Ethical concerns of nursing reviewers: an international survey.

PubMed

Broome, Marion; Dougherty, Molly C; Freda, Margaret C; Kearney, Margaret H; Baggs, Judith G

2010-11-01

Editors of scientific literature rely heavily on peer reviewers to evaluate the integrity of research conduct and validity of findings in manuscript submissions. The purpose of this study was to describe the ethical concerns of reviewers of nursing journals. This descriptive cross-sectional study was an anonymous online survey. The findings reported here were part of a larger investigation of experiences of reviewers. Fifty-two editors of nursing journals (six outside the USA) agreed to invite their review panels to participate. A 69-item forced-choice and open-ended survey developed by the authors based on the literature was pilot tested with 18 reviewers before being entered into SurveyMonkey(TM). A total of 1675 reviewers responded with useable surveys. Six questions elicited responses about ethical issues, such as conflict of interest, protection of human research participants, plagiarism, duplicate publication, misrepresentation of data and 'other'. The reviewers indicated whether they had experienced such a concern and notified the editor, and how satisfied they were with the outcome. They provided specific examples. Approximately 20% of the reviewers had experienced various ethical dilemmas. Although the majority reported their concerns to the editor, not all did so, and not all were satisfied with the outcomes. The most commonly reported concern perceived was inadequate protection of human participants. The least common was plagiarism, but this was most often reported to the editor and least often led to a satisfactory outcome. Qualitative responses at the end of the survey indicate this lack of satisfaction was most commonly related to feedback provided on resolution by the editor. The findings from this study suggest several areas that editors should note, including follow up with reviewers when they identify ethical concerns about a manuscript.

Ethical concerns in nurse migration.

PubMed

McElmurry, Beverly J; Solheim, Karen; Kishi, Rieko; Coffia, Marcia A; Woith, Wendy; Janepanish, Poolsuk

2006-01-01

International nurse migration is natural and to be expected. Recently, however, those who have fostered nurse migration believe that it will solve nursing shortages in developed countries and offer nurse migrants better working conditions and an improved quality of life. Whether natural or manipulated, migration flow patterns largely occur from developing to developed countries. In this article, nurse migration is examined using primary health care (PHC) as an ethical framework. The unmanaged flow of nurse migrants from developing to developed countries is inconsistent with "health for all" principles. Removing key health personnel from countries experiencing resource shortages is contrary to PHC equity. Often, nurse migrants are placed in vulnerable, inequitable work roles, and employing nurse migrants fails to address basic causes of nurse shortages in developed countries, such as dissatisfaction with work conditions and decreased funding for academic settings. Nurse migration policies and procedures can be developed to satisfy PHC ethics criteria if they (1) leave developing countries enhanced rather than depleted, (2) contribute to country health outcomes consistent with essential care for all people, (3) are based on community participation, (4) address common nursing labor issues, and (5) involve equitable and clear financial arrangements.

Balancing Ethics and Quality in Educational Research--The Ethical Matrix Method

ERIC Educational Resources Information Center

Tangen, Reidun

2014-01-01

This paper addresses ethical issues in educational research with a focus on the interplay between research ethics and both internal and external quality of research. Research ethics is divided into three domains: (1) ethics "within" the research community; (2) ethics concerning relationships with "individuals and groups directly…

Ethical issues raised in addressing the needs of people with serious mental disorders in complex emergencies.

PubMed

Wissow, Lawrence S; Rutkow, Lainie; Kass, Nancy E; Rabins, Peter V; Vernick, Jon S; Hodge, James G

2012-03-01

Recent manmade and natural disasters highlight weaknesses in the public health systems designed to protect populations from harm and minimize disruption of the social and built environments. Emergency planning and response efforts have, as a result, focused largely on ensuring populations' physical well-being during and after a disaster. Many public health authorities, including the World Health Organization, have recognized the importance of addressing both mental and physical health concerns in emergency plans. Individuals with mental disorders represent a notable proportion of the overall population, and anticipating their needs is critical to comprehensive emergency planning and response efforts. Because people with serious mental disorders historically have been stigmatized, and many individuals with mental disorders may be unable to care for themselves, ethical guidance may be of assistance to those engaged in emergency planning and response. This article considers several broad categories of ethical issues that arise during emergencies for people with serious mental disorders and offers recommendations for ways in which emergency planners and other stakeholders can begin to address these ethical challenges.

Ethical Concerns and Procedural Pathways for Patients Who are Incapacitated and Alone: Implications from a Qualitative Study for Advancing Ethical Practice.

PubMed

Moye, Jennifer; Catlin, Casey; Kwak, Jennifer; Wood, Erica; Teaster, Pamela B

2017-06-01

Adults who are incapacitated and alone, having no surrogates, may be known as "unbefriended." Decision-making for these particularly vulnerable patients is a common and vexing concern for healthcare providers and hospital ethics committees. When all other avenues for resolving the need for surrogate decision-making fail, patients who are incapacitated and alone may be referred for "public guardianship" or guardianship of last resort. While an appropriate mechanism in theory, these programs are often under-staffed and under-funded, laying the consequences of inadequacies on the healthcare system and the patient him or herself. We describe a qualitative study of professionals spanning clinical, court, and agency settings about the mechanisms for resolving surrogate consent for these patients and problems therein within the state of Massachusetts. Interviews found that all participants encountered adults who are incapacitated and without surrogates. Four approaches for addressing surrogate needs were: (1) work to restore capacity; (2) find previously unknown surrogates; (3) work with agencies to obtain surrogates; and (4) access the guardianship system. The use of guardianship was associated with procedural challenges and ethical concerns including delays in care, short term gains for long term costs, inabilities to meet a patient's values and preferences, conflicts of interest, and ethical discomfort among interviewees. Findings are discussed in the context of resources to restore capacity, identify previously unknown surrogates, and establish improved surrogate mechanisms for this vulnerable population.

Ethical Issues for Direct-to-Consumer Digital Psychotherapy Apps: Addressing Accountability, Data Protection, and Consent

PubMed Central

Kreitmair, Karola

2018-01-01

This paper focuses on the ethical challenges presented by direct-to-consumer (DTC) digital psychotherapy services that do not involve oversight by a professional mental health provider. DTC digital psychotherapy services can potentially assist in improving access to mental health care for the many people who would otherwise not have the resources or ability to connect with a therapist. However, the lack of adequate regulation in this area exacerbates concerns over how safety, privacy, accountability, and other ethical obligations to protect an individual in therapy are addressed within these services. In the traditional therapeutic relationship, there are ethical obligations that serve to protect the interests of the client and provide warnings. In contrast, in a DTC therapy app, there are no clear lines of accountability or associated ethical obligations to protect the user seeking mental health services. The types of DTC services that present ethical challenges include apps that use a digital platform to connect users to minimally trained nonprofessional counselors, as well as services that provide counseling steered by artificial intelligence and conversational agents. There is a need for adequate oversight of DTC nonprofessional psychotherapy services and additional empirical research to inform policy that will provide protection to the consumer. PMID:29685865

Psychologists abandon the Nuremberg ethic: concerns for detainee interrogations.

PubMed

Pope, Kenneth S; Gutheil, Thomas G

2009-01-01

In the aftermath of 9-11, the American Psychological Association, one of the largest U.S. health professions, changed its ethics code so that it now runs counter to the Nuremberg Ethic. This historic post-9-11 change allows psychologists to set aside their ethical responsibilities whenever they are in irreconcilable conflict with military orders, governmental regulations, national and local laws, and other forms of governing legal authority. This article discusses the history, wording, rationale, and implications of the ethical standard that U.S. psychologists adopted 7 years ago, particularly in light of concerns over health care professionals' involvement in detainee interrogations and the controversy over psychologists' prominent involvement in settings like the Guantánamo Bay Detainment Camp and the Abu Ghraib prison. It discusses possible approaches to the complex dilemmas arising when ethical responsibilities conflict with laws, regulations, or other governing legal authority.

Forgive Me Now, Fire Me Later: Mass Communication Students' Ethics Gap Concerning School and Journalism

ERIC Educational Resources Information Center

Conway, Mike; Groshek, Jacob

2009-01-01

Survey data on mass communication students' perceptions of plagiarism and fabrication indicate an ethics gap in which students are more concerned about ethical breaches in journalism than in academics. Further analyses found that the ethics gap increases among students near graduation who had higher levels of concern and suggested harsher…

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

PubMed

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.

Ethical Concerns and Procedural Pathways for Patients Who are Incapacitated and Alone: Implications from a Qualitative Study for Advancing Ethical Practice

PubMed Central

Catlin, Casey; Kwak, Jennifer; Wood, Erica; Teaster, Pamela B.

2017-01-01

Adults who are incapacitated and alone, having no surrogates, may be known as “unbefriended.” Decision-making for these particularly vulnerable patients is a common and vexing concern for healthcare providers and hospital ethics committees. When all other avenues for resolving the need for surrogate decision-making fail, patients who are incapacitated and alone may be referred for “public guardianship” or guardianship of last resort. While an appropriate mechanism in theory, these programs are often under-staffed and under-funded, laying the consequences of inadequacies on the healthcare system and the patient him or herself. We describe a qualitative study of professionals spanning clinical, court, and agency settings about the mechanisms for resolving surrogate consent for these patients and problems therein within the state of Massachusetts. Interviews found that all participants encountered adults who are incapacitated and without surrogates. Four approaches for addressing surrogate needs were: (1) work to restore capacity; (2) find previously unknown surrogates; (3) work with agencies to obtain surrogates; and (4) access the guardianship system. The use of guardianship was associated with procedural challenges and ethical concerns including delays in care, short term gains for long term costs, inabilities to meet a patient’s values and preferences, conflicts of interest, and ethical discomfort among interviewees. Findings are discussed in the context of resources to restore capacity, identify previously unknown surrogates, and establish improved surrogate mechanisms for this vulnerable population. PMID:28084575

Nontechnical issues in waste management: ethical, institutional, and political concerns

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hebert, J.A.; Rankin, W.L.; Brown, P.G.

1978-05-01

The report consists of a presentation and distillation of major nontechnical issues surrounding commercial waste management, followed by ethical, institutional, and political analyses of these issues. The ethical analysis consists of a discusson of what is meant by ''ethics'' and ''morality'' in the waste management context and an illustrative attempt at an ethical analysis of the commercial nuclear waste problem. Two institutional analyses are presented: one is an analysis of the possible problems of long-term human institutions in waste management; the other is a presentation of institutional arrangements for the short term. A final chapter discusses issues and concerns involvingmore » intergovernmental relations--that is, local, state, and federal interface problems in waste management.« less

Ethical Issues for Direct-to-Consumer Digital Psychotherapy Apps: Addressing Accountability, Data Protection, and Consent.

PubMed

Martinez-Martin, Nicole; Kreitmair, Karola

2018-04-23

This paper focuses on the ethical challenges presented by direct-to-consumer (DTC) digital psychotherapy services that do not involve oversight by a professional mental health provider. DTC digital psychotherapy services can potentially assist in improving access to mental health care for the many people who would otherwise not have the resources or ability to connect with a therapist. However, the lack of adequate regulation in this area exacerbates concerns over how safety, privacy, accountability, and other ethical obligations to protect an individual in therapy are addressed within these services. In the traditional therapeutic relationship, there are ethical obligations that serve to protect the interests of the client and provide warnings. In contrast, in a DTC therapy app, there are no clear lines of accountability or associated ethical obligations to protect the user seeking mental health services. The types of DTC services that present ethical challenges include apps that use a digital platform to connect users to minimally trained nonprofessional counselors, as well as services that provide counseling steered by artificial intelligence and conversational agents. There is a need for adequate oversight of DTC nonprofessional psychotherapy services and additional empirical research to inform policy that will provide protection to the consumer. ©Nicole Martinez-Martin, Karola Kreitmair. Originally published in JMIR Mental Health (http://mental.jmir.org), 23.04.2018.

Ethical Concerns Raised by the Use of the Internet in Academia.

ERIC Educational Resources Information Center

Peace, A. Graham; Hartzel, Kathleen S.

2002-01-01

Outlines several major ethical and social concerns that face an institution in attempting to integrate "cyberspace" into its academic arena. Focuses on American universities, though the issues are relevant for all levels of education in all geographic areas. Discusses major ethical dilemmas that academic use of cyberspace may present. Identifies…

Ethical issues in research and publication.

PubMed

Iammarino, N K; O'Rourke, T W; Pigg, R M; Weinberg, A D

1989-03-01

Ethical considerations inherent in the process of research and publication represent one issue of particular concern to professionals. Members of a profession usually are guided by a code of ethics that specifies standards for practice. However, rarely do professional preparation programs sufficiently prepare students to deal with the concerns associated with research and professional publication. The authors address three specific areas of concern for health educators: the student-professor relationship, joint authorship, and ethics in publishing. Potential problems are discussed, and implications for the profession are cited.

Ethics consultants and ethics committees.

PubMed

La Puma, J; Toulmin, S E

1989-05-01

To address moral questions in patient care, hospitals and health care systems have enlisted the help of hospital ethicists, ethics committees, and ethics consultation services. Most physicians have not been trained in the concepts, skills, or language of clinical ethics, and few ethicists have been trained in clinical medicine, so neither group can fully identify, analyze, and resolve clinical ethical problems. Some ethics committees have undertaken clinical consultations themselves, but liability concerns and variable standards for membership hinder their efforts. An ethics consultation service comprising both physician-ethicists and nonphysician-ethicists brings complementary viewpoints to the management of particular cases. If they are to be effective consultants, however, nonphysician-ethicists need to be "clinicians": professionals who understand an individual patient's medical condition and personal situation well enough to help in managing the case. Ethics consultants and ethics committees may work together, but they have separate identities and distinct objectives: ethics consultants are responsible for patient care, while ethics committees are administrative bodies whose primary task is to advise in creating institutional policy.

Ethics and Social Justice within the New DEEL: Addressing the Paradox of Control/Democracy

ERIC Educational Resources Information Center

Shapiro, Joan Poliner

2006-01-01

This paper addresses the ethical and social justice implications of an educational movement called, The New DEEL (Democratic Ethical Educational Leadership). In particular, this paper emphasizes the ethical underpinnings of this movement by focusing on the paradox in the form of the dyad of control/democracy. This important paradox is developed…

Panglobalism and pandemics: ecological and ethical concerns.

PubMed

Rolston, Holmes

2005-10-01

A pandemic is a human medical problem but must be understood at multiple levels. Analysis of social and commercial forces is vital, and, more comprehensively, an ecological framework is necessary for an inclusive picture. Ecological health webworked with political and social determinants surrounds issues of human health. In this constellation of both natural and social factors, ethical concerns will arise at these multiple levels, from human health to the conservation and health of wild nature.

Addressing Ethics and Technology in Business: Preparing Today's Students for the Ethical Challenges Presented by Technology in the Workplace

ERIC Educational Resources Information Center

Brooks, Rochelle

2008-01-01

The ethical development of information systems is but one of those sensitive scenarios associated with computer technology that has a tremendous impact on individuals and social life. The significance of these issues of concern cannot be overstated. However, since computer ethics is meant to be everybody's responsibility, the result can often be…

A social-ecological framework: A model for addressing ethical practice in nursing.

PubMed

Davidson, Patricia; Rushton, Cynda Hylton; Kurtz, Melissa; Wise, Brian; Jackson, Debra; Beaman, Adam; Broome, Marion

2018-03-01

To develop a framework to enable discussion, debate and the formulation of interventions to address ethical issues in nursing practice. Social, cultural, political and economic drivers are rapidly changing the landscape of health care in our local environments but also in a global context. Increasingly, nurses are faced with a range of ethical dilemmas in their work. This requires investigation into the culture of healthcare systems and organisations to identify the root causes and address the barriers and enablers of ethical practice. The increased medicalisation of health care; pressures for systemisation; efficiency and cost reduction; and an ageing population contribute to this complexity. Often, ethical issues in nursing are considered within the abstract and philosophical realm until a dilemma is encountered. Such an approach limits the capacity to tangibly embrace ethical values and frameworks as pathways to equitable, accessible, safe and quality health care and as a foundation for strengthening a supportive and enabling workplace for nurses and other healthcare workers. Conceptual framework development. A comprehensive literature review was undertaken using the social-ecological framework as an organising construct. This framework views ethical practice as the outcome of interaction among a range of factors at eight levels: individual factors (patients and families); individual factors (nurses); relationships between healthcare professionals; relationships between patients and nurses; organisational healthcare context; professional and education regulation and standards; community; and social, political and economic. Considering these elements as discrete, yet interactive and intertwined forces can be useful in developing interventions to promote ethical practice. We consider this framework to have utility in policy, practice, education and research. Nurses face ethical challenges on a daily basis, considering these within a social-ecological framework can

Methods to identify and address the ethical issues associated with managed care.

PubMed

Lundy, Courtnee

2006-01-01

There are many benefits of managed care, such as its focus on disease prevention and health promotion, its integration of healthcare services to minimize inefficiencies, and its ability to restrict healthcare costs; however, there are also some ethical concerns that arise from managing care. In the context of managed care, ethics is a method for examining conflicts of values and obligations where there are competing interests, each of which presents a reasonably justified position. The principles of procedural, commutative, and general justice are particularly applicable to the ethical issues associated with managed care. Through a review of relevant literature, this paper will examine different methods and principles of justice to consider in establishing an ethical managed care organization and it will offer some examples of plans that have established policies to meet their ethical goals. By setting common goals, plans and enrollees can minimize ethical conflicts and collaborate to ensure that plans consistently use just procedures to ensure that quality care is available.

Addressing Religious Plurality--A Teacher Perspective on Minority Religion and Secular Ethics Education

ERIC Educational Resources Information Center

Zilliacus, Harriet

2013-01-01

The Finnish education system recognizes religious plurality by offering education in pupils' own religion or in secular ethics. However, little research has been undertaken on how plurality is addressed in classroom practice. This study investigates how 31 minority religion and secular ethics teachers view the task of supporting and including…

Health care voluntourism: addressing ethical concerns of undergraduate student participation in global health volunteer work.

PubMed

McCall, Daniel; Iltis, Ana S

2014-12-01

The popularity and availability of global health experiences has increased, with organizations helping groups plan service trips and companies specializing in "voluntourism," health care professionals volunteering their services through different organizations, and medical students participating in global health electives. Much has been written about global health experiences in resource poor settings, but the literature focuses primarily on the work of health care professionals and medical students. This paper focuses on undergraduate student involvement in short term medical volunteer work in resource poor countries, a practice that has become popular among pre-health professions students. We argue that the participation of undergraduate students in global health experiences raises many of the ethical concerns associated with voluntourism and global health experiences for medical students. Some of these may be exacerbated by or emerge in unique ways when undergraduates volunteer. Guidelines and curricula for medical student engagement in global health experiences have been developed. Guidelines specific to undergraduate involvement in such trips and pre-departure curricula to prepare students should be developed and such training should be required of volunteers. We propose a framework for such guidelines and curricula, argue that universities should be the primary point of delivery even when universities are not organizing the trips, and recommend that curricula should be developed in light of additional data.

The Ethics of Evaluation in Museums

ERIC Educational Resources Information Center

Heimlich, Joe E.

2015-01-01

Ethics in research and evaluation has a long standing history, one steeped with legal and moral implications. This article addresses the technicalities of ethics in evaluation as well as highlights the importance for museum educators to prioritize adopting such practices. While understanding the myriad of ethical concerns and best practices can be…

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

PubMed

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

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

PubMed Central

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

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

PubMed

Osborn, D P J; Fulford, K W M

2003-02-01

Psychiatric research can occasionally present particular ethical dilemmas, but it is not clear what kind of problems local research ethics committees (LRECs) actually experience in this field. We aimed to assess the type of problems that committees encounter with psychiatric research, using a postal survey of 211 LRECs. One hundred and seven (51%) of those written to replied within the time limit. Twenty eight (26%) experienced few problems with psychiatric applications. Twenty six (24%) emphasised the value of a psychiatric expert on the committee. The most common issues raised were informed consent (n=64, 60%) and confidentiality (n=17, 16%). The use of placebos (and washout periods) (n=18, 17%), the validity of psychiatric questionnaires (n=16, 15%) and overuse of psychiatric "jargon" (n=14, 13%) in psychiatric applications also raised concern. Our results suggest that LRECs have specific concerns regarding methodology, consent, and confidentiality in psychiatric research, and that they find psychiatric input invaluable.

Asserting the Possible: Gunzenhauser's "Ethics of the Everyday." Response to the Presidential Address

ERIC Educational Resources Information Center

Worley, Virginia

2013-01-01

In this article, the author responds to the Presidential address, "Ethics for the New Political Economy: What Can It Mean to Be Professionally Responsible?" in which Michael G. Gunzenhauser defines, names, and proposes a professional ethics for educators: an ethics of the everyday. The author introduces her response by stating that…

Moral mindfulness: The ethical concerns of healthcare professionals working in a psychiatric intensive care unit.

PubMed

Salzmann-Erikson, Martin

2018-06-22

Healthcare professionals working on inpatient wards face the externalizing or challenging behaviour of the patients who are admitted. Ethical values and principles in psychiatric nursing have been reported to be important when approaching patients during the most acute phase of deterioration in their mental health. Hence, the aim of this study was to discover and describe staff members' ethical and moral concerns about their work as healthcare professionals in a psychiatric intensive care unit. The study has a qualitative descriptive design and makes use of Framework Analysis. Registered nurses and psychiatric aides in a psychiatric intensive care unit in Sweden were observed during ethical reflection meetings. Four to six staff attended the 90-min meetings. The data comprise observations from six meetings, which provided 94 pages of text. The results demonstrate that the work was described as being both motivating and exhausting. The staff faced ethical concerns in their daily work, as patients often demonstrated challenging behaviours. Three themes were identified as follows: (i) concerns about the staff impacting on patients' experience of care, (ii) concerns about establishing a safe working environment, and (iii) concerns about becoming unprofessional due to expectations and a high workload. Ethical concerns included simultaneously taking into account both the patients' dignity and safety aspects, while also being exposed to high workloads. These elements of work are theorized as influencing complex psychiatric nursing. If we are to bring these influential factors to light in the workplace, advanced nursing practice must be grounded in moral mindfulness. © 2018 Australian College of Mental Health Nurses Inc.

Food and agricultural biotechnology: a summary and analysis of ethical concerns.

PubMed

Thompson, Paul B; Hannah, William

2008-01-01

The range of social and ethical concerns that have been raised in connection with food and agricultural biotechnology is exceedingly broad. Many of these deal with risks and possible outcomes that are not unique to crops or animals developed using recombinant DNA. Food safety, animal welfare, socio-economic and environmental impacts, as well as shifts in power relations or access to technology raise concerns that might be generalized to many technologies. These aspects of the controversy over biotechnology are analyzed below as elements of general technological ethics, and key norms or values pertinent to each of these categories are specified in some detail. However, a number of special concerns unique to the use of rDNA in manipulating plant and animal genomes have been raised, and these are reviewed as well. The chapter concludes by reviewing two broad policy strategies for responding to the issues, one involving labels and consumer consent, the other applying the precautionary principle.

Engaging science in a climate of values: tools for animal scientists tasked with addressing ethical problems.

PubMed

Croney, C C; Anthony, R

2010-04-01

In the United States, escalating concerns about current farm animal science and production methods have resulted not only in increased food animal protection policies, but also in animal welfare legislation. Animal scientists and industry leaders are apprehensive that such policies may be driven primarily by emotion and a lack of scientific understanding, and thus may have unforeseen consequences. However, decisions about animal care, and particularly animal welfare, cannot be made solely on the basis of science because the potential effects on producers, animals, and concerned citizens and the implications for the environment and on food prices must also be considered. Balancing the interests and values of all stakeholders in regard to animal welfare problems has presented a considerable challenge. Ethical accounting processes, such as the Ethical Matrix and the ethics assessment process by Campbell, offer models to combine socioethical concerns with relevant factual information, thereby facilitating decision making that is ethically responsible and that offers viable solutions. A case study is used to illustrate application of the ethics assessment process by Campbell that includes identification of the ethical problems, the embedded values, the relevant facts, and moral tests that can be applied. Awareness of these emerging ways of examining ethics that offer real solutions to conflicts of interests and not merely "one size fits all" answers should be an asset to animal and poultry scientists.

Some Ethical Concerns About Human Induced Pluripotent Stem Cells.

PubMed

Zheng, Yue Liang

2016-10-01

Human induced pluripotent stem cells can be obtained from somatic cells, and their derivation does not require destruction of embryos, thus avoiding ethical problems arising from the destruction of human embryos. This type of stem cell may provide an important tool for stem cell therapy, but it also results in some ethical concerns. It is likely that abnormal reprogramming occurs in the induction of human induced pluripotent stem cells, and that the stem cells generate tumors in the process of stem cell therapy. Human induced pluripotent stem cells should not be used to clone human beings, to produce human germ cells, nor to make human embryos. Informed consent should be obtained from patients in stem cell therapy.

Energy decisions reframed as justice and ethical concerns

NASA Astrophysics Data System (ADS)

Sovacool, Benjamin K.; Heffron, Raphael J.; McCauley, Darren; Goldthau, Andreas

2016-05-01

All too often, energy policy and technology discussions are limited to the domains of engineering and economics. Many energy consumers, and even analysts and policymakers, confront and frame energy and climate risks in a moral vacuum, rarely incorporating broader social justice concerns. Here, to remedy this gap, we investigate how concepts from justice and ethics can inform energy decision-making by reframing five energy problems — nuclear waste, involuntary resettlement, energy pollution, energy poverty and climate change — as pressing justice concerns. We conclude by proposing an energy justice framework centred on availability, affordability, due process, transparency and accountability, sustainability, equity and responsibility, which highlights the futurity, fairness and equity dimensions of energy production and use.

Evaluating programs that address ideological issues: ethical and practical considerations for practitioners and evaluators.

PubMed

Lieberman, Lisa D; Fagen, Michael C; Neiger, Brad L

2014-03-01

There are important practical and ethical considerations for organizations in conducting their own, or commissioning external, evaluations and for both practitioners and evaluators, when assessing programs built on strongly held ideological or philosophical approaches. Assessing whether programs "work" has strong political, financial, and/or moral implications, particularly when expending public dollars, and may challenge objectivity about a particular program or approach. Using a case study of the evaluation of a school-based abstinence-until-marriage program, this article discusses the challenges, lessons learned, and ethical responsibilities regarding decisions about evaluation, specifically associated with ideologically driven programs. Organizations should consider various stakeholders and views associated with their program to help identify potential pitfalls in evaluation. Once identified, the program or agency needs to carefully consider its answers to two key questions: Do they want the answer and are they willing to modify the program? Having decided to evaluate, the choice of evaluator is critical to assuring that ethical principles are maintained and potential skepticism or criticism of findings can be addressed appropriately. The relationship between program and evaluator, including agreements about ownership and eventual publication and/or promotion of data, should be addressed at the outset. Programs and organizations should consider, at the outset, their ethical responsibility when findings are not expected or desired. Ultimately, agencies, organizations, and programs have an ethical responsibility to use their data to provide health promotion programs, whether ideologically founded or not, that appropriately and effectively address the problems they seek to solve.

Addressing the Health Concerns of VA Women with Sexual Trauma

DTIC Science & Technology

2017-10-01

AWARD NUMBER: W81XWH-14-1-0368 TITLE: Addressing the Health Concerns of VA Women with Sexual Trauma PRINCIPAL INVESTIGATOR: Caron Zlotnick, PhD...develop and assess a computer-delivered intervention (Safety and Health Experiences Program; SHE) that will provide a screening and brief behavior...intervention for women veterans with any lifetime ST. More specifically, the intervention, SHE, will address interrelated health concerns for women

Ethics in health sciences librarianship.

PubMed Central

Hurych, J M; Glenn, A C

1987-01-01

Against a background of discussion about drafting of an ethical code for librarians and a review of articles confronting ethical issues in librarianship, the authors surveyed the 150 institutional members of the Health Science Librarians of Illinois (HSLI) regarding their perceptions of ethical concerns. Among the issues addressed in the survey are library organization, personnel policies, and professional competency, along with the traditional concerns of professional versus personal values, privacy and confidentiality, access to materials, and materials selection criteria in a health sciences context. Based on a 60% response rate, survey results indicate widespread agreement on some issues and a conspicuous lack of consensus on others. Further research is suggested in order to assess the need for a separate ethical code for health sciences librarians. PMID:3450346

Assessing and addressing moral distress and ethical climate, part 1.

PubMed

Sauerland, Jeanie; Marotta, Kathleen; Peinemann, Mary Anne; Berndt, Andrea; Robichaux, Catherine

2014-01-01

There is minimal research exploring moral distress and its relationship to ethical climate among nurses working in acute care settings. Objectives of the study were to explore moral distress, moral residue, and perception of ethical climate among registered nurses working in an academic medical center and develop interventions to address study findings. A mixed-methods design was used. Two versions of Corley and colleagues' Moral Distress Scale, adult and pediatric/neonatal, were used in addition to Olson's Hospital Ethical Climate Survey. Participants were invited to respond to 2 open-ended questions. This article reports the results for those nurses working in adult acute and critical care units. The sample (N = 225) was predominantly female (80%); half held a bachelor of science in nursing or higher, were aged 30 to 49 years, and staff nurses (77.3%). The mean item score for moral distress intensity ranged from 3.79 (SD, 2.21) to 2.14 (SD, 2.42) with mean item score frequency ranging from 2.86 (SD, 1.88) to 0.23 (SD, 0.93). The mean score for total Hospital Ethical Climate Survey was 94.39 (SD, 18.3) ranging from 23 to 130. Qualitative comments described bullying, lateral violence, and retribution. Inadequate staffing and perceived incompetent coworkers were the most distressing items. Almost 22% left a previous position because of moral distress and perceived the current climate to be less ethical compared with other participants. Findings may potentially impact nurse retention and recruitment and negatively affect the quality and safety of patient care. Interventions developed focus on the individual nurse, including ethics education and coping skills, intraprofessional/interprofessional approaches, and administrative/policy strategies.

Whistleblowing and organizational ethics.

PubMed

Ray, Susan L

2006-07-01

The purpose of this article is to discuss an external whistleblowing event that occurred after all internal whistleblowing through the hierarchy of the organization had failed. It is argued that an organization that does not support those that whistle blow because of violation of professional standards is indicative of a failure of organizational ethics. Several ways to build an ethics infrastructure that could reduce the need to resort to external whistleblowing are discussed. A relational ethics approach is presented as a way to eliminate the negative consequences of whistleblowing by fostering an interdependent moral community to address ethical concerns.

Ethics Issues for the College/University Lawyer.

ERIC Educational Resources Information Center

Connell, Mary Ann

This paper addresses recurring ethical questions faced by college and university attorneys concerning who is the client, representation of individual and institutional defendants, and the witness-advocate rule. It also provides an overview of ethical considerations which can arise when the college/university attorney participates in the…

The Ethics of Sharing Plastic Surgery Videos on Social Media: Systematic Literature Review, Ethical Analysis, and Proposed Guidelines.

PubMed

Dorfman, Robert G; Vaca, Elbert E; Fine, Neil A; Schierle, Clark F

2017-10-01

Recent videos shared by plastic surgeons on social media applications such as Snapchat, Instagram, and YouTube, among others, have blurred the line between entertainment and patient care. This has left many in the plastic surgery community calling for the development of more structured oversight and guidance regarding video sharing on social media. To date, no official guidelines exist for plastic surgeons to follow. Little is known about the ethical implications of social media use by plastic surgeons, especially with regard to video sharing. A systematic review of the literature on social media use in plastic surgery was performed on October 31, 2016, with an emphasis on ethics and professionalism. An ethical analysis was conducted using the four principles of medical ethics. The initial search yielded 87 articles. Thirty-four articles were included for analyses that were found to be relevant to the use of social media in plastic surgery. No peer-reviewed articles were found that mentioned Snapchat or addressed the ethical implications of sharing live videos of plastic surgery on social media. Using the four principles of medical ethics, it was determined that significant ethical concerns exist with broadcasting these videos. This analysis fills an important gap in the plastic surgery literature by addressing the ethical issues concerning live surgery broadcasts on social media. Plastic surgeons may use the guidelines proposed here to avoid potential pitfalls.

School-Based Gay-Affirmative Interventions: First Amendment and Ethical Concerns

PubMed Central

Bayer, Ronald

2013-01-01

Public health professionals and educators have developed effective school-based interventions to reduce prejudice and stigma against lesbian, gay, bisexual, and transgender (LGBT) students. Such interventions can reduce the harm caused to sexual minority youths by stigma and can improve health outcomes. However, critics have warned that these interventions attempt to control speech and religious beliefs protected by the First Amendment. We review this critique and assess the legal and ethical arguments. We conclude that, both legally and ethically, there is great leeway for schools to implement LGBT-affirmative interventions. Still, we recommend that interventionists attend critics’ concerns using principles of community-based participatory research (CBPR). Using CBPR approaches, interventionists can achieve better community acceptance and cooperation and more successful interventions. PMID:23948002

School-based gay-affirmative interventions: first amendment and ethical concerns.

PubMed

Meyer, Ilan H; Bayer, Ronald

2013-10-01

Public health professionals and educators have developed effective school-based interventions to reduce prejudice and stigma against lesbian, gay, bisexual, and transgender (LGBT) students. Such interventions can reduce the harm caused to sexual minority youths by stigma and can improve health outcomes. However, critics have warned that these interventions attempt to control speech and religious beliefs protected by the First Amendment. We review this critique and assess the legal and ethical arguments. We conclude that, both legally and ethically, there is great leeway for schools to implement LGBT-affirmative interventions. Still, we recommend that interventionists attend critics' concerns using principles of community-based participatory research (CBPR). Using CBPR approaches, interventionists can achieve better community acceptance and cooperation and more successful interventions.

Ethical Issues Concerning the Use of Videoconferencing To Supervise International Social Work Field Practicum Students.

ERIC Educational Resources Information Center

Panos, Patrick T.; Panos, Angelea; Cox, Shirley E.; Roby, Jini L.; Matheson, Kenneth W.

2002-01-01

Examines current ethical guidelines affecting the use of videoconferencing in the supervision of social work students nationally and internationally. Suggests protocols to address ethical and professional practice issues that are likely to arise as a result of using videoconferencing to conduct supervision across international borders. (EV)

The ethics of and the appropriate legislation concerning killing people and letting them die: a response to Merkel.

PubMed

McLachlan, Hugh V

2017-07-01

With regard to ethics and legislation, what is the significant difference between a doctor terminating the life-supporting treatment of a patient in the course of his job and a greedy relative of the patient doing the same thing to inherit his wealth? Merkel offers an interesting and inventive answer to this question in terms of the improper violation of personal boundaries. However, despite Merkel's claim to the contrary, his answer does not directly address the question of the relevant ethical similarities and differences between killing and letting die in general. Furthermore, it does not provide the basis a plausible rationale for legislation concerning killing and letting die. The questions of whether letting someone die is ethically the same as killing someone and whether it should be treated the same way by the criminal law are not the same as or tantamount to the question of whether or not it involves the transgression of another person's boundaries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Security and privacy of EHR systems--ethical, social and legal requirements.

PubMed

Kluge, Eike-Henner W

2003-01-01

This paper addresses social, ethical and legal concerns about security and privacy that arise in the development of international interoperable health information systems. The paper deals with these concerns under four rubrics: the ethical status of electronic health records, the social and legal embedding of interoperable health information systems, the overall information-requirements healthcare as such, and the role of health information professionals as facilitators. It argues that the concerns that arise can be met if the development of interoperability protocols is guided by the seven basic principles of information ethics that have been enunciated in the IMIA Code of Ethics for Health Information Professionals and that are central to the ethical treatment of electronic health records.

Moving Beyond the Theoretical: Medical Students' Desire for Practical, Role-Specific Ethics Training.

PubMed

Stites, Shana D; Clapp, Justin; Gallagher, Stefanie; Fiester, Autumn

2018-05-04

Background It has been widely reported that medical trainees experience situations with profound ethical implications during their clinical rotations. To address this most U.S. medical schools include ethics curricula in their undergraduate programs. However, the content of these curricula vary substantially. Our pilot study aimed to discover, from the students' perspective, how ethics pedagogy prepares medical students for clerkship and what gaps might remain. This qualitative study organized focus groups of third- and fourth-year medical students. Participants recounted ethical concerns encountered during clerkship rotations and reflected on how their medical school ethics curriculum informed their responses to these scenarios. Transcripts of the focus group sessions were analyzed using a grounded theory approach to identify common themes that characterized the students' experiences. While students' accounts demonstrated a solid grasp of ethical theory and attunement to ethical concerns presented in the clinic, they also consistently evinced an inability to act on these issues given clerks' particular position in a complex learning hierarchy. Students felt they received too little training in the role-specific application of medical ethics as clinical trainees. We found a desire among trainees for enhanced practical ethics training in preparation for the clerkship phase of medical education. We recommend several strategies that can begin to address these findings. The use of roleplaying with standardized patients can enable students to practice engagement with ethical issues. Conventional ethics courses can focus more on action-based pedagogy and instruction in conflict management techniques. Finally, clear structures for reporting and seeking advice and support for addressing ethical issues can lessen students' apprehension to act on ethical concerns.

Ethical Issues for an Editorial Board: "Kairaranga"

ERIC Educational Resources Information Center

Clark, John

2008-01-01

With academic journals, we think of the ethical aspects of the research contained in the articles rather than with the journal itself. However, journal editing has its own set of ethical concerns, which this article addresses. One is ensuring that the anonymity of institutions and participants, in research and the reporting of practice, is…

Teaching medical ethics and law.

PubMed

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.

Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context.

PubMed

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

Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context

PubMed Central

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

Some Ethical-Moral Concerns in Administration.

ERIC Educational Resources Information Center

Enns, Frederick

1981-01-01

Presents and analyzes moral-ethical issues that arise in administration and concludes that past descriptive, objective, and scientific approaches to administration have failed to take full account of the moral-ethical dimension of human existence. (Author/WD)

Medical ethics and ethical dilemmas.

PubMed

Iyalomhe, G B S

2009-01-01

Ethical problems routinely arise in the hospital and outpatient practice settings and times of dilemma do occur such that practitioners and patients are at cross-roads where choice and decision making become difficult in terms of ethics. This paper attempts a synopsis of the basic principles of medical ethics, identifies some ethical dilemmas that doctors often encounter and discusses some strategies to address them as well as emphasizes the need for enhanced ethics education both for physicians and patients particularly in Nigeria. Literature and computer programmes (Medline and PsychoInfo databases) were searched for relevant information. The search showed that the fundamental principles suggested by ethicists to assist doctors to evaluate the ethics of a situation while making a decision include respect for autonomy, beneficence, non-maleficence and justice. Although the above principles do not give answers as to how to handle a particular situation, they serve as a guide to doctors on what principles ought to apply to actual circumstances. The principles sometimes conflict with each other leading to ethical dilemmas when applied to issues such as abortion, contraception, euthanasia, professional misconduct, confidentiality truth telling, professional relationship with relatives, religion, traditional medicine and business concerns. Resolution of dilemmas demand the best of the doctor's knowledge of relevant laws and ethics, his training and experience, his religious conviction and moral principles as well as his readiness to benefit from ethics consultation and the advice of his colleagues. Ethics education should begin from the impressionable age in homes, continued in the medical schools and after graduation to ensure that doctors develop good ethical practices and acquire the ability to effectively handle ethical dilemmas. Also, education of patients and sanction of unethical behaviour will reduce ethical dilemmas.

The ethics of reviving long extinct species.

PubMed

Sandler, Ronald

2014-04-01

There now appears to be a plausible pathway for reviving species that have been extinct for several decades, centuries, or even millennia. I conducted an ethical analysis of de-extinction of long extinct species. I assessed several possible ethical considerations in favor of pursuing de-extinction: that it is a matter of justice; that it would reestablish lost value; that it would create new value; and that society needs it as a conservation last resort. I also assessed several possible ethical arguments against pursuing de-extinction: that it is unnatural; that it could cause animal suffering; that it could be ecologically problematic or detrimental to human health; and that it is hubristic. There are reasons in favor of reviving long extinct species, and it can be ethically acceptable to do so. However, the reasons in favor of pursuing de-extinction do not have to do with its usefulness in species conservation; rather, they concern the status of revived species as scientific and technological achievements, and it would be ethically problematic to promote de-extinction as a significant conservation strategy, because it does not prevent species extinctions, does not address the causes of extinction, and could be detrimental to some species conservation efforts. Moreover, humanity does not have a responsibility or obligation to pursue de-extinction of long extinct species, and reviving them does not address any urgent problem. Therefore, legitimate ecological, political, animal welfare, legal, or human health concerns associated with a de-extinction (and reintroduction) must be thoroughly addressed for it to be ethically acceptable. © 2013 Society for Conservation Biology.

Participatory action research: considerations for ethical review.

PubMed

Khanlou, N; Peter, E

2005-05-01

This paper addresses the distinctive nature of participatory action research (PAR) in relation to ethical review requirements. As a framework for conducting research and reducing health disparities, PAR is gaining increased attention in community and public health research. As a result, PAR researchers and members of Research Ethics Boards could benefit from an increased understanding of the array of ethical concerns that can arise. We discuss these concerns in light of commonly held ethical requirements for clinical research (social or scientific value, scientific validity, fair subject/participant selection, favourable risk-benefit ratio, independent review, informed consent, and respect for potential and enrolled participants) and refer to guidelines specifically developed for participatory research in health promotion. We draw from our community-based experiences in mental health promotion research with immigrant and culturally diverse youth to illustrate the ethical advantages and challenges of applying a PAR approach. We conclude with process suggestions for Research Ethics Boards.

Addressing a community's cancer cluster concerns

PubMed Central

Gavin, AT; Catney, D

2006-01-01

The felling of a telecommunications mast highlighted a community's concern regarding an alleged cancer cluster of eleven cases in a small rural area of Northern Ireland. At the request of the Local District Council, the Northern Ireland Cancer Registry (NICR) undertook an investigation. After extensive searching and contact with the community, only 6 of the alleged cases could be identified. Of these six, two did not have cancer and one had a non-malignant tumour. In addition to the three confirmed cancer cases, a search of the NICR database identified a further 17 cancers of mixed types in keeping with the population pattern of cancers. Standardised incidence and mortality rates were within, or lower than, the expected level. The results were presented to the local community at an open meeting. Despite extensive media interest when the issue of the alleged cluster was first raised, the negative findings received only local media attention. This study illustrates the value of an accurate population cancer registry in addressing cancer cluster concerns. PMID:16964811

Incorporating ethical principles into clinical research protocols: a tool for protocol writers and ethics committees

PubMed Central

Li, Rebecca H; Wacholtz, Mary C; Barnes, Mark; Boggs, Liam; Callery-D'Amico, Susan; Davis, Amy; Digilova, Alla; Forster, David; Heffernan, Kate; Luthin, Maeve; Lynch, Holly Fernandez; McNair, Lindsay; Miller, Jennifer E; Murphy, Jacquelyn; Van Campen, Luann; Wilenzick, Mark; Wolf, Delia; Woolston, Cris; Aldinger, Carmen; Bierer, Barbara E

2016-01-01

A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. PMID:26811365

Iran's experience with surrogate motherhood: an Islamic view and ethical concerns.

