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Sample records for ethical dilemmas presented

  1. [Ethical dilemmas in health].

    PubMed

    Boléo-Tomé, J

    2009-01-01

    It is difficult to speak of ethic dilemmas in a society that has relativism as the oficial philosophical and political doctrine, i.e., stable values and behavior references, are denied, both in health care and in any other area of human knowledge. In the field of medical sciences it is even pretended to pass from the observational methodology to a field of manipulation and manipulability. It is the very Ethic that is presented as a dilemma. In these conditions one needs to know the lines of thought that are defended, to replace and make disappear the stable ethic references: ecletism, historicism, scientificism, pragmatism, and nihilism itself, that lead to the 'new ethic paradigm', that has created by itself a pseudo-spirituality. The truth is we are adrift in the 'Ethic of Convenience' which changes according to the majorities. In this setting the way to go is to rediscover the abandoned ethic values: only with an objective ethic, with sound references and foundations, it is possible to re-establish and perfect the patient-physician relationship, for a better social health. And this begins with the ethic problem of human life. PMID:20350468

  2. Nurses' Resolutions of Six Ethical Dilemmas.

    ERIC Educational Resources Information Center

    Lawrence, Jeanette A.; Crisham, Patricia

    Six ethical dilemmas related to nursing practice were developed and presented to registered and trainee nurses for their resolution. A non-nurse group of university students also gave decisions about what a nurse should do in each ethically-loaded situation. A dilemma was classified as recurrent if its core problem was spontaneously mentioned by…

  3. Ethical Dilemmas of Prosocial Television.

    ERIC Educational Resources Information Center

    Brown, William J.; Singhal, Arvind

    1990-01-01

    Examines ethical dilemmas associated with using entertainment television for prosocial development. Discusses the ethics of distinguishing prosocial from antisocial television content; depicting socio-cultural equality through television programs; limiting the unintended effects of television programs; and using television as a persuasive tool to…

  4. Coverage: An Ethical Dilemma.

    ERIC Educational Resources Information Center

    Feldman, Brenda J.

    1994-01-01

    Discusses how a high school journalism advisor dealt with ethical issues (including source attribution) surrounding the publication of a story about violation of school board policies by representatives of a nationally recognized ring company. (RS)

  5. Ethical dilemmas in clerkship rotations.

    PubMed

    Myers, Michael F; Herb, Alice

    2013-11-01

    A sound clinical education should include the opportunity for medical students to engage in a spirited and informed discussion with faculty about the ethical challenges they will undoubtedly face. Unfortunately, in many medical schools today this goal is thwarted by many factors, including denial that a problem exists, relentless system overload, unprofessional behavior, breakdown in communication, and inertia. What is worse is that this problem is not new, and the fallout is not insignificant. Another potential contributing factor is burnout, which is well documented in a high percentage of medical students, residents, and faculty, and two of its most serious consequences are patient dissatisfaction and medical error.The authors draw on hundreds of student reflections on ethical dilemmas submitted during classroom exercises to examine persistent themes. They posit that classroom and didactic teaching is not enough to enable students to face ethical dilemmas. The authors call for a major culture change in medical education: "buy in" from top administration, especially the dean (and associate/assistant deans), chairs of all departments, and clerkship and residency training directors; the appointing of an ombudsperson and/or ethicist to oversee and resolve issues as they arise; instructional workshops and materials to enhance and impart skills for all teachers; remediation or retiring of errant faculty; and ongoing research and dialogue between and among medical centers about novel solutions. PMID:24072128

  6. Thinking About Ethical Dilemmas in Pharmacy.

    ERIC Educational Resources Information Center

    Lowenthal, Werner; And Others

    1986-01-01

    Pharmacy students and pharmacists surveyed on ethical dilemmas in pharmacy practice indicated a high degree of concern over patient welfare. The major area of disagreements was on economic concerns. The ethical dilemmas in pharmacy practice survey is appended. (Author/MLW)

  7. Ethical Dilemmas: A Model to Understand Teacher Practice

    ERIC Educational Resources Information Center

    Ehrich, Lisa Catherine; Kimber, Megan; Millwater, Jan; Cranston, Neil

    2011-01-01

    Over recent decades, the field of ethics has been the focus of increasing attention in teaching. This is not surprising given that teaching is a moral activity that is heavily values-laden. Because of this, teachers face ethical dilemmas in the course of their daily work. This paper presents an ethical decision-making model that helps to explain…

  8. Ethical dilemmas in perioperative nursing practice.

    PubMed

    Reeder, J M

    1989-12-01

    Ethical dilemmas in perioperative nursing practice occur during all phases and in every practice setting. Awareness of commonly experienced dilemmas and understanding of a model available to analyze and resolve these dilemmas can benefit patients and perioperative nurses. Patients will benefit from nurse advocates who recognize and act to resolve actual and potential ethical dilemmas. Nurses will benefit when they are empowered with the knowledge and ethical skills to enhance patient autonomy, to protect dignity and confidentiality, and human rights. Perioperative nurses should reflect on previous dilemmas and use them to assist with resolution of similar dilemmas. They should be knowledgeable of personal, departmental, institutional, and professional resources available when faced with ethical dilemmas. The ANA code for Nurses and the AORN Statements of Competency in Perioperative Nursing are two resources available to perioperative nurses. In the increasingly complex, technologically laden surgical environment, patients who are sicker and living longer will require services of highly skilled and educated professionals. They are vulnerable in the surgical setting and need surgical teams to act on their behalf. Perioperative nurses with ethical skill are an asset to patients and other members of the surgical team when they seek to resolve ethical dilemmas in knowledgeable and systematic ways. PMID:2685781

  9. Teachers' Ethical Dilemmas: What Would You Do?

    ERIC Educational Resources Information Center

    Bucholz, Jessica L.; Keller, Cassandra L.; Brady, Michael P.

    2007-01-01

    Educators will face a variety of ethical and moral dilemmas throughout their teaching careers; however, they do not have a common board that governs its members' ethical behavior. Instead, there are numerous educational organizations that have written their own specific codes for ethical behavior. The Council for Exceptional Children (CEC) has…

  10. Pediatric liver transplantation - ethical dilemmas in a disabled patient.

    PubMed

    Toker, A; Salzer, L

    2012-09-01

    Allocation of medical resources, especially resources with absolute scarcity such as organs for transplant, is a difficult task. Medical, surgical, and ethical considerations should be evaluated. In solid organ transplantation, ethics committees are the gate keepers that deal with moral philosophy when moral values are in conflict. Often, no good solution to a dilemma in these medical ethics exists. Our case presents split living liver donation for retransplantation in a mentally disabled girl, with few medical ethics principles at stake. PMID:22081968

  11. Physical therapists as double agents. Ethical dilemmas of divided loyalties.

    PubMed

    Bruckner, J

    1987-03-01

    Ethical dilemmas arise when physical therapists encounter conflicts between loyalty to their patients and loyalty to their employers. This type of ethical conflict is called "the dilemma of the double agent." If physical therapists perceive themselves as agents of their patients, their employment may be threatened. If physical therapists perceive themselves as agents of their employers, their patients may suffer physical or psychological harm. The double-agent dilemma is illustrated in this article by a hypothetical case study derived from sports physical therapy. Three ethical theories--egoism, utilitarianism, and formalism--are used to analyze the conflict and formulate solutions. A second conflict also is raised between patient autonomy and medical paternalism. As physical therapists become more autonomous, they will assume increased responsibility. Inherent in this increased responsibility is the obligation to recognize and confront ethical dilemmas in physical therapy practice. Resolving ethical dilemmas is difficult, but use of ethical theories can help in the systematic examination of basic assumptions and principles. This article introduces therapists to three ethical theories and presents a model for ethical decision making. PMID:3823152

  12. Ethical dilemmas faced by hospice social workers.

    PubMed

    Dennis, Mary Kate; Washington, Karla T; Koenig, Terry L

    2014-10-01

    Ethical decision making is critically important in hospice social work. Through in-depth interviews, researchers explored ethical dilemmas faced by 14 hospice social workers and the processes they used to move toward resolution. The dilemmas were integrated into a framework focused on the sources of ethical conflict: the client system, the agency, and the profession. Processes involved in resolving ethical dilemmas included consulting with other professionals, weighing the pros and cons of options, and bringing about desired outcomes. Findings suggest that hospice teams should be provided with opportunities to meaningfully discuss ethical decision making. Further, the involvement of social workers in administrative leadership is recommended to increase the likelihood that discipline-specific perspectives are incorporated into formal policies and procedures that shape practice in ethically complex situations. PMID:25397348

  13. Analyzing Ethics in the Administration of Interscholastic Sports: Three Key Gender-Related Ethical Dilemmas Faced by Educational Leaders

    ERIC Educational Resources Information Center

    Whisenant, Warren A.; Pedersen, Paul M.; Clavio, Galen

    2010-01-01

    Athletic administrators and decision makers within interscholastic athletics are expected to embrace a code of ethics that serves as a set of rules to guide their professional behavior. Included within this code are areas of controversy that present gender-related ethical dilemmas for administrators. Three specific ethical dilemmas involve (1)…

  14. Grades and Graduation: An Ethical Dilemma

    ERIC Educational Resources Information Center

    Salmonowicz, Michael J.

