that Seedhouse's position, if it can be defended, is likely to lead to a fruitful and important line of inquiry which reconnects philosophy and medical ethics.

  5. The historic and national aspects of medical ethics and deontology.

    OpenAIRE

    2009-01-01

    Researches of problems of medical ethics and deontology in activity of the medical worker presented. Historical and national aspects of the delivered problem are considered. They open diversity and complexity of realization of problems of formation of the person of the medical worker. The humanism in medicine makes its ethical basis and morals. The humanism serves moral development of the person of the medical worker. Without humanism the medicine loses the right on existence. Its scientific ...

  6. Medication monitoring and drug testing ethics project.

    Science.gov (United States)

    Payne, Richard; Moe, Jeffrey L; Sevier, Catherine Harvey; Sevier, David; Waitzkin, Michael

    2015-01-01

    In 2012, Duke University initiated a research project, funded by an unrestricted research grant from Millennium Laboratories, a drug testing company. The project focused on assessing the frequency and nature of questionable, unethical, and illegal business practices in the clinical drug testing industry and assessing the potential for establishing a business code of ethics. Laboratory leaders, clinicians, industry attorneys, ethicists, and consultants participated in the survey, were interviewed, and attended two face-to-face meetings to discuss a way forward. The study demonstrated broad acknowledgment of variations in the legal and regulatory environment, resulting in inconsistent enforcement of industry practices. Study participants expressed agreement that overtly illegal practices sometimes exist, particularly when laboratory representatives and clinicians discuss reimbursement, extent of testing, and potential business incentives with medical practitioners. Most respondents reported directly observing probable violations involving marketing materials, contracts, or, in the case of some individuals, directly soliciting people with offers of clinical supplies and other "freebies." While many study respondents were skeptical that voluntary standards alone would eliminate questionable business practices, most viewed ethics codes and credentialing as an important first step that could potentially mitigate uneven enforcement, while improving quality of care and facilitating preferred payment options for credentialed parties. Many were willing to participate in future discussions and industry-wide initiatives to improve the environment.

  7. The principles of medical ethics and medical research

    Directory of Open Access Journals (Sweden)

    Harris John

    1999-01-01

    Full Text Available In this paper I discuss the application of the principles of medical ethics and of medical research to the case of children and others whose consent to treatment and to research is problematic. Public health depends substantially on the possibility of ongoing research into all conditions which affect the health of the people. Constraints on this research are therefore a public health issue. Moreover and more importantly the possibility of predictive testing and indeed of screening for health-relevant conditions is an important public health tool, and limitations on the use of this tool are of great significance to public health medicine. Having considered the particular problems created by research and predictive testing on children for late-onset conditions I go on to discuss research on those whose consent is problematic more generally. I conclude with radical recommendations for the reform of The Declaration of Helsinki and of the International Ethics Guidelines for Biomedical Research Involving Human Subjects, prepared by the Council for International Organizations of Medical Sciences (CIOMS.

  8. Social and ethical challenges for metallurgical companies

    OpenAIRE

    B. Gajdzik

    2008-01-01

    The subject of this article is an analysis of one of the most crucial aspects of the contemporary business, which is corporate social responsibility and ethical business. The notion of a socially responsible business signifies the business obligation to contribute to the sustainable economical development by way of working with employees and their families, local communities and the society as a whole in order to improve the quality of their lives. Ethical business means following the princip...

  9. Medical errors: legal and ethical responses.

    Science.gov (United States)

    Dickens, B M

    2003-04-01

    Liability to err is a human, often unavoidable, characteristic. Errors can be classified as skill-based, rule-based, knowledge-based and other errors, such as of judgment. In law, a key distinction is between negligent and non-negligent errors. To describe a mistake as an error of clinical judgment is legally ambiguous, since an error that a physician might have made when acting with ordinary care and the professional skill the physician claims, is not deemed negligent in law. If errors prejudice patients' recovery from treatment and/or future care, in physical or psychological ways, it is legally and ethically required that they be informed of them in appropriate time. Senior colleagues, facility administrators and others such as medical licensing authorities should be informed of serious forms of error, so that preventive education and strategies can be designed. Errors for which clinicians may be legally liable may originate in systemically defective institutional administration.

  10. Ebola Virus Disease: Ethics and Emergency Medical Response Policy.

    Science.gov (United States)

    Jecker, Nancy S; Dudzinski, Denise M; Diekema, Douglas S; Tonelli, Mark

    2015-09-01

    Caring for patients affected with Ebola virus disease (EVD) while simultaneously preventing EVD transmission represents a central ethical challenge of the EVD epidemic. To address this challenge, we propose a model policy for resuscitation and emergent procedure policy of patients with EVD and set forth ethical principles that lend support to this policy. The policy and principles we propose bear relevance beyond the EVD epidemic, offering guidance for the care of patients with other highly contagious, virulent, and lethal diseases. The policy establishes (1) a limited code status for patients with confirmed or suspected EVD. Limited code status means that a code blue will not be called for patients with confirmed or suspected EVD at any stage of the disease; however, properly protected providers (those already in full protective equipment) may initiate resuscitative efforts if, in their clinical assessment, these efforts are likely to benefit the patient. The policy also requires that (2) resuscitation not be attempted for patients with advanced EVD, as resuscitation would be medically futile; (3) providers caring for or having contact with patients with confirmed or suspected EVD be properly protected and trained; (4) the treating team identify and treat in advance likely causes of cardiac and respiratory arrest to minimize the need for emergency response; (5) patients with EVD and their proxies be involved in care discussions; and (6) care team and provider discretion guide the care of patients with EVD. We discuss ethical issues involving medical futility and the duty to avoid harm and propose a utilitarian-based principle of triage to address resource scarcity in the emergency setting.

  11. Medical Ethics Today. The BMA's Handbook of Ethics and Law

    African Journals Online (AJOL)

    Ethics and Law goes beyond a simple guidebook or manual and is a voluminous ... at the end of life, euthanasia and physician assisted suicide and responsibilities after a ... form of vignettes and case law together with best practice in real.

  12. Patient decision-making: medical ethics and mediation.

    Science.gov (United States)

    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 already being used informally in good patient care, and that there is a case for developing it further. PMID:8798939

  13. [Ethic review on clinical experiments of medical devices in medical institutions].

    Science.gov (United States)

    Shuai, Wanjun; Chao, Yong; Wang, Ning; Xu, Shining

    2011-07-01

    Clinical experiments are always used to evaluate the safety and validity of medical devices. The experiments have two types of clinical trying and testing. Ethic review must be done by the ethics committee of the medical department with the qualification of clinical research, and the approval must be made before the experiments. In order to ensure the safety and validity of clinical experiments of medical devices in medical institutions, the contents, process and approval criterions of the ethic review were analyzed and discussed.

  14. [Complementary medicine--Jewish medical ethics].

    Science.gov (United States)

    Katz, Yisrae; Schiff, Elad

    2011-08-01

    In Israel, as in the Western world, the use of different methods of complementary and alternative medicine ICAM) is spreading. CAM raises ethical questions of concern to healthcare providers and to the public: Can physicians recommend a treatment that has no scientific evidence? Should the government include such therapies in the health budget? Can complementary therapists receive protection against lawsuits if their treatment is recognized? The purpose of this article is to present a Jewish perspective on these issues. The fundamental sources that deal with the subject are based on the approach of rabbinic authorities toward unproven medicine, as expressed in the "Mishnah" and "Talmud" (200-500 C.E). The great Jewish scholar who discusses the subject in detail is Maimonides (1135-1204), who defines what "medicine" is and claims that medicine has to rely on reason or experience. Contemporary Jewish commentators present their position based on the interpretation of Maimonides' texts. In this article we claim that treatments can be divided into four groups, each group having a different halachic status: (1) Treatment that might be dangerous--should not be used. (2) Treatment that is safe--can be used, but has no other special status. (3) Treatment recognized by alternative therapists--has consequences for the observant Jew, such as laws of Kashrut and Shabbat. (4) Treatment that was tested and proven using modern medical methods has public significance--the therapist is entitled to legal defense if he made a reasonable mistake; the government can consider funding such treatment using public money. This article presents the Jewish halachic sources upon which we propose an ethical-practical approach to CAM.

  15. Ethical challenges embedded in qualitative research interviews with close relatives.

    Science.gov (United States)

    Haahr, Anita; Norlyk, Annelise; Hall, Elisabeth Oc

    2014-02-01

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

  16. Virtue and the scientist: using virtue ethics to examine science's ethical and moral challenges.

    Science.gov (United States)

    Chen, Jiin-Yu

    2015-02-01

    As science has grown in size and scope, it has also presented a number of ethical and moral challenges. Approaching these challenges from an ethical framework can provide guidance when engaging with them. In this article, I place science within a virtue ethics framework, as discussed by Aristotle. By framing science within virtue ethics, I discuss what virtue ethics entails for the practicing scientist. Virtue ethics holds that each person should work towards her conception of flourishing where the virtues enable her to realize that conception. The virtues must become part of the scientist's character, undergirding her intentions and motivations, as well as the resulting decisions and actions. The virtue of phronêsis, or practical wisdom, is critical for cultivating virtue, enabling the moral agent to discern the appropriate actions for a particular situation. In exercising phronêsis, the scientist considers the situation from multiple perspectives for an in-depth and nuanced understanding of the situation, discerns the relevant factors, and settles upon an appropriate decision. I examine goods internal to a practice, which are constitutive of science practiced well and discuss the role of phronêsis when grappling with science's ethical and moral features and how the scientist might exercise it. Although phronêsis is important for producing scientific knowledge, it is equally critical for working through the moral and ethical questions science poses.

  17. Ethical challenges in designing and conducting medicine quality surveys.

    Science.gov (United States)

    Tabernero, Patricia; Parker, Michael; Ravinetto, Raffaella; Phanouvong, Souly; Yeung, Shunmay; Kitutu, Freddy E; Cheah, Phaik Yeong; Mayxay, Mayfong; Guerin, Philippe J; Newton, Paul N

    2016-06-01

    In this paper we discuss the main ethical challenges related to the conduct of medicine quality surveys and make suggestions on how to address them. Most evidence-based information regarding medicine quality derives from surveys. However, existing research ethical guidelines do not provide specific guidance for medicine quality surveys. Hence, those conducting surveys are often left wondering how to judge what counts as best practice. A list of the main ethical challenges in the design and conduct of surveys is presented. It is vital that the design and conduct of medicine quality surveys uphold moral and ethical obligations and analyse the ethical implications and consequences of such work. These aspects include the impact on the local availability of and access to medicines; the confidentiality and privacy of the surveyors and the surveyed; questions as to whether outlet staff personnel should be told they are part of a survey; the need of ethical and regulatory approvals; and how the findings should be disseminated. Medicine quality surveys should ideally be conducted in partnership with the relevant national Medicine Regulatory Authorities. An international, but contextually sensitive, model of good ethical practice for such surveys is needed. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  18. Teaching medical ethics to undergraduate students in post‐apartheid South Africa, 2003–2006

    Science.gov (United States)

    Moodley, Keymanthri

    2007-01-01

    The apartheid ideology in South Africa had a pervasive influence on all levels of education including medical undergraduate training. The role of the health sector in human rights abuses during the apartheid era was highlighted in 1997 during the Truth and Reconciliation Commission hearings. The Health Professions Council of South Africa (HPCSA) subsequently realised the importance of medical ethics education and encouraged the introduction of such teaching in all medical schools in the country. Curricular reform at the University of Stellenbosch in 1999 presented an unparalleled opportunity to formally introduce ethics teaching to undergraduate students. This paper outlines the introduction of a medical ethics programme at the Faculty of Health Sciences from 2003 to 2006, with special emphasis on the challenges encountered. It remains one of the most comprehensive undergraduate medical ethics programmes in South Africa. However, there is scope for expanding the curricular time allocated to medical ethics. Integrating the curriculum both horizontally and vertically is imperative. Implementing a core curriculum for all medical schools in South Africa would significantly enhance the goals of medical education in the country. PMID:17971474

  19. Teaching medical ethics to undergraduate students in post-apartheid South Africa, 2003 2006.

    Science.gov (United States)

    Moodley, Keymanthri

    2007-11-01

    The apartheid ideology in South Africa had a pervasive influence on all levels of education including medical undergraduate training. The role of the health sector in human rights abuses during the apartheid era was highlighted in 1997 during the Truth and Reconciliation Commission hearings. The Health Professions Council of South Africa (HPCSA) subsequently realised the importance of medical ethics education and encouraged the introduction of such teaching in all medical schools in the country. Curricular reform at the University of Stellenbosch in 1999 presented an unparalleled opportunity to formally introduce ethics teaching to undergraduate students. This paper outlines the introduction of a medical ethics programme at the Faculty of Health Sciences from 2003 to 2006, with special emphasis on the challenges encountered. It remains one of the most comprehensive undergraduate medical ethics programmes in South Africa. However, there is scope for expanding the curricular time allocated to medical ethics. Integrating the curriculum both horizontally and vertically is imperative. Implementing a core curriculum for all medical schools in South Africa would significantly enhance the goals of medical education in the country.

  20. Preparing Students for the Ethical Challenges of Global Citizenship

    Directory of Open Access Journals (Sweden)

    Madelyn Flammia

    2012-08-01

    Full Text Available This paper describes an approach to teaching ethical intercultural communication. This approach helps students become aware of their own ethnocentric attitudes and helps them move beyond those perspectives to develop a mindful approach to intercultural communication. The paper begins by introducing the concept of mindful communication and the challenges of developing of a code of ethical behavior for communicating across cultures. Then, strategies for reconciling cultural relativism and universalism are offered. Finally, the paper provides a set of guidelines for ethical behavior in intercultural encounters.

  1. Playing God? Synthetic biology as a theological and ethical challenge

    OpenAIRE

    2009-01-01

    In the ethical debate over synthetic biology the formula “playing god” is widely used in order to attack this new branch of biotechnology. The article analyses, contextualizes and criticises this usage with respect to the theological concepts of creation, sin and humans as created in the image of God. Against the background of these theological understandings an ethical corridor of how to responsibly cope with the societal challenges of synthetic biology is presented.

  2. Playing God? Synthetic biology as a theological and ethical challenge.

    Science.gov (United States)

    Dabrock, Peter

    2009-12-01

    In the ethical debate over synthetic biology the formula "playing god" is widely used in order to attack this new branch of biotechnology. The article analyses, contextualizes and criticises this usage with respect to the theological concepts of creation, sin and humans as created in the image of God. Against the background of these theological understandings an ethical corridor of how to responsibly cope with the societal challenges of synthetic biology is presented.

  3. Ethical concepts and future challenges of neuroimaging: an Islamic perspective.

    Science.gov (United States)

    Al-Delaimy, Wael K

    2012-09-01

    Neuroscience is advancing at a rapid pace, with new technologies and approaches that are creating ethical challenges not easily addressed by current ethical frameworks and guidelines. One fascinating technology is neuroimaging, especially functional Magnetic Resonance Imaging (fMRI). Although still in its infancy, fMRI is breaking new ground in neuroscience, potentially offering increased understanding of brain function. Different populations and faith traditions will likely have different reactions to these new technologies and the ethical challenges they bring with them. Muslims are approximately one-fifth of world population and they have a specific and highly regulated ethical and moral code, which helps them deal with scientific advances and decision making processes in an Islamically ethical manner. From this ethical perspective, in light of the relevant tenets of Islam, neuroimaging poses various challenges. The privacy of spirituality and the thought process, the requirement to put community interest before individual interest, and emphasis on conscious confession in legal situations are Islamic concepts that can pose a challenge for the use of something intrusive such as an fMRI. Muslim moral concepts such as There shall be no harm inflicted or reciprocated in Islam and Necessities overrule prohibitions are some of the criteria that might appropriately be used to guide advancing neuroscience. Neuroscientists should be particularly prudent and well prepared in implementing neuroscience advances that are breaking new scientific and ethical ground. Neuroscientists should also be prepared to assist in setting the ethical frameworks in place in advance of what might be perceived as runaway applications of technology.

  4. Adab and its significance for an Islamic medical ethics.

    Science.gov (United States)

    Sartell, Elizabeth; Padela, Aasim I

    2015-09-01

    Discussions of Islamic medical ethics tend to focus on Sharī'ah-based, or obligation-based, ethics. However, limiting Islamic medical ethics discourse to the derivation of religious duties ignores discussions about moulding an inner disposition that inclines towards adherence to the Sharī'ah. In classical Islamic intellectual thought, such writings are the concern of adab literature. In this paper, we call for a renewal of adabi discourse as part of Islamic medical ethics. We argue that adab complements Sharī'ah-based writings to generate a more holistic vision of Islamic medical ethics by supplementing an obligation-based approach with a virtue-based approach. While Sharī'ah-based medical ethics focuses primarily on the moral status of actions, adab literature adds to this genre by addressing the moral formation of the agent. By complementing Sharī'ah-based approaches with adab-focused writings, Islamic medical ethics discourse can describe the relationship between the agent and the action, within a moral universe informed by the Islamic intellectual tradition. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Misdiagnosis as an ethical and scientific challenge

    Directory of Open Access Journals (Sweden)

    Michele Farisco

    2014-09-01

    Full Text Available Difficulties of behavioral assessment of consciousness. An astonishingly high rate of misdiagnosis between vegetative state/unresponsive wakefulness syndrome and minimally conscious state has been detected. This raises the issue of the adequacy of the consciousness' assessment in patients with disorders of consciousness. The behavioral assessment of consciousness could be not able to detect covert awareness, which is increasingly identified by the instrumental assessment. Ancillary methods. Neurotechnology, particularly neuroimaging, provides relevant data concerning the neurological underlying condition of patients with DOCs, but the instrumental approach has still to assess some technical issues. Ethical considerations. A correct diagnosis of a DOC is not only an instrumental issue, but also an ethically relevant demand to the scientific community. Finally, an integration between behavioral and instrumental assessments seems to be the most adequate strategy in order to decrease the rate of misdiagnosis.

  6. Ethical challenges of the globalization process

    Directory of Open Access Journals (Sweden)

    Radenko Maric

    2009-12-01

    Full Text Available Whereas roots of globalization are far reaching, it is primarily a modern age phenomenon. Modern business operation and the world economy are characterized by domination of multinational corporations, strong presence of the government in economy and the long-term tendency towards globalization in manufacturing, trading and consumption in the world. Containing both risks and opportunities, globalization is a problem of manifold nature. For some it means regression and falling into “neocolonialism”, the others glorify it. It is logical to ask the following questions: What are the consequences of globalization for governments, nations, companies and individuals? What are the business, social and ethical issues it causes? In one word, is it possible to be ethical, to avoid and correct “bad” and keep “good” consequences of total phenomena as the globalization, and whether it is rewarding in the increasing market competition?

  7. Medical big data: promise and challenges.

    Science.gov (United States)

    Lee, Choong Ho; Yoon, Hyung-Jin

    2017-03-01

    The concept of big data, commonly characterized by volume, variety, velocity, and veracity, goes far beyond the data type and includes the aspects of data analysis, such as hypothesis-generating, rather than hypothesis-testing. Big data focuses on temporal stability of the association, rather than on causal relationship and underlying probability distribution assumptions are frequently not required. Medical big data as material to be analyzed has various features that are not only distinct from big data of other disciplines, but also distinct from traditional clinical epidemiology. Big data technology has many areas of application in healthcare, such as predictive modeling and clinical decision support, disease or safety surveillance, public health, and research. Big data analytics frequently exploits analytic methods developed in data mining, including classification, clustering, and regression. Medical big data analyses are complicated by many technical issues, such as missing values, curse of dimensionality, and bias control, and share the inherent limitations of observation study, namely the inability to test causality resulting from residual confounding and reverse causation. Recently, propensity score analysis and instrumental variable analysis have been introduced to overcome these limitations, and they have accomplished a great deal. Many challenges, such as the absence of evidence of practical benefits of big data, methodological issues including legal and ethical issues, and clinical integration and utility issues, must be overcome to realize the promise of medical big data as the fuel of a continuous learning healthcare system that will improve patient outcome and reduce waste in areas including nephrology.

  8. Medical big data: promise and challenges

    Directory of Open Access Journals (Sweden)

    Choong Ho Lee

    2017-03-01

    Full Text Available The concept of big data, commonly characterized by volume, variety, velocity, and veracity, goes far beyond the data type and includes the aspects of data analysis, such as hypothesis-generating, rather than hypothesis-testing. Big data focuses on temporal stability of the association, rather than on causal relationship and underlying probability distribution assumptions are frequently not required. Medical big data as material to be analyzed has various features that are not only distinct from big data of other disciplines, but also distinct from traditional clinical epidemiology. Big data technology has many areas of application in healthcare, such as predictive modeling and clinical decision support, disease or safety surveillance, public health, and research. Big data analytics frequently exploits analytic methods developed in data mining, including classification, clustering, and regression. Medical big data analyses are complicated by many technical issues, such as missing values, curse of dimensionality, and bias control, and share the inherent limitations of observation study, namely the inability to test causality resulting from residual confounding and reverse causation. Recently, propensity score analysis and instrumental variable analysis have been introduced to overcome these limitations, and they have accomplished a great deal. Many challenges, such as the absence of evidence of practical benefits of big data, methodological issues including legal and ethical issues, and clinical integration and utility issues, must be overcome to realize the promise of medical big data as the fuel of a continuous learning healthcare system that will improve patient outcome and reduce waste in areas including nephrology.

  9. Aesthetic/Cosmetic surgery and ethical challenges.

    Science.gov (United States)

    Atiyeh, Bishara S; Rubeiz, Michel T; Hayek, Shady N

    2008-11-01

    Is aesthetic surgery a business guided by market structures aimed primarily at material gain and profit or a surgical intervention intended to benefit patients and an integral part of the health-care system? Is it a frivolous subspecialty or does it provide a real and much needed service to a wide range of patients? At present, cosmetic surgery is passing through an identity crisis as well as an acute ethical dilemma. A closer look from an ethical viewpoint makes clear that the doctor who offers aesthetic interventions faces many serious ethical problems which have to do with the identity of the surgeon as a healer. Aesthetic surgery that works only according to market categories runs the risk of losing the view for the real need of patients and will be nothing else than a part of a beauty industry which has the only aim to sell something, not to help people. Such an aesthetic surgery is losing sight of real values and makes profit from the ideology of a society that serves only vanity, youthfulness, and personal success. Unfortunately, some colleagues brag that they chose the plastic surgery specialty just to become rich aesthetic surgeons, using marketing tactics to promote their practice. This is, at present, the image we project. As rightly proposed, going back a little to Hippocrates, to the basics of being a physician, is urgently warranted! Being a physician is all that a "cosmetic" surgeon should be. In the long run, how one skillfully and ethically practices the art of plastic surgery will always speak louder than any words.

  10. Good medical ethics, justice and provincial globalism.

    Science.gov (United States)

    Prah Ruger, Jennifer

    2015-01-01

    The summer 2014 Ebola virus outbreak in Western Africa illustrates global health's striking inequalities. Globalisation has also increased pandemics, and disparate health system conditions mean that where one falls ill or is injured in the world can mean the difference between quality care, substandard care or no care at all, between full recovery, permanent ill effects and death. Yet attention to the normative underpinnings of global health justice and distribution remains, despite some important exceptions, inadequate in medical ethics, bioethics and political philosophy. We need a theoretical foundation on which to build a more just world. Provincial globalism (PG), grounded in capability theory, offers a foundation; it provides the components of a global health justice framework that can guide implementation. Under PG, all persons possess certain health entitlements. Global health justice requires progressively securing this health capabilities threshold for every person. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Contemporary ethical challenges in industrial psychological testing in South Africa

    OpenAIRE

    2012-01-01

    M.Phil. (Industrial Psychology) Psychometric testing in South Africa faces many challenges at present. Among these challenges is the fact that many individuals utilising psychometric tests are not professionally registered with the Health Professions Council of South Africa. The key objective of this qualitative study was to gain a better understanding of the contemporary ethical challenges in psychometric testing in South Africa. A total of ten industrial psychologists participated in the...

  12. The ethical concerns of using medical male circumcision in HIV ...

    African Journals Online (AJOL)

    that medical male circumcision raises ethical questions among implementers and participants. ..... or euthanasia and situations in which the physician and patient agree to withdraw ..... The Journal of Theological. Studies 2011;62:1-9. 17.

  13. Medical ethics in the developing world: a liberation theology perspective.

    Science.gov (United States)

    Anjos, M F

    1996-12-01

    Standard medical ethical analyses typically focus on the physician/patient relationship, patient autonomy, and the clinical encounter. For Liberation Theology this amounts to neglecting the larger context of social injustice. Medicine is a social institution. Any medical ethics which purports to provide an ethics of medicine and medical practice must necessarily address the larger social issues of class structure, poverty and access to adequate health care. Liberation Theology provides a very specific perspective that draws on the needs of the poverty stricken, assesses the relationship among social classes, and focuses on societal conditions. Given such an analysis, medical ethics is reconfigured as concerned not only with clinical encounters but also with background cultural conditions and social justice.

  14. Biopiracy and the ethics of medical heritage: the case of India's traditional knowledge digital library'.

    Science.gov (United States)

    Kidd, Ian James

    2012-09-01

    Medical humanities have a central role to play in combating biopiracy. Medical humanities scholars can articulate and communicate the complex structures of meaning and significance which human beings have invested in their ways of conceiving health and sickness. Such awareness of the moral significance of medical heritage is necessary to ongoing legal, political, and ethical debates regarding the status and protection of medical heritage. I use the Indian Traditional Knowledge Digital Library as a case study of the role of medical humanities in challenging biopiracy by deepening our sense of the moral value of medical heritage.

  15. The Overlapping Spheres of Medical Professionalism and Medical Ethics: A Conceptual Inquiry

    Science.gov (United States)

    Ruitenberg, Claudia W.

    2016-01-01

    This essay examines the concepts of "professionalism" and "ethics" as they are used in health professions education and, in particular, medical education. It proposes that, in order to make sense of the construct of "professional ethics," it would be helpful to conceive of professionalism and ethics as overlapping but…

  16. Ethical challenges of containing Ebola: the Nigerian experience.

    Science.gov (United States)

    Maduka, Omosivie; Odia, Osaretin

    2015-11-01

    Responding effectively to an outbreak of disease often requires routine processes to be set aside in favour of unconventional approaches. Consequently, an emergency response situation usually generates ethical dilemmas. The emergence of the Ebola virus in the densely populated cities of Lagos and Port Harcourt in Nigeria brought bleak warnings of a rapidly expanding epidemic. However, these fears never materialised largely due to the swift reaction of emergency response and incident management organisations, and the WHO has now declared Nigeria free of Ebola. However, numerous ethical issues arose in relation to the response to the outbreak. This paper discusses some of these ethical challenges and the vital lessons learned. Ethical challenges relating to confidentiality, the dignity of persons, non-maleficence, stigma and the ethical obligations of health workers are examined. Interventions implemented to ensure that confidentiality and the dignity of persons improved and stigma was reduced, included community meetings, knowledge communication and the training of media personnel in the ethical reporting of Ebola issues. In addition, training in infection prevention and control helped to allay the fears of health workers. A potential disaster was also averted when the use of an experimental medicine was reconsidered. Other countries currently battling the epidemic can learn a lot from the Nigerian experience.

  17. Islam and the four principles of medical ethics.

    Science.gov (United States)

    Mustafa, Yassar

    2014-07-01

    The principles underpinning Islam's ethical framework applied to routine clinical scenarios remain insufficiently understood by many clinicians, thereby unfortunately permitting the delivery of culturally insensitive healthcare.This paper summarises the foundations of the Islamic ethical theory, elucidating the principles and methodology employed by the Muslim jurist in deriving rulings in the field of medical ethics. The four-principles approach, as espoused by Beauchamp and Childress, is also interpreted through the prism of Islamic ethical theory. Each of the four principles (beneficence, nonmaleficence,justice and autonomy) is investigated in turn, looking in particular at the extent to which each is rooted in the Islamic paradigm. This will provide an important insight into Islamic medical ethics, enabling the clinician to have a better informed discussion with the Muslim patient. It will also allow for a higher degree of concordance in consultations and consequently optimise culturally sensitive healthcare delivery.

  18. [The challenges of the ethics of personalism to clinical toxicology].

    Science.gov (United States)

    Brusiło, Jerzy

    2011-01-01

    The fields of philosophical anthropology and the ethics of personalism overlap in the area of many difficult personal situations involving clinical toxicology. These therapeutic situations need an integral, multidimensional, and personal approach for both the patient and the toxicologist. This means that man is treated not only as a physical (biological) being but also there is an appreciation for the mental sphere, which includes rational, emotional, and spiritual elements while not forgetting that the human person is also part of the human community. Studying such an individual's personal decision as suicide, we must realize that it's not just physiological or biochemical poisons but also includes the poisoning of the psyche, as well as poisoning relationships with loved ones (family), poisoning social relations (in school or the workplace) and poisoning the spirit, in other words, there is no meaning in life itself, nor the meaning of God's existence, nor the meaning of faith, hope and love. Not only is there a greater "variety of poisons" than before, they are much more extensive and deep. For example, we can name environmental pollution, industrial poisons, chemical waste, genetic modification, powerful medications, or even the toxic social environment of evil ideas, malicious manipulation of the human mind (destructive religious sects). In approaching the challenges of clinical toxicology, the doctor must not only be a specialist in chemistry, biochemistry and pharmacology. What then is of future of toxicology because of this human dimension (anthropological, ethical and spiritual) of this teaching? As today marks the occasion of the 45th anniversary of the Clinic of Toxicology CM UJ, should we shape the ethos of young doctors who want to deal with toxicology seriously?

  19. Chinese Confucian culture and the medical ethical tradition.

    Science.gov (United States)

    Guo, Z

    1995-08-01

    The Confucian culture, rich in its contents and great in its significance, exerted on the thinking, culture and political life of ancient China immense influences, unparalleled by any other school of thought or culture. Confucian theories on morality and ethics, with 'goodness' as the core and 'rites' as the norm, served as the 'key notes' of the traditional medical ethics of China. The viewpoints of Confucianism on benevolence and material interests, on good and evil, on kindheartedness, and on character cultivation were all inherited by the medical workers and thus became prominent in Chinese traditional medical ethics. Hence, it is clear that the medical profession and Confucianism have long shared common goals in terms of ethics. Influenced by the excellent Confucian thinking and culture, a rather highly-developed system of Chinese traditional medical ethics emerged with a well-defined basic content, and the system has been followed and amended by medical professionals of all generations throughout Chinese history. This system, just to mention briefly, contains concepts such as the need: to attach great importance to the value of life; to do one's best to rescue the dying and to heal the wounded; to show concern to those who suffer from diseases; to practise medicine with honesty; to study medical skills painstakingly; to oppose a careless style of work; to comfort oneself in a dignified manner; to respect local customs and to be polite; to treat patients, noble or humble, equally, and to respect the academic achievements of others, etc. Of course, at the same time, Confucian culture has its own historical and class limitations, which exerted negative influences on traditional medical ethics. Now, if we are to keep up with the development of modern medicine, a serious topic must be addressed. That is how to retain the essence of our traditional medical ethics so as to maintain historic continuity and yet, at the same time, add on the new contents of medical

  20. Ethical Challenges embedded in qualitative research interviews with close relatives

    DEFF Research Database (Denmark)

    Haahr, Anita; Norlyk, Annelise; Hall, Elisabeth

    2013-01-01

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

  1. Space Toxicology Challenges and Ethical Considerations

    Science.gov (United States)

    James, John T.

    2010-01-01

    Before delineating specific ways that nanotechnology enterprises might contribute to better management of toxicological risks during spaceflight, I will show how ethical considerations and several theories of justice can be applied to nanotechnology strategic plans. The principles that guide an ethical technical enterprise include autonomy, beneficence, non-maleficence, veracity and justice. Veracity (truth) is the underpinning principle; however, beyond this, proponents of nanotechnology must think carefully about balancing conflicting principles. For example, autonomy must yield to beneficence when fearful individuals simply lack knowledge to appreciate nanotechnology's beneficial advances. Justice is a complex topic upon which I will place six models: utilitarian, distributive, free-exchange/choice, individual dignity (social participation), equity vs. greed, and liberation of the poor. After briefly summarizing each model, I will present what I call an iterative-hybrid model of justice to show specifically how our thinking can be applied to nanotechnology enterprises. Within that broad landscape, I will discuss a single feature: how our early effort to understand health risks of carbon nanotubes fits into the iterative model. Finally, I will suggest ways that nanotechnology might advance our management of toxicological risks during spaceflight, but always with an eye toward how such advances might result in a more just world.

  2. Great expectations: teaching ethics to medical students in South Africa.

    Science.gov (United States)

    Behrens, Kevin Gary; Fellingham, Robyn

    2014-12-01

    Many academic philosophers and ethicists are appointed to teach ethics to medical students. We explore exactly what this task entails. In South Africa the Health Professions Council's curriculum for training medical practitioners requires not only that students be taught to apply ethical theory to issues and be made aware of the legal and regulatory requirements of their profession, it also expects moral formation and the inculcation of professional virtue in students. We explore whether such expectations are reasonable. We defend the claim that physicians ought to be persons of virtuous character, on the grounds of the social contract between society and the profession. We further argue that since the expectations of virtue of health care professionals are reasonable, it is also sound reasoning to expect ethics teachers to try to inculcate such virtues in their students, so far as this is possible. Furthermore, this requires of such teachers that they be suitable role models of ethical practice and virtue, themselves. We claim that this applies to ethics teachers who are themselves not members of the medical profession, too, even though they are not bound by the same social contract as doctors. We conclude that those who accept employment as teachers of ethics to medical students, where as part of their contractual obligation they are expected to inculcate moral values in their students, ought to be prepared to accept their responsibility to be professionally ethical, themselves. © 2013 John Wiley & Sons Ltd.

  3. Teaching Medical Ethics in Graduate and Undergraduate Medical Education: A Systematic Review of Effectiveness.

    Science.gov (United States)

    de la Garza, Santiago; Phuoc, Vania; Throneberry, Steven; Blumenthal-Barby, Jennifer; McCullough, Laurence; Coverdale, John

    2017-08-01

    One objective was to identify and review studies on teaching medical ethics to psychiatry residents. In order to gain insights from other disciplines that have published research in this area, a second objective was to identify and review studies on teaching medical ethics to residents across all other specialties of training and on teaching medical students. PubMed, EMBASE, and PsycINFO were searched for controlled trials on teaching medical ethics with quantitative outcomes. Search terms included ethics, bioethics, medical ethics, medical students, residents/registrars, teaching, education, outcomes, and controlled trials. Nine studies were found that met inclusion criteria, including five randomized controlled trails and four controlled non-randomized trials. Subjects included medical students (5 studies), surgical residents (2 studies), internal medicine house officers (1 study), and family medicine preceptors and their medical students (1 study). Teaching methods, course content, and outcome measures varied considerably across studies. Common methodological issues included a lack of concealment of allocation, a lack of blinding, and generally low numbers of subjects as learners. One randomized controlled trial which taught surgical residents using a standardized patient was judged to be especially methodologically rigorous. None of the trials incorporated psychiatry residents. Ethics educators should undertake additional rigorously controlled trials in order to secure a strong evidence base for the design of medical ethics curricula. Psychiatry ethics educators can also benefit from the findings of trials in other disciplines and in undergraduate medical education.

  4. The historic and national aspects of medical ethics and deontology.

    Directory of Open Access Journals (Sweden)

    Prikhoda Igor' Viktorovich

    2009-02-01

    Full Text Available Researches of problems of medical ethics and deontology in activity of the medical worker presented. Historical and national aspects of the delivered problem are considered. They open diversity and complexity of realization of problems of formation of the person of the medical worker. The humanism in medicine makes its ethical basis and morals. The humanism serves moral development of the person of the medical worker. Without humanism the medicine loses the right on existence. Its scientific and professional principles conflict to its basic purpose - to serve the person.

  5. Medical Ethics and Law in Radiologic Technology.

    Science.gov (United States)

    Matthews, Eric P; Matthews, Tracy M

    2015-01-01

    At every stage of their careers, radiologic technologists and student technologists must adhere to high ethical standards, obey the law, and consistently conduct themselves with professionalism. This article explains how modern health care ethics evolved, focusing on 8 important theorists. It also describes the ethical responsibilities of health care providers and the rights of patients. Important civil rights laws are discussed, focusing on the rights of health care workers as employees. A brief overview of the U.S. legal system follows, including the causes of action that most commonly involve health care professionals. Finally, this article discusses professionalism and its implications for radiologic technologists.

  6. An empirical study of tissue banking in Australia: navigating regulatory and ethical challenges.

    Science.gov (United States)

    Clark, Georgina; Lipworth, Wendy; Les, Bokey; Little, J M; Kerridge, Ian H

    2006-08-01

    Collections of tumour samples can be an invaluable resource for medical research. There are, however, numerous ethical and legal challenges associated with tumour banking. While there has been extensive discussion of these issues in the legal and ethical literature, there are few available empirical data in relation to the activities of tumour banks in Australia, their practices around ethically charged issues, and their success in implementing complex regulatory guidelines. The aim of this study was to gain more information about the activities of tumour banks in New South Wales, Australia, with a particular focus on their management of, and attitudes towards, ethical and regulatory issues. A survey of 27 tumour collection and research facilities was conducted using a 55-item questionnaire. There is significant heterogeneity of research methodologies as well as of methods for gaining consent and ensuring donor privacy, and there is general concern among the research community about ethical and regulatory issues related to tumour banking. Heterogeneity of practice and uncertainty about ethical and regulatory requirements is problematic in its potential to hinder research and its potential to generate the space for unethical practice, whether intentional or unintentional. There is a pressing need to address these issues so that tumour banks can be used in the most ethical and efficient way possible.

  7. Avoiding evasion: medical ethics education and emotion theory.

    Science.gov (United States)

    Leget, C

    2004-10-01

    Beginning with an exemplary case study, this paper diagnoses and analyses some important strategies of evasion and factors of hindrance that are met in the teaching of medical ethics to undergraduate medical students. Some of these inhibitions are inherent to ethical theories; others are connected with the nature of medicine or cultural trends. It is argued that in order to avoid an attitude of evasion in medical ethics teaching, a philosophical theory of emotions is needed that is able to clarify on a conceptual level the ethical importance of emotions. An approach is proposed with the help of the emotion theory Martha Nussbaum works out in her book Upheavals of thought. The paper ends with some practical recommendations.

  8. Uterus transplantation: ethical and regulatory challenges.

    Science.gov (United States)

    Arora, Kavita Shah; Blake, Valarie

    2014-06-01

    Moving forward rapidly in the clinical research phase, uterus transplantation may be a future treatment option for women with uterine factor infertility, which accounts for three per cent of all infertility in women. This new method of treatment would allow women, who currently rely on gestational surrogacy or adoption, to gestate and birth their own genetic offspring. Since uterus transplantation carries significant risk when compared with surrogacy and adoption as well as when compared with other organ transplants, it requires greater justification because its goals are quality of life, not life-saving, in their scope. It is important to address questions regarding the physical, psychosocial and ethical risks and benefits of uterus transplantation for all three parties involved--the patient, the donor and the potential child--as well as discuss the regulatory implications as research on uterus transplantations moves forward.

  9. Ethical challenges in everyday work with adults with learning disabilities

    DEFF Research Database (Denmark)

    Solvoll, Betty-Ann; Hall, Elisabeth; Støre Brinchmann, Berit

    2015-01-01

    Background: Healthcare providers caring for learning-disabled individuals in institutions face challenges of what is right or wrong in their daily work. Serving this group, it is of utmost importance for the healthcare staff to raise awareness and to understand how ethical values are at stake....... Research question: What ethical challenges are discussed among healthcare providers working with adults with learning disabilities? Research design: The study had a qualitative and investigative design. Participants and research context: The study was conducted in a community institution for adults...... with learning disabilities. Participants were healthcare providers joining regular focused group discussions. Two groups participated and each group consisted of six participants. The conversations were taped and transcribed. Ethical considerations: The study was reported to Norwegian Social Science Data...

  10. Ethical challenges in everyday work with adults with learning disabilities

    DEFF Research Database (Denmark)

    Solvoll, Betty-Ann; Hall, Elisabeth; Støre Brinchmann, Berit

    2015-01-01

    Background: Healthcare providers caring for learning-disabled individuals in institutions face challenges of what is right or wrong in their daily work. Serving this group, it is of utmost importance for the healthcare staff to raise awareness and to understand how ethical values are at stake...... with learning disabilities. Participants were healthcare providers joining regular focused group discussions. Two groups participated and each group consisted of six participants. The conversations were taped and transcribed. Ethical considerations: The study was reported to Norwegian Social Science Data....... Research question: What ethical challenges are discussed among healthcare providers working with adults with learning disabilities? Research design: The study had a qualitative and investigative design. Participants and research context: The study was conducted in a community institution for adults...

  11. Virtuous acts as practical medical ethics: an empirical study.

    Science.gov (United States)

    Little, Miles; Gordon, Jill; Markham, Pippa; Rychetnik, Lucie; Kerridge, Ian

    2011-10-01

    To examine the nature, scope and significance of virtues in the biographies of medical practitioners and to determine what kind of virtues are at play in their ethical behaviour and reflection. A case study involving 19 medical practitioners associated with the Sydney Medical School, using semi-structured narrative interviews. Narrative data were analysed using dialectical empiricism, constant comparison and iterative reformulation of research questions. Participants represented virtuous acts as centrally important in their moral assessments of both themselves and others. Acts appeared to be contextually virtuous, rather than expressions of stable character traits, and virtue was linked to acts that served to protect or enhance fundamental values attached to ontological security and human flourishing. Virtue ethics, in this sense, was the single most important ethical system for each of the participants. Virtue ethics, construed as the appraisal of acts in contexts of risk, danger or threat to foundational values, emerged as the 'natural' ethical approach for medical practitioners in this case study. Teaching medical ethics to students and graduates alike needs to accommodate the priority attached to virtuous acts. © 2011 Blackwell Publishing Ltd.

  12. [Civil, criminal and ethical liability of medical doctors].