PubMed

Aramesh, K

2009-05-01

Gestational surrogacy as a treatment for infertility is being practised in some well-known medical institutions in Tehran and some other cities in Iran. While the majority of Muslims in the world are Sunni, the majority of Iranians are Shiite. Most Sunni scholars do not permit surrogate motherhood, since it involves introducing the sperm of a man into the uterus of a woman to whom he is not married. Most Shiite scholars, however, have issued jurisprudential decrees (fatwas) that allow surrogate motherhood as a treatment for infertility, albeit only for legal couples. They regard this practice as transferring an embryo or fetus from one womb to another, which is not forbidden in Shiite jurisprudence. Nevertheless, there are some controversies concerning some issues such as kinship and inheritance. The main ethical concern of Iran's experience with gestational surrogacy is the monetary relation between the intended couple and the surrogate mother. While monetary remuneration is practised in Iran and allowed by religious authorities, it seems to suffer from ethical problems. This article proposes that this kind of monetary relation should be modified and limited to reimbursement of normal costs. Such modification requires new legislation and religious decrees.

Should nutritional supplements and sports drinks companies sponsor sport? A short review of the ethical concerns.

PubMed

Outram, Simon M; Stewart, Bob

2015-06-01

This paper proposes that the sponsorship of sport by nutritional supplements and sport drinks companies should be re-examined in the light of ethical concerns about the closeness of this relationship. A short overview is provided of the sponsorship of sport, arguing that ethical concerns about its appropriateness remain despite the imposition of severe restrictions on tobacco sponsorship. Further, the paper examines the main concerns about supplement use and sports drinks with respect to efficacy, health and the risks of doping. Particular consideration is given to the health implications of these concerns. It is suggested that they, of themselves, do not warrant the restriction of sponsorship by companies producing supplements and sports drinks. Nevertheless, it is argued that sports sponsorship does warrant further ethical examination--above and beyond that afforded to other sponsors of sport--as sport sponsorship is integral to the perceived need for such products. In conclusion, it is argued that sport may have found itself lending unwarranted credibility to products which would otherwise not necessarily be seen as beneficial for participation in sports and exercise or as inherently healthy products. 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.

Molecular genetics research in ADHD: ethical considerations concerning patients' benefit and resource allocation.

PubMed

Rothenberger, Lillian Geza

2012-12-01

Immense resource allocations have led to great data output in genetic research. Concerning ADHD resources spent on genetic research are less than those spent on clinical research. But there are successful efforts made to increase support for molecular genetics research in ADHD. Concerning genetics no evidence based conclusive results have significant impact on prevention, diagnosis or treatment yet. With regard to ethical aspects like the patients' benefit and limited resources the question arises if it is indicated to think about a new balance of resource allocation between molecular genetics and non-genetics research in ADHD. An ethical reflection was performed focusing on recent genetic studies and reviews based on a selective literature search. There are plausible reasons why genetic research results in ADHD are somehow disappointing for clinical practice so far. Researchers try to overcome these gaps systematically, without knowing what the potential future benefits for the patients might be. Non-genetic diagnostic/therapeutic research may lead to clinically relevant findings within a shorter period of time. On the other hand, non-genetic research in ADHD may be nurtured by genetic approaches. But, with the latter there exist significant risks of harm like stigmatization and concerns regarding data protection. Isolated speeding up resources of genetic research in ADHD seems questionable from an ethical point of view. There is a need to find a new balance of resource allocation between genetic and non-genetic research in ADHD, probably by integrating genetics more systematically into clinical research. A transdisciplinary debate is recommended. Copyright © 2012 Wiley Periodicals, Inc.

Animal models in biological and biomedical research - experimental and ethical concerns.

PubMed

Andersen, Monica L; Winter, Lucile M F

2017-09-04

Animal models have been used in experimental research to increase human knowledge and contribute to finding solutions to biological and biomedical questions. However, increased concern for the welfare of the animals used, and a growing awareness of the concept of animal rights, has brought a greater focus on the related ethical issues. In this review, we intend to give examples on how animals are used in the health research related to some major health problems in Brazil, as well as to stimulate discussion about the application of ethics in the use of animals in research and education, highlighting the role of National Council for the Control of Animal Experimentation (Conselho Nacional de Controle de Experimentação Animal - CONCEA) in these areas. In 2008, Brazil emerged into a new era of animal research regulation, with the promulgation of Law 11794, previously known as the Arouca Law, resulting in an increased focus, and rapid learning experience, on questions related to all aspects of animal experimentation. The law reinforces the idea that animal experiments must be based on ethical considerations and integrity-based assumptions, and provides a regulatory framework to achieve this. This review describes the health research involving animals and the current Brazilian framework for regulating laboratory animal science, and hopes to help to improve the awareness of the scientific community of these ethical and legal rules.

Ethical and Economic Issues in Academe: The Point of View of a University President.

ERIC Educational Resources Information Center

Hardin, Paul

Ethical dilemmas concerning faculty compensation are considered by a university president who served as a nonadministrative professor of law for 10 years. It is suggested that trustees, administrators, and board members have as much to be concerned about as do faculty members when compensation and ethical dilemmas are addressed. The fact that…

Familiar ethical issues amplified: how members of research ethics committees describe ethical distinctions between disaster and non-disaster research.

PubMed

Tansey, Catherine M; Anderson, James; Boulanger, Renaud F; Eckenwiler, Lisa; Pringle, John; Schwartz, Lisa; Hunt, Matthew

2017-06-28

setting over and above those typically encountered in global health research to achieve meaningful community engagement. Disaster research presents distinctive ethical considerations that require attention to ensure that participants are protected. As RECs review disaster research protocols, they should address these concerns and consider how justification, vulnerability, security and confidentially, and community engagement are shaped by the realities of conducting research in a disaster.

Nursing informatics and nursing ethics: addressing their disconnect through an enhanced TIGER-vision.

PubMed

Kaltoft, Mette Kjer

2013-01-01

All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities in the clinical-disciplinary landscape. Each sees itself as providing decision support by way of information inputs and ethical insights, respectively. Both have reasons - ideological, professional, institutional - for their task construction, but this simultaneously disables each from engaging fully in the point-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched virtual learning environment (VLE). This provides an enhanced TIGER-vision for educational reform to deliver ethically coherent, person-centered care transparently.

Addressing EO-1 Spacecraft Pulsed Plasma Thruster EMI Concerns

NASA Technical Reports Server (NTRS)

Zakrzwski, C. M.; Davis, Mitch; Sarmiento, Charles; Bauer, Frank H. (Technical Monitor)

2001-01-01

The Pulsed Plasma Thruster (PPT) Experiment on the Earth Observing One (EO-1) spacecraft has been designed to demonstrate the capability of a new generation PPT to perform spacecraft attitude control. Results from PPT unit level radiated electromagnetic interference (EMI) tests led to concerns about potential interference problems with other spacecraft subsystems. Initial plans to address these concerns included firing the PPT at the spacecraft level both in atmosphere, with special ground support equipment. and in vacuum. During the spacecraft level tests, additional concerns where raised about potential harm to the Advanced Land Imager (ALI). The inadequacy of standard radiated emission test protocol to address pulsed electromagnetic discharges and the lack of resources required to perform compatibility tests between the PPT and an ALI test unit led to changes in the spacecraft level validation plan. An EMI shield box for the PPT was constructed and validated for spacecraft level ambient testing. Spacecraft level vacuum tests of the PPT were deleted. Implementation of the shield box allowed for successful spacecraft level testing of the PPT while eliminating any risk to the ALI. The ALI demonstration will precede the PPT demonstration to eliminate any possible risk of damage of ALI from PPT operation.

What Is the (ethical) Role of Scientists?

NASA Astrophysics Data System (ADS)

Oreskes, N.

2014-12-01

Many scientists are reluctant to speak out on issues of broad societal importance for fear that doing so crosses into territory that is not the scientists' domain. Others fear that scientists lose credibility when they address ethical and moral issues. A related concern is that discussing social or ethical questions runs the risk of politicizing science. Yet history shows that in the past, scientists often have spoken out on broad issues of societal concern, often (although not always) effectively. This paper explores the conditions under which scientists may be effective spokesmen and women on ethical and moral choices, and suggests some criteria by which scientists might decide when and whether it is appropriate for them to speak out beyond the circles of other technical experts.

Ethical questions must be considered for electronic health records.

PubMed

Spriggs, Merle; Arnold, Michael V; Pearce, Christopher M; Fry, Craig

2012-09-01

National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing.

UNESCO's activities in ethics.

PubMed

ten Have, Henk A M J

2010-03-01

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

Incorporating ethical principles into clinical research protocols: a tool for protocol writers and ethics committees.

PubMed

Li, Rebecca H; Wacholtz, Mary C; Barnes, Mark; Boggs, Liam; Callery-D'Amico, Susan; Davis, Amy; Digilova, Alla; Forster, David; Heffernan, Kate; Luthin, Maeve; Lynch, Holly Fernandez; McNair, Lindsay; Miller, Jennifer E; Murphy, Jacquelyn; Van Campen, Luann; Wilenzick, Mark; Wolf, Delia; Woolston, Cris; Aldinger, Carmen; Bierer, Barbara E

2016-04-01

A novel Protocol Ethics Tool Kit ('Ethics Tool Kit') has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Addressing Palliative Care Clinician Burnout in Organizations: A Workforce Necessity, an Ethical Imperative.

PubMed

Harrison, Krista L; Dzeng, Elizabeth; Ritchie, Christine S; Shanafelt, Tait D; Kamal, Arif H; Bull, Janet H; Tilburt, Jon C; Swetz, Keith M

2017-06-01

Clinician burnout reduces the capacity for providers and health systems to deliver timely, high quality, patient-centered care and increases the risk that clinicians will leave practice. This is especially problematic in hospice and palliative care: patients are often frail, elderly, vulnerable, and complex; access to care is often outstripped by need; and demand for clinical experts will increase as palliative care further integrates into usual care. Efforts to mitigate and prevent burnout currently focus on individual clinicians. However, analysis of the problem of burnout should be expanded to include both individual- and systems-level factors as well as solutions; comprehensive interventions must address both. As a society, we hold organizations responsible for acting ethically, especially when it relates to deployment and protection of valuable and constrained resources. We should similarly hold organizations responsible for being ethical stewards of the resource of highly trained and talented clinicians through comprehensive programs to address burnout. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Ethical Concerns of and Risk Mitigation Strategies for Crowdsourcing Contests and Innovation Challenges: Scoping Review

PubMed Central

Pan, Stephen W; Mathews, Allison; Stein, Gabriella; Bayus, Barry; Rennie, Stuart

2018-01-01

Background Crowdsourcing contests (also called innovation challenges, innovation contests, and inducement prize contests) can be used to solicit multisectoral feedback on health programs and design public health campaigns. They consist of organizing a steering committee, soliciting contributions, engaging the community, judging contributions, recognizing a subset of contributors, and sharing with the community. Objective This scoping review describes crowdsourcing contests by stage, examines ethical problems at each stage, and proposes potential ways of mitigating risk. Methods Our analysis was anchored in the specific example of a crowdsourcing contest that our team organized to solicit videos promoting condom use in China. The purpose of this contest was to create compelling 1-min videos to promote condom use. We used a scoping review to examine the existing ethical literature on crowdsourcing to help identify and frame ethical concerns at each stage. Results Crowdsourcing has a group of individuals solve a problem and then share the solution with the public. Crowdsourcing contests provide an opportunity for community engagement at each stage: organizing, soliciting, promoting, judging, recognizing, and sharing. Crowdsourcing poses several ethical concerns: organizing—potential for excluding community voices; soliciting—potential for overly narrow participation; promoting—potential for divulging confidential information; judging—potential for biased evaluation; recognizing—potential for insufficient recognition of the finalist; and sharing—potential for the solution to not be implemented or widely disseminated. Conclusions Crowdsourcing contests can be effective and engaging public health tools but also introduce potential ethical problems. We present methods for the responsible conduct of crowdsourcing contests. PMID:29523500

Ancillary Care in South African HIV Vaccine Trials: Addressing Needs, Drafting Protocols, and Engaging Community

PubMed Central

Slack, Catherine M.

2014-01-01

There has been debate about sponsor-investigator ethical responsibilities to address participants’ medical needs in trials in resource-constrained contexts. Certain ethical guidelines make detailed recommendations. This study explored whether ethical guideline recommendations for care in HIV vaccine trials were being met, and whether stakeholders were facing difficulties addressed by guidelines. It sampled key stakeholders involved in two trials across five sites in South Africa, and reviewed relevant documentation. It concluded that sites were largely meeting guideline recommendations for addressing needs, with some exceeding these. Recommendations for writing protocols were only partially achieved. Recommendations for engaging participating community were mostly met, except for “moral negotiation” recommendations. Suggestions are made to strengthen practices, and to improve guidelines so they address empirical concerns. PMID:24572086

Ancillary care in South African HIV vaccine trials: addressing needs, drafting protocols, and engaging community.

PubMed

Slack, Catherine M

2014-02-01

There has been debate about sponsor-investigator ethical responsibilities to address participants' medical needs in trials in resource-constrained contexts. Certain ethical guidelines make detailed recommendations. This study explored whether ethical guideline recommendations for care in HIV vaccine trials were being met, and whether stakeholders were facing difficulties addressed by guidelines. It sampled key stakeholders involved in two trials across five sites in South Africa, and reviewed relevant documentation. It concluded that sites were largely meeting guideline recommendations for addressing needs, with some exceeding these. Recommendations for writing protocols were only partially achieved. Recommendations for engaging participating community were mostly met, except for "moral negotiation" recommendations. Suggestions are made to strengthen practices, and to improve guidelines so they address empirical concerns.

Ethical conflict resolution based on an ethics of relationships for brain injury rehabilitation.

PubMed

Malec, J F

1996-11-01

An ethics of relationships for brain injury (BI) rehabilitation is described based on three principles; (1) human relationships are important; (2) human relationships are as important as individual survival; (3) human relationships are important enough to extend throughout the family of humankind. Within the context of this ethics of relationships, ethical conflict resolution (ECR) is offered as a process to address disagreements among those involved in BI rehabilitation. ECR provides a means to arrive at moral decisions in situations in which people disagree about the appropriate course of action because of differing values. ECR recognizes that, although disagreements in BI rehabilitation settings can be associated with multiple other factors, including disturbed self-awareness, emotions, communication, and interpersonal dynamics, such disagreements may also be value-based, either in whole or part. ECR invites the professional team to identify the value-based portion of these disagreements and provides a rational and supportive process to address disagreements. In this discussion of ECR, common and potentially universal areas of ethical concern in BI rehabilitation are identified, as well as potential risks. Specific examples of the application of ECR in cases of vegetative state, coma stimulation, and cognitive rehabilitation are described.

Thinking clearly about the FIRST trial: addressing ethical challenges in cluster randomised trials of policy interventions involving health providers.

PubMed

Horn, Austin R; Weijer, Charles; Hey, Spencer Phillips; Brehaut, Jamie; Fergusson, Dean A; Goldstein, Cory E; Grimshaw, Jeremy; Taljaard, Monica

2018-04-27

The ethics of the Flexibility In duty hour Requirements for Surgical Trainees (FIRST) trial have been vehemently debated. Views on the ethics of the FIRST trial range from it being completely unethical to wholly unproblematic. The FIRST trial illustrates the complex ethical challenges posed by cluster randomised trials (CRTs) of policy interventions involving healthcare professionals. In what follows, we have three objectives. First, we critically review the FIRST trial controversy, finding that commentators have failed to sufficiently identify and address many of the relevant ethical issues. The 2012 Ottawa Statement on the Ethical Design and Conduct of Cluster Randomized Trials provides researchers and research ethics committees with specific guidance for the ethical design and conduct of CRTs. Second, we aim to demonstrate how the Ottawa Statement provides much-needed clarity to the ethical issues in the FIRST trial, including: research participant identification; consent requirements; gatekeeper roles; benefit-harm analysis and identification of vulnerable participants. We nonetheless also find that the FIRST trial raises ethical issues not adequately addressed by the Ottawa Statement. Hence, third and finally, we raise important questions requiring further ethical analysis and guidance, including: Does clinical equipoise apply to policy interventions with little or no evidence-base? Do healthcare providers have an obligation to participate in research? Does the power-differential in certain healthcare settings render healthcare providers vulnerable to duress and coercion to participant in research? If so, what safeguards might be implemented to protect providers, while allowing important research to proceed? © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Ethical androcentrism and maternal substance addiction.

PubMed

Parks, J A

1999-01-01

In this paper, I argue that bioethics suffers from a masculinist approach--what I call "ethical androcentrism." Despite the genesis of other legitimate approaches to ethics (such as feminist, narrative, and communicative ethics), this masculinist tradition persists. The first part of my paper concerns the problem of ethical androcentrism, and how it is manifest in our typical ways of "doing" bioethics (as teachers, ethicists, policymakers, and medical practitioners). After arguing that bioethics suffers from a masculinist ethic, I consider the case of maternal substance addiction to show how this ethic negatively affects the treatment of pregnant addicts. I argue that by treatment maternal substance addiction from an androcentric approach, we fail to serve both pregnant addicts and their fetuses; furthermore, we misrepresent the intentional state of pregnant substance addicts and label them "prenatal abusers." If maternal substance addiction is to be ethically addressed--and if pregnant substance addicts are to be effectively treated--we cannot tacitly accept an androcentric ethic.

From environmental to ecological ethics: toward a practical ethics for ecologists and conservationists.

PubMed

Minteer, Ben A; Collins, James P

2008-12-01

Ecological research and conservation practice frequently raise difficult and varied ethical questions for scientific investigators and managers, including duties to public welfare, nonhuman individuals (i.e., animals and plants), populations, and ecosystems. The field of environmental ethics has contributed much to the understanding of general duties and values to nature, but it has not developed the resources to address the diverse and often unique practical concerns of ecological researchers and managers in the field, lab, and conservation facility. The emerging field of "ecological ethics" is a practical or scientific ethics that offers a superior approach to the ethical dilemmas of the ecologist and conservation manager. Even though ecological ethics necessarily draws from the principles and commitments of mainstream environmental ethics, it is normatively pluralistic, including as well the frameworks of animal, research, and professional ethics. It is also methodologically pragmatic, focused on the practical problems of researchers and managers and informed by these problems in turn. The ecological ethics model offers environmental scientists and practitioners a useful analytical tool for identifying, clarifying, and harmonizing values and positions in challenging ecological research and management situations. Just as bioethics provides a critical intellectual and problem-solving service to the biomedical community, ecological ethics can help inform and improve ethical decision making in the ecology and conservation communities.

Ethical issues faced by field primatologists: asking the relevant questions.

PubMed

Fedigan, Linda Marie

2010-09-01

Field primatologists face unusual ethical issues. We study animals rather than people and receive research approval from animal care rather than ethics committees. However, animal care evaluation forms are developed from concerns about laboratory animal research and are based on the "Three R's" for humane treatment of captive experimental subjects (replacement, reduction and refinement), which are only debatably relevant to field research. Scientists who study wild, free-ranging primates in host countries experience many ethical dilemmas seldom dealt with in animal care forms. This paper reviews the ethical issues many field primatologists say they face and how these might be better addressed by animal care forms. The ethical issues arising for field researchers are divided into three categories: "Presence, Protocols and People" and for each the most frequent issues are described. The most commonly mentioned ethical concern arising from our presence in the field is the possibility of disease transmission. Although most primate field studies employ only observational protocols, the practice of habituating our study animals to close human presence is an ethical concern for many since it can lessen the animals' fear of all humans, thereby facilitating undesirable behaviors (e.g., crop-raiding) and rendering them vulnerable to harm. Field primatologists who work in host countries must observe national laws and local traditions. As conservationists, primatologists must often negotiate between the resource needs and cultural practices of local people and the interests of the nonhuman primates. Many say they face more ethical dilemmas arising from human interactions than from research on the animals per se. This review concludes with suggestions for relevant questions to ask on animal care forms, and actions that field primatologists can take to better inform animal care committees about the common ethical issues we experience as well as how to develop guidelines for

Concerns of early career agricultural science teachers and the perceived effectiveness of educator preparation programs in addressing those concerns

NASA Astrophysics Data System (ADS)

Pearson, Camilla E.

Little is known about the concerns and needs of early career agricultural teachers associated with the various routes to certification and how these routes address those concerns. The purpose of this study is to determine how selected early career agriculture teachers perceive their teacher preparation program and how effective their programs were at addressing these concerns during their first year of teaching. The sample consisted of secondary agricultural teachers in Texas FFA Areas V and VI, who self-identified themselves as an early career agricultural teacher in their first 3 years of teaching. The first phase included a web-based survey administered to assess the concerns of early career agricultural teachers. Two Likert-type scales were used, and these were used to assess the perceived importance of problems faced by early career agricultural teachers and the frequency in which they encounter those problems. The second phase included a qualitative interview to better understand the perceived relationship between participants' undergraduate preparation, experiences in agriculture and related organizations, and other related activities in preparing them as agriculture science teachers. The teachers interviewed in this study indicated that overall, they were pleased with their preparation. Teacher educators from both programs should address the concerns presented from all teachers to further prepare them for issues faced by early career teachers because it is evident that these issues are not going away.

The opportunities and ethics of big data: practical priorities for a national Council of Data Ethics.

PubMed

Varley-Winter, Olivia; Shah, Hetan

2016-12-28

In order to generate the gains that can come from analysing and linking big datasets, data holders need to consider the ethical frameworks, principles and applications that help to maintain public trust. In the USA, the National Science Foundation helped to set up a Council for Big Data, Ethics and Society, of which there is no equivalent in the UK. In November 2015, the Royal Statistical Society convened a workshop of 28 participants from government, academia and the private sector, and discussed the practical priorities that might be assisted by a new Council of Data Ethics in the UK. This article draws together the views from that meeting. Priorities for policy-makers and others include seeking a public mandate and informing the terms of the social contract for use of data; building professional competence and due diligence on data protection; appointment of champions who are competent to address public concerns; and transparency, across all dimensions. For government data, further priorities include improvements to data access, and development of data infrastructure. In conclusion, we support the establishment of a national Data Ethics Council, alongside wider and deeper engagement of the public to address data ethics dilemmas.This article is part of the themed issue 'The ethical impact of data science'. © 2016 The Author(s).

Ethical guidance in the era of managed care: an analysis of the American College of Healthcare Executives' Code of Ethics.

PubMed

Higgins, W

2000-01-01

Market competition and the rise of managed care are transforming the healthcare system from a physician-dominated cottage industry into a manager-dominated corporate enterprise. The managed care revolution is also undermining the safe-guards offered by medical ethics and raising serious public concerns. These trends highlight the growing importance of ethical standards for managers. The most comprehensive ethical guidance for health service managers is contained in the American College of Healthcare Executives' (ACHE) Code of Ethics. An analysis of the ACHE Code suggests that it does not adequately address several ethical concerns associated with managed care. The ACHE may wish to develop a supplemental statement regarding ethical issues in managed care. A supplemental statement that provides more specific guidance in the areas of financial incentives to reduce utilization, social mission, consumer/patient information, and the health service manager's responsibility to patients could be extremely valuable in today's complex and rapidly changing environment. More specific ethical guidelines would not ensure individual or organizational compliance. However, they would provide professional standards that could guide decision making and help managers evaluate performance in managed care settings.

Ethical aspects of clinical research with minors.

PubMed

Bos, Wendy; Tromp, Krista; Tibboel, Dick; Pinxten, Wim

2013-07-01

Over the past decades, clinical research has increasingly been subjected to ethical requirements and legal regulation. The specific focus of ethical and legal frameworks on competent adults (which serve as the paradigmatic research subject), however, has created an ambivalent attitude towards pediatric clinical research. On one hand, minors are regarded as a vulnerable population that deserves additional protection against the risks and burdens involved in clinical research. On the other hand, the population of minors should not be denied (or not get timely) access to the benefits of clinical research. In this paper, we will explore the legal regulation and ethical guidance that currently governs pediatric clinical research in the European Union and discuss the future challenges in this field. In addition, we will discuss major ethical concerns in pediatric clinical research, with a focus on the acceptability of research risks and the informed consent process. In the discussion, we will address key concerns in both regulating pediatric clinical research and implementing ethical and legal requirement in the actual pediatric research conduct.

Ethical Concerns of and Risk Mitigation Strategies for Crowdsourcing Contests and Innovation Challenges: Scoping Review.

PubMed

Tucker, Joseph D; Pan, Stephen W; Mathews, Allison; Stein, Gabriella; Bayus, Barry; Rennie, Stuart

2018-03-09

Crowdsourcing contests (also called innovation challenges, innovation contests, and inducement prize contests) can be used to solicit multisectoral feedback on health programs and design public health campaigns. They consist of organizing a steering committee, soliciting contributions, engaging the community, judging contributions, recognizing a subset of contributors, and sharing with the community. This scoping review describes crowdsourcing contests by stage, examines ethical problems at each stage, and proposes potential ways of mitigating risk. Our analysis was anchored in the specific example of a crowdsourcing contest that our team organized to solicit videos promoting condom use in China. The purpose of this contest was to create compelling 1-min videos to promote condom use. We used a scoping review to examine the existing ethical literature on crowdsourcing to help identify and frame ethical concerns at each stage. Crowdsourcing has a group of individuals solve a problem and then share the solution with the public. Crowdsourcing contests provide an opportunity for community engagement at each stage: organizing, soliciting, promoting, judging, recognizing, and sharing. Crowdsourcing poses several ethical concerns: organizing-potential for excluding community voices; soliciting-potential for overly narrow participation; promoting-potential for divulging confidential information; judging-potential for biased evaluation; recognizing-potential for insufficient recognition of the finalist; and sharing-potential for the solution to not be implemented or widely disseminated. Crowdsourcing contests can be effective and engaging public health tools but also introduce potential ethical problems. We present methods for the responsible conduct of crowdsourcing contests. ©Joseph D Tucker, Stephen W Pan, Allison Mathews, Gabriella Stein, Barry Bayus, Stuart Rennie. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.03.2018.

Hidden in plain view: feminists doing engineering ethics, engineers doing feminist ethics.

PubMed

Riley, Donna

2013-03-01

How has engineering ethics addressed gender concerns to date? How have the ideas of feminist philosophers and feminist ethicists made their way into engineering ethics? What might an explicitly feminist engineering ethics look like? This paper reviews some major themes in feminist ethics and then considers three areas in which these themes have been taken up in engineering ethics to date. First, Caroline Whitbeck's work in engineering ethics integrates considerations from her own earlier writings and those of other feminist philosophers, but does not use the feminist label. Second, efforts to incorporate the Ethic of Care and principles of Social Justice into engineering have drawn on feminist scholarship and principles, but these commitments can be lost in translation to the broader engineering community. Third, the film Henry's Daughters brings gender considerations into the mainstream of engineering ethics, but does not draw on feminist ethics per se; despite the best intentions in broaching a difficult subject, the film unfortunately does more harm than good when it comes to sexual harassment education. I seek not only to make the case that engineers should pay attention to feminist ethics and engineering ethicists make more use of feminist ethics traditions in the field, but also to provide some avenues for how to approach integrating feminist ethics in engineering. The literature review and analysis of the three examples point to future work for further developing what might be called feminist engineering ethics.

Science and ethics: Some issues for education

NASA Astrophysics Data System (ADS)

Andrew, Jennifer; Robottom, Ian

2001-11-01

Ethical issues concerning pain and suffering of animals are necessarily a consideration when it comes to killing pest or feral species in Australia. Within a continent where there are no large predators, many introduced animal species such as rabbits, foxes, horses, donkeys, camels, goats, and mice have been able to thrive, competing with the interests of farmers and graziers, and livestock and food production. These species, thus, gain the label of pest. Many methods now exist to kill these species and, consequently, ethical issues arise concerning the possible pain and suffering caused as a direct result of these methods. Yet within government and scientific communities, ethical issues are reduced to a secondary consideration without serious debate or contention. Ethical issues appear to be at odds with scientific agendas. How can environmental ethics be incorporated as part of science-based decision making that appeals to objectivity and scientific evidence? Within educational institutions as well, the same dilemma exists: How can ethical issues be addressed within the science curriculum and in the classroom? A greater understanding of various perspectives on the subject of environmental ethics and the value positions advocated by proponents of these perspectives may help teachers consider ways of handling such issues in the science classroom.

Ethical concerns and career satisfaction in obstetrics and gynecology: a review of recent findings from the Collaborative Ambulatory Research Network.

PubMed

Farrow, Victoria A; Leddy, Meaghan A; Lawrence, Hal; Schulkin, Jay

2011-09-01

Obstetricians-gynecologists (ob-gyns) are frequently confronted with situations that have ethical implications (e.g., whether to accept gifts or samples from drug companies or disclosing medical errors to patients). Additionally, various factors, including specific job-related tasks, costs, and benefits, may impact ob-gyns' career satisfaction. Ethical concerns and career satisfaction can play a role in the quality of women's health care. This article summarizes the studies published between 2005 and 2009 by the Research Department of the American College of Obstetricians and Gynecologists, which encompass ethical concerns regarding interactions with pharmaceutical representatives and patient safety/medical error reporting, as well as ob-gyn career satisfaction. Additionally, a brief discussion regarding ethical concerns in the ob-gyn field, in general, highlights key topics for the last 30 years. Ethical dilemmas continue to be of concern for ob-gyns. Familiarity with guidelines on appropriate interactions with industry is associated with lower percentages of potentially problematic relationships with pharmaceutical industries. Physicians report that the expense of patient safety initiatives is one of the top barriers for improving patient safety, followed by fear of liability. Overall, respondents reported being satisfied with their careers. However, half of the respondents reported that they were extremely concerned about the impact of professional liability costs on the duration of their careers. Increased familiarity with guidelines may lead to a decreased ob-gyn reliance on pharmaceutical representatives and free samples, whereas specific and practical tools may help them implement patient safety techniques. The easing of malpractice insurance and threat of litigation may enhance career satisfaction among ob-gyns. This article will discuss related findings in recent years. Obstetricians & Gynecologists and Family Physicians. After the completing the CME

An Ethics Study: Implications of Knowledge for School Counselor Candidates, School Counseling Supervisors, Practicing School Counselors and Training Programs

ERIC Educational Resources Information Center

Boes, Susan R.; Chibbaro, Julia S.; Bingeman, Brittany A.

2006-01-01

This paper addresses a survey conducted to examine knowledge of ethics in school counselor candidates. Students in school counseling practicum and internship classes indicated their familiarity with ethical codes and ethical decision making-models and responded to items pertaining to ethical dilemmas. Areas of concern to counselor educators…

Predictors of nurse practitioners' autonomy: effects of organizational, ethical, and market characteristics.

PubMed

Ulrich, Connie; Soeken, Karen; Miller, Nancy

2003-07-01

To identify the predictors of autonomy of nurse practitioners (NPs) affiliated directly and/or indirectly with managed-care systems (e.g., HMOs). A mailed survey sent to a stratified random sample of 254 NPs certified and licensed to practice in the state of Maryland. The measures consisted of selected organizational characteristics; market factors of HMO penetration and percentage of client population enrolled in managed care; and factors of ethical concern, such as ethical ideology, ethics education, and autonomy. The County Surveyor Database was used to assess market penetration in the state. Although NPs were ethically concerned about their autonomy in a managed-care environment (70.2%), actual autonomy scores were high. The higher the percentage of HMO penetration, percentage of client population enrolled in managed care, and perceived ethical concern, the lower the perceived autonomy of NPs. Findings may be used for future research to address the complexity of variables that influence the autonomous practice of NPs.

Internet Ethics for Users and Providers

ERIC Educational Resources Information Center

Ben-Jacob, Marion G.

2017-01-01

This article deliberates concepts of Internet ethics from the perspectives of user and providers. It discusses concerns of the users from different disciplines. It addresses issues and corresponding regulations of service providers. It considers matters of privacy. The culmination is an exercise for students that incorporates usage of the Internet…

Using an Ethical Decision-Making Model to Address Ethical Dilemmas in School Counseling

ERIC Educational Resources Information Center

Brown, Timothy; Armstrong, Stephen A.; Bore, Samuel; Simpson, Chris

2017-01-01

School counselors frequently face ethical dilemmas. These dilemmas often involve relationships with principals, parents, and other stakeholders. School counselors may confront complex ethical issues involving confidentiality, student safety, parental rights,and social media. The American School Counselor Association recommends following an ethical…

Ethical challenges in resuscitation.

PubMed

Mentzelopoulos, Spyros D; Slowther, Anne-Marie; Fritz, Zoe; Sandroni, Claudio; Xanthos, Theodoros; Callaway, Clifton; Perkins, Gavin D; Newgard, Craig; Ischaki, Eleni; Greif, Robert; Kompanje, Erwin; Bossaert, Leo

2018-06-01

A rapidly evolving resuscitation science provides more effective treatments to an aging population with multiple comorbidites. Concurrently, emergency care has become patient-centered. This review aims to describe challenges associated with the application of key principles of bioethics in resuscitation and post-resuscitation care; propose actions to address these challenges; and highlight the need for evidence-based ethics and consensus on ethical principles interpretation. Following agreement on the article's outline, subgroups of 2-3 authors provided narrative reviews of ethical issues concerning autonomy and honesty, beneficence/nonmaleficence and dignity, justice, specific practices/circumstances such as family presence during resuscitation, and emergency research. Proposals for addressing ethical challenges were also offered. Respect for patient autonomy can be realized through honest provision of information, shared decision-making, and advance directives/care planning. Essential prerequisites comprise public and specific healthcare professionals' education, appropriate regulatory provisions, and allocation of adequate resources. Regarding beneficence/nonmaleficence, resuscitation should benefit patients, while avoiding harm from futile interventions; pertinent practice should be based on neurological prognostication and patient/family-reported outcomes. Regarding dignity, aggressive life-sustaining treatments against patients preferences should be avoided. Contrary to the principle of justice, resuscitation quality may be affected by race/income status, age, ethnicity, comorbidity, and location (urban versus rural or country-specific/region-specific). Current evidence supports family presence during resuscitation. Regarding emergency research, autonomy should be respected without hindering scientific progress; furthermore, transparency of research conduct should be promoted and funding increased. Major ethical challenges in resuscitation science need to be

Ethical framework of assistive devices: review and reflection.

PubMed

Mansouri, Nazanin; Goher, Khaled; Hosseini, Seyed Ebrahim

2017-01-01

The population of ageing is growing significantly over the world, and there is an emerging demand for better healthcare services and more care centres. Innovations of Information and Communication Technology has resulted in development of various types of assistive robots to fulfil elderly's needs and independency, whilst carrying out daily routine tasks. This makes it vital to have a clear understanding of elderly's needs and expectations from assistive robots. This paper addresses current ethical issues to understand elderly's prime needs. Also, we consider other general ethics with the purpose of applying these theories to form a proper ethics framework. In the ethics framework, the ethical concerns of senior citizens will be prioritized to satisfy elderly's needs and also to diminish related expenses to healthcare services.

Ethical concerns and contributions in response to climate change and the links to well-being: a study of university students in The Netherlands.

PubMed

El Zoghbi, Mona Betour; El Ansari, Walid

2014-06-01

This study explored the concerns and contributions of university students in response to the ethical dimensions of climate change, and the implications for their well-being. The study focused on university students as leaders of future society while facing complex environmental and socio-economic challenges. A total of 8 focus groups (FG) were conducted (66 participants from over 10 different universities across The Netherlands). In addition, 9 in-depth interviews with Dutch university students from different academic backgrounds, and 16 interviews with Dutch key informants in the environment, youth and public health fields were undertaken. The first author also attended (as participant-observer) three major events themed around youth and environmental issues across different regions in The Netherlands. University students in the Netherlands are mostly concerned about the increasing social and economic inequalities between the global North and South, and the implications for impoverished and uneducated communities. Participants raised concerns over the transfer of materialistic value systems and unsustainable practices from developed to developing countries. The participants' main contributions in response to climate change were largely driven by feelings of guilt and responsibility, an ecological worldview, and desire to play a positive role in society. Establishing formal youth platforms across academic, civic and political institutions could provide legitimate and empowering opportunities for university students to participate in consultations and debates of future environmental policies and development strategies. Such platforms could enhance the agency and well-being of university students for addressing their concerns over existing climate inequalities and other ethical dilemmas.

Sugar, ethics and legislation.

PubMed

Azize, Joseph

2010-05-01

There are serious ethical and legal issues concerning the sale of sugar products, especially to children, yet one cannot address children's consumption without addressing consumption across society. The ethical principles are not even controversial. However, sugar has been insufficiently scrutinised, probably because sweetness is popular and plays a prominent, but dispensable, cultural role. Sugar is both addictive and toxic, although it is a very mild, very slow-working poison. Yet, over time, its effects can be quite serious. The social and health problems have proved grave and intractable. Given the nature of sugar, it should be regulated like alcohol and tobacco, if not more stringently, given its greater social and cultural penetration across all ages. That is, sales of sugar products at school canteens should be banned, advertising severely limited, full disclosure of sugar content made mandatory, warnings placed on certain products, and sugar itself should be taxed.

Ethics and mediation.

PubMed

Patthoff, D E

1993-12-01

Ethics dialogue in this case is first used as a framework to initiate reflection on which forms of conflict resolution are appropriate in specific situations. This helps in planning and strategies, but does not guarantee what the outcome will actually be. Ethics dialogue, however, can also be used as a form of conflict resolution. For example, when the patient in the story wants to avoid revealing the names of her past dentists, an ethical framework could be presented that would respect her autonomy (an ethical term) and her right to privacy (a legal term), while still addressing your need to determine if the primary problem is of an ethical or dental nature, and if your role is to be that of a healing mediator or a healing dentist. This same form of conflict resolution could also be applied elsewhere in the story. For example, ethics dialogue would have been appropriate during the consultation between you and the endodontist, or between you and the patient, prior to the lawyer's formal request for the patient's records. It is difficult, however, for you to reduce conflict through an ethical dialogue once the lawyer requests information from you because, at that point, the adjudication process has already begun. The ethical reflection exercise will, however, help you negotiate through the adjudication process by providing a solid ethical reference point concerning conflict resolution. The February issue's ethics column will provide a framework for evaluating the forms of power available in conflict resolution in terms of justice.

Practical guidelines addressing ethical issues pertaining to the curation of human locus-specific variation databases (LSDBs)

PubMed Central

Povey, Sue; Al Aqeel, Aida I; Cambon-Thomsen, Anne; Dalgleish, Raymond; den Dunnen, Johan T; Firth, Helen V; Greenblatt, Marc S; Barash, Carol Isaacson; Parker, Michael; Patrinos, George P; Savige, Judith; Sobrido, Maria-Jesus; Winship, Ingrid; Cotton, Richard GH

2010-01-01

More than 1,000 Web-based locus-specific variation databases (LSDBs) are listed on the Website of the Human Genetic Variation Society (HGVS). These individual efforts, which often relate phenotype to genotype, are a valuable source of information for clinicians, patients, and their families, as well as for basic research. The initiators of the Human Variome Project recently recognized that having access to some of the immense resources of unpublished information already present in diagnostic laboratories would provide critical data to help manage genetic disorders. However, there are significant ethical issues involved in sharing these data worldwide. An international working group presents second-generation guidelines addressing ethical issues relating to the curation of human LSDBs that provide information via a Web-based interface. It is intended that these should help current and future curators and may also inform the future decisions of ethics committees and legislators. These guidelines have been reviewed by the Ethics Committee of the Human Genome Organization (HUGO). Hum Mutat 31:–6, 2010. © 2010 Wiley-Liss, Inc. PMID:20683926

Addressing concerns about the inclusion of premenstrual dysphoric disorder in DSM-5.

PubMed

Hartlage, S Ann; Breaux, Cynthia A; Yonkers, Kimberly A

2014-01-01

Inclusion of premenstrual dysphoric disorder (PMDD) into the main text of the DSM has been a point of controversy for many years. The purpose of this article is to address the main concerns raised by opponents to its inclusion. Concerns are presented and countered in turn. To identify the most prevalent arguments against inclusion of PMDD, we searched MEDLINE (1966-2012), PsycINFO (1930-2012), the Internet, and reference lists of identified articles during September 1-17, 2012, using the keywords PMDD, premenstrual syndrome (PMS), DSM, DSM-5, concerns, controversy, women, political power, workforce, courts, and history. The search was restricted to English-language publications. A total of 55 articles were identified and included. The most pressing arguments against inclusion were grouped by similarity and addressed if they were reported 5 or more times. Our review of the sources yielded 38 concerns regarding PMDD; 6 concerns were reported at least 5 times and are addressed in this article. Evidence culled from historical and legal trends does not support the alleged societal use of PMS to harm women (eg, keeping women out of the workforce or using PMS against women in child custody disputes). Further, current epidemiologic research has answered all of the methodology criticisms of opponents. Studies have confirmed the existence of PMDD worldwide. The involvement of pharmaceutical companies in research has been questioned. However, irrespective of the level of association with industry, current research on PMDD has consistent results: PMDD exists in a minority of women. Historically, the pain and suffering of women have been dismissed, minimized, and negated. Similarly, women with PMDD have often had their experience invalidated. With the preponderance of evidence in its favor, PMDD has been placed in the main text of the DSM-5, opening the door for affected women to receive the attention full diagnostic status provides. © Copyright 2014 Physicians Postgraduate

How much dentists are ethically concerned about overtreatment; a vignette-based survey in Switzerland.

PubMed

Kazemian, Ali; Berg, Isabelle; Finkel, Christina; Yazdani, Shahram; Zeilhofer, Hans-Florian; Juergens, Philipp; Reiter-Theil, Stella

2015-06-19

Overtreatment (or unnecessary treatment) is when medical or dental services are provided with a higher volume or cost than is appropriate. This study aimed to investigate how a group of dentists in Switzerland, a wealthy country known to have high standards of healthcare including dentistry, evaluated the meaning of unnecessary treatments from an ethical perspective and, assessed the expected frequency of different possible behaviors among their peers. A vignette describing a situation that is susceptible for overtreatment of a patient was presented to a group of dentists. The vignette was followed by five options. A questionnaire including the vignette was posted to 2482 dentists in the German-speaking areas of Switzerland. The respondents were asked to rate each option according to their estimation about its prevalence and their judgment about the degree to which the behavior is ethically sound. 732 completed questionnaires were returned. According to the responses, the most ethical and the most unethical options are considered to be the most and the least prevalent behaviors among dentists practicing in Switzerland, respectively. Suggesting unnecessary treatments to patients seems to be an ethically unacceptable conduct in the eyes of a sample of dentists in Switzerland. Although the respondents believed their colleagues were very likely to behave in an ethical way in response to a situation that is susceptible to overtreatment, they still seemed to be concerned about the prevalence of unethical behaviors in this regard.

Ethical Issues in Social Media Research for Public Health.

PubMed

Hunter, Ruth F; Gough, Aisling; O'Kane, Niamh; McKeown, Gary; Fitzpatrick, Aine; Walker, Tom; McKinley, Michelle; Lee, Mandy; Kee, Frank

2018-03-01

Social media (SM) offer huge potential for public health research, serving as a vehicle for surveillance, delivery of health interventions, recruitment to trials, collection of data, and dissemination. However, the networked nature of the data means they are riddled with ethical challenges, and no clear consensus has emerged as to the ethical handling of such data. This article outlines the key ethical concerns for public health researchers using SM and discusses how these concerns might best be addressed. Key issues discussed include privacy; anonymity and confidentiality; authenticity; the rapidly changing SM environment; informed consent; recruitment, voluntary participation, and sampling; minimizing harm; and data security and management. Despite the obvious need, producing a set of prescriptive guidelines for researchers using SM is difficult because the field is evolving quickly. What is clear, however, is that the ethical issues connected to SM-related public health research are also growing. Most importantly, public health researchers must work within the ethical principles set out by the Declaration of Helsinki that protect individual users first and foremost.