    2008-01-01

    This case was written for use in courses dealing with school administration, philosophy of education, or ethics in educational leadership. It deals with the ethical dilemma of an assistant principal at a low-performing, urban high school. Caught between a principal and a teacher who have different views on plagiarism, the assistant principal must…

  15. Ethical dilemmas in workplace health promotion.

    PubMed

    Allegrante, J P; Sloan, R P

    1986-05-01

    In less than a decade, workplace health promotion programs designed to promote employee health and help reduce the high cost of health insurance premiums paid by business and industry have proliferated. Notwithstanding the latent benefits and cost savings that corporate management expects to gain from the investment in such programs, it is argued that workplace health promotion is not without potential misuse and that its goals and methods ought not to be above ethical scrutiny. Drawing on earlier work, we discuss how workplace health promotion may pose ethical problems related to social justice, protection of privacy, and social control. The attendant moral dilemmas for the professional whose responsibility it is to develop and implement such programs are also presented. PMID:3749011

  16. Nuclear weapons and medicine: some ethical dilemmas.

    PubMed

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

    1983-12-01

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

  17. Designing and Introducing Ethical Dilemmas into Computer-Based Business Simulations

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  18. Ethical dilemma: voluntarily stopping eating and drinking.

    PubMed

    Stinson, Cynthia Kellam; Godkin, Jennie; Robinson, Ruthie

    2004-01-01

    Nutritional support is an ethical/legal dilemma that healthcare providers must face when dealing with the elderly population of patients in critical care units. As nurses we have the responsibility to consider the issues concerning this topic. The debate concerning the issue of nutritional support, implications to terminate treatment, and fears concerning liability have shifted the decision-making process from the intensive care bedside to the courtroom. Hence, nurses must face this dilemma daily. This article utilizes a case study approach, explores legal issues, discusses ethical guidelines, and identifies techniques for conflict resolution. PMID:14734899

  19. Peeling Onions: Some Tools and a Recipe for Solving Ethical Dilemmas.

    ERIC Educational Resources Information Center

    Gordon, Joan Claire

    1993-01-01

    Presents a process for solving ethical dilemmas: define the problem; identify facts; determine values; "slice" the problem different ways--duties, virtues, rights, and common good; rank ethical considerations; consult colleagues; and take action. (SK)

  20. Ethics and Family Practice: Some Modern Dilemmas

    PubMed Central

    Dunn, Earl V.

    1990-01-01

    Ethical dilemmas in family practice have increased in frequency and complexity as both the potential benefit and the potential harm of medical treatments have increased. All physicians must be aware of moral issues relating to medicine. Family physicians commonly face ethical problems concerning the patient with diminished autonomy; the right to refuse treatment; allocation of resources; informed consent; surrogate consent (for children, for the incompetent, and for those with diminished autonomy); and the appropriate level of aggressiveness in treatment. PMID:11651132

  1. Resolving Ethical Dilemmas in the Classroom.

    ERIC Educational Resources Information Center

    Kidder, Rushworth M.; Born, Patricia L.

    1999-01-01

    Ethical teaching dilemmas generally fit four patterns: individual versus community, truth versus loyalty, short-term versus long-term, and justice versus mercy. Research discloses five core shared values: compassion, honesty, fairness, responsibility, and respect. When choosing among end-, rule-, and care-based resolution approaches, teachers'…

  2. Ethical Dilemmas in Retail Merchandising: Student Perceptions

    ERIC Educational Resources Information Center

    Paulins, V. Ann; Lombardy, Lisa

    2005-01-01

    Ethical dilemmas observed by students in retailing internships were the basis for a survey in which students indicated their perceptions as to whether case situations involved unethical behavior. Expanded case situations were offered to students for further exploration. The specific questions posed in this study included the following: (1) In what…

  3. Ethical Dilemmas in Interpretive Research.

    ERIC Educational Resources Information Center

    Maor, Dorit

    Ethical issues are fundamental in the planning and implementation of classroom research. This paper describes issues that arose as the researcher considered the ethical implications of a classroom research project studying teaching and learning issues in a grade 10 science classroom in Australia. Ethical issues were related to the relationships…

  4. The analysis and resolution of ethical dilemmas.

    PubMed

    Macauley, Robert C

    2013-01-01

    Perhaps no other field of medicine illustrates the ethical dilemmas occasioned by the explosion of technology more than neurology. Many dilemmas which at first appear to be ethical, however, are actually biotechnical, informational, or interpersonal in nature. For those which are, indeed, ethical, a review of existing information and acquisition of additional data can often serve to identify the proper response. When the optimal course of action remains unclear, the comprehensive, structured approach described in this chapter is both philosophically rigorous and clinically relevant. It takes into account a variety of critical considerations - including rights, duties, consequences, virtues, and similar cases - while utilizing both inductive and deductive methods. The end result is the "least bad" of available options, or, at the very least, a practical response which preserves future options and avoids crucial mistakes. PMID:24182364

  5. Ethical Dilemmas in Teaching and Nursing: The Israeli Case

    ERIC Educational Resources Information Center

    Shapira-Lishchinsky, Orly

    2010-01-01

    This article explores a cross-occupational approach for dealing with ethical dilemmas by comparing teaching and nursing. Findings indicate more shared patterns of ethical dilemmas (such as caring for needs for others versus following formal codes) than dilemmas specific to teaching (e.g., advancing universal values versus advancing knowledge) or…

  6. Ethical Dilemmas as Perceived by Healthcare Students with Teaching Implications

    ERIC Educational Resources Information Center

    Buelow, Janet R.; Mahan, Pamela L.; Garrity, April W.

    2010-01-01

    Ethical dilemmas are experienced by all individuals, but are especially prevalent among healthcare professionals. Universities and colleges preparing students to work and provide care in this arena are currently addressing this challenge through traditional ethics courses and lectures. However, student perspectives of the major ethical dilemmas in…

  7. Exploring Ethical Dilemmas Using the "Drifting Goals" Archetype

    ERIC Educational Resources Information Center

    Bardoel, E. Anne; Haslett, Tim

    2006-01-01

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

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

    ERIC Educational Resources Information Center

    Woloshin, Phyllis Lerman

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

  9. Solving Ethical Dilemmas with Children: Empowering Classroom Research

    ERIC Educational Resources Information Center

    Parr, Michelann

    2010-01-01

    This article identifies and discusses ethical dilemmas inherent when undertaking research with children or other vulnerable populations: power relations, risks and benefits, and informed consent and confidentiality (Maguire, 2005). Ethical dilemmas often arise when researchers attempt to merge the interests of their research and the interests of…

  10. Experienced Speech-Language Pathologists' Responses to Ethical Dilemmas: An Integrated Approach to Ethical Reasoning

    ERIC Educational Resources Information Center

    Kenny, Belinda; Lincoln, Michelle; Balandin, Susan

    2010-01-01

    Purpose: To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Method: Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual…

  11. A National Survey of U.S. Internists’ Experiences with Ethical Dilemmas and Ethics Consultation

    PubMed Central

    DuVal, Gordon; Clarridge, Brian; Gensler, Gary; Danis, Marion

    2004-01-01

    OBJECTIVE To identify the ethical dilemmas that internists encounter, the strategies they use to address them, and the usefulness of ethics consultation. DESIGN National telephone survey. SETTING Doctors’ offices. PARTICIPANTS General internists, oncologists, and critical care/pulmonologists (N = 344, 64% response rate). MEASUREMENTS Types of ethical dilemmas recently encountered and likelihood of requesting ethics consultation; satisfaction with resolution of ethical dilemmas with and without ethics consultation. RESULTS Internists most commonly reported dilemmas regarding end-of-life decision making, patient autonomy, justice, and conflict resolution. General internists, oncologists, and critical care specialists reported participating in an average of 1.4, 1.3, and 4.1 consultations in the preceding 2 years, respectively (P < .0001). Physicians with the least ethics training had the least access to and participated in the fewest ethics consultations; 19% reported consultation was unavailable at their predominant practice site. Dilemmas about end-of-life decisions and patient autonomy were often referred for consultation, while dilemmas about justice, such as lack of insurance or limited resources, were rarely referred. While most physicians thought consultations yielded information that would be useful in dealing with future ethical dilemmas (72%), some hesitated to seek ethics consultation because they believed it was too time consuming (29%), might make the situation worse (15%), or that consultants were unqualified (11%). CONCLUSIONS While most internists recall recent ethical dilemmas in their practices, those with the least preparation and experience have the least access to ethics consultation. Health care organizations should emphasize ethics educational activities to prepare physicians for handling ethical dilemmas on their own and should improve the accessibility and responsiveness of ethics consultation when needed. PMID:15009780

  12. Ethical and legal dilemmas around termination of pregnancy for severe fetal anomalies: A review of two African neonates presenting with ventriculomegaly and holoprosencephaly.