    Science.gov (United States)

    Udelsmann, Artur

    2002-01-01

    In the last years doctors have been the target of a growing number of civil, criminal law suits, as well as ethical procedures. Medicine is a widely targeted career, not only owing to its inherent risks, but also owing to a mistaken approach of the Judiciary Power about the obligations of medical doctors. Decisions of the Medical Board in ethical procedures have an impact in civil and criminal justice and therefore should be followed closely. The purpose of this review is to provide a wide view from a doctor-lawyer perspective of cases involving civil, criminal liability of anesthesiologists as well as ethical procedures against them, in an effort to make them comprehensible to doctors. After a brief historical introduction civil liability foundations and legal articles are examined. Responsibilities of doctors, hospitals and health insurance providers are discussed separately, as well as reparation mechanisms. Crimes possible to occur during medical practice and respective penalties are described; the direct relationship between crime and civil reparation is demonstrated. The administrative nature of ethical procedure is described, emphasizing that the legal character of its penalties often serve as grounds for civil and criminal justice decisions. Prevention is still the best medicine. Good medical practice and a good medical-patient relationship are still the best ways to minimize lawsuits and their repercussions. Doctors should have some knowledge of juridical mechanisms in lawsuits and ethical procedures, but should not take defense initiatives without prior consultation of an attorney. Civil, criminal and ethical liability of physicians.

  13. Medical ethics: enhanced or undermined by modes of payment?

    Science.gov (United States)

    Zweifel, Peter; Janus, Katharina

    2017-01-01

    In the medical literature [1, 2, 7], the view prevails that any change away from fee-for-service (FFS) jeopardizes medical ethics, defined as motivational preference in this article. The objective of this contribution is to test this hypothesis by first developing two theoretical models of behavior, building on the pioneering works of Ellis and McGuire [4] and Pauly and Redisch [11]. Medical ethics is reflected by a parameter α, which indicates how much importance the physician attributes to patient well-being relative to his or her own income. Accordingly, a weakening of ethical orientation amounts to a fall in the value of α. While traditional economic theory takes preferences as predetermined, more recent contributions view them as endogenous (see, e.g., Frey and Oberholzer-Gee [5]). The model variant based on Ellis and McGuire [4] depicts the behavior of a physician in private practice, while the one based on Pauly and Redisch [11] applies to providers who share resources such as in hospital or group practice. Two changes in the mode of payment are analyzed, one from FFS to prospective payment (PP), the other to pay-for-performance (P4P). One set of predictions relates physician effort to a change in the mode of payment; another, physician effort to a change in α, the parameter reflecting ethics. Using these two relationships, a change in ethics can observationally be related to a change in the mode of payment. The predictions derived from the models are pitted against several case studies from diverse countries. A shift from FFS to PP is predicted to give rise to a negative observed relationship between the medical ethics of physicians in private practice under a wide variety of circumstances, more so than a shift to P4P, which can even be seen as enhancing medical ethics, provided physician effort has a sufficiently high marginal effectiveness in terms of patient well-being. This prediction is confirmed to a considerable degree by circumstantial evidence

  14. Nurse prescribing ethics and medical marketing.

    Science.gov (United States)

    Adams, J

    This article suggests that nurse prescribers require an awareness of key concepts in ethics, such as deontology and utilitarianism to reflect on current debates and contribute to them. The principles of biomedical ethics have also been influential in the development of professional codes of conduct. Attention is drawn to the importance of the Association of the British Pharmaceutical Industry's code of practice for the pharmaceutical industry in regulating marketing aimed at prescribers.

  15. 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

  16. Ethical challenges in everyday work with adults with learning disabilities

    DEFF Research Database (Denmark)

    Solvoll, Betty-Ann; Hall, Elisabeth; Støre Brinchmann, Berit

    2015-01-01

    Background: Healthcare providers caring for learning-disabled individuals in institutions face challenges of what is right or wrong in their daily work. Serving this group, it is of utmost importance for the healthcare staff to raise awareness and to understand how ethical values are at stake...

  17. [History of medical ethics in Korea: focused on analysis of medical codes and covenants].

    Science.gov (United States)

    Shin, D W

    2000-12-01

    This article deals with the emergence of the codes of medical ethics and their change in Korean history. The modernized medical codes or covenants by the group of medical doctors has been made from the mid-twentieth century, although Korea has a long tradition of medical ethics, so called the Confucian medical ethics, Insul or Uido which were taken on very strong paternalistic characters. The history of the codes of medical ethics in contemporary Korea showed several revisions in 1961, 1965, 1979, and 1997 since the first establishment in 1955. Changes of political circumstances, the cultural level of the people, medical care system, and medical power leaded to the revisions. Throughout the revisions the codes or covenants of medical ethics in Korea has changed from simple translations of the codes by the World Medical Association and the American Medical Association to the reflexes of domestic medical situations; from the ones based on paternalistic doctor-patient relationship to more democratic ones; from the ones that only medical ethics were expressed to the ones that bioethics was expressed too.

  18. Ethical and professional considerations providing medical evaluation and care to refugee asylum seekers.

    Science.gov (United States)

    Asgary, Ramin; Smith, Clyde L

    2013-01-01

    A significant number of asylum seekers who largely survived torture live in the United States. Asylum seekers have complex social and medical problems with significant barriers to health care access. When evaluating and providing care for survivors, health providers face important challenges regarding medical ethics and professional codes. We review ethical concerns in regard to accountability, the patient-physician relationship, and moral responsibilities to offer health care irrespective of patient legal status; competing professional responsibility toward society and the judiciary system; concerns about the consistency of asylum seekers' claims; ethical concerns surrounding involving trainees and researching within the evaluation setting; and the implication of broader societal views towards rights and social justice. We discuss contributing factors, including inadequate and insufficient provider training, varying and inadequate institutional commitment, asylum seekers' significant medical and social problems, and the broader health and social system issues. We review existing resources to address these concerns and offer suggestions.

  19. Ethics of emergent information and communication technology applications in humanitarian medical assistance.

    Science.gov (United States)

    Hunt, Matthew; Pringle, John; Christen, Markus; Eckenwiler, Lisa; Schwartz, Lisa; Davé, Anushree

    2016-07-01

    New applications of information and communication technology (ICT) are shaping the way we understand and provide humanitarian medical assistance in situations of disaster, disease outbreak or conflict. Each new crisis appears to be accompanied by advancements in humanitarian technology, leading to significant improvements in the humanitarian aid sector. However, ICTs raise ethical questions that warrant attention. Focusing on the context of humanitarian medical assistance, we review key domains of ICT innovation. We then discuss ethical challenges and uncertainties associated with the development and application of new ICTs in humanitarian medical assistance, including avoiding harm, ensuring privacy and security, responding to inequalities, demonstrating respect, protecting relationships, and addressing expectations. In doing so, we emphasize the centrality of ethics in humanitarian ICT design, application and evaluation.

  20. Ethical and legal challenges in bioenergy governance

    DEFF Research Database (Denmark)

    Gamborg, Christian; Anker, Helle Tegner; Sandøe, Peter

    2014-01-01

    The article focuses on the interplay between two factors giving rise to friction in bioenergy governance: profound value disagreements (e.g. the prioritizing of carbon concerns like worries over GHG emissions savings over non-carbon related concerns) and regulatory complexity (in terms of regulat......The article focuses on the interplay between two factors giving rise to friction in bioenergy governance: profound value disagreements (e.g. the prioritizing of carbon concerns like worries over GHG emissions savings over non-carbon related concerns) and regulatory complexity (in terms...... of regulatory measures and options). We present ethical and legal analyses of the current stalemate on bioenergy governance in the EU using two illustrative cases: liquid biofuels for transport and solid biomass-based bioenergy. The two cases disclose some similarities between these two factors......, but the remaining differences may partly explain, or justify, contrasting forms of governance. While there seems to be no easy way in which the EU and national governments can deal with the multiple sustainability issues raised by bioenergy, it is argued that failure to deal explicitly with the underlying value...

  1. Medical Students’ Development of Ethical Judgment – Exploring the Learners’ Perspectives using a mixed methods approach

    Directory of Open Access Journals (Sweden)

    Langer, Thorsten

    2016-11-01

    Full Text Available Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students’ perspectives on their development in ethical judgment has received less attention. Better insights in the learners’ experiences can help to improve educational interventions in medical ethics.Methods: A vignette featuring a challenging case with opposing views between a patient’s parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5. The questionnaire included closed and open-ended questions addressing the participant’s preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28% over the study period. Participants’ responses changed overtime. Accepting parents’ autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%. On the contrary, not readily following the parents’ decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%. Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor. Conclusions: Over the course of

  2. Medical Students' Development of Ethical Judgment - Exploring the Learners' Perspectives using a mixed methods approach.

    Science.gov (United States)

    Langer, Thorsten; Jazmati, Danny; Jung, Ole; Schulz, Christian; Schnell, Martin W

    2016-01-01

    Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students' perspectives on their development in ethical judgment has received less attention. Better insights in the learners' experiences can help to improve educational interventions in medical ethics. Methods: A vignette featuring a challenging case with opposing views between a patient's parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5). The questionnaire included closed and open-ended questions addressing the participant's preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28%) over the study period. Participants' responses changed overtime. Accepting parents' autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%). On the contrary, not readily following the parents' decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%). Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor). Conclusions: Over the course of their medical training, the

  3. [Neuroethics: new quality of medical ethics?].

    Science.gov (United States)

    Niebrój, Lesław T

    2013-01-01

    During the last decade there has been a striking growth in interest in ethical issues arising from the development of neurosciences. It was as late as 2002 that the new discipline, called neuroethics, started. It was intended to be a new area of interdisciplinary discourse on moral dilemmas connected with recent advances in, broadly understood, neurosciences. Ten years after its launch neuroethics possesses a distinct body of knowledge and an institutional basis for its further development. As a very young discipline, however, neuroethics is still in a state offlux. Two essential theoretical concepts of how this discipline is to be built on are emerging. Both are discussed in this article. According to the first of them (i.e. ethics of neurosciences), neuroethics is basically understood as a sub--discipline of bioethics. Although there are some reasons for distinguishing several branches or sub-disciplines of bioethics (genethics, neuroethics, nanoethics, etc.), there are sound arguments against such a tendency for the proliferation of biomedical ethics. The second approach to neuroethics (neuroscience of ethics), which aims at studying neuronal correlates of the well-known ethical concepts (e.g. free-will, moral responsibility, etc.), seems to be much more promising. Neuroethics understood in this way (and only in this way) can be considered as a truly new opportunity for collaboration between neuroscientists and ethicists.

  4. Public Policy Systems Dealing with Ethically Contested Medical Technological Innovations

    NARCIS (Netherlands)

    Hoppe, Rob

    2008-01-01

    The questions tackled in this paper are: How do we deal with ethically contested medical innovations?, and Can we do better? First, I analyse how we deal with these problems by a division of labour and competitive boundary work between the medical R&D system's research and technological imperative,

  5. Teaching Medical Ethics in Iran: A Quantitative Study

    Directory of Open Access Journals (Sweden)

    Shabnam Bazmi

    2016-06-01

    Full Text Available Background and Purpose: Practice of good medicine raises many ethical issues. Teaching medical ethics is essential for medical students, but it seems that the content of the core curriculum, delivery resources, and the teaching and assessment methods, do not address this need. Our study assessed undergraduate medical and dentistry students’ opinion of a presented course on medical ethics as a basic research in order to evaluate the content and presentation method of this course. Methods: This study was a cross-sectional descriptive study on 244 students, including 146 medical and 98 dentistry students. Data were gathered using a questionnaire and analyzed by SPSS software, version 18. Results: Of the 244 students, 59.8% were medical and 40.2% were dentistry students, and 72.3% were female. The mean±SD age was 23.1±2.68 years. 52.87% of the students stated that the clinical period was the ideal time for presenting this type of course, 42.21% stated no more than 20 students as the acceptable size for a class, and 59.4% suggested case presentation as the best teaching method. Medical and dentistry students had different opinions regarding the capability induced by this course such as: The ability of course to empower students in recognition of the professional obligations and increasing the students’ ability to communicate with patients, their relatives and other members of the medical staff. Conclusions: According to the results of this study, it is necessary to establish an appropriate, content evaluated program with educated teachers for teaching medical ethics, especially to medical students. Keywords: Teaching medical ethics, curriculum, students’ opinion

  6. Ethical issues in genomic research on the African continent: experiences and challenges to ethics review committees.

    Science.gov (United States)

    Ramsay, Michèle; de Vries, Jantina; Soodyall, Himla; Norris, Shane A; Sankoh, Osman

    2014-01-01

    This is a report on a workshop titled 'Ethics for genomic research across five African countries: Guidelines, experiences and challenges', University of the Witwatersrand, Johannesburg, South Africa, 10 and 11 December 2012. The workshop was hosted by the Wits-INDEPTH partnership, AWI-Gen, as part of the H3Africa Consortium.

  7. Chinese Confucian culture and the medical ethical tradition.

    OpenAIRE

    Guo, Z

    1995-01-01

    The Confucian culture, rich in its contents and great in its significance, exerted on the thinking, culture and political life of ancient China immense influences, unparalleled by any other school of thought or culture. Confucian theories on morality and ethics, with 'goodness' as the core and 'rites' as the norm, served as the 'key notes' of the traditional medical ethics of China. The viewpoints of Confucianism on benevolence and material interests, on good and evil, on kindheartedness, and...

  8. Making sense of ethics and law in the medical curriculum.

    Science.gov (United States)

    Dowie, A L

    2011-01-01

    The moment a patient comes into the treatment room, the medical professional is placed in both an ethical and a legal context. The task for medical teachers is to equip students for this clinical reality in a way that makes sense both to the learners and to the variety of medical educators in the school, all of whom will have their own interpretations of the nature of this subject area. Ethics and law in the medical curriculum (Dowie and Martin 2011), aims to provide an understanding of how ethics and law can be incorporated into the curriculum in a structured, coherent, and logical manner. It is essential that we begin with a vision of the primary purpose of our course, and clarify the overall domain of learning to which it relates. Rather than presenting students with a miscellany of ethico-legal topics, their learning can be reinforced by constructing a frame around the key emphases in law and ethics. A professional ethics frame is proposed, highlighting the everyday, theory-based, habits, intentions, consequences and society elements of this approach. The course also has to be mediated within the wider curriculum, and this benefits from a coherent and communicated course scheme that is directly meaningful within the educational setting of the medical school. Finally, within the Guide, examples of humanistic schemes are presented that centre on aspects of boundary in patient care, themed around body, person and community of practice.

  9. Bearing response-ability: theater, ethics and medical education.

    Science.gov (United States)

    Rossiter, Kate

    2012-03-01

    This paper addresses a growing concern within the medical humanities community regarding the perceived need for a more empathically-focused medical curricula, and advocates for the use of creative pedagogical forms as a means to attend to issues of suffering and relationality. Drawing from the ethical philosophy of Emmanuel Levinas, I critique the notion of empathy on the basis that it erases difference and disregards otherness. Rather, I propose that the concept of empathy may be usefully replaced with that of ethical responsibility, which suggests a shared sense of humanity outside the boundaries of presumed knowledge of the other. To illustrate this argument, I theorize the importance of theater within medical education. Theater, I argue, may engender ethical responsibility in the Levinasian sense, and thus may allow learners to differently engage with the experience of the suffering other. As such, I examine Margaret Edson's widely used play Wit as a platform for such an ethical encounter to occur. Thus, rather than working to understand the value of theater in medical education in terms of knowledge and skill acquisition, I theorize that its primacy within medical curricula arises from its ethical/relational potential, or potential to engender new forms of inter-human relationality.

  10. Exploring the contemporary ethical challenges in coaching psychology in South Africa

    OpenAIRE

    Claire E. Simon; Aletta Odendaal; Xenia Goosen

    2014-01-01

    Orientation: This article focuses on the contemporary ethical challenges in coaching psychology in the South African context.Research purpose: The primary objective was to qualitatively explore the contemporary ethical challenges faced by coaching psychologists when coaching clients and organisations and develop an exploratory framework of ethical challenges.Motivation for the study: There may not be sufficient practical guidance to resolving the ethical challenges coaching psychologists enco...

  11. Global Ethics Applied: Global Ethics, Economic Ethics

    OpenAIRE

    Stückelberger, Christoph

    2016-01-01

    Global Ethics Applied’ in four volumes is a reader of 88 selected articles from the author on 13 domains: Vol. 1 Global Ethics, Economic Ethics; Vol. 2 Environmental Ethics; Vol. 3 Development Ethics, Political Ethics, Dialogue and Peace Ethics, Innovation and Research Ethics, Information and Communication Ethics; Vol. 4 Bioethics and Medical Ethics, Family Ethics and Sexual Ethics, Leadership Ethics, Theological Ethics and Ecclesiology, Methods of Ethics. It concludes with the extended Bibli...

  12. The ethics and editorial challenges of internet-based research.

    Science.gov (United States)

    Harriman, Stephanie; Patel, Jigisha

    2014-01-01

    The internet has opened up vast possibilities for research. An increasing number of studies are being conducted using the internet as both a source of data and a venue for research. Use of the internet in research has created many challenges, not just for those conducting and reviewing the studies, but also for editors publishing this work. Two key issues raised by internet-based research are ethics approval and informed consent. While some guidance exists regarding the ethics and consent of internet-based research, and some institutions provide their own guidelines, there appears to be a lack of definitive national standards. We discuss the issues surrounding ethics and consent for internet-based research and the need for a consensus on how to address these issues to ensure consistency.

  13. Time for a unified approach to medical ethics

    Directory of Open Access Journals (Sweden)

    McNamee Turi

    2009-09-01

    Full Text Available Abstract A code of ethics is used by individuals to justify their actions within an environment. Medical professionals require a keen understanding of specific ethical codes due to the potential consequences of their actions. Over the past thirty years there has been an increase in the scope and depth of ethics instruction in the medical profession; however the teaching of these codes is still highly variable. This inconsistency in implementation is problematic both for the medical practitioner and for the patient; without standardized training, neither party can be assured of the practitioner's overall depth of knowledge. Within the field of ethics certain principles have reached a consensus of importance. Incorporation of these concepts in meaningful ways via a consistent curriculum would provide students with an appropriate skill set for navigating their ethical environment. Moreover, this curriculum should also be extended to residents and professionals who may have missed formal ethical training. This would provide a consistent framework of knowledge for practitioners, creating a basis for clear judgment of complex issues.

  14. Levinas's ethics as a basis of healthcare - challenges and dilemmas.

    Science.gov (United States)

    Nordtug, Birgit

    2015-01-01

    Levinas's ethics has in the last decades exerted a significant influence on Nursing and Caring Science. The core of Levinas's ethics - his analyses of how our subjectivity is established in the ethical encounter with our neighbour or the Other - is applied both to healthcare practice and in the project of building an identity of Nursing and Caring Science. Levinas's analyses are highly abstract and metaphysical, and also non-normative. Thus, his analyses cannot be applied directly to practical problems and questions. Theorists in Nursing and Caring Science are generally aware of this. Nevertheless, many of them use Levinas's analyses to explore and solve questions of practical and normative character. This article focuses on the challenges and dilemmas of using Levinas in this manner. The article is divided into two parts. The first part presents some central ideas of Levinas's ethics based on the latter part of his authorship. The main focus is on the radicalism of Levinas's critique of the symbolic order (which includes concepts, categories, knowledge, etc.) - or as he puts it 'the said' - as a basis for subjectivity and responsibility. Levinas's notions of saying, anarchy, and singularity accentuate this point of view. These notions refer to conditions in the language, which counteract the symbolic order in the ethical encounter to such an extent that it becomes an incomprehensible. Levinas gives the argumentation a metaphysical frame: The encounter with the incomprehensible is an encounter with the Holy, which is not the ontological God, but a metaphysical desire. It is a mystery as to what this means, and herein lies possibly the main challenge when using Levinas's ethics in science and research: How to maintain the radicalism of his critique of the symbolic order when this is to be communicated in a scientific context that expects clarification of statements and ideas? The second part of the article explores this question by examining how some theorists use

  15. Developing a Questionnaire for Iranian Women’s Attitude on Medical Ethics in Vaginal Childbirth

    Directory of Open Access Journals (Sweden)

    Mirzaee Rabor

    2015-12-01

    Full Text Available Background Vaginal delivery is one of the challenging issues in medical ethics. It is important to use an appropriate instrument to assess medical ethics attitudes in normal delivery, but the lack of tool for this purpose is clear. Objectives The aim of this study was to develop and validate a questionnaire for the assessment of women’s attitude on medical ethics application in normal vaginal delivery. Patients and Methods This methodological study was carried out in Iran in 2013 - 2014. Medical ethics attitude in vaginal delivery questionnaire (MEAVDQ was developed using the findings of a qualitative data obtained from a grounded theory research conducted on 20 women who had vaginal childbirth, in the first phase. Then, the validation criteria of this tool were tested by content and face validity in the second phase. Exploratory factor analysis was used for construct validity and reliability was also tested by Cronbach’s alpha coefficient in the third phase of this study. SPSS version 13 was used in this study. The sample size for construct validity was 250 females who had normal vaginal childbirth. Results In the first phase of this study (tool development, by the use of four obtained categories and nine subcategories from grounded theory and literature review, three parts (98-items of this tool were obtained (A, B and J. Part A explained the first principle of medical ethics, part B pointed to the second and third principles of medical ethics, and part J explained the fourth principle of medical ethics. After evaluating and confirming its face and content validity, 75 items remained in the questionnaire. In construct validity, by the employment of exploratory factor analysis, in parts A, B and J, 3, 7 and 3 factors were formed, respectively; and 62.8%, 64% and 51% of the total variances were explained by the obtained factors in parts A, B and J, respectively. The names of these factors in the three parts were achieved by consideration of

  16. How Cuba's Latin American School of Medicine challenges the ethics of physician migration.

    Science.gov (United States)

    Huish, Robert

    2009-08-01

    This paper demonstrates a working alternative to the accepted ethics of physician migration. A dominant cosmopolitan ethics encourages upward mobility of physicians in a globalized labour force, and this ultimately advances the position of individuals rather than improving public health-care service for vulnerable communities in the global South. Cuba's Escuela Latinoamericana de Medicina (ELAM) challenges this trend as its institutional ethics furnishes graduates with appropriate skills, knowledge and service ethics to deliver quality care in marginalized areas. This paper provides an analysis of how ELAM trains physicians in community-oriented service for marginalized areas in the global South. The principle finding of this analysis is that ELAM exhibits a working alternative to the accepted ethics of physician migration, as it encourages graduates to practice in marginalized communities rather than feed the migration pipeline into the North. Arguably, ELAM serves as an important case study in how a medical school's ethics can work to bring graduates closer to the communities that are in desperate need of their skills and of their compassion.

  17. [Enhanced recovery after surgery based on medical ethics].

    Science.gov (United States)

    Zhao, Qingchuan

    2016-03-01

    Enhanced recovery after surgery (ERAS), a new model of perioperative management developed in recent years, can shorten hospital stay, reduce medical cost and postoperative discomfort. However, some of these measures under the strategy are negation of the traditional recommendation and many surgeons are concerned about the medical tangle by the complications coming with the ERAS strategy. In this paper, ERAS strategy is evaluated from an ethical standpoint and the assessment factors of medical behavior are introduced based on medical virtues and medical ethnics. It is also analyzed that how to deal with the conflicts between the textbooks and the ERAS strategy, and elaborated that the medical ethics should be observed if the ERAS strategy is implemented. The scientific principles must be followed, the rights and interests of the patients need to be protected, and the informed consent should be guaranteed.

  18. Developing an informational tool for ethical engagement in medical tourism.

    Science.gov (United States)

    Adams, Krystyna; Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory

    2017-08-25

    Medical tourism, the practice of persons intentionally travelling across international boundaries to access medical care, has drawn increasing attention from researchers, particularly in relation to potential ethical concerns of this practice. Researchers have expressed concern for potential negative impacts to individual safety, public health within both countries of origin for medical tourists and destination countries, and global health equity. However, these ethical concerns are not discussed within the sources of information commonly provided to medical tourists, and as such, medical tourists may not be aware of these concerns when engaging in medical tourism. This paper describes the methodology utilized to develop an information sheet intended to be disseminated to Canadian medical tourists to encourage contemplation and further public discussion of the ethical concerns in medical tourism. The methodology for developing the information sheet drew on an iterative process to consider stakeholder feedback on the content and use of the information sheet as it might inform prospective medical tourists' decision making. This methodology includes a literature review as well as formative research with Canadian public health professionals and former medical tourists. The final information sheet underwent numerous revisions throughout the formative research process according to feedback from medical tourism stakeholders. These revisions focused primarily on making the information sheet concise with points that encourage individuals considering travelling for medical tourism to do further research regarding their safety both within the destination country, while travelling, and once returning to Canada, and the potential impacts of their trip on third parties. This methodology may be replicated for the development of information sheets intending to communicate ethical concerns of other practices to providers or consumers of a certain service.

  19. New trends of short-term humanitarian medical volunteerism: professional and ethical considerations.

    Science.gov (United States)

    Asgary, Ramin; Junck, Emily

    2013-10-01

    Short-term humanitarian medical volunteerism has grown significantly among both clinicians and trainees over the past several years. Increasingly, both volunteers and their respective institutions have faced important challenges in regard to medical ethics and professional codes that should not be overlooked. We explore these potential concerns and their risk factors in three categories: ethical responsibilities in patient care, professional responsibility to communities and populations, and institutional responsibilities towards trainees. We discuss factors increasing the risk of harm to patients and communities, including inadequate preparation, the use of advanced technology and the translation of Western medicine, issues with clinical epidemiology and test utility, difficulties with the principles of justice and clinical justice, the lack of population-based medicine, sociopolitical effects of foreign aid, volunteer stress management, and need for sufficient trainee supervision. We review existing resources and offer suggestions for future skill-based training, organisational responsibilities, and ethical preparation.

  20. The cultural and philosophical foundations of normative medical ethics.

    Science.gov (United States)

    Hill, T P

    1994-11-01

    Thirty years ago, the idea that culture and philosophy could provide a foundation for normative medical ethics was more easily entertained than it is today when the very notion of a norm, whether culturally, philosophically or ethically derived, is in itself a problem. In large measure this comes from our contemporary embrace of cultural and philosophical pluralism and an increasing tendency to exchange the difficult belief in abstract and universally applicable norms for the more accessible notion that ethical values are cultural and relative derivatives. Despite this, in the face of the unprecedented ethical dilemmas presented by modern medicine, we have attempted to apply traditional ethical norms and analysis to modern medicine to establish a consensus for its right practice. Unfortunately, the attempt has not been successful, so that wherever we turn we find that ethical problems in medicine remain intractable and unresolved. That, in turn, has prompted a certain scepticism about the efficacy of ethics in medicine. In order to understand why we have reached this impasse, it is essential to realize that we have seriously underestimated the way science and technology have informed and, as a consequence, transformed the practice of medicine. Contributing to this, our tendency to think of technology simply as a way of doing things has blinded us to the fact that it is more fundamentally a way of thinking, knowing and valuing.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Space Exploration: Challenges in Medicine, Research, and Ethics

    Science.gov (United States)

    Davis, Jeffrey R.

    2007-01-01

    This viewgraph presentation describes the challenges that space exploration faces in terms of medicine, research and ethics. The topics include: 1) Effects of Microgravity on Human Physiology; 2) Radiation; 3) Bone; 4) Behavior and Performance; 5) Muscle; 6) Cardiovascular; 7) Neurovestibular; 8) Food and Nutrition; 9) Immunology and Hematology; 10) Environment; 11) Exploration; 12) Building Block Approach; 13) Exploration Issues; 14) Life Sciences Contributions; 15) Health Care; and 17) Habitability.

  2. Clinical research ethics in Irish healthcare: diversity, dynamism and medicalization.

    LENUS (Irish Health Repository)

    Condell, Sarah L

    2012-11-01

    Gaining ethical clearance to conduct a study is an important aspect of all research involving humans but can be time-consuming and daunting for novice researchers. This article stems from a larger ethnographic study that examined research capacity building in Irish nursing and midwifery. Data were collected over a 28-month time frame from a purposive sample of 16 nurse or midwife research fellows who were funded to undertake full-time PhDs. Gaining ethical clearance for their studies was reported as an early \\'rite of passage\\' in the category of \\'labouring the doctorate\\'. This article penetrates the complexities in Irish clinical research ethics by describing the practices these nurse and midwife researchers encountered and the experiences they had. The key issue of representation that occurred in the context of \\'medicalized\\' research ethics is further explored including its meaning for nursing or midwifery research.

  3. Surgical and ethical challenges in disorders of sexual development.

    Science.gov (United States)

    Fallat, Mary E; Hertweck, Paige; Ralston, Steven J

    2012-01-01

    A resolution to the difficulties faced by parents, physicians, and pediatric patients in treating DSDs will only come with better communication and improved research methodologies. Advocacy groups and the Internet have allowed the intersex community to have a larger role in guiding the research and the ethical frameworks that are used in treating these disorders. These disorders are unusual and collaboration across medical centers should be the rule rather than the exception. When possible, treatments that are innovative or experimental should be subjected to rigorous research oversight [29,30]. Defined periods of family crisis in which counseling and education become important are at the time of diagnosis [30,31], at the time of any surgical procedure, and at the beginning of major developmental stages. Historically, children were often left uninformed until someone judged them old and mature enough to comprehend how they were different. These attempts to protect individual children from their condition may have left them vulnerable to a personal crisis at an age when sexual identity and identity with a peer group are important. Both the needs of the child and the adult the child will become should be considered in making treatment decisions for children and adolescents with DSDs. It is best to counsel parents and educate developing children in a way that parallels chronologic and conceptual growth. When possible, the child should be involved in an age-appropriate fashion in the decision-making process and accurate information about the child's history and body should be made available. In addition, parents and families need as much information as possible and support systems that will help them navigate these challenging situations.

  4. Justice and care: the implications of the Kohlberg-Gilligan debate for medical ethics.

    Science.gov (United States)

    Sharpe, V A

    1992-12-01

    Carol Gilligan has identified two orientations to moral understanding; the dominant 'justice orientation' and the under-valued 'care orientation'. Based on her discernment of a 'voice of care', Gilligan challenges the adequacy of a deontological liberal framework for moral development and moral theory. This paper examines how the orientations of justice and care are played out in medical ethical theory. Specifically, I question whether the medical moral domain is adequately described by the norms of impartiality, universality, and equality that characterize the liberal ideal. My analysis of justice-oriented medical ethics, focuses on the libertarian theory of H.T. Engelhardt and the contractarian theory of R.M. Veatch. I suggest that in the work of E.D. Pellegrino and D.C. Thomasma we find not only a more authentic representation of medical morality but also a project that is compatible with the care orientation's emphasis on human need and responsiveness to particular others.

  5. Policy and ethical issues in applying medical biotechnology in developing countries.

    Science.gov (United States)

    Bhardwaj, Minakshi; Macer, Darryl R J

    2003-02-01

    A brief review of some of the key issues in policy relating to the ethical issues raised by medical biotechnology in developing countries is presented, using India as an example. A series of some key issues is discussed, including information obtained from interviewing Indian government policy makers. Some of the issues discussed include: Economic and social incentives to encourage biotechnology; Health policy and ethics review; Patents on drugs; Medical genetics; Relationship to traditional medical practices; Positive public attitudes to biotechnology; Limited public participation; Infrastructural hurdles; Indian progress in stem cell research; and dilemmas of expensive technologies. The results show that although the needs of developing countries are different to those of rich countries, government policy utilizing guidelines and ethics committees has evolved as mechanisms to aid ethical health care delivery in India. In all countries there may be some of these concerns that are raised here, however, the integration of traditional medicine and advanced medical technology, and access to medical services by people in need, are particularly important challenges in developing countries. Better public involvement in policy making will require education and infrastructural organization as well as mutual willingness on the part of policy makers and citizens.

  6. Western medical ethics taught to junior medical students can cross cultural and linguistic boundaries

    Directory of Open Access Journals (Sweden)

    Margolis Stephen A

    2004-07-01

    Full Text Available Abstract Background Little is known about teaching medical ethics across cultural and linguistic boundaries. This study examined two successive cohorts of first year medical students in a six year undergraduate MBBS program. Methods The objective was to investigate whether Arabic speaking students studying medicine in an Arabic country would be able to correctly identify some of the principles of Western medical ethical reasoning. This cohort study was conducted on first year students in a six-year undergraduate program studying medicine in English, their second language at a medical school in the Arabian Gulf. The ethics teaching was based on the four-principle approach (autonomy, beneficence, non-malfeasance and justice and delivered by a non-Muslim native English speaker with no knowledge of the Arabic language. Although the course was respectful of Arabic culture and tradition, the content excluded an analysis of Islamic medical ethics and focused on Western ethical reasoning. Following two 45-minute interactive seminars, students in groups of 3 or 4 visited a primary health care centre for one morning, sitting in with an attending physician seeing his or her patients in Arabic. Each student submitted a personal report for summative assessment detailing the ethical issues they had observed. Results All 62 students enrolled in these courses participated. Each student acting independently was able to correctly identify a median number of 4 different medical ethical issues (range 2–9 and correctly identify and label accurately a median of 2 different medical ethical issues (range 2–7 There were no significant correlations between their English language skills or general academic ability and the number or accuracy of ethical issues identified. Conclusions This study has demonstrated that these students could identify medical ethical issues based on Western constructs, despite learning in English, their second language, being in the third

  7. In Defense of Four Principles Approach in Medical Ethics

    Directory of Open Access Journals (Sweden)

    S Dabbagh

    2008-06-01

    Full Text Available "nPrinciplism, in general and Four Principles Approach in particular is largely discussed in current medical ethics. Accord­ing to principlism, the ethical relationship between physician and patient has to be categorized based on some princi­ples, the prin­ciples which are general, action-guiding and could help both the patient and the physician to arrange their ethical behav­ior. Four Principles Approach which is a principlistic view, has formulated the princi­ples which have to be considered in medi­cal ethics in the light of Rossian ethical framework as follows: respect for auton­omy, nonmalefi­cience, beneficence and jus­tice. Ethical Particularism, on the other hand, strongly criticizes princi­plism and repudi­ates the very idea of generalizabil­ity in the realm of ethics. According to particularists, the way in which a mor­ally relevant feature like fidelity and justice be­have in different ethical occasions is fully con­text-dependent so that they can­not be patternable in advance. It follows from this that fidelity, for instance, is not a good-making feature, generally speak­ing."nIn this paper, firstly, the Rossian ethics is discussed in order to make Four Principles Approach intelligible. Sec­ondly, the main particularists' argument against principlism is formulated. Finally, Particularists' argument is evalu­ated and its plau­si­bility is discussed.

  8. In search of the soul in science: medical ethics' appropriation of philosophy of science in the 1970s.

    Science.gov (United States)

    Aronova, Elena

    2009-01-01

    This paper examines the deployment of science studies within the field of medical ethics. For a short time, the discourse of medical ethics became a fertile ground for a dialogue between philosophically minded bioethicists and the philosophers of science who responded to Thomas Kuhn's challenge. In their discussion of the validity of Kuhn's work, these bioethicists suggested a distinct interpretation of Kuhn, emphasizing the elements in his account that had been independently developed by Michael Polanyi, and propelling a view of science that retreated from idealizations of scientific method without sacrificing philosophical realism. Appropriating Polanyi, they extended his account of science to biology and medicine. The contribution of Karl Popper to the debate on the applicability of philosophy of science to the issues of medical ethics provides the opportunity to discuss the ways in which political agendas of different epistemologies of science intertwined with questions of concern to medical ethics.

  9. Comradery, community, and care in military medical ethics.

    Science.gov (United States)

    Gross, Michael L

    2011-10-01

    Medical ethics prohibits caregivers from discriminating and providing preferential care to their compatriots and comrades. In military medicine, particularly during war and when resources may be scarce, ethical principles may dictate priority care for compatriot soldiers. The principle of nondiscrimination is central to utilitarian and deontological theories of justice, but communitarianism and the ethics of care and friendship stipulate a different set of duties for community members, friends, and family. Similar duties exist among the small cohesive groups that typify many military units. When members of these groups require medical care, there are sometimes moral grounds to treat compatriot soldiers ahead of enemy or allied soldiers regardless of the severity of their respective wounds.

  10. Drones--ethical considerations and medical implications.

    Science.gov (United States)

    Pepper, Tom

    2012-01-01

    Drones enhance military capability and form a potent element of force protection, allowing humans to be removed from hazardous environments and tedious jobs. However, there are moral, legal, and political dangers associated with their use. Although a time may come when it is possible to develop a drone that is able to autonomously and ethically engage a legitimate target with greater reliability than a human, until then military drones demand a crawl-walk-run development methodology, consent by military personnel for weapon use, and continued debate about the complex issues surrounding their deployment.

  11. The challenge of developing ethical guidelines for a research infrastructure

    Science.gov (United States)

    Kutsch, Werner Leo

    2016-04-01

    The mission of the Integrated Carbon Observation System (ICOS RI) is to enable research to understand the greenhouse gas (GHG) budgets and perturbations. The ICOS RI provides the long-term observations required to understand the present state and predict future behaviour of the global carbon cycle and GHG emissions. Technological developments and implementations, related to GHGs, will be promoted by the linking of research, education and innovation. In order to provide this data ICOS RI is a distributed research infrastructure. The backbones of ICOS RI are the national measurement stations such as ICOS atmosphere, ecosystem and ocean stations. ICOS Central Facilities are the European level ICOS RI Centres, which have the specific tasks in collecting and processing the data and samples received from the national measurement networks. During the establishment of ICOS RI ethical guidelines were developed. These guidelines describe principles of ethics in the research activities that should be applied within ICOS RI. They should be acknowledged and followed by all researchers affiliated to ICOS RI and should be supported by all participating institutions. The presentation describes (1) the general challenge to develop ethical guidelines in a complex international infrastructure and (2) gives an overview about the content that includes different kinds of conflicts of interests, data ethics and social responsibility.

  12. Medical ethics and new public management in Sweden.

    Science.gov (United States)

    Hansson, Sven Ove

    2014-07-01

    In order to shorten queues to healthcare, the Swedish government has introduced a yearly "queue billion" that is paid out to the county councils in proportion to how successful they are in reducing queues. However, only the queues for first visits are covered. Evidence has accumulated that queues for return visits have become longer. This affects the chronically and severely ill. Swedish physicians, and the Swedish Medical Association, have strongly criticized the queue billion and have claimed that it conflicts with medical ethics. Instead they demand that their professional judgments on priority setting and medical urgency be respected. This discussion provides an interesting illustration of some of the limitations of new public management and also more generally of the complicated relationships between medical ethics and public policy.

  13. Medical safety in boxing: administrative, ethical, legislative, and legal considerations.

    Science.gov (United States)

    Schwartz, Michael B

    2009-10-01

    The roles and responsibilities of the ringside physician are complex and have evolved into a unique specialty in sport medicine. In addition to the medical aspects of ringside medicine, the doctor is now responsible for many administrative, ethical, and legal considerations. This article reviews and details the numerous roles the ringside physician plays in the sport of boxing.

  14. The ethical leadership challenge: creating a culture of patient- and family-centered care in the hospital setting.

    Science.gov (United States)

    Piper, Llewellyn E

    2011-01-01

    The growing number of medical errors and resulting preventable deaths in hospitals presents an ethical dilemma that must be addressed by health care leaders and managers. These medical errors and deaths raise questions about safety and quality issues resulting in rising public mistrust and patient dissatisfaction. Many of these medical errors and deaths could have been avoided by including the patient and family in the care. The ethical challenge for leadership is creating a culture of patient- and family-centered care as a means to improve quality, safety, patient satisfaction, and public trust. This article addresses ways to improve safety, quality, patient satisfaction, and cost and thereby reduce medical errors and deaths by implementing a patient- and family-centered care culture. The first critical step for improvement is for hospital leaders and managers to answer the ethical call to create a culture centered on patient- and family-centered care in the hospital setting.

  15. The Terri Schiavo case: legal, ethical, and medical perspectives.

    Science.gov (United States)

    Perry, Joshua E; Churchill, Larry R; Kirshner, Howard S

    2005-11-15

    Although tragic, the plight of Terri Schiavo provides a valuable case study. The conflicts and misunderstandings surrounding her situation offer important lessons in medicine, law, and ethics. Despite media saturation and intense public interest, widespread confusion lingers regarding the diagnosis of persistent vegetative state, the judicial processes involved, and the appropriateness of the ethical framework used by those entrusted with Terri Schiavo's care. First, the authors review the current medical understanding of persistent vegetative state, including the requirements for patient examination, the differential diagnosis, and the practice guidelines of the American Academy of Neurology regarding artificial nutrition and hydration for patients with this diagnosis. Second, they examine the legal history, including the 2000 trial, the 2002 evidentiary hearing, and the subsequent appeals. The authors argue that the law did not fail Terri Schiavo, but produced the highest-quality evidence and provided the most judicial review of any end-of-life guardianship case in U.S. history. Third, they review alternative ethical frameworks for understanding the Terri Schiavo case and contend that the principle of respect for autonomy is paramount in this case and in similar cases. Far from being unusual, the manner in which Terri Schiavo's case was reviewed and the basis for the decision reflect a broad medical, legal, and ethical consensus. Greater clarity regarding the persistent vegetative state, less apprehension of the presumed mysteries of legal proceedings, and greater appreciation of the ethical principles at work are the chief benefits obtained from studying this provocative case.

  16. The impact of medical tourism and the code of medical ethics on advertisement in Nigeria.

    Science.gov (United States)

    Makinde, Olusesan Ayodeji; Brown, Brandon; Olaleye, Olalekan

    2014-01-01

    Advances in management of clinical conditions are being made in several resource poor countries including Nigeria. Yet, the code of medical ethics which bars physician and health practices from advertising the kind of services they render deters these practices. This is worsened by the incursion of medical tourism facilitators (MTF) who continue to market healthcare services across countries over the internet and social media thereby raising ethical questions. A significant review of the advertisement ban in the code of ethics is long overdue. Limited knowledge about advances in medical practice among physicians and the populace, the growing medical tourism industry and its attendant effects, and the possibility of driving brain gain provide evidence to repeal the code. Ethical issues, resistance to change and elitist ideas are mitigating factors working in the opposite direction. The repeal of the code of medical ethics against advertising will undoubtedly favor health facilities in the country that currently cannot advertise the kind of services they render. A repeal or review of this code of medical ethics is necessary with properly laid down guidelines on how advertisements can be and cannot be done.