Overview of research addressing ethical dimensions of participation in traumatic stress studies: autonomy and beneficence.

PubMed

Newman, Elana; Kaloupek, Danny

2009-12-01

One element of the design of human research studies is ethically informed decision-making. Key issues include the safety, costs, and benefits of participation. Historically, much of this decision-making was based on opinion rather than formal evidence. Recently, however, investigators in the traumatic stress field have begun to collect data that are relevant to these decisions. In this article, the authors focus on issues emanating from the ethical concepts of autonomy and respect for persons and beneficence and nonmaleficence, and then summarize relevant evidence from studies with trauma-exposed individuals. Discussion addresses implications of this evidence for research practice and policy, and identifies some potentially informative data collections opportunities for future trauma studies.

Ethical objections against including life-extension costs in cost-effectiveness analysis: a consistent approach.

PubMed

Gandjour, Afschin; Müller, Dirk

2014-10-01

One of the major ethical concerns regarding cost-effectiveness analysis in health care has been the inclusion of life-extension costs ("it is cheaper to let people die"). For this reason, many analysts have opted to rule out life-extension costs from the analysis. However, surprisingly little has been written in the health economics literature regarding this ethical concern and the resulting practice. The purpose of this work was to present a framework and potential solution for ethical objections against life-extension costs. This work found three levels of ethical concern: (i) with respect to all life-extension costs (disease-related and -unrelated); (ii) with respect to disease-unrelated costs only; and (iii) regarding disease-unrelated costs plus disease-related costs not influenced by the intervention. Excluding all life-extension costs for ethical reasons would require-for reasons of consistency-a simultaneous exclusion of savings from reducing morbidity. At the other extreme, excluding only disease-unrelated life-extension costs for ethical reasons would require-again for reasons of consistency-the exclusion of health gains due to treatment of unrelated diseases. Therefore, addressing ethical concerns regarding the inclusion of life-extension costs necessitates fundamental changes in the calculation of cost effectiveness.

Ethics in oncology: consulting for the investment industry.

PubMed

Berlin, Jordan; Bruinooge, Suanna S; Tannock, Ian F

2007-02-01

As Ethics Committee Chair, I am pleased to introduce the first in an ongoing series of ethics vignettes. These columns, which are based on true-to-life situations that arise in oncology research and practice, are intended to identify and explore important ethical issues and provide commentary that is specific to oncology. Please look for them periodically in both the Journal of Clinical Oncology and the Journal of Oncology Practice. The idea for publishing vignettes evolved through the joint efforts of the Ethics Committee and the Board of Directors. Rather than adopt a single set of ethical principles that applies vaguely to any situation and well to none, the Committee and the Board preferred to tackle ethical dilemmas individually, specifically, and directly. Because the Ethics Committee thought the ethical and legal implications of physician interactions with the investment industry were so important and timely, it chose to address this topic in both a position article, which was previously published in the January 20, 2007, issue of the Journal of Clinical Oncology (J Clin Oncol 25:338-340, 2007) and in its first vignette column. The Ethics Committee hopes this column will be the first of several that ASCO members will find helpful as they grapple with the many ethical issues that arise in daily practice in the field of oncology. Because these columns are intended to address the concerns of ASCO members, the Committee welcomes suggestions for future topics at vignettes@asco.org. Martin D. Abeloff, MD, Chair, Ethics Committee.

Ethical issues related to epilepsy care in the developing world.

PubMed

Tan, Chong-Tin; Avanzini, Giuliano

2009-05-01

There are three major issues of ethical concern related to epilepsy care in the developing world. First, is it ethical for a developing country to channel its limited resources from direct epilepsy care to research? The main considerations in addressing this question are the particular research questions to be addressed and whether such research will bring direct benefits to the local community. Second, in a country with limited resources, when does ignoring the high treatment gap become an ethical issue? This question is of particular concern when the community has enough resources to afford treatment for its poor, yet is not providing such care because of gross wastage and misallocation of the national resources. Third, do countries with plentiful resources have an ethical responsibility to help relieve the high epilepsy treatment gap of poor countries? Indeed, we believe that reasonable health care is a basic human right, and that human rights transcend national boundaries. Although health care is usually the responsibility of the nation-state, many modern states in the developing world are arbitrary creations of colonization. There is often a long process from the establishment of a political-legal state to a mature functional nation. During the long process of nation building, help from neighboring countries is often required.

Addressing the Health Concerns of VA Women With Sexual Trauma

DTIC Science & Technology

2016-10-01

SUPPLEMENTARY NOTES 14. ABSTRACT Lifetime ST disproportionately affects women veterans and can threaten their health and wellbeing. PTSD, IPV, and...alcohol use are closely interrelated and significant concerns for women veterans with lifetime ST . Providing effective and low-cost interventions to...address ST -related risks among women veterans with lifetime ST would advance clinical care for these women in an important area. 15. SUBJECT TERMS

Hitting the Moving Target: Challenges of Creating a Dynamic Curriculum Addressing the Ethical Dimensions of Geospatial Data

ERIC Educational Resources Information Center

Carr, John; Vallor, Shannon; Freundschuh, Scott; Gannon, William L.; Zandbergen, Paul

2014-01-01

While established ethical norms and core legal principles concerning the protection of privacy may be easily identified, applying these standards to rapidly evolving digital information technologies, markets for digital information and convulsive changes in social understandings of privacy is increasingly challenging. This challenge has been…

Ethical issues in perinatal mental health research.

PubMed

Brandon, Anna R; Shivakumar, Geetha; Lee, Simon Craddock; Inrig, Stephen J; Sadler, John Z

2009-11-01

To review the background of current ethical standards for the conduct of perinatal mental health research and describe the ethical challenges in this research domain. Current literature reflects a growing sentiment in the scientific community that having no information regarding the impact of psychiatric treatment on the mother and developing fetus/infant poses dangers that may exceed the risks involved in research. However, without sufficient consensus across the scientific community, both regulatory bodies and perinatal researchers find themselves without a framework for decision making that satisfactorily limits the risks and facilitates the benefits of participation of pregnant and lactating women in clinical research. Psychiatric research in perinatal mental health is critically important as it enables clinicians and patients to participate in informed decision-making concerning treatment for psychiatric disorders. Specific areas of concern include fetal safety, maternal risk, the therapeutic misconception, commercial interests, forensic/legal issues, the informed consent process, and study design. Developing guidelines that address ethical challenges and include the views and concerns of multiple stakeholders could improve the access of perinatal women to the benefits of participation in mental health research in addition to providing evidence-based mental healthcare for this subpopulation.

Ethical Responsibilities in Training Marriage and Family Counselors

ERIC Educational Resources Information Center

Levitt, Dana Heller

2004-01-01

Graduate programs in marriage and family counseling must adhere to ethical codes and standards for training students. A question arises concerning the amount of specialized training that should be included within the larger counselor education discipline. This article addresses the standards for training and competence as set forth by the Council…

Ethics and Community Involvement in Syntheses Concerning American Indian, Alaska Native, or Native Hawaiian Health: A Systematic Review

PubMed Central

Around Him, Deana M.

2014-01-01

Background The objective of the research was to review reporting of ethical concerns and community involvement in peer-reviewed systematic reviews or meta-analyses concerning American Indian, Alaska Native, or Native Hawaiian (AI/AN/NH) health. Methods Text words and indexed vocabulary terms were used to query PubMed, Embase, Cochrane Library, and the Native Health Database for systematic reviews or meta-analyses concerning AI/AN/NH health published in peer-reviewed journals, followed by a search through reference lists. Each article was abstracted by two independent reviewers; results were discussed until consensus was reached. Results We identified 107 papers published from 1986–2012 that were primarily about AI/AN/NH health or presented findings separately for AI/AN/NH communities. Two reported seeking indigenous reviewer feedback; none reported seeking input from tribes and communities. Approximately 7% reported on institutional review board (IRB) approval of included studies, 5% reported on tribal approval, and 4% referenced the sovereignty of AI/AN tribes. Approximately 63% used evidence from more than one AI/AN/NH population study, and 28% discussed potential benefits to communities from the synthesis research. Conclusions Reporting of ethics and community involvement are not prominent. Systematic reviews and meta-analyses making community-level inferences may pose risks to communities. Future systematic reviews and meta-analyses should consider ethical and participatory dimensions of research. PMID:25089283

Ethical Issues in Addressing Inequity in/through ESL Research

ERIC Educational Resources Information Center

Lee, Ena

2011-01-01

This article outlines a researcher's struggles with conducting "ethical" research when her case study reveals racializations faced by a minority teacher in a Canadian ESL program. How might becoming privy to research participants' experiences of inequity in ESL education complicate the notion of research ethics when "doing the right…

Ethical concerns in early 21st century organ transplantation

PubMed Central

Waness, Abdelkarim

2011-01-01

Medical ethics is an indispensible and challenging aspect of clinical practice. This is particularly prominent in the field of organ transplantation. In this paper, initially, a clinical case with brain death that ended up as an organ donor will be presented. Following the presentation, important moral challenges which initially formed medical ethics and some highlights of it in organ transplantation will be discussed in detail. The impact of complex modern influential factors that might interfere with the practice of medical ethics in this field such as patients’ vulnerability, financial temptations, and legal regulations will be also dealt with. Finally, we shall propose practical guidelines aiming at improving the practice of medical ethics in the emerging issue of organ transplantation. PMID:23908752

ICRP Publication 138: Ethical Foundations of the System of Radiological Protection.

PubMed

Cho, K-W; Cantone, M-C; Kurihara-Saio, C; Le Guen, B; Martinez, N; Oughton, D; Schneider, T; Toohey, R; ZöLzer, F

2018-02-01

Despite a longstanding recognition that radiological protection is not only a matter of science, but also ethics, ICRP publications have rarely addressed the ethical foundations of the system of radiological protection explicitly. The purpose of this publication is to describe how the Commission has relied on ethical values, either intentionally or indirectly, in developing the system of radiological protection with the objective of presenting a coherent view of how ethics is part of this system. In so doing, it helps to clarify the inherent value judgements made in achieving the aim of the radiological protection system as underlined by the Commission in Publication 103. Although primarily addressed to the radiological protection community, this publication is also intended to address authorities, operators, workers, medical professionals, patients, the public, and its representatives (e.g. NGOs) acting in the interest of the protection of people and the environment. This publication provides the key steps concerning the scientific, ethical, and practical evolutions of the system of radiological protection since the first ICRP publication in 1928. It then describes the four core ethical values underpinning the present system: beneficence/ non-maleficence, prudence, justice, and dignity. It also discusses how these core ethical values relate to the principles of radiological protection, namely justification, optimisation, and limitation. The publication finally addresses key procedural values that are required for the practical implementation of the system, focusing on accountability, transparency, and inclusiveness. The Commission sees this publication as a founding document to be elaborated further in different situations and circumstances.

Interventional studies in childhood dystonia do not address the concerns of children and their carers.

PubMed

Lumsden, Daniel E; Gimeno, Hortensia; Tustin, Kylee; Kaminska, Margaret; Lin, Jean-Pierre

2015-05-01

This study aimed to determine the main concerns/priorities of the parents and carers of children with dystonia referred to our service and whether medical interventional studies addressed these concerns. Records of children assessed by our service from June 2005-December 2012 were reviewed and expressed parental/carer concerns at initial assessment categorized using the International Classification of Functioning (ICF) Framework. Medline, CINAHL and Embase databases were searched for outcome measures of medical and surgical interventional studies in childhood dystonia. Data was collected from 273 children and young people with dystonia. The most commonly expressed concerns were: pain (104/273, 38.1%); difficulties in delivering activities of daily-living (66/273, 24.2%), difficulties with hand-use (59/273, 21.6%) and seating (41/273, 15.0%). Literature review identified 70 interventional studies, 46 neurosurgical and 24 pharmacological. The majority of neurosurgical studies (34/46) used impairment scales to measure change, with pharmacological studies typically reporting more subjective changes in motor symptoms. Only a minority of studies used assessments or scales capable of objectively addressing the concerns reported by our cohort. Existing interventional studies in childhood dystonia poorly address the main concerns of children with dystonia and their carers, limiting the conclusions which may be drawn as to true impact of these interventions in childhood. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Sound Trust and the Ethics of Telecare.

PubMed

Voerman, Sander A; Nickel, Philip J

2017-02-01

The adoption of web-based telecare services has raised multifarious ethical concerns, but a traditional principle-based approach provides limited insight into how these concerns might be addressed and what, if anything, makes them problematic. We take an alternative approach, diagnosing some of the main concerns as arising from a core phenomenon of shifting trust relations that come about when the physician plays a less central role in the delivery of care, and new actors and entities are introduced. Correspondingly, we propose an applied ethics of trust based on the idea that patients should be provided with good reasons to trust telecare services, which we call sound trust. On the basis of this approach, we propose several concrete strategies for safeguarding sound trust in telecare. © The Author 2016. Published by Oxford University Press, on behalf of The Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Speaking Up: Veterinary Ethical Responsibilities and Animal Welfare Issues in Everyday Practice

PubMed Central

Hernandez, Elein; Fawcett, Anne; Brouwer, Emily; Rau, Jeff

2018-01-01

Simple Summary Veterinarians have an ethical obligation to provide good care for the animals that they see in practice. However, at times, there may be conflicts between the interests of animal caregivers or owners, the interests of veterinarians and the interests of animals. We provide an overview of why and how veterinary ethics is taught to veterinary students, as well as providing a context for thinking about veterinary ethical challenges and animal welfare issues. We argue that veterinarians are ethically obliged to speak up and ask questions when problems arise or are seen and provide a series of clinical case examples in which there is scope for veterinarians to improve animal welfare by ‘speaking up’. Abstract Although expectations for appropriate animal care are present in most developed countries, significant animal welfare challenges continue to be seen on a regular basis in all areas of veterinary practice. Veterinary ethics is a relatively new area of educational focus but is thought to be critically important in helping veterinarians formulate their approach to clinical case management and in determining the overall acceptability of practices towards animals. An overview is provided of how veterinary ethics are taught and how common ethical frameworks and approaches are employed—along with legislation, guidelines and codes of professional conduct—to address animal welfare issues. Insufficiently mature ethical reasoning or a lack of veterinary ethical sensitivity can lead to an inability or difficulty in speaking up about concerns with clients and ultimately, failure in their duty of care to animals, leading to poor animal welfare outcomes. A number of examples are provided to illustrate this point. Ensuring that robust ethical frameworks are employed will ultimately help veterinarians to “speak up” to address animal welfare concerns and prevent future harms. PMID:29361786

Examining regional variability in work ethic within Mexico: Individual difference or shared value.

PubMed

Arciniega, Luis M; Woehr, David J; Del Rincón, Germán A

2018-02-19

Despite the acceptance of work ethic as an important individual difference, little research has examined the extent to which work ethic may reflect shared environmental or socio-economic factors. This research addresses this concern by examining the influence of geographic proximity on the work ethic experienced by 254 employees from Mexico, working in 11 different cities in the Northern, Central and Southern regions of the country. Using a sequence of complementary analyses to assess the main source of variance on seven dimensions of work ethic, our results indicate that work ethic is most appropriately considered at the individual level. © 2018 International Union of Psychological Science.

Managing ethical issues in patient care and the need for clinical ethics support.

PubMed

Doran, Evan; Fleming, Jennifer; Jordens, Christopher; Stewart, Cameron L; Letts, Julie; Kerridge, Ian H

2015-02-01

To investigate the range, frequency and management of ethical issues encountered by clinicians working in hospitals in New South Wales (NSW), Australia. A cross-sectional survey was conducted of a convenience sample of 104 medical, nursing and allied health professionals in two NSW hospitals. Some respondents did not provide data for some questions, therefore the denominator is less than 105 for some items. Sixty-two (62/104; 60%) respondents reported occasionally to often having ethical concerns. Forty-six (46/105; 44%) reported often to occasionally having legal concerns. The three most common responses to concerns were: talking to colleagues (96/105; 91%); raising the issue in a group forum (68/105; 65%); and consulting a relevant guideline (64/105; 61%). Most respondents were highly (65/99; 66%) or moderately (33/99; 33%) satisfied with the ethical environment of the hospital. Twenty-two (22/98; 22%) were highly satisfied with the ethical environment of their department and 74 (74/98; 76%) were moderately satisfied. Most (72/105; 69%) respondents indicated that additional support in dealing with ethical issues would be helpful. Clinicians reported frequently experiencing ethical and legal uncertainty and concern. They usually managed this by talking with colleagues. Although this approach was considered adequate, and the ethics of their hospital was reported to be satisfactory, most respondents indicated that additional assistance with ethical and legal concerns would be helpful. Clinical ethics support should be a priority of public hospitals in NSW and elsewhere in Australia.

Ethical issues concerning New Zealand sports doctors

PubMed Central

Anderson, L; Gerrard, D

2005-01-01

Success in sport can provide a source of national pride for a society, and vast financial and personal rewards for an individual athlete. It is therefore not surprising that many athletes will go to great lengths in pursuit of success. The provision of healthcare for elite sports people has the potential to create many ethical issues for sports doctors; however there has been little discussion of them to date. This study highlights these issues. Respondents to a questionnaire identified many ethical matters, common to other areas of medicine. However they also raised problems unique to sports medicine. Some of these ethical difficulties arise out of the place of the sports doctor within the hierarchy of sport. Yet others arise out of the special relationship between sports doctors and individual players/athletes. This study raises some important questions regarding the governance of healthcare in sport, and what support and guidance is available to sports doctors. As medical and scientific intervention in sport escalates, there is a risk that demands for enhanced performance may compromise the health of the athlete, and the role the sports doctor plays remains a critical question. PMID:15681672

Methods to address poultry robustness and welfare issues through breeding and associated ethical considerations

PubMed Central

Muir, William M.; Cheng, Heng-Wei; Croney, Candace

2014-01-01

As consumers and society in general become more aware of ethical and moral dilemmas associated with intensive rearing systems, pressure is put on the animal and poultry industries to adopt alternative forms of housing. This presents challenges especially regarding managing competitive social interactions between animals. However, selective breeding programs are rapidly advancing, enhanced by both genomics and new quantitative genetic theory that offer potential solutions by improving adaptation of the bird to existing and proposed production environments. The outcomes of adaptation could lead to improvement of animal welfare by increasing fitness of the animal for the given environments, which might lead to increased contentment and decreased distress of birds in those systems. Genomic selection, based on dense genetic markers, will allow for more rapid improvement of traits that are expensive or difficult to measure, or have a low heritability, such as pecking, cannibalism, robustness, mortality, leg score, bone strength, disease resistance, and thus has the potential to address many poultry welfare concerns. Recently selection programs to include social effects, known as associative or indirect genetic effects (IGEs), have received much attention. Group, kin, multi-level, and multi-trait selection including IGEs have all been shown to be highly effective in reducing mortality while increasing productivity of poultry layers and reduce or eliminate the need for beak trimming. Multi-level selection was shown to increases robustness as indicated by the greater ability of birds to cope with stressors. Kin selection has been shown to be easy to implement and improve both productivity and animal well-being. Management practices and rearing conditions employed for domestic animal production will continue to change based on ethical and scientific results. However, the animal breeding tools necessary to provide an animal that is best adapted to these changing conditions

Institutional Ethics Resources: Creating Moral Spaces.

PubMed

Hamric, Ann B; Wocial, Lucia D

2016-09-01

Since 1992, institutions accredited by The Joint Commission have been required to have a process in place that allows staff members, patients, and families to address ethical issues or issues prone to conflict. While the commission's expectations clearly have made ethics committees more common, simply having a committee in no way demonstrates its effectiveness in terms of the availability of the service to key constituents, the quality of the processes used, or the outcomes achieved. Beyond meeting baseline accreditation standards, effective ethics resources are requisite for quality care for another reason. The provision of care to the sick is a practice with profound moral dimensions. Clinicians need what Margaret Urban Walker has called "moral spaces," reflective spaces within institutions in which to explore and communicate values and ethical obligations as they undergird goals of care. Walker proposed that ethicists needed to be concerned with the design and maintenance of these moral spaces. Clearly, that concern needs to extend beyond ethicists to institutional leaders. This essay uses Walker's idea of moral space to describe individuals and groups who are actual and potential ethics resources in health care institutions. We focus on four requisite characteristics of effective resources and the challenges to achieving them, and we identify strategies to build them. In our view, such moral spaces are particularly important for nurses and their colleagues on interprofessional teams and need to be expanded and strengthened in most settings. © 2016 The Hastings Center.

Reframing and addressing horizontal violence as a workplace quality improvement concern.

PubMed

Taylor, Rosemary A; Taylor, Steven S

2018-06-27

To reframe horizontal violence as a quality improvement concern. Although the number of studies exploring horizontal violence has increased, evidence supporting the effectiveness of current interventions is weak and the problem persists. Often framed as an individual or interpersonal issue, horizontal violence has been recognized as a complex phenomenon that can only be understood through an examination of social, individual and organizational factors. As such, interventions to address horizontal violence must be applied systemically and address contributions from all sources. This is a discussion paper. This discussion is based on results of a study of nurses' perceptions of horizontal violence and review of the literature. Context is recognized as a contributing factor in human behavior, yet often overlooked in interventions to address horizontal violence. Moving the focus away from the individual and investigating systems contributions to horizontal violence using existing quality improvement frameworks is suggested. To date, efforts to address horizontal violence have not been proven effective. There is a call for a wider application and investigation of interventions. This reframing provides the system level application suggested and would address a broader range of factors contributing to the perpetuation of the phenomenon. © 2018 Wiley Periodicals, Inc.

Quality in ethics consultations.

PubMed

Magill, Gerard

2013-11-01

There is an increasing need for quality in ethics consultations, though there have been significant achievements in the United States and Europe. However, fundamental concerns that place the profession in jeopardy are discussed from the perspective of the U.S. in a manner that will be helpful for other countries. The descriptive component of the essay (the first two points) explains the achievements in ethics quality (illustrated by the IntegratedEthics program of the Veterans Health Administration) and the progress on standards and competencies for ethics consultations (represented by the Core Competencies of the American Society for Bioethics and Humanities). Based on these achievements, the analytical component of the essay (the final three points) identifies and seeks to resolve three fundamental concerns (with increasing levels of importance) that compromise quality in ethics consultations: standards of quality; professionalism; and credentialing. The analysis argues for clearer standards of quality in ethics consultation and urges further professionalism by explaining the need for the following: interpreting the ASBH core competencies in a normative manner, developing a Code of Ethics, and clarifying the meaning of best practices. However, the most serious concern that threatens quality in ethics consultations is the lack of a credentialing process. This concern can be resolved effectively by developing an independent Ethics Consultation Accreditation Council to accredit and standardize graduate degree programs, fellowship experiences, and qualifying examinations. This credentialing process is indispensable if we are to strategically enhance quality in ethics consultations.

Ethical and methodological issues in research with Sami experiencing disability.

PubMed

Melbøe, Line; Hansen, Ketil Lenert; Johnsen, Bjørn-Eirik; Fedreheim, Gunn Elin; Dinesen, Tone; Minde, Gunn-Tove; Rustad, Marit

2016-01-01

A study of disability among the indigenous Sami people in Norway presented a number of ethical and methodological challenges rarely addressed in the literature. The main study was designed to examine and understand the everyday life, transitions between life stages and democratic participation of Norwegian Sami people experiencing disability. Hence, the purpose of this article is to increase the understanding of possible ethical and methodological issues in research within this field. The article describes and discusses ethical and methodological issues that arose when conducting our study and identifies some strategies for addressing issues like these. The ethical and methodological issues addressed in the article are based on a qualitative study among indigenous Norwegian Sami people experiencing disability. The data in this study were collected through 31 semi-structured in-depth interviews with altogether 24 Sami people experiencing disability and 13 next of kin of Sami people experiencing disability (8 mothers, 2 fathers, 2 sister and 1 guardian). The researchers identified 4 main areas of ethical and methodological issues. We present these issues chronologically as they emerged in the research process: 1) concept of knowledge when designing the study, 2) gaining access, 3) data collection and 4) analysis and accountability. The knowledge generated from this study has the potential to benefit future health research, specifically of Norwegian Sami people experiencing disability, as well as health research concerning indigenous people in general, providing scientific-based insight into important ethical and methodological issues in research with indigenous people experiencing disability.

Addressing semen loss concerns: towards culturally appropriate HIV/AIDS interventions in Gujarat, India.

PubMed

Lakhani, A; Gandhi, K; Collumbien, M

2001-11-01

A situation analysis of sexual networking and sexual health in an industrial area of Gujarat, India, identified anxiety about masturbation and other semen loss concerns as major preoccupations among young men. This paper describes how the Deepak Charitable Trust addressed these concerns in their HIV prevention programme for young men aged 15 to 30. Flowcharts were used as participatory learning tools and to obtain data on the perceived consequences of masturbation, both before and after intervention activities. Research was also done on the relation between semen-related anxieties and sexual risk behaviour by DCT and two other NGOs among young men engaging in unsafe sexual behaviour. DCT advocates addressing masturbation and other semen loss concerns in all sexual health campaigns in South Asia, based on the magnitude of these concerns, their potential to confound syndromic management of STIs and their significance as an idiom of psychosocial distress. Masturbation and associated anxieties about sexual performance are seen as health issues and discussed as such by the programme. There is immediate identification among young men, whether or not they are already sexually active, and it provides an excellent entry point for sexual health and safer sex education. The community response to these efforts has been entirely positive.

The business of health promotion: ethical issues and professional responsibilities.

PubMed

McLeroy, K R; Gottlieb, N H; Burdine, J N

1987-01-01

In the nine years since an entire issue of Health Education Quarterly (then Health Education Monographs) was devoted to considering ethical issues in health education, several important social changes have occurred which have substantially influenced the practice of that discipline. New practice contexts and ethical issues have resulted, which require a fresh look at both these new issues as well as those addressed in the earlier monograph. The importance of understanding the principles underlying the ethical dilemmas raised by the authors is emphasized as a concern for both the individual practitioner as well as the profession of health education itself. Recommendations for personal and professional action are made by the authors.

The 'over-researched community': An ethics analysis of stakeholder views at two South African HIV prevention research sites.

PubMed

Koen, Jennifer; Wassenaar, Douglas; Mamotte, Nicole

2017-12-01

Health research in resource-limited, multi-cultural contexts raises complex ethical concerns. The term 'over-researched community' (ORC) has been raised as an ethical concern and potential barrier to community participation in research. However, the term lacks conceptual clarity and is absent from established ethics guidelines and academic literature. In light of the concern being raised in relation to research in low- and middle-income countries (LMICs), a critical and empirical exploration of the meaning of ORC was undertaken. Guided by Emanuel et al.'s (2004) eight principles for ethically sound research in LMICs, this study examines the relevance and meaning of the terms 'over-research' and 'over-researched community' through an analysis of key stakeholder perspectives at two South African research sites. Data were collected between August 2007 and October 2008. 'Over-research' was found to represent a conglomeration of ethical concerns often used as a proxy for standard research ethics concepts. 'Over-research' seemed fundamentally linked to disparate positions and perspectives between different stakeholders in the research interaction, arising from challenges in inter-stakeholder relationships. 'Over-research' might be interpreted to mean exploitation. However, exploitation itself could mean different things. Using the term may lead to obscured understanding of real or perceived ethical concerns, making it difficult to identify and address the underlying concerns. It is recommended that the term be carefully and critically interrogated for clarity when used in research ethics discourse. Because it represents other legitimate concerns, it should not be dismissed without careful exploration. Copyright © 2017 Elsevier Ltd. All rights reserved.

The ethical foundations of behavior therapy.

PubMed

Kitchener, Richard F

1991-01-01

In this article, I am concerned with the ethical foundations of behavior therapy, that is, with the normative ethics and the meta-ethics underlying behavior therapy. In particular, I am concerned with questions concerning the very possibilty of providing an ethical justification for things done in the context of therapy. Because behavior therapists must be able to provide an ethical justification for various actions (if the need arises), certain meta-ethical views widely accepted by behavior therapists must be abandoned; in particular, one must give up ethical subjectivism, ethical skepticism, and ethical relativism. An additional task is to show how it is possible to provide a nonsubjective, nonskeptical, and nonrelativistic moral justification for an ethical statement. Although this is a monumental task, I provide a rough sketch of such a model, one that is congenial to the value judgments underlying behavior therapy.

A strategic stakeholder approach for addressing further analysis requests in whole genome sequencing research.

PubMed

Thornock, Bradley Steven O

2016-01-01

Whole genome sequencing (WGS) can be a cost-effective and efficient means of diagnosis for some children, but it also raises a number of ethical concerns. One such concern is how researchers derive and communicate results from WGS, including future requests for further analysis of stored sequences. The purpose of this paper is to think about what is at stake, and for whom, in any solution that is developed to deal with such requests. To accomplish this task, this paper will utilize stakeholder theory, a common method used in business ethics. Several scenarios that connect stakeholder concerns and WGS will also posited and analyzed. This paper concludes by developing criteria composed of a series of questions that researchers can answer in order to more effectively address requests for further analysis of stored sequences.

Ethics at the End of Life: A Teaching Tool

ERIC Educational Resources Information Center

Wallace, Cara L.; Thielman, Kara J.; Cimino, Andrea N.; Rueda, Heidi L. Adams

2017-01-01

Social workers rarely receive education and training in the areas of grief, bereavement, and death and dying, which may lead to difficulties in compassionately and ethically addressing concerns in end-of-life or grief-related contexts. This article presents actual and potential outcomes from three challenging end-of-life case studies using…

Preparing Professionals to Face Ethical Challenges in Today's Workplace: Review of the Literature, Implications for PI, and a Proposed Research Agenda

ERIC Educational Resources Information Center

Frisque, Deloise A.; Lin, Hong; Kolb, Judith A.

2004-01-01

Ethics is very much in the news today and on the minds of those who teach and/or train current and future professionals to work successfully in today's workplaces. While there seems to be agreement that organizations need to address the topic of ethics, there is also a concern about how best to proceed. Ethics and compliance offices, professional…

A Relational Ethics Framework for Advancing Practice with Children with Complex Health Care Needs and Their Parents.

PubMed

Carnevale, Franco A; Teachman, Gail; Bogossian, Aline

2017-12-01

Children with complex health care needs are an emerging population that commonly requires long-term supportive services. A growing body of evidence has highlighted that these children and their families experience significant challenges. Many of these challenges involve ethical concerns that have been under-recognized. In this article, we (a) outline ethical concerns that arise in clinical practice with children with complex health care needs and their families (e.g.: exclusion of children's voices in discussions and decisions that affect them; difficulties in defining their best interests; clashes across the array of social roles that parents manage; limited recognition of the ethical significance of parents' and other family members' interests) and (b) propose a relational ethics framework for addressing these concerns. Our framework draws on hermeneutical interpretation and moral experience as foundational orientations, recognizing children with complex health care needs as relationally embedded agents, who while dependent and entitled to protection, are simultaneously agential. Children's and parents' interests are relationally intertwined and interdependent. Families are recognized as significant social microcosms for the cultivation and transmission of intergenerational cultural heritage, narratives, and outlooks. We describe strategies for (a) conducting a relational ethics inquiry and (b) reconciliation of identified ethical concerns through a process of rapprochement. A relational ethics framework can promote clinical practices that are ethically attuned to the complexity of this population's needs.

Chinese nurses' ethical concerns in a neurological ward.

PubMed

Tang, Ping Fen; Johansson, Camilla; Wadensten, Barbro; Wenneberg, Stig; Ahlström, Gerd

2007-11-01

Our aim was to describe Chinese nurses' experiences of workplace distress and ethical dilemmas on a neurological ward. Qualitative interviews were performed with 20 nurses. On using latent content analysis, themes emerged in four content areas: ethical dilemmas, workplace distress, quality of nursing and managing distress. The ethical dilemmas were: (1) conflicting views on optimal treatment and nursing; (2) treatment choice meeting with financial constraints; and (3) misalignment of nursing responsibilities, competence and available resources. The patients' relatives lacked respect for the nurses' skills. Other dilemmas could be traced to the transition from a planned to a market economy, resulting in an excessive workload and treatment withdrawal for financial reasons. Lack of resources was perceived as an obstacle to proper patient care in addition to hospital organization, decreasing the quality of nursing, and increasing moral and workplace distress. The nurses managed mainly by striving for competence, which gave them hope for the future.

[Continuing education in ethics: from clinical ethics to institutional ethics].

PubMed

Brazeau-Lamontagne, Lucie

2012-01-01

The mandate of the Ethics Committee of the Conseil de médecins, dentistes et pharmaciens (CMDP) at the Centre hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke, Quebec is three-fold: to guide the clinical decision; to address the institutional ethical function; to create the program for continuing education in ethics (Formation éthique continue or FEC). Might FEC be the means of bridging from individual ethics to institutional ethics at a hospital? To take the FEC perspectives considered appropriate for doctors and consider them for validation or disproving in the context of those of other professionals. Situate the proposed FEC mandate in a reference framework to evaluate (or triangulate) the clinical decision and the institutional ethic. CONVICTION: Sustainable professional development for doctors (DPD) includes ethics; it cannot be ignored. Without constant attention to upgrading one's abilities in professional ethics, these suffer the same fate as other professional aptitudes and competences (for example, techniques and scientific knowledge): decay.

Ethics and animal issues in US medical education.

PubMed

Wiebers, D O; Barron, R A; Leaning, J; Ascione, F R

1994-11-01

Increasing public and regulatory agency concern about a variety of animal protection issues that affect the field of medicine have made these issues increasingly relevant to medical school curricula. The purpose of this study was to assess the availability and forms of medical school training relating to ethical, conceptual, and societal concerns in the use of animals within the field of medicine and the perceived need for such training. Questionnaire surveys were mailed to the Deans of the 125 accredited US medical schools, and completed by Deans or their designees within the same medical institution. Questionnaire recipients were informed that results would be compiled in a fashion that did not identify specific individuals or institutions. Survey responses were obtained from 84 medical institutions (67% response). Sixty respondents (71%) indicated that their medical school offered or sponsored some type of activity related to ethical and conceptual concerns in the use of animals in medical research and training. Most schools (43) offered informal discussions/seminars relating to these issues, but nine schools offered full formal courses with up to 15 lectures on these topics. Programme content and perceived need for additional instruction varied greatly amongst respondents. The results suggest a wide diversity amongst US medical schools in the availability and perceived importance of medical school training relating to ethical and conceptual concerns in the uses of animals in medicine. It is proposed that instruction in these areas be pursued with more concerted efforts to address the growing body of knowledge about non-human beings and the ethical implications of such knowledge.

Nursing's Code of Ethics, Social Ethics, and Social Policy.

PubMed

Fowler, Marsha D

2016-09-01

Modern American nursing arose during the Civil War and subsequently adopted the Nightingale educational model in the 1870s. By 1889, the journal Trained Nurse and Hospital Review had been established. It published a six-part series on ethics in nursing. With the establishment of the American Nurses Association in 1893, the articles of incorporation gave the organization its first charge: "to establish and maintain a code of ethics." While the rich and enduring tradition of nursing's ethics has been concerned about individual patients and their relational nexus, nursing ethics has from the beginning been a social ethics, intimately concerned both for the shape of society and for social change. This concern has been for health, conceived broadly and not focused specifically on disease and its treatment, but including the social causes of disease. Nightingale herself was an ardent social reformer, instituting a wide range of types of army sanitation reform, sanitation reform in India, and hospital and nursing reform. Despite her gender, her wealth and privilege granted her access to men in power who furthered her policy and reform agenda. From the start, then, modern nursing was imbued with a social reformist bias. © 2016 The Hastings Center.

Integrating anticipated nutrigenomics bioscience applications with ethical aspects.

PubMed

Lévesque, Lise; Ozdemir, Vural; Gremmen, Bart; Godard, Béatrice

2008-03-01

Nutrigenomics is a subspecialty of nutrition science which aims to understand how gene-diet interactions influence individuals' response to food, disease susceptibility, and population health. Yet ethical enquiry into this field is being outpaced by nutrigenomics bioscience. The ethical issues surrounding nutrigenomics face the challenges of a rapidly evolving field which bring forward the additional dimension of crossdisciplinary integrative research between social and biomedical sciences. This article outlines the emerging nutrigenomics definitions and concepts and analyzes the existing ethics literature concerning personalized nutrition and presents "points to consider" over ethical issues regarding future nutrigenomics applications. The interest in nutrigenomics coincides with a shift in emphasis in medicine and biosciences toward prevention of future disease susceptibilities rather than treatment of already established disease. Hence, unique ethical issues emerge concerning the extent to which nutrigenomics can alter our relation to food, boundaries between health and disease, and the folklore of medical practice. Nutrigenomics can result in new social values, norms, and responsibilities for both individuals and societies. Nutrigenomics is not only another new application of "-omics" technologies in the context of gene-diet interactions. Nutrigenomics may fundamentally change the way we perceive human illness while shifting the focus and broadening the scope of health interventions from patients to healthy individuals. In resource- and time-limited healthcare settings, this creates unique ethical dilemmas and distributive justice issues. Ethical aspects of nutrigenomics applications should be addressed proactively, as this new science develops and increasingly coalesces with other applications of genomics in medicine and public health.

Oocyte cryopreservation beyond cancer: tools for ethical reflection.

PubMed

Linkeviciute, Alma; Peccatori, Fedro A; Sanchini, Virginia; Boniolo, Giovanni

2015-08-01

This article offers physicians a tool for structured ethical reflection on challenging situations surrounding oocyte cryopreservation in young healthy women. A systematic literature review offers a comprehensive overview of the ethical debate surrounding the practice. Ethical Counseling Methodology (ECM) offers a practical approach for addressing ethical uncertainties. ECM consists of seven steps: (i) case presentation; (ii) analysis of possible implications; (iii) presentation of ethical question(s); (iv) explanation of ethical terms; (v) presentation of the ethical arguments in favor of and against the procedure; (vi) examination of the individual patient's beliefs and wishes; and (vii) conclusive summary. The most problematic aspects in the ethical debate include the distinction between medical and non-medical use of oocyte cryopreservation, safety and efficiency of the procedure, and marketing practices aimed at healthy women. Female empowerment and enhanced reproductive choices (granted oocyte cryopreservation is a safe and efficient technique) are presented as ethical arguments supporting the practice, while ethical reservations towards oocyte cryopreservation are based on concerns about maternal and fetal safety and wider societal implications. Oocyte cryopreservation is gaining popularity among healthy reproductive age women. However, despite promised benefits it also involves risks that are not always properly communicated in commercialized settings. ECM offers clinicians a tool for structured ethical analysis taking into consideration a wide range of implications, various ethical standpoints, and patients' perceptions and beliefs.

The Ethics of Promoting Living Kidney Donation Using Nonargumentative Influence: Applications, Concerns, and Future Directions.

PubMed

Allen, M B; Reese, P P

2016-12-01

Recommendations from the 2014 Consensus Conference on Best Practices in Living Kidney Donation reflect increasing attention to overcoming barriers to donation as a means of expanding access to living donor kidney transplantation. "High priority" initiatives include empowering transplant candidates and their loved ones in their search for a living kidney donor. Transplant programs are assuming an unprecedented role as facilitators of patients' solicitation for donors, and nonprofits are promoting living kidney donation (LKD) in the community. New strategies to promote LKD incorporate "nonargumentative" forms of influence (i.e. approaches to shaping behavior that do not attempt to persuade through reason) such as appeals to emotion, messenger effects and social norms. These approaches have raised ethical concerns in other settings but have received little attention in the transplantation literature despite their increasing relevance. Previous work on using nonargumentative influence to shape patient behavior has highlighted implications for (1) the relationship between influencer and influenced and (2) patient autonomy. We argue that using nonargumentative influence to promote LKD is a promising strategy that can be compatible with ethical standards. We also outline potential concerns and solutions to be implemented in practice. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Institution animal care and use committees need greater ethical diversity.

PubMed

Hansen, Lawrence Arthur

2013-03-01

In response to public outrage stemming from exposés of animal abuse in research laboratories, the US Congress in 1985 mandated Institutional Animal Care and Use Committees (IACUCs) to oversee animal use at institutions receiving federal grants. IACUCs were enjoined to respect public concern about the treatment of animals in research, but they were not specifically instructed whether or not to perform ethical cost-benefit analyses of animal research protocols that IACUCs have chosen, with approval contingent upon a balancing of animal pain and suffering against a reasonable expectation of resultant human benefit. IACUCs have chosen not to make such ethical judgments but, rather, restrict themselves to an advisory role, often tweaking the details of animal-use protocols, but eventually approving all of them. This disinclination by IACUCs to take a broader ethical view of their authority and responsibilities may reflect a membership composition highly skewed towards animal researchers themselves (67%) and institutional veterinarians (15%), both with vested interests in continuing animal research. The resultant ethical monoculture may impair IACUC's ability to meet public concern for laboratory animal welfare. Psychological research has established that unconscious bias affects us all, that deliberations among the like-minded lead to adapting extremist positions, and that groupthink blinds organisations to alternatives that might be obvious to outsiders. Taken together, skewed IACUC membership composition and psychological research insights into unconscious bias and groupthink suggest that an infusion of ethical diversity by increasing the percentage of institutionally unaffiliated members on IACUCs would broaden their ethical perspectives and enable them to better address public concerns about laboratory animal welfare.

The paucity of ethical analysis in allergology

PubMed Central

2013-01-01

While a growing body of research is uncovering the aetiology and effective treatments for allergy, research that assess the broader ethical implications of this disease is lacking significantly. This article will demonstrate both the paucity of academic research concerning ethical implications in allergy and explain why ethical analysis is integral to formulating effective health strategies for allergic disease. An exhaustive literature search of publications in French and English identified less than 35 academic articles focussed on the topic of ethics and allergy; this is a miniscule number when compared to the amount of articles published on ethical issues related to other chronic illnesses, such as obesity. It is important to demonstrate to allergy specialists the need for, and utility of, further incorporating ethical analyses in allergology; the current success of Ethical, Legal, Social Implications (ELSI) research programmes in human genetics and nanotechnology will serve as notable examples. Indeed, future research and innovation in allergy will undoubtedly encounter ethical dilemmas and the allergology community should play a significant role in helping to address these issues. However, incorporating ethical analyses in allergology does not imply that the allergology community must acquire extensive knowledge in bioethics; instead, interdisciplinary research that incorporates expertise from allergology and bioethics would enable allergy specialists to advance critical knowledge development in this largely overlooked domain of study. PMID:23388345

Ethical and methodological issues in research with Sami experiencing disability.

PubMed

Melbøe, Line; Hansen, Ketil Lenert; Johnsen, Bjørn-Eirik; Fedreheim, Gunn Elin; Dinesen, Tone; Minde, Gunn-Tove; Rustad, Marit

2016-01-01

Background A study of disability among the indigenous Sami people in Norway presented a number of ethical and methodological challenges rarely addressed in the literature. Objectives The main study was designed to examine and understand the everyday life, transitions between life stages and democratic participation of Norwegian Sami people experiencing disability. Hence, the purpose of this article is to increase the understanding of possible ethical and methodological issues in research within this field. The article describes and discusses ethical and methodological issues that arose when conducting our study and identifies some strategies for addressing issues like these. Methods The ethical and methodological issues addressed in the article are based on a qualitative study among indigenous Norwegian Sami people experiencing disability. The data in this study were collected through 31 semi-structured in-depth interviews with altogether 24 Sami people experiencing disability and 13 next of kin of Sami people experiencing disability (8 mothers, 2 fathers, 2 sister and 1 guardian). Findings and discussion The researchers identified 4 main areas of ethical and methodological issues. We present these issues chronologically as they emerged in the research process: 1) concept of knowledge when designing the study, 2) gaining access, 3) data collection and 4) analysis and accountability. Conclusion The knowledge generated from this study has the potential to benefit future health research, specifically of Norwegian Sami people experiencing disability, as well as health research concerning indigenous people in general, providing scientific-based insight into important ethical and methodological issues in research with indigenous people experiencing disability.