    PubMed

    Chima, S C; Mamdoo, F

    2015-12-01

    Termination of pregnancy (TOP) or feticide for severe fetal anomalies is ethically and morally challenging and maybe considered illegal in countries with restrictive abortion laws. While diagnostic modalities such as fetal ultrasound, magnetic resonance imaging, and genetic screening have improved prenatal diagnosis, these technologies remain scarce in many African countries making diagnosis and counseling regarding TOP difficult. Ethical dilemmas such as women's autonomy rights may conflict with fetus' right to personhood, and doctor's moral obligations to society. In liberal jurisdictions, previable fetuses may not have legal rights of personhood; therefore, appropriate action would be to respect pregnant women's decisions regarding TOP. However, in countries with restrictive abortion laws the fetus maybe imbued with the right of personhood at conception, making TOP illegal and exposing doctors and patients to potential criminal prosecution. Birth of a severely disabled baby with independent legal rights creates further conflicts between parents and clinicians complicating healthcare decision-making. Irrespective of the maternal decision to accept or refuse TOP, the psychological and emotional impact of an impaired fetus or neonate, often lead to moral distress and posttraumatic stress reactions in parents. Doctors have legal and ethical obligations to provide an accurate antenatal diagnosis with full disclosure to enable informed decision making. Failure to provide timely or accurate diagnosis may lead to allegations of negligence with potential liability for "wrongful birth" or "wrongful life" following birth of severely disabled babies. Mismanagement of such cases also causes misuse of scarce healthcare resources in resource-poor countries. This paper describes ethical challenges in clinical management of two neonates born following declined and failed feticide for severe central nervous system anomalies with a critical appraisal of the relevant literature

  13. Experiences of ethical dilemmas in rehabilitation: Swedish occupational therapists' perspectives.

    PubMed

    Kassberg, Ann-Charlotte; Skär, Lisa

    2008-12-01

    The aim of this study was to describe Swedish occupational therapists' experiences of encountering ethical dilemmas in rehabilitation and strategies they used to handle the situations. Twelve occupational therapists who work with adults with developmental disabilities were interviewed using a semi-structured interview design. Data were analysed using qualitative content analysis. The results showed that ethical dilemmas were common in the occupational therapists' daily work within rehabilitation. Many situations that created ethical dilemmas were related to occupational therapists who worked with clients and their relatives, and other healthcare providers. The results showed further that occupational therapists found it difficult to make decisions and to optimize clients' participation in decision-making, to set limits and act professionally, and to best handle the situation for the client and avoid ethical dilemmas. This study indicates the importance of illustrating experiences of ethical dilemmas within occupational therapy praxis and the meaning of discussing ethical dilemmas with different healthcare providers to reach a divided view of the client in order to develop successful and healthy strategies that will optimize the rehabilitation of clients with developmental disabilities. PMID:18609243

  14. Exploring how IBCLCs manage ethical dilemmas: a qualitative study

    PubMed Central

    2012-01-01

    Background Professional health care practice should be based on ethical decisions and actions. When there are competing ethical standards or principles, one must choose between two or more competing options. This study explores ethical dilemmas experienced by International Board Certified Lactation Consultants. Methods The investigator interviewed seven International Board Certified Lactation Consultants and analyzed the interviews using qualitative research methods. Results "Staying Mother-Centred" emerged as the overall theme. It encompassed six categories that emerged as steps in managing ethical dilemmas: 1) recognizing the dilemma; 2) identifying context; 3) determining choices; 4) strategies used; 5) results and choices the mother made; and 6) follow-up. The category, "Strategies used", was further analyzed and six sub-themes emerged: building trust; diffusing situations; empowering mothers; finding balance; providing information; and setting priorities. Conclusions This study provides a framework for understanding how International Board Certified Lactation Consultants manage ethical dilemmas. Although the details of their stories changed, the essence of the experience remained quite constant with the participants making choices and acting to support the mothers. The framework could be the used for further research or to develop tools to support IBCLCs as they manage ethical dilemmas and to strengthen the profession with a firm ethics foundation. PMID:22824376

  15. Novel ethical dilemmas arising in geriatric clinical practice.

    PubMed

    Calleja-Sordo, Elisa Constanza; de Hoyos, Adalberto; Méndez-Jiménez, Jorge; Altamirano-Bustamante, Nelly F; Islas-Andrade, Sergio; Valderrama, Alejandro; García-Peña, Carmen; Altamirano-Bustamante, Myriam M

    2015-05-01

    The purpose of this study is to determine empirically the state of the art of the medical care, when healthcare personal is confronted with ethical dilemmas related with the care they give to the geriatric population. An observational, longitudinal, prospective and qualitative study was conducted by analyzing the correlation between healthcare personnel-patient relationship, and ethical judgments regarding dilemmas that arise in daily clinical practice with geriatric patients. Mexican healthcare personnel with current active practices were asked to write up an ethical dilemma that arose frequently or that had impacted their medical practice. From the narrative input, we were able to draw up a database with 421 dilemmas, and those corresponding to patients 60 years and older were selected (n = 54, 12.8 %). The axiological analysis of the narrative dilemmas of geriatric patients was made using dialectical empiricism. The axiological analysis values found most frequently were classified into three groups: the impact of healthcare, the roles of the physician, and refusal of therapy; the healthcare role of educator, caring for the patients' life and the risk of imminent death where the values found more often. The persistence and universality of certain dilemmas in geriatrics calls for awareness and requires a good training in the ethical discernment of these dilemmas. This would help to improve substantially the care and the life quality of this population. PMID:25185872

  16. "Living" Ethical Dilemmas for Researchers When Researching with Children

    ERIC Educational Resources Information Center

    Mortari, Luigina; Harcourt, Deborah

    2012-01-01

    This article will explore some of the ethical dilemmas that confront researchers when they seek to invite children's participation in research. It firstly tracks the historical landscape of ethical research and will examine the influence of the United Nations Convention on the Rights of the Child (UNCRC) on participatory research with children.…

  17. Ethical Dilemmas of Turkish Counsellors: A Critical Incidents Study

    ERIC Educational Resources Information Center

    Sivis-Cetinkaya, Rahsan

    2015-01-01

    Ethical dilemmas from a national purposive sample of Turkish counsellors (N = 172) were collected using critical incidents technique. Content analysis was performed with open coding guided by the classification of American Counseling Association code of ethics. Incidents regarding confidentiality and privacy (56.4%), with 37.1% involving incidents…

  18. Prolonging life: legal, ethical, and social dilemmas.

    PubMed

    Paulson, Steve; Comfort, Christopher P; Lee, Barbara Coombs; Shemie, Sam; Solomon, Mildred Z

    2014-11-01

    The ability of modern medicine to prolong life has raised a variety of difficult legal, ethical, and social issues on which reasonable minds can differ. Among these are the morality of euthanasia in cases of deep coma or irreversible injury, as well as the Dead Donor Rule with respect to organ harvesting and transplants. As science continues to refine and develop lifesaving technologies, questions remain as to how much medical effort and financial resources should be expended to prolong the lives of patients suspended between life and death. At what point should death be considered irreversible? What criteria should be used to determine when to withhold or withdraw life-prolonging treatments in cases of severe brain damage and terminal illness? To explore these complex dilemmas, Steve Paulson, executive producer and host of To the Best of Our Knowledge, moderated a discussion panel. Pediatrician Sam Shemie, hospice medical director Christopher P. Comfort, bioethicist Mildred Z. Solomon, and attorney Barbara Coombs Lee examined the underlying assumptions and considerations that ultimately shape individual and societal decisions surrounding these issues. The following is an edited transcript of the discussion that occurred November 12, 2013, 7:00-8:30 PM, at the New York Academy of Sciences in New York City. PMID:25079490

  19. Imperfect twinning: a clinical and ethical dilemma

    PubMed Central

    Denardin, Daniela; Telles, Jorge Alberto B.; Betat, Rosilene da Silveira; Fell, Paulo Renato K.; da Cunha, André Campos; Targa, Luciano Vieira; Zen, Paulo Ricardo G.; Rosa, Rafael Fabiano M.