  17. The impact of medical tourism and the code of medical ethics on advertisement in Nigeria

    Science.gov (United States)

    Makinde, Olusesan Ayodeji; Brown, Brandon; Olaleye, Olalekan

    2014-01-01

    Advances in management of clinical conditions are being made in several resource poor countries including Nigeria. Yet, the code of medical ethics which bars physician and health practices from advertising the kind of services they render deters these practices. This is worsened by the incursion of medical tourism facilitators (MTF) who continue to market healthcare services across countries over the internet and social media thereby raising ethical questions. A significant review of the advertisement ban in the code of ethics is long overdue. Limited knowledge about advances in medical practice among physicians and the populace, the growing medical tourism industry and its attendant effects, and the possibility of driving brain gain provide evidence to repeal the code. Ethical issues, resistance to change and elitist ideas are mitigating factors working in the opposite direction. The repeal of the code of medical ethics against advertising will undoubtedly favor health facilities in the country that currently cannot advertise the kind of services they render. A repeal or review of this code of medical ethics is necessary with properly laid down guidelines on how advertisements can be and cannot be done. PMID:25722776

  18. [Bioethics in medical institutions--new custom or help? The example of clinical ethics consultation at a University Medical Center].

    Science.gov (United States)

    Richter, G

    2014-08-01

    Although ethics committees are well established in the medical sciences for human clinical trials, animal research and scientific integrity, the development of clinical ethics in German hospitals started much later during the first decade of the twenty-first century. Clinical ethics consultation should be pragmatic and problem-centered and can be defined as an ethically qualified and informed conflict management within a given legal framework to deal with and resolve value-driven, normative problems in the care of patients. Clinical ethics consultations enable shared clinical decision-making of all parties (e.g. clinicians, patients, family and surrogates) involved in a particular patient's care. The clinical ethicist does not act as an ethics expert by making independent recommendations or decisions; therefore, the focus is different from other medical consultants. Ethics consultation was first established by healthcare ethics committees (HEC) or clinical ethics consultation (CEC) groups which were called in to respond to an ethically problematic situation. To avoid ethical dilemmas or crises and to act preventively with regard to ethical issues in individual patients, an ethics liaison service is an additional option to ethics case consultations which take place on a regular basis by scheduled ethics rounds during the normal ward rounds. The presence of the ethicist offers some unique advantages: it allows early recognition of even minor ethical problems and accommodates the dynamics of ethical and clinical goal-setting in the course of patient care. Most importantly, regular and non-authoritative participation of the ethicist in normal ward rounds allows continuous ethical education of the staff within the everyday clinical routine. By facilitating clinical ethical decision-making, the ethicist seeks to empower physicians and medical staff to deal appropriately with ethical problems by themselves. Because of this proactive approach, the ethics liaison service

  19. EARLIER FORMAL ETHICS EDUCATION, THE IMPORTANCE OF MEICAL ETHICS AND EXPECTATION OF ETHICS DOCTOR IN FIRST GRADE MEDICAL STUDENTS OF MEDICAL FACULTY UNIVERSITAS TANJUNGPURA PONTIANAK

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    Ita Armyanti

    2014-04-01

    Full Text Available AbstractHealth care decisions are based not only on clinical and technical grounds, but also onethical grounds. Although we carefully weigh the clinical and technical aspects, ethical issuesinvolved may be overlooked. A legal framework or code of conduct governing doctor's decisionsand behaviour may help overcome this problem but they often provide rigid guidelines for alimited number of situations. Earlier education in ethics might have some advantages to build agood medical character. The perception of the importance of medical ethics could also had aneffect to the expectation of a good medical doctor should be. This research was a cross sectionalstudy in first grade medical students of medical faculty Universitas Tanjungpura Pontianak,conducted in the last week of April, 2014. All of first grade medical students participated in thisstudy. This subjects given questionaire contained several questions : did they ever get a lessonof ethics in their Senior high schcol, how important the medical ethics and after studied medicalethics, what were their expectation ?. 86 subjects participated, 3'1 (36,05% subjects are maleand 55(63,95% subjects are female. The Age range from 16-20 years old, median 1B years oldand mode 1B years old. The subject came from 39 senior high school, was spread from papua,java dan kalimantan. Only 10(25,64% senior high school had been given ethics in theircurriculum and this'1C school all located in Kalinrantan. One subject (1,16%stated that ethicsjust a common lesson while 35 (40,7A %subjects stated ihat ethics was inrportani and most ofthe subjects, 50(58,14% subjects stated that ethics was very important lesson. The expectationafter studying medical ethics are : 39(45,35 o/o subjects: respect and emphatize the other people,17 (19.77% subjeets : be a betier person, 14(16,28o/c subjeets: hospitable docior, 11 (12,79o/osub;ects :Apply the basic principle of bioethics and 5 (5,81% sublects :treat the other like we'dlike to be

  20. Medical bribery and the ethics of trust: the Romanian case.

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    Manea, Teodora

    2015-02-01

    Medical bribery seems to be a global problem from Eastern Europe and the Balkans to China, a diffuse phenomenon, starting with morally acceptable gratitude and ending with institutional bribery. I focus my attention on Romania and analyze similar cases in Eastern European and postcommunist countries. Medical bribery can be regarded as a particular form of human transaction, a kind of primitive contract that occurs when people do not trust institutions or other forms of social contract that are meant to guarantee their rights and protect their interests. Concluding with strategies to fight medical bribery, I will underline better public policies for financing health and social care, and an ethic of trust that may help to restore trustworthiness of institutions and to rebuild interpersonal trust. This should be complemented by an educational program dedicated to understanding the negative consequences and mechanisms of corruption and the importance of ethical behavior.

  1. Zolpidem Overdose: A Medical and Ethical Dilemma.

    Science.gov (United States)

    Shuaib, Waqas; Beatrice, Cristina; Abazid, Ahmad G

    Acute altered mental status can be caused by a broad range of etiologies, including cerebrovascular, neurologic, traumatic, metabolic, infectious, psychiatric, medications, etc. We present a case of a 53-year-old healthcare professional with an acute altered mental status after a trip to Africa. The patient was extensively worked up for infectious, cardiovascular, and neurologic etiologies, and all results were within normal limits. Further history revealed an overdose of a self-medicated hypnotic (zolpidem) for insomnia. The patient was conservatively managed and discharged on trazadone for insomnia.

  2. Recurring themes arising during medical research ethics committee review.

    Science.gov (United States)

    Kelleher, E; Stanton, A; Vale, G; Smith, D

    2013-06-01

    A standard application form for the ethical review of health-related research studies has recently been adopted by many Irish medical research ethics committees. In order to assess the impact of the new form, we reviewed all comments made by the Beaumont Hospital Ethics Committee during two six-month periods, immediately prior to adoption of the new form (2010), and soon afterwards (2011). Neither volume nor comment type differed significantly between the two observation periods. Participant documentation (information leaflets and consent forms) accounted for the largest proportion of comments (2010; 44%, 2011; 37%). Other common areas prompting queries were study administration (7%), design (12%) and procedures (13%), participant selection and recruitmen (8%), and lastly data protection (9%). Because of these findings, the standard operating procedures of the committee have been revised--use of provided template participant documentation is strongly encouraged, and a "Recurring Review Themes" checklist is highlighted to all applicants.

  3. Medical and ethical considerations in uterus transplantation.

    Science.gov (United States)

    Benagiano, Giuseppe; Landeweerd, Laurens; Brosens, Ivo

    2013-11-01

    Transplanting a uterus has unique characteristics, since a successful outcome is represented only by the birth of a viable healthy child. For this reason, critical issues in this type of transplantation differ profoundly from those of other solid organs and, beside a functioning uterus, involve 3 additional steps. First, at the time of implantation, the quality of embryo is tested by specialized decidual cells surrounding the implanting embryo; such testing is aimed at allowing the development of a normal embryo. Second, from early gestation onward, blood supply to the uterus increases from 45 to 750mL per minute. Vascular anastomoses should support such a marked increase in blood flow. Third, full transformation of spiral arterioles in the placental bed is required to direct 75% of the uterine blood flow to the intervillous space. Unfortunately, no suitable animal model is available for experimentation. Three overarching ethical issues must be considered. Should organ transplant be conducted when it is not absolutely necessary as a life-saving or quality-of-life-saving measure? To what extent should medicine delimit its potential in spite of societal desires? Should society demand from medicine the application of whichever technology can be developed and, if so, to what extent?

  4. The medical leadership challenge in healthcare is an identity challenge.

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    Andersson, Thomas

    2015-01-01

    The purpose of this article is to describe and analyse the identity challenges that physicians with medical leadership positions face. Four qualitative case studies were performed to address the fact that identity is processual, relational and situational. Physicians with managerial roles were interviewed, as well as their peers, supervisors and subordinates. Furthermore, observations were made to understand how different identities are displayed in action. This study illustrates that medical leadership implies identity struggles when physicians have manager positions, because of the different characteristics of the social identities of managers and physicians. Major differences are related between physicians as autonomous individuals in a system and managers as subordinates to the organizational system. There are psychological mechanisms that evoke the physician identity more often than the managerial identity among physicians who are managers, which explains why physicians who are managers tend to remain foremost physicians. The implications of the findings, that there are major identity challenges by being both a physician and manager, suggest that managerial physicians might not be the best prerequisite for medical leadership, but instead, cooperative relationships between physicians and non-physician managers might be a less difficult way to support medical leadership. Acknowledging and addressing identity challenges can be important both in creating structures in organizations and designing the training for managers in healthcare (both physicians and non-physicians) to support medical leadership. Medical leadership is most often related to organizational structure and/or leadership skills, but this paper discusses identity requirements and challenges related to medical leadership.

  5. Researchers’ perceptions of ethical challenges in cluster randomized trials: a qualitative analysis

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    McRae Andrew D

    2013-01-01

    Full Text Available Abstract Background Cluster randomized trials (CRTs pose ethical challenges for investigators and ethics committees. This study describes the views and experiences of CRT researchers with respect to: (1 ethical challenges in CRTs; (2 the ethics review process for CRTs; and (3 the need for comprehensive ethics guidelines for CRTs. Methods Descriptive qualitative analysis of interviews conducted with a purposive sample of 20 experienced CRT researchers. Results Informants expressed concern over the potential for bias that may result from requirements to obtain informed consent from research participants in CRTs. Informants suggested that the need for informed consent ought to be related to the type of intervention under study in a CRT. Informants rarely expressed concern regarding risks to research participants in CRTs, other than risks to privacy. Important issues identified in the research ethics literature, including fair subject selection and other justice issues, were not mentioned by informants. The ethics review process has had positive and negative impacts on CRT conduct. Informants stated that variability in ethics review between jurisdictions, and increasingly stringent ethics review in recent years, have hampered their ability to conduct CRTs. Many informants said that comprehensive ethics guidelines for CRTs would be helpful to researchers and research ethics committees. Conclusions Informants identified key ethical challenges in the conduct of CRTs, specifically relating to identifying subjects, seeking informed consent, and the use of gatekeepers. These data have since been used to identify topics for in-depth ethical analysis and to guide the development of comprehensive ethics guidelines for CRTs.

  6. An investigative journalist looks at medical ethics.

    Science.gov (United States)

    Campbell, D

    1989-04-29

    Campbell criticizes Britain's medical and research community and the General Medical Council (GMC) for their lack of initiative in investigating the activities of Drs. James Sharp and Jabar Sultan. Sharp and Sultan conducted a series of highly-publicized but unethical and potentially harmful experiments with private patients that was eventually brought to public attention by Campbell's report and a BBC television program. Campbell questions why senior doctors, journal reviewers, and others failed to speak out against Sharp and Sultan or to alert the GMC, and why the GMC did not investigate the researchers independently. He warns that with the increasing commercialization of British medicine, legislation is needed to create a national regulatory body to oversee standards in the private sector.

  7. Medical genetic ethics, Islamic view and considerations in Iran

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    Farzaneh Zahedi

    2006-03-01

    Full Text Available The rapid progress of science and technology, including genetic research and technology has been led to new hopes in the treatment of some genetic conditions and diseases. But these developments have also raised ethical and societal concerns in different communities. Certainly, medical genetics knowledge should be applied so, we have to maximize its benefits and minimize any harm. In recent decades, many attempts have been performed by scientists, ethicists, jurisprudents and lawyers for compiling international and national guidelines for regulation and legislation in this field. "nFor compilation of this article, we searched some comprehensive electronic databases and some valid English and Farsi books and journals. In this intensive review, we intend to provide a basic knowledge about genetic ethics for health care professionals in order to facilitate their decision-making in clinical practice."nThere are various ethical issues related to medical genetics that we reviewed in this paper in brief. These key issues do need attention and urgent resolution universally. We also reviewed Islamic view of points in this regards and finally we addressed the status of genetic ethics in our country, containing new national guidelines in this field.

  8. Dilemmas in Military Medical Ethics: A Call for Conceptual Clarity

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    Rochon, Christiane

    2015-12-01

    Full Text Available Despite the increase in and evolving nature of armed conflicts, the ethical issues faced by military physicians working in such contexts are still rarely examined in the bioethics literature. Military physicians are members of the military, even if they are non-combatants; and their role is one of healer but also sometimes humanitarian. Some scholars wonder about the moral compatibility of being both a physician and soldier. The ethical conflicts raised in the literature regarding military physicians can be organized into three main perspectives: 1 moral problems in military medicine are particular because of the difficulty of meeting the requirements of traditional bioethical principles; 2 medical codes of ethics and international laws are not well adapted to or are too restrictive for a military context; and 3 physicians are social actors who should either be pacifists, defenders of human rights, politically neutral or promoters of peace. A review of the diverse dilemmas faced by military physicians shows that these differ substantially by level (micro, meso, macro, context and the actors involved, and that they go beyond issues of patient interests. Like medicine in general, military medicine is complex and touches on potentially contested views of the roles and obligations of the physician. Greater conceptual clarity is thus needed in discussions about military medical ethics.

  9. Medical education in Libya: the challenges.

    Science.gov (United States)

    Benamer, Hani T S; Bakoush, Omran

    2009-06-01

    The history of medical education in Libya spans over a period of 40 years. Medical schools had a good and promising start in the 1970s. The graduates of the first few classes had a good impact on the health services in Libya. However, the medical schools did not embrace the immense changes that medical education experienced over the last two decades. This article aims to give a background on the medical education in Libya and explore the challenges facing it, which may help in gaining the initial momentum that seems to have been lost.

  10. Biotechnology and ethics in medical education of the new millennium: physician roles and responsibilities.

    Science.gov (United States)

    Gonnella, Joseph S.; Hojat, Mohammadreza

    2001-07-01

    Although the medical education curriculum varies internationally, we suggest that it is desirable for medical educators to share a universal responsibility to prepare physicians to perform three distinct, yet interrelated professional roles. The first is that of a clinician who has the knowledge and technical skills to care for individual patients, as well as the public. The second role can be viewed as that of an educator, a teacher, or a consultant who has the interpersonal skills and personal qualities to teach, advise and counsel patients and the public about their health and illness, risk factors and healthy lifestyle. The third role is that of a resource manager to enable physicians to care for patients and serve the public not only by drawing on available material assets but also by prudent use of the resources for better serving the most number of people at the least expense without compromising the quality of care. The very nature of the medical profession also obligates medical educators through the world to sensitize medical students and physicians to the ethical responsibilities that are implicit to each of the three aforementioned roles. Although the basic ethical responsibilities of do no harm and confidentiality are universal, certain global changes, such as rapid advancements in biotechnology and resource allocation, are now reshaping medical ethics on every continent. Spawned by the rapid advances in the biomedical sciences, biotechnology is revolutionizing human reproduction, sustaining human life, cloning human beings, and mapping the entire human genetic terrain. These advances imply changes in medical education and formal preparation of physicians in performing their roles as clinicians, educators and resource managers. These biotechnological developments, coupled with the increasing cost of healthcare and maldistribution of resources worldwide, present unprecedented ethical-social challenges that need to be addressed in the education of the

  11. Influence of Course in Medical Ethics and Law on Career Plans of Medical Students

    Science.gov (United States)

    Cheng, Shi-Yann; Lin, Lih-Hwa; Kao, Chung-Han; Chan, Tzu-Min

    2015-01-01

    Background: The significant increase in medical disputes and lawsuits in recent years in Taiwan has severely affected behavior and ecology in medical practice. For this reason, we designed integrated courses on ethics and law and conducted a questionnaire-based career plan study to understand whether these issues influence their specialty…

  12. Medical and ethical dilemma in brain death.

    Science.gov (United States)

    Streba, Irina; Damian, Simona; Ioan, Beatrice

    2012-01-01

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

  13. Combining interdisciplinary and International Medical Graduate perspectives to teach clinical and ethical communication using multimedia.

    Science.gov (United States)

    Woodward-Kron, Robyn; Flynn, Eleanor; Delany, Clare

    2011-01-01

    In Australia, international medical graduates (IMGs) play a crucial role in addressing workforce shortages in healthcare. Their ability to deliver safe and effective healthcare in an unfamiliar cultural setting is intrinsically tied to effective communication. Hospital-based medical clinical educators, who play an important role in providing communication training to IMGs, would benefit from practical resources and an understanding of the relevant pedagogies to address these issues in their teaching. This paper examines the nature of an interdisciplinary collaboration to develop multimedia resources for teaching clinical and ethical communication to IMGs. We describe the processes and dynamics of the collaboration, and outline the methodologies from applied linguistics, medical education, and health ethics that we drew upon. The multimedia consist of three video clips of challenging communication scenarios as well as experienced IMGs talking about communication and ethics. The multimedia are supported by teaching guidelines that address relevant disciplinary concerns of the three areas of collaboration. In the paper's discussion we point out the pre-conditions that facilitated the interdisciplinary collaboration. We propose that such collaborative approaches between the disciplines and participants can provide new perspectives to address the multifaceted challenges of clinical teaching and practice.

  14. [Is personalism or utilitarianism an adequate foundation of medical ethics?].

    Science.gov (United States)

    Biesaga, T

    1998-01-01

    The article rejects utilitarianism as a proper theory for medical ethics. Utilitarians lavishly use various slogans of effective action, development and better civilization. However, the principle of prosperity of humanity in the utilitarian interpretation makes the value of the human person subject to society. Social interest threatens the individual here because it defines his/her value of life. The drift towards maximalization of benefits and prosperity of humanity strikes the seriously ill, e.g. babies with brain damages, Down's syndrome, etc., people after accidents and with serious brain defects, the terminally ill. The principle of quality of life (lebensunwertes Leben) used by utylitarians allows them to argue, that euthanasia, abortion is in the interest of the patient. Some utilitarians openly admit that such ideas as "universal happiness", "prosperity", "benefit" are empty ideas, fictions to which one cannot attribute any contents. So utilitarianism, not defining its fundamental ideas, can easily change medical ethics in a theory of elimination of the uncomfortable people. Therefore, as a theory utilitarianism cannot serve as the basis for medical ethics.

  15. Sexual harassment in the medical profession: legal and ethical responsibilities.

    Science.gov (United States)

    Mathews, Ben; Bismark, Marie M

    2015-08-17

    Sexual harassment of women in medicine has become a subject of national debate after a senior female surgeon stated that if a woman complained of unwanted advances her career would be jeopardised, and subsequent reports suggest that sexual harassment is a serious problem in the medical profession. Sexual harassment of women in the medical profession by their colleagues presents substantial legal, ethical and cultural questions for the profession. Women have enforceable legal rights to gender equality and freedom from sexual harassment in the workplace. Both individual offenders and employers face significant legal consequences for sexual harassment in every Australian state and territory, and individual medical practitioners and employers need to understand their legal and ethical rights and responsibilities in this context. An individual offender may be personally liable for criminal offences, and for breaching anti-discrimination legislation, duties owed in civil law, professional standards and codes of conduct. An employer may be liable for breaching anti-discrimination legislation, workplace safety laws, duties owed in contract law, and a duty of care owed to the employee. Employers, professional colleges and associations, and regulators should use this national debate as an opportunity to improve gender equality and professional culture in medicine; individuals and employers have clear legal and ethical obligations to minimise sexual harassment to the greatest extent possible.

  16. Treatment of tuberculosis in Turkey in terms of medical ethics.

    Science.gov (United States)

    Demir, Müge; Örnek Büken, Nüket

    2015-09-01

    Having a history as old as the history of humanity, Tuberculosis (TB) is a serious disease and it is regarded as an important a public health problem not only for its medical aspect but also for its social and ethical aspects. As a result of the discovery of the cure for TB and the improvement of humans' living conditions, the TB problem was believed to be solved and a relaxation in the battle against TB was observed around the world by 1980s. World Health Organization (WHO) declared a state of emergency for the battle against TB in 1993. According to the "Global Tuberculosis Control 2014" which was published by WHO, TB remains one of the world's deadliest communicable diseases. This article argues that tuberculosis is one of the most important neglected topics in medical ethics as regards individual obligations to avoid infecting others, coercive social distancing measures, third-party notification, health workers' duty to treat contagious patients, and justice.The purpose of this article is provide a picture of the current situation of TB treatment in Turkey in terms of medical ethics.

  17. [Assisted suicide - medical, legal, and ethical aspects].

    Science.gov (United States)

    Bosshard, G

    2012-02-01

    Unlike in most European countries, assisted suicide is not illegal in Switzerland. The number of assisted suicides procured by right-to-die organisations such as Exit or Dignitas has sharply increased in the last twenty years. Central part of the doctor's involvement is the prescription of a lethal dose of sodium pentobarbital. In doing so, the doctor has to apply to the rules of medical due care. A proper examination of the patient is required, who must be informed about his diagnosis, about the expected prognosis, and about different treatment options. Verification of the patient's decisional capacity is crucial. In general, a staff member of the organisation but not the doctor is present during suicide. Following death, the assisted suicide has to be reported to the police as an extraordinary death case.

  18. An investigation of challenges in managerial ethics and its role in sustainable development of Iranian industries

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    Hamid Reza Salmani MOJAVERI

    2010-06-01

    Full Text Available This paper tries to demonstrate ethical value as being an essential element in order to achieve sustainability in many societies such as Iran. In addition this paper lays out some of obstacle and challenges about ethical issues in Iranian industries. The evidence from our investigation supports that employee and management rather tend to ethical values.

  19. Ethics in action: Approving and improving medical research with human subjects

    NARCIS (Netherlands)

    J.P. de Jong

    2013-01-01

    In this thesis, Jean Philippe de Jong presents a new understanding of ethical oversight on medical research with human subjects and proposes that two philosophies for ethical oversight exist: '(dis)approving' and 'improving'. Systems for ethical oversight on medical research have been in place for m

  20. Discourses regarding ethical challenges in assessments - Insights through a novel approach

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    Madia M. Levin

    2011-03-01

    Full Text Available Orientation: From a pragmatic approach, a novel method called ‘the town hall focus group’ was utilised to provide insight into discourse regarding ethical issues in psychological assessments. This article contributes to the understanding of the practice of ethics in assessments and suggests the use of this particular method to facilitate discourse regarding ethical issues.Research purpose: To illustrate a forum where ethical discourse can occur in a practical fashion in order to deal with the diversity of situations, questions, demands and responsibilities experienced by psychologists.Motivation for the study: Although codes and guidelines on assessment exist, many psychologists feel that despite the existence of ethical beacons, they are often faced with challenges for which no obvious solution is evident. A need exists for ethical discourse by which psychologists grapple with unique situations through an active dialectical process.Research design, approach and method: A qualitative research approach was employed using the town hall focus group. The study was conducted with a convenience sample of 108 psychologists and practitioners.Main findings: The town hall focus group method provided an opportunity and platform for ethical discourse regarding the ethical challenges experienced by psychologists.Practical/managerial implications: This article contributes to the understanding of the practice of ethics in assessments by illustrating a platform for ethical discourse regarding ethical issues experienced in assessments. The town hall method appears to be valuable as it provides a forum to discuss ethical challenges where members are allowed to share their experiences and thus gain access to peer support, insight and shared resources.Contribution/value-add: Although the focus group results are not transferable, this article proposes it as a useful method contributing to the understanding of the ethical issues and challenges experienced in

  1. WHO'S IN CHARGE? THE RELATIONSHIP BETWEEN MEDICAL LAW, MEDICAL ETHICS, AND MEDICAL MORALITY?

    Science.gov (United States)

    Foster, Charles; Miola, José

    2015-01-01

    Medical law inevitably involves decision-making, but the types of decisions that need to be made vary in nature, from those that are purely technical to others that contain an inherent ethical content. In this paper we identify the different types of decisions that need to be made, and explore whether the law, the medical profession, or the individual doctor is best placed to make them. We also argue that the law has failed in its duty to create a coherent foundation from which such decision-making might properly be regulated, and this has resulted in a haphazard legal framework that contains no consistency. We continue by examining various medico-legal topics in relation to these issues before ending by considering the risk of demoralisation.

  2. Medical futility and its challenges: a review study

    Science.gov (United States)

    Aghabarary, Maryam; Dehghan Nayeri, Nahid

    2016-01-01

    Concerns over limited medical equipment and resources, particularly in intensive care units (ICUs), have raised the issue of medical futility. Medical futility draws a contrast between physician’s authority and patients’ autonomy and it is one of the major issues of end-of-life ethical decision-making. The aim of this study was to review medical futility and its challenges. In this systematized review study, a comprehensive search of the existing literature was performed using an internet search with broad keywords to access related articles in both Persian and English databases. Finally, 89 articles were selected and surveyed. Medical futility is a complex, ambiguous, subjective, situation-specific, value-laden, and goal-dependent concept which is almost always surrounded by some degrees of uncertainty; hence, there is no objective and valid criterion for its determination. This concept is affected by many different factors such as physicians’ and patients’ value systems, medical goals, and sociocultural and religious context, and individuals’ emotions and personal characteristics. It is difficult to achieve a clear consensus over the concept of medical futility; hence, it should be defined and determined at an individual level and based on the unique condition of each patient. PMID:28050241

  3. [The shaping of ethical approach to medical experimentation in Poland].

    Science.gov (United States)

    Heimrath, Tadeusz

    2003-06-01

    Contemporary awareness of bioethical norms in treatment and research experiments in medicine underwent a long evolution in Poland. The process was similar to that of other countries developing this kind of research. The negative experiences of World War II resulted in tendency to curb experimentation on humans. The seventies witnessed a heated discussion leading to settlement of this problem. The argument was that stringent limitations on such experiments would stop the development of new, indispensable drugs. This discussion also reached Poland where the majority of participants were doctors and lawyers expressing their views mostly in the press. This led in consequence to the establishment of the first ethical norms in medical experiment on humans. These were expressed in subsequent codes of ethics for the medical profession as well as in the founding of the first bioethical commissions at medical schools. Currently such norms based on the so-called "good clinical practice" standards were incorporated in the legal acts that establish bioethical committees at medical schools and other medical institutes. This paper also presents some specific aspects of research on female patients.

  4. History of evolution of the concept of medical ethics.

    Science.gov (United States)

    Majumdar, Sisir K

    2003-01-01

    "Time present and time past are both perhaps present in time future and time future contained in time past".--Thomas Steams Eliot (1888-1965), Noble Literature Laureate, 1948. History and evolution of the concept of Medical Ethics is the classical example of this poetic expression. Virtually, every human society has some forces of myth to explain the origin of morality. Indian ethics was philosophical from its very birth. In the Vedas (1500 B.C.), ethics was an integral aspect of philosophical and religious speculation about the nature of reality. The Vedas says how people ought to live and is the oldest philosophical literature in the world. It was the first account of philosophical ethics in human history. The old Testament of (c. 200 B.C.) the Hebrew Bible (Greek--ta biblia--"the books") gives account of God giving the Ten Commandments--the oral and written Law engraved on tablets of Stone to Moses around 13th century B.C. on Mount Sinai (Arabic--Gebel Musa) the Mountain near the tip of the Sinai Peninsula in West Asia.

  5. Exploring the contemporary ethical challenges in coaching psychology in South Africa

    Directory of Open Access Journals (Sweden)

    Claire E. Simon

    2014-02-01

    Full Text Available Orientation: This article focuses on the contemporary ethical challenges in coaching psychology in the South African context.Research purpose: The primary objective was to qualitatively explore the contemporary ethical challenges faced by coaching psychologists when coaching clients and organisations and develop an exploratory framework of ethical challenges.Motivation for the study: There may not be sufficient practical guidance to resolving the ethical challenges coaching psychologists encounter when coaching clients within organisations.In addition, available codes of ethics may not fundamentally cover all important ethical challenges, particularly in the South African context.Research approach, design and method: An interpretative paradigm with an explorative approach was applied. Semi-structured interviews and the Delphi technique were used to gather data from 16 participants who were purposively selected: six coaching psychologists were interviewed, whilst feedback from 10 expert panel members was obtained using the Delphi technique. The data was analysed using thematic analysis.Main findings: The findings point to a number of common ethical challenges in coaching psychology, as well as the typical ethical principles used by psychologists who coach as a guide to best ethical practice. The exploratory framework represents the broad systemic outline of factors that contribute to the ethical challenges and articulates these from the coach’s, coachee’s and organisation’s perspective.Practical/managerial implications: The framework can be applied by professionals and coaching clients and can be utilised proactively in identifying potential ethical challenges in the coaching relationship.Contribution/value-add: The framework identifies ethical principles that could be used as the foundation for a code of ethics in coaching psychology.

  6. Prenatal screening: current practice, new developments, ethical challenges.

    Science.gov (United States)

    de Jong, Antina; Maya, Idit; van Lith, Jan M M

    2015-01-01

    Prenatal screening pathways, as nowadays offered in most Western countries consist of similar tests. First, a risk-assessment test for major aneuploides is offered to pregnant women. In case of an increased risk, invasive diagnostic tests, entailing a miscarriage risk, are offered. For decades, only conventional karyotyping was used for final diagnosis. Moreover, several foetal ultrasound scans are offered to detect major congenital anomalies, but the same scans also provide relevant information for optimal support of the pregnancy and the delivery. Recent developments in prenatal screening include the application of microarrays that allow for identifying a much broader range of abnomalities than karyotyping, and non-invasive prenatal testing (NIPT) that enables reducing the number of invasive tests for aneuploidies considerably. In the future, broad NIPT may become possible and affordable. This article will briefly address the ethical issues raised by these technological developments. First, a safe NIPT may lead to routinisation and as such challenge the central issue of informed consent and the aim of prenatal screening: to offer opportunity for autonomous reproductive choice. Widening the scope of prenatal screening also raises the question to what extent 'reproductive autonomy' is meant to expand. Finally, if the same test is used for two different aims, namely detection of foetal anomalies and pregnancy-related problems, non-directive counselling can no longer be taken as a standard. Our broad outline of the ethical issues is meant as an introduction into the more detailed ethical discussions about prenatal screening in the other articles of this special issue.

  7. Unwanted pregnancy--medical and ethical dimensions.

    Science.gov (United States)

    Ravindran, J

    2003-03-01

    Globally, abortion mortality accounts for approximately 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high maternal mortality and morbidity from abortion tend to occur together. Unplanned and unwanted pregnancies constitute a serious public health responsibility. While fertility has declined by half in developing countries, the motivation to control and space births has risen faster than the rate of contraceptive use. Preventing maternal mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. A range of positive steps has been taken to reduce deaths and morbidity from abortion in a growing number of countries over the past 15 years. Making abortion legal is an essential prerequisite in making it safe. In this respect, changing the law does matter and assertions to the contrary are ill conceived and unsupported in practice. Although, in many countries, trends towards safer abortion have often occurred prior to or in the absence of changes in the law, legal changes need to take place if safety is to be sustained for all women. Religious laws may also require attention when legal change is being contemplated. There are three main ways of approaching this problem: liberalizing the existing law within the penal or criminal code; partially or fully legalizing abortion through a positive law or a court ruling; and decriminalising abortion by taking it out of the law. Women's health groups and other advocates, parliamentarians and health professionals, can work together to support the right of women not to die from unsafe abortions and to ensure they receive treatment for complications. Committed doctors can make a difference by providing treatment for abortion complications, interpreting the law in a liberal way and providing safe services where these are

  8. Ethics for pandemics beyond influenza: Ebola, drug-resistant tuberculosis, and anticipating future ethical challenges in pandemic preparedness and response.

    Science.gov (United States)

    Smith, Maxwell J; Silva, Diego S

    2015-01-01

    The unprecedented outbreak of Ebola virus disease (EVD) in West Africa has raised several novel ethical issues for global outbreak preparedness. It has also illustrated that familiar ethical issues in infectious disease management endure despite considerable efforts to understand and mitigate such issues in the wake of past outbreaks. To improve future global outbreak preparedness and response, we must examine these shortcomings and reflect upon the current state of ethical preparedness. To this end, we focus our efforts in this article on the examination of one substantial area: ethical guidance in pandemic plans. We argue that, due in part to their focus on considerations arising specifically in relation to pandemics of influenza origin, pandemic plans and their existing ethical guidance are ill-equipped to anticipate and facilitate the navigation of unique ethical challenges that may arise in other infectious disease pandemics. We proceed by outlining three reasons why this is so, and situate our analysis in the context of the EVD outbreak and the threat posed by drug-resistant tuberculosis: (1) different infectious diseases have distinct characteristics that challenge anticipated or existing modes of pandemic prevention, preparedness, response, and recovery, (2) clear, transparent, context-specific ethical reasoning and justification within current influenza pandemic plans are lacking, and (3) current plans neglect the context of how other significant pandemics may manifest. We conclude the article with several options for reflecting upon and ultimately addressing ethical issues that may emerge with different infectious disease pandemics.

  9. Publication ethics and the ghost management of medical publication.

    Science.gov (United States)

    Sismondo, Sergio; Doucet, Mathieu

    2010-07-01

    It is by now no secret that some scientific articles are ghost authored - that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry to shape the literature in ways that serve its interests. This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost-managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored.

  10. Medical Ethics in Plastic Surgery: A Mini Review.

    Science.gov (United States)

    Nejadsarvari, Nasrin; Ebrahimi, Ali; Ebrahimi, Azin; Hashem-Zade, Haleh

    2016-09-01

    Currently, cosmetic surgery is spread around the world. Several factors are involved in this rapidly evolving field such as socio-economic development, changes in cultural norms, globalization and the effects of Western culture, advertising, media, and mental disorders. Nowadays the cosmetic surgery is becoming a profitable business, which deals exclusively with human appearance and less from the perspective of beauty based on physical protests and considering factors such as sex, age, and race. The morality of plastic surgery subspecialty has undergone many moral dilemmas in the past few years. The role of the patient regardless of his unrealistic dreams has questionable ethical dimension. The problem is the loss of human values and replacing them with false values, of pride and glory to a charismatic person of higher status, that may underlie some of the posed ethical dilemmas. Cosmetic surgery has huge difference with the general principle of legal liability in professional orientation, because the objective for cosmetic surgeries is different from common therapeutic purposes. To observe excellence in the medical profession, we should always keep in mind that these service providers, often as a therapist (healer) must maintain a commitment and priority for patient safety and prior to any action, a real apply for this service recipient should be present. Also, patient-physician confidentiality is the cornerstone of medical ethics. In this review, we study the issues addressed and the ways that they can be resolved.

  11. Kidney transplantation: Ethical challenges in the Arab world

    Directory of Open Access Journals (Sweden)

    Hassan Chamsi-Pasha

    2014-01-01

    Full Text Available There is a wide gap between organ supply and demand, which results in a very long waiting time for kidney transplantation and an increasing number of deaths of the patients while on the waiting list. These events have raised many ethical, moral and societal issues regarding organ donation, allocation and use of living donors through exploitation of the poor for the benefit of the wealthy. Success in the implementation of kidney transplantation programs in a country depends on various factors including the economic situation, religious approval, public views, medical expertise and existing legislation. The public attitude toward donation is pivotal in all transplantation programs; increasing the awareness of the leaders of religion is vital in this regard.

  12. How Christian ethics became medical ethics: the case of Paul Ramsey.

    Science.gov (United States)

    Hauerwas, Stanley

    1995-03-01

    Over the last century Christian ethics has moved from an attempt to Christianize the social order to a quandary over whether being Christian unduly biases how medical ethics is done. This movement can be viewed as the internal development of protestant liberalism to its logical conclusion, and Paul Ramsey can be taken as one of the last great representatives of that tradition. By reducing the Christian message to the 'ethical upshot' of neighbour love, Ramsey did not have the resources to show how Christian practice might make a difference for understanding or forming the practice of medicine. Instead, medicine became the practice that exemplified the moral commitments of Christian civilization, and the goal of the ethicist was to identify the values that were constitutive of medicine. Ramsey thus prepared the way for the Christian ethicist to become a medical ethicist with a difference, and the difference simply involved vague theological presumptions that do no serious intellectual work other than explaining, perhaps, the motivations of the ethicist.

  13. Medical ethics for senior medical doctors (episode I).

    Science.gov (United States)

    Phaosavasdi, Sukhit; Taneepanichskul, Surasak; Tannirandorn, Yuen; Thamkhantho, Manopchai; Pruksapong, Chumsak; Kanjanapitak, Aurchart

    2005-05-01

    A good leader will never ever forget themselves, or abuse the power or authority, and also not trust only the inner circle voice, nevertheless they have to listen and consider the voice of disagreement from others. Otherwise, they will transform themselves to be a "dictator" unconsciously which is very dangerous and harmful to the democratic ruling system as well as themselves and their family members, as you can see from the past history of foreign countries and even Thailand itself. Thai culture is surrounded and consistes of kindness, mercy and good wishes to each other. The patient is so grateful and appreciates the value of the medical doctor for saving their life. Even although the Western culture is penetrating globally as a business-oriented culture in which medico-legal cases such as patient's rights, the value of the patient's benefit protection and certainly it requires the legal act to get involved eventually. The compromised culture which has been embedded in Thai society for a prolonged period can be changed firmly and gradually because of the usual and regular condition and definitely the good and valued medical doctors is still around. The opportunity of medical doctors to act as a pioneer of the trend and conflicted societies, is responsible to them and it's a great opportunity for Thai medical doctors to reach out to these goals and excellence. The above statements can be found in various media. Is it true that the medical doctors will absolutely be hundred percent good guys and have good luck from time to time? But for sure, even our medical colleagues are very much dedicated and concentrated in their job, as the family members of our medical profession, they have been left out, they have no time to share with or even be responsible to them. Many of our friends in the same profession might feel so sorry or appreciate the term "short-belt situation" or "unexpected" event which might attack us from the society violently and unmercifully.

  14. How to introduce medical ethics at the bedside - Factors influencing the implementation of an ethical decision-making model.

    Science.gov (United States)

    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

  15. Spatially explicit data: stewardship and ethical challenges in science.

    Science.gov (United States)

    Hartter, Joel; Ryan, Sadie J; Mackenzie, Catrina A; Parker, John N; Strasser, Carly A

    2013-09-01

    Scholarly communication is at an unprecedented turning point created in part by the increasing saliency of data stewardship and data sharing. Formal data management plans represent a new emphasis in research, enabling access to data at higher volumes and more quickly, and the potential for replication and augmentation of existing research. Data sharing has recently transformed the practice, scope, content, and applicability of research in several disciplines, in particular in relation to spatially specific data. This lends exciting potentiality, but the most effective ways in which to implement such changes, particularly for disciplines involving human subjects and other sensitive information, demand consideration. Data management plans, stewardship, and sharing, impart distinctive technical, sociological, and ethical challenges that remain to be adequately identified and remedied. Here, we consider these and propose potential solutions for their amelioration.

  16. The economic evaluation of personalised oncology medicines: ethical challenges.

    Science.gov (United States)

    Lewis, Jan R R; Lipworth, Wendy L; Kerridge, Ian H; Day, Richard O

    2013-10-01

    Insights into the molecular drivers of cancer are providing opportunities for the development of new targeted treatments and more personalised approaches to cancer management. Drugs targeting mutant epidermal growth factor receptors, such as erlotinib and gefitinib, may provide more effective, safer and better tolerated treatment options compared with chemotherapy among appropriately selected patients with advanced non-small cell lung cancer (NSCLC). First-line access to these newer treatments remains unfunded after several considerations by the Pharmaceutical Benefits Advisory Committee and their assessment that these are not cost-effective treatments. We suggest that there may be evidentiary and ethical challenges associated with the assessment of the cost-effectiveness of personalised oncology medicines in Australia, and that a new approach is needed to determine the value and cost-effectiveness of personalised medicine.

  17. Medical confidentiality versus disclosure: Ethical and legal dilemmas.

    LENUS (Irish Health Repository)

    Agyapong, V I O

    2009-02-01

    A case is described of a fifty year old single man who made disclosures about criminal sexual practices during a psychiatric assessment. In common practice with other professional men, a doctor is under a duty not to disclose, without the consent of his patient, information which he has gained in his professional capacity other than in exceptional circumstances. We discuss the ethical and legal considerations surrounding issues of medical confidentiality and the dilemma that sometimes face clinicians, when they feel obliged, in the public interest, to disclose information they have gained in confidence. Breach of confidences can have deleterious consequences; particularly for the doctor-patient relationship, but failure to disclose in some situations could have serious implications for the well-being of the wider society. Doctors should be aware of the basic principles of confidentiality and the ethical and legal framework around which they are built.

  18. A 450-Year-Old Turkish Poem on Medical Ethics.

    Science.gov (United States)

    Tekiner, Halil

    2017-06-20

    The Ottoman physician-poet Nidai of Ankara (1509 to post-1567) studied medicine in Crimea and served as a court physician in Istanbul during the reign of Sultan Selim II. Nidai marked the classical period of Ottoman medicine particularly with his acclaimed works and translations in Turkish, among which Manafi al-Nas (Benefits of People, 1566) became widely known. The final chapter of Manafi al-Nas also is known independently under the name Vasiyyetname (Last Will), which is a remarkable guide on medical ethics. This didactic, sixty-eight-line poem includes Nidai's moral advice to physicians that they should be well mannered, trustworthy, and competent in their arts and should treat their patients with modesty, honesty, and compassion. Even after 450 years of existence, Vasiyyetname retains its ethical and artistic relevance and still serves as a vehicle for the transmission of humanistic ideals far beyond the time and place it was written.