Ethical and methodological issues in research with Sami experiencing disability

PubMed Central

Melbøe, Line; Hansen, Ketil Lenert; Johnsen, Bjørn-Eirik; Fedreheim, Gunn Elin; Dinesen, Tone; Minde, Gunn-Tove; Rustad, Marit

2016-01-01

Background A study of disability among the indigenous Sami people in Norway presented a number of ethical and methodological challenges rarely addressed in the literature. Objectives The main study was designed to examine and understand the everyday life, transitions between life stages and democratic participation of Norwegian Sami people experiencing disability. Hence, the purpose of this article is to increase the understanding of possible ethical and methodological issues in research within this field. The article describes and discusses ethical and methodological issues that arose when conducting our study and identifies some strategies for addressing issues like these. Methods The ethical and methodological issues addressed in the article are based on a qualitative study among indigenous Norwegian Sami people experiencing disability. The data in this study were collected through 31 semi-structured in-depth interviews with altogether 24 Sami people experiencing disability and 13 next of kin of Sami people experiencing disability (8 mothers, 2 fathers, 2 sister and 1 guardian). Findings and discussion The researchers identified 4 main areas of ethical and methodological issues. We present these issues chronologically as they emerged in the research process: 1) concept of knowledge when designing the study, 2) gaining access, 3) data collection and 4) analysis and accountability. Conclusion The knowledge generated from this study has the potential to benefit future health research, specifically of Norwegian Sami people experiencing disability, as well as health research concerning indigenous people in general, providing scientific-based insight into important ethical and methodological issues in research with indigenous people experiencing disability. PMID:27396747

Identifying and addressing potential conflict of interest: a professional medical organization's code of ethics.

PubMed

Heim, Lori

2010-01-01

The new Consumer Alliance agreement between the American Academy of Family Physicians (AAFP) and The Coca-Cola Company provides a valuable opportunity to illustrate AAFP's adherence to its ethical foundation, demonstrate the AAFP's commitment to serving physicians and the public, and maintain the trust Americans put in their family physicians and the organization that represents them. Throughout the development of this program, as well as in all business interactions, the AAFP consistently addresses possible conflict of interest openly and directly, sharing with our members and the public exactly what measures we take to ensure that, in fact, no unethical conduct or breach of trust would--or will in the future--occur. In this case, the AAFP saw a public health and education need that was both unmet and undermined by the barrage of marketing messages and confusing information, and acted to fill that need. In so doing, the AAFP hewed to its high ethical standards, its core values, and its mission in the decisions made and the actions that followed.

Ethics, policy, and educational issues in genetic testing.

PubMed

Williams, Janet K; Skirton, Heather; Masny, Agnes

2006-01-01

Analyze ethics, public policy, and education issues that arise in the United States (US) and the United Kingdom (UK) when genomic information acquired as a result of genetic testing is introduced into healthcare services. Priorities in the Ethical, Legal, and Social Issues Research Program include privacy, integration of genetic services into clinical health care, and educational preparation of the nursing workforce. These constructs are used to examine health policies in the US and UK, and professional interactions of individuals and families with healthcare providers. Individual, family, and societal goals may conflict with current healthcare practices and policies when genetic testing is done. Current health policies do not fully address these concerns. Unresolved issues include protection of privacy of individuals while considering genetic information needs of family members, determination of appropriate monitoring of genetic tests, addressing genetic healthcare discrepancies, and assuring appropriate nursing workforce preparation. Introduction of genetic testing into health care requires that providers are knowledgeable regarding ethical, policy, and practice issues in order to minimize risk for harm, protect the rights of individuals and families, and consider societal context in the management of genetic test results. Understanding of these issues is a component of genetic nursing competency that must be addressed at all levels of nursing education.

Beyond a code of ethics: phenomenological ethics for everyday practice.

PubMed

Greenfield, Bruce; Jensen, Gail M

2010-06-01

Physical therapy, like all health-care professions, governs itself through a code of ethics that defines its obligations of professional behaviours. The code of ethics provides professions with a consistent and common moral language and principled guidelines for ethical actions. Yet, and as argued in this paper, professional codes of ethics have limits applied to ethical decision-making in the presence of ethical dilemmas. Part of the limitations of the codes of ethics is that there is no particular hierarchy of principles that govern in all situations. Instead, the exigencies of clinical practice, the particularities of individual patient's illness experiences and the transformative nature of chronic illnesses and disabilities often obscure the ethical concerns and issues embedded in concrete situations. Consistent with models of expert practice, and with contemporary models of patient-centred care, we advocate and describe in this paper a type of interpretative and narrative approach to moral practice and ethical decision-making based on phenomenology. The tools of phenomenology that are well defined in research are applied and examined in a case that illustrates their use in uncovering the values and ethical concerns of a patient. Based on the deconstruction of this case on a phenomenologist approach, we illustrate how such approaches for ethical understanding can help assist clinicians and educators in applying principles within the context and needs of each patient. (c) 2010 John Wiley & Sons, Ltd.

Xenotransplantation-theological-ethical considerations in an interdisciplinary symposium.

PubMed

Sautermeister, Jochen; Mathieu, Richard; Bogner, Veronika

2015-01-01

Unlike allotransplantation, reflections on xenotransplantation are infrequent in theological literature. However, xenotransplantation poses questions specifically concerning ethical and theological aspects that are imperative to address, such as personal identity between the poles of body, soul, and mind, the relationship between humans and animals, as well as challenges regarding specific issues of medical and social ethics. This study summarizes the lectures of the symposium on "Xenotransplantation-a challenge to theological ethics," which took place in Munich from September 30 until October 2, 2013, and analyses the implications of xenotransplantation from the perspectives of Christian theological ethics, biblical theology, and systematic theology. Furthermore, the issue of xenotransplantation is addressed from the perspectives of Judaism and Islam. Beyond these theological deliberations, the metaphorical and religious meaning of the human heart, which may have an impact on the societal acceptability of xenotransplantation, as well as the Christian notion of compassion regarding animals, is analyzed from the perspective of historical sciences. According to the perspectives of Christianity, Judaism, and Islam, there are no specifically religious fundamental and generally binding reasons to prohibit xenotransplantation as a means of treating grave and life-threatening organ insufficiencies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Barriers to Mental Health Service Use and Preferences for Addressing Emotional Concerns among Lung Cancer Patients

PubMed Central

Mosher, Catherine E.; Winger, Joseph G.; Hanna, Nasser; Jalal, Shadia I.; Fakiris, Achilles J.; Einhorn, Lawrence H.; Birdas, Thomas J.; Kesler, Kenneth A.; Champion, Victoria L.

2014-01-01

Objective This study examined barriers to mental health service use and preferences for addressing emotional concerns among lung cancer patients (N=165) at two medical centers in the midwestern United States. Methods Lung cancer patients completed an assessment of anxiety and depressive symptoms, mental health service use, barriers to using these services, and preferences for addressing emotional concerns. Results Only 45% of distressed patients received mental health care since their lung cancer diagnosis. The most prevalent patient-reported barriers to mental health service use among non-users of these services (n=110) included the desire to independently manage emotional concerns (58%) and inadequate knowledge of services (19%). In addition, 57% of distressed patients who did not access mental health services did not perceive the need for help. Seventy-five percent of respondents (123/164) preferred to talk to a primary care physician if they were to have an emotional concern. Preferences for counseling, psychiatric medication, peer support, spiritual care, or independently managing emotional concerns also were endorsed by many patients (range=40%–50%). Older age was associated with a lower likelihood of preferring to see a counselor. Conclusions Findings suggest that many distressed lung cancer patients underuse mental health services and do not perceive the need for such services. Efforts to increase appropriate use of services should address patients' desire for autonomy and lack of awareness of services. PMID:24493634

Facial transplants: current situation and ethical issues.

PubMed

Petrini, C

2015-01-01

The first transplantation of a face from a cadaver was performed in 2005, since when about thirty have been performed globally. The technique is now beginning to appear in Italy. Face transplants are performed exclusively on persons who have suffered devastating lesions to the face. The ethical problems involved are very considerable, particularly where personal identity is concerned. The case records reveal surprisingly positive outcomes regarding both clinical follow-up and functional recovery, as well as psychological aspects and social integration. Thus, while early documents addressing the ethical issues involved in facial transplants were somewhat cautious or even unfavourable on the subject of this technique, a positive approach is now more prevalent.

Avoid Ethical Misconduct in Manuscript Preparation.

PubMed

Hicks, Rodney W; Harris, Ruth

2016-01-01

In order for nurses and other health care professionals to make important contributions to the literature, there must be an awareness of the many areas where unintentional ethical conflicts can arise. Leading ethical concerns include plagiarism, duplicate submission, authorship standards, bias, and conflicts of interest. Although many sources are available on the variety of ethical concerns, this article takes the position to identify the area of concern and describe why it is an ethical violation. Solutions are posed for resolving the conflict, including why medical librarians can help in the publishing process.

[Clinical everyday ethics-support in handling moral distress? : Evaluation of an ethical decision-making model for interprofessional clinical teams].

PubMed

Tanner, S; Albisser Schleger, H; Meyer-Zehnder, B; Schnurrer, V; Reiter-Theil, S; Pargger, H

2014-06-01

High-tech medicine and cost rationing provoke moral distress up to burnout syndromes. The consequences are severe, not only for those directly involved but also for the quality of patient care and the institutions. The multimodal model METAP (Modular, Ethical, Treatment, Allocation, Process) was developed as clinical everyday ethics to support the interprofessional ethical decision-making process. The distinctive feature of the model lays in education concerning ethics competence in dealing with difficult treatment decisions. METAP has been evaluated for quality testing. The research question of interest was whether METAP supports the handling of moral distress. The evaluation included 3 intensive care units and 3 geriatric units. In all, 33 single and 9 group interviews were held with 24 physicians, 44 nurses, and 9 persons from other disciplines. An additional questionnaire was completed by 122 persons (return rate 57%). Two-thirds of the interview answers and 55% of the questionnaire findings show that clinical everyday ethics supports the handling of moral distress, especially for interdisciplinary communication and collaboration and for the explanation and evaluation of treatment goals. METAP does not provide support for persons who are rarely confronted with ethical problems or have not applied the model long enough yet. To a certain degree, moral distress is unavoidable and must be addressed as an interprofessional problem. Herein, clinical everyday ethics may provide targeted support for ethical decision-making competence.

Focus on Teaching: Ethics.

ERIC Educational Resources Information Center

Worley, Rebecca B.; Dyrud, Marilyn A.

1998-01-01

Notes that business today is concerned with the translation and application of ethical principles into everyday business life. Offers a list of Web sites on ethics and business ethics at various colleges and universities. (SR)

Feminist and community psychology ethics in research with homeless women.

PubMed

Paradis, E K

2000-12-01

This paper presents a feminist and community psychology analysis of ethical concerns that can arise throughout the process of doing research with women who are homeless. The unique contexts of the lives of women who are homeless demand that researchers redefine traditional ethical constructs such as consent, privacy, harm, and bias. Research that fails to do this may perpetuate the stereotyping, marginalization, stigmatization, and victimization homeless women face. Feminist and community research ethics must go beyond the avoidance of harm to an active investment in the well-being of marginalized individuals and communities. Using feminist and community psychology ethics, this paper addresses some common problems in research with women who are homeless, and argues for the transformation of research from a tool for the advancement of science into a strategy for the empowerment of homeless women and their communities.

The Role of Ethics in Reducing and Improving the Quality of Coercion in Mental Health Care.

PubMed

Norvoll, Reidun; Hem, Marit Helene; Pedersen, Reidar

2017-03-01

Coercion in mental health care gives rise to many ethical challenges. Many countries have recently implemented state policy programs or development projects aiming to reduce coercive practices and improve their quality. Few studies have explored the possible role of ethics (i.e., ethical theory, moral deliberation and clinical ethics support) in such initiatives. This study adds to this subject by exploring health professionals' descriptions of their ethical challenges and strategies in everyday life to ensure morally justified coercion and best practices. Seven semi-structured telephone interviews were carried out in 2012 with key informants in charge of central development projects and quality-assurance work in mental health services in Norway. No facilities used formal clinical ethics support. However, the informants described five areas in which ethics was of importance: moral concerns as implicit parts of local quality improvement initiatives; moral uneasiness and idealism as a motivational source of change; creating a normative basis for development work; value-based leadership; and increased staff reflexivity on coercive practices. The study shows that coercion entails both individual and institutional ethical aspects. Thus, various kinds of moral deliberation and ethics support could contribute to addressing coercion challenges by offering more systematic ways of dealing with moral concerns. However, more strategic use of implicit and institutional ethics is also needed.

Impact of managed care on the development of new medical technology: ethical concerns

NASA Astrophysics Data System (ADS)

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.

Institution animal care and use committees need greater ethical diversity

PubMed Central

Hansen, Lawrence Arthur

2013-01-01

In response to public outrage stemming from exposés of animal abuse in research laboratories, the US Congress in 1985 mandated Institutional Animal Care and Use Committees (IACUCs) to oversee animal use at institutions receiving federal grants. IACUCs were enjoined to respect public concern about the treatment of animals in research, but they were not specifically instructed whether or not to perform ethical cost-benefit analyses of animal research protocols that IACUCs have chosen, with approval contingent upon a balancing of animal pain and suffering against a reasonable expectation of resultant human benefit. IACUCs have chosen not to make such ethical judgments but, rather, restrict themselves to an advisory role, often tweaking the details of animal-use protocols, but eventually approving all of them. This disinclination by IACUCs to take a broader ethical view of their authority and responsibilities may reflect a membership composition highly skewed towards animal researchers themselves (67%) and institutional veterinarians (15%), both with vested interests in continuing animal research. The resultant ethical monoculture may impair IACUC's ability to meet public concern for laboratory animal welfare. Psychological research has established that unconscious bias affects us all, that deliberations among the like-minded lead to adapting extremist positions, and that groupthink blinds organisations to alternatives that might be obvious to outsiders. Taken together, skewed IACUC membership composition and psychological research insights into unconscious bias and groupthink suggest that an infusion of ethical diversity by increasing the percentage of institutionally unaffiliated members on IACUCs would broaden their ethical perspectives and enable them to better address public concerns about laboratory animal welfare. PMID:23131895

Law and ethics in conflict over confidentiality?

PubMed

Dickens, B M; Cook, R J

2000-09-01

Ethical principles that require the preservation of patients' confidential information are reinforced by principles found in several areas of law, such as law on contracts, negligence, defamation and fiduciary duty. However, laws sometimes compel disclosures of medical confidences, and more often may justify or excuse disclosures. Legally contentious issues concern patients' confidences regarding possible unlawful conduct, such as pregnancy termination, and the risk of spread of HIV and other infections. This article reviews the various legal bases of the duty of confidentiality, and legal challenges to the ethical obligation of non-disclosure. It addresses the justifications and limits of exchange of patients' health information among healthcare professionals and trainees, and considers legally recognized limits of confidential duties, and the scope of legitimate disclosure. An underlying theme is how to determine whether physicians are ethically justified in employing the discretion the law sometimes affords them to breach patients' expectations of confidentiality.

Diagnosing dementia: Ethnography, interactional ethics and everyday moral reasoning.

PubMed

Hillman, Alexandra

2017-02-01

This article highlights the contribution of ethnography and qualitative sociology to the ethical challenges that frame the diagnosis of dementia. To illustrate this contribution, the paper draws on an ethnographic study of UK memory clinics carried out between 2012 and 2014. The ethnographic data, set alongside other studies and sociological theory, contest the promotion of a traditional view of autonomy; the limiting of the point of ethical interest to a distinct moment of diagnosis disclosure; and the failure to recognise risk and uncertainty in the building of clinical 'facts' and their communication. In addressing these specific concerns, this article contributes to the wider debate over the relationship between sociology and bioethics (medical ethics). At the heart of these debates lies more fundamental questions: how can we best understand and shape moral decision-making and ethics that guide behaviour in medical practice, and what should be the guiding ideas, concepts and methods to inform ethics in the clinic? Using the case of dementia diagnosis, this article illustrates the benefits of an ethnographic approach, not just for understanding this ethical problem but also for exploring if and how a more empirically informed ethics can help shape healthcare practices for the better.

Adab and its significance for an Islamic medical ethics.

PubMed

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.

Ethics in Community-University-Artist Partnered Research: Tensions, Contradictions and Gaps Identified in an 'Arts for Social Change' Project.

PubMed

Yassi, Annalee; Spiegel, Jennifer Beth; Lockhart, Karen; Fels, Lynn; Boydell, Katherine; Marcuse, Judith

Academics from diverse disciplines are recognizing not only the procedural ethical issues involved in research, but also the complexity of everyday "micro" ethical issues that arise. While ethical guidelines are being developed for research in aboriginal populations and low-and-middle-income countries, multi-partnered research initiatives examining arts-based interventions to promote social change pose a unique set of ethical dilemmas not yet fully explored. Our research team, comprising health, education, and social scientists, critical theorists, artists and community-activists launched a five-year research partnership on arts-for-social change. Funded by the Social Science and Humanities Research Council in Canada and based in six universities, including over 40 community-based collaborators, and informed by five main field projects (circus with street youth, theatre by people with disabilities, dance for people with Parkinson's disease, participatory theatre with refugees and artsinfused dialogue), we set out to synthesize existing knowledge and lessons we learned. We summarized these learnings into 12 key points for reflection, grouped into three categories: community-university partnership concerns ( n  = 3), dilemmas related to the arts ( n  = 5), and team issues ( n  = 4). In addition to addressing previous concerns outlined in the literature (e.g., related to consent, anonymity, dangerous emotional terrain, etc.), we identified power dynamics (visible and hidden) hindering meaningful participation of community partners and university-based teams that need to be addressed within a reflective critical framework of ethical practice. We present how our team has been addressing these issues, as examples of how such concerns could be approached in community-university partnerships in arts for social change.

Dilemmas with Dilemmas...Exploring the Suitability of Dilemma Stories as a Way of Addressing Ethical Issues in Science Education.

ERIC Educational Resources Information Center

Settelmaier, Elisabeth

Traditionally, many science educators have taught science without addressing ethical questions. However, the inclusion of moral discourse in science teaching may help educators to bring to the fore problematic issues in relation to science, and it may offer an opportunity for students to practice their future engagement in the public discourse…

Ongoing ethical issues concerning authorship in biomedical journals: an integrative review

PubMed Central

Kornhaber, Rachel Anne; McLean, Loyola M; Baber, Rodney J

2015-01-01

Health professionals publishing within the field of health sciences continue to experience issues concerning appropriate authorship, which have clinical, ethical, and academic implications. This integrative review sought to explore the key issues concerning authorship from a bioethical standpoint, aiming to explore the key features of the authorship debate. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases of peer-reviewed research, published between 2009 and 2014, limited to English language research, with search terms developed to reflect the current issues of authorship. From among the 279 papers identified, 20 research papers met the inclusion criteria. Findings were compiled and then arranged to identify themes and relationships. The review incorporated a wide range of authorship issues encompassing equal-credited authors, honorary (guest/gift) and ghost authorship, perception/experiences of authorship, and guidelines/policies. This review suggests that the International Committee of Medical Journal Editors’ (ICMJE) recommended guidelines for authorship are not reflected in current authorship practices within the domain of health sciences in both low-and high-impact-factor journals. This devaluing of the true importance of authorship has the potential to affect the validity of authorship, diminish the real contributions of the true authors, and negatively affect patient care. PMID:26257520

Ongoing ethical issues concerning authorship in biomedical journals: an integrative review.

PubMed

Kornhaber, Rachel Anne; McLean, Loyola M; Baber, Rodney J

2015-01-01

Health professionals publishing within the field of health sciences continue to experience issues concerning appropriate authorship, which have clinical, ethical, and academic implications. This integrative review sought to explore the key issues concerning authorship from a bioethical standpoint, aiming to explore the key features of the authorship debate. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases of peer-reviewed research, published between 2009 and 2014, limited to English language research, with search terms developed to reflect the current issues of authorship. From among the 279 papers identified, 20 research papers met the inclusion criteria. Findings were compiled and then arranged to identify themes and relationships. The review incorporated a wide range of authorship issues encompassing equal-credited authors, honorary (guest/gift) and ghost authorship, perception/experiences of authorship, and guidelines/policies. This review suggests that the International Committee of Medical Journal Editors' (ICMJE) recommended guidelines for authorship are not reflected in current authorship practices within the domain of health sciences in both low-and high-impact-factor journals. This devaluing of the true importance of authorship has the potential to affect the validity of authorship, diminish the real contributions of the true authors, and negatively affect patient care.

Genetic counseling and the ethical issues around direct to consumer genetic testing.

PubMed

Hawkins, Alice K; Ho, Anita

2012-06-01

Over the last several years, direct to consumer(DTC) genetic testing has received increasing attention in the public, healthcare and academic realms. DTC genetic testing companies face considerable criticism and scepticism,particularly from the medical and genetic counseling community. This raises the question of what specific aspects of DTC genetic testing provoke concerns, and conversely,promises, for genetic counselors. This paper addresses this question by exploring DTC genetic testing through an ethic allens. By considering the fundamental ethical approaches influencing genetic counseling (the ethic of care and principle-based ethics) we highlight the specific ethical concerns raised by DTC genetic testing companies. Ultimately,when considering the ethics of DTC testing in a genetic counseling context, we should think of it as a balancing act. We need careful and detailed consideration of the risks and troubling aspects of such testing, as well as the potentially beneficial direct and indirect impacts of the increased availability of DTC genetic testing. As a result it is essential that genetic counselors stay informed and involved in the ongoing debate about DTC genetic testing and DTC companies. Doing so will ensure that the ethical theories and principles fundamental to the profession of genetic counseling are promoted not just in traditional counseling sessions,but also on a broader level. Ultimately this will help ensure that the public enjoys the benefits of an increasingly genetic based healthcare system.

Critical theory as an approach to the ethics of information security.

PubMed

Stahl, Bernd Carsten; Doherty, Neil F; Shaw, Mark; Janicke, Helge

2014-09-01

Information security can be of high moral value. It can equally be used for immoral purposes and have undesirable consequences. In this paper we suggest that critical theory can facilitate a better understanding of possible ethical issues and can provide support when finding ways of addressing them. The paper argues that critical theory has intrinsic links to ethics and that it is possible to identify concepts frequently used in critical theory to pinpoint ethical concerns. Using the example of UK electronic medical records the paper demonstrates that a critical lens can highlight issues that traditional ethical theories tend to overlook. These are often linked to collective issues such as social and organisational structures, which philosophical ethics with its typical focus on the individual does not tend to emphasise. The paper suggests that this insight can help in developing ways of researching and innovating responsibly in the area of information security.

Everyday Ethics: Ethical Issues and Stress in Nursing Practice

PubMed Central

Ulrich, Connie M.; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-01-01

Aim This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Background Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. Methods A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analyzed using descriptive statistics, cross-tabulations and Pearson correlations. Results A total of 422 questionnaires were used in the analysis. The five most frequently-occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Conclusion Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. PMID:20735502

Everyday ethics: ethical issues and stress in nursing practice.

PubMed

Ulrich, Connie M; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-11-01

This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. © 2010 Blackwell Publishing Ltd.

Ethical issues confronted by medical students during clinical rotations.

PubMed

Fard, Nazila Nikravan; Asghari, Fariba; Mirzazadeh, Azim

2010-07-01

This study aimed to examine the most common and important ethical issues confronting medical students during clinical rotations so that ethics-related topics can be prioritised according to students' needs and this information used to develop a curriculum for the ethics course. In a cross-sectional approach, we reviewed the medical ethics-related cases recorded in the logbooks of all medical students (n=241) at Tehran University of Medical Sciences who attended the medical ethics course during October 2006 to July 2007. As part of a graded assignment, each student was required to record three encounters with ethics-related issues in his or her logbook. A total of 713 cases were assessed. Information related to the ethical issues and the conditions in which ethical issues arose was extracted and recorded by two experts, whose analysis showed agreement of kappa 0.77. In cases of discrepancy, both experts reviewed and discussed the record until they achieved agreement. A total of 713 cases were analysed. The most common issues reported by students related to ethics in medical education (20.1%, n=143), professionalism (18.8%, n=134), confidentiality (7.6%, n=54), the doctor-patient relationship (7.3%, n=52), informed consent (7.0%, n=50) and the doctor-peer relationship (7.0%, n=50). After adjusting for length of rotation, the highest numbers of ethics-related incidents were reported from urology, general surgery, orthopaedics, internal medicine, neurology, and obstetrics and gynaecology wards. The results of this study indicate that professionalism and related elements represent one of the most important areas of concern that need to be addressed when planning courses for medical students. The other significant area of concern is that of ethics in medical education, which, although the subject is not considered essential for medical practitioners, should be taught and respected so that student sensitivity to medical ethics is maintained and even increased.

Implant ethics

PubMed Central

Hansson, S

2005-01-01

Implant ethics is defined here as the study of ethical aspects of the lasting introduction of technological devices into the human body. Whereas technological implants relieve us of some of the ethical problems connected with transplantation, other difficulties arise that are in need of careful analysis. A systematic approach to implant ethics is proposed. The major specific problems are identified as those concerning end of life issues (turning off devices), enhancement of human capabilities beyond normal levels, mental changes and personal identity, and cultural effects. PMID:16131553

Egg Production and Donation: A New Frontier in the Global Landscape of Cross-Border Reproductive Care: Ethical Concerns.

PubMed

Neri, Margherita; Turillazzi, Emanuela; Pascale, Natasha; Riezzo, Irene; Pomara, Cristoforo

2016-01-01

Cross-border reproductive care (CBRC) is a multifaceted phenomenon. It may involve both the movement of patients to undertake assisted reproductive treatment through technologies otherwise denied and the movement of assisted reproduction professionals, egg and sperm donors and surrogates, as well as the importing and exporting of gametes. The reasons for CBRC vary between countries. In this global landscape, the search for donor oocytes is one of the main reasons for patients seeking cross-border reproductive care. The egg market has led to ethical and political concerns about the means of procuring donor oocytes, the possibility of exploiting economically underprivileged women mainly in poor countries, and the issue of the responsibility and accountability of medical doctors and fertility clinics. Ethical concerns relating to international egg donation are discussed with special focus on the issues of compensation/ reimbursement, the health and welfare of women donating eggs, informed consent to donation, the possible conflict of interest for physicians involved in egg donation programmes, and equity in the distribution of economic resources from CBRC. Finally, the need for global solutions to this global issue is underlined.

Emotions, narratives, and ethical mindfulness.

PubMed

Guillemin, Marilys; Gillam, Lynn

2015-06-01

Clinical care is laden with emotions, from the perspectives of both clinicians and patients. It is important that emotions are addressed in health professions curricula to ensure that clinicians are humane healers as well as technical experts. Emotions have a valuable and generative role in health professional ethics education.The authors have previously described a narrative ethics pedagogy, the aim of which is to develop ethical mindfulness. Ethical mindfulness is a state of being that acknowledges everyday ethics and ethically important moments as significant in clinical care, with the aim of enabling ethical clinical practice. Using a sample narrative, the authors extend this concept to examine five features of ethical mindfulness as they relate to emotions: (1) being sensitized to emotions in everyday practice, (2) acknowledging and understanding the ways in which emotions are significant in practice, (3) being able to articulate the emotions at play during ethically important moments, (4) being reflexive and acknowledging both the generative aspects and the limitations of emotions, and (5) being courageous.The process of writing and engaging with narratives can lead to ethical mindfulness, including the capacity to understand and work with emotions. Strategies for productively incorporating emotions in narrative ethics teaching are described. This can be a challenging domain within medical education for both educators and health care students and thus needs to be addressed sensitively and responsibly. The potential benefit of educating health professionals in a way which addresses emotionality in an ethical framework makes the challenges worthwhile.

Buying and selling human eggs: infertility providers' ethical and other concerns regarding egg donor agencies.

PubMed

Klitzman, Robert

2016-11-08

Egg donor agencies are increasingly being used as part of IVF in the US, but are essentially unregulated, posing critical ethical and policy questions concerning how providers view and use them, and what the implications might be. Thirty-seven in-depth interviews of approximately 1 h were conducted - with 27 IVF providers and 10 patients. Clinicians vary in their views and interactions concerning egg donor agencies, ranging widely in whether and how often they use agencies. Agencies may offer egg recipients increased choices, but raise ethical and other concerns regarding respect for donors as individuals (e.g., adequacy of informed consent), potential harms, justice (e.g., concerns about possible eugenics - by encouraging and facilitating selection and marketing of facts for offspring), and donors constituting a vulnerable group. The quality of agencies appears to vary considerably, from acceptable to problematic. Agencies' medical and psychological screenings of donors can range, and be minimal. Not all agencies adequately track donors' prior numbers of donations, or share the relevant records with clinics. Clinics may find that potential donors have genetic mutations and medical problems about which they were unaware. Yet agencies and clinics do not provide care for such donors, generating stress. Dissemination of donors' personal data can potentially threaten confidentiality. Questions emerge of whether increased monitoring/oversight of agencies may be beneficial. These data, the first to examine providers' views and interactions regarding egg donor agencies, suggest wide variations in quality and use of agencies, and have critical implications for practice, policy, education and research. Given the potential limitations of the current model of self-regulation of agencies, the present data suggest needs to consider stronger professional guidelines or possible governmental regulations to establish, require and enforce higher standards for agencies to follow

Addressing parenting concerns of bone marrow transplant patients: opening (and closing) Pandora's box.

PubMed

Moore, C W; Rauch, P K

2006-12-01

Although a significant number of adults undergoing stem cell transplant (SCT) or bone marrow transplantation (BMT) care for dependent children, and these treatments pose significant challenges for families, research has virtually ignored the impact of parenting on patients' quality of life during BMT/SCT and children's responses to having a parent undergo these treatments. Physicians rarely inquire about parenting concerns related to the extended hospitalizations necessitated by these treatments, yet clinical experience suggests that addressing patient concerns about children's reactions to cancer and BMT/SCT can improve the experience of the patient and the patient's family, and help the medical team respond effectively to sources of patients' distress. Parents frequently want to know what reactions to expect from children, thus general developmental information is reviewed, and recommendations given for when professional help for children is warranted. A key way for parents to support their children is with open, honest communication; however, parents often find it extremely difficult to talk about cancer and BMT/SCT with their children. The medical team can assist patients' efforts to communicate with and support their children by asking about a patient's children, providing some targeted information, and discussing the potential impact of treatments on parenting capacity. Inquiring about and addressing parenting concerns may initially seem difficult, but can ultimately facilitate stronger doctor-patient alliances, and more compassionate care.

The Ethics of Strategic Ambiguity.

ERIC Educational Resources Information Center

Paul, Jim; Strbiak, Christy A.

1997-01-01

Examines the concept of strategic ambiguity in communication, and addresses the ethics of strategic ambiguity from an intrapersonal perspective that considers the congruity of communicators' espoused-ethics, ethics-in-use, and behavior, where ethical judgements are based on the congruity between espoused-ethics and actual behavior. Poses questions…

Identifying and Addressing Potential Conflict of Interest: A Professional Medical Organization’s Code of Ethics

PubMed Central

Heim, Lori

2010-01-01

The new Consumer Alliance agreement between the American Academy of Family Physicians (AAFP) and The Coca-Cola Company provides a valuable opportunity to illustrate AAFP’s adherence to its ethical foundation, demonstrate the AAFP’s commitment to serving physicians and the public, and maintain the trust Americans put in their family physicians and the organization that represents them. Throughout the development of this program, as well as in all business interactions, the AAFP consistently addresses possible conflict of interest openly and directly, sharing with our members and the public exactly what measures we take to ensure that, in fact, no unethical conduct or breach of trust would—or will in the future—occur. In this case, the AAFP saw a public health and education need that was both unmet and undermined by the barrage of marketing messages and confusing information, and acted to fill that need. In so doing, the AAFP hewed to its high ethical standards, its core values, and its mission in the decisions made and the actions that followed. PMID:20644192

A Latina/o Campus Community's Readiness to Address Lesbian, Gay, and Bisexual Concerns

ERIC Educational Resources Information Center

Rivera-Ramos, Zully A.; Oswald, Ramona F.; Buki, Lydia P.

2015-01-01

In response to the call for new and innovative methods of assessing campus climate (Worthington, 2008), the current study is the first to examine the readiness of a Latina/o campus community to address lesbian, gay, and bisexual (LGB) concerns. Using the Community Readiness Model, data were collected through individual interviews with a total of…

[Ethical issues concerning surrogate assisted sex therapy].

PubMed

Aloni, Ronit; Heruti, Rafi J

2009-09-01

Sex therapy, by definition, is a couple therapy as well as behavioral therapy by origin. As such, practicing a series of exercises is an essential part of the therapy. Masters and Johnson, in their book "Human Sexual Inadequacy", wrote that "one cannot learn about sexuality in any practical way without actually experiencing intimate behavior with a partner". This ethical approach directed them to develop the therapeutic method of working with surrogate partners, as they thought all people are entitled to receive therapy, if they so wish, including people without partners. Surrogate is a form of mentoring; this is a one-on-one relationship that allows practicing classic behavioral methods such as gradual progress, breaking the task into small goals, onsite feedback, rehearsals, role-play, modifying the environment, etc. The content and the skills that are practiced are related to sexual dysfunction as well as social, couple and intimate skills. The lack of those critical skills prevents the clients from fulfilling their wish to develop social or intimate relationships in which they will be able to accomplish their sexuality. Ethical procedures should be strictly kept in order to protect the clients and the surrogates, in a three-way therapeutic team, working together to reach the goals of the therapy. During the therapy process a weekly meeting is held between the therapist and the client, between the therapist and the surrogate and, only then, between the surrogate and the client. At the end of the therapy process the relationship between the client and the surrogate is terminated, completely. In this article, the authors illuminate the complexity of this therapy process, as well as dealing with some of the ethical issues that are raised. The article also identifies types of patients who can benefit from surrogate therapy.

Moral experience and ethical challenges in an emergency department in Pakistan: emergency physicians' perspectives.

PubMed

Zafar, Waleed

2015-04-01

Emergency departments (ED) are often stressful environments posing unique ethical challenges-issues that primarily raise moral rather than clinical concerns-in patient care. Despite this, there are very few reports of what emergency physicians find ethically challenging in their everyday work. Emergency medicine (EM) is a relatively young but rapidly growing specialty that is gaining acceptance worldwide. The aim of this study was to explore the perspectives of EM residents and physicians regarding the common ethical challenges they face during patient care in one of only two academic EM departments in Pakistan. These challenges could then be addressed in residents' training and departmental practice guidelines. A qualitative research design was employed and in-depth interviews were conducted with ED physicians. Participants were encouraged to think of specific examples from their work, to highlight the particular ethical concerns raised and to describe in detail the process by which those concerns were addressed or left unresolved. Transcripts were analysed using grounded theory methods. Thirteen participants were interviewed and they described four key challenges: how to provide highest quality care with limited resources; how to be truthful to patients; what to do when it is not possible to provide or continue treatment to patients; and when (and when not) to offer life-sustaining treatments. Participants' accounts provided important insights into how physicians tried to resolve these challenges in the 'local moral world' of an ED in Pakistan. The study highlights the need for developing systematic and contextually appropriate mechanisms for resolving common ethical challenges in the EDs and for training residents in moral problem solving. 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.

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

PubMed

Foglia, Mary Beth; Pearlman, Robert A; Bottrell, Melissa; Altemose, Jane K; Fox, Ellen

2009-04-01

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

Writing Centre Tutoring Sessions: Addressing Students' Concerns

ERIC Educational Resources Information Center

Winder, Roger; Kathpalia, Sujata S.; Koo, Swit Ling

2016-01-01

The guiding principle behind university writing centres is to focus on the process of writing rather than the finished product, prioritising higher order concerns related to organisation and argumentation of texts rather than lower order concerns of grammar and punctuation. Using survey-based data, this paper examines students' concerns regarding…

Synthetic biology and the ethics of knowledge

PubMed Central

Douglas, Thomas; Savulescu, Julian

2011-01-01

Synthetic biologists aim to generate biological organisms according to rational design principles. Their work may have many beneficial applications, but it also raises potentially serious ethical concerns. In this article, we consider what attention the discipline demands from bioethicists. We argue that the most important issue for ethicists to examine is the risk that knowledge from synthetic biology will be misused, for example, in biological terrorism or warfare. To adequately address this concern, bioethics will need to broaden its scope, contemplating not just the means by which scientific knowledge is produced, but also what kinds of knowledge should be sought and disseminated. PMID:20935316

A Bridge Back to the Future: Public Health Ethics, Bioethics, and Environmental Ethics.

PubMed

Lee, Lisa M

2017-09-01

Contemporary biomedical ethics and environmental ethics share a common ancestry in Aldo Leopold's and Van Rensselaer Potter's initial broad visions of a connected biosphere. Over the past five decades, the two fields have become strangers. Public health ethics, a new subfield of bioethics, emerged from the belly of contemporary biomedical ethics and has evolved over the past 25 years. It has moved from its traditional concern with the tension between individual autonomy and community health to a wider focus on social justice and solidarity. Public health has a broad focus that includes individual, community, and environmental health. Public health ethics attends to these broad commitments reflected in the increasing concern with the connectedness of health of individuals to the health of populations, to the health of animals, to the health of the environment; it is well situated to reconnect all three "fields" of ethics to promote a healthier planet.

Teaching ethics using popular songs: feeling and thinking.

PubMed

O'Mathúna, Dónal P

2008-01-01

A connection has long been made between music and moral education. Recent discussions have focused on concerns that certain lyrics can lead to acceptance of violence, suicide, inappropriate views of women, and other unethical behaviour. Debate over whether such connections exist at least illustrates that popular songs engage listeners with ethical issues; this arises from the unique blend of emotional and cognitive reactions to music. And while the emotional side of ethics has received less attention than other aspects of ethics, it is important and music can be a powerful and unique tool to introduce the emotional aspects of ethics. Music appeals to almost everyone. Throughout history songs have rallied people to action and drawn people into deeper reflection. Music engages our emotions, our imagination and our intellect. Students already spend many hours listening to songs, some of which address ethical issues; it is thus an ideal pedagogic aid in teaching subjects like ethics. This article will discuss how carefully selected songs can encourage thoughtful reflection and critical thinking about ethical issues: a number of specific examples will be described, along with a discussion of the general practicalities of using popular songs in teaching ethics and a demonstration of how students learn to listen critically and actively reflect on the ethical messages they receive. The enjoyment of music helps to engage students with ethics and its relevance for their lives and careers. This article aims to share some of the excitement and enthusiasm that popular songs have brought to my teaching of ethics.

Communicating Effectively to Resolve Ethical Concerns: The Role of School Psychology Supervisors

ERIC Educational Resources Information Center

Olley, Rivka I.

2010-01-01

It is incumbent upon each school psychologist to engage in ethical behavior based on current ethical codes guiding school psychology. The school psychologist is often the team member most knowledgeable regarding federal and state laws mandating educational services. Sometimes ethical dilemmas that school psychologists face are the result of a…

Care ethics and the global practice of commercial surrogacy.

PubMed

Parks, Jennifer A

2010-09-01

This essay will focus on the moral issues relating to surrogacy in the global context, and will critique the liberal arguments that have been offered in support of it. Liberal arguments hold sway concerning reproductive arrangements made between commissioning couples from wealthy nations and the surrogates from socioeconomically weak backgrounds that they hire to do their reproductive labor. My argument in this paper is motivated by a concern for controlling harms by putting the practice of globalized commercial surrogacy into the context of care ethics. As I will argue, the unstable situations into which children of global surrogacy arrangements are born is symbolic of the crisis of care that the practice raises. Using the Baby Manji case as my touch point, I will suggest that liberalism cannot address the harms experienced by Manji and children like her who are created through the global practice of assisted reproductive technology. I will argue that, if commissioning couples consider their proposed surrogacy contracts from a care ethics point of view, they will begin to think relationally about their actions, considering the practice from an ethical lens, not just an economic or contractual one.

Diagnosing dementia: Ethnography, interactional ethics and everyday moral reasoning

PubMed Central

Hillman, Alexandra

2016-01-01

This article highlights the contribution of ethnography and qualitative sociology to the ethical challenges that frame the diagnosis of dementia. To illustrate this contribution, the paper draws on an ethnographic study of UK memory clinics carried out between 2012 and 2014. The ethnographic data, set alongside other studies and sociological theory, contest the promotion of a traditional view of autonomy; the limiting of the point of ethical interest to a distinct moment of diagnosis disclosure; and the failure to recognise risk and uncertainty in the building of clinical ‘facts’ and their communication. In addressing these specific concerns, this article contributes to the wider debate over the relationship between sociology and bioethics (medical ethics). At the heart of these debates lies more fundamental questions: how can we best understand and shape moral decision-making and ethics that guide behaviour in medical practice, and what should be the guiding ideas, concepts and methods to inform ethics in the clinic? Using the case of dementia diagnosis, this article illustrates the benefits of an ethnographic approach, not just for understanding this ethical problem but also for exploring if and how a more empirically informed ethics can help shape healthcare practices for the better. PMID:28255279

The Role of Intent in Ethical Decision Making: The Ethical Choice Model

ERIC Educational Resources Information Center

King, Christine; Powell, Toni

2007-01-01

This paper reviews the major theories, studies and models concerning ethical decision making in organizations. The authors drew upon Jones' Model (1991) as the foundation for their Ethical Choice Model, which is designed to further clarify the ethical decision making process as it relates to the construct of intentionality. The model, illustrated…

Ethical issues in mental health

PubMed Central

DuBois, James; Bailey-Burch, Brendolyn; Bustillos, Dan; Campbell, Jean; Cottler, Linda; Fisher, Celia; Hadley, Whitney B.; Hoop, Jinger G.; Roberts, Laura; Salter, Erica K.; Sieber, Joan E.; Stevenson, Richard D.

2012-01-01

Purpose of review To describe community engaged research (CEnR) and how it may improve the quality of a research study while addressing ethical concerns that communities may have with mental health and substance abuse research. This article includes a review of the literature as well as recommendations from an expert panel convened with funding from the US National Institute of Mental Health. Recent findings CEnR represents a broad spectrum of practices including representation on institutional ethics committees, attitude research with individuals from the study population, engaging community advisory boards, forming research partnerships with community organizations, and including community members as co-investigators. Summary CEnR poses some challenges; for example, it requires funding and training for researchers and community members. However, it offers many benefits to researchers and communities and some form of CEnR is appropriate and feasible in nearly every study involving human participants. PMID:21460643

Towards a feminist global bioethics: addressing women's health concerns worldwide.