    2013-01-01

    OBJECTIVE To review the history, epidemiology, etiology, gestational aspects, diagnosis and prognosis of imperfect twinning. DATA SOURCES Scientific articles were searched in PubMed, SciELO and Lilacs databases, using the descriptors "conjoined twins", "multiple pregnancy", "ultrasound", "magnetic resonance imaging" and "prognosis". The research was not delimited to a specific period of time and was supplemented with bibliographic data from books. DATA SYNTHESIS: The description of conjoined twins is legendary. The estimated frequency is 1/45,000-200,000 births. These twins are monozygotic, monochorionic and usually monoamniotic. They can be classified by the most prominent fusion site, by the symmetry between the conjoined twins or by the sharing structure. The diagnosis can be performed in the prenatal period or after birth by different techniques, such as ultrasound, magnetic resonance imaging and echocardiography. These tests are of paramount importance for understanding the anatomy of both fetuses/children, as well as for prognosis and surgical plan determination. CONCLUSIONS Although imperfect twinning is a rare condition, the prenatal diagnosis is very important in order to evaluate the fusion site and its complexity. Hence, the evaluation of these children should be multidisciplinary, involving mainly obstetricians, pediatricians and pediatric surgeons. However, some decisions may constitute real ethical dilemmas, in which different points should be discussed and analyzed with the health team and the family. PMID:24142323

  20. Ethical Fairy Tales: Using Fairy Tales as Illustrative Ethical Dilemmas with Counseling Students

    ERIC Educational Resources Information Center

    Henderson, Kathryn L.; Malone, Stefanie L.

    2012-01-01

    Learning to navigate ethical dilemmas is important in counseling students' training. According to the Council for the Accreditation of Counseling and Related Educational Programs (2009 standards, counseling students must receive ethics education. A common goal for counselor educators is to assist students in translating ethical theory into…

  1. Ethical dilemmas for pediatric surgical patients.

    PubMed

    Boudreaux, Arthur M; Tilden, Samuel J

    2002-03-01

    Anesthesiologists are confronted with interesting and sometimes difficult ethical situations in pediatric surgery. They are forced to deal with everything from "do not resuscitate" issues, heroic last-chance surgical efforts, religious and cultural conflicts, disputes among colleagues, and situations that are, at worst, uncomfortable and, at best, miscarriages of duty. It is incumbent on anesthesiologists to learn how to logically and appropriately handle these issues. The pediatric surgical patient requires special consideration in bioethics. This article discusses the principle of autonomy and its ascension in importance in bioethics. The concepts of informed parental permission, assent, and dissent are presented. The authors provide a framework for ethical problem-solving, as well as a discussion of judicial decision-making. In addition, several examples of clinical-ethical situations and the processes used for resolutions are discussed. By using a well-reasoned ethical decision-making process, any situation, from the simple conflict to the most serious resuscitation and withdrawal of care issues, may be appropriately resolved. PMID:11892507

  2. Ethical dilemmas in the biology undergraduate classroom: role-playing congressional testimony.

    PubMed

    Wiles, Amy M

    2014-12-01

    Students often struggle with weighing multiple sides of bioethical dilemmas. The assignment described here incorporates discussion of ethical dilemmas in an upper-level undergraduate biology course. Students are introduced to ethical dilemmas in genetics through discussion of issues in small groups. They are then polled as to what positions they take on each dilemma and are assigned to argue a side opposite of one of their choices. Each student receives a subpoena to appear before a Senate subcommittee to give testimony as an expert witness. This role-play provides students with a starting point and motivation for developing their argument as well as a way to distance themselves from their own opinions by acting as someone holding the opposite stance. At the end of the presentations, students are required to reflect on the experience. PMID:25574284

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

    PubMed

    Nordtug, Birgit

    2015-01-01

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

  4. A virtue ethics approach to moral dilemmas in medicine.

    PubMed

    Gardiner, P

    2003-10-01

    Most moral dilemmas in medicine are analysed using the four principles with some consideration of consequentialism but these frameworks have limitations. It is not always clear how to judge which consequences are best. When principles conflict it is not always easy to decide which should dominate. They also do not take account of the importance of the emotional element of human experience. Virtue ethics is a framework that focuses on the character of the moral agent rather than the rightness of an action. In considering the relationships, emotional sensitivities, and motivations that are unique to human society it provides a fuller ethical analysis and encourages more flexible and creative solutions than principlism or consequentialism alone. Two different moral dilemmas are analysed using virtue ethics in order to illustrate how it can enhance our approach to ethics in medicine. PMID:14519840

  5. Advanced case of glioblastoma multiforme and pregnancy. An ethical dilemma.

    PubMed

    Al-Rasheedy, Intisar M; Al-Hameed, Fahad M

    2015-10-01

    Glioblastoma multiforme (GBM) is the most common and malignant form of the glial tumors. Advanced and treated GBM is rarely associated with pregnancy for many reasons. Glioblastoma multiforme presenting during pregnancy carries unique challenges to the patient, baby, family, and health care providers. We describe an unusual case of advanced GBM that was treated with maximum doses of chemotherapy and radiations, and she became pregnant and presented at eighteenth weeks of gestation. Her medical management was associated with a significant ethical dilemma. We managed to deliver the baby safely through cesarean section at week 28 despite the critical condition of the mother. Unfortunately, the mother died 2 weeks post delivery. We concluded that although recurrent and treated GBM is rarely associated with pregnancy and carries dismal prognosis, but if it occurs, it can still be carried, and a multidisciplinary team work is the key for successful outcome. PMID:26492122

  6. Ethical dilemmas in genetic testing: examples from the Cuban program for predictive diagnosis of hereditary ataxias.

    PubMed

    Mariño, Tania Cruz; Armiñán, Rubén Reynaldo; Cedeño, Humberto Jorge; Mesa, José Miguel Laffita; Zaldivar, Yanetza González; Rodríguez, Raúl Aguilera; Santos, Miguel Velázquez; Mederos, Luis Enrique Almaguer; Herrera, Milena Paneque; Pérez, Luis Velázquez

    2011-06-01

    Predictive testing protocols are intended to help patients affected with hereditary conditions understand their condition and make informed reproductive choices. However, predictive protocols may expose clinicians and patients to ethical dilemmas that interfere with genetic counseling and the decision making process. This paper describes ethical dilemmas in a series of five cases involving predictive testing for hereditary ataxias in Cuba. The examples herein present evidence of the deeply controversial situations faced by both individuals at risk and professionals in charge of these predictive studies, suggesting a need for expanded guidelines to address such complexities. PMID:21264501

  7. Social Workers' Participation in the Resolution of Ethical Dilemmas in Hospice Care

    ERIC Educational Resources Information Center

    Csikai, Ellen L.

    2004-01-01

    Ethical dilemmas are inherent in every health care setting. A sample of hospice social workers with no direct access to a hospice ethics committee (N = 110) was surveyed regarding ethical issues in hospice care, how the issues were managed, and the extent to which social workers participated in resolution of ethical dilemmas. Common issues…

  8. Teachers' Critical Incidents: Ethical Dilemmas in Teaching Practice

    ERIC Educational Resources Information Center

    Shapira-Lishchinsky, Orly

    2011-01-01

    The aim of this study is to explore ethical dilemmas in critical incidents and the emerged responses that these incidents elicit. Most teachers try to suppress these incidences because of the unpleasant feelings they evoke. Fifty teachers participated in the study. A three-stage coding process derived from grounded theory was utilized. A taxonomy…

  9. Ethical Dilemmas: The "Bread and Butter" of Educational Leaders' Lives

    ERIC Educational Resources Information Center

    Cranston, Neil; Ehrich, Lisa C.; Kimber, Megan

    2006-01-01

    Purpose: The purpose of this paper is to report on research into the ethical dilemmas faced by school heads from seven independent schools in Australia. Design/methodology/approach: Data for the research were gathered by semi-structured in-depth interviews with the Heads, all of whom were experienced school leaders. All the schools had religious…

  10. Teaching, Learning and Ethical Dilemmas: Lessons from Albert Camus

    ERIC Educational Resources Information Center

    Roberts, Peter

    2008-01-01

    Over the past half century, Albert Camus's story "The Guest" has attracted a great deal of scholarly attention. "The Guest" focuses on the ethical dilemmas faced by Daru, a school teacher in Algeria, and the two visitors he receives one day: Balducci, a gendarme, and an unnamed Arab prisoner. This paper addresses Camus's text from an educational…

  11. Ethical Dilemmas in Evaluations Using Indigenous Research Workers

    ERIC Educational Resources Information Center

    Alexander, Leslie B.; Richman, Kenneth A.