  19. The ethics of clinical innovation in psychopharmacology: Challenging traditional bioethics

    Directory of Open Access Journals (Sweden)

    Goodwin Frederick K

    2007-11-01

    Full Text Available Abstract Objective To assess the scientific and ethical basis for clinical innovation in psychopharmacology. Methods We conducted a literature review, utilizing MEDLINE search and bibliographic cross-referencing, and historical evidence regarding the discovery and development of new medications in psychiatry. Clinical innovation was defined as use of treatments in a clinical setting which have not been well-proven in a research setting. Results Empirical data regarding the impact of clinical innovation in psychopharmacology are lacking. A conceptual and historical assessment of this topic highlights the ethical and scientific importance of clinical innovation. Ethically, it touches a borderline that, in our judgment, is not adequately framed in contemporary mainstream bioethics. Currently, research is viewed as not at all benefiting the patients who participate in it, while clinical care is viewed as being solely for the benefit of patients. Clinical innovation straddles these two worlds, uncomfortably at times. While many argue that clinical innovation should either be avoided or folded into research projects, we argue that clinical innovation is necessary for progress in psychopharmacology research, and that it can prosper best when guided by the following ethical principles: 1. The treatment should be based on a viable hypothesis. 2. Whenever possible, one's clinical observations should be reported so they can be evaluated by the scientific community. 3. One should be willing to report unexpected observations of drug effects. 4. A high standard of informed consent should be maintained. Again, this proposal goes against the standard view among bioethicists that research and clinical care are categorically opposed activities, as made clear by the either-or dichotomy of the Belmont Report on bioethics. This approach has so polarized our profession into clinicians versus researchers, that many clinicians will not apply new knowledge produced by

  20. Gender in medical ethics: re-examining the conceptual basis of empirical research.

    Science.gov (United States)

    Conradi, Elisabeth; Biller-Andorno, Nikola; Boos, Margarete; Sommer, Christina; Wiesemann, Claudia

    2003-01-01

    Conducting empirical research on gender in medical ethics is a challenge from a theoretical as well as a practical point of view. It still has to be clarified how gender aspects can be integrated without sustaining gender stereotypes. The developmental psychologist Carol Gilligan was among the first to question ethics from a gendered point of view. The notion of care introduced by her challenged conventional developmental psychology as well as moral philosophy. Gilligan was criticised, however, because her concept of 'two different voices' may reinforce gender stereotypes. Moreover, although Gilligan stressed relatedness, this is not reflected in her own empirical approach, which still focuses on individual moral reflection. Concepts from social psychology can help overcome both problems. Social categories like gender shape moral identity and moral decisions. If morality is understood as being lived through actions of persons in social relationships, gender becomes a helpful category of moral analysis. Our findings will provide a conceptual basis for the question how empirical research in medical ethics can successfully embrace a gendered perspective.

  1. Building medical ethics education to improve Japanese medical students' attitudes toward respecting patients' rights.

    Science.gov (United States)

    Saito, Yukiko; Kudo, Yasushi; Shibuya, Akitaka; Satoh, Toshihiko; Higashihara, Masaaki; Aizawa, Yoshiharu

    2011-01-01

    In medical education, it is important for medical students to develop their ethics to respect patients' rights. Some physicians might make light of patients' rights, because the increased awareness of such rights might make it more difficult for them to conduct medical practice. In the present study, predictors significantly associated with "a sense of resistance to patients' rights" were examined using anonymous self-administered questionnaires. For these predictors, we produced original items with reference to the concept of ethical development and the teachings of Mencius. The subjects were medical students at the Kitasato University School of Medicine, a private university in Japan. A total of 518 students were analyzed (response rate, 78.4%). The average age of enrolled subjects was 22.5 ± 2.7 years (average age ± standard deviation). The average age of 308 male subjects was 22.7 ± 2.8 years, while that of 210 female subjects was 22.1 ± 2.5 years. The item, "Excessive measures to pass the national examination for medical practitioners," was significantly associated with "a sense of resistance to patients' rights." However, other items, including basic attributes such as age and gender, were not significant predictors. If students spent their school time only focusing on the national examination, they would lose the opportunity to receive the ethical education that would allow them to respect patients' rights. That ethical development cannot easily be evaluated with written exams. Thus, along with the acquisition of medical knowledge, educational programs to promote medical students' ethics should be developed.

  2. Workplace Stress and Ethical Challenges Experienced by Nursing Staff in a Nursing Home

    Science.gov (United States)

    Vondras, Dean D.; Flittner, Diane; Malcore, Sylvia A.; Pouliot, Gregory

    2009-01-01

    This research explores the workplace stress and ethical challenges reported by healthcare staff in a nursing home. A brief self-report survey was administered to 44 members of the nursing staff in a not-for-profit nursing home. The survey included items that elicited identification of specific workplace stressors and ethical challenges and global…

  3. Exploratory Study of Common and Challenging Ethical Dilemmas Experienced by Professional School Counselors

    Science.gov (United States)

    Bodenhorn, Nancy

    2006-01-01

    Results of a survey asking public school counselors in Virginia to indicate their most common and most challenging ethical dilemmas are presented. Ninety-two school counselors reported that the most common and challenging ethical dilemmas included those involving student confidentiality, dual relationship with faculty, parental rights, and acting…

  4. Ethically Challenging Situations Reported by School Psychologists: Implications for Training

    Science.gov (United States)

    Dailor, A. Nichole; Jacob, Susan

    2011-01-01

    Practitioner-members of the National Association of School Psychologists (N = 208) completed questionnaires regarding their ethics training, preparedness, the types of ethical transgressions and dilemmas encountered in the previous year, and the strategies used to solve problems. Respondents who received multilevel training in ethics (ethics…

  5. Knowledge and ethical perception regarding organ donation among medical students

    Science.gov (United States)

    2013-01-01

    Background To determine the knowledge and ethical perception regarding organ donation amongst medical students in Karachi- Pakistan. Methods Data of this cross sectional study was collected by self administered questionnaire from MBBS students of Ziauddin University from 2010 to 2011. Sample size of 158 (83 First years and 75 Fourth years) were selected by convenient sampling and those students who were present and gave consent were included in the study. The data was analyzed by SPSS version 20. Results A total of 158 participants from Ziauddin Medical University filled out the questionnaire out of which 83(52.5%) were first years and 75(47.5%) were fourth year medical students. Mean age of sample was 20 ± 1.7. Majority of students were aware about organ donation with print and electronic media as the main source of information. 81.6% agreed that it was ethically correct to donate an organ. In the students’ opinion, most commonly donated organs and tissues were kidney, cornea, blood and platelet. Ideal candidates for donating organ were parents (81%). Regarding list of options for preference to receive an organ, most of the students agreed on young age group patients and persons with family. Willingness to donate was significantly associated with knowledge of allowance of organ donation in religion (P=0.000). Conclusion Both 1st year and 4th year students are aware of Organ Donation, but there is a significant lack of knowledge regarding the topic. PMID:24070261

  6. Private-sector research ethics: marketing or good conflicts management? The 2005 John J. Conley Lecture on Medical Ethics.

    Science.gov (United States)

    Dresser, Rebecca

    2006-01-01

    Pharmaceutical companies are major sponsors of biomedical research. Most scholars and policymakers focus their attention on government and academic oversight activities, however. In this article, I consider the role of pharmaceutical companies' internal ethics statements in guiding decisions about corporate research and development (R&D). I review materials from drug company websites and contributions from the business and medical ethics literature that address ethical responsibilities of businesses in general and pharmaceutical companies in particular. I discuss positive and negative uses of pharmaceutical companies' ethics materials and describe shortcomings in the companies' existing ethics programs. To guide employees and reassure outsiders, companies must add rigor, independence, and transparency to their R&D ethics programs.

  7. From colleague to patient: ethical challenges in integrated primary care.

    Science.gov (United States)

    Kanzler, Kathryn E; Goodie, Jeffrey L; Hunter, Christopher L; Glotfelter, Michael Ann; Bodart, Jennifer J

    2013-03-01

    Ethical codes and guidelines for mental health professionals focus on traditional avenues of practice, leaving considerable gaps for clinicians in unique settings, such as behavioral health providers in integrated primary care. In this article, an ethical scenario is presented, where a behavioral health provider is faced with a colleague physician seeking assistance for emotional distress. The scenario highlights important ethical questions about multiple relationships/conflict of interest, impaired colleagues, informed consent, and confidentiality. We review gaps in ethical guidance pertinent to the scenario and provide an eight-step rubric for ethical clinical decision making in integrated primary care.

  8. Fidelity to the healing relationship: a medical student's challenge to contemporary bioethics and prescription for medical practice.

    Science.gov (United States)

    Corcoran, Blake C; Brandt, Lea; Fleming, David A; Gu, Chris N

    2016-04-01

    As a medical  student, I observed that different physicians had strikingly different attitudes and approaches when caring for patients. The care of one patient in particular continues to challenge my understanding of illness and moral responsibility in the practice of medicine. In this paper, I illustrate the care of this patient in order to evaluate the dominant ethics I was taught in medical school, in theory and in practice, and argue neither principlism nor the ethics of care fully captures the moral responsibility of physicians. Emphasising fidelity to the healing relationship, a core principle derived from Pellegrino's virtue theory, I conclude that this approach to clinical ethics fully explains physician responsibility. Pellegrino deconstructs the practice of medicine to clarify the moral event within the clinical encounter and offers a sufficiently useful and justified approach to patient care.

  9. Researching student absence: methodological challenges and ethical issues.

    Science.gov (United States)

    Young, Pat; Yates, Sue; Rickaby, Caroline; Snelling, Paul; Lipscomb, Martin; Lockyer, Lesley

    2010-05-01

    This article describes the challenges encountered in a research project aiming to explore non-attendance from the perspective of absent students. These students are nursing students in a Faculty of Health and Social Care, but the issues raised here are of wider interest. Although attendance at the sessions monitored for this project is stated to be compulsory, there is typically a non-attendance rate of around 20%. Previous studies within the Faculty have reported positively on students' views of the sessions, but have relied on data collected from students present in the university and attending the sessions. We felt it was important to correct this imbalance with the views of those students who do not attend. We hoped to access the views of students not present in the university by means of telephone interviews, carried out by a researcher independent from the course management. This article explores a number of ethical and methodological issues which arose from the research, focusing on the difficulties in gaining informed consent from students who do not attend, and the challenges in moving beyond surface responses to questions on reasons for non-attendance. Copyright 2009 Elsevier Ltd. All rights reserved.

  10. China confidential: methodological and ethical challenges in global nursing historiography.

    Science.gov (United States)

    Grypma, Sonya; Wu, Na

    2012-01-01

    As the history of nursing as a field of scholarship expands its global consciousness, it seems timely to join other scholars of international history in rethinking conventional approaches to historiography. The lament by mission scholars at the invisibility of nurses and indigenous workers in historical mission records coincides with calls by China scholars to reconsider traditional reliance on English-language data generation and interpretation for an English-speaking audience. In a similar way, nursing scholars are challenging historians of nursing to find ways to build a body of scholarship and a cadre of scholars that can open up new linguistic and cultural space for vibrant discussion and dialogue. Drawing on Sonya Grypma's research on the role of missionary nurses in the development of modern nursing in China and based on a series of interviews by the authors in China of participants with ties to a former Canadian mission hospital, we explore methodological and ethical challenges in global nursing historiography. By offering insights gleaned from our early attempts to capture voices not included in conventional mission records, we hope to stimulate more dialogue about conceptual and structural issues central to a "new" global nursing historiography.

  11. Effectiveness of the course of medical ethics for undergraduate medical students.

    Science.gov (United States)

    Asghari, Fariba; Samadi, Aniseh; Dormohammadi, Taraneh

    2009-01-01

    Judgment This study was done in order to evaluate the effectiveness of the revisions made in the course of medical ethics for undergraduate medical students. Medical Students of Tehran University of Medical Sciences who took the course of medical ethics in a semester before the implementation of the revision and those who took the course after the implementation of the revision at the beginning and at the end of course responded to two questionnaires (one for evaluating knowledge and the other for assessing their moral judgment). Response rate was between 70 to 93.1 percent. Students' knowledge was significantly higher in the semester after the course revision (mean ± SD: 6.12 ± 1.3) in comparison with the semester before the reform (mean ± SD: 3.63 ± 1.7) (P=0.001). Students' knowledge after taking this course showed an increase of about 60% when compared with their knowledge level before starting the course (P=0.001). There was no significant difference in the level of moral judgment before and after taking the revised course of medical ethics while moral judgment level of students in two semester[before (21.21 ± 4.0) and after 15.25 ± 2.87) reform] were significantly different (P=0.02). The revisions made in the course of medical ethics for medical students were effective in improving students' knowledge but could not improve their moral judgment. This could be due to the short length of this course and also the small sample size in this study. We suggest that this study should be repeated with larger sample size and also with other methods of a course evaluation.

  12. Reflecting on the ethical administration of computerized medical records

    Science.gov (United States)

    Collmann, Jeff R.

    1995-05-01

    This presentation examines the ethical issues raised by computerized image management and communication systems (IMAC), the ethical principals that should guide development of policies, procedures and practices for IMACS systems, and who should be involved in developing a hospital's approach to these issues. The ready access of computerized records creates special hazards of which hospitals must beware. Hospitals must maintain confidentiality of patient's records while making records available to authorized users as efficiently as possible. The general conditions of contemporary health care undermine protecting the confidentiality of patient record. Patients may not provide health care institutions with information about themselves under conditions of informed consent. The field of information science must design sophisticated systems of computer security that stratify access, create audit trails on data changes and system use, safeguard patient data from corruption, and protect the databases from outside invasion. Radiology professionals must both work with information science experts in their own hospitals to create institutional safeguards and include the adequacy of security measures as a criterion for evaluating PACS systems. New policies and procedures on maintaining computerized patient records must be developed that obligate all members of the health care staff, not just care givers. Patients must be informed about the existence of computerized medical records, the rules and practices that govern their dissemination and given the opportunity to give or withhold consent for their use. Departmental and hospital policies on confidentiality should be reviewed to determine if revisions are necessary to manage computer-based records. Well developed discussions of the ethical principles and administrative policies on confidentiality and informed consent and of the risks posed by computer-based patient records systems should be included in initial and continuing

  13. Educational challenges faced by international medical graduates in the UK

    Directory of Open Access Journals (Sweden)

    Hashim A

    2017-06-01

    Full Text Available Ahmed Hashim Gastroenterology Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK Introduction: International medical graduates (IMGs in the UK constitute approximately one-quarter of the total number of doctors registered in the General Medical Council (GMC. The transition of IMGs into the health care system in the UK is accompanied by significant sociocultural and educational challenges. This study aims to explore the views of IMGs in medical training on the educational challenges they face.Methods: This study was conducted in the Kent, Surrey and Sussex region in 2015. All IMGs who work in medical (physicianly training programs were included. Data were collected through a questionnaire and semi-structured interviews. Thematic approach was used to analyze the qualitative data.Results: Of the total 61 IMGs included, 17 responded to the survey and 3 were interviewed. The common educational barriers faced by IMGs were related to lack of appreciation of the values and structure of the National Health Service (NHS, ethical and medicolegal issues, receiving feedback from colleagues and the different learning strategies in the UK. IMGs suggested introduction of a mandatory dedicated induction program in the form of formal teaching sessions. They also believed that a supervised shadowing period prior in the first job in the UK would be beneficial. Further assessment areas should be incorporated into the prequalifying examinations to address specific educational needs such as NHS structure and hospital policies. Other measures such as buddying schemes with senior IMGs and educating NHS staff on different needs of IMGs should also be considered.Conclusion: This study highlighted important educational challenges faced by IMGs and generated relevant solutions. However, the opinions of the supervisors and other health care professionals need to be explored. Keywords: international medical graduates, IMG, educational barriers

  14. A comparison of general medical and clinical ethics consultations: what can we learn from each other?

    Science.gov (United States)

    Geppert, Cynthia M A; Shelton, Wayne N

    2012-04-01

    Despite the emergence of clinical ethics consultation as a clinical service in recent years, little is known about how clinical ethics consultation differs from, or is the same as, other medical consultations. A critical assessment of the similarities and differences between these 2 types of consultations is important to help the medical community appreciate ethics consultation as a vital service in today's health care setting. Therefore, this Special Article presents a comparison of medical and clinical ethics consultations in terms of fundamental goals of consultation, roles of consultants, and methodologic approaches to consultation, concluding with reflections on important lessons about the physician-patient relationship and medical education that may benefit practicing internists. Our aim is to examine ethics consultation as a clinical service integral to the medical care of patients. Studies for this analysis were obtained through the PubMed database using the keywords ethics consultation, medical consultation, ethics consults, medical consults, ethics consultants, and medical consultants. All English-language articles published from 1970 through August 2011 that pertained to the structure and process of medical and ethics consultation were reviewed.

  15. Legal and ethical implications of medically enforced feeding of detained asylum seekers on hunger strike.

    Science.gov (United States)

    Kenny, Mary A; Silove, Derrick M; Steel, Zachary

    2004-03-01

    The current practice of non-consensual medical treatment of hunger-striking asylum seekers in detention needs closer inquiry. An Australian Government regulation empowers the Department of Immigration and Multicultural and Indigenous Affairs (DIMIA) to authorise non-consensual medical treatment for a person in immigration detention if they are at risk of physical harm, but there are doubts about whether the regulation would withstand legal challenge. Authorisation by DIMIA does not compel medical practitioners to enforce treatment if such action is contrary to their "ethical, moral or religious convictions". The World Medical Association has established guidelines for doctors involved in managing people on hunger strikes. The Declaration of Tokyo (1975) and the Declaration of Malta (1991) both prohibit the use of non-consensual force-feeding of hunger strikers who are mentally competent. If called upon to treat hunger strikers, medical practitioners should be aware of their ethical and legal responsibilities, and that they should act independently of government or institutional interests.

  16. Nurse leaders' role in medical assistance in dying: A relational ethics approach.

    Science.gov (United States)

    Thiele, Tracy; Dunsford, Jennifer

    2017-01-01

    Recent changes to the Criminal Code of Canada have resulted in the right of competent adult Canadians to request medical assistance in dying (MAID). Healthcare professionals now can participate if the individual meets specific outlined criteria. There remains confusion and lack of knowledge about the specific role of nurses in MAID. MAID is a controversial topic and nurses may be faced with the challenge of balancing the duty to provide routine care, with moral reservations about MAID. The role of a nursing leader is to support nurses by ensuring they have the knowledge they require to care for patients requesting the service, whether or not the nurse is directly involved in the MAID process. The moral dilemmas raised by MAID provide an opportunity to look at a relational ethics approach to nursing leadership both for MAID and other difficult situations that arise in nursing practice. Relational ethics is a framework that proposes that the ethical moments in healthcare are based on relationships and fostering growth, healing, and health through the foundational concepts of mutual respect, engagement, embodiment, and environment. This article will use a relational ethics framework to examine how nursing leadership can support nurses who care for patients requesting MAID.

  17. [Medical ethics and economics in the era of insufficient resources].

    Science.gov (United States)

    Bin Nun, Gabi; Afek, Arnon

    2009-03-01

    During the Golden Age of Medicine (20th Century), scientific and technological breakthroughs enabled physicians to cure people's illnesses. The idealist, romantic approach of medical practice believed in the right of every human being to receive the best treatment possible, regardless of cost. However, the rise in health care expenditure at the end of the 20th Century made this impossible, therefore other approaches were adopted. The aim of this study is to investigate the causes of the change in medical approaches while distinguishing between the different methods practiced by nations in order to deal with the disparity created by ethical dilemmas caused by scare resources and delivery of medical treatment. This study is based on the evaluation of macro economic data and the comparison of international health data. Special emphasis was given to the evaluation of Israeli health economics since the National Health Insurance Act (1995). The study shows two different approaches to the problem of scarce resources: the liberal approach, as practiced in the USA, and the Social Democratic approach which is common in many European countries, including Israel. The Social Democratic ideology believes in public financing of defined health care services to all citizens. This method implies rationing and managed care in order to absorb medical expenses. The ethical dilemmas arising from the necessity to add economic considerations to a physician's care of his patient, demand that any given healthcare system find the right equilibrium. This balance between clinical, social, and economical considerations is not easily achieved. Only dialogue within the health care system itself, and with the public, can achieve the best possible balance.

  18. [PRAGMATIC TURN IN HEALTHCARE ETHICS: CHALLENGES AND OPPORTUNITIES FOR TRAINING].

    Science.gov (United States)

    Aiguier, Grégory; Cobbaut, Jean-Philippe

    2016-01-01

    The complexity of health care practices has given rise to a new need for ethics. Ethics is indeed less mobilized to produce a moral discourse on practices, then as a resource for action, a skill, for the development, by the actors, of autonomous, responsible and critical acting. This pragmatic approach to ethics requires changes in teaching practices, in a more experiential, reflexive and situational perspective. However, an epistemological rereading of the notion of competence will lead us to question its use in ethics. Just focusing on the capacity of actors to re-mobilize predetermined resources of action does not guarantee the effective capacity of the actors to initiate a new situated action, according to the singularity of the context. This text will propose to go beyond an ethical competence approach, revisiting the latter through the prism of capacitation. In this context, the educational line of sight of ethics is no longer "knowing how to do ", but developping "power to do".

  19. Engineering Ethics Education : Its Necessity, Objectives, Methods, Current State, and Challenges

    Science.gov (United States)

    Fudano, Jun

    The importance of engineering ethics education has become widely recognized in the industrialized countries including Japan. This paper examines the background against which engineering ethics education is required, and reviews its objectives, methods, and challenges, as well as its current state. In pointing out important issues associated with the apparent acceptance and quantitative development of ethics education, especially after the establishment of the Japan Accreditation Board for Engineering Education in 1999, the author stresses that the most serious problem is the lack of common understanding on the objectives of engineering ethics education. As a strategy to improve the situation, the so-called “Ethics-across-the-Curriculum” approach is introduced. The author also claims that business/organization ethics which is consistent with engineering ethics should be promoted in Japan.

  20. HEP technologies to address medical imaging challenges

    CERN Document Server

    CERN. Geneva

    2016-01-01

    Developments in detector technologies aimed at solving challenges in present and future CERN experiments, particularly at the LHC, have triggered exceptional advances in the performance of medical imaging devices, allowing for a spectacular progress in in-vivo molecular imaging procedures, which are opening the way for tailored therapies of major diseases. This talk will briefly review the recent history of this prime example of technology transfer from HEP experiments to society, will describe the technical challenges being addressed by some ongoing projects, and will present a few new ideas for further developments and their foreseeable impact.

  1. APLLICATION OF ENGINEERING ETHICS THROUGH EFFECTIVE COMMUNICATION: ISSUES AND CHALLENGES

    Directory of Open Access Journals (Sweden)

    Naveen K MEHTA

    2013-07-01

    Full Text Available The profession of Engineering is one of the highly acclaimed professions. As the active members of this profession, engineers are expected to possess and practice ethical standards. The invaluable services offered by professionals require honesty, impartiality, fairness, integrity and equity. They should devote themselves for allround social welfare. Engineers should perform their duties with utmost care and concern. Through effective communication, Engineering Professionals can promote ethical practices. This paper explores application engineering ethics through effective communication.

  2. BUSINESS AND ENGINEERING ETHICS – SIMILARITIES, DIFFERENCES AND CHALLENGES

    OpenAIRE

    Tomljenović, Ljerka; Stilin, Anita; Hirnig, Saša

    2015-01-01

    Issues of applied ethics and its influence on the behaviour of people in the wider social context have been investigated from many different aspects. The aim of this paper is to clarify the fundamental differences and similarities between business and engineering ethics, determine the areas which represent potential source of conflict and explore specific ethical dilemmas that occur with individuals who are engaged in the engineering profession in the business surroundings. Previous research ...

  3. The ethics of social media in dental practice: challenges.

    Science.gov (United States)

    Peltier, Bruce; Curley, Arthur

    2013-07-01

    This is the first of two essays written to consider several important trends in dental practice that result from innovations in digital and social media. This essay reviews ethical and legal implications of the use of websites, Facebook, review sites, email and other digital innovations in dental practice. The second essay provides ethical tools for analysis, illuminates areas of ethical concern in today's practice environment and offers recommendations for future practice.

  4. Using Technology to Meet the Challenges of Medical Education.

    Science.gov (United States)

    Guze, Phyllis A

    2015-01-01

    Medical education is rapidly changing, influenced by many factors including the changing health care environment, the changing role of the physician, altered societal expectations, rapidly changing medical science, and the diversity of pedagogical techniques. Changes in societal expectations put patient safety in the forefront, and raises the ethical issues of learning interactions and procedures on live patients, with the long-standing teaching method of "see one, do one, teach one" no longer acceptable. The educational goals of using technology in medical education include facilitating basic knowledge acquisition, improving decision making, enhancement of perceptual variation, improving skill coordination, practicing for rare or critical events, learning team training, and improving psychomotor skills. Different technologies can address these goals. Technologies such as podcasts and videos with flipped classrooms, mobile devices with apps, video games, simulations (part-time trainers, integrated simulators, virtual reality), and wearable devices (google glass) are some of the techniques available to address the changing educational environment. This article presents how the use of technologies can provide the infrastructure and basis for addressing many of the challenges in providing medical education for the future.

  5. Using Technology to Meet the Challenges of Medical Education

    Science.gov (United States)

    Guze, Phyllis A.

    2015-01-01

    Medical education is rapidly changing, influenced by many factors including the changing health care environment, the changing role of the physician, altered societal expectations, rapidly changing medical science, and the diversity of pedagogical techniques. Changes in societal expectations put patient safety in the forefront, and raises the ethical issues of learning interactions and procedures on live patients, with the long-standing teaching method of “see one, do one, teach one” no longer acceptable. The educational goals of using technology in medical education include facilitating basic knowledge acquisition, improving decision making, enhancement of perceptual variation, improving skill coordination, practicing for rare or critical events, learning team training, and improving psychomotor skills. Different technologies can address these goals. Technologies such as podcasts and videos with flipped classrooms, mobile devices with apps, video games, simulations (part-time trainers, integrated simulators, virtual reality), and wearable devices (google glass) are some of the techniques available to address the changing educational environment. This article presents how the use of technologies can provide the infrastructure and basis for addressing many of the challenges in providing medical education for the future. PMID:26330687

  6. Research Ethics Education in Post-Graduate Medical Curricula in I.R. Iran.

    Science.gov (United States)

    Nikravanfard, Nazila; Khorasanizadeh, Faezeh; Zendehdel, Kazem

    2016-08-16

    Research ethics training during post-graduate education is necessary to improve ethical standards in the design and conduct of biomedical research. We studied quality and quantity of research ethics training in the curricula of post-graduate programs in the medical science in I.R. Iran. We evaluated curricula of 125 post-graduate programs in medical sciences in I.R. Iran. We qualitatively studied the curricula by education level, including the Master and PhD degrees and analyzed the contents and the amount of teaching allocated for ethics training in each curriculum. We found no research ethics training in 72 (58%) of the programs. Among the 53 (42%) programs that considered research ethics training, only 17 programs had specific courses for research ethics and eight of them had detailed topics on their courses. The research ethics training was optional in 25% and mandatory in 76% of the programs. Post-graduate studies that were approved in the more recent years had more attention to the research ethics training. Research ethics training was neglected in most of the medical post-graduate programs. We suggest including sufficient amount of mandatory research ethics training in Master and PhD programs in I.R. Iran. Further research about quality of research ethics training and implementation of curricula in the biomedical institutions is warranted.

  7. The historical context of business ethics: implications for choices and challenges in wound care.

    Science.gov (United States)

    Gallagher, S M

    1999-08-01

    Wound care clinicians are regularly asked to make decisions of an ethical nature within their work settings. Business and business practices are influenced by a number of factors, such as history, culture, and individual choices. This article describes business practices and ultimately business ethics from an historical context, the meaning of business culture within the dominant culture, and the debate over business ethics as it relates to choices and challenges for wound care clinicians.

  8. The unique ethical challenges of the bogus pipeline methodology: let the data speak.

    Science.gov (United States)

    Aguinis, H; Handelsman, M M

    1997-04-01

    Sigall (1997) asserted that the bogus pipeline (BPL) methodology is not a uniquely deceptive technique and, therefore, does not pose unique ethical challenges for social psychology researchers. We argue that empirical research is needed to clarify the controversial issue of the ethics of using the BPL. Results of such a research program will provide guidance for researchers as well as institutional review boards regarding conditions under which the use of the BPL may or may not be ethically justified.

  9. Harm in the absence of care: Towards a medical ethics that cares.

    Science.gov (United States)

    Martinsen, Elin

    2011-03-01

    The aim of this article is to investigate the concept of care in contemporary medical practice and medical ethics. Although care has been hailed throughout the centuries as a crucial ideal in medical practice and as an honourable virtue to be observed in codes of medical ethics, I argue that contemporary medicine and medical ethics suffer from the lack of a theoretically sustainable concept of care and then discuss possible reasons that may help to explain this absence. I draw on the empirical studies of Carol Gilligan on care and connectedness as ontologically situated realities in human life. Based on a philosophical elaboration of her findings on the ethics of care emphasizing relationality, I try to show how the notion of 'relational ontology' originating from this stream of thought may be of help in developing a medical ethics that acknowledges care as a perspective to be observed in all interactions between physicians and patients.

  10. Technical and ethical challenges of fertility preservation in young cancer patients.

    Science.gov (United States)

    Deepinder, Fnu; Agarwal, Ashok

    2008-06-01

    As cancer treatment improves, more young men and women survive, but they suffer from infertility as a major sequel of cancer treatment. Gamete and embryo cryopreservation are the only options available to these patients for preserving their fertility. Although cryopreservation of spermatozoa and embryos are already established, oocyte banking is still experimental. The advent of testicular tissue cryopreservation and spermatogonial stem cell transplantation in men, and ovarian tissue cryopreservation and in-vitro follicular maturation in women, has started a frenzy of experiments worldwide trying to demonstrate their potential use in fertility preservation. Although major improvements have been made in tissue cryobanking in the past decade, there are still many unresolved technical issues related to these procedures. Furthermore, the intersection of cancer and fertility preservation in young patients raises ethical, legal and policy issues for oncologists and cancer survivors. Informed consent of minor patients, legal parentage and medical negligence claims are some of the potential legal challenges faced by society and healthcare providers. This review summarizes the technical and ethical challenges of gamete cryopreservation in young cancer patients.

  11. Ethical and professional challenges in mental health care in low- and middle-income countries.

    Science.gov (United States)

    Hanlon, Charlotte; Tesfaye, Markos; Wondimagegn, Dawit; Shibre, Teshome

    2010-01-01

    Mental health practitioners in low- and middle-income countries (LAMICs) face particular ethical and professional challenges in their day-to-day clinical practice. A systematic review of the published literature from all LAMICs identified 42 relevant articles. The majority of papers dealt with violations of individual autonomy, particularly in the context of involuntary admission, use of electro-convulsive therapy and the lack of information given to patients about prescribed psychotropic medications. However, the appropriateness of this focus on individual autonomy was challenged in settings where values emphasizing the interconnectedness of communities prevail and the family shoulder the burden for most mental health care. When access to the least restrictive, culturally relevant, evidence-based care is limited to the privileged few, caregivers may be forced to over-ride the individual autonomy of the patient in order to ensure receipt of effective treatment or protection of others. Enactment of modern mental health legislation in all LAMICs remains an essential goal to protect the rights of the mentally ill. In parallel with this, supporting calls for the scaling up of mental health care will do more to ensure the right to mental health care and ensure actual implementation of international ethical frameworks.

  12. Challenges with Ethical Behavior and Accountability in Leadership

    Directory of Open Access Journals (Sweden)

    Laura Thompson

    2016-04-01

    Full Text Available In terms of purpose, accountability systems are designed to apply governance, and in some cases, legislate rules, in order to impact the quality of the end result, or control the behavior of people and their environments [19]. The rules within accountability systems are usually implicit, intrinsic, very detailed, and fully known by only a few people. Education and levels of leadership are some of the main factors leading to breakdown of communication and accountability within organizational structure. However, business intelligence tools like knowledge management [11], make it easier to access, capture share information and make decisions on accountability within organizations. Strategic Misalignment occurs when decisions are made, without communication or ethical standards [13]. To address the challenges associated with accountability in for and non profit organizations, a sequential explanatory mixed method design was employed, along with action research. Participants of the study were interviewed and asked seven qualitative questions, in efforts to explain the quantitative results. The process to gather and culminate the qualitative results took approximately 6 months. Three main classifications of accountability systems were derived from the interviews; personal accountability, financial accountability, and organizational accountability [8]. To ensure the credibility of findings in the qualitative analysis, the framework for additional study with more rigor is presented here.

  13. Practical Barriers and Ethical Challenges in Genetic Data Sharing

    Directory of Open Access Journals (Sweden)

    Claire L. Simpson

    2014-08-01

    Full Text Available The underlying ethos of dbGaP is that access to these data by secondary data analysts facilitates advancement of science. NIH has required that genome-wide association study data be deposited in the Database of Genotypes and Phenotypes (dbGaP since 2003. In 2013, a proposed updated policy extended this requirement to next-generation sequencing data. However, recent literature and anecdotal reports suggest lingering logistical and ethical concerns about subject identifiability, informed consent, publication embargo enforcement, and difficulty in accessing dbGaP data. We surveyed the International Genetic Epidemiology Society (IGES membership about their experiences. One hundred and seventy five (175 individuals completed the survey, a response rate of 27%. Of respondents who received data from dbGaP (43%, only 32% perceived the application process as easy but most (75% received data within five months. Remaining challenges include difficulty in identifying an institutional signing official and an overlong application process. Only 24% of respondents had contributed data to dbGaP. Of these, 31% reported local IRB restrictions on data release; an additional 15% had to reconsent study participants before depositing data. The majority of respondents (56% disagreed that the publication embargo period was sufficient. In response, we recommend longer embargo periods and use of varied data-sharing models rather than a one-size-fits-all approach.

  14. Practical Barriers and Ethical Challenges in Genetic Data Sharing

    Science.gov (United States)

    Simpson, Claire L.; Goldenberg, Aaron J.; Culverhouse, Rob; Daley, Denise; Igo, Robert P.; Jarvik, Gail P.; Mandal, Diptasri M.; Mascalzoni, Deborah; Montgomery, Courtney Gray; Pierce, Brandon L.; Plaetke, Rosemarie; Shete, Sanjay; Goddard, Katrina A. B.; Stein, Catherine M.

    2014-01-01

    The underlying ethos of dbGaP is that access to these data by secondary data analysts facilitates advancement of science. NIH has required that genome-wide association study data be deposited in the Database of Genotypes and Phenotypes (dbGaP) since 2003. In 2013, a proposed updated policy extended this requirement to next-generation sequencing data. However, recent literature and anecdotal reports suggest lingering logistical and ethical concerns about subject identifiability, informed consent, publication embargo enforcement, and difficulty in accessing dbGaP data. We surveyed the International Genetic Epidemiology Society (IGES) membership about their experiences. One hundred and seventy five (175) individuals completed the survey, a response rate of 27%. Of respondents who received data from dbGaP (43%), only 32% perceived the application process as easy but most (75%) received data within five months. Remaining challenges include difficulty in identifying an institutional signing official and an overlong application process. Only 24% of respondents had contributed data to dbGaP. Of these, 31% reported local IRB restrictions on data release; an additional 15% had to reconsent study participants before depositing data. The majority of respondents (56%) disagreed that the publication embargo period was sufficient. In response, we recommend longer embargo periods and use of varied data-sharing models rather than a one-size-fits-all approach. PMID:25153467

  15. Ethical Challenges when Interviewing Close Relatives Together – An Integrative Review

    DEFF Research Database (Denmark)

    Voltelen, Barbara; Konradsen, Hanne; Østergaard, Birte

    2015-01-01

    Background and purpose Interviewing two interrelated persons (or more) simultaneously might pose different ethical considerations than interviewing just one person. Such ethical considerations, however, remain largely undescribed in literature, challenging the researcher who wishes to conduct them...... was analysed using thematic analysis with an inductive approach searching for themes about ethical considerations doing joint interviews. The SPIDER search tool was applied using keywords relatives, ethic, dyadic interview, challenges and qualitative methods created on the basis of relevant pseudonyms, Mesh......: The researcher/interviewer, Planning of joint interviews and Participant well-being. Conclusions and implications The nature of joint interviews poses many ethical challenges as more people are involved. They provide insight into shared accounts and communication patterns between interviewees, highlighting...

  16. Ethical challenges in rheumatology: a survey of the American College of Rheumatology membership.

    Science.gov (United States)

    MacKenzie, C Ronald; Meltzer, Michele; Kitsis, Elizabeth A; Mancuso, Carol A

    2013-10-01

    Despite the frequency of ethical issues arising in patient care, ethical discourse in the rheumatology literature is negligible. To better understand the scope of ethical problems occurring in our specialty, the American College of Rheumatology (ACR) Committee on Ethics and Conflict of Interest surveyed ACR members. Specific objectives of the survey were 1) to learn the perceived frequency of ethical issues in rheumatology, 2) to identify activities that pose ethical problems in rheumatologic practice, 3) to determine the extent of education on, and self-perceived knowledge about, ethics among ACR members, and 4) to determine member interest in, and suggest content for, future ACR-sponsored educational activities related to bioethics. The survey included 12 non-open-ended questions addressing 5 core areas: 1) ethical dilemmas in daily practice, 2) ethical concerns in basic and clinical research, 3) influence of industry, 4) ethics of regulatory policies, potential conflicts, and disclosure, and 5) personal education on and interest in ethics. Two open-ended questions were also included, asking respondents to list the ethical issues most relevant to rheumatology and to provide any comments. Data analysis was descriptive. Seven hundred seventy-one responses were received. Respondents believed that ethical issues arise most frequently in practice and in clinical research. The most common ethical issues cited were the high cost of treatment for patients (51% of respondents) and for society (48%), and the practice of defensive medicine (45%). The survey results suggest that ethical problems in rheumatology are of concern to the ACR membership. Further, there is a perceived need for educational programs targeted at helping members address such professional challenges. Copyright © 2013 by the American College of Rheumatology.

  17. An Ethics Challenge for School Counselors: Part 2

    Science.gov (United States)

    Hicks, Janet G. Froeschle; Noble, Nicole; Berry, Steve; Talbert, Steve; Crews, Charles; Li, Jiaqi; Castillo, Yvette

    2014-01-01

    Ethical and legal issues are dealt with daily by school counselors (Bodenhorn, 2006; Moyer, Sullivan & Growcock, 2012). Despite the prevalence of these issues, few resources exist to assist these professionals when making ethical and legal decisions. In addition, a lack of supervision for school counselors and managing complexities inherent…

  18. Ethical Issues in Maternal and Child Health Nursing: Challenges ...

    African Journals Online (AJOL)

    action brought about the moral questions of right ... examines what our behaviour ought to be in ... [5] It include the study of theories, ... Ethical principles are a set of rules that can be ... Beneficience is the obligation to do good, as ... The Utilitarian Approach: This approach posits ..... rational and systematic, based on ethical.

  19. The Future Entering: Reflections on and Challenges to Ethical Leadership

    Science.gov (United States)

    Reilly, Elizabeth C.

    2006-01-01

    To enter a future that waits to be born, educational leaders must continually assess their own ethical stance as well as that of the organizations they serve. Three frames form a model for examining the ethics of both individual and organization, with internal monologue and engaged conversation as the means for reflection and action.

  20. Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology.

    Science.gov (United States)

    Magalhães-Sant'Ana, M; More, S J; Morton, D B; Hanlon, A

    2016-10-29

    Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. British Veterinary Association.

  1. Integrating Ethics into International Business Teaching: Challenges and Methodologies in the Greater China Context

    Science.gov (United States)

    Whitla, Paul

    2011-01-01

    This paper examines the process of integrating ethics into the teaching of international business within the Greater China region. An example of how ethics is integrated into a required undergraduate international business course at a Hong Kong based university is presented. The contextual challenges of developing a course for use in the Greater…

  2. Integrating Ethics into International Business Teaching: Challenges and Methodologies in the Greater China Context

    Science.gov (United States)

    Whitla, Paul

    2011-01-01

    This paper examines the process of integrating ethics into the teaching of international business within the Greater China region. An example of how ethics is integrated into a required undergraduate international business course at a Hong Kong based university is presented. The contextual challenges of developing a course for use in the Greater…

  3. Jewish and secular medical ethics share themes but diverge on issues such as heroic measures

    Science.gov (United States)

    Cohen, L

    1997-01-01

    An american expert on Jewish medical ethics explained the nuances of these rules during a recent address in Ottawa. Although Jewish and secular rules concerning medical ethics often coincide, they diverge in several important areas, including the subject of patient autonomy. PMID:9371074

  4. An ethical facade? Medical students' miscomprehensions of substituted judgment.

    Directory of Open Access Journals (Sweden)

    Farr A Curlin

    Full Text Available BACKGROUND: We studied how well first-year medical students understand and apply the concept of substituted judgment, following a course on clinical ethics. METHOD: Students submitted essays on one of three ethically controversial scenarios presented in class. One scenario involved a patient who had lost decisional capacity. Through an iterative process of textual analysis, the essays were studied and coded for patterns in the ways students misunderstood or misapplied the principle of substituted judgment. RESULTS: Students correctly articulated course principles regarding patient autonomy, substituted judgment, and non-imposition of physician values. However, students showed misunderstanding by giving doctors the responsibility of balancing the interests of the patient against the interests of the family, by stating doctors and surrogates should be guided primarily by a best-interest standard, and by suggesting that patient autonomy becomes the guiding principle only when patients can no longer express their wishes. CONCLUSION: Students did not appear to internalize or correctly apply the substituted judgment standard, even though they could describe it accurately. This suggests the substituted judgment standard may run counter to students' moral intuitions, making it harder to apply in clinical practice.

  5. Top 10 health care ethics challenges facing the public: views of Toronto bioethicists

    Directory of Open Access Journals (Sweden)

    Bell Jennifer

    2005-06-01

    Full Text Available Abstract Background There are numerous ethical challenges that can impact patients and families in the health care setting. This paper reports on the results of a study conducted with a panel of clinical bioethicists in Toronto, Ontario, Canada, the purpose of which was to identify the top ethical challenges facing patients and their families in health care. A modified Delphi study was conducted with twelve clinical bioethicist members of the Clinical Ethics Group of the University of Toronto Joint Centre for Bioethics. The panel was asked the question, what do you think are the top ten ethical challenges that Canadians may face in health care? The panel was asked to rank the top ten ethical challenges throughout the Delphi process and consensus was reached after three rounds. Discussion The top challenge ranked by the group was disagreement between patients/families and health care professionals about treatment decisions. The second highest ranked challenge was waiting lists. The third ranked challenge was access to needed resources for the aged, chronically ill, and mentally ill. Summary Although many of the challenges listed by the panel have received significant public attention, there has been very little attention paid to the top ranked challenge. We propose several steps that can be taken to help address this key challenge.

  6. [Medical research-ethics applied to social sciences: relevance, limits, issues and necessary adjustments].