PubMed

Tong, R

2001-01-01

In this paper I argue that a global bioethics is possible. Specifically, I present the view that there are within feminist approaches to bioethics some conceptual and methodological tools necessary to forge a bioethics that embraces the health-related concerns of both developing and developed nations equally. To support my argument I discuss some of the challenges that have historically confronted feminists. If feminists accept the idea that women are entirely the same, then feminists present as fact the fiction of the essential "Woman." Not only does "Woman" not exist, -she" obscures important racial, ethnic, cultural, and class differences among women. However, if feminists stress women's differences too much, feminists lose the power to speak coherently and cogently about gender justice, women's rights, and sexual equality in general. Analyzing the ways in which the idea of difference as well as the idea of sameness have led feminists astray, I ask whether it is possible to avoid the Scylla of absolutism (imperialism, colonialism, hegemony) on the one hand and the Charybdis of relativism (postmodernism, fragmentation, Balkanization) on the other. Finally, after reflecting upon the work of Uma Narayan, Susan Muller Okin, and Martha Nussbaum, I conclude that there is a way out of this ethical bind. By focusing on women's, children's, and men's common human needs, it is possible to lay the foundation for a just and caring global bioethics.

Ethics for Management.

ERIC Educational Resources Information Center

Jaques, Elliott

2003-01-01

Notes that it is essential that business organizations establish organizational systems that require satisfactory ethical business behaviors from everyone concerned, regardless of differences in personal outlooks. Outlines what needs to be done in order to effectively teach business ethics. (SG)

Ethical Issues Associated with Client Values Conversion and Therapist Value Agendas in Family Therapy.

ERIC Educational Resources Information Center

Odell, Mark; Stewart, Scott Philip

1993-01-01

Raises ethical concerns inherent in dealing with issue of values in family therapy, focusing on conversion of client values and therapists who may hold evangelistic agendas. Presents brief review of research addressing client values conversion in individual psychotherapy, along with proposed solutions for dealing with values. Offers suggestions…

Challenges created by data dissemination and access restrictions when attempting to address community concerns: individual privacy versus public wellbeing.

PubMed

Colquhoun, Amy; Aplin, Laura; Geary, Janis; Goodman, Karen J; Hatcher, Juanita

2012-05-08

Population health data are vital for the identification of public health problems and the development of public health strategies. Challenges arise when attempts are made to disseminate or access anonymised data that are deemed to be potentially identifiable. In these situations, there is debate about whether the protection of an individual's privacy outweighs potentially beneficial public health initiatives developed using potentially identifiable information. While these issues have an impact at planning and policy levels, they pose a particular dilemma when attempting to examine and address community concerns about a specific health problem. Research currently underway in northern Canadian communities on the frequency of Helicobacter pylori infection and associated diseases, such as stomach cancer, is used in this article to illustrate the challenges that data controls create on the ability of researchers and health officials to address community concerns. Barriers are faced by public health professionals and researchers when endeavouring to address community concerns; specifically, provincial cancer surveillance departments and community-driven participatory research groups face challenges related to data release or access that inhibit their ability to effectively address community enquiries. The resulting consequences include a limited ability to address misinformation or to alleviate concerns when dealing with health problems in small communities. The development of communication tools and building of trusting relationships are essential components of a successful investigation into community health concerns. It may also be important to consider that public wellbeing may outweigh the value of individual privacy in these situations. As such, a re-evaluation of data disclosure policies that are applicable in these circumstances should be considered.

Detecting, preventing, and responding to "fraudsters" in internet research: ethics and tradeoffs.

PubMed

Teitcher, Jennifer E F; Bockting, Walter O; Bauermeister, José A; Hoefer, Chris J; Miner, Michael H; Klitzman, Robert L

2015-01-01

Internet-based health research is increasing, and often offers financial incentives but fraudulent behavior by participants can result. Specifically, eligible or ineligible individuals may enter the study multiple times and receive undeserved financial compensation. We review past experiences and approaches to this problem and propose several new strategies. Researchers can detect and prevent Internet research fraud in four broad ways: (1) through the questionnaire/instrument (e.g., including certain questions in survey; and software for administering survey); (2) through participants' non-questionnaire data and seeking external validation (e.g., checking data for same email addresses, usernames, passwords, and/or fake addresses or phone numbers; (3) through computer information, (e.g., IP addresses and cookies), and 4) through study design (e.g., avoid lump sum compensation and interviewing participants). These approaches each have pros and cons, and raise ethical, legal, and logistical questions, given that ethical tensions can emerge between preserving the integrity of research vs. protecting the privacy and confidentiality of study respondents. While past discussions concerning the ethics of online research have tended to focus on the participants' ability to trust the researchers, needs now arise to examine researchers' abilities to trust the participants. This analysis has several critical implications for future practice, policy, and research. © 2015 American Society of Law, Medicine & Ethics, Inc.

Ethical Barriers in Adolescent Oncofertility Counseling.

PubMed

Runco, Daniel V; Taylor, Julia F; Helft, Paul R

2017-01-01

Adult survivors of pediatric cancers are at substantial risk for infertility. Oncofertility is an emerging field in medicine that has focused on the fertility preservation of these patients. As the field continues to develop, there are several areas in which our practice has improved. However, several ethical concerns still exist involving beneficence, nonmaleficence, informed consent, adolescent assent, and posthumous use of reproductive tissues. Because the field is still developing, great disparities exist in available options depending on age, ability to pay, and geographic location. Such discrepancies in access may lead to health disparities in the adolescent patient population. As the science continues to make future fertility more feasible, the ethical questions will continue to be more complex. The purpose of this article is to review some of the developments regarding oncoferility and address future directions for research and inquiry in specific areas.

Business Ethics

DTIC Science & Technology

2002-06-01

NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS Approved for public release; distribution is unlimited. BUSINESS ETHICS by Wojciech...Thesis 4. TITLE AND SUBTITLE Business Ethics. 5. FUNDING NUMBERS 6. AUTHOR (S) Wojciech Górski 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS...INTENTIONALLY LEFT BLANK iii Approved for public release; distribution is unlimited. BUSINESS

There's More to Ethics than Justice and Harm: Teaching a Broader Understanding of Journalism Ethics

ERIC Educational Resources Information Center

Knowlton, Steven; McKinley, J. Christopher

2016-01-01

Most applied ethics training in journalism in the West follows Enlightenment-era, reason-based ethical principles: Justice is intrinsically better than injustice (Kant), and the best choice is achieving the best outcome for all concerned (Mill). Recent scholarship in ethics suggests that ethics is much broader than this. This article examines a…

[Lawyer members of a hospital ethics committee, a training in bioethics?].

PubMed

Mathieu, Géraldine; Rommelaere, Claire

2013-01-01

As lawyer members of a hospital ethics committee, we wanted to address the question if being part of such a committee allowed us to call ourselves "bioethicists". Before answering, it is important to put Belgian hospital ethics committees in context, firstly by explaining their missions: defining general ethical guidelines in order to help physicians in their practice, providing for punctual advice and assessing every clinical research protocol which is proposed to a physician of the hospital. Theoretical information concerning the missions of Belgian hospital ethics committees is the opportunity to develop some thinking elements of about the role and duties of those committees. We can then wonder who are or should be the members of hospital ethics committees: what does the law say and what to think about it? Questions about ethics committees'missions and members allow us to come to the conclusion that the mere fact of being member of a hospital ethics committee is not enough to call oneself a bioethicist. On the one hand, experience should be accompanied by proper training; on the other hand, one should always be aware that "becoming a bioethicist" is a never ending journey.

A Response to Sam McKegney's "Strategies for Ethical Engagement: An Open Letter Concerning Non-Native Scholars of Native Literatures"

ERIC Educational Resources Information Center

Appleford, Rob

2009-01-01

This article presents the author's response to Sam McKegney's "Strategies for Ethical Engagement: An Open Letter Concerning Non-Native Scholars of Native Literatures." In his response to Sam's diagnosis of the malaise currently afflicting non-Aboriginal critics of this literature, the author attempts to consider the "cure" Sam offers (albeit…

Medical ethics in an era of bioethics: resetting the medical profession's compass.

PubMed

Pellegrino, Edmund D

2012-02-01

What it means to be a medical professional has been defined by medical ethicists throughout history and remains a contemporary concern addressed by this paper. A medical professional is generally considered to be one who makes a public promise to fulfill the ethical obligations expressed in the Hippocratic Code. This presentation summarizes the history of medical professionalism and refocuses attention on the interpersonal relationship of doctor and patient. This keynote address was delivered at the Founders of Bioethics International Congress (June, 2010).

Battlefield ethics training: integrating ethical scenarios in high-intensity military field exercises.

PubMed

Thompson, Megan M; Jetly, Rakesh

2014-01-01

There is growing evidence that modern missions have added stresses and ethical complexities not seen in previous military operations and that there are links between battlefield stressors and ethical lapses. Military ethicists have concluded that the ethical challenges of modern missions are not well addressed by current military ethics educational programs. Integrating the extant research in the area, we propose that scenario-based operational ethics training in high-intensity military field training settings may be an important adjunct to traditional military ethics education and training. We make the case as to why this approach will enhance ethical operational preparation for soldiers, supporting their psychological well-being as well as mission effectiveness.

Ethical dilemmas concerning autonomy when persons with dementia wish to live at home: a qualitative, hermeneutic study.

PubMed

Smebye, Kari Lislerud; Kirkevold, Marit; Engedal, Knut

2016-01-19

Caring for people with dementia living in their own homes is a challenging care issue that raises ethical dilemmas of how to balance autonomy with their safety and well-being. The theoretical framework for this study consisted of the concepts of autonomy, beneficence, non-maleficence, paternalism and from the ethics of care. The aim of this study was to explore ethical dilemmas concerning autonomy that were identified when persons with dementia wished to live at home. This Norwegian study had a qualitative, hermeneutic design and was based on nine cases. Each case consisted of of a triad: the person with dementia, the family carer and the professional caregiver. Inclusion criteria for the persons with dementia were: (1) 67 years or older (2) diagnosed with dementia (3) Clinical Dementia Rating score 2 i.e. dementia of moderate degree (4) able to communicate verbally and (5) expressed a wish to live at home. The family carers and professional caregivers registered in the patients' records were included in the study. An interview guide was used in interviews with family carers and professional caregivers. Field notes were written after participant observation of interactions between persons with dementia and professional caregivers during morning care or activities at a day care centre. By means of deductive analysis, autonomy-related ethical dilemmas were identified. The final interpretation was based on perspectives from the theoretical framework. The analysis revealed three main ethical dilemmas: When the autonomy of the person with dementia conflicted with (1) the family carer's and professional caregiver's need to prevent harm (non-maleficence) (2) the beneficence of family carers and professional caregivers (3) the autonomy of the family carer. In order to remain living in their own homes, people with dementia accepted their dependence on others in order to uphold their actual autonomy and live in accordance with their identified values. Paternalism could be

An ethics of body scanners: requirements and future challenges from an ethical point of view

NASA Astrophysics Data System (ADS)

Rampp, Benjamin; Wolkenstein, Andreas F. X.; Ammicht Quinn, Regina

2011-05-01

At the moment, body scanners based on terahertz and millimeter-wave technologies are implemented at airports around the world. Thus, challenges of acceptance and acceptability become pressing. In this context, we present the results of an ethical research project on the development and implementation of body scanners. We will show which requirements concerning the system, its developers, and its users should be met in order that the scanners can be acceptable from an ethical point of view. These requirements involve, among others, questions of privacy, health, data protection, and security processes. A special ethical challenge for body scanners, however, still remains: Automatic anonymization processes are based on the assumption of "normal" bodies. Certain groups of persons with "deviant bodies" (e.g. persons with hidden disabilities, persons with aberrant sex characteristics, etc.) are affected in a special way: Their deviation from the standard (for instance their disability) is socially hidden, but eventually exposed by body scanners, even (and even more) if the produced pictures are anonymized. Here, we address the question how the possible discrimination against and exclusion of people with "deviant bodies" could be mitigated or prevented.

What Ethics for Bioart?

PubMed

Vaage, Nora S

Living artworks created with biotechnology raise a range of ethical questions, some of which are unprecedented, others well known from other contexts. These questions are often discussed within the framework of bioethics, the ethics of the life sciences. The basic concern of institutionalised bioethics is to develop and implement ethical guidelines for ethically responsible handling of living material in technological and scientific contexts. Notably, discussions of ethical issues in bioart do not refer to existing discourses on art and morality from the field of aesthetics. The latter framework is primarily concerned with how the moral value of an artwork affects its artistic value. The author argues that a successful integration of these two frameworks will make possible an ethics of bioart that is adequate to its subject matter and relevant for practice. Such an integrated approach can give increased depth to understandings of ethical issues in bioart, inspire new ways of thinking about ethics in relation to art in general and give novel impulses to bioethics and technology assessment. Artworks by the Tissue Culture and Art Project and their reception serve as the empirical starting point for connecting perspectives in art with those of bioethics, developing an ethics for bioart. The author suggests that consideration of the effect of these artworks is vital in validating ethically problematical applications of biotechnology for art. It is argued that the affective, visceral qualities of living artworks may spur the audience to adjust, revise or develop their personal ethical framework.

Ethical considerations of teaching spirituality in the academy.

PubMed

Becker, Annette L

2009-11-01

Despite evidence in college students indicating a hunger for spiritual insight and spirituality's application in health care, there continues to be guardedness within the academy towards inclusion of curricula that address spirituality. The purpose of this article is to examine the ethical considerations of teaching spirituality in the academy by describing current trends, issues relevant to nursing education and practice, legitimate concerns of the academy, and the importance of an ethical instructional response when teaching about spirituality. Data supporting the interest and desire by students to explore meaning and purpose in the context of spirituality will be presented. Challenges and barriers inherent in teaching this topic will be described, including the affective response, the lack of a universally accepted definition of spirituality, and spirituality's relationship to religion. Pedagogical strategies consistent with an ethical instructional response will be discussed as the key to eliciting trust within the academy. A model of teaching spirituality and health will be offered to illustrate these possibilities.

Ethical foundations of environmental radiological protection.

PubMed

Oughton, D H

2016-06-01

Assessing the potential ecological impact of ionising radiation raises a number of ethical questions. These include fundamental questions such as what exactly constitutes harming the environment, and how the environment should be valued, as well as links to political protection principles such as sustainability and biodiversity. Starting from developments within ecological risk assessment, this paper summarises some of the ethical issues concerning the protection of the environment from radiation. Chapter 2 gives a brief overview of different philosophical and cultural world views on valuing the environment in a context of radiation risk. Chapter 3 addresses some recent challenges to proposed environmental protection frameworks, including practical applications following the Chernobyl and Fukushima accidents, and some scientific developments such as the ecosystem approach. Finally, Chapter 4 offers some recommendations on how ethical evaluation can help produce a more robust and transparent approach to the protection of the environment. In conclusion, there is a need for a holistic evaluation of the environmental impacts of ionising radiation that not only considers the direct consequences on the health of humans and non-human species, but also the more complex social, ethical, and economic consequences of both human and non-human exposures. © The International Society for Prosthetics and Orthotics.

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

PubMed

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.

Addressing Male Facial Skin Concerns: Clinical Efficacy of a Topical Skincare Treatment Product for Men.

PubMed

Makino, Elizabeth T; Jiang, Lily I; Tan, Priscilla; Cheng, Tsing; Mehta, Rahul C

2018-03-01

The growing male skincare market reflects the increased interest of men in addressing facial aging concerns and maintaining a healthy youthful appearance. Because of differences in skin structure and aging as well as in lifestyle and behavior, male facial skin presents unique challenges that may result in different priorities or treatment strategies compared to female skin. A clinical study was conducted to assess clinical efficacy and tolerability of a topical skincare treatment product that was developed to address several male facial skin concerns related to skin quality, skin aging, and shaving. The treatment product provided significant improvements in all clinical efficacy parameters including overall photodamage, tactile roughness, fine line/wrinkles, and coarse lines/wrinkles. Furthermore, significant improvements in erythema as well as dryness/scaling were observed. Subject self-assessment questionnaires showed that the treatment product was highly rated in both self-perceived efficacy as well as product attributes. Use of skincare treatment products that tackle specific male facial skin concerns could further optimize skin quality and support healthy and youthful looking skin in men.

J Drugs Dermatol. 2018;17(3):301-306.

Humankind Takes up Environmental Ethics

ERIC Educational Resources Information Center

Huiying, Xu

2004-01-01

Environmental ethics examines the relationship between human beings and nature from the moral perspective. It is also a kind of ethics arising from a concern with an earth which is on the verge of losing balance. Environmental ethics originated at the end of the 1940s. Since the 1970s, great progress has been made in environmental ethics. This…

Ethics and geographical equity in health care

PubMed Central

Rice, N.; Smith, P.

2001-01-01

Important variations in access to health care and health outcomes are associated with geography, giving rise to profound ethical concerns. This paper discusses the consequences of such concerns for the allocation of health care finance to geographical regions. Specifically, it examines the ethical drivers underlying capitation systems, which have become the principal method of allocating health care finance to regions in most countries. Although most capitation systems are based on empirical models of health care expenditure, there is much debate about which needs factors to include in (or exclude from) such models. This concern with legitimate and illegitimate drivers of health care expenditure reflects the ethical concerns underlying the geographical distribution of health care finance. Key Words: Health economics • resource allocation • ethics of regional health care finance • capitation systems PMID:11479357

Clarifying perspectives: Ethics case reflection sessions in childhood cancer care.

PubMed

Bartholdson, Cecilia; Lützén, Kim; Blomgren, Klas; Pergert, Pernilla

2016-06-01

Childhood cancer care involves many ethical concerns. Deciding on treatment levels and providing care that infringes on the child's growing autonomy are known ethical concerns that involve the whole professional team around the child's care. The purpose of this study was to explore healthcare professionals' experiences of participating in ethics case reflection sessions in childhood cancer care. Data collection by observations, individual interviews, and individual encounters. Data analysis were conducted following grounded theory methodology. Healthcare professionals working at a publicly funded children's hospital in Sweden participated in ethics case reflection sessions in which ethical issues concerning clinical cases were reflected on. The children's and their parents' integrity was preserved through measures taken to protect patient identity during ethics case reflection sessions. The study was approved by a regional ethical review board. Consolidating care by clarifying perspectives emerged. Consolidating care entails striving for common care goals and creating a shared view of care and the ethical concern in the specific case. The inter-professional perspectives on the ethical aspects of care are clarified by the participants' articulated views on the case. Different approaches for deliberating ethics are used during the sessions including raising values and making sense, leading to unifying interactions. The findings indicate that ethical concerns could be eased by implementing ethics case reflection sessions. Conflicting perspectives can be turned into unifying interactions in the healthcare professional team with the common aim to achieve good pediatric care. Ethics case reflection sessions is valuable as it permits the discussion of values in healthcare-related issues in childhood cancer care. Clarifying perspectives, on the ethical concerns, enables healthcare professionals to reflect on the most reasonable and ethically defensible care for the child

Print Me an Organ? Ethical and Regulatory Issues Emerging from 3D Bioprinting in Medicine.

PubMed

Gilbert, Frederic; O'Connell, Cathal D; Mladenovska, Tajanka; Dodds, Susan

2018-02-01

Recent developments of three-dimensional printing of biomaterials (3D bioprinting) in medicine have been portrayed as demonstrating the potential to transform some medical treatments, including providing new responses to organ damage or organ failure. However, beyond the hype and before 3D bioprinted organs are ready to be transplanted into humans, several important ethical concerns and regulatory questions need to be addressed. This article starts by raising general ethical concerns associated with the use of bioprinting in medicine, then it focuses on more particular ethical issues related to experimental testing on humans, and the lack of current international regulatory directives to guide these experiments. Accordingly, this article (1) considers whether there is a limit as to what should be bioprinted in medicine; (2) examines key risks of significant harm associated with testing 3D bioprinting for humans; (3) investigates the clinical trial paradigm used to test 3D bioprinting; (4) analyses ethical questions of irreversibility, loss of treatment opportunity and replicability; (5) explores the current lack of a specific framework for the regulation and testing of 3D bioprinting treatments.

Gaps, conflicts, and consensus in the ethics statements of professional associations, medical groups, and health plans.

PubMed

Berkman, N D; Wynia, M K; Churchill, L R

2004-08-01

Patients today interact with physicians, physician groups, and health plans, each of which may follow distinct ethical guidelines. We systematically compared physician codes of ethics with ethics policies at physician group practices and health plans, using the 1998-99 policies of 38 organisations-18 medical associations (associations), nine physician group practices (groups), and 12 health plans (plans)-selected using random and stratified purposive sampling. A clinician and a social scientist independently abstracted each document, using a 397-item health care ethics taxonomy; a reconciled abstraction form was used for analysis. This study focuses on ethics policies regarding professional obligation towards patients, resource allocation, and care for the vulnerable in society. A majority in all three groups mention "fiduciary obligations" of one sort or another, but associations generally address physician/patient relations but not health plan obligations, while plans rarely endorse physicians' obligations of advocacy, beneficence, and non-maleficence. Except for occasional mentions of cost effectiveness or efficiency, ethical considerations in resource allocation rarely arise in the ethics policies of all three organisational types. Very few associations, groups, or plans specifically endorse obligations to vulnerable populations. With some important exceptions, we found that the ethics policies of associations, groups, and plans are narrowly focused and often ignore important ethical concerns for society, such as resource allocation and care for vulnerable populations. More collaborative work is needed to build integrated sets of ethical standards that address the aims and responsibilities of the major stakeholders in health care delivery.

What really separates casuistry from principlism in biomedical ethics.

PubMed

Cudney, Paul

2014-06-01

Since the publication of the first edition of Tom Beauchamp and James Childress's Principles of Biomedical Ethics there has been much debate about what a proper method in medical ethics should look like. The main rival for Beauchamp and Childress's account, principlism, has consistently been casuistry, an account that recommends argument by analogy from paradigm cases. Admirably, Beauchamp and Childress have modified their own view in successive editions of Principles of Biomedical Ethics in order to address the concerns proponents of casuistry and others have had about principlism. Given these adjustments to their view, some have claimed that principlism and casuistry no longer count as distinct methods. Even so, many still consider these two conceptions of bioethical methodologies as rivals. Both accounts of the relationship between casuistry and principlism are wrong. These two conceptions of methodology in biomedical ethics are significantly different, but the differences are not the ones pointed out by those who still claim that they are distinct positions. In this article, I explain where the real similarities and differences lie between these two views.

The Value of Environmental Ethics.

ERIC Educational Resources Information Center

Hargrove, Eugene C.

1987-01-01

Discusses some of the views of environmentalists toward the study of environmental ethics. Addresses the problem that environmental ethics literature is difficult to read and argues that certain opinions about the value of the study of environmental ethics are rooted in misconceptions. (TW)

Higher Education and Ethical Value

ERIC Educational Resources Information Center

Lee, Jeong-Kyu

2017-01-01

The purpose of this study is to explore the importance of ethical value in higher education as well as the relevance between ethical value and higher education. In order to examine the study logically, three research questions are addressed: First, what is value, ethical value, and Asiatic ethical value? Second, for whom and what is higher…

Ethical, social, and legal issues surrounding studies of susceptible populations and individuals.

PubMed Central

Soskolne, C L

1997-01-01

Calls for professional accountability have resulted in the development of ethics guidelines by numerous specialty and subspecialty groups of scientists. Indeed, guidelines among some health professions now address vulnerable and dependent groups: but these are silent on issues related to biomarkers. In parallel, attention has been drawn to human rights concerns associated with attempts to detect hypersusceptible workers, especially in democratic countries. Despite this, concern for vulnerable populations grows as advances in biomarker technology make the identification of genetic predisposition and susceptibility markers of both exposure and outcome more attainable. In this article, the principles derived from the ethical theory of utilitarianism provide the basis for principle-based ethical analysis. In addition, the four principles of biomedical ethics--respect for autonomy, beneficence, nonmaleficence, and social justice--are considered for biomarker studies. The need for a context in which ethical analysis is conducted and from which prevailing social values are shown to drive decisions of an ethical nature is emphasized; these include statutory regulation and law. Because biomarker studies can result in more harm than good, special precautions to inform research participants prior to any involvement in the use of biomarkers are needed. In addition, safeguards to maintain the privacy of data derived from biomarker studies must be developed and implemented prior to the application of these new technologies. Guidelines must be expanded to incorporate ethical, social, and legal considerations surrounding the introduction of new technologies for studying susceptible populations and individuals who may be vulnerable to environmental exposures. PMID:9255569

Battlefield ethics training: integrating ethical scenarios in high-intensity military field exercises

PubMed Central

Thompson, Megan M.; Jetly, Rakesh

2014-01-01

There is growing evidence that modern missions have added stresses and ethical complexities not seen in previous military operations and that there are links between battlefield stressors and ethical lapses. Military ethicists have concluded that the ethical challenges of modern missions are not well addressed by current military ethics educational programs. Integrating the extant research in the area, we propose that scenario-based operational ethics training in high-intensity military field training settings may be an important adjunct to traditional military ethics education and training. We make the case as to why this approach will enhance ethical operational preparation for soldiers, supporting their psychological well-being as well as mission effectiveness. PMID:25206947

Ethics of justice vs the ethics of care in moral decision making.

PubMed

Botes, A

1998-03-01

The question to be addressed in this paper is: How can the ethics of justice and the ethics of care be used complementary to each other in ethical decision making within the health care team? Various arguments are presented that justify the reasons that the ethics of justice and the ethics of care should be used complementary to each other for effective ethical decision making within the health care team. The objective is to explore and describe the compatibility of the ethics of justice and the ethics of care from two perspectives: firstly an analysis of the characteristics of the two ethical theories, and secondly the scientific-philosophical viewpoints of these theories. The two theories are incompatible when viewed from these perspectives. For a probable solution to this incompatibility arguments are presented from the perspectives of reflection and virtue-based ethics.

Ethical reflection and psychotherapy.

PubMed

Vyskocilová, Jana; Prasko, Jan

2013-01-01

Theories of ethics and ethical reflection may be applied to both theory and practice in psychotherapy. There is a natural affinity between ethics and psychotherapy. Psychotherapy practice is concerned with human problems, dilemmas and emotions related to both one's own and other people's values. Ethics is also concerned with dilemmas in human thinking and with how these dilemmas reflect other individuals' values. Philosophical reflection itself is not a sufficient basis for the ethics of psychotherapy but it may aid in exploring attitudes related to psychotherapy, psychiatry and health care. PubMed, Web of Science and Scopus databases were searched for articles containing the keywords "psychotherapy", "ethics", "therapeutic relationship" and "supervision". The search was conducted by repeating the terms in various combinations without language or time restrictions. Also included were data from monographs cited in reviews. The resulting text is a review with conclusions concerning ethical aspects of psychotherapy. The ability to behave altruistically, sense for justice and reciprocity and mutual help are likely to be genetically determined as dispositions to be later developed by upbringing or to be formed or deformed by upbringing. Early experiences lead to formation of ethical attitudes which are internalized and then applied to both one's own and other people's behavior. Altruistic behavior has a strong impact on an individual's health and its acceptance may positively influence the pathophysiological mechanisms underlying numerous diseases. Ethical theory and reflection, however, may be applied to both theory and practice of psychotherapy in a conscious, targeted and thoughtful manner. In everyday practice, psychotherapists and organizations must necessarily deal with conscious conflicts between therapeutic possibilities, clients' wishes, their own as well as clients' ideas and the real world. Understanding one's own motives in therapy is one of the aims of a

Ethics rounds: An appreciated form of ethics support.

PubMed

Silén, Marit; Ramklint, Mia; Hansson, Mats G; Haglund, Kristina

2016-03-01

Ethics rounds are one way to support healthcare personnel in handling ethically difficult situations. A previous study in the present project showed that ethics rounds did not result in significant changes in perceptions of how ethical issues were handled, that is, in the ethical climate. However, there was anecdotal evidence that the ethics rounds were viewed as a positive experience and that they stimulated ethical reflection. The aim of this study was to gain a deeper understanding of how the ethics rounds were experienced and why the intervention in the form of ethics rounds did not succeed in improving the ethical climate for the staff. An exploratory and descriptive design with a qualitative approach was adopted, using individual interviews. A total of 11 healthcare personnel, working in two different psychiatry outpatient clinics and with experience of participating in ethics rounds, were interviewed. The study was based on informed consent and was approved by one of the Swedish Regional Ethical Review Boards. The participants were generally positive about the ethics rounds. They had experienced changes by participating in the ethics rounds in the form of being able to see things from different perspectives as well as by gaining insight into ethical issues. However, these changes had not affected daily work. A crucial question is whether or not increased reflection ability among the participants is a good enough outcome of ethics rounds and whether this result could have been measured in patient-related outcomes. Ethics rounds might foster cooperation among the staff and this, in turn, could influence patient care. By listening to others during ethics rounds, a person can learn to see things from a new angle. Participation in ethics rounds can also lead to better insight concerning ethical issues. © The Author(s) 2014.

Science and ethics of human immunodeficiency virus/acquired immunodeficiency syndrome controversies in Africa.

PubMed

Brewster, David

2011-09-01

The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in Africa has raised important ethical issues for both researchers and clinicians. The most notorious controversy has been related to the zidovudine (AZT) trials in Africa in the late 1990s, in which the control groups were given a placebo rather than an effective drug to prevent vertical transmission. This raised concerns in the sponsoring country about exploitation of subjects, injustice and an ethical double standard between donor countries and resource-poor settings. However, the real double standard is between clinical practice standards in Western versus African countries, which must be addressed as part of the increasing global inequity of wealth both between countries and also within countries. There are important limitations to ethical declarations, principles and guidelines on their own without contextual ethical reasoning. The focus on research ethics with the HIV epidemic has led to a relative neglect of ethical issues in clinical practice. Although the scientific advances in HIV/AIDS have changed the ethical issues since the 1990s, there has also been progress in the bioethics of HIV/AIDS in terms of ethical review capability by local committees as well as in exposure to ethical issues by clinicians and researchers in Africa. However, serious concerns remain about the overregulation of research by bureaucratic agencies which could discourage African research on specifically African health issues. There is also a need for African academic institutions and researchers to progressively improve their research capacity with the assistance of research funders and donor agencies. © 2011 The Author. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

[When is psychosis dangerous? Ethical, professional en juridical considerations concerning psychosis and coercion in Belgium].

PubMed

Verbrugghe, A; Nys, H; Vandenberghe, J

2008-01-01

In Belgium a patient can only be compulsorily admitted to a psychiatric hospital if he is a danger to himself or others (law concerning coercion in Belgium, 26/06/1990). To explore the relationship between psychosis and danger, and to analyse the various interpretations of the 'dangerousness' criterion in the context of psychotic disorders and the underlying ethical positions. We studied the literature by means of PubMed, PsycINFO, manuals and references and used the search terms: 'coercion', 'commitment of mentally ill', 'dangerous behaviour', and 'psychotic disorders'. results The correlation between psychosis and danger is limited but is strengthened by comorbid substance abuse and non-compliance. The clinical assessment of danger does not have a firm scientific basis. The underlying ethical position determines when danger is regarded as being serious enough to justify coercion. Danger is a problematical criterion for coercion. We propose a model that weighs up the likelihood of danger against the expected pros and contrasts of coercion and the extent to which the disorder can be treated. The fluid nature of the 'dangerousness' criterion and the principle of proportionality call for a more varied arsenal of coercive measures which are less drastic than compulsory admission.

Aristotle and Autism: Reconsidering a Radical Shift to Virtue Ethics in Engineering.

PubMed

Furey, Heidi

2017-04-01

Virtue-based approaches to engineering ethics have recently received considerable attention within the field of engineering education. Proponents of virtue ethics in engineering argue that the approach is practically and pedagogically superior to traditional approaches to engineering ethics, including the study of professional codes of ethics and normative theories of behavior. This paper argues that a virtue-based approach, as interpreted in the current literature, is neither practically or pedagogically effective for a significant subpopulation within engineering: engineers with high functioning autism spectrum disorder (ASD). Because the main argument for adopting a character-based approach is that it could be more successfully applied to engineering than traditional rule-based or algorithmic ethical approaches, this oversight is problematic for the proponents of the virtue-based view. Furthermore, without addressing these concerns, the wide adoption of a virtue-based approach to engineering ethics has the potential to isolate individuals with ASD and to devalue their contributions to moral practice. In the end, this paper gestures towards a way of incorporating important insights from virtue ethics in engineering that would be more inclusive of those with ASD.

Representation or reason: consulting the public on the ethics of health policy.

PubMed

Mullen, Caroline

2008-12-01

Consulting the public about the ethical approaches underlying health policies can seem an appealing means of addressing concerns about limited public participation in development of health policy. However ambiguity surrounds questions of whether, or how consultation can really contribute to more defensible decisions about ethical aspects of policy. This paper clarifies the role and limits of public consultation on ethics, beginning by separating different senses of defensibility in decisions on ethics. Defensibility of ethical decisions could be understood either in the sense of legitimacy in virtue of reflecting the opinions of the public whose interests are affected, or in the sense of being able to withstand and respond to challenges presented in ethical debate. The question then is whether there are forms of consultation which have the potential to realise more defensible decisions in either of these senses. Problems of adequately accounting for the views of those affected by policy decisions casts doubt on the plausibility of using consultation as a means of determining the opinions of the public. Consultation can have a role by bringing new ideas and challenges to debate, although it is uncertain whether this will increase the defensibility of any decision on ethics.

Ethical considerations: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

Biddison, Lee Daugherty; Berkowitz, Kenneth A; Courtney, Brooke; De Jong, Col Marla J; Devereaux, Asha V; Kissoon, Niranjan; Roxland, Beth E; Sprung, Charles L; Dichter, Jeffrey R; Christian, Michael D; Powell, Tia

2014-10-01

Mass critical care entails time-sensitive decisions and changes in the standard of care that it is possible to deliver. These circumstances increase provider uncertainty as well as patients' vulnerability and may, therefore, jeopardize disciplined, ethical decision-making. Planning for pandemics and disasters should incorporate ethics guidance to support providers who may otherwise make ad hoc patient care decisions that overstep ethical boundaries. This article provides consensus-developed suggestions about ethical challenges in caring for the critically ill or injured during pandemics or disasters. The suggestions in this article are important for all of those involved in any pandemic or disaster with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. We adapted the American College of Chest Physicians (CHEST) Guidelines Oversight Committee's methodology to develop suggestions. Twenty-four key questions were developed, and literature searches were conducted to identify evidence for suggestions. The detailed literature reviews produced 144 articles. Based on their expertise within this domain, panel members also supplemented the literature search with governmental publications, interdisciplinary workgroup consensus documents, and other information not retrieved through PubMed. The literature in this field is not suitable to support evidence-based recommendations. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. We report the suggestions that focus on five essential domains: triage and allocation, ethical concerns of patients and families, ethical responsibilities to providers, conduct of research, and international concerns. Ethics issues permeate virtually all aspects of pandemic and disaster response. We have addressed some of the most pressing issues, focusing on five essential domains: triage and allocation, ethical

Everyday Ethics: Reflections on Practice

ERIC Educational Resources Information Center

Rossman, Gretchen B.; Rallis, Sharon F.

2010-01-01

This introductory article frames the contributions for this issue on everyday ethics--moments that demand moral considerations and ethical choices that researchers encounter. We discuss concerns raised within the research community about the tendency to observe merely obligatory ethical procedures as outlined in Human Subjects Review regulations.…

Journalism Ethics: There Is a Difference between Law and Ethics.

ERIC Educational Resources Information Center

Hossom, Kathy

1998-01-01

Covers a session from the recent meetings of the Indiana High School Press Association (IHSPA). States that students discussed ethical decisions they face in their yearbooks and newspapers, such as handling death. Finds the biggest concern is "really covering the good and bad things in the school." Gives IHSPA's 10-point Code of Ethics.…

A systematic literature review on the ethics of palliative sedation: an update (2016).

PubMed

Henry, Blair

2016-09-01

Palliative sedation has been the subject of intensive debate since its first appearance in 1990. In a 2010 review of palliative sedation, the following areas were identified as lacking in consensus: inconsistent terminology, its use in nonphysical suffering, the ongoing experience of distress, and concern that the practice of palliative sedation may hasten death. This review looks at the literature over the past 6 years and provides an update on these outstanding concerns. Good clinical guidelines and policies are still required to address issues of emotional distress and waylay concerns that palliative sedation hastens death. The empirical evidence suggests some movement toward consensus on the practice of palliative sedation. However, a continued need exists for evidence-informed practice guidelines, education, and research to support the ethical practice of palliative sedation at the end of life. Until that time, clinicians are advised to adopt a framework or guideline that has been expert driven to ensure consistent and ethical use of palliative sedation at the end of life.

Ethical Issues and Practical Challenges in Suicide Research.

PubMed

Hom, Melanie A; Podlogar, Matthew C; Stanley, Ian H; Joiner, Thomas E

2017-03-01

Research with human subjects represents a critical avenue for suicide prevention efforts; however, such research is not without its ethical and practical challenges. Specifically, given the nature of research with individuals at elevated risk for suicide (e.g., increased concerns regarding participant safety, adverse events, liability, difficulties often arise during the institutional review board (IRB) evaluation and approval process. This paper aims to discuss IRB-related issues associated with suicide prevention research, including researcher and IRB panel member responsibilities, suicide risk assessment and management ethics and procedures, informed consent considerations, preparation of study protocols, and education and training. Points to consider and components to potentially include in an IRB application for suicide-related research are additionally provided. Literature relevant to ethics in suicide research and suicide risk assessment and management was reviewed and synthesized. Suicide research can be conducted in accordance with ethical principles while also furthering the science of suicide prevention. Despite the challenging nature of suicide prevention research, empirically informed solutions exist to address difficulties that may emerge in interfacing with IRBs. There remain areas for improvement in the IRB approval process that warrant further investigation and work.

Ethical issues with colorectal cancer screening-a systematic review.

PubMed

Hofmann, Bjørn

2017-06-01

Colorectal cancer (CRC) screening is widely recommended and implemented. However, sometimes CRC screening is not implemented despite good evidence, and some types of CRC screening are implemented despite lack of evidence. The objective of this article is to expose and elucidate relevant ethical issues in the literature on CRC screening that are important for open and transparent deliberation on CRC screening. An axiological question-based method is used for exposing and elucidating ethical issues relevant in HTA. A literature search in MEDLINE, Embase, PsycINFO, PubMed Bioethics subset, ISI Web of Knowledge, Bioethics Literature Database (BELIT), Ethics in Medicine (ETHMED), SIBIL Base dati di bioetica, LEWI Bibliographic Database on Ethics in the Sciences and Humanities, and EUROETHICS identified 870 references of which 114 were found relevant according to title and abstract. The content of the included papers were subject to ethical analysis to highlight the ethical issues, concerns, and arguments. A wide range of important ethical issues were identified. The main benefits are reduced relative CRC mortality rate, and potentially incidence rate, but there is no evidence of reduced absolute mortality rate. Potential harms are bleeding, perforation, false test results, overdetection, overdiagnosis, overtreatment (including unnecessary removal of polyps), and (rarely) death. Other important issues are related to autonomy and informed choice equity, justice, medicalization, and expanding disease. A series of important ethical issues have been identified and need to be addressed in open and transparent deliberation on CRC screening. © 2016 John Wiley & Sons, Ltd.

A survey of healthcare industry representatives' participation in surgery: some new ethical concerns.

PubMed

Bedard, Jeffrey; Moore, Crystal Dea; Shelton, Wayne

2014-01-01

To provide preliminary evidence of the types and amount of involvement by healthcare industry representatives (HCIRs) in surgery, as well as the ethical concerns of those representatives. A link to an anonymous, web-based survey was posted on several medical device boards of the website http://www. cafepharma.com. Additionally, members of two different medical device groups on LinkedIn were asked to participate. Respondents were self-identified HCIRs in the fields of orthopedics, cardiology, endoscopic devices, lasers, general surgery, ophthalmic surgery, oral surgery, anesthesia products, and urologic surgery. A total of 43 HCIRs replied to the survey over a period of one year: 35 men and eight women. Respondents reported attending an average of 184 surgeries in the prior year and had an average of 17 years as an HCIR and six years with their current employer. Of the respondents, 21 percent (nine of 43) had direct physical contact with a surgical team or patient during a surgery, and 88 percent (38 of 43) provided verbal instruction to a surgical team during a surgery. Additionally, 37 percent (16 of 43) had participated in a surgery in which they felt that their involvement was excessive, and 40 percent (17 of 43) had attended a surgery in which they questioned the competence of the surgeon. HCIRs play a significant role in surgery. Involvement that exceeds their defined role, however, can raise serious ethical and legal questions for surgeons and surgical teams. Surgical teams may at times be substituting the knowledge of the HCIR for their own competence with a medical device or instrument. In some cases, contact with the surgical team or patient may violate the guidelines not only of hospitals and medical device companies, but the law as well. Further study is required to determine if the patients involved have any knowledge or understanding of the role that an HCIR played in their surgery. Copyright 2014 The Journal of Clinical Ethics. All rights reserved.

Progression in Ethical Reasoning When Addressing Socio-scientific Issues in Biotechnology

NASA Astrophysics Data System (ADS)

Berne, Birgitta

2014-11-01

This article reports on the outcomes of an intervention in a Swedish school in which the author, a teacher-researcher, sought to develop students' (14-15 years old) ethical reasoning in science through the use of peer discussions about socio-scientific issues. Prior to the student discussions various prompts were used to highlight different aspects of the issues. In addition, students were given time to search for further information themselves. Analysis of students' written arguments, from the beginning of the intervention and afterwards, suggests that many students seem to be moving away from their use of everyday language towards using scientific concepts in their arguments. In addition, they moved from considering cloning and 'designer babies' solely in terms of the present to considering them in terms of the future. Furthermore, the students started to approach the issues in additional ways using not only consequentialism but also the approaches of virtue ethics, and rights and duties. Students' progression in ethical reasoning could be related to the characteristics of the interactions in peer discussions as students who critically and constructively argued with each other's ideas, and challenged each other's claims, made progress in more aspects of ethical reasoning than students merely using cumulative talk. As such, the work provides valuable indications for the importance of introducing peer discussions and debates about SSIs in connection to biotechnology into the teaching of science in schools.

Exposure ethics: does HIV pre-exposure prophylaxis raise ethical problems for the health care provider and policy maker?

PubMed

Venter, Francois; Allais, Lucy; Richter, Marlise

2014-07-01

The last few years have seen dramatic progress in the development of HIV pre-exposure prophylaxis (PrEP). These developments have been met by ethical concerns. HIV interventions are often thought to be ethically difficult. In a context which includes disagreements over human rights, controversies over testing policies, and questions about sexual morality and individual responsibility, PrEP has been seen as an ethically complex intervention. We argue that this is mistaken, and that in fact, PrEP does not raise new ethical concerns. Some of the questions posed by PrEP are not specific to HIV prophylaxis, but simply standard public health considerations about resource allocation and striking a balance between individual benefit and public good. We consider sexual disinhibition in the context of private prescriptions, and conclude that only unjustified AIDS-exceptionalism or inappropriate moralism about sex supports thinking that PrEP raises new ethical problems. This negative conclusion is significant in a context where supposed ethical concerns about PrEP have been raised, and in the context of HIV exceptionalism. © 2013 John Wiley & Sons Ltd.

Survey of ethical issues reported by Indian medical students: basis for design of a new curriculum.

PubMed

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.

This "Ethical Trap" Is for Roboticists, Not Robots: On the Issue of Artificial Agent Ethical Decision-Making.