    2008-01-01

    This article addresses ethical dilemmas experienced by street-level research and evaluation workers recruiting and gathering data in community-based research projects. The authors focus on a subgroup of street-level research workers, whom they call research extenders (REs), employed because they share important characteristics with the target…

  12. The ethical dilemmas of aesthetic medicine: what every provider should consider.

    PubMed

    Spear, Marcia

    2010-01-01

    The purpose of aesthetic medicine is embellishment and enhancement. As these procedures are elective in nature, media messages and misleading advertisements do influence those consumers seeking to improve or enhance their appearance. The role of provider demands that prudent guide these treatment options and not only succumb to patient demands. This article discusses the ethical principles of autonomy, beneficence, nonmaleficence, and justice, and presents a framework to guide practice to enhance resolution of ethical dilemmas confronting the provider of aesthetic medicine. PMID:20814270

  13. Examining Teacher Ethical Dilemmas in Classroom Assessment

    ERIC Educational Resources Information Center

    Pope, Nakia; Green, Susan K.; Johnson, Robert L.; Mitchell, Mark

    2009-01-01

    The current spotlight on assessment in education raises ethical issues as practices evolve. This study documents ethical conflicts faced by teachers in the United States regarding assessment of students. Critical incidents generated by practising teachers revealed a majority of reported conflicts related to score pollution, and conflicts…

  14. [Ethical dilemmas in public health care organizations].

    PubMed

    Pereda Vicandi, M

    2014-01-01

    Today you can ask if you can apply ethics to organizations because much of the greater overall impact decisions are not made by private individuals, are decided by organizations. Any organization is legitimate because it satisfies a need of society and this legitimacy depends if the organization does with quality. To offer a good service, quality service, organizations know they need to do well, but seem to forget that should do well not only instrumental level, must also make good on the ethical level. Public health care organizations claim to promote attitudes and actions based on ethics, level of their internal functioning and level of achievement of its goals, but increased awareness and analysis of its inner workings can question it. Such entities, for its structure and procedures, may make it difficult for ethical standards actually govern its operation, also can have negative ethical consequences at the population level. A healthcare organization must not be organized, either structurally or functionally, like any other organization that offers services. In addition, members of the organization can not simply be passive actors. It is necessary that operators and users have more pro-ethical behaviors. Operators from the professionalism and users from liability. PMID:25467632

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

    PubMed

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

    2013-03-01

    A qualitative study aimed at describing the situations experienced and the ethical dilemmas of nurses in the process of referring and receiving hospitalized patients by court order who require admission to the Intensive Care Unit (ICU). A partially structured interview was conducted with 10 nurses who worked in the ICU and 10 who worked in the Emergency Room (ER) in public and private hospitals in the metropolitan area of Porto Alegre, Brazil. The data was analyzed following the Semantic Analysis. The results indicated that nurses experienced ethical dilemmas associated with problems of overcrowding in emergency rooms and ICUs, poor specialized technology and orientation as to the benefits provided by law. We concluded that it is essential for nurses to participate in discussions that allow the planning of the different instances that have been promoting this often chaotic situation. PMID:23781732

  16. Ethical dilemmas in forensic psychiatry: two illustrative cases

    PubMed Central

    Sen, Piyal; Gordon, Harvey; Adshead, Gwen; Irons, Ashley

    2007-01-01

    One approach to the analysis of ethical dilemmas in medical practice uses the “four principles plus scope” approach. These principles are: respect for autonomy, beneficence, non‐maleficence and justice, along with concern for their scope of application. However, conflicts between the different principles are commonplace in psychiatric practice, especially in forensic psychiatry, where duties to patients often conflict with duties to third parties such as the public. This article seeks to highlight some of the specific ethical dilemmas encountered in forensic psychiatry: the excessive use of segregation for the protection of others, the ethics of using mechanical restraint when clinically beneficial and the use of physical treatment without consent. We argue that justice, as a principle, should be paramount in forensic psychiatry, and that there is a need for a more specific code of ethics to cover specialised areas of medicine like forensic psychiatry. This code should specify that in cases of conflict between different principles, justice should gain precedence over the other principles. PMID:17526683

  17. Ethical and medical dilemmas of space tourism

    NASA Astrophysics Data System (ADS)

    Marsh, Melinda

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

  18. Anatomical investigations and their ethical dilemmas.

    PubMed

    Jones, D Gareth

    2007-04-01

    The multi-faceted nature of modern anatomy comes as a surprise to many, especially when confronted by such seemingly different topics as cadavers and human embryo research. However, even these disparate facets of anatomy are linked by common underlying ethical considerations. This article traces historical views of anatomy and places them alongside the more contemporary dimensions of whole-body plastination, use of human material obtained under unethical circumstances, and human embryo research. These dimensions introduce issues of respect, human dignity, consent, scientific integrity, and societal expectations. PMID:17072864

  19. Strategies for Navigating Common Ethical Dilemmas Encountered by Operational Radiation Safety Professionals.

    PubMed

    Emery, Robert J; Rios, Janelle

    2016-02-01

    Because operational radiation safety professionals can encounter ethical dilemmas in the course of their work, codes of ethics and professional standards of conduct are maintained by the Health Physics Society (HPS) and the American Academy of Health Physics (AAHP). While these works provide valuable guidance, they do not operationalize the types of ethical dilemmas radiation safety practitioners might encounter. For example, consider the ethical conundrum of “dual loyalty,” defined as the situation in which an individual holds simultaneous obligations to two or more parties. In the case of radiation safety, practicing professionals hold obligations to the workers being protected and to the leaders of the organization. If these obligations are in conflict, serious difficulties can arise. The conundrum of dual loyalty is described and a strategy for reducing its effect is discussed. Two other common ethical issues; “confidentiality” and “organizational dissent” are similarly presented. A foundation from which to launch an ongoing dialogue about ethical issues within the radiation safety profession is also proposed. PMID:26710164

  20. Comparison of Ethical Dilemmas across Public and Private Sectors in Rehabilitation Counseling Practice

    ERIC Educational Resources Information Center

    Beveridge, Scott; Garcia, Jorge; Siblo, Matt

    2015-01-01

    Purpose: To examine the nature of ethical dilemmas most frequently reported by rehabilitation counselors in the private and public sectors and determine if significant differences exist in how practitioners experience ethical dilemmas in these two settings. Method: A mixed-methods internet-based survey design was utilized and included descriptive,…

  1. A Survey of Current and Projected Ethical Dilemmas of Rehabilitation Counselors

    ERIC Educational Resources Information Center

    Hartley, Michael T.; Cartwright, Brenda Y.

    2016-01-01

    Purpose: This study surveyed current and projected ethical dilemmas of rehabilitation counselors. Method: As a mixed-methods approach, the study used both quantitative and qualitative analyses. Results: Of the 211 participants who completed the survey, 116 (55.0%) reported an ethical dilemma. Based on the descriptions, common themes involved roles…

  2. Ethical dilemmas in extreme prematurity: recent answers; more questions.

    PubMed

    Simeoni, Umberto; Vendemmia, Mariella; Rizzotti, Alina; Gamerre, Marc

    2004-11-15

    Advances in perinatal care allow survival of more extremely premature infants, but the implementation and continuation of intensive care may itself constitute an ethical dilemma, given the limited chances of intact survival among the patients most at risk. This paper discusses several key issues raised by the options that are under general consideration with reference to births of infants at the threshold of viability, in particular: the implications of making a distinction between extreme prematurity and other general medical situations that may involve decisions on ending support; the concrete nature of the restrictions on therapy in such patients interactions and the need for feedback between parents, medical staff and society. PMID:15530714

  3. An ethical dilemma: when the family wants the withdrawal of care.

    PubMed

    Wagle, Rinata K; Ede, Kekoa; Craig, Jana; Bottum, Kathleen

    2004-09-01

    The ethical principles of beneficence, nonmaleficence, and respect for the dignity and autonomy of the patient provide the moral-ethical foundation for the doctor-patient relationship. However, inability to obtain informed consent in the absence of advance directives as well as conflicting family sentiments can give rise to ethical dilemmas. We present a case of a 59-year-old man who survived a near fatal suicide attempt by shooting himself in the face and whose family communicated their desire for the patient to have medical care withheld. The ethical issues that emerged from this suicide attempt, including the family's perspective on the patient's right to die, are discussed in the context of a consultation-liaison psychiatrist's recommendations to a multi-specialty treatment team. PMID:15361749

  4. Governance of dual-use research: an ethical dilemma

    PubMed Central

    2009-01-01

    Abstract Scenarios where the results of well-intentioned scientific research can be used for both good and harmful purposes give rise to what is now widely known as the “dual-use dilemma”. There has been growing debate about the dual-use nature of life science research with implications for making biological weapons. This paper reviews several controversial publications that have been the focus of debates about dual-use life science research and critically examines relevant policy developments, particularly in the United States of America. Though the dual-use dilemma is inherently ethical in nature, the majority of debates about dual-use research have primarily involved science and security experts rather than ethicists. It is important that there is more ethical input into debates about the governance of dual-use research. PMID:19784453

  5. Ethical dilemmas created by the criminalization of status behaviors: case examples from ethnographic field research with injection drug users.