    Science.gov (United States)

    Desclaux, A

    2008-04-01

    Social sciences are concretely concerned by the ethics of medical research when they deal with topics related to health, since they are subjected to clearance procedures specific to this field. This raises at least three questions: - Are principles and practices of medical research ethics and social science research compatible? - Are "research subjects" protected by medical research ethics when they participate in social science research projects? - What can social sciences provide to on-going debates and reflexion in this field? The analysis of the comments coming from ethics committees about social science research projects, and of the experience of implementation of these projects, shows that the application of international ethics standards by institutional review boards or ethics committees raises many problems in particular for researches in ethnology anthropology and sociology. These problems may produce an impoverishment of research, pervert its meaning, even hinder any research. They are not only related to different norms, but also to epistemological divergences. Moreover, in the case of studies in social sciences, the immediate and differed risks, the costs, as well as the benefits for subjects, are very different from those related to medical research. These considerations are presently a matter of debates in several countries such as Canada, Brasil, and USA. From another hand, ethics committees seem to have developed without resorting in any manner to the reflexion carried out within social sciences and more particularly in anthropology Still, the stakes of the ethical debates in anthropology show that many important and relevant issues have been discussed. Considering this debate would provide openings for the reflexion in ethics of health research. Ethnographic studies of medical research ethics principles and practices in various sociocultural contexts may also contribute to the advancement of medical ethics. A "mutual adjustment" between ethics of

  7. ETHICS AND DEONTOLOGY OF MEDICAL EDUCATION AND NURSES IN PORTUGUAL

    Directory of Open Access Journals (Sweden)

    Clara Costa Oliveira

    2012-07-01

    Full Text Available This article discusses deontological issues of health care professions in relation to their ethical foundation. We present four models of teaching ethics and deontology in doctors’ training and the results of a PhD research on the teaching of these subjects in nurses’ training in Portugal. Given the importance of bioethics in deontological training of health care professions, we present a comparative analysis of. bioethical principles enunciated by Beauchamp and Childress (1979, related to ‘ethics of justice’, and Kemp’s(2000 proposal, associated to an ‘ethics of care’. Given the ambiguity of these bioethical expressions, we focus on the analysis of its contents and the need to discuss the fundamentals of ethical training of doctors and nurses in relation to the ethical theories they are derived from. Utilitarian ethics, duty ethics, virtue ethics, when the analysis of bioethics’ fundaments is not trained, the duty of caring of suffering can be put at risk.

  8. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies.

    Science.gov (United States)

    Haddad, Peter M; Brain, Cecilia; Scott, Jan

    2014-01-01

    Nonadherence with medication occurs in all chronic medical disorders. It is a particular challenge in schizophrenia due to the illness's association with social isolation, stigma, and comorbid substance misuse, plus the effect of symptom domains on adherence, including positive and negative symptoms, lack of insight, depression, and cognitive impairment. Nonadherence lies on a spectrum, is often covert, and is underestimated by clinicians, but affects more than one third of patients with schizophrenia per annum. It increases the risk of relapse, rehospitalization, and self-harm, increases inpatient costs, and lowers quality of life. It results from multiple patient, clinician, illness, medication, and service factors, but a useful distinction is between intentional and unintentional nonadherence. There is no gold standard approach to the measurement of adherence as all methods have pros and cons. Interventions to improve adherence include psychoeducation and other psychosocial interventions, antipsychotic long-acting injections, electronic reminders, service-based interventions, and financial incentives. These overlap, all have some evidence of effectiveness, and the intervention adopted should be tailored to the individual. Psychosocial interventions that utilize combined approaches seem more effective than unidimensional approaches. There is increasing interest in electronic reminders and monitoring systems to enhance adherence, eg, Short Message Service text messaging and real-time medication monitoring linked to smart pill containers or an electronic ingestible event marker. Financial incentives to enhance antipsychotic adherence raise ethical issues, and their place in practice remains unclear. Simple pragmatic strategies to improve medication adherence include shared decision-making, regular assessment of adherence, simplification of the medication regimen, ensuring that treatment is effective and that side effects are managed, and promoting a positive

  9. The field worker's fields: ethics, ethnography and medical sociology.

    Science.gov (United States)

    Anspach, Renée R; Mizrachi, Nissim

    2006-09-01

    Sociologists who do field work in medical settings face an intractable tension between their disciplinary field, which takes a critical perspective toward medicine, and their ethnographic field, which often includes physicians. This paper explores the ethical problems that result from the collision of the two fields. While in the field, ethnographers are forced to choose between sociology and their obligations to host members, as they decide whether to disclose their actual research agendas, whether to ask tough questions or to reveal their concerns, and whether to give advice. The tension persists when field workers leave the field to write, forcing them to choose between competing interpretations and to decide what to reveal or conceal in the interests of confidentiality. Through these moral choices about what to ask, record or present to the reader, ethnographers shape the academic field even as it shapes them.

  10. Helping doctors become better doctors: Mary Lobjoit--an unsung heroine of medical ethics in the UK.

    Science.gov (United States)

    Brazier, Margaret R; Gillon, Raanan; Harris, John

    2012-06-01

    Medical Ethics has many unsung heros and heroines. Here we celebrate one of these and on telling part of her story hope to place modern medical ethics and bioethics in the UK more centrally within its historical and human contex.

  11. [Ethical Attitudes of Brazilian Medical Students and Graduates with Active Methodologies.

    Science.gov (United States)

    Novaes, Maria Rita Carvalho Garbi; Novaes, Luiz Carlos Garcez; Guilhem, Dirce; Stepke, Fernando Lolas; Silveira, Carla Cristina Costa; Komatsu, Ricardo Shoiti; Trindade, Eliane Mendonça Vilar; Guiotti, Murilo Galvão

    2010-01-01

    The objective of this study was to conduct a diagnosis of the comprehensive inclusion of ethics in Brazilian medical training with a problem-based learning methodology and to describe students' and graduates' perceptions of ethical attitudes. The methodological design was a descriptive and documental case study with a qualitative and quantitative approach. The sample consisted of 20 students per course year, totaling 120 students and 40 alumni from two graduating classes at the ESCS School of Medicine. The project was approved by the Institutional Review Board of the State Health Secretariat, Federal District, Brazil. ESCS students and graduates showed that they approach ethical conflicts and respect for patients. However, an analysis of ethical sensitivity revealed weak perceptions and inappropriate attitudes by medical students, especially in the early years of medical school, requiring more systematic discussions on ethical and bioethical aspects integrated with practical activities, in order to increase and strengthen ethical reflection by students.

  12. Ethical orientation, functional linguistics, and the codes of ethics of the Canadian Nurses Association and the Canadian Medical Association.

    Science.gov (United States)

    Hadjistavropoulos, Thomas; Malloy, David C; Douaud, Patrick; Smythe, William E

    2002-09-01

    The literature on codes of ethics suggests that grammatical and linguistic structures as well as the theoretical ethical orientation conveyed in codes of ethics have implications for the manner in which such codes are received by those bound by them. Certain grammatical and linguistic structures, for example, tend to have an authoritarian and disempowering impact while others can be empowering. The authors analyze and compare the codes of ethics of the Canadian Nurses Association (CNA) and the Canadian Medical Association (CMA) in terms of their ethical orientation and grammatical/linguistic structures. The results suggest that the two codes differ substantially along these two dimensions. The CNA code contains proportionally more statements that provide a rationale for ethical behaviour; the statements of the CMA code tend to be more dogmatic. Functional grammar analysis suggests that both codes convey a strong deontological tone that does not enhance the addressee's ability to engage in discretionary decision-making. The nurses' code nonetheless implies a collaborative relationship with the client, whereas the medical code implies that the patient is the recipient of medical wisdom. The implications of these findings are discussed.

  13. Bio-ethical principles of medical law with an emphasis on the law of Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Mahdavi Sabet

    2016-12-01

    Full Text Available There has been many talks about the necessity of ethics in all affairs, especially medical affairs which deal with the lives of individuals and the society expects Medical Group to be abide by morals more than laws. This matter indicates on the fact that the society considers ethics as a stronger enforcement of the law and deplores a doctor who has ignored ethics in the medical profession. Thus, they blamed the doctor from ethical aspect more than deploring him from a legal aspect (civil or criminal liability. The legislator is also influenced by public in anticipation of responsibility (both criminal and civil for doctors and imposes legal rules on this basis. The concept of this article has an extremely close relationship with three concepts of morality, professional ethics and law. Initially first two concepts will be defined and separated and then the relation between professional ethics and medical laws will be expressed. Then, the relation between two concepts of medical ethics and bioethics ethics will be evaluated. Two religion or secularism basis have been taken for medical rights and strengths and weaknesses of each are discussed and the approach of the Iranian legal system will also be mentioned with evaluation of controversial medical samples.

  14. The ethics of the medical-pharmaceutical relationship.

    Science.gov (United States)

    Vashi, Neelam A; Latkowski, Jo-Ann M

    2012-01-01

    Physician interaction with the pharmaceutical industry raises many ethical concerns. This relationship is complex, owing to a pluralism of beliefs held by physicians, patients, and third parties. As a result, determining whether physicians fulfill their responsibilities to both the professional and public communities is an arduous endeavor. In an effort to clarify the situation and provide transparency to this complex relationship, medical and pharmaceutical organizations have enacted their own respective codes and guidelines. Even with adherence to these guidelines, questions remain regarding the codependent relationship that interweaves the pharmaceutical industry with the medical community. Owing to the ever-changing landscape enmeshing product development, scientific advancement, corporate realities and patient care, the proper choice for physicians is rarely obvious; however, to operate to the highest standards, those in the medical community must be candid about relations with the pharmaceutical industry and transparent in their financial interests. Further undertakings should focus not on the eradication of physician-pharmaceutical interaction, but instead on the education of physicians about industry marketing strategies and the delineation of boundaries of these interactions to benefit not the individual physician, but our patients.

  15. Terrorism and the ethics of emergency medical care.

    Science.gov (United States)

    Pesik, N; Keim, M E; Iserson, K V

    2001-06-01

    The threat of domestic and international terrorism involving weapons of mass destruction-terrorism (WMD-T) has become an increasing public health concern for US citizens. WMD-T events may have a major effect on many societal sectors but particularly on the health care delivery system. Anticipated medical problems might include the need for large quantities of medical equipment and supplies, as well as capable and unaffected health care providers. In the setting of WMD-T, triage may bear little resemblance to the standard approach to civilian triage. To address these issues to the maximum benefit of our patients, we must first develop collective forethought and a broad-based consensus that these decisions must reach beyond the hospital emergency department. Critical decisions like these should not be made on an individual case-by-case basis. Physicians should never be placed in a position of individually deciding to deny treatment to patients without the guidance of a policy or protocol. Emergency physicians, however, may easily find themselves in a situation in which the demand for resources clearly exceeds supply. It is for this reason that emergency care providers, personnel, hospital administrators, religious leaders, and medical ethics committees need to engage in bioethical decision making before an acute bioterrorist event.

  16. Doing "Good Work": Negotiating Possibilities in Ethical Challenges

    Science.gov (United States)

    Burge, Elizabeth J.

    2009-01-01

    In this article, the author takes a look at how reflective and courageous practitioners show their critical and constructive thinking for handling the intellectual and interpersonal complexities of ethical analysis. The author also discusses six lessons practitioners need to learn.

  17. Ethical and practical challenges in implementing informed consent ...

    African Journals Online (AJOL)

    Background/rationale: Ethical issues regarding HIV/AIDS human research in the ... coercion or monetary inducement, language difficulties, illiteracy or lack of ... Conclusions: International investigators of HIV human research should bear in ...

  18. The gastroenterologist and his endoscope: the embodiment of technology and the necessity for a medical ethics.

    Science.gov (United States)

    Cooper, M W

    1996-12-01

    The purpose of this essay is to argue for the necessity of an ethics of the practice of the specialist-technologist in medicine. In the first part I sketch three stages of medical ethics, each with a particular viewpoint regarding the technology of medicine. I focus on Brody's consideration of the "physician's power" as a example of contemporary medical ethics which explicitly excludes the specialist-technologist as a locus of development of medical ethics. Next, the philosophy of Heidegger is examined to suggest an approach to the problem, and, finally, some of Levinas' contributions regarding the "other" are introduced to suggest a preliminary approach to a medical ethics of the specialist-technologist.

  19. The ethics of medical tourism: from the United Kingdom to India seeking medical care.

    Science.gov (United States)

    Meghani, Zahra

    2013-01-01

    Is the practice of UK patients traveling to India as medical tourists morally justified? This article addresses that question by examining three ethically relevant issues. First, the key factor motivating citizens of the United Kingdom to seek medical treatment in India is identified and analyzed. Second, the life prospects of the majority of the citizens of the two nations are compared to determine whether the United Kingdom is morally warranted in relying on India to meet the medical needs of its citizens. Third, as neoliberal reforms are justified on the grounds that they will help the indigent populations affected by them, the impact of medical tourism--a neoliberal initiative--on India's socially and economically marginalized groups is scrutinized.

  20. Transforming educational accountability in medical ethics and humanities education toward professionalism.

    Science.gov (United States)

    Doukas, David J; Kirch, Darrell G; Brigham, Timothy P; Barzansky, Barbara M; Wear, Stephen; Carrese, Joseph A; Fins, Joseph J; Lederer, Susan E

    2015-06-01

    Effectively developing professionalism requires a programmatic view on how medical ethics and humanities should be incorporated into an educational continuum that begins in premedical studies, stretches across medical school and residency, and is sustained throughout one's practice. The Project to Rebalance and Integrate Medical Education National Conference on Medical Ethics and Humanities in Medical Education (May 2012) invited representatives from the three major medical education and accreditation organizations to engage with an expert panel of nationally known medical educators in ethics, history, literature, and the visual arts. This article, based on the views of these representatives and their respondents, offers a future-tense account of how professionalism can be incorporated into medical education.The themes that are emphasized herein include the need to respond to four issues. The first theme highlights how ethics and humanities can provide a response to the dissonance that occurs in current health care delivery. The second theme focuses on how to facilitate preprofessional readiness for applicants through reform of the medical school admission process. The third theme emphasizes the importance of integrating ethics and humanities into the medical school administrative structure. The fourth theme underscores how outcomes-based assessment should reflect developmental milestones for professional attributes and conduct. The participants emphasized that ethics and humanities-based knowledge, skills, and conduct that promote professionalism should be taught with accountability, flexibility, and the premise that all these traits are essential to the formation of a modern professional physician.

  1. [Discussion forum on medical ethics. A8. How can ethics be made practical? 3 philosophical positions].

    Science.gov (United States)

    Meran, J

    1990-05-01

    Ethics as a theory of morality is expected to find a way into practical use. A short historical overview from Aristotle's hermeneutic ethic and the axiomatic position of Kant and Fichte leads to a modern "analysis of possibility" which shows up a new approach solving the practical dimensions of ethics.

  2. Ethical and professional conduct of medical students: review of current assessment measures and controversies

    Science.gov (United States)

    Boon, K; Turner, J

    2004-01-01

    As medical education increasingly acknowledges the importance of the ethical and professional conduct of practitioners, and moves towards more formal assessment of these issues, it is important to consider the evidence base which exists in this area. This article discusses literature about the health needs and problems experienced by medical practitioners as a background to a review of the current efforts in medical education to promote ethical conduct and develop mechanisms for the detection and remediation of problems. PMID:15082823

  3. Curricular priorities for business ethics in medical practice and research: recommendations from Delphi consensus panels.

    Science.gov (United States)

    DuBois, James M; Kraus, Elena M; Gursahani, Kamal; Mikulec, Anthony; Bakanas, Erin

    2014-11-15

    No published curricula in the area of medical business ethics exist. This is surprising given that physicians wrestle daily with business decisions and that professional associations, the Institute of Medicine, Health and Human Services, Congress, and industry have issued related guidelines over the past 5 years. To fill this gap, the authors aimed (1) to identify the full range of medical business ethics topics that experts consider important to teach, and (2) to establish curricular priorities through expert consensus. In spring 2012, the authors conducted an online Delphi survey with two heterogeneous panels of experts recruited in the United States. One panel focused on business ethics in medical practice (n = 14), and 1 focused on business ethics in medical research (n = 12). Panel 1 generated an initial list of 14 major topics related to business ethics in medical practice, and subsequently rated 6 topics as very important or essential to teach. Panel 2 generated an initial list of 10 major topics related to business ethics in medical research, and subsequently rated 5 as very important or essential. In both domains, the panel strongly recommended addressing problems that conflicts of interest can cause, legal guidelines, and the goals or ideals of the profession. The Bander Center for Medical Business Ethics at Saint Louis University will use the results of the Delphi panel to develop online curricular resources for each of the highest rated topics.

  4. Ethical Challenges of Animal Biotechnology : Application of Ben Mepham's Ethical Matrix

    OpenAIRE

    Bhuiyan, Anwarullah

    2010-01-01

    This thesis examines whether animal biotechnology is compatible with the norms of animal welfare, environment, and public health. For this purpose, it explores two lines of ethical controversy — intrinsic argument and extrinsic argument. The intrinsic argument against biotechnology maintains that it is “objectionable in itself”. On the other hand, according to extrinsic argument animal biotechnology is ethically wrong because it has got negative consequences upon human beings, animals, and en...

  5. Ethics and the comprehensive application of epistemology in medical practice.

    Science.gov (United States)

    Phaosavasdi, Sukhit; Taneepanichskul, Surasak; Tannirandorn, Yuen; Uerpairojkit, Boonchai; Thamkhantho, Manopchai; Pruksapong, Chumsak; Kanjanapitak, Aurchart; Phupong, Vorapong

    2005-12-01

    Our simple definition of ethics is good thought, speak and action. Epistemology means the hypothesis of facts about thought, speech and action. Medical practice is all means of medicine. Medicine classifies people into normal and abnormal. The abnormal are the sick. They loose some organs or those normal looking organs are dysfunctional. They are social problems, some can be treated, and some do not get the appropriate care. The problems of society of normal people are overeating and obesity, abortion, drug abuse, promiscuity, torture, terrorism, disobeying rules and order, corruption, brain-washing and unethical advertisements, etc. On the other hand, the social problems of the abnormal are down, deafness, blindness, dumb, hypertension, hypercholesterolemia, diabetes mellitus and cancer, etc. An example of the social-doctor problem is the mal distribution of doctors in rural areas. It was reported by the ministry of public health that the ratio of doctor to population to be 1:800 in Bangkok and 1:5, 700 in some rural areas in the north eastern part of Thailand. The doctors, themselves, are at a high grade of worker and intelligent quotient. They know all the problem and, at the same time, create problems, both, faster than the general population can do. It affects good and bad in the society. In the past, present and the foreseeable future the medical students get their studies in the western style. Their medical schools are situated in big cities. These schools are old and famous. They learn their medical procedure in a big hospital of more than 400 beds in the inpatient department wards. Their instructors and professors are highly qualified, are middle class people and well accepted in the society. Their families are lovely and warm. Their children study in the first class schools in town. The medical students feel very happy and appreciate seeing their professors in television routinely at prime time. In conclusion, their professors are an example of role model

  6. Ethics approval: a challenge for public health researchers in India.

    Science.gov (United States)

    Nagaraja, Sharath Burugina; Menezes, Ritesh G; Zachariah, Rony; Wilson, Nevin

    2015-01-01

    There is increasing impetus, interest and opportunity for people working in public health programmes in India to carry out operational research (OR) around relevant programme issues and then publish that in peer-reviewed publications. These published researches are valuable in analysing, documenting and advocating for locally generated evidence to inform policy and practice. Ethics review and approval is an essential step in the process of OR but is often viewed as a barrier rather than a prerequisite of good practice in OR. Journals and peer reviewers are also increasingly requiring approvals from local institutional ethics committees (IECs).

  7. [Social consensus on medical technology policy: ethical issues and citizen participation].

    Science.gov (United States)

    Sato, Hajime

    2004-01-01

    Social consensus is considered to be a necessary condition for a policy to be introduced and implemented effectively. This is the case with the approval, regulation and prohibition of certain advanced medical research and technology, especially when they could invoke moral disputes in society. Public policies on organ transplantation, definition of death, euthanasia, genetic screening and diagnosis, and human stem cell research are recent examples. The concept of consensus, however, is elusive, along with the measures to secure it. Technocratic decision making, as a paternalistic activity frequently led by experts, sometimes poses a challenge to democratic decision making, supposedly based on a well-informed and rational public. It also remains to be proved whether public involvement in policymaking can be a solution to ethical value conflicts in society. From the perspective of policy sciences, this paper first introduces the concept of consensus, especially consensus on moral issues in pluralistic societies, and its implications to public policy, including citizen participation in decision making. Then, it briefly explains the historical background with which social consensus and public involvement have increasingly flourished in the field of technology assessments and technology policy making, including biomedical technology. Next, major institutions, governmental and nongovernmental, involved in the ethical aspects of medical research and technology, are presented along with their efforts for citizen participation. Finally, the paper discusses some of the future agendas on this issue.

  8. Towards a Confucian virtue bioethics: reframing Chinese medical ethics in a market economy.

    Science.gov (United States)

    Fan, Ruiping

    2006-01-01

    This essay addresses a moral and cultural challenge facing health care in the People's Republic of China: the need to create an understanding of medical professionalism that recognizes the new economic realities of China and that can maintain the integrity of the medical profession. It examines the rich Confucian resources for bioethics and health care policy by focusing on the Confucian tradition's account of how virtue and human flourishing are compatible with the pursuit of profit. It offers the Confucian account of the division of labor and the financial inequalities this produces with special attention to China's socialist project of creating the profession of barefoot doctors as egalitarian peasant physicians and why this project failed. It then further develops the Confucian acknowledgement of the unequal value of different services and products and how this conflicts with the current system of payment to physicians which has led to the corruption of medical professionalism through illegal supplementary payments. It further gives an account the oblique intentionality of Confucian moral psychology that shows how virtuous persons can pursue benevolent actions while both foreseeing profit and avoiding defining their character by greed. This account of Confucian virtue offers the basis for a medical professionalism that can function morally within a robustly profit-oriented market economy. The paper concludes with a summary of the characteristics of Confucian medical professionalism and of how it places the profit motive within its account of virtue ethics.

  9. Discussion on medical ethics education%刍议医学职业道德教育

    Institute of Scientific and Technical Information of China (English)

    汤召兵

    2012-01-01

    Medical profession is confronted with epidemiology changes,fast innovation in diagnosis and treatment and reform in medical system and management.Therefore,physicians face many new challenges in providing medical and social services.We should enhance doctors' understanding of professional moral,enhance their humanities accomplishment,promote their sense of responsibility,improve their service consciousness and sublimate their values.Meanwhile,we should reiterate the medical professional ethics aiming at boosting the development of medical and health services.%医学职业面临疾病流行病学变化、诊治技术快速革新、医疗体制与管理改革等问题,医师在践行医疗和社会服务时遇到诸多新挑战.应通过加强医师对行业道德的理解、提升其人文修养、增进其责任感、提高其服务意识、升华其价值观等途径,重申医学职业道德,促进医疗卫生事业的发展.

  10. Ethical challenges in the use of social service robots for elderly people.

    Science.gov (United States)

    Körtner, T

    2016-06-01

    Socially assistive robots are increasingly discussed as solutions in care and domestic use for the support of senior adults; however, this raises ethical questions which hitherto have not been considered or were not predictable. The most important questions are those of privacy and data protection, safety and responsibility as well as involvement of vulnerable persons and deception. Consequently, the ethical principles of nonmaleficence, beneficence, autonomy and fairness should be transposed to robotics. Clear answers and solutions are not yet available for every ethical challenge in robotics; however, the development of ethical guidelines for deployment of robots and research in the field of social service robots (SSR) are essential steps in order to embed ethics into dealing with socially assistive robots. This article provides some practical suggestions on this issue from a robotics project.

  11. Big Data Challenges : Society, Security, Innovation and Ethics

    NARCIS (Netherlands)

    Bunnik, Anno; Cawley, Anthony; Mulqueen, Michael; Zwitter, Andrej

    2016-01-01

    This book brings together an impressive range of academic and intelligence professional perspectives to interrogate the social, ethical and security upheavals in a world increasingly driven by data. Written in a clear and accessible style, it offers fresh insights to the deep reaching implications o

  12. Teaching Business Ethics in Hong Kong: Challenges and Response.

    Science.gov (United States)

    McCann, Dennis P.; Lam, Joanna Kit Chun; Chiu, Randy K.

    2001-01-01

    Describes a program for teaching business ethics to undergraduate business students at the Hong Kong Baptist University. Provides an anecdotal account to illustrate that in non-Western cultural contexts, figurative rather than scientific language often captures the essence of qualitative phenomena. Underscores the importance of understanding and…

  13. The Organisational Boundaries of Responsibility: An Ethical Challenge.

    Science.gov (United States)

    Inbar, Dan E.

    1990-01-01

    Summarizes some ethical roots of organizational behavior, clarifies the meaning of responsibility, discusses the importance of motives underlying the assumption of responsibility as a moral action, analyzes four basic behavior theories, and advances a theory of bounded organizational responsibility. Includes 20 references. (MLH)

  14. Ethical Challenges: To Participate or Not to Participate?

    Science.gov (United States)

    Cooksy, Leslie J.

    2006-01-01

    This issue's scenario, To Participate or Not to Participate, describes an evaluator's shift in method from nonparticipant to participant observation. Although evaluation theorists differ on the extent to which methods decisions are ethical decisions (Morris, 1998), neither of the two commentators considers the methodological decision problematic;…

  15. Are Military and Medical Ethics Necessarily Incompatible? A Canadian Case Study.

    Science.gov (United States)

    Rochon, Christiane; Williams-Jones, Bryn

    2016-12-01

    Military physicians are often perceived to be in a position of 'dual loyalty' because they have responsibilities towards their patients but also towards their employer, the military institution. Further, they have to ascribe to and are bound by two distinct codes of ethics (i.e., medical and military), each with its own set of values and duties, that could at first glance be considered to be very different or even incompatible. How, then, can military physicians reconcile these two codes of ethics and their distinct professional/institutional values, and assume their responsibilities towards both their patients and the military institution? To clarify this situation, and to show how such a reconciliation might be possible, we compared the history and content of two national professional codes of ethics: the Defence Ethics of the Canadian Armed Forces and the Code of Ethics of the Canadian Medical Association. Interestingly, even if the medical code is more focused on duties and responsibility while the military code is more focused on core values and is supported by a comprehensive ethical training program, they also have many elements in common. Further, both are based on the same core values of loyalty and integrity, and they are broad in scope but are relatively flexible in application. While there are still important sources of tension between and limits within these two codes of ethics, there are fewer differences than may appear at first glance because the core values and principles of military and medical ethics are not so different.

  16. Let's keep metaphysics out of medical ethics: a critique of Poplawski and Gillett.

    OpenAIRE

    Leavitt, F J

    1992-01-01

    I argue that the concept of 'longitudinal form', which Poplawski and Gillett have introduced into ethical discussions about embryos and gametes, involves too many metaphysical subtleties to be a useful aid to making moral decisions. I conclude by suggesting a criterion for relevance in medical ethics.

  17. Challenges and opportunities for suicide bereavement research: the experience of ethical board review.

    Science.gov (United States)

    Moore, Melinda; Maple, Myfanwy; Mitchell, Ann M; Cerel, Julie

    2013-01-01

    While high-quality and ethically sound research is needed to better understand and respond to the needs of those bereaved by suicide, there is a concern that ethical boards internationally raise unreasonable objections to research with those bereaved by suicide. This pilot study was conducted to examine the issues faced by suicide bereavement and postvention researchers while obtaining ethical board approval. Suicide bereavement and postvention researchers from four continents were surveyed on their experiences of responding to ethical board challenges to research proposals and requests to amend their research as a result of ethical board concerns. While ethical boards differ in their response to suicide bereavement research, eight of 19 researchers surveyed indicated they had had proposals challenged, with two of these eight researchers reporting having to make major changes to their proposals as a result. The researchers provided examples of how they responded to those concerns about perceived risks of their research by ethical board members. There are strict guidelines regarding the treatment of research study participants, and ethical boards must ensure the proposed research procedures adhere to these guidelines. Yet, in the field of suicide bereavement research it would appear that some ethical boards place restrictions or raise concerns about research being conducted in an absence of sound knowledge about the safety of such research. This ultimately may influence the design of research being conducted. Such influence in turn shapes the data generated from the research and thus what is published in the literature. It is both timely and imperative for ethical board members to be well educated on what the risks of those who are bereaved by suicide may be prior to making recommendations on research project designs.

  18. Challenges of Postmodern Thought in Christian Higher Education Institutions: Implications for Ethical Leadership

    Science.gov (United States)

    Darroux, Dean A.

    2013-01-01

    The study investigated the question: What is the process that Christian higher education administrators and faculty members used when understanding the challenges of postmodern thought at the institutions, and what are the challenges for ethical leadership? Utilizing a grounded theory methodology, the researcher sought to develop a theory that…

  19. Challenges of Postmodern Thought in Christian Higher Education Institutions: Implications for Ethical Leadership

    Science.gov (United States)

    Darroux, Dean A.

    2013-01-01

    The study investigated the question: What is the process that Christian higher education administrators and faculty members used when understanding the challenges of postmodern thought at the institutions, and what are the challenges for ethical leadership? Utilizing a grounded theory methodology, the researcher sought to develop a theory that…

  20. Documentation of torture and the Istanbul Protocol: applied medical ethics.

    Science.gov (United States)

    Furtmayr, Holger; Frewer, Andreas

    2010-08-01

    The so-called Istanbul Protocol, a Manual on the Effective Investigation and Documentation of Torture and other Cruel, Inhumane or Degrading Treatment or Punishment was adopted by the United Nations soon after its completion in 1999 and since then has become an acknowledged standard for documenting cases of alleged torture and other forms of severe maltreatment. In 2009 the "Forum for medicine and human rights" at the Medical Faculty at the University Erlangen-Nuremburg has provided the first German edition of this manual. The article traces back the development of the protocol taking into account the general background as well as the factual occasion of its initiation. The main ethical and legal principles of the manual are introduced as well as the projects for implementing the rules provided in the protocol that have been carried out so far. From this the urgent need for implementation of the Istanbul Protocol guidelines also in Europe and in German-speaking countries and here not exclusively but especially within asylum procedures becomes clear.

  1. Authenticity as a foundational principle of medical ethics.

    Science.gov (United States)

    Welie, J V

    1994-01-01

    Increasingly, contemporary medical ethicists have become aware of the need to explicate a foundation for their various models of applied ethics. Many of these theories are inspired by the apparent incompatibility of patient autonomy and provider beneficence. The principle of patient autonomy derives its current primacy to a large extent from its legal origins. However, this principle seems at odds with the clinical reality. In the bioethical literature, the notion of authenticity has been proposed as an alternative foundational principle to autonomy. This article examines this proposal in reference to various existentialist philosophers (Heidegger, Sartre, Camus and Marcel). It is concluded that the principle of autonomy fails to do what it is commonly supposed to do: provide a criterion of distinction that can be invoked to settle moral controversies between patients and providers. The existentialist concept of authenticity is more promising in at least one crucial respect: It acknowledges that the essence of human life disappears from sight if life's temporal character is reduced to a series of present decisions and actions. This also implies that the very quest for a criterion that allows physicians to distinguish between sudden, unexpected decisions of their patients to be or not to be respected, without recourse to the patient's past or future, is erroneous.

  2. Ethical challenges in the management of multiple pregnancies: the professional responsibility model of perinatal ethics.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2013-01-01

    Abstract Ethics is an essential component for the responsible clinical management of multiple gestation and decision-making about such pregnancies with pregnant women. The ethical concept of the fetus as a patient is presented as the basis for identifying a professionally responsible approach to selective termination, twin-to-twin transfusion syndrome, and to discordant beneficence-based obligations that exist when one or more fetuses are adversely affected by a fetal anomaly or complication of pregnancy. The roles for directive counseling, i.e., making evidence-based recommendations, and for non-directive counseling, i.e., offering evidence-based alternatives but making no recommendations, are described. The professional responsibility model of perinatal ethics creates a practical framework to guide the clinical judgment of perinatologists and the informed process about the clinical management of multiple pregnancies.

  3. Ethics teaching in a medical education environment: preferences for diversity of learning and assessment methods

    Science.gov (United States)

    AlMahmoud, Tahra; Hashim, M. Jawad; Elzubeir, Margaret Ann; Branicki, Frank

    2017-01-01

    ABSTRACT Background: Ethics and professionalism are an integral part of medical school curricula; however, medical students’ views on these topics have not been assessed in many countries. Objective: The study aimed to examine medical students’ perceptions toward ethics and professionalism teaching, and its learning and assessment methods. Design: A self-administered questionnaire eliciting views on professionalism and ethics education was distributed to a total of 128 final-year medical students. Results: A total of 108 students completed the survey, with an 84% response rate. Medical students reported frequently encountering ethical conflicts during training but stated only a moderate level of ethics training at medical school (mean = 5.14 ± 1.8). They noted that their education had helped somewhat to deal with ethical conflicts (mean = 5.39 ± 2.0). Students strongly affirmed the importance of ethics education (mean = 7.63 ± 1.03) and endorsed the value of positive role models (mean = 7.45 ± 1.5) as the preferred learning method. The cohort voiced interest in direct faculty supervision as an approach to assessment of knowledge and skills (mean = 7.62 ± 1.26). Female students perceived greater need for more ethics education compared to males (p = Medical students viewed ethics education positively and preferred clinically attuned methods for learning. PMID:28562234

  4. What is it to practise good medical ethics? A Muslim's perspective.

    Science.gov (United States)

    Serour, G I

    2015-01-01

    Good medical ethics should aim at ensuring that all human beings enjoy the highest attainable standard of health. With the development of medical technology and health services, it became necessary to expand the four basic principles of medical ethics and link them to human rights. Despite the claim of the universality of those ethical principles, their perception and application in healthcare services are inevitably influenced by the religious background of the societies in which those services are provided. This paper highlights the methodology and principles employed by Muslim jurists in deriving rulings in the field of medical ethics, and it explains how ethical principles are interpreted through the lens of Islamic theory. The author explains how, as a Muslim obstetrician-gynaecologist with a special interest in medical ethics, including international consideration of reproductive ethics issues, he attempts to 'practise good medical ethics' by applying internationally accepted ethical principles in various healthcare contexts, in ways that are consistent with Islamic principles, and he identifies the evidence supporting his approach. He argues that healthcare providers have a right to respect for their conscientious convictions regarding both undertaking and not undertaking the delivery of lawful procedures. However, he also argues that withholding evidence-based medical services based on the conscientious objection of the healthcare provider is unethical as patients have the right to be referred to services providing such treatment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Ethical Challenges when Interviewing Close Relatives Together – An Integrative Review

    DEFF Research Database (Denmark)

    Voltelen, Barbara; Konradsen, Hanne; Østergaard, Birte

    2015-01-01

    . The purpose of this study is to describe the special ethical perspectives concerning joint interviews with interrelated persons. Method An integrative review was performed. A search was conducted in Pub Med, Cinahl, Philosophers Index and Academic Search from 1980 -2014. Data corpus from the 17 articles...... was analysed using thematic analysis with an inductive approach searching for themes about ethical considerations doing joint interviews. The SPIDER search tool was applied using keywords relatives, ethic, dyadic interview, challenges and qualitative methods created on the basis of relevant pseudonyms, Mesh...

  6. Knowledge and attitudes of doctors on medical ethics in a teaching hospital, Manipur.

    Science.gov (United States)

    Brogen, Akoijam S; Rajkumari, Bishwalata; Laishram, Jalina; Joy, Akoijam

    2009-01-01

    This study aimed to assess the knowledge of and attitudes to, medical ethics among doctors in the Regional Institute of Medical Sciences (RIMS), Imphal, Manipur. It also looked at the association between levels of knowledge and selected variables. A self-administered structured questionnaire was distributed to all doctors working in RIMS, Imphal between September and October 2007. 315 of 440 (71.6%) doctors contacted, responded. 62.2% of respondents (196) were below 35 years of age. 22.5% (71) were faculty members. 98.7% (311) had heard of the Code of Medical Ethics but only 188 (59.7%) had read it, even in part. 69.2% (218) felt that the undergraduate curriculum on medical ethics was not adequate. 10.5% (33) could describe what medical professionalism meant. Knowledge of medical ethics was higher among those who were over 35 years of age, those who graduated before 1999 and those having higher educational qualifications. The doctors in this survey lacked adequate and detailed knowledge on the code of ethics, though most of them had read it once. There is a need to sensitise doctors on medical ethics and professionalism.

  7. Medical ethics and tomorrow's physicians: an aspect of coverage in the formal curriculum.

    Science.gov (United States)

    Al-Umran, Khalid Umran; Al-Shaikh, Basil Abdulrahman; Al-Awary, Bassam Hassan; Al-Rubaish, Abdullah Mohammed; Al-Muhanna, Fahd Abdulaziz

    2006-03-01

    Medical ethics has created contentious issues and requires reforms in medical education such as renewed emphasis on formal instruction. The aim here was to review the current status of bioethics teaching in medical schools, determine Saudi students' perception of its coverage in the formal curriculum and make recommendations. Using a self-administered questionnaire in a cross-sectional study, undergraduate students' opinion about medical ethics coverage was obtained. Fourteen clinical departments and 201 students were studied. Only 46% of respondents were satisfied with the current coverage of ethical issues in the formal curriculum; 23% were unaware of the value of the subject. Students' approval rate was highest in Neurology and Psychiatry (70%). The study confirmed inadequate formal instruction on medical ethics in a developing country. Five recommendations are made. At admission, students' integrity and character should be assessed. Bioethics should be taught in clinical settings. In the Islamic world, medical curricula should include the Islamic code of medical ethics. Peers, nurses and patients should evaluate graduates' performance in ethics at the bedside. Evidence-based assessment and continuous quality improvement are required to maintain the requisite standard.

  8. Medical students′ evaluation of their exposure to the teaching of ethics

    Directory of Open Access Journals (Sweden)

    Ali I Al-Haqwi

    2010-01-01

    Full Text Available Background: The subject of Biomedical Ethics has become recognized as an essential integral component in the undergraduate curriculum of medical students. Objectives: (1 To review the current Biomedical Ethics Course offered at the College of Medicine, King Saud bin Abdul-Aziz University for Health Sciences (KSAU-HS. (2 To explore the perception of medical students on the different components of the course. Materials and Methods: The medical students were requested to participate in the study at the end of the course by filling in a pre-designed questionnaire. A qualitative approach was used also to examine their perceptions about certain components of the course. Results: Forty-one medical students participated in this study. All students expressed their strong agreement on the importance of their learning biomedical ethics. Their views about the role of Biomedical Ethics were also considered. These include professional development, assessment of ethical competencies, and the timing of the teaching of ethics. Conclusion: The students provided valuable comments that were supported by the literature reviews. Medical Students′ views of the teaching of the various components of biomedical ethics are important and should be sought in the planning of a curriculum.

  9. Quality of publication ethics in the instructions to the authors of Iranian journals of medical sciences.

    Science.gov (United States)

    Salamat, Fatemeh; Sobhani, Abdol-Rasoul; Mallaei, Mahin

    2013-03-01

    Providing a perfect instruction to authors can prevent most potential publication ethics errors. This study was conducted to determine the quality of ethical considerations in the instructions to the authors of Iranian research scientific journals of medical sciences (accredited by the Commission for Accreditation and Improvement of Iranian Medical Journals) in October 2011. Checklist items (n=15) were extracted from the national manual of ethics in medical research publications, and the validity of the manual of ethics was assessed. All the accredited Iranian journals of medical sciences (n=198) were entered into the study. The instructions to the authors of 160 accredited Iranian journals were available online and were reviewed. The ANOVA and Kendall Correlation coefficient were performed to analyze the results. A total of 76 (47.5%) of the 160 journals were in English and 84 (52.5%) were in Farsi. The most frequently mentioned items related to publication ethics comprised "commitment not to send manuscripts to other journals and re-publish manuscripts" (85%, 83.8%), "aim and scope" of the journal (81.9%), "principles of medical ethics in the use of human samples" (74.4%), and "review process" (74.4%). On the other hand, the items of "principles of advertising" (1.2%), "authorship criteria" (15%), and "integrity in publication of clinical trial results" (30.6%) were the least frequently mentioned ones. Based on the study findings, the quality of publication ethics, as instructed to the authors, can improve the quality of the journals.

  10. Ethics and professionalism in medical physics: A survey of AAPM members

    Science.gov (United States)

    Ozturk, Naim; Armato, Samuel G.; Giger, Maryellen L.; Serago, Christopher F.; Ross, Lainie F.

    2013-01-01

    Purpose: To assess current education, practices, attitudes, and perceptions pertaining to ethics and professionalism in medical physics. Methods: A link to a web-based survey was distributed to the American Association of Physicists in Medicine (AAPM) e-mail membership list, with a follow-up e-mail sent two weeks later. The survey included questions about ethics/professionalism education, direct personal knowledge of ethically questionable practices in clinical care, research, education (teaching and mentoring), and professionalism, respondents’ assessment of their ability to address ethical/professional dilemmas, and demographics. For analysis, reports of unethical or ethically questionable practices or behaviors by approximately 40% or more of respondents were classified as “frequent.” Results: Partial or complete responses were received from 18% (1394/7708) of AAPM members. Overall, 60% (827/1377) of the respondents stated that they had not received ethics/professionalism education during their medical physics training. Respondents currently in training were more likely to state that they received instruction in ethics/professionalism (80%, 127/159) versus respondents who were post-training (35%, 401/1159). Respondents’ preferred method of instruction in ethics/professionalism was structured periodic discussions involving both faculty and students/trainees. More than 90% (1271/1384) supported continuing education in ethics/professionalism and 75% (1043/1386) stated they would attend ethics/professionalism sessions at professional/scientific meetings. In the research setting, reports about ethically questionable authorship assignment were frequent (approximately 40%) whereas incidents of ethically questionable practices about human subjects protections were quite infrequent (5%). In the clinical setting, there was frequent recollection of incidents regarding lack of training, resources and skills, and error/incident reporting. In the educational setting

  11. Visiting Holocaust-Related Sites with Medical Students as an Aid in Teaching Medical Ethics.

    Science.gov (United States)

    González-López, Esteban; Ríos-Cortés, Rosa

    2016-05-01

    During the Nazi period numerous doctors and nurses played a nefarious role. In Germany they were responsible for the sterilization and killing of disabled persons. Furthermore, the Nazi doctors used concentration camp inmates as guinea pigs in medical experiments for military or racial purposes. A study of the collaboration of doctors with National Socialism exemplifies behavior that must be avoided. Combining medical teaching with lessons from the Holocaust could be a way to transmit Medical Ethics to doctors, nurses and students. The authors describe a study tour with medical students to Poland, to the largest Nazi extermination camp, Auschwitz, and to the city of Krakow. The tour is the final component of a formal course entitled: "The Holocaust, a Reflection from Medicine" at the Autónoma University of Madrid, Spain. Visiting sites related to the Holocaust, the killing centers and the sites where medical experiments were conducted has a singular meaning for medical students. Tolerance, non-discrimination, and the value of human life can be both learnt and taught at the very place where such values were utterly absent.