PubMed

Miller, Keith W; Wolf, Marty J; Grodzinsky, Frances

2017-04-01

In this paper we address the question of when a researcher is justified in describing his or her artificial agent as demonstrating ethical decision-making. The paper is motivated by the amount of research being done that attempts to imbue artificial agents with expertise in ethical decision-making. It seems clear that computing systems make decisions, in that they make choices between different options; and there is scholarship in philosophy that addresses the distinction between ethical decision-making and general decision-making. Essentially, the qualitative difference between ethical decisions and general decisions is that ethical decisions must be part of the process of developing ethical expertise within an agent. We use this distinction in examining publicity surrounding a particular experiment in which a simulated robot attempted to safeguard simulated humans from falling into a hole. We conclude that any suggestions that this simulated robot was making ethical decisions were misleading.

“Reality Surgery” — A Research Ethics Perspective on the Live Broadcast of Surgical Procedures

PubMed Central

Williams, Judson B.; Mathews, Robin; D'Amico, Thomas A.

2013-01-01

In recent years, the live broadcasting of medical and surgical procedures has gained worldwide popularity. While the practice has appropriately been met with concerns for patient safety and privacy, many physicians tout the merits of real time viewing as a form of investigation, accelerating the process leading to adoption or abolition of newer techniques or technologies. This view introduces a new series of ethical considerations that need to be addressed. As such, this article considers, from a research ethics perspective, the use of live surgical procedure broadcast for investigative purposes. PMID:21292217

Will Virtue Ethics Improve Ethical Conduct in Multicultural Settings and Interactions?

ERIC Educational Resources Information Center

Vasquez, Melba J. T.

1996-01-01

Responds to Meara et al.'s (1996) article concerning virtue ethics on the issue of applying ethical standards as a means of responding sensitively to minority groups. Questions the definition of community and reliance on community values as a guiding principle, and suggests that psychologists generally choose theoretical orientations based on…

Research Ethics and Ethical Research: Some Observations from the Global South

ERIC Educational Resources Information Center

Zhang, J. J.

2017-01-01

This paper aims to achieve two objectives. Firstly, it elicits some of the concerns for universal research ethics. It is argued that ethical codes are never universal; they are geographically sensitive. As such, it is important to "develop authentic individual responses to potentially unique circumstances". Secondly, in going beyond a…

An ethical exploration of barriers to research on controlled drugs

PubMed Central

ANDREAE, Michael H; RHODES, Evelyn; BOURGOISE, Tylor; CARTER, George; WHITE, Robert S.; INDYK, Debbie; SACKS, Henry; RHODES, Rosamond

2016-01-01

We examine the ethical, social and regulatory barriers that may hamper research on therapeutic potential of certain controversial controlled substances like marijuana, heroin or ketamine. Hazards for individuals and society, and their potential adverse effects on communities may be good reasons for limiting access and justify careful monitoring of certain substances. Overly strict regulations, fear of legal consequences, stigma associated with abuse and populations using illicit drugs, and lack of funding may hinder research on their considerable therapeutic potential. We review the surprisingly sparse literature and address the particular ethical concerns of undue inducement, informed consent, risk to participants, researchers and institutions, justice and liberty germane to the research with illicit and addictive substances. We debate the disparate research stakeholder perspectives and why they are likely to be infected with bias. We propose an empirical research agenda to provide a more evidentiary basis for ethical reasoning. PMID:26982922

Followup Audit: DLA Officials Took Appropriate Actions to Address Concerns With Repair Parts for the High Mobility Multipurpose Wheeled Vehicle

DTIC Science & Technology

2016-04-29

Followup Audit : DLA Officials Took Appropriate Actions to Address Concerns With Repair Parts for the High Mobility Multipurpose Wheeled Vehicle A P R I L...Results in Brief Followup Audit : DLA Officials Took Appropriate Actions to Address Concerns With Repair Parts for the High Mobility Multipurpose Wheeled...and Maritime Paid Too Much for High Mobility Multipurpose Wheeled Vehicle Repair Parts,” (HMMWV) was issued on April 4, 2014. The audit

A Selected Review of the Underpinnings of Ethics for Human Performance Technology Professionals--Part One: Key Ethical Theories and Research.

ERIC Educational Resources Information Center

Dean, Peter J.

1993-01-01

Provides a review of the key ethical theories and relevant empirical research relating to the practice of human performance technology. Topics addressed include ethics, morals, business ethics, ethics officers, empiricism versus normative ethical theory, consequentialism, utilitarianism, nonconsequentialism, Kohlberg model of cognitive moral…

Gaps, conflicts, and consensus in the ethics statements of professional associations, medical groups, and health plans

PubMed Central

Berkman, N; Wynia, M; Churchill, L

2004-01-01

Background: Patients today interact with physicians, physician groups, and health plans, each of which may follow distinct ethical guidelines. Method: We systematically compared physician codes of ethics with ethics policies at physician group practices and health plans, using the 1998–99 policies of 38 organisations—18 medical associations (associations), nine physician group practices (groups), and 12 health plans (plans)—selected using random and stratified purposive sampling. A clinician and a social scientist independently abstracted each document, using a 397-item health care ethics taxonomy; a reconciled abstraction form was used for analysis. This study focuses on ethics policies regarding professional obligation towards patients, resource allocation, and care for the vulnerable in society. Results: A majority in all three groups mention "fiduciary obligations" of one sort or another, but associations generally address physician/patient relations but not health plan obligations, while plans rarely endorse physicians' obligations of advocacy, beneficence, and non-maleficence. Except for occasional mentions of cost effectiveness or efficiency, ethical considerations in resource allocation rarely arise in the ethics policies of all three organisational types. Very few associations, groups, or plans specifically endorse obligations to vulnerable populations. Conclusions: With some important exceptions, we found that the ethics policies of associations, groups, and plans are narrowly focused and often ignore important ethical concerns for society, such as resource allocation and care for vulnerable populations. More collaborative work is needed to build integrated sets of ethical standards that address the aims and responsibilities of the major stakeholders in health care delivery. PMID:15289536

Ethical issues in the export, storage and reuse of human biological samples in biomedical research: perspectives of key stakeholders in Ghana and Kenya.

PubMed

Tindana, Paulina; Molyneux, Catherine S; Bull, Susan; Parker, Michael

2014-10-18

For many decades, access to human biological samples, such as cells, tissues, organs, blood, and sub-cellular materials such as DNA, for use in biomedical research, has been central in understanding the nature and transmission of diseases across the globe. However, the limitations of current ethical and regulatory frameworks in sub-Saharan Africa to govern the collection, export, storage and reuse of these samples have resulted in inconsistencies in practice and a number of ethical concerns for sample donors, researchers and research ethics committees. This paper examines stakeholders' perspectives of and responses to the ethical issues arising from these research practices. We employed a qualitative strategy of inquiry for this research including in-depth interviews and focus group discussions with key research stakeholders in Kenya (Nairobi and Kilifi), and Ghana (Accra and Navrongo). The stakeholders interviewed emphasised the compelling scientific importance of sample export, storage and reuse, and acknowledged the existence of some structures governing these research practices, but they also highlighted the pressing need for a number of practical ethical concerns to be addressed in order to ensure high standards of practice and to maintain public confidence in international research collaborations. These concerns relate to obtaining culturally appropriate consent for sample export and reuse, understanding cultural sensitivities around the use of blood samples, facilitating a degree of local control of samples and sustainable scientific capacity building. Drawing on these findings and existing literature, we argue that the ethical issues arising in practice need to be understood in the context of the interactions between host research institutions and local communities and between collaborating institutions. We propose a set of 'key points-to-consider' for research institutions, ethics committees and funding agencies to address these issues.

Approaches to Ethics in International Business Education.

ERIC Educational Resources Information Center

Iyer, Gopalkrishnan R.

1999-01-01

Identifies major issues in international business ethics (such as cultural relativism and ethical imperialism) that should be addressed when incorporating ethics in international business education. Also discusses instructional approaches, including alternative ways of thinking about morality, philosophy versus practice, the ethical agent, and…

Ethic's Askew: A Case Study of Ethics in an Educational Environment

ERIC Educational Resources Information Center

Shurden, Susan; Santandreu, Juan; Shurden, Mike

2010-01-01

For a formal definition of ethics, Webster's New World Dictionary (1995) defines the term as "the study of standards of conduct and moral judgment". Ethics is important to individuals because we are concerned with what leaders do and who they are--their conduct and character. "Conduct" is a word that implies behavior. Behavior…

Codes of medical ethics: traditional foundations and contemporary practice.

PubMed

Sohl, P; Bassford, H A

1986-01-01

The Hippocratic Coprus recognized the interaction of 'business' and patient-health moral considerations, and urged that the former be subordinated to the latter. During the 1800s with the growth of complexity in both scientific knowledge and the organization of health services, the medical ethical codes addressed themselves to elaborate rules of conduct to be followed by the members of the newly emerging national medical associations. After World War II the World Medical Association was established as an international forum where national medical associations could debate the ethical problems presented by modern medicine. The International Code of Medical ethics and the Declaration of Geneva were written as 20th century restatements of the medical profession's commitment to the sovereignty of the patient-care norm. Many ethical statements have been issued by the World Medical Association in the past 35 years; they show the variety and difficulties of contemporary medical practice. The newest revisions were approved by the General Assembly of the World Medical Association in Venice, Italy October 1983. Their content is examined and concern is voiced about the danger of falling into cultural relativism when questions about the methods of financing medical services are the subject of an ethical declaration which is arrived at by consensus in the W.M.A.

Another look at the legal and ethical consequences of pharmacological memory dampening: the case of sexual assault.

PubMed

Chandler, Jennifer A; Mogyoros, Alexandra; Rubio, Tristana Martin; Racine, Eric

2013-01-01

Research on the use of propranolol as a pharmacological memory dampening treatment for post-traumatic stress disorder is continuing and justifies a second look at the legal and ethical issues raised in the past. We summarize the general ethical and legal issues raised in the literature so far, and we select two for in-depth reconsideration. We address the concern that a traumatized witness may be less effective in a prosecution emerging from the traumatic event after memory dampening treatment. We analyze this issue in relation to sexual assault, where the suggestion that corroborating evidence may remedy any memory defects is less likely to be helpful. We also consider the clinical ethical question about a physician's obligation to discuss potential legal consequences of memory dampening treatment. We conclude that this latter question reflects a general problem related to novel medical treatments where the broader socio-legal consequences may be poorly understood, and suggest that issues of this sort could usefully be addressed through the promulgation of practice guidelines. © 2013 American Society of Law, Medicine & Ethics, Inc.

Ethical considerations and potential threats to validity for three methods commonly used to collect geographic information in studies among people who use drugs.

PubMed

Rudolph, Abby E; Bazzi, Angela Robertson; Fish, Sue

2016-10-01

Analyses with geographic data can be used to identify "hot spots" and "health service deserts", examine associations between proximity to services and their use, and link contextual factors with individual-level data to better understand how environmental factors influence behaviors. Technological advancements in methods for collecting this information can improve the accuracy of contextually-relevant information; however, they have outpaced the development of ethical standards and guidance, particularly for research involving populations engaging in illicit/stigmatized behaviors. Thematic analysis identified ethical considerations for collecting geographic data using different methods and the extent to which these concerns could influence study compliance and data validity. In-depth interviews with 15 Baltimore residents (6 recruited via flyers and 9 via peer-referral) reporting recent drug use explored comfort with and ethics of three methods for collecting geographic information: (1) surveys collecting self-reported addresses/cross-streets, (2) surveys using web-based maps to find/confirm locations, and (3) geographical momentary assessments (GMA), which collect spatiotemporally referenced behavioral data. Survey methods for collecting geographic data (i.e., addresses/cross-streets and web-based maps) were generally acceptable; however, participants raised confidentiality concerns regarding exact addresses for illicit/stigmatized behaviors. Concerns specific to GMA included burden of carrying/safeguarding phones and responding to survey prompts, confidentiality, discomfort with being tracked, and noncompliance with study procedures. Overall, many felt that confidentiality concerns could influence the accuracy of location information collected for sensitive behaviors and study compliance. Concerns raised by participants could result in differential study participation and/or study compliance and questionable accuracy/validity of location data for sensitive

Inclusion of ethical issues in dementia guidelines: a thematic text analysis.

PubMed

Knüppel, Hannes; Mertz, Marcel; Schmidhuber, Martina; Neitzke, Gerald; Strech, Daniel

2013-08-01

Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care. To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained. Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors

Factors influencing African-American mothers' concerns about immunization safety: a summary of focus group findings.

PubMed Central

Shui, Irene; Kennedy, Allison; Wooten, Karen; Schwartz, Benjamin; Gust, Deborah

2005-01-01

OBJECTIVE: To examine the vaccine safety concerns of African-American mothers who, despite concerns, have their children immunized. METHODS: Six focus groups of Atlanta-area African-American mothers who were very concerned about vaccine safety but whose children were fully vaccinated were conducted. RESULTS: Major factors influencing participants' concerns about immunizations included: lack of information and mistrust of the medical community and government. Factors that convinced parents to have their child immunized despite their concerns included social norms and/or laws supporting immunization and fear of the consequences of not immunizing. Suggestions given to reduce concerns included improving available information that addressed their concerns and provider-patient communication. CONCLUSIONS: Addressing mothers' concerns about immunization is important both from an ethical perspective, in assuring that they are fully informed of the risks and benefits of immunizations, as well as from a practical one, in reducing the possibility that they will decide not to immunize their child. Changes in the childhood immunization process should be made to reduce parental concern about vaccine safety. Some changes that may be considered include improved provider communication about immunizations and additional tailored information about the necessity and safety of vaccines. PMID:15926642

Food Culture, Preferences and Ethics in Dysphagia Management.

PubMed

Kenny, Belinda

2015-11-01

Adults with dysphagia experience difficulties swallowing food and fluids with potentially harmful health and psychosocial consequences. Speech pathologists who manage patients with dysphagia are frequently required to address ethical issues when patients' food culture and/ or preferences are inconsistent with recommended diets. These issues incorporate complex links between food, identity and social participation. A composite case has been developed to reflect ethical issues identified by practising speech pathologists for the purposes of illustrating ethical concerns in dysphagia management. The case examines a speech pathologist's role in supporting patient autonomy when patients and carers express different goals and values. The case presents a 68-year-old man of Australian/Italian heritage with severe swallowing impairment and strong values attached to food preferences. The case is examined through application of the dysphagia algorithm, a tool for shared decision-making when patients refuse dietary modifications. Case analysis revealed the benefits and challenges of shared decision-making processes in dysphagia management. Four health professional skills and attributes were identified as synonymous with shared decision making: communication, imagination, courage and reflection. © 2015 John Wiley & Sons Ltd.

Ethical Implications of Social Stigma Associated with the Promotion and Use of Pre-Exposure Prophylaxis for HIV Prevention.

PubMed

Herron, Patrick D

2016-04-01

Identifying sources of and eliminating social stigma associated with the promotion and use of pre-exposure prophylaxis (PrEP) for the prevention of sexually acquired HIV infection among men who have sex with men (MSM) is both a moral imperative and necessary requirement to ensure that public health objectives of HIV prevention can be met. This article will examine and address ethical concerns and criticisms regarding the use of PrEP, barriers to its promotion, and use among MSM and examine the types of social stigma associated with PrEP. An ethical justification for both healthcare and LGBT communities to address and overcome social stigma regarding the use of PrEP among MSM is offered.

Ethical Challenges in Promoting the Implementation of Preventive Interventions: Report of the SPR Task Force.

PubMed

Leadbeater, Bonnie J; Dishion, Tom; Sandler, Irwin; Bradshaw, Catherine P; Dodge, Kenneth; Gottfredson, Denise; Graham, Phillip W; Lindstrom Johnson, Sarah; Maldonado-Molina, Mildred M; Mauricio, Anne M; Smith, Emilie Phillips

2018-06-23

Prevention science researchers and practitioners are increasingly engaged in a wide range of activities and roles to promote evidence-based prevention practices in the community. Ethical concerns invariably arise in these activities and roles that may not be explicitly addressed by university or professional guidelines for ethical conduct. In 2015, the Society for Prevention Research (SPR) Board of Directors commissioned Irwin Sandler and Tom Dishion to organize a series of roundtables and establish a task force to identify salient ethical issues encountered by prevention scientists and community-based practitioners as they collaborate to implement evidence-based prevention practices. This article documents the process and findings of the SPR Ethics Task Force and aims to inform continued efforts to articulate ethical practice. Specifically, the SPR membership and task force identified prevention activities that commonly stemmed from implementation and scale-up efforts. This article presents examples that illustrate typical ethical dilemmas. We present principles and concepts that can be used to frame the discussion of ethical concerns that may be encountered in implementation and scale-up efforts. We summarize value statements that stemmed from our discussion. We also conclude that the field of prevention science in general would benefit from standards and guidelines to promote ethical behavior and social justice in the process of implementing evidence-based prevention practices in community settings. It is our hope that this article serves as an educational resource for students, investigators, and Human Subjects Review Board members regarding some of the complexity of issues of fairness, equality, diversity, and personal rights for implementation of preventive interventions.

Just sustainability? Sustainability and social justice in professional codes of ethics for engineers.

PubMed

Brauer, Cletus S

2013-09-01

Should environmental, social, and economic sustainability be of primary concern to engineers? Should social justice be among these concerns? Although the deterioration of our natural environment and the increase in social injustices are among today's most pressing and important issues, engineering codes of ethics and their paramountcy clause, which contains those values most important to engineering and to what it means to be an engineer, do not yet put either concept on a par with the safety, health, and welfare of the public. This paper addresses a recent proposal by Michelfelder and Jones (2011) to include sustainability in the paramountcy clause as a way of rectifying the current disregard for social justice issues in the engineering codes. That proposal builds on a certain notion of sustainability that includes social justice as one of its dimensions and claims that social justice is a necessary condition for sustainability, not vice versa. The relationship between these concepts is discussed, and the original proposal is rejected. Drawing on insights developed throughout the paper, some suggestions are made as to how one should address the different requirements that theory and practice demand of the value taxonomy of professional codes of ethics.

New Hampshire critical access hospitals: CEOs' report on ethical challenges.

PubMed

Nelson, William; Rosenberg, Marie-Claire; Weiss, Julie; Goodrich, Martha

2009-01-01

Research into the importance of organizational healthcare ethics has increasingly appeared in healthcare publications. However, to date, few published studies have examined ethical issues from the perspective of healthcare executives, and no empirical study has addressed organizational ethics with an explicit focus on rural hospitals. For our study, we sought to identify the frequency of ethical conflicts occurring within 12 general categories (domains) of administrative activities. Also, we wanted to determine what ethics resources are currently available and whether additional resources would be helpful. We conducted a structured telephone interview of all 13 chief executive officers (CEOs) of critical access hospitals in New Hampshire. All the CEOs in the study indicated that they encountered ethical conflicts. On average, the three most frequently noted domains were organizational-professional staff relations, reimbursement, and clinical care. All CEOs indicated they would like to have additional ethics resources to address these conflicts. This study verified that CEOs encounter a broad spectrum of ethical conflicts and need additional ethics resources to address them. Because this study used a small sample of CEOs and represented only one New England state, further ethics-related research in rural healthcare facilities is warranted. Follow-up study would allow for (1) a higher level of generalization of the findings, (2) clarity regarding specific ethical dilemmas that rural healthcare executives encounter, and (3) an assessment of ethics resources and training that healthcare executives need to address the ethical conflicts.

Ethical concerns for maternal surrogacy and reproductive tourism.

PubMed

Deonandan, Raywat; Green, Samantha; van Beinum, Amanda

2012-12-01

Reproductive medical tourism is by some accounts a multibillion dollar industry globally. The seeking by clients in high income nations of surrogate mothers in low income nations, particularly India, presents a set of largely unexamined ethical challenges. In this paper, eight such challenges are elucidated to spur discussion and eventual policy development towards protecting the rights and health of vulnerable women of the Global South.

The Aesthetics of Ethical Virtues and the Ethical Virtues of Aesthetics

ERIC Educational Resources Information Center

Garrison, James W.

2004-01-01

My paper concentrates on that small part of Dewey's ethical theory that deals with the personal virtues of character. Even more narrowly, I focus on a single section of Dewey's "Ethics" titled "The Conception of Virtue in Reflective Morality." I do so because my primary concern here is not so much with the virtues Dewey discusses, important as…

Antisocial personality disorder: diagnostic, ethical and treatment issues.

PubMed

Kaylor, L

1999-01-01

Antisocial personality disorder (ASPD) is a complex disorder that creates a diagnostic, ethical, and treatment dilemma for mental health professionals. Psychosocial, biological, and cultural influences play a role in the development of ASPD. People with ASPD often had harsh early childhoods that impaired their ability to trust in adulthood. Research supports intriguing biological links, but it remains unclear if biological differences are the cause or the effect of ASPD. Individualism, patriarchy, and widespread media violence create the cultural context for the development of ASPD. ASPD is difficult to clinically diagnose and treat, and there is controversy concerning whether ASPD is a psychiatric or a legal-ethical problem. However, the management of ASPD often falls to mental health services. This article addresses treatment and primary prevention of ASPD in a way that is relevant to mental health practice.

Response to article titled "US-funded measurements of cervical cancer death rates in India: scientific and ethical concerns" by Eric J Suba.

PubMed

Sankaranarayanan, Rengaswamy; Nene, Bhagwan M; Shastri, Surendra; Esmy, Pullikotil Ekkuru; Rajkumar, Rajamanickam; Muwonge, Richard; Swaminathan, Rajaraman; Malvi, Sylla G; Kane, Shubada; Desai, Sangeeta; Kelkar, Rohini; Hingmire, Sanjay; Jayant, Kasturi

2014-01-01

Dr Eric Suba has been distorting facts and persistently disseminating biased and misleading views and statements regarding our studies over the past several years. His article in the Indian Journal of Medical Ethics fails to mention the facts that seem unfavourable to his arguments, and the ethical concerns are unsubstantiated by the evidence. In this context, we present the following clarifications for the attention of your readers, notably with regard to: (i) the study design and inclusion of a control group; (ii) the informed consent of the women participating in the study; (iii) the conformity with international ethical standards and guidelines, and (iv) the provision of screening to women in the control arm of the studies. We also highlight the benefits that are flowing from this research and the risk that misinformation may further delay access for women to life-saving cervical cancer screening.

Neurofunctional correlates of ethical, food-related decision-making.

PubMed

Cherry, J Bradley C; Bruce, Jared M; Lusk, Jayson L; Crespi, John M; Lim, Seung-Lark; Bruce, Amanda S

2015-01-01

For consumers today, the perceived ethicality of a food's production method can be as important a purchasing consideration as its price. Still, few studies have examined how, neurofunctionally, consumers are making ethical, food-related decisions. We examined how consumers' ethical concern about a food's production method may relate to how, neurofunctionally, they make decisions whether to purchase that food. Forty-six participants completed a measure of the extent to which they took ethical concern into consideration when making food-related decisions. They then underwent a series of functional magnetic resonance imaging (fMRI) scans while performing a food-related decision-making (FRDM) task. During this task, they made 56 decisions whether to purchase a food based on either its price (i.e., high or low, the "price condition") or production method (i.e., with or without the use of cages, the "production method condition"), but not both. For 23 randomly selected participants, we performed an exploratory, whole-brain correlation between ethical concern and differential neurofunctional activity in the price and production method conditions. Ethical concern correlated negatively and significantly with differential neurofunctional activity in the left dorsolateral prefrontal cortex (dlPFC). For the remaining 23 participants, we performed a confirmatory, region-of-interest (ROI) correlation between the same variables, using an 8-mm3 volume situated in the left dlPFC. Again, the variables correlated negatively and significantly. This suggests, when making ethical, food-related decisions, the more consumers take ethical concern into consideration, the less they may rely on neurofunctional activity in the left dlPFC, possibly because making these decisions is more routine for them, and therefore a more perfunctory process requiring fewer cognitive resources.

Fast, cheap, and out of control? Speculations and ethical concerns in the conduct of outsourced clinical trials in India.

PubMed

Kamat, Vinay R

2014-03-01

The globalization of biopharmaceutical clinical trials and their offshore outsourcing, from the West to low and middle-income countries, has come under increasing scrutiny from academic scholars, practitioners, regulatory agencies and the media. This article reports the results of a study conducted in Bangalore and Hyderabad between 2007 and 2009, to elicit the perspectives of stakeholders, concerning media representations of their work and the ethical issues that emanate from their engagement in the clinical trials enterprise. In acknowledging the inherently problematic nature of the outsourcing of clinical trials to low income countries, I argue that the practice of not prioritizing research on diseases that are most prevalent among communities, from which subjects are recruited, demands a coordinated and sustained critique. I propose that the critical discourse on the outsourcing of clinical trials should not only emphasize the perils of this practice, but also address some broader issues of equity and distributive justice that determine people's access to basic health care in low income countries. Close attention to the specific context of clinical trials in an increasingly neoliberal medical and health environment in emerging economies such as India can provide critical insights into the on-the-ground complexities and challenges of outsourced global clinical trials. Copyright © 2013 Elsevier Ltd. All rights reserved.

Addressing disparities and achieving equity: cultural competence, ethics, and health-care transformation.

PubMed

Betancourt, Joseph R; Corbett, James; Bondaryk, Matthew R

2014-01-01

The passage of health-care reform and current efforts in payment reform signal the beginning of a significant transformation of the US health-care system. An entire new set of structures is being developed to facilitate increased access to care that is cost-effective and of high quality. As described in The Institute of Medicine report "Crossing the Quality Chasm," our nation is charting a path toward quality health care that aims to be safe, efficient, effective, timely, patient-centered, and equitable. As our health-care system rapidly undergoes dramatic transformation, several truths-and challenges-remain. First, racial and ethnic disparities in health care persist and are a clear sign of inequality in quality. Second, although the root causes for these disparities are complex, there exists a well-developed set of evidence-based approaches to address them; among these is improving the cultural competence of health-care providers and the health-care system. Third, as part of our care redesign, we must assure that we are prepared to meet the ethical challenges ahead and reassert the importance of equity, fairness, and caring as key building blocks of a new care delivery system. As we move ahead, it is critical to assure that our health-care system is culturally competent and has the capacity to deliver high-quality care for all, while eliminating disparities and assuring equity. Disparities are unjust, unethical, costly, and unacceptable-and integrating strategies to achieve equity as part of our health-care system's transformation will give us an incredible opportunity to comprehensively address them.

Exploring Ethics with Contemporary Communications

ERIC Educational Resources Information Center

Webb, Joyce G.

2015-01-01

This paper addresses the way in which we should go about introducing ethics into the study of our interpersonal relations in the hope of formulating a foundation upon which to base our theories and analyze our behavior. We should ask ourselves whether there should be different criteria for interpersonal ethics than for ethics in other areas of…

[Ethical and legal issues concerning renal replacement therapy withdrawal or withholding].

PubMed

Radziszewski, Andrzej; Stompór, Tomasz; Gajda, Mariusz; Sułowicz, Władysław

2006-01-01

Rapid and dynamic increase of the number of patients that need different forms of renal replacement therapy can be noticed in the developed countries. This increase is associated with increased number of patients with 'diseases of modern civilization', such as diabetes and hypertension, which lead to kidney complications (e.g. diabetic and hypertensive nephropathy). Improved long-term care (especially diabetic and cardiologic) allows these patients to survive longer and to reach the stage of end-stage renal disease. This leads to increasing age and morbidity of patients treated with dialysis. In many cases, due to extremely advanced level of co-morbidity patients on dialysis are exposed to extreme level of suffering and unacceptably low quality of life. Persistent continuing of renal replacement therapy under such circumstances (with no hope for recovery or improvement) raises also some economical issues, especially in the context of permanent crisis and shortage of resources in health systems of most countries in the world. In this review the current practice concerning withdrawal or withholding of renal replacement therapy as well as some legal and ethical issues of this practice are discussed.

"Reality surgery"--a research ethics perspective on the live broadcast of surgical procedures.

PubMed

Williams, Judson B; Mathews, Robin; D'Amico, Thomas A

2011-01-01

In recent years, the live broadcasting of medical and surgical procedures has gained worldwide popularity. While the practice has appropriately been met with concerns for patient safety and privacy, many physicians tout the merits of real time viewing as a form of investigation, accelerating the process leading to adoption or abolition of newer techniques or technologies. This view introduces a new series of ethical considerations that need to be addressed. As such, this article considers, from a research ethics perspective, the use of live surgical procedure broadcast for investigative purposes. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Organs and organisations: Situating ethics in organ donation after circulatory death in the UK.

PubMed

Cooper, Jessie

2018-05-25

Controlled organ donation after circulatory death (DCD) has recently been revived in the UK, as part of attempts to increase organ donation rates. The re-introduction of DCD has subsequently become the focus of bioethical controversy, since it necessitates intervening in the care of dying patients to obtain quality donor organs. Transplant policy responses to these concerns have generated new legal and ethical guidelines to address uncertainties around DCD, producing claims that the UK has overcome' the ethical challenge of DCD. In contrast, by drawing on Lynch's call to 'respecify' ethics, this paper argues that ethics in DCD cannot be reduced to abstract directives for practice, but, instead, are composed and dealt with as an organisational problem. To do this, I utilise data from an ethnographic study examining the production of the 'minority ethnic organ donor' within UK organ donation settings; in particular, the data pertains to a case hospital which was in the process of developing a DCD programme during the period of fieldwork. Findings show that the ethics of DCD are encountered as practical sets of problems, constructed in relation to particular institutional locales. I describe how these issues are worked-around by creating conditions to make DCD organisationally possible, and through the animation of standard procedures into acceptable forms of practice. I argue that ethics in DCD go far beyond normative bioethical principles, to encompass concerns around: the reputation of hospital Trusts, public perceptions of organ donation, the welfare of potential donor families, and challenges to the work of health professionals caring for dying patients. The paper enriches understanding of ethics in science and medicine by showing how ethics are assembled and negotiated as a practical-organisational concern, and calls for further examination of how DCD gets constructed as a potential problem and is made to happen in practice. Crown Copyright © 2018. Published by

An Insufferable Business: Ethics, Nonhuman Animals and Biomedical Experiments.

PubMed

Peggs, Kay

2015-07-22

Each year millions of nonhuman animals suffer in biomedical experiments for human health benefits. Clinical ethics demand that nonhuman animals are used in the development of pharmaceuticals and vaccines. Nonhuman animals are also used for fundamental biomedical research. Biomedical research that uses nonhuman animals is big business but the financial gains are generally occluded. This paper explores how such research generates profits and gains for those associated with the industry. Research establishments, scientists, laboratories, companies that sell nonhuman animal subjects, that supply equipment for the research, and corporations that market the resulting products are among those that benefit financially. Given the complex articulation of ethical codes, enormous corporate profits that are secured and personal returns that are made, the accepted moral legitimacy of such experiments is compromised. In order to address this, within the confines of the moral orthodoxy, more could to be done to ensure transparency and to extricate the vested financial interests from the human health benefits. But such a determination would not address the fundamental issues that should be at the heart of human actions in respect of the nonhuman animals who are used in experiments. The paper concludes with such an address by calling for an end to the denigration of nonhuman animals as experimental subjects who can be used as commodities for profit-maximisation and as tools in experiments for human health benefits, and the implementation of a more inclusive ethic that is informed by universal concern about the suffering of and compassion for all oppressed beings.

The ethics curriculum for doctor of nursing practice programs.

PubMed

Peirce, Anne Griswold; Smith, Jennifer A

2008-01-01

Ethical questions dealt with by nurses who have Doctor of Nursing Practice (DNP) degrees include traditional bioethical questions, but also business and legal ethics. Doctorally prepared nurses are increasingly in positions to make ethical decisions rather than to respond to decisions made by others. The traditional master's-degree advanced practice nursing curriculum does not address the extended expertise and decision-making skills needed by DNP practitioners as they face these new types of ethical dilemmas. We propose that a curricular framework that addresses clinical, research, business, and legal ethics is needed by all DNP students.

Nurses' contributions to the resolution of ethical dilemmas in practice.

PubMed

Barlow, Nichola Ann; Hargreaves, Janet; Gillibrand, Warren P

2018-03-01

Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification. Participants and context: Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis. Ethical considerations: Ethical approval was obtained from the local National Research Ethics Committee. Four major themes emerged: 'best for the patient', 'accountability', 'collaboration and conflict' and 'concern for others'. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas. Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing

Ethics, big data and computing in epidemiology and public health.

PubMed

Salerno, Jennifer; Knoppers, Bartha M; Lee, Lisa M; Hlaing, WayWay M; Goodman, Kenneth W

2017-05-01

This article reflects on the activities of the Ethics Committee of the American College of Epidemiology (ACE). Members of the Ethics Committee identified an opportunity to elaborate on knowledge gained since the inception of the original Ethics Guidelines published by the ACE Ethics and Standards of Practice Committee in 2000. The ACE Ethics Committee presented a symposium session at the 2016 Epidemiology Congress of the Americas in Miami on the evolving complexities of ethics and epidemiology as it pertains to "big data." This article presents a summary and further discussion of that symposium session. Three topic areas were presented: the policy implications of big data and computing, the fallacy of "secondary" data sources, and the duty of citizens to contribute to big data. A balanced perspective is needed that provides safeguards for individuals but also furthers research to improve population health. Our in-depth review offers next steps for teaching of ethics and epidemiology, as well as for epidemiological research, public health practice, and health policy. To address contemporary topics in the area of ethics and epidemiology, the Ethics Committee hosted a symposium session on the timely topic of big data. Technological advancements in clinical medicine and genetic epidemiology research coupled with rapid advancements in data networks, storage, and computation at a lower cost are resulting in the growth of huge data repositories. Big data increases concerns about data integrity; informed consent; protection of individual privacy, confidentiality, and harm; data reidentification; and the reporting of faulty inferences. Copyright © 2017 Elsevier Inc. All rights reserved.

The nature and ethics of natural experiments.

PubMed

Dawson, Angus; Sim, Julius

2015-10-01

Natural experiments are an important methodology often used to answer research questions that would, otherwise, be impossible to address, or employed because of ethical concerns about the use of randomisation to interventions that carry known risks. The UK Medical Research Council (MRC) recently produced an extremely useful document discussing the nature and significance of natural experiments within medical and public health research. In this paper, however, we suggest that the MRC document's definition of the term 'natural experiment' is insufficiently precise. In response, we offer a taxonomy of different types of natural experiments and related methods, and explore the ethical implications of these different types. We argue that while the ethical issues that may arise within natural experiments in relation to risks of harm or informed consent may differ from those within the randomised controlled trial, they are not thereby less pressing. The implications of the argument are explored and recommendations made for those involved in research governance. 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.

Ethics of justice and ethics of care. Values and attitudes among midwifery students on adolescent sexuality and abortion in Vietnam and their implications for midwifery education: a survey by questionnaire and interview.

PubMed

Klingberg-Allvin, Marie; Van Tam, Vu; Nga, Nguyen Thu; Ransjo-Arvidson, Anna-Berit; Johansson, Annika

2007-01-01

Adolescent's sexuality and related reproductive health and rights problems are sensitive issues in Vietnam. Globalisation has had an impact on the lifestyles of young people, and rising numbers of abortion and STI/HIV risks among youth are posing major health concerns in the country. These problems need to be addressed. Midwives belong to a key category of health personnel in Vietnam, whose task it is to promote adolescents' sexual and reproductive health and prevent reproductive ill health. It is important to understand future midwives' perceptions and attitudes in order to improve their education and training programmes. The aim of this study was to investigate Vietnamese midwifery students' values and attitudes towards adolescent sexuality, abortion and contraception and their views on professional preparation. A quantitative survey including 235 midwifery students from four different secondary medical colleges in northern Vietnam was carried out in 2003. A qualitative study addressing similar questions was performed and 18 midwifery students were individually interviewed. Findings revealed a general disapproval of adolescent pre-marital sexual relations and abortion-'an ethics of justice'-but also an empathic attitude and willingness to support young women, who bear the consequences of unwanted pregnancies and social condemnation-'an ethics of care'. Gender-based imbalance in sexual relationships, limited knowledge about reproductive health issues among youth, and negative societal attitudes were concerns expressed by the students. The students saw their future tasks mainly related to childbearing and less to other reproductive health issues, such as abortion and prevention of STI/HIV. Midwifery education in Vietnam should encourage value-reflective thinking around gender inequality and ethical dilemmas, in order to prepare midwives to address adolescents' reproductive health needs.

Ethical analyses of institutional measures to increase health care worker influenza vaccination rates.

PubMed

Zimmerman, Richard K

2013-12-16

Health care worker (HCW) influenza vaccination rates are modest. This paper provides a detailed ethical analysis of the major options to increase HCW vaccination rates, comparing how major ethical theories would address the options. The main categories of interventions to raise rates include education, incentives, easy access, competition with rewards, assessment and feedback, declination, mandates with alternative infection control measures, and mandates with administrative action as consequences. The aforementioned interventions, except mandates, arouse little ethical controversy. However, these efforts are time and work intensive and rarely achieve vaccination rates higher than about 70%. The primary concerns voiced about mandates are loss of autonomy, injustice, lack of due process, and subsuming the individual for institutional ends. Proponents of mandates argue that they are ethical based on beneficence, non-maleficence, and duty. A number of professional associations support mandates. Arguments by analogy can be made by mandates for HCW vaccination against other diseases. The ethical systems used in the analyses include evolutionary ethics, utilitarianism, principalism (autonomy, beneficence, non-maleficence, and justice), Kantism, and altruism. Across these systems, the most commonly preferred options are easy access, assessment and feedback, declinations, and mandates with infection control measures as consequences for non-compliance. Given the ethical imperatives of non-maleficence and beneficence, the limited success of lower intensive interventions, and the need for putting patient safety ahead of HCW convenience, mandates with additional infection control measures as consequences for non-compliance are preferred. For those who opt out of vaccination due to conscience concerns, such mandates provide a means to remain employed but not put patient safety at risk. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ethical considerations in the study of online illness narratives: a qualitative review.

PubMed

Heilferty, Catherine McGeehin

2011-05-01

This aim of the review was to describe differences in ethical approaches to research on Internet communication during illness and to report conclusions drawn relevant to a proposed narrative analysis of parent blogs of childhood illness. As the study of the online expression of illness experiences becomes more expansive, discussion of related ethical issues is central to promoting research trustworthiness and rigour. Ethical considerations are central to the patient-provider relationship. The EBSCO Host, CINAHL, Medline, Communication & Mass Media Complete, and Google Scholar databases were searched from January 1990 to September 2009 using the terms 'Internet research and ethics', 'Internet research, illness and ethics' and 'blog, Internet research and ethics'. Of the 4114 references found, 21 met the inclusion criteria for the review. The review was designed to be a comprehensive assessment of the concepts analysed and the qualitative research measures taken concerning ethics in Internet research across formats. Three main approaches to ethical conduct in Internet research on illness experiences were found: human subjects, representation and open source approaches. The personal and sensitive nature of online illness narratives demand their consideration in health care as 'human subjects' research. The best hope for ethical treatment of author-participants is the creation of a comprehensive plan for addressing any and all potential ethical conflicts that may arise in the collection, analysis and reporting of data, taking into consideration rapid changes in technology. © 2011 Blackwell Publishing Ltd.

Ethical questions regarding health insurance in India.

PubMed

Mathur, Vineesh

2011-01-01

Improved health and healthcare are of vital concern to the welfare of Indian society. The nascent health insurance system of the country is experiencing an explosive expansion and various models of health insurance provision are under trial by different agencies. Since the country has been relatively late in introducing health insurance, it can study the effects of different systems of healthcare and insurance and develop a system of health coverage which addresses the unique social character of our country as well as the ethical questions of comprehensiveness and inclusion. This article seeks to explore these issues in detail.

The ethics and politics of mindfulness-based interventions.

PubMed

Schmidt, Andreas T

2016-07-01

Recently, there has been a lot of enthusiasm for mindfulness practice and its use in healthcare, businesses and schools. An increasing number of studies give us ground for cautious optimism about the potential of mindfulness-based interventions (MBIs) to improve people's lives across a number of dimensions. This paper identifies and addresses some of the main ethical and political questions for larger-scale MBIs. First, how far are MBIs compatible with liberal neutrality given the great diversity of lifestyles and conceptions of the good characteristic of modern societies? It will be argued that the potential benefits of contemporary secular mindfulness practice are indeed of a sufficiently primary or all-purpose nature to qualify as suitable goals of liberal public policy. Second, what challenges are brought up if mindfulness is used in contexts and applications-such as military settings-whose goals seem incompatible with the ethical and soteriological views of traditional mindfulness practice? It will be argued that, given concerns regarding liberal neutrality and reasonable disagreement about ethics, MBIs should avoid strong ethical commitments. Therefore, it should, in principle, be applicable in contexts of controversial moral value. Finally, drawing on recent discussions within the mindfulness community, it is argued that we should not overstate the case for mindfulness and not crowd out discussion of organisational and social determinants of stress, lowered well-being, and mental illness and the collective measures necessary to address them. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Review paper: Organ transplants: ethical, social, and religious issues in a multicultural society.

PubMed

Robson, Noor Zurani Md Haris; Razack, Azad Hassan; Dublin, Norman

2010-07-01

Recent advances in the fields of organ donation and organ transplant have introduced new hope for the treatment of serious diseases. However, this promise has been accompanied by several issues. The most common issue raised is ethical implications, but in a multicultural society like Malaysia, additional concerns arise pertaining to social and religious issues. These concerns needs to be addressed as attitudes toward and acceptability of organ donation varies according to social, culture, and religion. The diverse cultural, religious, and traditional concepts pertaining to organ donation may hamper its acceptability and cause a lack of willingness to donate organs. The purpose of this article is to briefly explore the ethical issues involved in organ transplant and the various religious opinions on organ donation. It is hoped that this knowledge and understanding may benefit both health care providers and patients in a multicultural society like Malaysia.

Downsizing genomic medicine: approaching the ethical complexity of whole-genome sequencing by starting small.

PubMed

Sharp, Richard R

2011-03-01

As we look to a time when whole-genome sequencing is integrated into patient care, it is possible to anticipate a number of ethical challenges that will need to be addressed. The most intractable of these concern informed consent and the responsible management of very large amounts of genetic information. Given the range of possible findings, it remains unclear to what extent it will be possible to obtain meaningful patient consent to genomic testing. Equally unclear is how clinicians will disseminate the enormous volume of genetic information produced by whole-genome sequencing. Toward developing practical strategies for managing these ethical challenges, we propose a research agenda that approaches multiplexed forms of clinical genetic testing as natural laboratories in which to develop best practices for managing the ethical complexities of genomic medicine.

Ethical, religious and factual beliefs about the supply of emergency hormonal contraception by UK community pharmacists.

PubMed

Cooper, Richard J; Bissell, Paul; Wingfield, Joy

2008-01-01

Community pharmacists' role in the sale and supply of emergency hormonal contraception (EHC) represents an opportunity to increase EHC availability and utilise pharmacists' expertise but little is known about pharmacists' attendant ethical concerns. Semi-structured qualitative interviews were undertaken with 23 UK pharmacists to explore their views and ethical concerns about EHC. Dispensing EHC was ethically acceptable for almost all pharmacists but beliefs about selling EHC revealed three categories: pharmacists who sold EHC, respected women's autonomy and peers' conscientious objection but feared the consequences of limited EHC availability; contingently selling pharmacists who believed doctors should be first choice for EHC supply but who occasionally supplied and were influenced by women's ages, affluence and genuineness; non-selling pharmacists who believed EHC was abortion and who found selling EHC distressing and ethically problematic. Terminological/factual misunderstandings about EHC were common and discussing ethical issues was difficult for most pharmacists. Religion informed non-selling pharmacists' ethical decisions but other pharmacists prioritised professional responsibilities over their religion. Pharmacists' ethical views on EHC and the influence of religion varied and, together with some pharmacists' reliance upon non-clinical factors, led to a potentially variable supply, which may threaten the prompt availability of EHC. Misunderstandings about EHC perpetuated lay beliefs and potentially threatened correct advice. The influence of subordination and non-selling pharmacists' dispensing EHC may also lead to variable supply and confusion amongst women. Training is needed to address both factual/terminological misunderstandings about EHC and to develop pharmacists' ethical understanding and responsibility.