    PubMed

    Buchanan, David; Khoshnood, Kaveh; Stopka, Tom; Shaw, Susan; Santelices, Claudia; Singer, Merrill

    2002-02-01

    The criminalization of behaviors such as the ingestion of certain mood-altering drugs creates ethical dilemmas for researchers studying those behaviors. The Syringe Access, Use, and Discard (SAUD) project is designed to uncover microcontextual factors that influence HIV and hepatitis risk behaviors of injection drug users. The article presents seven ethical dilemmas encountered using ethnographic methods: issues involving syringe replacement at injection locales, risks of participants' arrest, potential disruptions in participants' supply routes, risks of research staff arrest, threats to the protection of confidentiality, issues surrounding informed consent in working with addicts, and the confiscation of potentially incriminating information by police. The article concludes with a discussion of the limitations of traditional ethical frameworks, such as utilitarianism, for resolving these dilemmas and recommends instead improving public health professionals' capacity for practical reasoning (phronesis) through the greater use of case studies in public health curricula. PMID:11822551

  6. Ethical dilemmas experienced by speech-language pathologists working in private practice.

    PubMed

    Flatley, Danielle R; Kenny, Belinda J; Lincoln, Michelle A

    2014-06-01

    Speech-language pathologists experience ethical dilemmas as they fulfil their professional roles and responsibilities. Previous research findings indicated that speech-language pathologists working in publicly funded settings identified ethical dilemmas when they managed complex clients, negotiated professional relationships, and addressed service delivery issues. However, little is known about ethical dilemmas experienced by speech-language pathologists working in private practice settings. The aim of this qualitative study was to describe the nature of ethical dilemmas experienced by speech-language pathologists working in private practice. Data were collected through semi-structured interviews with 10 speech-language pathologists employed in diverse private practice settings. Participants explained the nature of ethical dilemmas they experienced at work and identified their most challenging and frequently occurring ethical conflicts. Qualitative content analysis was used to analyse transcribed data and generate themes. Four themes reflected the nature of speech-language pathologists' ethical dilemmas; balancing benefit and harm, fidelity of business practices, distributing funds, and personal and professional integrity. Findings support the need for professional development activities that are specifically targeted towards facilitating ethical practice for speech-language pathologists in the private sector. PMID:24735456

  7. Ethical dilemmas in today's nuclear medicine and radiology practice.

    PubMed

    Barron, Bruce J; Kim, E Edmund

    2003-11-01

    Throughout history, societies have developed their own codes of ethics, including those pertaining to the practice of medicine. In the United States, physicians have adopted a set of ethics based on religious values and historical teachings. We, as physicians, have been presented several codes of ethics, including the American Medical Association Code of Ethics and the American College of Radiology Code of Ethics. Over time, we have learned to appropriately apply these codes to our daily practice. With the advent of new technologies in imaging, we may lose sight as to the transfer of these principles to reflect current conditions. Recent history has shown a trend of new technology leading to potential misuse of this technology and further leading to stricter governmental regulations. It is the purpose of this review to give guidelines for dealing with new technologies, such as PET imaging, and we describe a radiologist's ethical responsibility in a doctor-patient relationship. A historical review of medical ethics will lead to discussions about various issues affecting radiologists and nuclear physicians. To be sure, not all ethical situations are black and white, and therefore there are many gray areas. The opinions expressed in this article are those of the authors and are based on extension of already established rules of ethical conduct. PMID:14602866

  8. Moral dilemmas in surgical training: intent and the case for ethical ambiguity.

    PubMed Central

    Newton, M J

    1986-01-01

    It is often assumed that the central problem in a medical ethics issue is determining which course of action is morally correct. There are some aspects of ethical issues that will yield to such analysis. However, at the core of important medical moral problems is an irreducible dilemma in which all possible courses of action, including inaction, seem ethically unsatisfactory. When facing these issues ethical behaviour depends upon an individual's understanding and acceptance of this painful dilemma without recourse to external moral authority. PMID:3806633

  9. Ethical Perspective on Quality of Care: The Nature of Ethical Dilemmas Identified by New Graduate and Experienced Speech Pathologists

    ERIC Educational Resources Information Center

    Kenny, Belinda J.; Lincoln, Michelle; Blyth, Katrina; Balandin, Susan

    2009-01-01

    Background: Speech pathologists are confronted by ethical issues when they need to make decisions about client care, address team conflict, and fulfil the range of duties and responsibilities required of health professionals. However, there has been little research into the specific nature of ethical dilemmas experienced by speech pathologists and…

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

    PubMed

    Sorta-Bilajac, Iva; Baždarić, Ksenija; Žagrović, Morana Brkljačić; Jančić, Ervin; Brozović, Boris; Čengic, Tomislav; Ćorluka, Stipe; Agich, George J

    2011-05-01

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

  11. Resolving the ethical dilemma of nurse managers over chemically-dependent colleagues.

    PubMed

    Chiu, W; Wilson, D

    1996-12-01

    This paper addresses the nurse manager's role regarding chemically-dependent nurses in the workplace. The manager may intervene by: terminating the contract of the impaired colleague; notifying a disciplinary committee; consulting with a counselling committee; or referring the impaired nurse to an employee assistance programme. A dilemma may arise about which of these interventions is ethically the best. The ethical theories relevant to nursing involve ethical relativism, utilitarianism, Kantian ethics, Kohlberg's justice, and Gilligan's ethic of care. Nurse managers first need to understand these theories in order to clarify their own perceptions and attitudes towards chemical dependency, and then satisfactorily resolve this ethical dilemma. Education and social learning are routes to a better understanding of chemical dependency and to broadening the ethical dimensions of nurse managers. PMID:8998031

  12. Ethical Leadership and Decision Making in Education: Applying Theoretical Perspectives to Complex Dilemmas. Topics in Educational Leadership.

    ERIC Educational Resources Information Center

    Shapiro, Joan Poliner; Stefkovich, Jacqueline A.

    This book discusses how students and practitioners should take into account four ethics paradigms to help solve authentic dilemmas. These paradigms are the ethic of justice, ethic of care, ethic of critique, and ethic of the profession. The book's purposes include demonstrating the application of these different paradigms through the discussion…

  13. Ethical Dilemmas of Rehabilitation Counselors: Results of an International Qualitative Study

    ERIC Educational Resources Information Center

    Tarvydas, Vilia; Barros-Bailey, Mary

    2010-01-01

    This study reports the results of an international qualitative study conducted to inform the process of revising the Commission on Rehabilitation Counselor Certification's Code of Professional Ethics for Rehabilitation Counselors. The online survey gathered information regarding ethical dilemmas from a sample of certified rehabilitation counselors…

  14. The Changes of Ethical Dilemmas in Palliative Care. A Lesson Learned from Comparison Between 1998 and 2013 in Taiwan.

    PubMed

    Chih, An-Hsuan; Su, Peijen; Hu, Wen-Yu; Yao, Chien-An; Cheng, Shao-Yi; Lin, Yen-Chun; Chiu, Tai-Yuan

    2016-01-01

    The current ethical dilemmas met by healthcare professionals were never compared with those 15 years ago when the palliative care system was newly developing in Taiwan. The aim of the study was to investigate the ethical dilemmas met by palliative care physicians and nurses in 2013 and compare the results with the survey in 1998. This cross-sectional study surveyed 213 physicians and nurses recruited from 9 representative palliative care units across Taiwan in 2013. The compared survey in 1998 studied 102 physicians and nurses from the same palliative care units. All participants took a questionnaire to survey the "frequency" and "difficulty" of 20 frequently encountered ethical dilemmas, which were grouped into 4 domains by factor analysis. The "ethical dilemma" scores were calculated and then compared across 15 years by Student's t tests. A general linear model analysis was used to identify significant factors relating to a high average "ethical dilemma" score in each domain. All of the highest-ranking ethical dilemmas in 2013 were related to insufficient resources. Physicians with less clinical experience had a higher average "ethical dilemma" score in clinical management. Physicians with dissatisfaction in providing palliative care were associated a higher average "ethical dilemma" score in communication. Nurses reported higher "ethical dilemma" scores in all items of resource allocation in 2013. Further analysis confirmed that, in 2013, nurses had a higher average "ethical dilemma" score in resource allocation after adjustment for other relating factors. Palliative care nursing staff in Taiwan are more troubled by ethical dilemmas related to insufficient resources than they were 15 years ago. Training of decision making in nurses under the framework of ethical principles and community palliative care programs may improve the problems. To promote the dignity of terminal cancer patients, long-term fundraising plans are recommended for countries in which the

  15. Ethical Dilemmas in Pediatric and Adolescent Psychogenic Non-Epileptic Seizures

    PubMed Central

    Cole, Cristie M.; Falcone, Tatiana; Caplan, Rochelle; Timmons-Mitchell, Jane; Jares, Kristine; Ford, Paul J.