  12. Ethical challenges of the new economy: An agenda of issues

    OpenAIRE

    Argandoña, Antonio

    2002-01-01

    The new economy is a technological revolution involving the information and communication technologies which affects almost all aspects of the economy, business, and our personal lives. The problems it raises for businesses are not radically new, least of all from an ethical viewpoint. However, they deserve particular attention, especially now, in the first years of the 21st century, when we are feeling the full impact of the changes brought about by this technological revolution. In this art...

  13. The Challenge of Timely, Responsive and Rigorous Ethics Review of Disaster Research: Views of Research Ethics Committee Members

    Science.gov (United States)

    Hunt, Matthew; Tansey, Catherine M.

    2016-01-01

    Background Research conducted following natural disasters such as earthquakes, floods or hurricanes is crucial for improving relief interventions. Such research, however, poses ethical, methodological and logistical challenges for researchers. Oversight of disaster research also poses challenges for research ethics committees (RECs), in part due to the rapid turnaround needed to initiate research after a disaster. Currently, there is limited knowledge available about how RECs respond to and appraise disaster research. To address this knowledge gap, we investigated the experiences of REC members who had reviewed disaster research conducted in low- or middle-income countries. Methods We used interpretive description methodology and conducted in-depth interviews with 15 respondents. Respondents were chairs, members, advisors, or coordinators from 13 RECs, including RECs affiliated with universities, governments, international organizations, a for-profit REC, and an ad hoc committee established during a disaster. Interviews were analyzed inductively using constant comparative techniques. Results Through this process, three elements were identified as characterizing effective and high-quality review: timeliness, responsiveness and rigorousness. To ensure timeliness, many RECs rely on adaptations of review procedures for urgent protocols. Respondents emphasized that responsive review requires awareness of and sensitivity to the particularities of disaster settings and disaster research. Rigorous review was linked with providing careful assessment of ethical considerations related to the research, as well as ensuring independence of the review process. Conclusion Both the frequency of disasters and the conduct of disaster research are on the rise. Ensuring effective and high quality review of disaster research is crucial, yet challenges, including time pressures for urgent protocols, exist for achieving this goal. Adapting standard REC procedures may be necessary. However

  14. The Challenge of Timely, Responsive and Rigorous Ethics Review of Disaster Research: Views of Research Ethics Committee Members.

    Directory of Open Access Journals (Sweden)

    Matthew Hunt

    Full Text Available Research conducted following natural disasters such as earthquakes, floods or hurricanes is crucial for improving relief interventions. Such research, however, poses ethical, methodological and logistical challenges for researchers. Oversight of disaster research also poses challenges for research ethics committees (RECs, in part due to the rapid turnaround needed to initiate research after a disaster. Currently, there is limited knowledge available about how RECs respond to and appraise disaster research. To address this knowledge gap, we investigated the experiences of REC members who had reviewed disaster research conducted in low- or middle-income countries.We used interpretive description methodology and conducted in-depth interviews with 15 respondents. Respondents were chairs, members, advisors, or coordinators from 13 RECs, including RECs affiliated with universities, governments, international organizations, a for-profit REC, and an ad hoc committee established during a disaster. Interviews were analyzed inductively using constant comparative techniques.Through this process, three elements were identified as characterizing effective and high-quality review: timeliness, responsiveness and rigorousness. To ensure timeliness, many RECs rely on adaptations of review procedures for urgent protocols. Respondents emphasized that responsive review requires awareness of and sensitivity to the particularities of disaster settings and disaster research. Rigorous review was linked with providing careful assessment of ethical considerations related to the research, as well as ensuring independence of the review process.Both the frequency of disasters and the conduct of disaster research are on the rise. Ensuring effective and high quality review of disaster research is crucial, yet challenges, including time pressures for urgent protocols, exist for achieving this goal. Adapting standard REC procedures may be necessary. However, steps should be

  15. Medical rescue of naval combat:challenge and future

    Institute of Scientific and Technical Information of China (English)

    Hai Jin; Li-Jun Hou; Xiao-Bing Fu

    2015-01-01

    There has been no large-scale naval combat in the last 30 years. With the rapid development of battleships, weapons manufacturing and electronic technology, naval combat will present some new characteristics. Additionally, naval combat is facing unprecedented challenges. In this paper, we discuss the topic of medical rescue at sea: what chal-lenges we face and what we could do. The contents discussed in this paper contain battlefield self-aid buddy care, clinical skills, organized health services, medical training and future medical research programs. We also discuss the characteristics of modern naval combat, medical rescue challenges, medical treatment highlights and future develop-ments of medical rescue at sea.

  16. Family Counseling and Ethical Challenges with Gay, Lesbian, Bisexual, and Transgendered (GLBT) Clients: More Questions Than Answers.

    Science.gov (United States)

    Janson, Gregory R.; Steigerwald, Fran J.

    2002-01-01

    Gay, lesbian, bisexual, and transgendered (GLBT) persons and their families present unique ethical challenges for marriage and family counselors. A series of brief case vignettes touch on a range of ethical issues for couples and family counselors, including training, supervision, custody evaluation, ethical decision making, counselor bias,…

  17. The medical ethics of Erasmus and the physician-patient relationship.

    Science.gov (United States)

    Albury, W R; Weisz, G M

    2001-06-01

    Desiderius Erasmus set out his views on medical ethics just over 500 years ago. Applying the characteristic approach of Renaissance Humanism, he drew upon a variety of classical sources to develop his own account of medical obligation. Of particular interest is Erasmus's attention to the patient's duties as well as the physician's. By treating this reciprocal relationship as a friendship between extreme unequals, Erasmus was able to maintain the nobility of the medical art and at the same time deal with the culturally sensitive issue of payment for physicians' services. The use of physician-patient reciprocity as a principle of medical ethics has until recently been considered a novel feature of nineteenth-century medical codes. As Erasmus's treatment of physician-patient reciprocity arose from a classical conception of friendship, there may be grounds for reconsidering the role of friendship in other discourses on medical ethics from the Renaissance to the nineteenth century.

  18. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies

    Directory of Open Access Journals (Sweden)

    Haddad PM

    2014-06-01

    Full Text Available Peter M Haddad,1,2 Cecilia Brain,3,4 Jan Scott5,6 1Neuroscience and Psychiatry Unit, University of Manchester, Manchester, 2Greater Manchester West Mental Health NHS Foundation Trust, Salford, UK; 3Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, 4Nå Ut-teamet, Psychosis Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden; 5Academic Psychiatry, Institute of Neuroscience, Newcastle University, 6Centre for Affective Disorders, Institute of Psychiatry, London, UK Abstract: Nonadherence with medication occurs in all chronic medical disorders. It is a particular challenge in schizophrenia due to the illness's association with social isolation, stigma, and comorbid substance misuse, plus the effect of symptom domains on adherence, including positive and negative symptoms, lack of insight, depression, and cognitive impairment. Nonadherence lies on a spectrum, is often covert, and is underestimated by clinicians, but affects more than one third of patients with schizophrenia per annum. It increases the risk of relapse, rehospitalization, and self-harm, increases inpatient costs, and lowers quality of life. It results from multiple patient, clinician, illness, medication, and service factors, but a useful distinction is between intentional and unintentional nonadherence. There is no gold standard approach to the measurement of adherence as all methods have pros and cons. Interventions to improve adherence include psychoeducation and other psychosocial interventions, antipsychotic long-acting injections, electronic reminders, service-based interventions, and financial incentives. These overlap, all have some evidence of effectiveness, and the intervention adopted should be tailored to the individual. Psychosocial interventions that utilize combined approaches seem more effective than unidimensional approaches. There is increasing interest in electronic reminders

  19. Faculty development on professionalism and medical ethics: the design, development and implementation of Objective Structured Teaching Exercises (OSTEs).

    Science.gov (United States)

    Lu, Wei-Hsin; Mylona, Elza; Lane, Susan; Wertheim, William A; Baldelli, Perrilynn; Williams, Peter C

    2014-10-01

    As students are expected to develop competency in professionalism and medical ethics, faculty are also expected to facilitate medical students' learning and understanding of these areas. One of the main challenges to success in this domain has been uncertainty of whether or not faculty know the content and the methods to teach and assess these competencies. We used the Objective Structured Teaching Exercise (OSTE) format as a faculty development tool to train and evaluate faculty on how to teach professionalism and medical ethics to students in clinical settings. The process for the design, development and implementation of OSTEs consisted of five phases: (1) performing a literature review and student needs assessment, (2) developing the OSTE cases and performance checklists, (3) recruiting and training of standardized students, (4) conducting a mock training session and (5) organizing faculty development workshops using OSTEs. Twenty clinical faculty members participated in one of three half-day OSTE workshops offered. Faculty confidence and attitudes about teaching professionalism increased significantly (p teaching medical students, the information and skills they learned from the workshop are important to them as clinical educators, and that the information and skills will likely have an impact on the way they teach professionalism and ethics in the future.

  20. Awareness of ethical issues in medical education: an interactive teach-the-teacher course

    Directory of Open Access Journals (Sweden)

    Chiapponi, Costanza

    2016-05-01

    Full Text Available Purpose: We conducted an international, interdisciplinary teach-the-teacher course to sensitize physicians from different countries to ethical issues in medical education. The purpose of this study was to assess the effects of this course.Method: Before and after participating in a short session on ethical issues in medical education, 97 physicians from different countries in Africa, Asia, and Europe completed a self-assessment questionnaire on their competence and interest in this field. The short session consisted of working in small groups to identify, analyze and discuss ethical dilemmas described in case vignettes adapted from published examples or written by medical students. In addition to the questionnaire, we conducted a large-group experience to explore four basic orientations of participants in ethical thinking: relativism, intentionalism, consequentialism, and absolutism.Results: We found a significant self-perceived increase in the participants’ ability to identify and describe ethical issues and students’ dilemmas, in their knowledge about these issues and teaching professionalism, and in their ability to describe both students’ perspectives and teachers’ and students’ behaviors. In addition, participants’ feeling of understanding their own culturally learned patterns of determining what is right and wrong increased after taking part in the course. The four contrasting basic ethical orientations showed no significant differences between participants regarding nationality, age, or gender. Conclusion: Ethics of education is an important issue for medical teachers. Teachers’ self-perceived competence can be increased by working on case vignettes in small groups.

  1. The Stories We Tell: Introduction to the Special Issue on Ethical Challenges in Community Psychology Research and Practice.

    Science.gov (United States)

    Campbell, Rebecca; Morris, Michael

    2017-09-18

    This Special Issue examines ethical challenges in community psychology research and practice. The literature on ethics in community psychology has remained largely abstract and aspirational, with few concrete examples and case studies, so the goal of this Special Issue was to expand our written discourse about ethical dilemmas in our field. In these articles, researchers and practitioners share stories of specific ethical challenges they faced and how they sought to resolve them. These first-person narratives examine how ethical challenges come about, how community psychology values inform ethical decision making, and how lessons learned from these experiences can inform an ethical framework for community psychology. © Society for Community Research and Action 2017.

  2. Palliative sedation : not just normal medical practice. Ethical reflections on the Royal Dutch Medical Association's guideline on palliative sedation

    NARCIS (Netherlands)

    Janssens, Rien; van Delden, Johannes J. M.; Widdershoven, Guy A. M.

    2012-01-01

    The main premise of the Royal Dutch Medical Association's (RDMA) guideline on palliative sedation is that palliative sedation, contrary to euthanasia, is normal medical practice. Although we do not deny the ethical distinctions between euthanasia and palliative sedation, we will critically analyse t

  3. Palliative sedation : not just normal medical practice. Ethical reflections on the Royal Dutch Medical Association's guideline on palliative sedation

    NARCIS (Netherlands)

    Janssens, Rien; van Delden, Johannes J. M.; Widdershoven, Guy A. M.

    2012-01-01

    The main premise of the Royal Dutch Medical Association's (RDMA) guideline on palliative sedation is that palliative sedation, contrary to euthanasia, is normal medical practice. Although we do not deny the ethical distinctions between euthanasia and palliative sedation, we will critically analyse t

  4. [The vegetarian appeal and killing animals. An ethical challenge].

    Science.gov (United States)

    Luy, J; Hildebrandt, G; von Mickwitz, G

    2001-01-01

    The demand for renunciation of killing animals has already been discussed by mankind since ancient times. Many arguments for and against this demand have accumulated in the meantime. The reproaches of the vegetarians repeatedly forced the ones who eat meat to justify their diet. Today most of these historical justifications however have to be rejected because of lacking plausibility. Many of the vegetarian arguments on the other hand must be rejected for similar reasons as well. Remaining as morally convincing is the demand for doing the killing absolutely painless and without frightening the animals, which was already formulated for example by Kant and Schopenhauer. Arguments which consider this way of killing as still immoral belong in a broad sense to the "anthropocentric" animal ethics. They do not belong to what is called in Germany "pathocentric" animal ethics, because an animal that is killed without being frightened or tortured, has not suffered, for it hasn't consciously realized anything like danger or harm. We do even argue that these animals are not harmed at all, because it seems senseless to talk about harm without negative conscious phenomena. To push ahead a ban on animal slaughter for moral reasons could be itself morally wrong because it would disturb indirectly many people's conscious well-being without being justified by protecting an animal's conscious well-being. It is however possible to derive from a general duty not to make animals suffer (pathocentric animal ethics) a duty to boycott food of animal origin if these animals had to suffer during their lives.

  5. [Living donors for kidney transplantation: ethical and legal challenges].

    Science.gov (United States)

    Mamzer-Bruneel, Marie-France; Fournier, Catherine; Legendre, Christophe

    2010-05-01

    Living donor kidney transplantation has developed very heterogeneously worldwide despite excellent results and without taking into account the context of global organ shortage. Such a heterogeneity highlights persistent ethical issues, whereas organ trafficking is emerging as an organized transplant tourism reinforcing the need for strong national legal frameworks. Despite its powerful regulation system, which ensures standardization, transparency and accountability of support for donation, France remains reluctant to enlarge the circle of legal donors, whereas it would be the first step to give a greater role to living organ donation.

  6. Eloquent Brain, Ethical Challenges: Functional Brain Mapping in Neurosurgery.

    Science.gov (United States)

    Klein, Eran

    2015-06-01

    Functional brain mapping is an increasingly relied upon tool in presurgical planning and intraoperative decision making. Mapping allows personalization of structure-function relationships when surgical or other treatment of pathology puts eloquent functioning like language or vision at risk. As an innovative technology, functional brain mapping holds great promise but also raises important ethical questions. In this article, recent work in neuroethics on functional imaging and functional neurosurgery is explored and applied to functional brain mapping. Specific topics discussed in this article are incidental findings, responsible innovation, and informed consent.

  7. Walter Lippmann’s Ethical Challenge to the Individual

    Directory of Open Access Journals (Sweden)

    Steve Urbanski

    2012-01-01

    Full Text Available This essay analyzes in hermeneutic fashion random concepts of the individual from three of philosopher Walter Lippmann’s major works, Liberty and the News, Public Opinion, and The Phantom Public. The article addresses the following: By considering Lippmann’s multileveled representation of the individual, 21st-century media professionals can become empowered to avoid emotivism and strive toward a more narrative-based form of ethics. The article compares and contrasts Lippmann’s representation of the individual with John Dewey’s Great Community and Daniel Boorstin’s notion of the pseudo-event.

  8. Paradigm shift, metamorphosis of medical ethics, and the rise of bioethics.

    Science.gov (United States)

    Almeida, J L; Schramm, F R

    1999-01-01

    Both the increasing incorporation of medical technology and new social demands (including those for health care) beginning in the 1960s have brought about significant changes in medical practice. This situation has in turn sparked a growth in the philosophical debate over problems pertaining to ethical practice. These issues no longer find answers in the Hippocratic ethical model. The authors believe that the crisis in Hippocratic ethics could be described as a period of paradigm shift in which a new set of values appears to be emerging. Beginning with the bioethics movement, the authors expound on the different ethical theories applied to medical practice and conclude that principlism is the most appropriate approach for solving the new moral dilemma imposed on clinical practice.

  9. Paradigm shift, metamorphosis of medical ethics, and the rise of bioethics

    Directory of Open Access Journals (Sweden)

    José Luiz Telles de Almeida

    Full Text Available Both the increasing incorporation of medical technology and new social demands (including those for health care beginning in the 1960s have brought about significant changes in medical practice. This situation has in turn sparked a growth in the philosophical debate over problems pertaining to ethical practice. These issues no longer find answers in the Hippocratic ethical model. The authors believe that the crisis in Hippocratic ethics could be described as a period of paradigm shift in which a new set of values appears to be emerging. Beginning with the bioethics movement, the authors expound on the different ethical theories applied to medical practice and conclude that principlism is the most appropriate approach for solving the new moral dilemma imposed on clinical practice.

  10. Paradigm shift, metamorphosis of medical ethics, and the rise of bioethics

    Directory of Open Access Journals (Sweden)

    Almeida José Luiz Telles de

    1999-01-01

    Full Text Available Both the increasing incorporation of medical technology and new social demands (including those for health care beginning in the 1960s have brought about significant changes in medical practice. This situation has in turn sparked a growth in the philosophical debate over problems pertaining to ethical practice. These issues no longer find answers in the Hippocratic ethical model. The authors believe that the crisis in Hippocratic ethics could be described as a period of paradigm shift in which a new set of values appears to be emerging. Beginning with the bioethics movement, the authors expound on the different ethical theories applied to medical practice and conclude that principlism is the most appropriate approach for solving the new moral dilemma imposed on clinical practice.

  11. Teaching and evaluation methods of medical ethics in the Saudi public medical colleges: cross-sectional questionnaire study.

    Science.gov (United States)

    Alkabba, Abdulaziz F; Hussein, Ghaiath M A; Kasule, Omar H; Jarallah, Jamal; Alrukban, Mohamed; Alrashid, Abdulaziz

    2013-09-10

    Saudi Arabia is considered one of the most influential Muslim countries being as the host of the two most holy places for Muslims, namely Makkah and Madina. This was reflected in the emphasis on teaching medical ethics in a lecture-based format as a part of the subject of Islamic culture taught to medical students. Over the last few years, both teaching and evaluation of medical ethics have been changing as more Saudi academics received specialized training and qualifications in bioethics from western universities. This study aims at studying the current teaching methods and evaluation tools used by the Saudi public medical schools. It is done using a self-administered online questionnaire. Out of the 14 medical schools that responded, the majority of the responding schools (6; 42.8%), had no ethics departments; but all schools had a curriculum dedicated to medical ethics. These curricula were mostly developed by the faculty staff (12; 85.7%). The most popular teaching method was lecturing (13; 92.8%). The most popular form of student assessment was a paper-based final examination (6; 42.8%) at the end of the course that was allocated 40% or more of the total grade of the ethics course. Six schools (42.8%) allocated 15-30% of the total grade to research. Although there is a growing interest and commitment in teaching ethics to medical students in Saudi schools; there is lack of standardization in teaching and evaluation methods. There is a need for a national body to provide guidance for the medical schools to harmonize the teaching methods, particularly introducing more interactive and students-engaging methods on the account of passive lecturing.

  12. Teaching and evaluation methods of medical ethics in the Saudi public medical colleges: cross-sectional questionnaire study

    Science.gov (United States)

    2013-01-01

    Background Saudi Arabia is considered one of the most influential Muslim countries being as the host of the two most holy places for Muslims, namely Makkah and Madina. This was reflected in the emphasis on teaching medical ethics in a lecture-based format as a part of the subject of Islamic culture taught to medical students. Over the last few years, both teaching and evaluation of medical ethics have been changing as more Saudi academics received specialized training and qualifications in bioethics from western universities. Methods This study aims at studying the current teaching methods and evaluation tools used by the Saudi public medical schools. It is done using a self-administered online questionnaire. Results Out of the 14 medical schools that responded, the majority of the responding schools (6; 42.8%), had no ethics departments; but all schools had a curriculum dedicated to medical ethics. These curricula were mostly developed by the faculty staff (12; 85.7%). The most popular teaching method was lecturing (13; 92.8%). The most popular form of student assessment was a paper-based final examination (6; 42.8%) at the end of the course that was allocated 40% or more of the total grade of the ethics course. Six schools (42.8%) allocated 15-30% of the total grade to research. Conclusion Although there is a growing interest and commitment in teaching ethics to medical students in Saudi schools; there is lack of standardization in teaching and evaluation methods. There is a need for a national body to provide guidance for the medical schools to harmonize the teaching methods, particularly introducing more interactive and students-engaging methods on the account of passive lecturing. PMID:24020917

  13. Promoting social responsibility amongst health care users: medical tourists’ perspectives on an information sheet regarding ethical concerns in medical tourism

    Science.gov (United States)

    2013-01-01

    Background Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism. Results According to feedback provided in interviews with former Canadian medical tourists, the majority of participants responded positively to the information sheet and indicated that this document prompted them to engage in further consideration of these issues. Participants indicated some frustration after reading the information sheet regarding a lack of know-how in terms of learning more about the concerns discussed in the document and changing their decision-making. This frustration was due to participants’ desperation for medical care, a topic which participants frequently discussed regarding ethical concerns related to health care provision. Conclusions The overall perceptions of former medical tourists indicate that an information sheet may promote further consideration of ethical concerns of medical tourism. However, given that these interviews were performed with former medical tourists, it remains unknown whether such a document might impact upon the decision-making of prospective medical tourists. Furthermore, participants indicated a need for an additional tool such as a website for continued discussion about these concerns. As such, along with dissemination of the information sheet

  14. Promoting social responsibility amongst health care users: medical tourists' perspectives on an information sheet regarding ethical concerns in medical tourism.

    Science.gov (United States)

    Adams, Krystyna; Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory

    2013-12-06

    Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism. According to feedback provided in interviews with former Canadian medical tourists, the majority of participants responded positively to the information sheet and indicated that this document prompted them to engage in further consideration of these issues. Participants indicated some frustration after reading the information sheet regarding a lack of know-how in terms of learning more about the concerns discussed in the document and changing their decision-making. This frustration was due to participants' desperation for medical care, a topic which participants frequently discussed regarding ethical concerns related to health care provision. The overall perceptions of former medical tourists indicate that an information sheet may promote further consideration of ethical concerns of medical tourism. However, given that these interviews were performed with former medical tourists, it remains unknown whether such a document might impact upon the decision-making of prospective medical tourists. Furthermore, participants indicated a need for an additional tool such as a website for continued discussion about these concerns. As such, along with dissemination of the information sheet, future research implications should

  15. Ethics teaching on 'Beginning of Life' issues in UK medical schools.

    Science.gov (United States)

    Oldroyd, Christopher; Fialova, Lydie

    2014-12-01

    Medical ethics forms an essential component of an undergraduate medical programme. In the UK the Institute of Medical Ethics has released a consensus statement detailing its recommendations for a minimum curriculum for ethics. One important issue it highlights for inclusion is 'Beginning of Life', which includes a wide range of themes. This paper presents an evaluation of the current teaching and assessment of these important issues in UK medical schools, complemented by a specific analysis of students' reaction to the teaching they received at the University of Edinburgh as part of their Obstetrics and Gynaecology rotation. Schools which responded to the survey reported a wide range of teaching and assessment methods. While there was a good overall coverage of topics, only one of them was covered by every institution and the religious/cultural elements of those topics were often neglected. The medical schools viewed better clinical integration of ethics teaching as the best route to improvement, but the students reported a desire for more ethics teaching in the form of specific tutorials, lectures or discussions. It is likely that a combination of these approaches will lead to significant improvements in the delivery of ethics teaching in this area and in others.

  16. Facebook’s Emotional Contagion Experiment as a Challenge to Research Ethics

    Directory of Open Access Journals (Sweden)

    Jukka Jouhki

    2016-10-01

    Full Text Available This article analyzes the ethical discussion focusing on the Facebook emotional contagion experiment published by the Proceedings of the National Academy of Sciences in 2014. The massive-scale experiment manipulated the News Feeds of a large amount of Facebook users and was successful in proving that emotional contagion happens also in online environments. However, the experiment caused ethical concerns within and outside academia mainly for two intertwined reasons, the first revolving around the idea of research as manipulation, and the second focusing on the problematic definition of informed consent. The article concurs with recent research that the era of social media and big data research are posing a significant challenge to research ethics, the practice and views of which are grounded in the pre social media era, and reflect the classical ethical stances of utilitarianism and deontology.

  17. Facebook’s Emotional Contagion Experiment as a Challenge to Research Ethics

    Directory of Open Access Journals (Sweden)

    Jukka Jouhki

    2016-10-01

    Full Text Available This article analyzes the ethical discussion focusing on the Facebook emotional contagion experiment published by the Proceedings of the National Academy of Sciences in 2014. The massive-scale experiment manipulated the News Feeds of a large amount of Facebook users and was successful in proving that emotional contagion happens also in online environments. However, the experiment caused ethical concerns within and outside academia mainly for two intertwined reasons, the first revolving around the idea of research as manipulation, and the second focusing on the problematic definition of informed consent. The article concurs with recent research that the era of social media and big data research are posing a significant challenge to research ethics, the practice and views of which are grounded in the pre social media era, and reflect the classical ethical stances of utilitarianism and deontology.

  18. Ethical and regulatory challenges posed by synthetic biology.

    Science.gov (United States)

    Rager-Zisman, Bracha

    2012-01-01

    Synthetic biology is a relatively new science with tremendous potential to change how we view and know the life sciences, but like many developing technologies, it has provoked ethical concerns from the scientific community and the public and confronts demands for new regulatory measures. The concerns raised involve the danger of "dual use," in which results for improving human well-being and the environment may be misappropriated for bioterror. To counteract these dangers, many governments, but the United States and Israel in particular, have introduced new laws and redoubled measures for biosafety and biosecurity. In the United States, the recent H5N1 results achieved by two groups of NIH-funded investigators highlighted the dilemma of balancing the risk of dual-use research and the freedom of science. In Israel, concern for unconventional terrorism is long-standing, and the country is constantly engaged in improving biosecurity and biodefense measures. In 2008, the Israeli parliament passed the Regulation of Research into Biological Disease Agents Law, a legislative framework for safeguarding research into biological disease agents. This article summarizes and analyzes the current state of affairs in the United States and Israel, ethical attitudes, and regulatory responses to synthetic biology.

  19. [Problems and ethical challenges in public health communication].

    Science.gov (United States)

    Loss, J; Nagel, E

    2009-05-01

    Health communication, e.g., mass media campaigns, patient information leaflets or websites, plays an important role in public health. It contributes to citizen empowerment and helps them make informed decisions in health matters. However, public health communication can lead to adverse effects on both individual and societal level, e.g., by inaccurate or partial information, discriminatory messages, scandalizing coverage or inadequate tailoring to relevant target groups. It seems important to suggest ethical criteria for health information, e.g., (1) accuracy, completeness and balance, (2) transparency, (3) participation of the target group, (4) respect for human dignity, (5) social justice and equity, (6) appropriateness. Thoughtfulness is important in order not to stigmatize population subgroups. In addition, it is laborious to comprehensively and correctly present benefits and risks of a certain health behavior. Marketing principles guide how to 'sell' a certain health behavior, but health campaigns should not manipulate target persons for the sake of a population health aim. It remains unclear, however, how the different providers of health information can be held ethically responsible.

  20. The patient-centered medical home: an ethical analysis of principles and practice.

    Science.gov (United States)

    Braddock, Clarence H; Snyder, Lois; Neubauer, Richard L; Fischer, Gary S

    2013-01-01

    The patient-centered medical home (PCMH), with its focus on patient-centered care, holds promise as a way to reinvigorate the primary care of patients and as a necessary component of health care reform. While its tenets have been the subject of review, the ethical dimensions of the PCMH have not been fully explored. Consideration of the ethical foundations for the core principles of the PCMH can and should be part of the debate concerning its merits. The PCMH can align with the principles of medical ethics and potentially strengthen the patient-physician relationship and aspects of health care that patients value. Patient choice and these ethical considerations are central and at least as important as the economic and practical arguments in support of the PCMH, if not more so. Further, the ethical principles that support key concepts of the PCMH have implications for the design and implementation of the PCMH. This paper explores the PCMH in light of core principles of ethics and professionalism, with an emphasis both on how the concept of the PCMH may reinforce core ethical principles of medical practice and on further implications of these principles.

  1. Perspectives on Applied Ethics

    OpenAIRE

    2007-01-01

    Applied ethics is a growing, interdisciplinary field dealing with ethical problems in different areas of society. It includes for instance social and political ethics, computer ethics, medical ethics, bioethics, envi-ronmental ethics, business ethics, and it also relates to different forms of professional ethics. From the perspective of ethics, applied ethics is a specialisation in one area of ethics. From the perspective of social practice applying eth-ics is to focus on ethical aspects and ...

  2. Bridging problems and models in medical ethics: four images of local ethics committees.

    Science.gov (United States)

    Incorvati, G

    In the context of the continuing debate about how ethics committees in Italy should be structured (see Bulletin 160) Professor Incorvati, from the Comitato Nazionale per la Bioetica in Rome, considers four theoretical models of how such committees may be arranged, and why one in particular looks better placed to face the growing ethical problems that are emerging as a result of current developments in medicine.

  3. The Council for International Organizations and Medical Sciences (CIOMS) guidelines on ethics of clinical trials.

    Science.gov (United States)

    Macrae, Duncan J

    2007-05-01

    Numerous bodies from many countries, including governments, government regulatory departments, research organizations, medical professional bodies, and health care providers, have issued guidance or legislation on the ethical conduct of clinical trials. It is possible to trace the development of current guidelines back to the post-World War II Nuremburg war crimes trials, more specifically the "Doctors' Trial." From that trial emerged the Nuremburg Code, which set out basic principles to be observed when conducting research involving human subjects and which subsequently formed the basis for comprehensive international guidelines on medical research, such as the Declaration of Helsinki. Most recently, the Council for International Organizations and Medical Sciences (CIOMS) produced detailed guidelines (originally published in 1993 and updated in 2002) on the implementation of the principles outlined in the Declaration of Helsinki. The CIOMS guidelines set in an appropriate context the challenges of present-day clinical research, by addressing complex issues including HIV/AIDS research, availability of study treatments after a study ends, women as research subjects, safeguarding confidentiality, compensation for adverse events, as well guidelines on consent.

  4. On-the-Job Ethics – Proximity Morality Forming in Medical School: A grounded theory analysis using survey data

    Directory of Open Access Journals (Sweden)

    Hans O. Thulesius, MD, Ph.D.

    2009-03-01

    Full Text Available On-the-job-ethics exist in all businesses and can also be called proximity morality forming. In this paper we propose that medical students take a proximity morality stance towards ethics education at medical school. This means that they want to form physician morality “on the job” instead of being taught ethics like any other subject. On-the-job-ethics for medical students involves learning ethics that is used when practicing ethics. Learning ethics includes comprehensive ethics courses in which quality lectures provide ethics grammar useful for the ethics practicing in attitude exercises and vignette reflections in tutored group discussions. On-the-job-ethics develops professional identity, handles diversity of religious and existential worldviews, trains students described as ethically naive, processes difficult clinical experiences, and desists negative role modeling from physicians in clinical or teaching situations. This grounded theory analysis was made from a questionnaire survey on attitudes to ethics education with 409 Swedish medical students participating. We analyzed over 8000 words of open-ended responses and multiplechoice questions using classic grounded theory procedures, but also compared questionnaire data using statistics such as multiple regression models. The paper gives an example of how grounded theory can be used with a limited amount of survey data.

  5. Sport Ethics. The challenges of 21st century sport.

    Directory of Open Access Journals (Sweden)

    2016-04-01

    Full Text Available La filosofía del deporte, al igual que la pedagogía, la historia y otros estudios humanísticos alrededor del fenómeno deportivo, ha permanecido tradicionalmente en un segundo plano en facultades e instituciones educativas, incluso en aquellas cuyo fin es, precisamente, comprender adecuadamente cómo y por qué jugamos del modo que lo hacemos y con qué finalidades (Kretchmar, 2005. En una reciente editorial de la revista Sport, Ethics and Philosophy, Michael McNamee (2015 hace un repaso de la actualidad, exponiendo cómo a pesar de que la disciplina no para de crecer y ganar protagonismo, sobre todo en el ámbito editorial, no acaba de hacerse el hueco pertinente en la academia. 

  6. The impaired practitioner - scope of the problem and ethical challenges.

    Science.gov (United States)

    Dhai, A; Szabo, C P; McQuoid-Mason, D J

    2006-10-01

    Practitioner impairment occurs when a physical, mental or substance-related disorder interferes with his or her ability to engage in professional activities competently and safely. The Health Professions Council of South Africa makes reporting of impaired colleagues and students mandatory. The ethical dilemma faced by many colleagues on the issue of reporting an impaired practitioner is that of having to choose between protecting the privacy of the practitioner and the safety of patients. However, medicine as a profession with an acknowledged fiduciary relationship has a clear responsibility to assure the public, and all patients, that its practitioners and institutions are trustworthy. An awareness of and sensitivity to physician vulnerability and early detection and prevention of impairment is important.

  7. The Development Study of a Medical Ethics Education Program by Using Simple ISD Model.

    Science.gov (United States)

    Kim, Young Jon; Yoo, Hyoo Hyun; Joo, Chan Uhng

    2011-09-01

    Simple instructional systems design (ISD) model is based on a fast development, usability test, and continuos feedback, which are necessary for educational program development in medical school. This study aims to figure out the usability of Simple ISD model for a medical ethics education program by describing a developmental details of each phase and its evaluation results. Research has been conducted in two steps. First, while researchers participated in the program development by using Simple ISD model, we collected empirical data of each development activities. Second, the developed program was evaluated by students' web-based usability test, a 8-students' focus group interview and 5 faculty members' individual interviews in 4 domains; learning contents, instructional methods and strategies, achievement evaluation, and self-evaluation. Following the circular process of analysis, design, development, and usability test of Simple ISD model, a 10-week medical ethics program covering 9 instructional topics was developed. The average points of response on the developed medical ethics program in 2008 and 2009 are increased from 3.96 to 4.59 and 4.41, respectively. The prospects and limitations of the program are discussed. From a development study of the medical ethics program by using Simple ISD model, we could implement a more usable medical ethics program, and found 4 different usability of the Simple ISD model; the rapid development of educational program, program improvement by continuous feedback, faculty members' engagement in instructional design, and professional development of the faculty members.

  8. The patient/client/consumer/service user and medical ethics 40 years on.

    Science.gov (United States)

    Neuberger, Julia

    2015-01-01

    This essay, written from my non-doctor's 'lay' perspective, sketches a gradually improving approach to medical ethics over the 40-year period since this journal was founded. A central feature of this improvement has been the increasing focus of medical ethics on the interests and perspectives of the patients/clients/consumers/service users, whose interests doctors and other healthcare workers serve. Events such as misuse of the end of life 'Liverpool Care Pathway' and the shockingly poor care revealed in National Health Service hospitals in Mid-Staffordshire show that these improvements are by no means universal. Nonetheless, there has been a steady improvement in general terms towards putting patients first and it is not flattery to say that in its consistent support for this concern and in its promotion of non-medical involvement in medical ethics education the Journal of Medical Ethics has itself made a significant contribution to 'doing good medical ethics'. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. A syllabus for Jewish medical ethics in the context of general bioethics.

    Science.gov (United States)

    Gesundheit, Benjamin; Shaham, Dorith

    2008-05-01

    Since the beginning of medical history, ethics has interested medical practitioners. The subject has become particularly important in recent years due to the huge advancements in medicine and medical technology and has elicited much public interest. While international ethical principles and guidelines have been established, classical Jewish tradition has always placed great emphasis on bioethics. Prof. Avraham Steinberg's monumental Encyclopedia of Jewish Medical Ethics presents the subject comprehensively and in depth. We propose a bioethics syllabus, to be integrated into the medical curriculum in three stages: i) preclinical - covering basic ethical concepts and principles, relevant history, and ethical codes; ii) clinical - covering bioethical topics relating to the human life cycle; iii) prior to students' final examinations and further specialization - covering bioethical topics relating to their personal interests. Steinberg's Encyclopedia is an ideal basis for the development of a professional course, including Jewish traditional aspects. Such a course would provide future physicians with a varied cultural and intercultural background, help shape their image, and improve the quality of medical care.

  10. Building a Privacy, Ethics, and Data Access Framework for Real World Computerised Medical Record System Data: A Delphi Study. Contribution of the Primary Health Care Informatics Working Group.

    Science.gov (United States)

    Liyanage, H; Liaw, S-T; Di Iorio, C T; Kuziemsky, C; Schreiber, R; Terry, A L; de Lusignan, S

    2016-11-10

    Privacy, ethics, and data access issues pose significant challenges to the timely delivery of health research. Whilst the fundamental drivers to ensure that data access is ethical and satisfies privacy requirements are similar, they are often dealt with in varying ways by different approval processes. To achieve a consensus across an international panel of health care and informatics professionals on an integrated set of privacy and ethics principles that could accelerate health data access in data-driven health research projects. A three-round consensus development process was used. In round one, we developed a baseline framework for privacy, ethics, and data access based on a review of existing literature in the health, informatics, and policy domains. This was further developed using a two-round Delphi consensus building process involving 20 experts who were members of the International Medical Informatics Association (IMIA) and European Federation of Medical Informatics (EFMI) Primary Health Care Informatics Working Groups. To achieve consensus we required an extended Delphi process. The first round involved feedback on and development of the baseline framework. This consisted of four components: (1) ethical principles, (2) ethical guidance questions, (3) privacy and data access principles, and (4) privacy and data access guidance questions. Round two developed consensus in key areas of the revised framework, allowing the building of a newly, more detailed and descriptive framework. In the final round panel experts expressed their opinions, either as agreements or disagreements, on the ethics and privacy statements of the framework finding some of the previous round disagreements to be surprising in view of established ethical principles. This study develops a framework for an integrated approach to ethics and privacy. Privacy breech risk should not be considered in isolation but instead balanced by potential ethical benefit.

  11. Ethics and deontology of medical education and nurses in Portugual

    Directory of Open Access Journals (Sweden)

    Clara Costa Oliveira

    2012-01-01

    Full Text Available This article discusses deontological issues of health care professions in relation to their ethical foundation. We present four models of teaching ethics and deontology in doctors’ training and the results of a PhD research on the teaching of these subjects in nurses’ training in Portugal. Given the importance of bioethics in deontological training of health care professions, we present a comparative analysis of. bioethical principles enunciated by Beauchamp and Childress (1979, related to ‘ethics of justice’, and Kemp’s(2000 proposal, associated to an ‘ethics of care’. Given the ambiguity of these bioethical expressions, we focus on the analysis of its contents and the need to discuss the fundamentals of ethical training of doctors and nurses in relation to the ethical theories they are derived from. Utilitarian ethics, duty ethics, virtue ethics, when the analysis of bioethics’ fundaments is not trained, the duty of caring of suffering can be put at risk.Abstract Abordaremos a deontologia de profissões de saúde (médicos e enfermeiros, relacionando-a com os seus fundamentos éticos. Apresentamos quatro modelos de ensino da ética e deontologia na formação dos médicos, e os resultados da pesquisa de doutorado sobre o ensino dessas disciplinas na formação de enfermeiros em Portugal. Dada a importância da bioética na formação desses profissionais, explicitam-se duas orientações fundamentais neste campo: os princípios bioéticos enunciados por Beauchamp e Childress(1979, relacionados com uma ‘ética da justiça’, e a proposta de Kemp(2000, próxima de uma ‘ética do cuidado’. Dada a ambiguidade dos termos ‘ética da justiça’ e ‘ética do cuidado’, detemo-nos na análise de seu conteúdo e na necessidade de discutir os fundamentos da formação ética de médicos e enfermeiros, reportando-os às concepções éticas de que se derivam: ética utilitarista, ética do dever, ética da virtude. Indicaremos

  12. An "Ethics of Resistance" Challenges Taken-for-Granted Ideas in Swedish Early Childhood Education

    Science.gov (United States)

    Taguchi, Hillevi Lenz

    2008-01-01

    In the present action-research project, three teachers and the researcher engaged in a series of meetings to analyze children's drawings from several different theoretical perspectives, or "readings." Using two interrelated processes, deconstructive talks and an ethic of resistance, the teachers purposefully sought to recognize and challenge the…

  13. Stakeholders' views on the ethical challenges of pragmatic trials investigating pharmaceutical drugs

    NARCIS (Netherlands)

    Kalkman, S; van Thiel, Ghislaine J M W; Grobbee, Diederick E.; Meinecke, Anna Katharina; Zuidgeest, Mira G P; van Delden, Johannes J M

    2016-01-01

    Background: We explored the views of key stakeholders to identify the ethical challenges of pragmatic trials investigating pharmaceutical drugs. A secondary aim was to capture stakeholders' attitudes towards the implementation of pragmatic trials in the drug development process. Methods: We conducte

  14. Seeing through Medical Ethics: A Request for Professional Transparency and Accountability

    Science.gov (United States)

    Connor, J. T. H.

    2016-01-01

    This essay is a critique of medical/clinical ethics from the personal perspective of a medical historian in an academic health science centre who has interacted with ethicists. It calls for greater transparency and accountability of ethicists involved in "bedside consulting"; it questions the wisdom of the four principles of biomedical…

  15. Enhancing research ethics capacity in the Middle East: experience and challenges of a Fogarty-sponsored training program.

    Science.gov (United States)

    Silverman, Henry; Edwards, Hillary; Shamoo, Adil; Matar, Amal

    2013-12-01

    We describe the research ethics capacity needs of the countries from the Middle East region. Against this background, we relate the experience of an international training program focused on providing long-term training in research ethics to individuals from low and middle-income countries in the Middle East area. We describe our pedagogical approach to training, program changes to address challenges faced, and accomplishments of trainees. Many former trainees developed research ethics curricula in their home institutions, established or enhanced their institutions' research ethics committees, provided leadership to national research ethics systems, and conducted research in research ethics. Based on our analysis, we make recommendations for how trainees can further address current regional research ethics needs in the Middle East and conduct future research. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education and Curriculum Development program.