Neurofunctional Correlates of Ethical, Food-Related Decision-Making

PubMed Central

Cherry, J. Bradley C.; Bruce, Jared M.; Lusk, Jayson L.; Crespi, John M.; Lim, Seung-Lark; Bruce, Amanda S.

2015-01-01

For consumers today, the perceived ethicality of a food’s production method can be as important a purchasing consideration as its price. Still, few studies have examined how, neurofunctionally, consumers are making ethical, food-related decisions. We examined how consumers’ ethical concern about a food’s production method may relate to how, neurofunctionally, they make decisions whether to purchase that food. Forty-six participants completed a measure of the extent to which they took ethical concern into consideration when making food-related decisions. They then underwent a series of functional magnetic resonance imaging (fMRI) scans while performing a food-related decision-making (FRDM) task. During this task, they made 56 decisions whether to purchase a food based on either its price (i.e., high or low, the “price condition”) or production method (i.e., with or without the use of cages, the “production method condition”), but not both. For 23 randomly selected participants, we performed an exploratory, whole-brain correlation between ethical concern and differential neurofunctional activity in the price and production method conditions. Ethical concern correlated negatively and significantly with differential neurofunctional activity in the left dorsolateral prefrontal cortex (dlPFC). For the remaining 23 participants, we performed a confirmatory, region-of-interest (ROI) correlation between the same variables, using an 8-mm3 volume situated in the left dlPFC. Again, the variables correlated negatively and significantly. This suggests, when making ethical, food-related decisions, the more consumers take ethical concern into consideration, the less they may rely on neurofunctional activity in the left dlPFC, possibly because making these decisions is more routine for them, and therefore a more perfunctory process requiring fewer cognitive resources. PMID:25830288

Beyond procedural ethics: foregrounding questions of justice in global health research ethics training for students.

PubMed

Hunt, Matthew R; Godard, Beatrice

2013-07-01

Interest in global health is growing among students across many disciplines and fields of study. In response, an increasing number of academic programmes integrate and promote opportunities for international research, service or clinical placements. These activities raise a range of ethical issues and are associated with important training needs for those who participate. In this paper, we focus on research fieldwork conducted in lower income nations by students from more affluent countries and the ethics preparation they would benefit from receiving prior to embarking on these projects. Global health research is closely associated with questions of justice and equity that extend beyond concerns of procedural ethics. Research takes place in and is shaped by matrices of political, social and cultural contexts and concerns. These realities warrant analysis and discussion during research ethics training. Training activities present an opportunity to encourage students to link global health research to questions of global justice, account for issues of justice in planning their own research, and prepare for 'ethics-in-practice' issues when conducting research in contexts of widespread inequality. Sustained engagement with questions of justice and equity during research ethics training will help support students for involvement in global health research.

Inclusion of Ethical Issues in Dementia Guidelines: A Thematic Text Analysis

PubMed Central

Knüppel, Hannes; Schmidhuber, Martina; Neitzke, Gerald

2013-01-01

Background Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care. Methods and Findings To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained. Conclusions Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please

Ethical dilemmas in community-based participatory research: recommendations for institutional review boards.

PubMed

Flicker, Sarah; Travers, Robb; Guta, Adrian; McDonald, Sean; Meagher, Aileen

2007-07-01

National and international codes of research conduct have been established in most industrialized nations to ensure greater adherence to ethical research practices. Despite these safeguards, however, traditional research approaches often continue to stigmatize marginalized and vulnerable communities. Community-based participatory research (CBPR) has evolved as an effective new research paradigm that attempts to make research a more inclusive and democratic process by fostering the development of partnerships between communities and academics to address community-relevant research priorities. As such, it attempts to redress ethical concerns that have emerged out of more traditional paradigms. Nevertheless, new and emerging ethical dilemmas are commonly associated with CBPR and are rarely addressed in traditional ethical reviews. We conducted a content analysis of forms and guidelines commonly used by institutional review boards (IRBs) in the USA and research ethics boards (REBs) in Canada. Our intent was to see if the forms used by boards reflected common CBPR experience. We drew our sample from affiliated members of the US-based Association of Schools of Public Health and from Canadian universities that offered graduate public health training. This convenience sample (n = 30) was garnered from programs where application forms were available online for download between July and August, 2004. Results show that ethical review forms and guidelines overwhelmingly operate within a biomedical framework that rarely takes into account common CBPR experience. They are primarily focused on the principle of assessing risk to individuals and not to communities and continue to perpetuate the notion that the domain of "knowledge production" is the sole right of academic researchers. Consequently, IRBs and REBs may be unintentionally placing communities at risk by continuing to use procedures inappropriate or unsuitable for CBPR. IRB/REB procedures require a new framework more

Experiences of ethical issues when caring for children with cancer.

PubMed

Bartholdson, Cecilia; Lützén, Kim; Blomgren, Klas; Pergert, Pernilla

2015-01-01

The treatment for pediatric cancer is often physically, socially, and psychologically demanding and often gives rise to ethical issues. The purpose of this study was to describe healthcare professionals' experiences of ethical issues and ways to deal with these when caring for children with cancer. A study-specific questionnaire was given to healthcare professionals at a pediatric hospital in Sweden. Qualitative content analysis was used to analyze answers to open-ended questions. The data were sorted into 2 domains based on the objective of the study. In the next step, the data in each domain were inductively coded, generating categories and subcategories. The main ethical issues included concerns of (1) infringing on autonomy, (2) deciding on treatment levels, and (3) conflicting perspectives that constituted a challenge to collaboration. Professionals desired teamwork and reflection to deal with ethical concerns, and they needed resources for dealing with ethics. Interprofessional consideration needs to be improved. Forums and time for ethics reflections need to be offered to deal with ethical concerns in childhood cancer care. Experiences of ethical concerns and dealing with these in caring for children with cancer evoked strong feelings and moral perplexity among nursing staff. The study raises a challenging question: How can conflicting perspectives, lack of interprofessional consideration, and obstacles related to parents' involvement be "turned around," that is, contribute to a holistic perspective of ethics in cancer care of children?

Genetically Modified (GM) Foods and Ethical Eating.

PubMed

Dizon, Francis; Costa, Sarah; Rock, Cheryl; Harris, Amanda; Husk, Cierra; Mei, Jenny

2016-02-01

The ability to manipulate and customize the genetic code of living organisms has brought forth the production of genetically modified organisms (GMOs) and consumption of genetically modified (GM) foods. The potential for GM foods to improve the efficiency of food production, increase customer satisfaction, and provide potential health benefits has contributed to the rapid incorporation of GM foods into the American diet. However, GM foods and GMOs are also a topic of ethical debate. The use of GM foods and GM technology is surrounded by ethical concerns and situational judgment, and should ideally adhere to the ethical standards placed upon food and nutrition professionals, such as: beneficence, nonmaleficence, justice and autonomy. The future of GM foods involves many aspects and trends, including enhanced nutritional value in foods, strict labeling laws, and potential beneficial economic conditions in developing nations. This paper briefly reviews the origin and background of GM foods, while delving thoroughly into 3 areas: (1) GMO labeling, (2) ethical concerns, and (3) health and industry applications. This paper also examines the relationship between the various applications of GM foods and their corresponding ethical issues. Ethical concerns were evaluated in the context of the code of ethics developed by the Academy of Nutrition and Dietetics (AND) that govern the work of food and nutrition professionals. Overall, there is a need to stay vigilant about the many ethical implications of producing and consuming GM foods and GMOs. © 2015 Institute of Food Technologists®

The H1N1 influenza pandemic: need for solutions to ethical problems.

PubMed

Bhatia, Prateek

2013-01-01

The rapid spread of the novel influenza virus of H1N1 swine origin led to widespread fear, panic and unrest among the public and healthcare personnel. The pandemic not only tested the world's health preparedness, but also brought up new ethical issues which need to be addressed as soon as possible. This article highlights these issues and suggests ethical answers to the same. The main areas that require attention are the distribution of scarce resources, prioritisation of antiviral drugs and vaccines, obligations of healthcare workers, and adequate dissemination and proper communication of information related to the pandemic. It is of great importance to plan in advance how to confront these issues in an ethical manner. This is possible only if a comprehensive contingency plan is prepared with the involvement of and in consultation with all the stakeholders concerned.

Ethics consultation and autonomy.

PubMed

Varelius, Jukka

2008-03-01

Services of ethics consultants are nowadays commonly used in such various spheres of life as engineering, public administration, business, law, health care, journalism, and scientific research. It has however been maintained that use of ethics consultants is incompatible with personal autonomy; in moral matters individuals should be allowed to make their own decisions. The problem this criticism refers to can be conceived of as a conflict between the professional autonomy of ethics experts and the autonomy of the persons they serve. This paper addresses this conflict and maintains that when the nature of both ethics consultation and individual autonomy is properly understood, the professional autonomy of ethics experts is compatible with the autonomy of the persons they assist.

A Pedagogical Model for Ethical Inquiry into Socioscientific Issues In Science

NASA Astrophysics Data System (ADS)

Saunders, Kathryn J.; Rennie, Léonie J.

2013-02-01

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

[The beginning of human life: ethical and legal perspectives in the context of biotechnological progress].

PubMed

Barretto, Vicente de Paulo; Lauxen, Elis Cristina Uhry

2017-07-13

Questions concerning the beginning of human life have pervaded society since antiquity. In the post-modern world, scientific and technological advances have fueled discussions on the issue, such that debates previously concentrated on abortion now also focus on biotechnological interventions. The article addresses the latter, reflecting on the extent to which human dignity can be considered a (hermeneutic) reference in establishing ethical and legal parameters for biotechnological advances in the definition of the beginning of human life. The study's method was critical hermeneutic ethics, with ethics at the center of the process of understanding and interpretation, observing the contours of facticity. No consensus was found on the beginning of human life, so it is essential to engage in dialogue with the new reality resulting from biotechnological advances in the process of defining ethical and legal principles for protecting the embryo and human nature, with human dignity as the reference.

Ethical Issues in Internet Research: International Good Practice and Irish Research Ethics Documents

ERIC Educational Resources Information Center

Felzmann, Heike

2013-01-01

This chapter discusses the main research ethical concerns that arise in internet research and reviews existing research ethical guidance in the Irish context in relation to its application to internet research. The chapter begins with a brief outline of high profile cases in the early history of the internet that highlighted specific emerging…

Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations.

PubMed

Reilly, T; Crawford, G; Lobo, R; Leavy, J; Jancey, J

2016-04-01

Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap.

Ethical framework for resource allocation during a drug supply shortage.

PubMed

Gibson, Jennifer L; Bean, Sally; Chidwick, Paula; Godkin, Dianne; Sibbald, Robert W; Wagner, Frank

2012-01-01

Drug supply shortages are common in health systems due to manufacturing and other delays. Frequently, shortages are successfully addressed through conservation and redistribution efforts, with limited impact on patient care. However, when Sandoz Canada Inc. announced in February 2012 that it was reducing production of a number of generic injectable drugs at its Quebec facility, the scope and magnitude of the drug supply shortage were unprecedented in Canada. The potential for an extreme scarcity of some drugs raised ethical concerns about patient care, including the need to limit access to some health services. In this article, the authors describe the development and implementation of an ethical framework to promote equitable access to drugs and healthcare services in the context of a drug supply shortage within and across health systems.

Ethical living: relinking ethics and consumption through care in Chile and Brazil.

PubMed

Ariztia, Tomas; Agloni, Nurjk; Pellandini-Simányi, Léna

2018-06-01

Mainstream conceptualizations of 'ethical consumption' equate the notion with conscious, individual, market-mediated choices motivated by ethical or political aims that transcend ordinary concerns. Drawing on recent sociology and anthropology of consumption literature on the links between ordinary ethics and ethical consumption, this article discusses some of the limitations of this conceptualization. Using data from 32 focus groups conducted in Chile and Brazil, we propose a conceptualization of ethical consumption that does not centre on individual, market-mediated choices but understands it at the level of practical outcomes, which we refer to as different forms of 'ethical living'. To do that, we argue, we need to depart from the deontological understanding of ethics that underpins mainstream approaches to ethical consumption and adopt a more consequentialist view focusing on ethical outcomes. We develop these points through describing one particular ordinary moral regime that seemed to be predominant in participants' accounts of ethics and consumption in both Chile and Brazil: one that links consumption and ethics through care. We show that the moral regime of care leads to 'ethical outcomes', such as energy saving or limiting overconsumption, yet contrary to the mainstream view of ethical consumption emphasizing politicized choice expressed through markets, these result from following ordinary ethics, often through routines of practices. © London School of Economics and Political Science 2017.

Ethics of Information Supply.

ERIC Educational Resources Information Center

Oppenheim, Charles

This discussion of the ethics of the information process provides a brief review of the process of information supply and flow, primarily in science and technology; looks at various points in the flow of information; and highlights particular ethical concerns. Facets of the process discussed in more detail include ways in which some scientists…

Questioning (as) Violence: Teaching Ethics in a Global Knowledge Enterprise

ERIC Educational Resources Information Center

Hoofd, Ingrid M.

2011-01-01

This article seeks to address the contemporary politics and ethics at work in the teaching of ethics in higher education. It will do so by addressing the stakes inherent in the translation of certain "urgent reformulations" of teaching ethics in a contemporary Asian university, in light of a "demise of politics" due to…

Ethical perspectives in neuroscience nursing practice.

PubMed

Murphy, W J; Olsen, B J

1999-09-01

The role of neuroscience nurses in relation to ethical issues has become increasingly complex. Knowledge of ethical principles and theories assists the nurse in the development of a theoretical basis for resolution of ethical issues or concerns. Additionally, the nurse must possess information regarding practice codes or standards as well as legislative requirements. The nurse must act as an advocate for the patient and society through active participation in institutional ethics committees and legislative forums.

Addressing the ethical issues raised by synthetic human entities with embryo-like features

PubMed Central

Aach, John; Lunshof, Jeantine; Iyer, Eswar; Church, George M

2017-01-01

The "14-day rule" for embryo research stipulates that experiments with intact human embryos must not allow them to develop beyond 14 days or the appearance of the primitive streak. However, recent experiments showing that suitably cultured human pluripotent stem cells can self-organize and recapitulate embryonic features have highlighted difficulties with the 14-day rule and led to calls for its reassessment. Here we argue that these and related experiments raise more foundational issues that cannot be fixed by adjusting the 14-day rule, because the framework underlying the rule cannot adequately describe the ways by which synthetic human entities with embryo-like features (SHEEFs) might develop morally concerning features through altered forms of development. We propose that limits on research with SHEEFs be based as directly as possible on the generation of such features, and recommend that the research and bioethics communities lead a wide-ranging inquiry aimed at mapping out solutions to the ethical problems raised by them. DOI: http://dx.doi.org/10.7554/eLife.20674.001 PMID:28494856

Active Ethical Leadership, Giftedness, and Creativity

ERIC Educational Resources Information Center

Runco, Mark A.

2017-01-01

This commentary is focused on Robert Sternberg's new Active Concerned Citizenship and Ethical Leadership (ACCEL) model. The new model is well conceived and goes far beyond existing models. It is especially attractive in that the emphasis is on ethics. Now more than ever before there is a clear need for education to support ethical reasoning and…

Implications of organizational ethics to healthcare.

PubMed

Ells, Carolyn; MacDonald, Chris

2002-01-01

Organizational ethics is an emerging field concerned with the study and practice of the ethical behaviour of organizations. For effective application to healthcare settings, we argue that organizational ethics requires attention to organizations' special characteristics combined with tools borrowed from the fields of business ethics and bioethics. We identify and discuss several implications of this burgeoning field to healthcare organizations, showing how organizational ethics can facilitate policy making, accountability, self-evaluation, and patient and business perspectives. In our conclusion, we suggest an action plan for healthcare organizations to help them respond appropriately to their ethical responsibilities.

Ethics of human testing.

PubMed

Salter, D C

1990-08-01

What should one do, and why? Anyone asking such questions--and everyone does so hundreds of time each day--is concerned with ethics. Product development and testing raise many ethical questions. Particularly since the rise of 'green consumerism', these are of increasing concern to people outside the cosmetics industry, and so should be of interest to those inside it. The major problem seems to be that of reaching agreement on moral and ethical issues. Overcoming this problem involves investigating what is meant by 'ethics', and how decisions depend not on facts but on 'facts-as-perceived'. These in turn depend on many factors, with one's philosophy being the most fundamental. The range of philosophical options is reviewed and it is proposed that wider discussion is the only just way to achieve agreement. Yet some things are not negotiable. There are certain key moral concepts in terms of which discussion must take place for it to be relevant. In ethics of human testing, 'respect for others', that is, avoiding exploitation, is the principal one. Some synthesis of the key moral concepts like that of Immanuel Kant is therefore recommended as the soundest and most widely acceptable basis for the necessary discussion. Defining the responsible use of human subjects covers a range of issues, moral, historical, legal and professional. For example, there may be ethical difficulties in deliberate damage induction as in SPF and irritancy testing. But above all, to avoid exploitation, there is a moral and also a legal requirement that subjects are truly volunteers. This is the basis of the concept of 'informed consent', required but not generally explained in current professional codes of practice. It is unjustified to exploit those who may be under duress, such as 'in-house volunteers' and those with low incomes. Hence in conclusion, criteria for obtaining valid informed consent are briefly reviewed. By considering issues such as these, we can help ensure that cosmetic

Ethical Implications of Technological Advances on Business Communication.

ERIC Educational Resources Information Center

Herschel, Richard T.; Andrews, Patricia Hayes

1997-01-01

Explores ethical issues heightened by use of technology, and examines a means for managing these ethical concerns. Argues that ethical problems are not inherent in technological advances, but rather it is how human beings choose to use these new tools that may lead to ethical dilemmas in business contexts. (SR)

States Address Concerns about Concussions in Youth Sports

ERIC Educational Resources Information Center

Kreck, Carol

2014-01-01

Education Commission of the States (ECS) reviewed legislation in the 50 states to see how state leaders are responding to concerns about concussions in youth sports. This report reviews state responses to concussion concerns, and provides examples of provisions put in place by California, Connecticut, and Texas. Three emerging innovations are…

Applying Applied Ethics through ethics consulting.

PubMed

Moore, W

2010-04-01

Applied Ethics is frequently described as a discipline of philosophy that concerns itself with the application of moral theories such as deontology and utilitarianism to real world dilemmas. However, these applications often remain restricted to the academic world. The focus of new versions ethics consulting has since the mid-1980s shifted from what the ethicist knows to what the ethicist does or enables. This shift remodelled the ethicist's role to that of a facilitator in an inherently social process of moral inquiry. Applying these developments in the Namibian context has already proved to be of great value to the local health care industry. (c) 2010. Published by Elsevier Ltd.

Ethics education in undergraduate pre-health programs. The contribution of undergraduate colleges and universities to the ethical and moral development of future doctors in the medical and dental professions.

PubMed

Erratt, Tamie D

2011-08-01

There are many barriers to ethics education of students attending medical and dental schools. The question is asked, "Should more attention be given to addressing students' ethics education during their undergraduate years of preparation for professional healthcare programs?" This qualitative study utilizes digitally recorded personal interviews with two undergraduate pre-healthcare students, one medical student, one recently matriculated dental student, one undergraduate pre-healthcare faculty member, three dental school faculty members, and three medical school faculty members. Interview participants discuss areas of personal knowledge and experience concerning: the admissions process and screening of potential medical/dental students for ethical traits and behaviors, influences on student ethical development, undergraduate pre-healthcare ethics training, and preferred college major for pre-healthcare students. The study concludes that undergraduate pre-healthcare programs should take the initiative to be proactive and deliberate in strengthening the positive influences on students. Strategies include: 1) humanities curricula to broaden perspectives and increase non-prejudice; 2) mentoring and modeling by older students, faculty, and community and professional volunteers; 3) ethical case study discussions in class or extracurricular activities; and 4) volunteer/service learning activities. Additionally, curriculum learning is enhanced by the use of reflection and writing, discussions, and media.

Education as an Ethical Concern in the Global Era

ERIC Educational Resources Information Center

Arnove, Robert; Bull, Barry L.

2015-01-01

This article examines the issue of the ethical status of education, particularly as related to individual dignity and freedom. We select cases that have been described in fine detail by social science--the education of girls and the education of all children within counter-hegemonic movements. These cases involve issues of access to equitable and…

Assessing and addressing moral distress and ethical climate Part II: neonatal and pediatric perspectives.

PubMed

Sauerland, Jeanie; Marotta, Kathleen; Peinemann, Mary Anne; Berndt, Andrea; Robichaux, Catherine

2015-01-01

Moral distress remains a pervasive and, at times, contested concept in nursing and other health care disciplines. Ethical climate, the conditions and practices in which ethical situations are identified, discussed, and decided, has been shown to exacerbate or ameliorate perceptions of moral distress. The purpose of this mixed-methods study was to explore perceptions of moral distress, moral residue, and ethical climate among registered nurses working in an academic medical center. Two versions of the Moral Distress Scale in addition to the Hospital Ethical Climate Survey were used, and participants were invited to respond to 2 open-ended questions. Part I reported the findings among nurses working in adult acute and critical care units. Part II presents the results from nurses working in pediatric/neonatal units. Significant differences in findings between the 2 groups are discussed. Subsequent interventions developed are also presented.

Ethical Issues in School Health: A Survey.

ERIC Educational Resources Information Center

Richardson, Glenn E.; Jose, Nancy

1983-01-01

The need for a code of ethics for health educators is discussed, and results of a survey of school health educators' opinions on curriculum-related ethical issses are reported. Ethical issues of concern include use of scare tactics, efforts to change behavior and attitudes, and appropriate subject matter. (PP)

The NHS and market forces in healthcare: the need for organisational ethics.

PubMed

Frith, Lucy

2013-01-01

The NHS in England is an organisation undergoing substantial change. The passage of the Health and Social Care Act 2012, consolidates and builds on previous health policies and introduces further 'market-style' reforms of the NHS. One of the main aspects of these reforms is to encourage private and third sector providers to deliver NHS services. The rationale for this is to foster a more competitive market in healthcare to encourage greater efficiency and innovation. This changing healthcare environment in the English NHS sharpens the need for attention to be paid to the ethical operation of healthcare organisations. All healthcare organisations need to consider the ethical aspects of their operation, whether state or privately run. However, the changes in the type of organisations used to provide healthcare (such as commercial companies) can create new relationships and ethical tensions. This paper will chart the development of organisational ethics as a concern in applied ethics and how it arose in the USA largely owing to changes in the organisation of healthcare financing and provision. It will be argued that an analogous transition is happening in the NHS in England. The paper will conclude with suggestions for the development of organisational ethics programmes to address some of the possible ethical issues raised by this new healthcare environment that incorporates both private and public sector providers.

The Ethics of Biosafety Considerations in Gain-of-Function Research Resulting in the Creation of Potential Pandemic Pathogens

PubMed Central

Lipsitch, Marc; Levinson, Meira

2015-01-01

This paper proposes an ethical framework for evaluating biosafety risks of gain-of-function (GOF) experiments that create novel strains of influenza expected to be virulent and transmissible in humans, so-called potential pandemic pathogens (PPP). Such research raises ethical concerns because of the risk that accidental release from a laboratory could lead to extensive or even global spread of a virulent pathogen. Biomedical research ethics has focused largely on human subjects research, while biosafety concerns about accidental infections, seen largely as a problem of occupational health, have been ignored. GOF/PPP research is an example of a small but important class of research where biosafety risks threaten public health, well beyond the small number of persons conducting the research. We argue that bioethical principles that ordinarily apply only to human subjects research should also apply to research that threatens public health, even if, as in GOF/PPP studies, the research involves no human subjects. Specifically we highlight the Nuremberg Code’s requirements of “fruitful results for the good of society, unprocurable by other methods,” and proportionality of risk and humanitarian benefit, as broad ethical principles that recur in later documents on research ethics and should also apply to certain types of research not involving human subjects. We address several potential objections to this view, and conclude with recommendations for bringing these ethical considerations into policy development. PMID:26320212

Does the Golem Feel Pain? Moral Instincts and Ethical Dilemmas Concerning Suffering and the Brain.

PubMed

Devor, Marshall; Rappaport, Isabelle; Rappaport, Z Harry

2015-07-01

Pain has variously been used as a means of punishment, extracting information, or testing commitment, as a tool for education and social control, as a commodity for sacrifice, and as a draw for sport and entertainment. Attitudes concerning these uses have undergone major changes in the modern era. Normative convictions on what is right and wrong are generally attributed to religious tradition or to secular-humanist reasoning. Here, we elaborate the perspective that ethical choices concerning pain have much earlier roots that are based on instincts and brain-seated empathetic responses. They are fundamentally a function of brain circuitry shaped by processes of Darwinian evolution. Social convention and other environmental influences, with their idiosyncrasies, are a more recent, ever-changing overlay. We close with an example in which details on the neurobiology of pain processing, specifically the question of where in the brain the experience of pain is generated, affect decision making in end-of-life situations. By separating innate biological substrates from culturally imposed attitudes (memes), we may arrive at a more reasoned approach to a morality of pain prevention. © 2014 World Institute of Pain.

Preventive Ethics Through Expanding Education.

PubMed

Ho, Anita; MacDonald, Lisa Mei-Hwa; Unger, David

2016-03-01

Healthcare institutions have been making increasing efforts to standardize consultation methodology and to accredit both bioethics training programs and the consultants accordingly. The focus has traditionally been on the ethics consultation as the relevant unit of ethics intervention. Outcome measures are studied in relation to consultations, and the hidden assumption is that consultations are the preferred or best way to address day-to-day ethical dilemmas. Reflecting on the data from an internal quality improvement survey and the literature, we argue that having general ethics education as a key function of ethics services may be more important in meeting the contemporaneous needs of acute care settings. An expanded and varied ethics education, with attention to the time constraints of healthcare workers' schedules, was a key recommendation brought forward by survey respondents. Promoting ethical reflection and creating a culture of ethics may serve to prevent ethical dilemmas or mitigate their effects.

Ethical reflection on the harm in reproductive decision‐making

PubMed Central

Murtagh, G M

2007-01-01

Advances in reproductive technologies continue to present ethical problems concerning their implementation and use. These advances have preoccupied bioethicists in their bid to gauge our moral responsibilities and obligations when making reproductive decisions. The aim of this discussion is to highlight the importance of a sensibility to differences in moral perspective as part of our ethical inquiry in these matters. Its focal point is the work of John Harris, who has consistently addressed the ethical issues raised by advancing reproductive technologies. The discussion is aimed at a central tenet of Harris's position on reproductive decision‐making—namely, that in some instances, giving birth to a worthwhile life may cause harm and will therefore be morally wrong. It attempts to spell out some of the implications of Harris's position that the author takes to involve a misplaced generality. To support this claim, some examples are explored that demonstrate the variety of ways in which concepts (such as harm) may manifest themselves as moral considerations within the context of reproductive decision‐making. The purpose is to demonstrate that Harris's general conception of the moral limits of reproductive autonomy obscures the issues raised by particular cases, which in themselves may reveal important directions for our ethical inquiry. PMID:18055903

Defense mechanisms in ethics consultation.

PubMed

Agich, George J

2011-12-01

While there is no denying the relevance of ethical knowledge and analytical and cognitive skills in ethics consultation, such knowledge and skills can be overemphasized. They can be effectively put into practice only by an ethics consultant, who has a broad range of other skills, including interpretive and communicative capacities as well as the capacity effectively to address the psychosocial needs of patients, family members, and healthcare professionals in the context of an ethics consultation case. In this paper, I discuss how emotion can play an important interpretive role in clinical ethics consultation and why attention to the role of defense mechanisms can be helpful. I concentrate on defense mechanisms, arguing first, that the presence of these mechanisms is understandable given the emotional stresses and communicative occlusions that occur between the families of patients and critical care professionals in the circumstances of critical care; second, that identifying these mechanisms is essential for interpreting and managing how these factors influence the way that the "facts" of the case are understood by family members; and, third, that effectively addressing these mechanisms is an important component for effectively doing ethics consultation. Recognizing defense mechanisms, understanding how and why they operate, and knowing how to deal with these defense mechanisms when they pose problems for communication or decision making are thus essential prerequisites for effective ethics consultation, especially in critical care.

Surgical ethics and the challenge of surgical innovation.

PubMed

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. Copyright © 2014 Elsevier Inc. All rights reserved.

Crossroads: Integrated Models for Teaching Ethics and Spirituality.

ERIC Educational Resources Information Center

Gorman, Michael J., Ed.

This anthology presents seven articles that focus on the integration of ethical and spiritual concerns into the academic curriculum. The argument is made for the inclusion of ethical and religious concerns in the study of subjects such as literature, history, foreign languages and cultures, and science. The articles include: "The Voice of the…

Engineering ethics beyond engineers' ethics.

PubMed

Basart, Josep M; Serra, Montse

2013-03-01

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

Modular Approach for Ethics

ERIC Educational Resources Information Center

Wyne, Mudasser F.

2010-01-01

It is hard to define a single set of ethics that will cover an entire computer users community. In this paper, the issue is addressed in reference to code of ethics implemented by various professionals, institutes and organizations. The paper presents a higher level model using hierarchical approach. The code developed using this approach could be…

Ethical dilemmas among nurses as they transition to hospital case management: implications for organizational ethics, part II.

PubMed

O'Donnell, Lolita T

2007-01-01

The purpose of this study was to describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute care setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice of case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between

Ethical dilemmas among nurses as they transition to hospital case management: implications for organizational ethics, part I.

PubMed

O'Donnell, Lolita T

2007-01-01

To describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute hospital setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice in case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the

Financial incentives for antipsychotic depot medication: ethical issues.

PubMed

Claassen, Dirk

2007-04-01

Giving money as a direct incentive for patients in exchange for depot medication has proved beneficial in some clinical cases in assertive outreach (AO). However, ethical concerns around this practice have been raised, and will be analysed in more detail here. Ethical concern voiced in a survey of all AO teams in England were analysed regarding their content. These were grouped into categories. 53 of 70 team managers mentioned concerns, many of them serious and expressing a negative attitude towards giving money for depot adherence. Four broad categories of ethical concern following Christensen's concept were distinguished: valid consent and refusal (n = 5), psychiatric paternalism (n = 31), resource allocation (n = 4), organisational relationships (n = 2), with a residual category others and unspecified (n = 11). The main concerns identified are discussed on the background of existing ethical theories in healthcare and the specific problems of community mental health and AO. Points for practice are derived from this discussion. A way forward is outlined that includes informed consent and an operational policy in the use of incentives, further randomised controlled trials and qualitative studies, and continuing discussions with all stakeholders, especially service users.

Dreams and nightmares: practical and ethical issues for patients and physicians using personal health records.

PubMed

Wynia, Matthew; Dunn, Kyle

2010-01-01

Electronic health records for patients, personal health records (PHRs), have become increasingly popular among policy makers and purchasers, but uptake among patients and physicians has been relatively slow. PHRs have varying uses that might make them more or less appealing to different stakeholders. The three core uses for PHRs - promoting communication, data use, and patient responsibility - each raises a set of potential practical and financial dilemmas. But some ethical concerns are also at play, some of which are rarely recognized as values-based barriers to the use of PHRs. Recognizing these ethical issues, and addressing them explicitly in PHR design and policy making, would help PHRs to achieve their promise.

Scientific Integrity and Professional Ethics at AGU - The Establishment and Evolution of an Ethics Program at a Large Scientific Society

NASA Astrophysics Data System (ADS)

McPhaden, Michael; Leinen, Margaret; McEntee, Christine; Townsend, Randy; Williams, Billy

2016-04-01

The American Geophysical Union, a scientific society of 62,000 members worldwide, has established a set of scientific integrity and professional ethics guidelines for the actions of its members, for the governance of the union in its internal activities, and for the operations and participation in its publications and scientific meetings. This presentation will provide an overview of the Ethics program at AGU, highlighting the reasons for its establishment, the process of dealing ethical breaches, the number and types of cases considered, how AGU helps educate its members on Ethics issues, and the rapidly evolving efforts at AGU to address issues related to the emerging field of GeoEthics. The presentation will also cover the most recent AGU Ethics program focus on the role for AGU and other scientific societies in addressing sexual harassment, and AGU's work to provide additional program strength in this area.

Ethical issues in exercise psychology.

PubMed

Pauline, Jeffrey S; Pauline, Gina A; Johnson, Scott R; Gamble, Kelly M

2006-01-01

Exercise psychology encompasses the disciplines of psychiatry, clinical and counseling psychology, health promotion, and the movement sciences. This emerging field involves diverse mental health issues, theories, and general information related to physical activity and exercise. Numerous research investigations across the past 20 years have shown both physical and psychological benefits from physical activity and exercise. Exercise psychology offers many opportunities for growth while positively influencing the mental and physical health of individuals, communities, and society. However, the exercise psychology literature has not addressed ethical issues or dilemmas faced by mental health professionals providing exercise psychology services. This initial discussion of ethical issues in exercise psychology is an important step in continuing to move the field forward. Specifically, this article will address the emergence of exercise psychology and current health behaviors and offer an overview of ethics and ethical issues, education/training and professional competency, cultural and ethnic diversity, multiple-role relationships and conflicts of interest, dependency issues, confidentiality and recording keeping, and advertisement and self-promotion.

Crowdfunding FOR MEDICAL CARE: Ethical Issues in an Emerging Health Care Funding Practice.

PubMed

Snyder, Jeremy

2016-11-01

Crowdfunding websites allow users to post a public appeal for funding for a range of activities, including adoption, travel, research, participation in sports, and many others. One common form of crowdfunding is for expenses related to medical care. Medical crowdfunding appeals serve as a means of addressing gaps in medical and employment insurance, both in countries without universal health insurance, like the United States, and countries with universal coverage limited to essential medical needs, like Canada. For example, as of 2012, the website Gofundme had been used to raise a total of 8.8 million dollars (U.S.) for seventy-six hundred campaigns, the majority of which were health related. This money can make an important difference in the lives of crowdfunding users, as the costs of unexpected or uninsured medical needs can be staggering. In this article, I offer an overview of the benefits of medical crowdfunding websites and the ethical concerns they raise. I argue that medical crowdfunding is a symptom and cause of, rather than a solution to, health system injustices and that policy-makers should work to address the injustices motivating the use of crowdfunding sites for essential medical services. Despite the sites' ethical problems, individual users and donors need not refrain from using them, but they bear a political responsibility to address the inequities encouraged by these sites. I conclude by suggesting some responses to these concerns and future directions for research. © 2016 The Hastings Center.

Ethical and professional challenges posed by patients with genetic concerns: a report of focus group discussions with genetic counselors, physicians, and nurses.

PubMed

Veach, P M; Bartels, D M; LeRoy, B S

2001-04-01

Ninety-seven physicians, nurses, and genetic counselors from four regions within the United States participated in focus groups to identify the types of ethical and professional challenges that arise when their patients have genetic concerns. Responses were taped and transcribed and then analyzed using the Hill et al. (1997, Counsel Psychol 25:517-522) Consensual Qualitative Research method of analysis. Sixteen major ethical and professional domains and 63 subcategories were identified. Major domains are informed consent; withholding information; facing uncertainty; resource allocation; value conflicts, directiveness/nondirectiveness; determining the primary patient; professional identity issues; emotional responses; diversity issues; confidentiality; attaining/maintaining proficiency; professional misconduct; discrimination; colleague error; and documentation. Implications for practitioners who deal with genetic issues and recommendations for additional research are given.

An overview on ethical considerations in stem cell research in Iran and ethical recommendations: A review.

PubMed

Farajkhoda, Tahmineh

2017-02-01

Conducting research on the stem cell lines might bring some worthy good to public. Human Stem Cells (hSCs) research has provided opportunities for scientific progresses and new therapies, but some complex ethical matters should be noticed to ensure that stem cell research is carried out in an ethically appropriate manner. The aim of this review article is to discuss the importance of stem cell research, code of ethics for stem cell research in Iran and ethical recommendation. Generation of stem cells for research from human embryo or adult stem cells, saving, maintenance and using of them are the main ethical, legal and jurisprudence concerns in Iran. Concerns regarding human reproduction or human cloning, breach of human dignity, genetic manipulation and probability of tumorogenisity are observed in adult/somatic stem cells. Destruction of embryo to generate stem cell is an important matter in Iran. In this regards, obtaining stem cell from donated frozen embryos through infertility treatment that would be discarded is an acceptable solution in Iran for generation of embryo for research. Ethical, legal, and jurisprudence strategies for using adult/somatic stem cells are determination of ownership of stem cells, trade prohibition of human body, supervision on bio banks and information of Oversight Committee on Stem Cell Research. Recommendations to handle ethical issues for conducting stem cell research are well-designed studies, compliance codes of ethics in biomedical research (specifically codes of ethics on stem cell research, codes of ethics on clinical trials studies and codes of ethics on animals studies), appropriate collaboration with ethics committees and respecting of rights of participants (including both of human and animal rights) in research. In addition, there is a necessity for extending global networks of bioethics for strengthening communications within organizations at both the regional and international level, strengthening legislation systems

An overview on ethical considerations in stem cell research in Iran and ethical recommendations: A review

PubMed Central

Farajkhoda, Tahmineh

2017-01-01

Conducting research on the stem cell lines might bring some worthy good to public. Human Stem Cells (hSCs) research has provided opportunities for scientific progresses and new therapies, but some complex ethical matters should be noticed to ensure that stem cell research is carried out in an ethically appropriate manner. The aim of this review article is to discuss the importance of stem cell research, code of ethics for stem cell research in Iran and ethical recommendation. Generation of stem cells for research from human embryo or adult stem cells, saving, maintenance and using of them are the main ethical, legal and jurisprudence concerns in Iran. Concerns regarding human reproduction or human cloning, breach of human dignity, genetic manipulation and probability of tumorogenisity are observed in adult/somatic stem cells. Destruction of embryo to generate stem cell is an important matter in Iran. In this regards, obtaining stem cell from donated frozen embryos through infertility treatment that would be discarded is an acceptable solution in Iran for generation of embryo for research. Ethical, legal, and jurisprudence strategies for using adult/somatic stem cells are determination of ownership of stem cells, trade prohibition of human body, supervision on bio banks and information of Oversight Committee on Stem Cell Research. Recommendations to handle ethical issues for conducting stem cell research are well-designed studies, compliance codes of ethics in biomedical research (specifically codes of ethics on stem cell research, codes of ethics on clinical trials studies and codes of ethics on animals studies), appropriate collaboration with ethics committees and respecting of rights of participants (including both of human and animal rights) in research. In addition, there is a necessity for extending global networks of bioethics for strengthening communications within organizations at both the regional and international level, strengthening legislation systems

Bioethics methods in the ethical, legal, and social implications of the human genome project literature.

PubMed

Walker, Rebecca L; Morrissey, Clair

2014-11-01

While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications (ELSI) of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross-disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample of ELSI publications appearing between 2003 and 2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries (such as social, legal, or political investigations). © 2013 John Wiley & Sons Ltd.

BIOETHICS METHODS IN THE ETHICAL, LEGAL, AND SOCIAL IMPLICATIONS OF THE HUMAN GENOME PROJECT LITERATURE

PubMed Central

Walker, Rebecca; Morrissey, Clair

2013-01-01

While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications (ELSI) of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross-disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample of ELSI publications appearing between 2003-2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries (such as social, legal, or political investigations). PMID:23796275

There Is More to Ethics than Principles.

ERIC Educational Resources Information Center

Kitchener, Karen Strohm

1996-01-01

In response to Meara et al.'s (1996) article concerning virtue ethics, asserts that moral virtues are not synonymous with moral ideals. Additionally, because virtue ethics can be community specific, they are also in danger of becoming ethnocentric. Suggests that the promotion of virtue ethics itself poses important unanswered question for the…

Workplace distress and ethical dilemmas in neuroscience nursing.

PubMed

Silén, Marit; Tang, Ping Fen; Wadensten, Barbro; Ahlström, Gerd

2008-08-01

This study concerns Swedish nurses' experiences of workplace stress and the occurrence of ethical dilemmas in a neurological setting. Qualitative interviews were conducted with 21 nurses. The interview results were subjected to qualitative latent content analysis and sorted into 4 content areas: workplace distress, ethical dilemmas, managing distress and ethical dilemmas, and quality of nursing. Common workplace stressors were high workload and lack of influence. These were perceived to have negative consequences for the quality of nursing. Ethical dilemmas mainly concerned decision making on initiation or withdrawal of treatment, which was experienced as a troublesome situation where conflicts could arise. The nurses managed the distress and ethical dilemmas by accepting and adjusting to the situation and seeking support from colleagues. They also endeavored to gain new strength in their private lives.

Ethical Obligations in the Face of Dilemmas Concerning Patient Privacy and Public Interests: The Sasebo Schoolgirl Murder Case.

PubMed

Kadooka, Yasuhiro; Okita, Taketoshi; Asai, Atsushi

2016-09-01

A murder case that had some features in common with the Tarasoff case occurred in Sasebo City, Japan, in 2014. A 15-year-old high school girl was murdered and her 16-year-old classmate was arrested on suspicion of homicide. One and a half months before the murder, a psychiatrist who had been examining the girl called a prefectural child consultation centre to warn that she might commit murder, but he did not reveal her name, considering it his professional duty to keep it confidential. Article 134 of the Japanese Criminal Law states that doctors should not disclose patient information obtained in clinical practice without a legitimate reason, but the Japanese Supreme Court has not specified what constitutes a legitimate reason. Mass media and commentators suggested that the murder could have been prevented if the psychiatrist had disclosed the girl's name to the authorities or had isolated her coercively in a psychiatric ward. However, the authors disagree with such claims. This article discusses obligations imposed on concerned individuals and third party members in cases involving ethical dilemmas regarding patient confidentiality and information disclosure. It is concluded that everyone should fulfill their obligations to prevent such tragedies and one should judge the appropriateness of others' actions based not on the consequences of their actions, but on the processes used to decide on a course of action and their commitment. It is necessary for us to establish a society in which concerned parties can do what they think is ethically best without fearing ungrounded charges. © 2016 John Wiley & Sons Ltd.

Sage Series in Business Ethics.

ERIC Educational Resources Information Center

Kanungo, Rabindra Nath; Mendonca, Manuel

This book argues that the literature on leadership, especially business leadership, has neglected ethical issues by focusing on approaches and strategies that emphasize individualistic concerns. The book calls for an end to the traditional separation of personal and public morality. It also argues that ethics of leadership is consistent with the…

Teaching Ethically: Challenges and Opportunities

ERIC Educational Resources Information Center

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…

Ethical hot spots of combined individual and group therapy: applying four ethical systems.