    2014-01-01

    To date only a very narrow window of ethical dilemmas in psychogenic non-epileptic seizures (PNES) have been explored. Numerous distinct ethical dilemmas arise in diagnosing and treating pediatric and adolescent patients with PNES. Important ethical values at stake include trust, transparency, confidentiality, professionalism, autonomy of all stakeholders and justice. In order to further elucidate the ethical challenges in caring for this population, an ethical analysis of the special challenges faced in four specific domains is undertaken: (1) conducting and communicating a diagnosis of PNES; (2) advising patients about full transparency and disclosure to community including patients’ peers; (3) responding to requests to continue anti-epileptic drugs; and (4) managing challenges arising from school policy and procedure. An analysis of these ethical issues is essential for the advancement of best care practices that promote the overall well-being of patients and their families. PMID:25022823

  16. Qualitative analysis of healthcare professionals' viewpoints on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas.

    PubMed

    Marcus, Brian S; Shank, Gary; Carlson, Jestin N; Venkat, Arvind

    2015-03-01

    Ethics consultation is a commonly applied mechanism to address clinical ethical dilemmas. However, there is little information on the viewpoints of health care providers towards the relevance of ethics committees and appropriate application of ethics consultation in clinical practice. We sought to use qualitative methodology to evaluate free-text responses to a case-based survey to identify thematically the views of health care professionals towards the role of ethics committees in resolving clinical ethical dilemmas. Using an iterative and reflexive model we identified themes that health care providers support a role for ethics committees and hospitals in resolving clinical ethical dilemmas, that the role should be one of mediation, rather than prescription, but that ultimately legal exposure was dispositive compared to ethical theory. The identified theme of legal fears suggests that the mediation role of ethics committees is viewed by health care professionals primarily as a practical means to avoid more worrisome medico-legal conflict. PMID:25475170

  17. Dilemmas in military medical ethics since 9/11.

    PubMed

    Howe, Edmund G

    2003-06-01

    The attack on the United States by terrorists on 9/11 and the war with Iraq have raised new ethical questions for the military and for military physicians (Herman 2002; Elshtain 2003). How and when attacks may occur now is less predictable. Planes have been hijacked, and persons dressed as civilians may carry bombs to blow themselves and others up. These dangers pose an increased threat, and, thus, there is a need for new defensive measures. How far these measures should go is, however, greatly open to debate. One of the most difficult ethical question raised for the military and military doctors by these developments is what interrogation methods are permissable when questioning captured terrorists. The licitness of different interrogation practices is, however, only one of the ethical problems potentially encountered by military physicians now having to treat terrorists and POWs. The following discussion presents the major concerns regarding this and other issues. PMID:14570019

  18. Mandatory counseling for gamete donation recipients: ethical dilemmas.

    PubMed

    Benward, Jean

    2015-09-01

    Mental health professionals have engaged in mandatory pretreatment counseling and assessment of patients seeking treatment at IVF programs in the United States since the 1980s. At present, most recipient patients undergoing IVF with egg or embryo donation in the United States are required to meet with a mental health professional for one pretreatment session. Mandatory counseling of gamete recipients is fraught with ethical questions for the mental health professional. Attention to issues of autonomy, confidentiality, role clarity, along with self-evaluation and openness with the patient can help lessen the impact of these ethical challenges. PMID:26235569

  19. REASONS AND CONSEQUENCES OF APPLIED LEADERSHIP STYLES IN ETHICAL DILEMMAS WHEN NURSE MANAGERS MAKE DECISIONS.

    PubMed

    Zydziunaite, V; Suominen, T

    2014-09-21

    Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. Purpose: To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. Methods: The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (n=278) were nurse managers. The data were analyzed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. Results: The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients', relatives' and nurse managers' needs. Conclusions: Nurse managers exhibited leadership styles oriented to maintenance, focusing more on the "doing the job" than on managing the decision-making in ethical dilemmas. PMID:25242639

  20. Ethical dilemmas in geosciences. We can ask, but, can we ans?

    NASA Astrophysics Data System (ADS)

    Marone, Eduardo

    2016-04-01

    Philosophy tries to provide rules and principles enabling us to solve the ethical dilemmas we face in a wide sense, and, also, in particular fields as (geo)sciences. One alleged goal of ethics is to figure out how to solve ethical dilemmas. But, is it possible to solve such dilemmas? And what can we do if we cannot? An ethical dilemma is a problem that offers an alternative between two or more solutions, none of which proves to be fully acceptable in practice. Dilemmas arise because of conflict between the rightness or wrongness of the actions/means and the goodness or badness of the consequences/ends. They involve an apparent conflict between moral imperatives, in which to follow one would result in violating another. Can a geoscientist answer those dilemmas that appear in the exercise of his/her profession? Always? In some cases? Not at all? What if we cannot? Have we? As geoscientists, we hold the knowledge (our scientific principles), not perfect, thus fallible, and always subject to changes and improvements. If we have to do what is right, based on our principles, despite potentially bad consequences, then we have to be sure that the principle is an absolute true. But, are our scientific principles such a true? Deontological theories may deny that consequences are of any concern, provided the intention was a good one. However, if our principles are not perfect (and we know that): can we answer in one or other direction to geoethical dilemmas in good faith? Although, if a geoscientist action does usually go for the best consequences, sometimes bad consequences may be accepted. But, who have to decide to accept the bad consequences? If ethical dilemmas with a conflict between means and ends cannot simply be solved by a geoscientist, where is our duty? If there is no real solution to the conflict of the right with the good, in the sense that a solution usually seems to be expected, what has to be our professional attitude? When we have duties of omission and when

  1. Resolving Ethical Dilemmas in the Workplace: A New Focus for Career Development. ERIC Digest No. 112.

    ERIC Educational Resources Information Center

    Lankard, Bettina A.

    The diverse, multicultural population that constitutes today's work force faces ethical dilemmas on the job that bring pressures to protect their own or their company's interests, at the risk of losing their personal integrity. Employers and vocational and career development personnel are recognizing the need for decision-making and…

  2. Ethical Tensions and Dilemmas Experienced in a Northern Ugandan Social Work Internship

    ERIC Educational Resources Information Center

    Corbin, Joanne

    2012-01-01

    This article explores the ethical tensions and dilemmas that arose for 2 U.S. social work students during an 8-month international clinical internship in northern Uganda. These students encountered cultural differences related to issues of confidentiality, autonomy, and self-determination. Student experiences were analyzed using the cultural…

  3. Teaching Social Work Students to Resolve Ethical Dilemmas in Domestic Violence

    ERIC Educational Resources Information Center

    Bent-Goodley, Tricia B.

    2007-01-01

    This article examines findings from three focus groups conducted about resolving ethical dilemmas in the area of domestic violence. The study's findings point to the need to increase content on domestic violence throughout the social work curriculum and provide educational opportunities for field instructors and local professionals. Helping…

  4. Meeting Literacy Needs of Pre-Service Cohorts: Ethical Dilemmas for Socially Just Teacher Educators

    ERIC Educational Resources Information Center

    Zipin, Lew; Brennan, Marie

    2006-01-01

    Australian teacher education, like the rest of the university sector in Australia, is under significant pressure and highly politicised. In this paper, we examine ethical dilemmas facing teacher educators who, in a context of difficult and eroding work conditions, grapple with literacy needs of pre-service students. We focus particularly on…

  5. "Bridge over Troubled Water": Phenomenologizing Filipino College Deans' Ethical Dilemmas in Academic Administration

    ERIC Educational Resources Information Center

    Catacutan, Maria Rosario G.; de Guzman, Allan B.

    2016-01-01

    This phenomenological study intends to capture and describe Filipino college deans' lived experiences of ethical dilemmas as they carry out their work as administrators. Using semi-structured in-depth interviews and following Collaizzi's method, data was collected and subjected to cool and warm analyses yielding a set of themes and sub-themes that…

  6. Institutions and Scholars Face Ethical Dilemmas over Pursuit of Research with Commercial Value.

    ERIC Educational Resources Information Center

    Mangan, Katherine S.