  16. Medical Tourism in Malaysia: Prospect and Challenges.

    Science.gov (United States)

    Sarwar, Abdullah

    2013-08-01

    Tourism, combined with the phrase medical, seems to be a new form of tourism which has gained huge popularity in recent decades. Though, a number of literatures available with regard to the tourism industry and the competitiveness of the destination, however, the major aspects which determine the satisfaction of medical tourists are hardly focused specifically on Malaysia. There is a lack of empirical evidence in this area of study which needs to be bridged. Hence, this study aimed at investigating the various factors contributing towards the development of medical tourism in Malaysia. As the purpose of the research was to find out various factors contributing towards the development of medical tourism in Malaysia, so this study used Structural Equation modeling (SEM) for data analysis. The target population for this study consisted of the medical tourists coming to Malaysia with the primary intension of seeking medical procedures other than sightseeing. A total sample size of 266 was collected through non-probability judgment sampling during the period between December 2012 and February 2013. The result confirms that destination competitiveness and service quality play an important role in the medical tourist's mind towards medical tourism aspect in Malaysia. Thus, Malaysia need to promote various medical success stories together with the services they offer to attract more foreign patients. This study contributes to the theoretical development in the tourism industry by offering the structured relationship among various aspects contributing towards the development of medical tourism in Malaysia.

  17. Comparative effectiveness research: Challenges for medical journals

    Directory of Open Access Journals (Sweden)

    Tovey David

    2010-04-01

    Full Text Available Abstract Editors from a number of medical journals lay out principles for journals considering publication of Comparative Effectiveness Research (CER. In order to encourage dissemination of this editorial, this article is freely available in PLoS Medicine and will be also published in Medical Decision Making, Croatian Medical Journal, The Cochrane Library, Trials, The American Journal of Managed Care, and Journal of Clinical Epidemiology.

  18. Research Ethics Education in the STEM Disciplines: The Promises and Challenges of a Gaming Approach.

    Science.gov (United States)

    Briggle, Adam; Holbrook, J Britt; Oppong, Joseph; Hoffmann, Joesph; Larsen, Elizabeth K; Pluscht, Patrick

    2016-02-01

    While education in ethics and the responsible conduct of research (RCR) is widely acknowledged as an essential component of graduate education, particularly in the STEM disciplines (science, technology, engineering, and math), little consensus exists on how best to accomplish this goal. Recent years have witnessed a turn toward the use of games in this context. Drawing from two NSF-funded grants (one completed and one on-going), this paper takes a critical look at the use of games in ethics and RCR education. It does so by: (a) setting the development of research and engineering ethics games in wider historical and theoretical contexts, which highlights their promise to solve important pedagogical problems; (b) reporting on some initial results from our own efforts to develop a game; and (c) reflecting on the challenges that arise in using games for ethics education. In our discussion of the challenges, we draw out lessons to improve this nascent approach to ethics education in the STEM disciplines .

  19. Continuing education in ethical decision making using case studies from medical social work.

    Science.gov (United States)

    McCormick, Andrew J; Stowell-Weiss, Patti; Carson, Jennifer; Tebo, Gerald; Hanson, Inga; Quesada, Bianca

    2014-01-01

    Medical social workers have needs for training in ethics that is specific to dilemmas that arise while providing service to patients who are very ill, mentally compromised, or in a terminal condition. A social work department developed a continuing education training to educate social workers in bioethics related to determining decisional capacity and understanding standards of ethical decision making. Case studies are used to illustrate ethical conflicts and the role of social workers in resolving them. The benefits of case study training are discussed.

  20. Psychoanalysis and analytic psychotherapy in the NHS--a problem for medical ethics.

    Science.gov (United States)

    Wilkinson, G

    1986-01-01

    I question the place of psychoanalysis and psychoanalytically oriented psychotherapy in the National Health Service (NHS), with reference to published material; and, particularly, in relation to primary care, health economics and medical ethics. I argue that there are pressing clinical, research, economic, and ethical reasons in support of the contention that an urgent review of the extent and impact of psychoanalytic practices in the health service is called for. PMID:3735363

  1. Ethical challenges in voluntary blood donation in Kerala, India.

    Science.gov (United States)

    Choudhury, L P; Tetali, S

    2007-03-01

    The National Blood Policy in India relies heavily on voluntary blood donors, as they are usually assumed to be associated with low levels of transfusion-transmitted infections (TTIs). In India, it is mandatory to test every unit of blood collected for hepatitis B, hepatitis C, HIV/AIDS, syphilis and malaria. Donors come to the blood bank with altruistic intentions. If donors test positive to any of the five infections, their blood is discarded. Although the blood policy advocates disclosure of TTI status, donors are not, in practice, informed about their results. The onus is on the donor to contact the blood bank. Out of approximately 16 000 donations in the past 2 years, 438 tested positive for TTI, including 107 for HIV. Only 20% of the donors contacted the blood bank; none of them were HIV positive. Disclosure by blood banks of TTI status by telephone or mail has resulted in serious consequences for some donors. Health providers face an ethical dilemma, in the absence of proper mechanisms in place for disclosure of test results, regarding notification to donors who may test positive but remain ignorant of their TTI status. Given the high cost of neglecting to notify infected donors, the authors strongly recommend the use of rapid tests before collecting blood, instead of the current practice, which takes 3 h to obtain results, and disclosure of results directly to the donor by a counsellor, to avoid dropouts and to ensure confidentiality.

  2. Ethics and bioethics concerning challenges in the 21st Century

    Directory of Open Access Journals (Sweden)

    José Geraldo De Freitas Drumond

    2012-12-01

    Full Text Available The contemporary world is characterized by a formidable accumulation of scientific knowledge, which is responsible for developing the technology that permeates all latitudes of the planet and is incorporated, so virtually irreplaceably, to the daily life of human beings. However, the world is in a borderline: serious responsibilities determined by the process of increasingly aggressive human intervention in the biosphere (accelerating its deterioration and the very human biology, reaching its genetic identity. Humanity is wrapped in a moral dilemma, since it is found that most of the benefits offered by human knowledge —the whole set of scientific and technological progress of humanity— remains inaccessible to most of the universal family. A recurring issue in today’s society is to establish the boundaries between normal and abnormal, between natural and artificial. Is the human being willing, once again, to transgress the parameters established by her concerning what is normal, anatomically and physiologically? Will she not be satisfied by merely making her biological structure sufficiently adapted to the current practices of the species? Will she want more? In the singular historical transition experienced by contemporary society, the emergence of a new ethical reflection to modulate human behavior has become imperative, so that the actions of men and women can converge to the achievement of universal benefits, so as not to endanger the very survival of human beings on the planet.

  3. The impact of a modern medical curriculum on students' proposed behaviour on meeting ethical dilemmas.

    Science.gov (United States)

    Goldie, John; Schwartz, Lisa; McConnachie, Alex; Morrison, Jillian

    2004-09-01

    To evaluate the impact of a modern medical curriculum on students' proposed behaviour on encountering ethical dilemmas. Cohort design. University of Glasgow Medical School. The first intake of students into Glasgow's new curriculum (n = 238). Main outcome measure Student answers consistent with consensus professional judgement on the ethical dilemmas posed by the vignettes of the Ethics and Health Care Survey Instrument. The probability of giving a consensus answer was lowest pre-Year 1 and highest post-Year 1. It reduced slightly post-Years 3 and 5, but remained significantly higher than at pre-Year 1. The performance of students undertaking a 1-year intercalated BSc, however, appeared to regress on testing post-Year 4. While the first year of the curriculum had a positive impact on students, the remainder of the curriculum did not impact to the same extent. These findings support the recommendation that small group teaching, the predominant teaching method in Year 1, should be preferred to lecture and large group teaching, the predominant method of the remaining curricular years. Full integration of ethics and law teaching within the rest of the curriculum is recommended, particularly during the clinical years. This has training implications for all medical teachers involved in the curriculum. The assessment of ethics should be incorporated into all formal examinations. It is recommended that ethics be addressed as part of a wider approach to professionalism in order to promote integration.

  4. The Computational Challenges of Medical Imaging

    Science.gov (United States)

    2004-02-01

    JASON will undertake a study for the DOE and the NIH National Institute for Bio- medical Imaging and Bio-engineering on the role of computation...broadly defined to include raw computational capabilities, mass storage needs, and connectivity) for medical imaging . This study will address the

  5. Quality of Publication Ethics in the Instructions to the Authors of Iranian Journals of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Fatemeh Salamat

    2013-03-01

    Full Text Available Providing a perfect instruction to authors can prevent most potential publication ethics errors. This study was conducted to determine the quality of ethical considerations in the instructions to the authors of Iranian research scientific journals of medical sciences (accredited by the Commission for Accreditation and Improvement of Iranian Medical Journals in October 2011. Checklist items (n=15 were extracted from the national manual of ethics in medical research publications, and the validity of the manual of ethics was assessed. All the accredited Iranian journals of medical sciences (n=198 were entered into the study. The instructions to the authors of 160 accredited Iranian journals were available online and were reviewed. The ANOVA and Kendall Correlation coefficient were performed to analyze the results. A total of 76 (47.5% of the 160 journals were in English and 84 (52.5% were in Farsi. The most frequently mentioned items related to publication ethics comprised “commitment not to send manuscripts to other journals and re-publish manuscripts” (85%, 83.8%, “aim and scope” of the journal (81.9%, “principles of medical ethics in the use of human samples” (74.4%, and “review process” (74.4%. On the other hand, the items of “principles of advertising” (1.2%, “authorship criteria” (15%, and “integrity in publication of clinical trial results” (30.6% were the least frequently mentioned ones. Based on the study findings, the quality of publication ethics, as instructed to the authors, can improve the quality of the journals.

  6. Patients' Medical Ethics in Hospitalization%论患者的就医道德

    Institute of Scientific and Technical Information of China (English)

    李天颖; 孙一阳; 贾周

    2013-01-01

    对患者就医道德的实质进行了探析,阐述了我国患者就医道德现状以及患者就医道德与医务人员职业道德之间的辩证关系,认为要提高患者的就医道德,需要教育患者正确认识医疗行为;医务人员要通过积极的医患沟通,赢得患者的信任,使患者积极配合治疗;医务人员必须加强职业道德修养;大众传媒应客观公正的报道医疗事件,并积极进行医学知识宣传;司法机关要公正执法,维护正常的医疗秩序.%The authors stated the current situation of the medical ethics of Chinese patients and the dialectical relations between patients'medical ethics and medical staff's professional morality,considering that only did patient set up a correct medical treatment concept,have a correct understanding on medical behavior,trust and understand and have a good cooperation with medical staff,they would have a steady view of medical ethics.The medical personnel should strengthen professional ethics,the public opinion should point a right direction,the mass media should vigorously promote the patient's medical ethics,the judicial organs should be fair to treat the dispute between patient and doctor.It is hoped to make some contribution to promote harmonious doctor-patient relationship through these measures.

  7. New Ethical Challenges within Environmental and Sustainability Education: A Response

    Science.gov (United States)

    Todd, Sharon

    2016-01-01

    One of the major points to grow out of the four papers presented in this issue is how to think of education in relation to the various challenges facing the biosphere, facing the future of human and other than human life forms, and facing the sheer difficulties of planning what to do about them. The differences in the role of education, of course,…

  8. New Ethical Challenges within Environmental and Sustainability Education: A Response

    Science.gov (United States)

    Todd, Sharon

    2016-01-01

    One of the major points to grow out of the four papers presented in this issue is how to think of education in relation to the various challenges facing the biosphere, facing the future of human and other than human life forms, and facing the sheer difficulties of planning what to do about them. The differences in the role of education, of course,…

  9. Challenges of traditional bioethical principles in the implementation of contemporary standards of medical law

    Directory of Open Access Journals (Sweden)

    Mujović-Zornić Hajrija M.

    2012-01-01

    Full Text Available The paper focuses on issues of development dimensions of Medical Law and its ongoing process of standardization and harmonization on one hand, versus the traditionally rooted and available principles of biomedical ethics, on the other. The collision of new legal institutes and the spread of human rights protections is evident. This paper follows the theory and practice of medical ethics and medical law. The theoretical aspect points out medical ethics as one of the sources of medical law. Legal theory makes a distinction between formal and autonomous sources of medical law. Even though ethics is morally much higher, law prevails because it has stronger sanctions and legal power. In its practical aspect, this paper gives examples of different situations of medical decision-making processes. Ethical rules are of the utmost relevance in the domain of confidentiality and options of medical treatment. But, in concrete medical procedures, where legal positions of patients are evidently very significant, law has a more distinct function. Therefore, explaining particular cases from medical malpractice, such as cases of penal, civil or professional liability have an ethical dimension as well. Members of medical professions in Serbia often find these cases unfair. Mostly this is the consequence of ignorance in this kind of medical law and ethics relations. A discussion about practical cases has in that sense a self-learning component, which could be developed to strengthen ethical reasoning and judgment.

  10. Ethics of care in medical tourism: Informal caregivers' narratives of responsibility, vulnerability and mutuality.

    Science.gov (United States)

    Whitmore, Rebecca; Crooks, Valorie A; Snyder, Jeremy

    2015-09-01

    This study examines the experiences of informal caregivers in medical tourism through an ethics of care lens. We conducted semi-structured interviews with 20 Canadians who had accompanied their friends or family members abroad for surgery, asking questions that dealt with their experiences prior to, during and after travel. Thematic analysis revealed three themes central to an ethics of care: responsibility, vulnerability and mutuality. Ethics of care theorists have highlighted how care has been historically devalued. We posit that medical tourism reproduces dominant narratives about care in a novel care landscape. Informal care goes unaccounted for by the industry, as it occurs in largely private spaces at a geographic distance from the home countries of medical tourists. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Analysis of Work Assignments After Medical Ethics Workshop for First-Year Residents at Siriraj Hospital

    Directory of Open Access Journals (Sweden)

    Sakda Sathirareuangchai

    2016-11-01

    Full Text Available Background: Upon entering the residency training program, all 1st year residents at Siriraj Hospital must join medical ethics workshop held by the Division of Postgraduate Studies. At the end of the workshop, the residents were given a work assignment to write a clinical ethics situation they have encountered in their past practice. Methods: This study is an analysis of content described in the work assignments in order to gain the information regarding common medical ethics dilemmas, which the physicians faced in the early days of practice. Results: 740 work assignments were reviewed. The 4 most common ethical principle mentioned in these assign- ments were autonomy (144, 19.5%, palliative care (133, 18.0%, beneficence (121, 16.4%, and confidentiality (110, 14.9%. More than half of the situations described were during their internship (474, 64.1% and tended to distributed equally among community hospital (39.1%, university hospital (28.0%, and general hospital (24.3%. Conclusion: This study should raise the awareness of the medical educator towards these medical ethics issues during curriculum planning.

  12. Phronesis as an ideal in professional medical ethics: some preliminary positionings and problematics.

    Science.gov (United States)

    Kristjánsson, Kristján

    2015-10-01

    Phronesis has become a buzzword in contemporary medical ethics. Yet, the use of this single term conceals a number of significant conceptual controversies based on divergent philosophical assumptions. This paper explores three of them: on phronesis as universalist or relativist, generalist or particularist, and natural/painless or painful/ambivalent. It also reveals tensions between Alasdair MacIntyre's take on phronesis, typically drawn upon in professional ethics discourses, and Aristotle's original concept. The paper offers these four binaries as a possible analytical framework for classifying and evaluating accounts of phronesis in the medical ethics literature. It argues that to make sense of phronesis as a putative ideal in professional medical ethics--for example, with the further aim of crafting interventions to cultivate phronesis in medical ethics education--the preliminary question of which conception of phronesis is most serviceable for the aim in question needs to be answered. The paper identifies considerable lack of clarity in the current discursive field on phronesis and suggests how that shortcoming can be ameliorated.

  13. Medical tourism in Iran: Issues and challenges.

    Science.gov (United States)

    Jabbari, Alireza; Delgoshaei, Bahram; Mardani, Raja; Tabibi, Seid Jamaledin

    2012-01-01

    Medical tourism is rapidly becoming a worldwide, multibillion-dollar industry. Iran has a high potential for this industry. The purpose of this study was to examine the medical tourism cluster, using Diamond Analysis tool. This study is a descriptive, analytical and qualitative one. Thirty professionals and researchers in this field were interviewed and official documents belonging to the Health ministry as well as tourism organization and finally related literature were examined. The data was analyzed using content analysis method. Positive and negative parts of the medical tourism industry of Iran were determined according to diamond of advantage. The strategic issues were identified and a number of possible solutions for addressing them were recommended. More and effective public-private participations, aggressive marketing, improving infrastructures, and international accreditation of health care facilities and human resources development could improve medical tourism industry in the country.

  14. Medical Device Development: the challenge for ergonomics

    OpenAIRE

    Martin, Jennifer L; Norris, Beverley J.; Murphy, Elizabeth; Crowe, John A.

    2008-01-01

    High quality, well designed medical devices are necessary to provide safe and effective clinical care for patients as well as to ensure the health and safety of professional and lay device users. Capturing the user requirements of users and incorporating these into design is an essential component of this. The field of ergonomics has an opportunity to assist, not only with this area, but also to encourage a more general consideration of the user during medical device development. A review ...

  15. Anticipated Ethics and Regulatory Challenges in PCORnet: The National Patient-Centered Clinical Research Network.

    Science.gov (United States)

    Ali, Joseph; Califf, Robert; Sugarman, Jeremy

    2016-01-01

    PCORnet, the National Patient-Centered Clinical Research Network, seeks to establish a robust national health data network for patient-centered comparative effectiveness research. This article reports the results of a PCORnet survey designed to identify the ethics and regulatory challenges anticipated in network implementation. A 12-item online survey was developed by leadership of the PCORnet Ethics and Regulatory Task Force; responses were collected from the 29 PCORnet networks. The most pressing ethics issues identified related to informed consent, patient engagement, privacy and confidentiality, and data sharing. High priority regulatory issues included IRB coordination, privacy and confidentiality, informed consent, and data sharing. Over 150 IRBs and five different approaches to managing multisite IRB review were identified within PCORnet. Further empirical and scholarly work, as well as practical and policy guidance, is essential if important initiatives that rely on comparative effectiveness research are to move forward.

  16. Solidarity in family medicine in Brazil and in Italy: reflecting on ethical issues and contemporary challenges

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Gabrielli Souza Lima

    2010-01-01

    Full Text Available This study reflects on solidarity in the practice of family medicine in two realities. The objective is to search for solidarity as an ethical principle in the relationship between family doctor and subject. It is a descriptive exploratory research carried out in Florianópolis, state of Santa Catarina, Brazil, and in the Province of Rome, Lazio Region, Italy. It included fourteen Brazilian family doctors and fifteen Italian family doctors. The theoretical framework consisted of Pierre Bourdieu's theory of Symbolic Power. The results show the importance of the role of the family doctor in the materialization of this ethical principle, as a spokesman for scientific knowledge and as an agent of a State policy. Solidarity was understood within distinct domains and the discursive productions also demonstrated the negation of solidarity in such practice. Globalization proved to be a contemporary challenge for an ethical practice of family medicine that is marked by solidarity.

  17. Creating and selling embryos for "donation": ethical challenges.

    Science.gov (United States)

    Klitzman, Robert; Sauer, Mark V

    2015-02-01

    The commercial creation and sale of embryos has begun, which poses a series of ethical questions that have received little scholarly attention. Some of the concerns that arise are similar to those posed by the sale of gametes, while other issues differ markedly. Questions emerge, first, regarding the rights of the unborn children and their ability to know their biological parents. Companies that create human embryos de novo may wish to keep gamete providers anonymous. Many of these offspring thus will never learn that their parents are not their biologic parents. Yet, such disclosures, regarding not only one but both of these biologic parents, may be important for these individuals; and a lack of this knowledge may impede their physical and psychological health. Second, questions surface regarding the fees that providers should charge for embryos and whether these amounts should vary based on the traits of 1 or both of the gamete donors. Some prospective parents may seek specific traits in a baby (eg, height or eye/hair coloring), which prompts the creation of embryos from 2 gamete donors who possess these characteristics. Third, ownership of embryos created without an advanced directive by patients poses dilemmas (eg, disposition of any remaining embryos). Fourth, guidelines do not yet exist to limit the number of embryos sold from each pair of gamete donors. Hence, unbeknownst to each other, full siblings could potentially meet, get married, and procreate. This discussion has several critical implications for future practice and professional education and policy. Patients with diseases associated with genetic tests may well ask obstetricians, gynecologists, and other physicians about these techniques and practices. Clinicians can refer such patients to assisted reproductive technology specialists; however, familiarity with the basic aspects of the issues and complexities involved could aid these providers and their patients Several of these issues can be

  18. (ETHNO-)MEDICAL ETHICS IN GLOBALIZING CHINA: TRACING LOCAL KNOWLEDGE AND ADAPTATION OF BIOMEDICINE.

    Science.gov (United States)

    Micollier, Evelyne

    2015-12-01

    Encounters between several bodies of therapeutic knowledge have led to a restructuring of the entire health system, including a transformation in medical ethics. Defining "new ethics" with both Chinese and international characteristics, is part of the ongoing knowledge production process: plural health ideas, practices and medical sciences develop within the broader framework of social and economic transition. Such transition simultaneously reveals and encourages China's influence and position in an era of globalization including in the technical and knowledge production domains. Re-alignments in medical ethics in Reform China (post-1979) highlight a rather under-explored aspect of medical plurality enabling these ethics to be used as an analytical lens to provide information about social and political issues. In this article, two sets of ethical principles, one from Late Imperial China (Late Ming Era), the other from post-Mao China (1980s), are detailed and analysed. They were selected as case-studies mainly because they reflected at the time of their emergence an on-going radical change in society in the realm of health and medicine. Therefore both sets unveil the process of legitimizing a "Chinese medicine" in a context of epistemological shift: such a process takes various conceptual and practicalforms framed along the lines of the current dominant ideological system and constrained by socio-economic and political factors. Finally, issues relative to research ethics, bioethics and the New Health Reform guidelines raised in the 2000s, which represents also a significant historical turn for China, are discussed. Drawn from the overall discussion throughout the text, several concluding remarks contribute to advocate for "win-win" encounters--from the East to the West and from the South to the South, and for more implementable transnational/global ethics designing.

  19. Perspectives on Medical Students’ Reflections on Ethical Dilemmas during their Clinical Stay. Oral Presentation, COMET Conference in Aalborg, Denmark

    DEFF Research Database (Denmark)

    Gormsen, Lise Kirstine; Søndergaard, Sara; Hoffmann, Tine

    Work-in- progress Roundtable: Title: What ethical problems are out there? – a study of medical students’ reflexive writing about ethical dilemmas in the clinic. Authors: Lise Gormsen, MD, MHH, PhD., Institute of Clinical Medicine, Aarhus University, Denmark Jane Ege Møller, MA, PhD., Center.......gormsen@ki.au.dk Conference themes: Ethics and Communication Medical Education Research Ethics Values and Responsibilities in Professional Practice Background: As many other countries, Denmark has implemented the seven physician roles as the basis for medical education. Pre-graduate medical education in ethics contribute.......Schön) We have collected reflexive texts (45 texts, 199 pages in total) produced by 4th-year students (n=316). The texts were analyzed and characteristic patterns were characterized. Results: The students observe 3 types of ethical problem 1) everyday problems e.g. confidentiality in a busy ward 2...

  20. Teaching corner: "first do no harm": teaching global health ethics to medical trainees through experiential learning.

    Science.gov (United States)

    Logar, Tea; Le, Phuoc; Harrison, James D; Glass, Marcia

    2015-03-01

    Recent studies show that returning global health trainees often report having felt inadequately prepared to deal with ethical dilemmas they encountered during outreach clinical work. While global health training guidelines emphasize the importance of developing ethical and cultural competencies before embarking on fieldwork, their practical implementation is often lacking and consists mainly of recommendations regarding professional behavior and discussions of case studies. Evidence suggests that one of the most effective ways to teach certain skills in global health, including ethical and cultural competencies, is through service learning. This approach combines community service with experiential learning. Unfortunately, this approach to global health ethics training is often unattainable due to a lack of supervision and resources available at host locations. This often means that trainees enter global health initiatives unprepared to deal with ethical dilemmas, which has the potential for adverse consequences for patients and host institutions, thus contributing to growing concerns about exploitation and "medical tourism." From an educational perspective, exposure alone to such ethical dilemmas does not contribute to learning, due to lack of proper guidance. We propose that the tension between the benefits of service learning on the one hand and the respect for patients' rights and well-being on the other could be resolved by the application of a simulation-based approach to global health ethics education.

  1. [New evidence for the author of the medical ethics novel Doctor's Mirror].

    Science.gov (United States)

    Yang, Fang; Zhu, Hui; Pan, Rong-Hua

    2012-07-01

    Yijiejing (Doctor's Mirror), the first novel focused on medical ethics in the late Qing dynasty, aimed at meliorating medical ethical atmosphere by criticizing disorders among medical practitioners. Some contents of this novel were the same as those in Yijie Xianxingji (Revelation of Medical Community). By comparison between the two books and investigation on Doctor's Mirror's introduction, preface and advertisement in the newspaper at that time, we could find that the author of Doctor's Mirror was not the novelist LU Shi-e, but YU Wen-yao, the author of Yijie Xianxingji. Distribution of Yijie Xianxingji was stopped soon after its publication by the Commercial Press for its allusion to a famous doctor in Shanghai. Two years later, YU made some slight modifications the details of the novel's characters and his book was published with a different title Doctor's Mirror and the pen-name 'medical hermit among scholars'.

  2. Appealing to the crowd: ethical justifications in Canadian medical crowdfunding campaigns.

    Science.gov (United States)

    Snyder, Jeremy; Crooks, Valorie A; Mathers, Annalise; Chow-White, Peter

    2017-01-30

    Medical crowdfunding is growing in terms of the number of active campaigns, amount of funding raised and public visibility. Little is known about how campaigners appeal to potential donors outside of anecdotal evidence collected in news reports on specific medical crowdfunding campaigns. This paper offers a first step towards addressing this knowledge gap by examining medical crowdfunding campaigns for Canadian recipients. Using 80 medical crowdfunding campaigns for Canadian recipients, we analyse how Canadians justify to others that they ought to contribute to funding their health needs. We find the justifications campaigners tend to fall into three themes: personal connections, depth of need and giving back. We further discuss how these appeals can understood in terms of ethical justifications for giving and how these justifications should be assessed in light of the academic literature on ethical concerns raised by medical crowdfunding.

  3. An eight-year follow-up national study of medical school and general hospital ethics committees in Japan

    Science.gov (United States)

    Akabayashi, Akira; Slingsby, Brian T; Nagao, Noriko; Kai, Ichiro; Sato, Hajime

    2007-01-01

    Background Ethics committees and their system of research protocol peer-review are currently used worldwide. To ensure an international standard for research ethics and safety, however, data is needed on the quality and function of each nation's ethics committees. The purpose of this study was to describe the characteristics and developments of ethics committees established at medical schools and general hospitals in Japan. Methods This study consisted of four national surveys sent twice over a period of eight years to two separate samples. The first target was the ethics committees of all 80 medical schools and the second target was all general hospitals with over 300 beds in Japan (n = 1457 in 1996 and n = 1491 in 2002). Instruments contained four sections: (1) committee structure, (2) frequency of annual meetings, (3) committee function, and (4) existence of a set of guidelines for the refusal of blood transfusion by Jehovah's Witnesses. Results Committee structure was overall interdisciplinary. Frequency of annual meetings increased significantly for both medical school and hospital ethics committees over the eight years. The primary activities for medical school and hospital ethics committees were research protocol reviews and policy making. Results also showed a significant increase in the use of ethical guidelines, particularly those related to the refusal of blood transfusion by Jehovah's Witnesses, among both medical school and hospital ethics committees. Conclusion Overall findings indicated a greater recognized degree of responsibilities and an increase in workload for Japanese ethics committees. PMID:17598923

  4. Ethics Guide Recommendations for Organ-Donation-Focused Physicians: Endorsed by the Canadian Medical Association.

    Science.gov (United States)

    Shemie, Sam D; Simpson, Christy; Blackmer, Jeff; MacDonald, Shavaun; Dhanani, Sonny; Torrance, Sylvia; Byrne, Paul

    2017-05-01

    Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services. In anticipation of actual, potential or perceived ethical challenges with the role, Canadian Blood Services in partnership with the Canadian Medical Association organized the development of an evidence-informed consensus process of donation experts and bioethicists to produce an ethics guide. This guide includes overarching principles and benefits of the DP role, and recommendations in regard to communication with families, role disclosure, consent discussions, interprofessional conflicts, conscientious objection, death determination, donation specific clinical practices in neurological determination of death and donation after circulatory death, end-of-life care, performance metrics, resources and remuneration. Although this report is intended to inform donation physician practices, it is recognized that the recommendations may have applicability to other professionals (eg, physicians in intensive care, emergency medicine, neurology, neurosurgery, pulmonology) who may also participate in the end-of-life care of potential donors in various clinical settings. It is hoped that this guidance will assist practitioners and their sponsoring organizations in preserving their duty of care, protecting the interests of dying patients, and fulfilling best practices for organ and tissue donation.

  5. Why would medical publishers not incorporate core bioethical values into their Ethics Guidelines?

    Science.gov (United States)

    Watine, Joseph

    2014-01-01

    It is quite universally acknowledged by bioethicists, at least in the western world, that respect for the patients' autonomy, non-malevolence, beneficence, and justice (also called equity) are four core ethical values in medicine. The Ethics Guidelines of key journals in laboratory medicine are not explicit about the first three of these values, and even implicitly, they seem to miss values of justice. Health equity being one of the main objectives of public health policy across the world, we suggest that values of equity explicitly become part of the Ethics Guidelines of laboratory medicine journals. Biochemia Medica could show the way to other medical publishers by incorporating into its Ethics Guidelines these very important core bioethical values.

  6. Dying and death in some Roma communities: ethical challenges.

    Science.gov (United States)

    Roman, Gabriel; Gramma, Rodica; Enache, Angela; Pârvu, Andrada; Ioan, Beatrice; Moisa, Ştefana Maria; Dumitraş, Silvia; Chirita, Radu

    2014-04-01

    The Roma people have specific values, therefore their views and beliefs about illness, dying and death are important to be known for health care providers caring for members of this community. The aim of this qualitative study based on 48 semi-structured interviews with Roma patients and caregivers in communities in two regions of Romania was to examine their selfdescribed behaviors and practices, their experiences and perceptions of illness, dying and death. Five more important themes about the Roma people facing dying and death have been identified: (1) The perception of illness in the community as reason for shame and the isolation that results from this, as well as the tendency for Roma people to take this on in their self image; (2) The importance of the family as the major support for the ill/dying individual, including the social requirement that family gather when someone is ill/dying; (3) The belief that the patient should not be told his/her diagnosis for fear it will harm him/her and that the family should be informed of the diagnosis as the main decision maker regarding medical treatment; (4) The reluctance of the Roma to decide on stopping life prolonging treatment; (5) The view of death as 'impure'. These results can be useful for health care providers working with members of the Roma community. By paying attention to and respecting the Roma patients' values, spirituality, and relationship dynamics, the medical staff can provide the most suitable healthcare by respecting the patients' wishes and expectations.

  7. Establishing institutional ethics committees: challenges and solutions - a review of the literature.

    Science.gov (United States)

    Kuyare, Mukta S; Taur, Santosh R; Thatte, Urmila M

    2014-01-01

    This review of the literature was conducted to identify the challenges faced while establishing institutional ethics committees (IECs) as well as to suggest some solutions. The search of the literature was carried out with the help of the PubMed search engine, using “research ethics committees” (MeSH] and “India” (MeSH]) as the key words for articles published between 2004 and 2012. We found 31 articles related to the topic, and the most common challenge mentioned was inappropriate functioning of IECs (n=17), followed by inappropriate structure (n=14). The authors identified many challenges related to the lack of oversight by regulatory bodies (n=14) as well as issues pertaining to the ethical training of IEC members and investigators (n=13). It is evident from the multitude of papers on the issue that the challenges related to the constitution and functioning of IECs must be given the attention they deserve to ensure that research participants in India are better protected.

  8. Maintaining professionalism in today's business environment: ethical challenges for the pain medicine specialist.

    Science.gov (United States)

    Lebovits, Allen

    2012-09-01

    There are many external influences in today's market force that impair the relationship between the pain medicine specialist and the patient, and ultimately prevent optimal quality of care. This article explores the ethical challenges facing the pain medicine specialist in today's increasingly "business" environment and will offer solutions for maintaining the professionalism of pain medicine. Four commonly encountered bioethical principles in the practice of pain medicine are reviewed: beneficence, nonmaleficence, justice, and autonomy. The following ethical challenges of the pain medicine specialist are reviewed: practicing outside ones specialty area, practice characteristics, the consultant role, the economic lure of aggressive intervention, not evaluating for and treating comorbid psychopathology, reimbursement pressures, workers' compensation, and use of unproven methods. Solutions offered include collegial associations, social responsibility, legislative initiatives, pain education, interdisciplinary evaluation and treatment, improved relationships with third-party payers, reduced racial disparities, and ethics education. Ethics is the "roadmap" that enables the pain medicine specialist to navigate the increasingly murky waters of practicing pain management today by maintaining the professionalism necessary to combat today's "business" pressures. Wiley Periodicals, Inc.

  9. [Medical education challenged by the learning society].

    Science.gov (United States)

    Abreu-Hernández, Luis Felipe; Infante-Castañeda, Claudia B

    2004-01-01

    This paper analyzes the limitations of dominant paradigms in education and identifies the necessity of research-situated learning in real environments and how medical education must be involved with knowledge management in real, complex, adaptive systems, and concludes with the need for constructing novel educative paradigms with regard to new educational paradigms.

  10. Qualitative outcome assessment of a medical ethics program for clinical clerkships: a pilot study.

    Science.gov (United States)

    Hayes, R P; Stoudemire, A; Kinlaw, K; Dell, M L; Loomis, A

    1999-01-01

    This study assessed the usefulness of an open-ended case analysis test instrument for evaluating the effects of a 1-year ethics course on medical students' decision-making skills. Through case-oriented seminars in gynecology, internal medicine, obstetrics, pediatrics, psychiatry, and surgery, third-year medical students were taught a structured analytic framework for analyzing clinical ethical problems stressing the interactive relationships among medical indications, patient preferences, quality of life, and contextual (social, legal, economic) matters. At precourse, the students were given a test case and asked to provide a line of reasoning for their clinical decisions. At postcourse, the students were given the same case. Content analysis of pre- and postcourse responses of a random student sample revealed increases in student awareness in the following areas: 1) consideration of informed consent, 2) professional liability, 3) physician-assisted suicide, and 4) resource utilization. With some modifications, open-ended case analysis holds promise for evaluating medical ethics courses. The authors make recommendations for future research in evaluating the true impact of clinical ethics courses in medical education.

  11. Survey of ethical issues reported by Indian medical students: basis for design of a new curriculum.

    Science.gov (United States)

    Rose, Anuradha; George, Kuryan; T, Arul Dhas; Pulimood, Anna Benjamin

    2014-01-01

    Education in ethics is now a formal part of the undergraduate medical curriculum. However, most courses are structured around principles and case studies more appropriate to western countries. The cultures and practices of countries like India differ from those of western countries. It is, therefore, essential that our teaching should address the issues which are the most relevant to our setting. An anonymised, questionnaire-based, cross-sectional survey of medical students was carried out to get a picture of the ethical problems faced by students in India. The data were categorised into issues related to professional behaviour and ethical dilemmas. Unprofessional behaviour was among the issues reported as a matter of concern by a majority of the medical students. The survey highlights the need to design the curriculum in a way that reflects the structure of medical education in India, where patients are not always considered socio-culturally equal by students or the medical staff. This perspective must underpin any further efforts to address education in ethics in India.

  12. An introductory on medical ethics history in different era in Iran

    Directory of Open Access Journals (Sweden)

    Bagher Larijani

    2006-03-01

    Full Text Available Medical ethics has a long history worldwide, and the move towards a transcultural ethics must be based on an appreciation of the history that has produced the present relationships. It is often thought that medical ethics history has begun at the time of Hippocrates, however it is much older. It is clear that various cultures such as Babylonia, ancient Egypt, Greece, and the Persians have attempted to regulate medicine and to protect patients' rights in the known ancient world. One of the earliest written provisions in this field that comes back to about 1750 BC is the code of Hammurabi. In medieval, great Iranian physicians had paid special attention to ethics in their practices, teachings and manuscripts."nIn this paper we aimed to explore the roots of medical ethics in Persian history, particularly after adherence of Iranians to Islam. History of medicine in Iran has begun at about fourth century BC. There was a gap between the ancient civilizations and the Renaissance era in Europe, commonly called the dark ages. The immense strides have been made by the Persians in that long interval which is briefly reviewed.

  13. Ethical issues in cesarean delivery.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2017-08-01

    Cesarean delivery is the most common and important surgical intervention in obstetric practice. Ethics provides essential guidance to obstetricians for offering, recommending, recommending against, and performing cesarean delivery. This chapter provides an ethical framework based on the professional responsibility model of obstetric ethics. This framework is then used to address two especially ethically challenging clinical topics in cesarean delivery: patient-choice cesarean delivery and trial of labor after cesarean delivery. This chapter emphasizes a preventive ethics approach, designed to prevent ethical conflict in clinical practice. To achieve this goal, a preventive ethics approach uses the informed consent process to offer cesarean delivery as a medically reasonable alternative to vaginal delivery, to recommend cesarean delivery, and to recommend against cesarean delivery. The limited role of shared decision making is also described. The professional responsibility model of obstetric ethics guides this multi-faceted preventive ethics approach. Copyright © 2017. Published by Elsevier Ltd.

  14. Comparison of lecture and team-based learning in medical ethics education.

    Science.gov (United States)

    Ozgonul, Levent; Alimoglu, Mustafa Kemal

    2017-01-01

    Medical education literature suggests that ethics education should be learner-centered and problem-based rather than theory-based. Team-based learning is an appropriate method for this suggestion. However, its effectiveness was not investigated enough in medical ethics education. Is team-based learning effective in medical ethics education in terms of knowledge retention, in-class learner engagement, and learner reactions? This was a prospective controlled follow-up study. We changed lecture with team-based learning method to teach four topics in a 2-week medical ethics clerkship, while the remaining topics were taught by lectures. For comparison, we formed team-based learning and lecture groups, in which the students and instructor are the same, but the topics and teaching methodologies are different. We determined in-class learner engagement by direct observation and student satisfaction by feedback forms. Student success for team-based learning and lecture topics in the end-of-clerkship exam and two retention tests performed 1 year and 2 years later were compared. Ethical considerations: Ethical approval for the study was granted by Akdeniz University Board of Ethics on Noninvasive Clinical Human Studies Ethics committee. Short-term knowledge retention did not differ; however, team-based learning was found superior to lecture at long-term retention tests. Student satisfaction was high with team-based learning and in-class engagement was better in team-based learning sessions. Our results on learner engagement and satisfaction with team-based learning were similar to those of previous reports. However, knowledge retention results in our study were contrary to literature. The reason might be the fact that students prepared for the end-of-clerkship pass/fail exam (short term) regardless of the teaching method. But, at long-term retention tests, they did not prepare for the exam and answered the questions just using the knowledge retained in their memories. Our

  15. Thai and American doctors on medical ethics: religion, regulation, and moral reasoning across borders.

    Science.gov (United States)

    Grol-Prokopczyk, Hanna

    2013-01-01

    Recent scholarship argues that successful international medical collaboration depends crucially on improving cross-cultural understanding. To this end, this study analyzes recent writings on medical ethics by physicians in two countries actively participating in global medicine, Thailand and the United States. Articles (133; published 2004-2008) from JAMA, the New England Journal of Medicine, and the Journal of the Medical Association of Thailand are analyzed to inductively build a portrait of two discursive ethical cultures. Frameworks of moral reasoning are identified across and within the two groups, with a focus on what authority (religion, law, etc.) is invoked to define and evaluate ethical problems. How might similarities and differences in ethical paradigms reflect the countries' historical "semicolonial" relationship, shed light on debates about Eastern vs. Western bioethics, and facilitate or hinder contemporary cross-national communication? Findings demonstrate substantial overlap in Thai and American doctors' vocabulary, points of reference, and topics covered, though only Thai doctors emphasize national interests and identity. American authors display a striking homogeneity in styles of moral reasoning, embracing a secular, legalistic, deontological ethics that generally eschews discussion of religion, personal character, or national culture. Among Thai authors, there is a schism in ethical styles: while some hew closely to the secular, deontological model, others embrace a virtue ethics that liberally cites Buddhist principles and emphasizes the role of doctors' good character. These two approaches may represent opposing reactions-assimilation and resistance, respectively-to Western influence. The current findings undermine the stereotype of Western individualism versus Eastern collectivism. Implications for cross-national dialog are discussed.

  16. The Ethical Practice of Podiatric Medicine.

    Science.gov (United States)

    McCarthy, Daniel J.

    1978-01-01

    A close examination of the Hippocratic Oath and the Code of Ethics of the American Podiatry Association is proposed as a outline for the parameters of ethical professional conduct. Ethical challenges facing the medical community, such as euthanasia, are discussed. (LBH)

  17. Preparing students for the ethical challenges on international health electives: A systematic review of the literature on educational interventions.

    Science.gov (United States)

    Rahim, Anika; Knights Née Jones, Felicity; Fyfe, Molly; Alagarajah, Janagan; Baraitser, Paula

    2016-09-01

    International health electives pose specific ethical challenges for students travelling from to low and middle income countries. We undertook a systematic review of the literature on interventions to prepare students to identify ethical issues addressed, educational approaches and to collate evidence on the effectiveness of different strategies. We searched nine electronic databases of peer-reviewed literature and identified grey literature through key word searches; supplemented through citation mapping and expert consultation. Articles that described ethical training conducted by universities or professional bodies were included for review. We reviewed forty-four full text articles. Ten sources of published literature and seven sources of grey literature met our inclusion criteria. We identified thirteen ethical situations that students should be prepared to manage and eight generic skills to support this process. Most interventions were delivered before the elective, used case studies or guidelines. Some suggested ethical principles or a framework for analysis of ethical issues. Only two papers evaluated the intervention described. Our paper collates a small but growing body of work on education to prepare students to manage ethical issues. Ethical training should have elements that are delivered before, during and after the elective. Interventions should include case studies covering thirteen ethical issues identified here, linked to ethical principles and a process for responding to ethical issues. We suggest that evaluations of interventions are an important area for future research.