PubMed

Brabender, Virginia M; Fallon, April

2009-01-01

Abstract Combined therapy presents ethical quandaries that occur in individual psychotherapy and group psychotherapy, and dilemmas specifically associated with their integration. This paper examines two types of ethical frameworks (a classical principle-based framework and a set of context-based frameworks) for addressing the ethical hot spots of combined therapy: self-referral, transfer of information, and termination. The principle-based approach enables the practitioner to see what core values may be served or violated by different courses of action in combined therapy dilemmas. Yet, the therapist is more likely to do justice to the complexity and richness of the combined therapy situation by supplementing a principle analysis with three additional ethical frameworks. These approaches are: virtue ethics, feminist ethics, and casuistry. An analysis of three vignettes illustrates how these contrasting ethical models not only expand the range of features to which the therapist attends but also the array of solutions the therapist generates.

Mega-sized concerns from the nano-sized world: the intersection of nano- and environmental ethics.

PubMed

Attia, Peter

2013-09-01

As rapid advances in nanotechnology are made, we must set guidelines to balance the interests of both human beneficiaries and the environment by combining nanoethics and environmental ethics. In this paper, I reject Leopoldian holism as a practical environmental ethic with which to gauge nanotechnologies because, as a nonanthropocentric ethic, it does not value the humans who will actually use the ethic. Weak anthropocentrism is suggested as a reasonable alternative to ethics without a substantial human interest, as it treats nonhuman interests as human interests. I also establish the precautionary principle as a useful situational guideline for decision makers. Finally, I examine existing and potential applications of nanotechnology, including water purification, agriculture, mining, energy, and pollutant removal, from the perspective of weak anthropocentrism using the precautionary principle.

Pilot Study: The Role of Predeployment Ethics Training, Professional Ethics, and Religious Values on Naval Physicians' Ethical Decision Making.

PubMed

Gaidry, Alicia D; Hoehner, Paul J

2016-08-01

Military physicians serving overseas in cross-cultural settings face the challenge of meeting patients' needs and adhering to their personal and professional ethics while abiding by military obligations and duties. Predeployment ethics training for Naval physicians continues to be received in many forms, if received at all, and has largely not addressed their specific roles as medical providers in the military. This study explores the perceived effectiveness of predeployment ethics training received by Naval physicians. Additionally, it considers the contribution of different types of ethics training, religious values, and the professional ethics on Naval physicians' perceived ability to effectively manage ethically challenging scenarios while on deployment. A total of 49 Naval physicians participated in an online survey. 16.3% reported not receiving any form of ethics training before deployment. Of those that reported receiving ethics training before deployment, 92.7% found the ethics training received was helpful in some way while on deployment. While a medical school course was most contributory overall to their ability to handle ethically difficult situations while on deployment (70.7%), what most Naval physicians felt would help them better handle these types of situations would be a mandatory military training/military course (63.2%) or personal mentorship (57.9%). Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Addressing social resistance in emerging security technologies

PubMed Central

Mitchener-Nissen, Timothy

2013-01-01

In their efforts to enhance the safety and security of citizens, governments and law enforcement agencies look to scientists and engineers to produce modern methods for preventing, detecting, and prosecuting criminal activities. Whole body scanners, lie detection technologies, biometrics, etc., are all being developed for incorporation into the criminal justice apparatus.1 Yet despite their purported security benefits these technologies often evoke social resistance. Concerns over privacy, ethics, and function-creep appear repeatedly in analyses of these technologies. It is argued here that scientists and engineers continue to pay insufficient attention to this resistance; acknowledging the presence of these social concerns yet failing to meaningfully address them. In so doing they place at risk the very technologies and techniques they are seeking to develop, for socially controversial security technologies face restrictions and in some cases outright banning. By identifying sources of potential social resistance early in the research and design process, scientists can both engage with the public in meaningful debate and modify their security technologies before deployment so as to minimize social resistance and enhance uptake. PMID:23970863

Mandatory influenza immunization for health care workers--an ethical discussion.

PubMed

Steckel, Cynthia M

2007-01-01

Influenza is a serious vaccine-preventable disease affecting 20% of the U.S. population each year. Vaccination of high-risk groups has been called the single most important influenza control measure by the Centers for Disease Control and Prevention. Studies show that vaccination can lead to decreases in flu-related illness and absenteeism among health care workers, as well as fewer acute care outbreaks and reduced patient mortality in long-term care settings. However, to date, voluntary programs have achieved only a 40% vaccination rate among health care workers, causing concern among government and infectious disease organizations. This article addresses the ethical justification for mandating influenza vaccination for health care workers. Health care workers' attitudes toward vaccination are presented, as well as historical and legal perspectives on compulsory measures. The ethical principles of effectiveness, beneficence, necessity, autonomy, justice, and transparency are discussed.

Ethical Considerations in Designing the International Business Communication Course.

ERIC Educational Resources Information Center

Victor, David A.

As awareness of the need for ethical business behavior increases, businesspeople must address the issue of an ethical standard acceptable for use in international business or, in individual situations, which country's ethical standards will be respected. Ethical absolutes cannot be determined without cultural bias. Legalistic, religious, and…

Ethics approval: responsibilities of journal editors, authors and research ethics committees.

PubMed

Bain, Luchuo Engelbert

2017-01-01

Meaningful progress of medicine depends on research that must ultimately involve human subjects. Obtaining ethical approval therefore, especially in medical sciences, should be a moral reflex for researchers. This unfortunately is not the case, with numerous researchers bypassing the ethics approval procedure, or simply unaware of its importance. Good research involves risks taken by research participants and uses tax payers' money in the process. These mandates the research endeavor to aim at attaining the highest degree of respect for the sacrifices made by others for science. Most researchers mistake scientific clearance or approval, for ethics approval. For a study to be ethical sound, it must be scientifically sound. This is only one of the activities carried out during protocol review. It is not uncommon for sensitive ethical concerns, especially in the social sciences to be overlooked and considered not to be accompanied by any serious risks for the research participants.The researcher has the responsibility of systematically consulting the competent ethics committee for advice and consequent approvals or ethical waivers. Journal editors and reviewers have the duty to systematically evaluate the ethical soundness of manuscripts submitted for review. Capacity building in research ethics and institutional support for Research Ethics Committees to speed up protocol review could reduce the incentive of carrying out research in human subjects without ethics approvals. It is hypocritical and idle to continue to expect optimal reviews on time and of good quality, from ethics committees functioning purely on altruistic grounds. Capacity building for researchers in research ethics, and institutional reforms and support for Research Ethics Committees appear not to have received the attention they truly deserve.

Professional ethics and professional etiquette in dentistry: are they compatible?

PubMed

Newbrun, Ernest

2007-01-01

In keeping with the theme of this colloquium, two aspects of ethics in dentistry are addressed: its evolution and its future. With respect to its evolution, two examples of changes in the design of clinical trials in dentistry are discussed. These concern the current requirement of informed consent from the subjects in the trial, now taken for granted, but not necessarily observed before 1964. The Vipeholm dental caries study is one example of pre-Helsinki Declaration experimentation. The second example, also drawn from caries research design, concerns the stricture on the use of placebo-controlled trials in the face of a proven drug. For example, the design of clinical trials of fluoride dentifrices has evolved since the mid 1970s. The use of a placebo-inactive control group is no longer acceptable as it would deprive its subjects of a proven caries-preventive agent and would expose its subjects to increased caries risk. While definitions of professional ethics in dentistry may vary, the ADA Code of Ethics includes five principles: patient autonomy ("self-governance"), non-maleficence ("do no harm"), beneficence ("do good"), justice ("fairness") and veracity ("truthfulness"). Professional etiquette refers to the way dentists relate to one another and is governed by the ADA Code of Professional Conduct which expresses specific types of conduct that are either required or prohibited. Sometimes, ethics and etiquette may conflict. The problem of financial issues that conflict with ethical ones is discussed along with the problem of commercialism in the practice of dentistry. Debts from dental school may adversely affect the professional behavior of young dentists, while general dentists might succumb to "goodies" provided by specialists. These often include continuing education courses, gifts, trips, and kickbacks. Specialists may fail to inform patients of improper or poor quality treatment by the referring general practitioner, fearing loss of referrals. Of course

Ethical guidelines for the evaluation of living organ donors

PubMed Central

Wright, Linda; Faith, Karen; Richardson, Robert; Grant, David

2004-01-01

Transplantation is an effective, life-prolonging treatment for organ failure. Demand has steadily increased over the past decade, creating a shortage in the supply of organs. In addition, the number of deceased organ donors has reached a plateau. Living-donor transplantation is increasingly an option, influenced by favourable clinical outcomes and increased waiting times at most transplant centres across North America. Living-donor kidney transplants have exceeded deceased-donor transplant rates at some centres. Organ donations from living donors have challenged transplant programs to develop a framework for determining donor acceptability. After a multidisciplinary consensus-building process of discussion and debate, the Multi-Organ Transplant Program of the University Health Network in Toronto has developed ethical guidelines for these procedures. These proposed guidelines address ethical concerns related to selection criteria and procedures, voluntariness, informed consent and disclosure of risks and benefits to both donor and recipient. PMID:15646438

Advancing Ethical Neuroscience Research.

PubMed

Borah, B Rashmi; Strand, Nicolle K; Chillag, Kata L

2016-12-01

As neuroscience research advances, researchers, clinicians, and other stakeholders will face a host of ethical challenges. The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has published two reports that provide recommendations on how to advance research endeavors ethically. The commission addressed, among other issues, how to prioritize different types of neuroscience research and how to include research participants who have impaired consent capacity. The Bioethics Commission's recommendations provide a foundation for ethical guidelines as neuroscience research advances and progresses. © 2016 American Medical Association. All Rights Reserved.

Utilizing Social Media to Study Information-Seeking and Ethical Issues in Gene Therapy

PubMed Central

Robillard, Julie M; Whiteley, Louise; Johnson, Thomas Wade; Lim, Jonathan; Wasserman, Wyeth W

2013-01-01

Background The field of gene therapy is rapidly evolving, and while hopes of treating disorders of the central nervous system and ethical concerns have been articulated within the academic community, little is known about views and opinions of different stakeholder groups. Objective To address this gap, we utilized social media to investigate the kind of information public users are seeking about gene therapy and the hopes, concerns, and attitudes they express. Methods We conducted a content analysis of questions containing the keywords “gene therapy” from the Q&A site “Yahoo! Answers” for the 5-year period between 2006 and 2010. From the pool of questions retrieved (N=903), we identified those containing at least one theme related to ethics, environment, economics, law, or society (n=173) and then characterized the content of relevant answers (n=399) through emergent coding. Results The results show that users seek a wide range of information regarding gene therapy, with requests for scientific information and ethical issues at the forefront of enquiry. The question sample reveals high expectations for gene therapy that range from cures for genetic and nongenetic diseases to pre- and postnatal enhancement of physiological attributes. Ethics questions are commonly expressed as fears about the impact of gene therapy on self and society. The answer sample echoes these concerns but further suggests that the acceptability of gene therapy varies depending on the specific application. Conclusions Overall, the findings highlight the powerful role of social media as a rich resource for research into attitudes toward biomedicine and as a platform for knowledge exchange and public engagement for topics relating to health and disease. PMID:23470490

Utilizing social media to study information-seeking and ethical issues in gene therapy.

PubMed

Robillard, Julie M; Whiteley, Louise; Johnson, Thomas Wade; Lim, Jonathan; Wasserman, Wyeth W; Illes, Judy

2013-03-04

The field of gene therapy is rapidly evolving, and while hopes of treating disorders of the central nervous system and ethical concerns have been articulated within the academic community, little is known about views and opinions of different stakeholder groups. To address this gap, we utilized social media to investigate the kind of information public users are seeking about gene therapy and the hopes, concerns, and attitudes they express. We conducted a content analysis of questions containing the keywords "gene therapy" from the Q&A site "Yahoo! Answers" for the 5-year period between 2006 and 2010. From the pool of questions retrieved (N=903), we identified those containing at least one theme related to ethics, environment, economics, law, or society (n=173) and then characterized the content of relevant answers (n=399) through emergent coding. The results show that users seek a wide range of information regarding gene therapy, with requests for scientific information and ethical issues at the forefront of enquiry. The question sample reveals high expectations for gene therapy that range from cures for genetic and nongenetic diseases to pre- and postnatal enhancement of physiological attributes. Ethics questions are commonly expressed as fears about the impact of gene therapy on self and society. The answer sample echoes these concerns but further suggests that the acceptability of gene therapy varies depending on the specific application. Overall, the findings highlight the powerful role of social media as a rich resource for research into attitudes toward biomedicine and as a platform for knowledge exchange and public engagement for topics relating to health and disease.

Happiness and Ethical Values in Higher Education

ERIC Educational Resources Information Center

Lee, Jeong-Kyu

2017-01-01

The purpose of this paper is to discuss relations between happiness and ethical values in higher education, focusing on the need for the university to pursue happiness and ethical values. To examine the paper logically, four research questions are addressed. First, what are general concepts of happiness and ethical values? Second, why higher…

Information Ethics Education for a Multicultural World

ERIC Educational Resources Information Center

Fleischmann, Kenneth R.; Robbins, Russell W.; Wallace, William A.

2011-01-01

How can we prepare information systems students to face the ethical challenges of a globalized world? This paper describes a three-step approach for addressing these challenges. First, we have designed undergraduate and graduate information ethics courses that expand the range of learning of ethical theories beyond the traditional Western canon to…

Relationships between organizational and individual support, nurses' ethical competence, ethical safety, and work satisfaction.

PubMed

Poikkeus, Tarja; Suhonen, Riitta; Katajisto, Jouko; Leino-Kilpi, Helena

2018-03-12

Organizations and nurse leaders do not always effectively support nurses' ethical competence. More information is needed about nurses' perceptions of this support and relevant factors to improve it. The aim of the study was to examine relationships between nurses' perceived organizational and individual support, ethical competence, ethical safety, and work satisfaction. A cross-sectional questionnaire survey was conducted. Questionnaires were distributed to nurses (n = 298) working in specialized, primary, or private health care in Finland. Descriptive statistics, multifactor analysis of variance, and linear regression analysis were used to test the relationships. The nurses reported low organizational and individual support for their ethical competence, whereas perceptions of their ethical competence, ethical safety, and work satisfaction were moderate. There were statistically significant positive correlations between both perceived individual and organizational support, and ethical competence, nurses' work satisfaction, and nurses' ethical safety. Organizational and individual support for nurses' ethical competence should be strengthened, at least in Finland, by providing more ethics education and addressing ethical problems in multiprofessional discussions. Findings confirm that organizational level support for ethical competence improves nurses' work satisfaction. They also show that individual level support improves nurses' sense of ethical safety, and both organizational and individual support strengthen nurses' ethical competence. These findings should assist nurse leaders to implement effective support practices to strengthen nurses' ethical competence, ethical safety, and work satisfaction.

Ethics rounds do not improve the handling of ethical issues by psychiatric staff.

PubMed

Silén, Marit; Haglund, Kristina; Hansson, Mats G; Ramklint, Mia

2015-08-01

One way to support healthcare staff in handling ethically difficult situations is through ethics rounds that consist of discussions based on clinical cases and are moderated by an ethicist. Previous research indicates that the handling of ethically difficult situations in the workplace might have changed after ethics rounds. This, in turn, would mean that the "ethical climate", i.e. perceptions of how ethical issues are handled, would have changed. To investigate whether ethics rounds could improve the ethical climate perceived by staff working in psychiatry outpatient clinics. In this quasi-experimental study, six inter-professional ethics rounds led by a philosopher/ethicist were conducted at two psychiatry outpatient clinics. Changes in ethical climate were measured at these clinics as well as at two control clinics at baseline and after the intervention period using the instrument Hospital Ethical Climate Survey. Within-groups comparisons of median sum scores of ethical climate showed that no statistically significant differences were found in the intervention group before or after the intervention period. The median sum scores for ethical climate were significantly higher, both at baseline and after the intervention period (P ≤ 0.001; P = 0.046), in the intervention group. Ethics rounds in psychiatric outpatient clinics did not result in significant changes in ethical climate. Outcomes of ethics rounds might, to a higher degree, be directed towards patient-related outcomes rather than towards the staff's working environment, as the questions brought up for discussion during the ethics rounds concerned patient-related issues.

Enacting Social Justice Ethically: Individual and Communal Habits. A Response to "Ethics in Teaching for Democracy and Social Justice"

ERIC Educational Resources Information Center

Gunzenhauser, Michael G.

2015-01-01

In response to Hytten's provocative opening of a conversation about an ethics for activist teaching, in this essay I address three interesting contributions that Hytten made. First, I explore the significance of the imagined ethical subject in Hytten's example and in many prior authors' work on ethics in social justice teaching. Expanding the…

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

PubMed

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

2013-11-01

Organ donation after uncontrolled cardiac death raises complex ethical issues. We conducted a survey in a large hospital staff population, including caregivers and administrators, to determine their ethical viewpoints regarding organ donation after uncontrolled cardiac death. Multicenter observational survey using a questionnaire, including information on the practical modalities of the procedure. Respondents were asked to answer 15 detailed ethical questions corresponding to different ethical issues raised in the literature. Ethical concerns was defined when respondents expressed ethical concerns in their answers to at least three of nine specifically selected ethical questions. One thousand one hundred ninety-six questionnaires were received, and 1057 could be analysed. According to our definition, 573 respondents out of 1057 (54%) had ethical concerns with regard to donation after cardiac death and 484 (46 %) had no ethical concerns. Physicians (55%) and particularly junior intensivists (65%) tended to have more ethical issues than nurses (52%) and hospital managers (37%). Junior intensivists had more ethical issues than senior intensivists (59%), emergency room physicians (46%) and transplant specialists (43%). Only 46% of hospital-based caregivers and managers appear to accept easily the legitimacy of organ donation after cardiac death. A significant number of respondents especially intensivists, expressed concerns over the dilemma between the interests of the individual and those of society. These results underline the need to better inform both healthcare professionals and the general population to help to the development of such procedure. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

An ethical assessment model for digital disease detection technologies.

PubMed

Denecke, Kerstin

2017-09-20

Digital epidemiology, also referred to as digital disease detection (DDD), successfully provided methods and strategies for using information technology to support infectious disease monitoring and surveillance or understand attitudes and concerns about infectious diseases. However, Internet-based research and social media usage in epidemiology and healthcare pose new technical, functional and formal challenges. The focus of this paper is on the ethical issues to be considered when integrating digital epidemiology with existing practices. Taking existing ethical guidelines and the results from the EU project M-Eco and SORMAS as starting point, we develop an ethical assessment model aiming at providing support in identifying relevant ethical concerns in future DDD projects. The assessment model has four dimensions: user, application area, data source and methodology. The model supports in becoming aware, identifying and describing the ethical dimensions of DDD technology or use case and in identifying the ethical issues on the technology use from different perspectives. It can be applied in an interdisciplinary meeting to collect different viewpoints on a DDD system even before the implementation starts and aims at triggering discussions and finding solutions for risks that might not be acceptable even in the development phase. From the answers, ethical issues concerning confidence, privacy, data and patient security or justice may be judged and weighted.

Ethical Perspectives on Evaluating Community College Faculty

ERIC Educational Resources Information Center

Stumpf, Dan; King, Stephanie; Blendinger, Jack; Davis, Ed

2013-01-01

Because the process of faculty evaluation in the community college gives rise to ethical concerns about what is evaluated, who is involved in the process, and how data are collected and used, the purpose of this paper is to provide a meaningful ethical perspective for conducting faculty evaluation. The authors discuss ethical issues that arise in…

Good epidemiology, good ethics: empirical and ethical dimensions of global public health.

PubMed

Rentmeester, Christy A; Dasgupta, Rajib

2012-01-01

This paper examines the following ethically and epidemiologically relevant challenges, as yet neglected in public health ethics: how to distribute resources and health risks and benefits, how to define evidentiary criteria that justify public health interventions, and how to define terms in which programme goals, successes, and failures will be assessed and monitored. We illuminate critical intersections of empirical and ethical dimensions of public health work, drawing upon three global public health interventions-inclusion of the Hepatitis B vaccine in the Universal Immunisation Programme, Universal Salt Iodisation, and the Global Polio Eradication Initiative-and suggest strategies for addressing and responding to them.

A Consideration to Two Main Ethical Issues in Educational Research, and How May These Be Addressed

ERIC Educational Resources Information Center

Abed, Mohaned Ghazi

2015-01-01

This paper has firstly discussed the topic of Ethical Issues in Education, and has accordingly highlighted the fact that ethics are not something to deem at the commencement of a research project or fieldwork, but rather throughout the entire research process. Furthermore, two of the most important ethical issues have been given…

Ethics outside of inpatient care: the need for alliances between clinical and organizational ethics.

PubMed

Barina, Rachelle

2014-12-01

The norms and practices of clinical ethics took form relative to the environment and relationships of hospital care. These practices do not easily translate into the outpatient context because the environment and relational dynamics differ. Yet, as outpatient care becomes the center of health care delivery, the experiences of ethical tension for outpatient clinicians warrant greater responses. Although a substantial body of literature on the nature of the doctor-physician relationship has been developed and could provide theoretical groundwork for an outpatient ethics, this literature is not sufficient to support outpatient caregivers in practical dilemmas. For physicians who are employed by or affiliated with a larger organization, a stronger alliance between clinical ethics and organizational ethics, identity, and mission will promote expansion of ethics resources in outpatient settings and address structural constraints in outpatient clinical care.

Ethical Dilemmas for Academic Professionals.

ERIC Educational Resources Information Center

Payne, Stephen L., Ed.; Charnov, Bruce H., Ed.

Ethical dilemmas faced by many academicians in the course of their work activities and role demands are described in eight articles and 24 case illustrations. Article titles and authors are as follows: "The Academician as Good Citizen" (Bruce H. Charnov); "Fundamental Means to Ethical Teaching" (Gordon A. Walter, Mary Ann Von Glinow); "Concern for…

Ethical Challenges in the Teaching of Multicultural Course Work

ERIC Educational Resources Information Center

Fier, Elizabeth Boyer; Ramsey, MaryLou

2005-01-01

The authors explore the ethical issues and challenges frequently encountered by counselor educators of multicultural course work. Existing ethics codes are examined, and the need for greater specificity with regard to teaching courses of multicultural content is addressed. Options for revising existing codes to better address the challenges of…

Is globalisation outpacing ethics and social responsibility in occupational health?

PubMed

Voyi, Kuku

2006-01-01

The definition of globalisation is varied. However, one certainty is that in a globalised world the borders are porous in many aspects; people movement, goods exchange, knowledge sharing and redistribution of labour. The concept of globalisation, its impact on society, and its direction leads to a two-sided argument. Could this be the effect of globalisation on ethics and social responsibility, as it is perceived? This paper endeavours to further our understanding of the dynamic relationship of globalisation, ethics and social responsibility in occupational health. The multidisciplinary activity approach to occupational health was used. The globalisation, ethical and social responsibility relationship of the activities in occupational health was analysed using a schematic map of the direct and indirect influences. The analysis revealed areas that can be clustered to address the interaction between driving forces in occupational health ethics and social responsibility for a healthy workforce. Each cluster is discussed highlighting areas of concern. In the discussion proposals are made on how we can modify the way we think in order to avoid repeating mistakes. Suggestion is made of using an innovative method borrowed from other disciplines and adopted for use in occupational health. A partnership approach is proposed and explored on how it will be applied in situations of unequal balance of power.

Resolving Ethical Issues at School

ERIC Educational Resources Information Center

Benninga, Jacques S.

2013-01-01

Although ethical dilemmas are a constant in teachers' lives, the profession has offered little in the way of training to help teachers address such issues. This paper presents a framework, based on developmental theory, for resolving professional ethical dilemmas. The Four-Component Model of Moral Maturity, when used in conjunction with a…

Polio immunization in Pakistan: ethical issues and challenges.

PubMed

Basharat, Sarah; Shaikh, Babar Tasneem

2017-01-01

Immunization should be considered a basic human right to health and well-being. It is everybody's business, and it is everybody's responsibility: the individual, the community, the health system and the state. This paper attempts to review some of the literature that highlights the ethical and religious concerns surrounding polio vaccination and what approaches may be used to counter the problems faced in Pakistan. This paper is developed through a literature review on public health and polio in Pakistan, consulting local, regional and globally published peer reviewed articles focussing on religion, culture, ethics and public health. Human behaviour, including the utilization and acceptability of healthcare services, is greatly influenced by religious beliefs and dogmas. Immunization, specifically for the purpose of polio eradication, has been a topic under focus and in the news in Pakistan. The government is doing its best through a variety of interventions to increase access, inform the public and increase vaccination rates. Nevertheless, the country still faces a huge challenge from certain stern pockets of uncompromising populations who resist and refuse vaccination. Beliefs, practices and cultural norms overshadow public health priorities and ethics. Understanding of the context, therefore, is critical to determine the social hindrances in polio eradication and strategize thereon. Having programmatic, system-wide, socio-cultural and of course ethical dimensions, the policy makers and the programme managers in Pakistan must attempt to address the multitude of challenges to polio vaccination, whereby the plan of action developed within the ethical norms could potentially lead to an ultimate success.

Ethics and reproduction.

PubMed

Macnaughton, M

1990-04-01

In Western culture, the ethical principles of respect for persons can be further divided into 2 categories - a) autonomy and b) protection of the vulnerable; beneficence; and justice. The principles of ethics can be directed towards 2 levels: microethics - concerned with the individual and macroethics - concerned with the greater community. In the case of obstetrical procedures such as in vitro fertilization, prenatal diagnosis, and fetal sex selection, the principles of microethics and macroethics conflict. The exact number and/or kind of babies may benefit the parents by they may not benefit a society that is expected to accommodate these new members. This aspect can also be addressed when dealing with abortion. Support for and against has led to a questioning and reexamining of present abortion laws; the aim is to either restrict abortion or reduce the abortion time limit from 28 to 24 weeks. Policies of the United States have an effect on other policies, worldwide. Abortions are needed as a form of birth control in developing countries; 500,000 women/year die from birthing complications and 100,000 die from complications of illegal abortions. There has also been some questioning of in vitro fertilization. Why fertilize a certain number of eggs which may never be allowed to grow and mature? There has also been some questioning of whether or not an embryo in vitro fertilization is a person or not. Deciding the status of the embryo has opened up research possibilities in the United State and the United Kingdom. Discussion on in vitro fertilization has opened up discussion on surrogacy. There seems to be more support for surrogacy in the United States than in the United Kingdom - where there is a restrictive ban on commercial surrogacy.

Ethical and Legal Implications of the Methodological Crisis in Neuroimaging.

PubMed

Kellmeyer, Philipp

2017-10-01

Currently, many scientific fields such as psychology or biomedicine face a methodological crisis concerning the reproducibility, replicability, and validity of their research. In neuroimaging, similar methodological concerns have taken hold of the field, and researchers are working frantically toward finding solutions for the methodological problems specific to neuroimaging. This article examines some ethical and legal implications of this methodological crisis in neuroimaging. With respect to ethical challenges, the article discusses the impact of flawed methods in neuroimaging research in cognitive and clinical neuroscience, particularly with respect to faulty brain-based models of human cognition, behavior, and personality. Specifically examined is whether such faulty models, when they are applied to neurological or psychiatric diseases, could put patients at risk, and whether this places special obligations on researchers using neuroimaging. In the legal domain, the actual use of neuroimaging as evidence in United States courtrooms is surveyed, followed by an examination of ways that the methodological problems may create challenges for the criminal justice system. Finally, the article reviews and promotes some promising ideas and initiatives from within the neuroimaging community for addressing the methodological problems.

New Issues for New Methods: Ethical and Editorial Challenges for an Experimental Philosophy.

PubMed

Polonioli, Andrea

2017-08-01

This paper examines a constellation of ethical and editorial issues that have arisen since philosophers started to conduct, submit and publish empirical research. These issues encompass concerns over responsible authorship, fair treatment of human subjects, ethicality of experimental procedures, availability of data, unselective reporting and publishability of research findings. This study aims to assess whether the philosophical community has as yet successfully addressed such issues. To do so, the instructions for authors, submission process and published research papers of 29 main journals in philosophy have been considered and analyzed. In light of the evidence reported here, it is argued that the philosophical community has as yet failed to properly tackle such issues. The paper also delivers some recommendations for authors, reviewers and editors in the field.

Outsourcing ethical obligations: should the revised common rule address the responsibilities of investigators and sponsors?

PubMed

Shah, Seema K

2013-01-01

The Common Rule creates a division of moral labor in research. It implies that investigators and sponsors can outsource their ethical obligations to IRBs and participants, thereby fostering a culture of compliance, rather than one of responsibility. The proposed revisions to the Common Rule are likely to exacerbate this problem. To harness the expressive power of the law, I propose the Common Rule be revised to include the ethical responsibilities of investigators and sponsors. © 2013 American Society of Law, Medicine & Ethics, Inc.

Ethics in perioperative practice--patient advocacy.

PubMed

Schroeter, Kathryn

2002-05-01

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this second of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the third provision statement, which addresses nurses' position as patient advocates.

The ethics of social media in dental practice: ethical tools and professional responses.

PubMed

Peltier, Bruce; Curley, Arthur

2013-07-01

This article considers several important trends in dental practice that result from innovations in digital and social media. It provides ethical tools for analysis, Illuminates areas of ethical concern in the current practice environment and offers recommendations for future practice. A summary in the form of a checklist is posted at the end of this essay for dentists considering the use of social media in their practice.

The Ethical Implication of Bartering for Mental Health Services: Examining Interdisciplinary Ethical Standards

ERIC Educational Resources Information Center

Lane, Joel A.

2013-01-01

The present paper discusses literature concerning the practice of bartering for counseling, psychological, or social work services in lieu of traditional monetary payment. The author contrasts the language concerning the practice of bartering found in the respective ethical codes for each profession, and presents literature describing both risks…

Ethical considerations in industry-sponsored multiregional clinical trials.

PubMed

Ibia, Ekopimo; Binkowitz, Bruce; Saillot, Jean-Louis; Talerico, Steven; Koerner, Chin; Ferreira, Irene; Agarwal, Anupam; Metz, Craig; Maman, Marianne

2010-01-01

During the last several decades, the scientific and ethics communities have addressed important ethical issues in medical research, resulting in the elaboration and adoption of concepts, guidelines, and codes. Ethical issues in the conduct of Multiregional Clinical Trials have attracted significant attention mainly in the last two decades. With the globalization of clinical research and the rapid expansion to countries with a limited tradition of biomedical research, sponsors must proactively address local ethical issues, the adequacy of oversight as well as the applicability and validity of data, and scientific conclusions drawn from diverse patient populations. This paper highlights some core ethical principles and milestones in medical research, and, from an industry perspective, it discusses ethical issues that the clinical trial team may face when conducting Multiregional Clinical Trials (MRCT, clinical trials conducted at sites located across multiple geographic regions of the world). This paper further highlights the areas of consensus and controversies and proposes points to consider. Copyright © 2010 John Wiley & Sons, Ltd.

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

PubMed

Schleidgen, Sebastian; Marckmann, Georg

2013-05-24

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

Is there room for ethics within bioinformatics education?

PubMed

Taneri, Bahar

2011-07-01

When bioinformatics education is considered, several issues are addressed. At the undergraduate level, the main issue revolves around conveying information from two main and different fields: biology and computer science. At the graduate level, the main issue is bridging the gap between biology students and computer science students. However, there is an educational component that is rarely addressed within the context of bioinformatics education: the ethics component. Here, a different perspective is provided on bioinformatics education, and the current status of ethics is analyzed within the existing bioinformatics programs. Analysis of the existing undergraduate and graduate programs, in both Europe and the United States, reveals the minimal attention given to ethics within bioinformatics education. Given that bioinformaticians speedily and effectively shape the biomedical sciences and hence their implications for society, here redesigning of the bioinformatics curricula is suggested in order to integrate the necessary ethics education. Unique ethical problems awaiting bioinformaticians and bioinformatics ethics as a separate field of study are discussed. In addition, a template for an "Ethics in Bioinformatics" course is provided.

Foundations for Ethical Standards and Codes: The Role of Moral Philosophy and Theory in Ethics

ERIC Educational Resources Information Center

Freeman, Stephen J.; Engels, Dennis W.; Altekruse, Michael K.

2004-01-01

Ethical practice is a concern for all who practice in the psychological, social, and behavioral sciences. A central problem is discerning what action is ethically correct in a particular situation. It has been said that there is nothing so practical as good theory, because theory can help counselors organize and integrate knowledge. It seems,…

Philosophical Perspectives on Values and Ethics in Speech Communication.

ERIC Educational Resources Information Center

Becker, Carl B.

There are three very different concerns of communication ethics: (1) applied speech ethics, (2) ethical rules or standards, and (3) metaethical issues. In the area of applied speech ethics, communications theorists attempt to determine whether a speech act is moral or immoral by focusing on the content and effects of specific speech acts. Specific…

Psychiatry's new manual (DSM-5): ethical and conceptual dimensions.

PubMed

Blumenthal-Barby, J S

2014-08-01

The introduction of the Diagnostic and statistical manual of mental disorders (DSM-5) in May 2013 is being hailed as the biggest event in psychiatry in the last 10 years. In this paper I examine three important issues that arise from the new manual:(1) Expanding nosology: Psychiatry has again broadened its nosology to include human experiences not previously under its purview (eg, binge eating disorder, internet gaming disorder, caffeine use disorder, hoarding disorder, premenstrual dysphoric disorder). Consequence-based ethical concerns about this expansion are addressed, along with conceptual concerns about a confusion of "construct validity" and "conceptual validity" and a failure to distinguish between "disorder" and "non disordered conditions for which we help people."(2) The role of claims about societal impact in changes in nosology: Several changes in the DSM-5 involved claims about societal impact in their rationales. This is due in part to a new online open comment period during DSM development. Examples include advancement of science, greater access to treatment, greater public awareness of condition, loss of identify or harm to those with removed disorders, stigmatization, offensiveness, etc. I identify and evaluate four importantly distinct ways in which claims about societal impact might operate in DSM development. (3) Categorisation nosology to spectrum nosology: The move to "degrees of severity" of mental disorders, a major change for DSM-5, raises concerns about conceptual clarity and uniformity concerning what it means to have a severe form of a disorder, and ethical concerns about communication. 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.

The ethical commitments of academic faculty in psychiatric education.

PubMed

Green, Stephen A

2006-01-01

This article explores the commitment of faculty to ethics training in psychiatric education. Although psychiatry has insufficiently addressed the profession's need for ethics training in education, program directors acknowledge its critical importance, and its positive impact has been demonstrated. Additionally, residents often seek ethics training as part of their instruction. The author suggests that academic faculty could respond to the profession's inadequate treatment of ethics training by helping trainees develop moral agency--the ability to recognize, assess, and respond to ethical dilemmas; decide what constitutes right or wrong care; and act accordingly. The author also describes how this objective could be met by promoting professionalism and offering didactic instruction that address substantive and process issues regarding psychiatric care. Specific recommendations are provided.

Addressing Consent Issues in Donation After Circulatory Determination of Death.

PubMed

Overby, Kim J; Weinstein, Michael S; Fiester, Autumn

2015-01-01

Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria (i.e., brain death), there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients.

Ethical Dilemmas in Community-Based Participatory Research: Recommendations for Institutional Review Boards

PubMed Central

Travers, Robb; Guta, Adrian; McDonald, Sean; Meagher, Aileen

2007-01-01

National and international codes of research conduct have been established in most industrialized nations to ensure greater adherence to ethical research practices. Despite these safeguards, however, traditional research approaches often continue to stigmatize marginalized and vulnerable communities. Community-based participatory research (CBPR) has evolved as an effective new research paradigm that attempts to make research a more inclusive and democratic process by fostering the development of partnerships between communities and academics to address community-relevant research priorities. As such, it attempts to redress ethical concerns that have emerged out of more traditional paradigms. Nevertheless, new and emerging ethical dilemmas are commonly associated with CBPR and are rarely addressed in traditional ethical reviews. We conducted a content analysis of forms and guidelines commonly used by institutional review boards (IRBs) in the USA and research ethics boards (REBs) in Canada. Our intent was to see if the forms used by boards reflected common CBPR experience. We drew our sample from affiliated members of the US-based Association of Schools of Public Health and from Canadian universities that offered graduate public health training. This convenience sample (n = 30) was garnered from programs where application forms were available online for download between July and August, 2004. Results show that ethical review forms and guidelines overwhelmingly operate within a biomedical framework that rarely takes into account common CBPR experience. They are primarily focused on the principle of assessing risk to individuals and not to communities and continue to perpetuate the notion that the domain of “knowledge production” is the sole right of academic researchers. Consequently, IRBs and REBs may be unintentionally placing communities at risk by continuing to use procedures inappropriate or unsuitable for CBPR. IRB/REB procedures require a new framework

Why Are There So Few Ethics Consults in Children's Hospitals?

PubMed

Carter, Brian; Brockman, Manuel; Garrett, Jeremy; Knackstedt, Angie; Lantos, John

2018-06-01

In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children's hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are (1) ethics committee meetings, (2) Nursing Ethics Forum, (3) ethics Brown Bag workshops, (4) PICU ethics rounds, (5) Grand Rounds, (6) NICU Comprehensive Care Rounds, (7) Palliative Care Team (PaCT) case conferences, (8) multidisciplinary consults in Fetal Health Center, and (9) ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of "core competencies" than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple "moral spaces" in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set

Management Communication Ethics Research: Finding the Bull's-Eye.

ERIC Educational Resources Information Center

Reinsch, N. Lamar, Jr.

1996-01-01

Argues that scholars who wish to produce substantive research in management communication ethics would be helped by a clear vision of what the term designates. States that management communication ethics should designate concerns that lie at the intersection of management, communication, and ethics. Concludes that this approach could help to…

What's the matter with business ethics?

PubMed

Stark, A

1993-01-01

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

Using rhetorical theory in medical ethics cases.

PubMed

Heifferon, B

2000-01-01

In this paper I argue that rhetorical theory is a valuable tool in medical ethics cases. The case I use as an example is one in which traditional, philosophy-based medical ethics are applied. In this case the traditional ethical approach is not adequate to the task. Key issues and problems are not addressed, resulting in a problem that seems to be solved on the surface, but, when rhetorically analyzed, it's obvious that none of the issues have been resolved in any satisfactory way. By using rhetorical theory, such as that Michel Foucault uses in Power/Knowledge, we discover that the reason this case has not been solved is that the power issues have not been addressed. Using Foucault's concepts of "subjugated knowledge", "local knowledge", "situated knowledge", and "docile bodies", we can tease out the real issues that surface in this ethics case and solve them. Foucault also recommends we use theory as a "toolkit". I propose a model that is a further iteration of this idea. My model uses numerous rhetorical and literary theories, depending on the issues that need to be addressed in each individual medical ethics case. I briefly describe the various theories and include a handout of what the new model of using rhetorical theory in such cases would look like.

An overview of ethical frameworks in public health: can they be supportive in the evaluation of programs to prevent overweight?

PubMed Central

2010-01-01

Background The prevention of overweight sometimes raises complex ethical questions. Ethical public health frameworks may be helpful in evaluating programs or policy for overweight prevention. We give an overview of the purpose, form and contents of such public health frameworks and investigate to which extent they are useful for evaluating programs to prevent overweight and/or obesity. Methods Our search for frameworks consisted of three steps. Firstly, we asked experts in the field of ethics and public health for the frameworks they were aware of. Secondly, we performed a search in Pubmed. Thirdly, we checked literature references in the articles on frameworks we found. In total, we thus found six ethical frameworks. We assessed the area on which the available ethical frameworks focus, the users they target at, the type of policy or intervention they propose to address, and their aim. Further, we looked at their structure and content, that is, tools for guiding the analytic process, the main ethical principles or values, possible criteria for dealing with ethical conflicts, and the concrete policy issues they are applied to. Results All frameworks aim to support public health professionals or policymakers. Most of them provide a set of values or principles that serve as a standard for evaluating policy. Most frameworks articulate both the positive ethical foundations for public health and ethical constraints or concerns. Some frameworks offer analytic tools for guiding the evaluative process. Procedural guidelines and concrete criteria for solving important ethical conflicts in the particular area of the prevention of overweight or obesity are mostly lacking. Conclusions Public health ethical frameworks may be supportive in the evaluation of overweight prevention programs or policy, but seem to lack practical guidance to address ethical conflicts in this particular area. PMID:20969761

Ethics and the Early Childhood Teacher Educator: A Proposed Addendum to the NAEYC Code of Ethical Conduct.

ERIC Educational Resources Information Center

Freeman, Nancy; Feeney, Stephanie; Moravcik, Eva

2003-01-01

Proposes an addendum to the National Association for the Education of Young Children's Code of Ethical Conduct concerning the unique ethical challenges facing teacher educators. Presents a conception of professional responsibility in six areas: children and families, adult students, programs hosting practicum students and programs' staffs and…

Ethical issues for otolaryngology and surgery in the elderly.

PubMed

Seidman, M D; Shapiro, D P; Shirwany, N A

1999-06-01

Clinical ethics is an intrinsic aspect of medical practice. Concerns for ethical conduct arise in the management of medical benefits, patient preferences, quality of life, and the relationship between patient care and its attendant familial, social, economic, and legal circumstances. Ethical concerns in surgical practice are central to the essence of the Hippocratic doctrine, "First do no harm." In caring for our patients, particularly in light of the modern practice of medicine, we often use the risk-benefit calculus. The range of ethical concerns for the otolaryngologist who deals with the elderly and infirm covers many diverse situations. Superimposed over this spectrum is the idea of patient autonomy, which is considered to be a cardinal issue in any ethical discussion. Furthermore, increasing medical care costs have created a debate regarding the rationing of healthcare. Ethicists continue the discussion as to whether age should be a decisive factor in the rationing of this care. Definitions of "heroic" and "extraordinary" assume greater significance, and controversies of language become pivotal when the comprehension and cognitive orientation of the patient are compromised by disease and senescence.

Health care ethics consultation: an update on core competencies and emerging standards from the American Society For Bioethics and Humanities' core competencies update task force.

PubMed

Tarzian, Anita J

2013-01-01

Ethics consultation has become an integral part of the fabric of U.S. health care delivery. This article summarizes the second edition of the Core Competencies for Health Care Ethics Consultation report of the American Society for Bioethics and Humanities. The core knowledge and skills competencies identified in the first edition of Core Competencies have been adopted by various ethics consultation services and education programs, providing evidence of their endorsement as health care ethics consultation (HCEC) standards. This revised report was prompted by thinking in the field that has evolved since the original report. Patients, family members, and health care providers who encounter ethical questions or concerns that ethics consultants could help address deserve access to efficient, effective, and accountable HCEC services. All individuals providing such services should be held to the standards of competence and quality described in the revised report.

Ethics in global surgery.

PubMed

Wall, Anji E

2014-07-01

Global surgery, while historically a small niche, is becoming a larger part of the global health enterprise. This article discusses the burden of global surgery, emphasizing the importance of addressing surgical needs in low- and middle-income countries. It describes the barriers to surgical care in the developing world, the ethical challenges that these barriers create, and strategies to overcome these barriers. It emphasizes the crucial role of preparation for global surgical interventions as a way to maximize benefits as well as minimize harms and ethical challenges. It ends with the cautionary statement that preparation does not eliminate ethical problems, so surgical volunteers must be prepared not only for the technical challenges of global surgery but also for the ethical challenges.

Beyond procedural ethics: Foregrounding questions of justice in global health research ethics training for students