  18. Employee Anonymous Online Dissent: Dynamics and Ethical Challenges for Employees, Targeted Organisations, Online Outlets and Audiences

    DEFF Research Database (Denmark)

    Ravazzani, Silvia; Mazzei, Alessandra

    2015-01-01

    ethical challenges that take into consideration the perspectives of employees, targeted organisations, online outlet administrators and audiences. The ethical challenge for employees is to disclose problems for organisational and societal changes in a safe context and supported by a large audience, while......This paper aims to enhance understanding of dissent expressive acts that employees voice via anonymous online public contexts. Based on literature on organisational dissent, anonymity and online disclosure, we first point out key dynamics of employee anonymous online dissent, and then present...... remaining accountable for them and avoiding emotion-focused and defensive disclosure. Targeted organisations need to prevent external disclosure while ensuring freedom of speech and employee privacy, and to respond effectively when overt criticism is found online. Other tensions concern online outlet...

  19. Quagmires for clinical psychology and executive coaching? Ethical considerations and practice challenges.

    Science.gov (United States)

    Gebhardt, Judith Ann

    2016-04-01

    As the coaching field burgeons, both the mental health and coaching professionals, and their respective professions, face a myriad of potential quagmires, especially if the unique challenges encountered are ignored. After a short introduction and presentation on ethics and morals related to executive coaching and clinical therapy, a discussion follows on the lengthy and intimate relationship between executive coaching and psychology. Next are definitions and comparisons and 6 areas that are potential quagmires. This includes roles, skill sets/core competencies, education/training, licensing/credentialing-certification, governing bodies and confidentiality, and fees/reimbursement. Each section includes a discussion and several questions to highlight potentially problematic areas, practice challenges, and/or ethical issues, followed with brief responses. This paper concludes with the inquiry, "Where do we go from here?"

  20. Ethical values in emergency medical services: A pilot study.

    Science.gov (United States)

    Bremer, Anders; Herrera, María Jiménez; Axelsson, Christer; Martí, Dolors Burjalés; Sandman, Lars; Casali, Gian Luca

    2015-12-01

    Ambulance professionals often address conflicts between ethical values. As individuals' values represent basic convictions of what is right or good and motivate behaviour, research is needed to understand their value profiles. To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure the presence of utilitarianism, moral rights and/or social justice in ambulance professionals' value profiles in Spain and Sweden. The instrument was translated and culturally adapted. A content validity index was calculated. Pilot tests were carried out with 46 participants. This study conforms to the ethical principles for research involving human subjects and adheres to national laws and regulations concerning informed consent and confidentiality. Spanish professionals favoured justice and Swedish professionals' rights in their ambulance organizations. Both countries favoured utilitarianism least. Gender differences across countries showed that males favoured rights. Spanish female professionals favoured justice most strongly of all. Swedes favour rights while Spaniards favour justice. Both contexts scored low on utilitarianism focusing on total population effect, preferring the opposite, individualized approach of the rights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardize ambulance professionals' moral right to make individual assessments based on the needs of the patient at hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer's professional role. Since both the justice and rights perspectives portrayed in the survey mainly concern relationship to the organization and peers within the organization, this relationship might at worst be given priority over the equal treatment and moral rights of the patient. A balanced view on ethical perspectives is needed to make professionals observant and

  1. Medical legal and ethical questions in palliative medicine and euthanasia.

    Science.gov (United States)

    Pribilla, O

    1994-12-16

    The increasing importance of legal and ethical questions in palliative medicine and euthanasia due to the increased technical possibilities for extending life will be considered. In palliative medicine, the choice of the best therapy will be discussed, especially in the case of oncological diseases. Here, consideration of the prospects of success, for example, in chemotherapy, is faced with partly serious side-effects. The requirements of palliative medicine that the patient has to be fully informed of the fatal prognosis of his disease is equally debated as the optimum pain therapy. In this respect, the modification of the Narcotics Act of 1 February 1993 is also under discussion. In the field of euthanasia, the technical development of life extension versus dying has raised considerable legal and ethical problems regarding termination of therapy. Additionally, fiscal considerations are of increasing relevance. The common development of the legal and ethical discussion, for example, with regard to the publicity of the work of the so-called 'Gesellschaft für humanes Sterben', the public discussion leading up to a hearing of the 'Bundestag' regarding active euthanasia leads to a realization of the subject. The proposals for an active termination of life by discontinuing therapy for adults and also for malformed newborns are discussed. A dispute concerning the new legal regulation of active euthanasia in the Netherlands of February 1993 is also discussed. There, around 2% of all deaths per year result from active termination of life and also cases where persons are not able to consent. This also has enormous consequences for the position of the physician.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Documentation of ethical conduct of human subject research published in Saudi medical journals.

    Science.gov (United States)

    Al-Gaai, E A; Hammami, M M; Al Eidan, M

    2012-07-01

    We evaluated the documentation of ethical conduct (obtaining institutional review board approval and consent and following ethical guidelines) of human subject research studies published in Saudi Arabian medical journals between 1979 and 2007. Studies were classified as retrospective, prospective noninterventional, interventional or survey/interview. Of 1838 studies published in 286 journal issues of 11 Saudi Arabian medical journals, only 0.9% documented the ethical guidelines followed, with a significantly higher rate for studies published after year 2000 (1.7%). Of 821 studies requiring institutional review board approval, 8.6% documented obtaining the approval and informed consent, with a significantly higher rate for interventional studies (19.4%), post-year 2000 studies (19.7%) and studies performed outside Saudi Arabia (15.9%). The low documentation rate suggests editor's lack of rigor and/or investigators' ignorance of guidelines. The higher documentation rate after year 2000 suggests an ongoing improvement.

  3. Religious morality (and secular humanism) in Western civilization as precursors to medical ethics: A historic perspective

    Science.gov (United States)

    Faria, Miguel A.

    2015-01-01

    In discussing bioethics and the formulation of neuroethics, the question has arisen as to whether secular humanism should be the sole philosophical guiding light, to the exclusion of any discussion (or even mention) of religious morality, in professional medical ethics. In addition, the question has arisen as to whether freedom or censorship should be part of medical (and neuroscience) journalism. Should independent medical journals abstain from discussing certain issues, or should only the major medical journals — i.e., the New England Journal of Medicine (NEJM), the Journal of the American Medical Association (JAMA) or Lancet — be heard, speaking with one “consensual,” authoritative voice? This issue is particularly important in controversial topics impacting medical politics — e.g., public health policy, socio-economics, bioethics, and the so-called redistributive justice in health care. Should all sides be heard when those controversial topics are discussed or only a consensual (monolithic) side? This historical review article discusses those issues and opts for freedom in medical and surgical practice as well as freedom in medical journalism, particularly in opinion pieces such as editorials, commentaries, or letters to the editor, as long as they relate to medicine and, in our special case, to neuroscience and neurosurgery. After answering those questions, and in response to a critical letter to the editor, this review article then expounds comprehensively on the historical and philosophical origins of ethics and religious morality. Necessarily, we discuss the Graeco-Roman legacy and the Judeo-Christian inheritance in the development of ethics and religious morality in Western civilization and their impact on moral conduct in general and on medical and neuroscience ethics in particular. PMID:26110085

  4. Religious morality (and secular humanism in Western civilization as precursors to medical ethics: A historic perspective

    Directory of Open Access Journals (Sweden)

    Miguel A Faria

    2015-01-01

    Full Text Available In discussing bioethics and the formulation of neuroethics, the question has arisen as to whether secular humanism should be the sole philosophical guiding light, to the exclusion of any discussion (or even mention of religious morality, in professional medical ethics. In addition, the question has arisen as to whether freedom or censorship should be part of medical (and neuroscience journalism. Should independent medical journals abstain from discussing certain issues, or should only the major medical journals - i.e., the New England Journal of Medicine (NEJM, the Journal of the American Medical Association (JAMA or Lancet - be heard, speaking with one "consensual," authoritative voice? This issue is particularly important in controversial topics impacting medical politics - e.g., public health policy, socio-economics, bioethics, and the so-called redistributive justice in health care. Should all sides be heard when those controversial topics are discussed or only a consensual (monolithic side? This historical review article discusses those issues and opts for freedom in medical and surgical practice as well as freedom in medical journalism, particularly in opinion pieces such as editorials, commentaries, or letters to the editor, as long as they relate to medicine and, in our special case, to neuroscience and neurosurgery. After answering those questions, and in response to a critical letter to the editor, this review article then expounds comprehensively on the historical and philosophical origins of ethics and religious morality. Necessarily, we discuss the Graeco-Roman legacy and the Judeo-Christian inheritance in the development of ethics and religious morality in Western civilization and their impact on moral conduct in general and on medical and neuroscience ethics in particular.

  5. Zika Virus: Medical Countermeasure Development Challenges

    Science.gov (United States)

    Malone, Robert W.; Homan, Jane; Callahan, Michael V.; Glasspool-Malone, Jill; Damodaran, Lambodhar; Schneider, Adriano De Bernardi; Zimler, Rebecca; Talton, James; Cobb, Ronald R.; Ruzic, Ivan; Smith-Gagen, Julie; Janies, Daniel; Wilson, James

    2016-01-01

    Introduction Reports of high rates of primary microcephaly and Guillain–Barré syndrome associated with Zika virus infection in French Polynesia and Brazil have raised concerns that the virus circulating in these regions is a rapidly developing neuropathic, teratogenic, emerging infectious public health threat. There are no licensed medical countermeasures (vaccines, therapies or preventive drugs) available for Zika virus infection and disease. The Pan American Health Organization (PAHO) predicts that Zika virus will continue to spread and eventually reach all countries and territories in the Americas with endemic Aedes mosquitoes. This paper reviews the status of the Zika virus outbreak, including medical countermeasure options, with a focus on how the epidemiology, insect vectors, neuropathology, virology and immunology inform options and strategies available for medical countermeasure development and deployment. Methods Multiple information sources were employed to support the review. These included publically available literature, patents, official communications, English and Lusophone lay press. Online surveys were distributed to physicians in the US, Mexico and Argentina and responses analyzed. Computational epitope analysis as well as infectious disease outbreak modeling and forecasting were implemented. Field observations in Brazil were compiled and interviews conducted with public health officials. PMID:26934531

  6. Zika Virus: Medical Countermeasure Development Challenges.

    Science.gov (United States)

    Malone, Robert W; Homan, Jane; Callahan, Michael V; Glasspool-Malone, Jill; Damodaran, Lambodhar; Schneider, Adriano De Bernardi; Zimler, Rebecca; Talton, James; Cobb, Ronald R; Ruzic, Ivan; Smith-Gagen, Julie; Janies, Daniel; Wilson, James

    2016-03-01

    Reports of high rates of primary microcephaly and Guillain-Barré syndrome associated with Zika virus infection in French Polynesia and Brazil have raised concerns that the virus circulating in these regions is a rapidly developing neuropathic, teratogenic, emerging infectious public health threat. There are no licensed medical countermeasures (vaccines, therapies or preventive drugs) available for Zika virus infection and disease. The Pan American Health Organization (PAHO) predicts that Zika virus will continue to spread and eventually reach all countries and territories in the Americas with endemic Aedes mosquitoes. This paper reviews the status of the Zika virus outbreak, including medical countermeasure options, with a focus on how the epidemiology, insect vectors, neuropathology, virology and immunology inform options and strategies available for medical countermeasure development and deployment. Multiple information sources were employed to support the review. These included publically available literature, patents, official communications, English and Lusophone lay press. Online surveys were distributed to physicians in the US, Mexico and Argentina and responses analyzed. Computational epitope analysis as well as infectious disease outbreak modeling and forecasting were implemented. Field observations in Brazil were compiled and interviews conducted with public health officials.

  7. Zika Virus: Medical Countermeasure Development Challenges.

    Directory of Open Access Journals (Sweden)

    Robert W Malone

    2016-03-01

    Full Text Available Reports of high rates of primary microcephaly and Guillain-Barré syndrome associated with Zika virus infection in French Polynesia and Brazil have raised concerns that the virus circulating in these regions is a rapidly developing neuropathic, teratogenic, emerging infectious public health threat. There are no licensed medical countermeasures (vaccines, therapies or preventive drugs available for Zika virus infection and disease. The Pan American Health Organization (PAHO predicts that Zika virus will continue to spread and eventually reach all countries and territories in the Americas with endemic Aedes mosquitoes. This paper reviews the status of the Zika virus outbreak, including medical countermeasure options, with a focus on how the epidemiology, insect vectors, neuropathology, virology and immunology inform options and strategies available for medical countermeasure development and deployment.Multiple information sources were employed to support the review. These included publically available literature, patents, official communications, English and Lusophone lay press. Online surveys were distributed to physicians in the US, Mexico and Argentina and responses analyzed. Computational epitope analysis as well as infectious disease outbreak modeling and forecasting were implemented. Field observations in Brazil were compiled and interviews conducted with public health officials.

  8. An analytic approach to resolving problems in medical ethics.

    Science.gov (United States)

    Candee, D; Puka, B

    1984-06-01

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

  9. An analytic approach to resolving problems in medical ethics.

    Science.gov (United States)

    Candee, D; Puka, B

    1984-01-01

    Education in ethics among practising professionals should provide a systematic procedure for resolving moral problems. A method for such decision-making is outlined using the two classical orientations in moral philosophy, teleology and deontology. Teleological views such as utilitarianism resolve moral dilemmas by calculating the excess of good over harm expected to be produced by each feasible alternative for action. The deontological view focuses on rights, duties, and principles of justice. Both methods are used to resolve the 1971 Johns Hopkins case of a baby born with Down's syndrome and duodenal atresia. PMID:6234395

  10. Social learning in the Anthropocene: Novel challenges, shadow networks, and ethical practices.

    Science.gov (United States)

    Schmidt, Jeremy J

    2017-05-15

    The Anthropocene presents novel challenges for environmental management. This paper considers the challenges that the Anthropocene poses for social learning techniques in adaptive management. It situates these challenges with respect to how anthropogenic forcing on the Earth system affects the conditions required for: (1) The cooperative exercises of social learning; (2) The techniques used for assessing the fit of institutions to social-ecological systems; and, (3) The strategies employed for identifying management targets that are transformed by human action. In view of these challenges, the paper then examines how the practices of shadow networks may provide paths for incorporating a broader, more robust suite of social learning practices in the Anthropocene. The paper emphasizes how novel challenges in the Anthropocene demand increased attention to ethical practices, particularly those that establish center-periphery relationships between social learning communities and shadow networks. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. How Important is Medical Ethics and History of Medicine Teaching in the Medical Curriculum? An Empirical Approach towards Students' Views

    Science.gov (United States)

    Schulz, Stefan; Woestmann, Barbara; Huenges, Bert; Schweikardt, Christoph; Schäfer, Thorsten

    2012-01-01

    Objectives: It was investigated how students judge the teaching of medical ethics and the history of medicine at the start and during their studies, and the influence which subject-specific teaching of the history, theory and ethics of medicine (GTE) - or the lack thereof - has on the judgement of these subjects. Methods: From a total of 533 students who were in their first and 5th semester of the Bochum Model curriculum (GTE teaching from the first semester onwards) or followed the traditional curriculum (GTE teaching in the 5th/6th semester), questionnaires were requested in the winter semester 2005/06 and in the summer semester 2006. They were asked both before and after the 1st and 5th (model curriculum) or 6th semester (traditional curriculum). We asked students to judge the importance of teaching medical ethics and the history of medicine, the significance of these subjects for physicians and about teachability and testability (Likert scale from -2 (do not agree at all) to +2 (agree completely)). Results: 331 questionnaire pairs were included in the study. There were no significant differences between the students of the two curricula at the start of the 1st semester. The views on medical ethics and the history of medicine, in contrast, were significantly different at the start of undergraduate studies: The importance of medical ethics for the individual and the physician was considered very high but their teachability and testability were rated considerably worse. For the history of medicine, the results were exactly opposite. GTE teaching led to a more positive assessment of items previously ranked less favourably in both curricula. A lack of teaching led to a drop in the assessment of both subjects which had previously been rated well. Conclusion: Consistent with the literature, our results support the hypothesis that the teaching of GTE has a positive impact on the views towards the history and ethics of medicine, with a lack of teaching having a negative

  12. What Ethical Issues Really Arise in Practice at an Academic Medical Center? A Quantitative and Qualitative Analysis of Clinical Ethics Consultations from 2008 to 2013.

    Science.gov (United States)

    Wasson, Katherine; Anderson, Emily; Hagstrom, Erika; McCarthy, Michael; Parsi, Kayhan; Kuczewski, Mark

    2016-09-01

    As the field of clinical ethics consultation sets standards and moves forward with the Quality Attestation process, questions should be raised about what ethical issues really do arise in practice. There is limited data on the type and number of ethics consultations conducted across different settings. At Loyola University Medical Center, we conducted a retrospective review of our ethics consultations from 2008 through 2013. One hundred fifty-six cases met the eligibility criteria. We analyzed demographic data on these patients and conducted a content analysis of the ethics consultation write-ups coding both the frequency of ethical issues and most significant, or key, ethical issue per case. Patients for whom ethics consultation was requested were typically male (55.8 %), white (57.1 %), between 50 and 69 years old (38.5 %), of non-Hispanic origin (85.9 %), and of Roman Catholic faith (43.6 %). Nearly half (47.4 %) were in the intensive care unit and 44.2 % died in the hospital. The most frequent broad ethical categories were decision-making (93.6 %), goals of care/treatment (80.8 %), and end-of-life (73.1 %). More specifically, capacity (57.1 %), patient's wishes/autonomy (54.5 %), and surrogate decision maker (51.3 %) were the most frequent particular ethical issues. The most common key ethical issues were withdrawing/withholding treatment (12.8 %), patient wishes/autonomy (12.2 %), and capacity (11.5 %). Our findings provide additional data to inform the training of clinical ethics consultants regarding the ethical issues that arise in practice. A wider research agenda should be formed to collect and compare data across institutions to improve education and training in our field.

  13. [Medical history and ethics. In memoriam Rolf Winau (1937-2006)].

    Science.gov (United States)

    Schott, Heinz

    2008-01-01

    The paper contributes to the discussion on the self-image of the institutionalized medical history at the medical schools in Germany. Influenced by the curriculum of the new licence to practice medicine (Approbationsordnung für Arzte) containing a so-called cross-section (Querschnittsbereich) "history, theory, ethics of medicine", the scientific community is to a certain extent rather prone to assume clear cut different disciplines--especially medical history versus medical ethics--than to consider overlapping and almost inseparable fields of work with corresponding implications. The author supports the latter approach and advocates the appreciation of the "subjective factor" in regard to teaching granting an ample scope for the individual teacher.

  14. Psychotropic Medication Consultation in Schools: An Ethical and Legal Dilemma for School Psychologists

    Science.gov (United States)

    Carlson, John S.; Thaler, Cara L.; Hirsch, Amanda J.

    2006-01-01

    Assessing, consulting, and intervening with students being treated with psychotropic medications is an increasingly common activity for school psychologists. This article reviews some of the literature providing evidence for the greater need for training in school psychopharmacology. A legal and ethical case study is presented that highlights the…

  15. Medication-Related Practice Roles: An Ethical and Legal Primer for School Psychologists

    Science.gov (United States)

    Shahidullah, Jeffrey D.

    2014-01-01

    Given the prevalence of school-age children and adolescents who are prescribed with and are taking psychotropic medications, a critical issue that school psychologists may likely encounter in contemporary practice is providing both quality and continuity of care to these students in the context of relevant legal and ethical parameters. With a…

  16. The first medical ethics and deontology in Europe as derived from Greek mythology.

    Science.gov (United States)

    Konstantinidou, Meropi K; Pavlides, Pavlos; Fiska, Aliki

    2016-01-01

    Medical ethics and deontology are mentioned in Greek myths long before 700 B.C. We collected and present information derived from ancient Greek mythology and related to (how) ancient physicians took care of the sick or injured and how they were rewarded for their services.

  17. Relevance of the Rationalist-Intuitionist Debate for Ethics and Professionalism in Medical Education

    Science.gov (United States)

    Leffel, G. Michael; Mueller, Ross A. Oakes; Curlin, Farr A.; Yoon, John D.

    2015-01-01

    Despite widespread pedagogical efforts to modify discrete behaviors in developing physicians, the professionalism movement has generally shied away from essential questions such as what virtues characterize the good physician, and how are those virtues formed? Although there is widespread adoption of medical ethics curricula, there is still no…

  18. Can Opening ‘Ethics Files’ on Medical Staff Improve Patients’ Care?

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Healthcare workers in Shanghai are walking the line after recent news that regulations issued by local health authorities will soon enforce the opening of an “ethics file” for each of the city’s 140,000 medical workers. According to the regulations, once

  19. [Challenges Analysis and Strategic Consideration on Medical Equipment Maintenance].

    Science.gov (United States)

    Deng, Tianhua; Yu, Bo

    2015-03-01

    Expounding the status of the current domestic medical equipment maintenance management, and puting forward the strategic thinking of medical maintenance for the challenges of equipment maintenance management in the hospital. This discussion can be performed to control the maintenance costs of hospital effectively, increase the income and social benefits of the hospital.

  20. Medical law - challenges in bosnia and herzegovina.

    Science.gov (United States)

    Masic, Izet; Hajdarevic, Braco; Ridjanovic, Zoran

    2010-01-01

    THERE ARE FOUR TYPES OF RESPONSIBILITIES THAT ARISE ON THE BASIS OF MEDICAL ERRORS: a) Disciplinary (Punishment of the competent Association for restriction or revocation of the license); b) Civil liability (compensation); c) Criminal responsibility (protection of individual interests to protect the interests of the society); d) Violation (fine for minor damage) To increase the number of criminal proceedings mostly influenced the lack of compensation system for harm because the injured party considered that after the positive completion of criminal proceedings can easily make a claim. Therefore they do not address the local Association or Ministry of Health to investigate a case, but to the criminal proceedings to try to get compensation. It turned out that this is a dispute that is usually long lasting, with an uncertain outcome, which does not bring satisfaction to the plaintiff, and had a series of negative consequences in the general approach to the treatment of patients known as "defensive medicine". As a result of the increased number of lawsuits due to medical errors are caused the following negative consequences: a) Great vigilance of physicians in communicating with patients, who must sign a 2-3 statements when entering the hospital, and that sometimes are not really familiar with the nature of illness and required treatment; b) Significant increase in the number of unnecessary tests which are required by doctors to insure themselves from the potential liability, which at a given moment are not really necessary; c) Lack of medical error reporting system allows individuals to avoid their reporting, which affects the course of treatment and prognosis; d) Often avoidance by the doctors to perform some necessary procedures that are risky, with increasingly open refusal to cure a poor prognosis case which they left to the next level of treatment. Disappears so called "heroic approach" to the treatment in the B&H health system known from the war period and gives

  1. Impact of managed care on the development of new medical technology: ethical concerns

    Science.gov (United States)

    Saha, Pamela; Saha, Subrata

    1995-10-01

    During the last three decades, development of new medical technology has been largely responsible for the spectacular advances in the diagnosis and treatment of many human diseases. This has contributed to improved medical care of our population. However, concerns have been raised that in today's managed care environment of health care, introduction of new medical technology will be difficult. Cost-sensitive health care providers should consider various ethical issues involved before demanding that only those technologies that save money and show highly positive cost benefit ratio will be reimbursed. The impact of such considerations on the innovations of new medical devices and their developments is discussed.

  2. Application of legal principles and medical ethics: multifetal pregnancy and fetal reduction.

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    Cheong, M A; Tay, S K

    2014-06-01

    In the management of complex medical cases such as a multifetal pregnancy, knowledge of the ethical and legal implications is important, alongside having competent medical skills. This article reviews these principles and applies them to scenarios of multifetal pregnancy and fetal reduction. Such a discussion is not solely theoretical, but is also relevant to clinical practice. The importance of topics such as bioethical principles and informed consent are also herein addressed.

  3. From individual to population: Challenges in Medical Visualization

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    Botha, Charl P; Kaufman, Arie; Takahashi, Shigeo; Ynnerman, Anders

    2012-01-01

    In this paper, we first give a high-level overview of medical visualization development over the past 30 years, focusing on key developments and the trends that they represent. During this discussion, we will refer to a number of key papers that we have also arranged on the medical visualization research timeline. Based on the overview and our observations of the field, we then identify and discuss the medical visualization research challenges that we foresee for the coming decade.

  4. The ethical commitment of Australian radiographers: Does medical dominance create an influence?

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    Lewis, Sarah [School of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, East Street, PO Box 170, Lidcombe, NSW 1825 (Australia)], E-mail: s.lewis@fhs.usyd.edu.au; Heard, Robert [School of Behavioural and Community Health Science, Faculty of Health Sciences, University of Sydney, East Street, PO Box 170, Lidcombe, NSW 1825 (Australia); Robinson, John [School of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, East Street, PO Box 170, Lidcombe, NSW 1825 (Australia); White, Karolyn [Centre for Values and Ethics and the Law in Medicine, Faculty of Medicine, University of Sydney, East Street, PO Box 170, Lidcombe, NSW 1825 (Australia); Poulos, Ann [School of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, East Street, PO Box 170, Lidcombe, NSW 1825 (Australia)

    2008-05-15

    There is a lack of awareness and openness surrounding ethical debate in Diagnostic Radiography literature and culture, perpetuated in part by the historical growth of the technical realm of radiography, radiology and medicine. Hence, the impact of Australian radiographers' current level of professional autonomy, combined with the influence of medical dominance and radiographers' ethical commitment was undocumented. This study investigated the role, importance and attitudes of Australian radiographers towards ethics through a qualitative study following a grounded theory approach. Semi-structured interviews were conducted with 25 Australian. A conceptual framework mapping the causal conditions affecting the ethical commitment was developed. This study argues that a number of internal and external variables weave an intricate fabric of poor identity, subservience and negative workplace culture. Australian radiographers, whist attempting to set a standard of ethical commitment, are hindered by difficulties of medical dominance, relatively poor professional autonomy and difficulty in accepting responsibility. The presence of private radiology enterprise and the association between patient referral and money has eroded the radiographer-patient relationship and introduced the potential for unethical practice in the radiographer-radiologist-referring practitioner relationship.

  5. Poverty and maternal mortality in Nigeria: towards a more viable ethics of modern medical practice

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    Lanre-Abass Bolatito A

    2008-04-01

    Full Text Available Abstract Poverty is often identified as a major barrier to human development. It is also a powerful brake on accelerated progress toward the Millennium Development Goals. Poverty is also a major cause of maternal mortality, as it prevents many women from getting proper and adequate medical attention due to their inability to afford good antenatal care. This Paper thus examines poverty as a threat to human existence, particularly women's health. It highlights the causes of maternal deaths in Nigeria by questioning the practice of medicine in this country, which falls short of the ethical principle of showing care. Since high levels of poverty limit access to quality health care and consequently human development, this paper suggests ways of reducing maternal mortality in Nigeria. It emphasizes the importance of care ethics, an ethical orientation that seeks to rectify the deficiencies of medical practice in Nigeria, notably the problem of poor reproductive health services. Care ethics as an ethical orientation, attends to the important aspects of our shared lives. It portrays the moral agent (in this context the physician as a self who is embedded in webs of relations with others (pregnant women. Also central to this ethical orientation is responsiveness in an interconnected network of needs, care and prevention of harm. This review concludes by stressing that many human relationships involve persons who are vulnerable, including pregnant women, dependent, ill and or frail, noting that the desirable moral response is that prescribed by care ethics, which thus has implications for the practice of medicine in Nigeria.

  6. Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context.

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    London, Leslie; Tangwa, Godfrey; Matchaba-Hove, Reginald; Mkhize, Nhlanhla; Nwabueze, Remi; Nyika, Aceme; Westerholm, Peter

    2014-06-23

    International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address workplace hazards demand

  7. Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context

    Science.gov (United States)

    2014-01-01

    Background International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Discussion Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address

  8. Practising virtue: a challenge to the view that a virtue centred approach to ethics lacks practical content.

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    Begley, Ann Marie

    2005-11-01

    A virtue centred approach to ethics has been criticized for being vague owing to the nature of its central concept, the paradigm person. From the perspective of the practitioner the most damaging charge is that virtue ethics fails to be action guiding and, in addition to this, it does not offer any means of act appraisal. These criticisms leave virtue ethics in a weak position vis-à-vis traditional approaches to ethics. The criticism is, however, challenged by Hursthouse in her analysis of the accounts of right action offered by deontology, utilitarianism and virtue ethics. It is possible to defend the action guiding nature of virtue ethics: there are virtue rules and exemplars to guide action. Insights from Aristotle's practical approach to ethics are considered alongside Hursthouse's analysis and it is suggested that virtue ethics is also capable of facilitating action appraisal. It is at the same time acknowledged that approaches to virtue ethics vary widely and that the challenges offered here would be rejected by those who embrace a radical replacement virtue approach.

  9. [New challenges for humanism in medical practice].

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    Soberón-Acevedo, G; García-Viveros, M; Narro-Robles, J

    1994-01-01

    This work is a review of the philosophical analysis surrounding the concept of "humanism" and what it means to be a human being, in relationship to daily life, education and medicine. The authors establish a direct relationship between humanism and bioethics as they relate to the new trends acquired through the development of institutional medicine and the increasing application of technological innovations in the health field. Both of these conditions tend to depersonalize the practice of medicine, and transform an ill person into a clinical file. Reflections are made about current topics, such as the knowledge and manipulation of human genome, assisted reproduction, abortion, survival of premature infants, organ transplants, technological innovation, euthanasia and disthanasia. Concepts and ideas are reviewed in relation to medical institutions and the sick, the physician and the community, and the physician and the government.

  10. Fearing a non-existing Minotaur? The ethical challenges of research on cytoplasmic hybrid embryos.

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    Camporesi, S; Boniolo, G

    2008-11-01

    In this paper we address the ethical challenges of research on cytoplasmic hybrid embryos, or "cybrids". The controversial pronouncement of the UK's Human Embryology and Fertilisation Authority of September 2007 on the permissibility of this area of research is the starting point of our discussion, and we argue in its favour. By a rigorous definition of the entities at issue, we show how the terms "chimera" and "hybrid" are improper in the case of cybrids, and how their use can bias the debate creating moral prejudices. After analysing the scientific aspects of cybrids research and sketching out current alternatives, we enter the ethical debate, starting from the premise that research on early human embryos is ethically permissible under some circumstances. We emphasise how research on cybrids has positive consequences in terms of scientific and therapeutic applications, since it allows the derivation of human embryonic stem cells genetically tailored to the somatic cell donor. Such cell lines offer a unique in vitro model both for studies of human pathogenesis and for drug screening and discovery. Research on cybrids also circumvents the problem of the scarcity of human oocytes and their ethically dubious donation. Finally, we object to the most common arguments against cybrids research, that is, moral repugnance, the slippery slope argument, the appeal to "nature", and the unfair distribution of economical resources.

  11. 移动互联网视阈下的医德教育思考%Thinking about medical ethics education from the perspective of mobile Internet

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    孙莹炜; 刘芳

    2015-01-01

    移动互联网给医德教育带来机遇与挑战,如何在移动互联网时代加强医德教育效果,彰显医德教育力量显得尤为紧迫和重要。本文通过梳理移动互联网时代的变化和特点,对在移动互联网视阈下如何改进和加强医德教育进行分析,对途径效果进行思考,以期多方面提升医德教育的针对性和实效性。%Mobile internet brings opportunities and challenges to medical ethics education. It is particularly urgent and important to explore how to advance the effect and express the power of medical ethics education in the era of mobile Internet. This article analyzes the changes and characteristics of the mobile Internet era, studies how to improve and enhance medical ethics education from the perspective of mobile Internet and explores the effect of ways, in order to improve the pertinence and effectiveness of medical ethics education in many aspects.

  12. A New Ethical Challenge for Institutional Review Boards (IRBs)/Ethics Committees (ECs) in the Assessment of Pediatric Clinical Trials.

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    Rose, Klaus; Kummer, Hans

    2015-01-01

    Both the US and EU have introduced pediatric pharmaceutical legislation to facilitate clinical trials in children and development of better medicines for children. The first concerns were published in 2014 that the European Medicines Agency (EMA)'s Pediatric Committee (PDCO) may be over-enthusiastic and has compelled questionable pediatric clinical trials from pharmaceutical companies. Numerous clinical trials are mandated in rare conditions for which not enough patients exist for even one trial. Furthermore, where these trials are mandated in adolescent patients, the legal age limit of the 18th birthday is confused with a medical age limit and can result in separate clinical trials in adolescent patients that neither make medical nor scientific sense nor will ever recruit enough patients for a meaningful outcome. To confirm our concerns we searched the registry clinicaltrials.gov and found examples for PDCO-triggered unethical trials. We conclude that such trials should not be accepted by institutional review boards (IRBs)/ethics committees (ECs) and that clinical trials resulting from negotiations with EMA's PDCO need extra careful scrutiny by IRBs/ECs in order to prevent unethical studies and damage to pediatric research and unnecessary risks to pediatric patients.

  13. A New Ethical Challenge for Institutional Review Boards (IRBs/Ethics Committees (ECs in the Assessment of Pediatric Clinical Trials

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    Klaus Rose

    2015-05-01

    Full Text Available Both the US and EU have introduced pediatric pharmaceutical legislation to facilitate clinical trials in children and development of better medicines for children. The first concerns were published in 2014 that the European Medicines Agency (EMA’s Pediatric Committee (PDCO may be over-enthusiastic and has compelled questionable pediatric clinical trials from pharmaceutical companies. Numerous clinical trials are mandated in rare conditions for which not enough patients exist for even one trial. Furthermore, where these trials are mandated in adolescent patients, the legal age limit of the 18th birthday is confused with a medical age limit and can result in separate clinical trials in adolescent patients that neither make medical nor scientific sense nor will ever recruit enough patients for a meaningful outcome. To confirm our concerns we searched the registry clinicaltrials.gov and found examples for PDCO-triggered unethical trials. We conclude that such trials should not be accepted by institutional review boards (IRBs/ethics committees (ECs and that clinical trials resulting from negotiations with EMA’s PDCO need extra careful scrutiny by IRBs/ECs in order to prevent unethical studies and damage to pediatric research and unnecessary risks to pediatric patients.

  14. PERCEPTIONS OF INTERNS TOWARDS A MODULE FOR TEACHING MEDICAL ETHICS USING THE ANDROID SMARTPHONE APPLICATION WHATSAPP

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    Archana

    2015-10-01

    Full Text Available Introduction of ethics and communication skills into the undergraduate medical curriculum is being contemplated by the medical council of India as a part of competency training. The methods of delivering the content are still in the formative process. Interns experience e thical dilemmas when they step into the real world clinical experiences albeit supervised. Delivering a curriculum to them is practically difficult because they are at different places and have different work shifts. This study is a pilot project to know t he extent to which interns felt engaged with medical ethics and how relevant they considered structured classes for learning principles of medical ethics and to explore the whatsapp messenger system in teaching medical ethics. MATERIALS AND METHODS: A what sapp group of consenting interns was formed and a series of short notes with activities were posted on the whatsapp group for them to learn. They were then assessed by 2 assessors in the form of responses to 4 short essay questions for 15 marks that they p osted on a google form, the link for which was also posted on the whatsapp group. RESULTS AND DISCUSSION: Out of 20 interns, 12 consented to participate in the study and the others could not as they did not have a smartphone. The average duration to comple te the responses was 4.5 days [ + 3.1 days]. Average marks obtained were 5.3[ + 4.1] out of 15 marks. Only 6 interns crossed the benchmark of 50%. Most of them liked whatsapp as a tool of education but found structured classes for ethics unnecessary. They expr essed the need for developing a module incorporating pictures, videos and multiple choice questions if whatsapp was to be used as a tool to learn ethics. CONCLUSIONS: There is need to reinforce the training of interns in medical ethics and professionalism. The present method of using whatsapp messenger as a teaching tool is met with a few barriers that need improvisation. LIMITATIONS: This study is limited by a

  15. Intervention Research with Youths at Elevated Risk for Suicide: Meeting the Ethical and Regulatory Challenges of Informed Consent and Assent

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    King, Cheryl A.; Kramer, Anne C.

    2008-01-01

    Intervention research with youths at elevated risk for suicidal behavior and suicide--a vulnerable and high risk population--presents investigators with numerous ethical challenges. This report specifically addresses those challenges involving the informed consent and assent process with parents/guardians and youths. The challenges are delineated…

  16. Drug advertisements published in Indian Medical Journals: Are they ethical?

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    Jaykaran Charan

    2011-01-01

    Full Text Available Context : It is observed in studies done for western medical journals that insufficient information related to drug is usually provided in the drug advertisements published in them. Aims : As data for advertisements published in Indian Medical Journals were lacking, this study was designed with the aim of evaluating drug advertisements published in Indian Medical Journals for adequacy of information on drug and references given to support the claim made in the advertisements. Settings and Design : Cross-sectional survey. Methods and Materials : All medical journals related to clinical practice subscribed by the Central Library of Government Medical College, Surat, (Indian Journal of Pediatrics [IJP], Indian Pediatrics [IP], Journal of the Association of Physicians of India [JAPI], Journal of Indian Medical Association [JIMA], Indian Journal of Critical Care Medicine [IJCCM], Indian Journal of Medical and Pediatric Oncology [IJMPO], Indian Journal of Gastroenterology [IJG], Indian Journal of Ophthalmology [IJO], and Journal of Obstetrics and Gynecology of India [JOGI] were evaluated for adequacy of reporting of various parameters in drug advertisements published in these journals on the basis of "World Heath Organization (WHO" criteria. References mentioned to support claims were also evaluated. Statistical Analysis Used : Descriptive statistics was used to describe data as frequencies, percentages, and 95% confidence interval around the percentage. Results : Generic name was mentioned in 90% advertisements. Indications were mentioned in 84% advertisements. Dose, precautions, and contraindications were mentioned in 24%, 17%, and 16% advertisements, respectively. Adverse effects and postal address of pharmaceutical company was mentioned in 19% and 74% advertisements, respectively. Price was mentioned in only 5% advertisements. Only 28% claims were supported by references. Most common references were Journal articles (75%. Conclusion : Drug

  17. Drug advertisements published in Indian Medical Journals: Are they ethical?

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    Charan, Jaykaran; Yadav, Preeti; Saxena, Deepak; Kantharia, N D

    2011-07-01

    It is observed in studies done for western medical journals that insufficient information related to drug is usually provided in the drug advertisements published in them. As data for advertisements published in Indian Medical Journals were lacking, this study was designed with the aim of evaluating drug advertisements published in Indian Medical Journals for adequacy of information on drug and references given to support the claim made in the advertisements. Cross-sectional survey. All medical journals related to clinical practice subscribed by the Central Library of Government Medical College, Surat, (Indian Journal of Pediatrics [IJP], Indian Pediatrics [IP], Journal of the Association of Physicians of India [JAPI], Journal of Indian Medical Association [JIMA], Indian Journal of Critical Care Medicine [IJCCM], Indian Journal of Medical and Pediatric Oncology [IJMPO], Indian Journal of Gastroenterology [IJG], Indian Journal of Ophthalmology [IJO], and Journal of Obstetrics and Gynecology of India [JOGI] were evaluated for adequacy of reporting of various parameters in drug advertisements published in these journals on the basis of "World Heath Organization (WHO)" criteria. References mentioned to support claims were also evaluated. Descriptive statistics was used to describe data as frequencies, percentages, and 95% confidence interval around the percentage. Generic name was mentioned in 90% advertisements. Indications were mentioned in 84% advertisements. Dose, precautions, and contraindications were mentioned in 24%, 17%, and 16% advertisements, respectively. Adverse effects and postal address of pharmaceutical company was mentioned in 19% and 74% advertisements, respectively. Price was mentioned in only 5% advertisements. Only 28% claims were supported by references. Most common references were Journal articles (75%). Drug advertisements published in Indian Medical Journals are poor in reporting various parameters according to WHO criteria.

  18. Human guinea pigs and the ethics of experimentation: the BMJ's correspondent at the Nuremberg medical trial.

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    Weindling, P

    1996-12-07

    Though the Nuremberg medical trial was a United States military tribunal, British forensic pathologists supplied extensive evidence for the trial. The BMJ had a correspondent at the trial, and he endorsed a utilitarian legitimation of clinical experiments, justifying the medical research carried out under Nazism as of long term scientific benefit despite the human costs. The British supported an international medical commission to evaluate the ethics and scientific quality of German research. Medical opinions differed over whether German medical atrocities should be given publicity or treated in confidence. The BMJ's correspondent warned against medical researchers being taken over by a totalitarian state, and these arguments were used to oppose the NHS and any state control over medical research.

  19. Pedagogy and Purpose: Moral Imagination and the Teaching of Medical Ethics.

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    Hart, Curtis W

    2016-04-01

    This essay is an exploration of the development of moral imagination as an important outcome in the teaching of medial ethics. It is contextualized within the growth of professionalism and pays attention to the formation of character of physicians in their formal training and in the first phase of their careers. Issues around formation as it is understood historically in the vocation of the clergy are also considered. Finally, there is discussion of the place rites of passage as they figure in the lives of those who teach medical ethics.

  20. Analysis and Understanding of Medical Ethics%对医学伦理学的浅析和理解

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    潘金燕; 张晗; 崔凤梅

    2016-01-01

    医学伦理学是医学生的一门必修课,在职业道德培养和指导解决医疗技术带来的社会问题中具有重要作用。本文从非医学专业视角探讨了对医学伦理学的认识和理解,对非医学专业人员理解和接受医学伦理学具有一定科普性质,对督促医学生尽早用伦理学的知识武装自己,形成良好的医德,正确利用先进的医疗技术具有一定的指导作用。%Medical ethics is a required course for medical students, and it plays an important role in the cultivation of professional ethics and the guidance of the social problems brought by medical technology. The from the perspective of non medical professional discussed knowledge and understanding of medical ethics, to non medical professionals to understand and accept medical ethics has a certain nature of science, to urge the medical students as soon as possible with ethics of knowledge to arm themselves, the formation of good medical ethics, the correct use of the advanced medical technology has a certain guiding role.