    1987-01-01

    Increased university efforts to help faculty members transfer the results of their research from the laboratory to the marketplace are posing ethical dilemmas for both institutions and scholars. Stanford's Office of Technology Licensing is cited, as are biotechnology developments, and secrecy and competitiveness issues. (LB)

  7. Dilemmas of Leadership: Decision Making and Ethics in the Community College.

    ERIC Educational Resources Information Center

    Vaughan, George B.; And Others

    Focusing primarily on issues that can be directly influenced by actions of the governing board or president, the nine chapters of this book explore the ethical dilemmas of leadership in today's community colleges. In "Leaders on a Tightrope: The Risks and Tensions of Community College Leadership," George B. Vaughan provides an overview of some of…

  8. Ethical dilemmas in occupational therapy and physical therapy: a survey of practitioners in the UK National Health Service.

    PubMed Central

    Barnitt, R

    1998-01-01

    OBJECTIVES: To identify ethical dilemmas experienced by occupational and physical therapists working in the UK National Health Service (NHS). To compare ethical contexts, themes and principles across the two groups. DESIGN: A structured questionnaire was circulated to the managers of occupational and physical therapy services in England and Wales. SUBJECTS: The questionnaires were given to 238 occupational and 249 physical therapists who conformed to set criteria. RESULTS: Ethical dilemmas experienced during the previous six months were reported by 118 occupational and 107 physical therapists. The two groups were similar in age, grade, and years of experience. Fifty of the occupational therapy dilemmas occurred in mental health settings but no equivalent setting emerged for physical therapy. Different ethical themes emerged between the two groups, with the most common in occupational therapy being difficult/dangerous behaviour in patients and unprofessional staff behaviour, and for physical therapists resource limitations and treatment effectiveness. No differences were found in the ethical principles used. CONCLUSION: The ethical dilemmas reported by the therapists were primarily concerned with health care ethics, rather than the more dramatic ethics reported in much of the biomedical ethics literature. Differences were found between the two professional groups when ethical contexts and themes were compared but not when ethical principles were compared. This suggests that educators and researchers need to be aware of work settings and the interdisciplinary nature of employment as well as ethical principles held by individual therapists. PMID:9650115

  9. Addressing ethical dilemmas in the clinical care of adolescents: an international view.

    PubMed

    Michaud, Pierre-André; Berg-Kelly, Kristina; Macfarlane, Aidan; Renteria, Saira-Christine; Wyss, Danielle; Benaroyo, Lazare

    2009-12-01

    This chapter reviews some basic concepts underlying ethical issues in adolescence and provides a step-by-step procedure to address ethical dilemmas involving minor adolescents, based on a deliberative approach. "Deliberation" with the patient, along with involving the opinion of relevant stakeholders if possible, allows for a careful, multidisciplinary examination of all options, the medical and psychosocial consequences, and the moral values stressed by each option. Although the final decision regarding which ethical option should be chosen usually belongs to the health care providers and his or her patient, the deliberative approach provides the ingredients for sound, unbiased decision-making. PMID:20653211

  10. AIDS, policy and bioethics: ethical dilemmas facing China in HIV prevention: a report from China.

    PubMed

    Wang, Yan-Guang

    1997-01-01

    The present situation of the HIV/AIDS epidemic is very grim in China. The probability of China becoming a country with a high prevalence of HIV/AIDS cannot be excluded because there have been factors which promote the wide spread of HIV if we fail to take timely action to prevent it at the opportune moment. However, China's HIV prevention policy is inadequate. Health professionals and programmers believed that they could take a conventional public health approach to cope with the HIV epidemic. They simply ignored the fact that HIV infection is an epidemic so special that their approach is not effective to deter the epidemic. Many health professionals and programmers bypassed ethical issues that had emerged in the prevention of the HIV epidemic. Even some health educators, sexologists and officials believe that 'AIDS is the punishment for promiscuity', and this belief has led to discrimination and stigmatization of AIDS patients, HIV positive people, their family members and high risk groups. Although homosexuality is not illegal, the police can always find any reason to detain homosexuals. A difficult ethical issue is about the laws prohibiting prostitution and drug use in China which force prostitutes and intravenous drug users underground, giving them no chance to access information, education and the services needed to protect them. The dilemma facing China is whether to stay with a restrictive policy for the reason of ideology cleansing or to turn to a more supportive policy. It is necessary to have some change in the ethical framework to evaluate the action in HIV prevention. Tolerance should be the first ethical principle. PMID:11654786

  11. Surgical patents and patients--the ethical dilemmas.

    PubMed

    Tołłoczko, Tadeusz

    2005-01-01

    It is obvious that every inventor should be rewarded for the intellectual effort, and at the same time be encouraged to successively improve his or her discovery and to work on subsequent innovations. Patents also ensure that patent owners are officially protected against intellectual piracy, but protection of intellectual property may be difficult to accomplish. Nevertheless, it all comes down to this basic question: Does a contradiction exist between medical ethics and the "Medical and Surgical Procedure Patents" system? It may well turn out that medical-procedure patents can have a negative influence on the standard of medical care. Medical-method patents may also interfere with the physician-patient relationship. At present, physicians do not question the usefulness of patent protection for medicines, biotechnology, equipment and devices, but they strongly oppose it for surgical procedures. PMID:15727000

  12. [How does Hinduism analyze an ethical clinical dilemma].

    PubMed

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

    2009-11-01

    It is indispensable for physicians to understand and recognize the fusion of different cultures, to deliver the best possible service to patients with different cultural backgrounds, especially when ethical-medical problems are involved. The Hindu community in Chile differs in significant ways with the western culture. This is especially true for some issues such as the belief in reincarnation or gender inequality, among others. These discrepancies can be relevant for the analysis of several bioethical problems. Therefore, it is necessary to understand the different beliefs, traditions and Hindu visions. We hereby present a review of Hinduism, its relation with medical practice and, as an example, a case of abortion in a Hindu family. Reviewing the traditions, beliefs and methods will help to understand and respect the beliefs of different cultures in contemporary and globalized bioethics. PMID:20098814

  13. A Study of Reactions to Ethical Dilemmas in Public Relations.

    ERIC Educational Resources Information Center

    Stacks, Don W.; Wright, Donald K.

    In order to justify ethical instruction for media students, 109 university students in basic communication courses were asked to confront a moral-ethical problem, specifically, the request for information that a sponsoring company or organization wished suppressed. Respondents were randomly assigned to one of four conditions: working for a public…

  14. Ethical Dilemmas of Providing Pro Bono Art Therapy

    ERIC Educational Resources Information Center

    Moon, Bruce L.

    2011-01-01

    This viewpoint addresses ethical questions regarding the provision of art therapy as a pro bono service, a term from Latin roots that mean "for the public good." Approaches to ethical reasoning are discussed using the case of pro bono art therapy in a residential treatment program for adolescents.

  15. 12-hour shifts: an ethical dilemma for the nurse executive.

    PubMed

    Lorenz, Susan G

    2008-06-01

    Flexible work hours, including 12-hour shifts, have become a common scheduling option for nurses. The author explores whether 12-hour shifts are an ethical scheduling option for nurses because recent research suggests that 12-hour shifts are a potential hazard to patients. A multistep model for ethical decision making, reflecting the concept of procedural justice, is used to examine this issue. PMID:18562834

  16. Educational Context: Preparing Accounting Students to Identify Ethical Dilemmas

    ERIC Educational Resources Information Center

    Billiot, Mary Jo; Daniel, David; Glandon, Sid; Glandon, TerryAnn

    2012-01-01

    We examine the effect of different contexts in an educational process on measures of ethical sensitivity and levels of moral reasoning of accounting majors in the first Intermediate Accounting course. The educational process compared a context that centers on ethical issues with one that focuses on technical accounting issues. At the end of the…

  17. Moral Dilemmas in a Military Context. a Case Study of a Train the Trainer Course on Military Ethics

    ERIC Educational Resources Information Center

    van Baarle, Eva; Bosch, Jolanda; Widdershoven, Guy; Verweij, Desiree; Molewijk, Bert

    2015-01-01

    Moral competence is important for soldiers who have to deal with complex moral dilemmas in practice. However, openly dealing with moral dilemmas and showing moral competence is not always easy within the culture of a military organization. In this article, based on analysis of experiences during a train the trainer course on military ethics, we…

  18. Reflections on the ethical dilemmas involved in promoting self-management

    PubMed Central

    Severinsson, Elisabeth

    2014-01-01

    Due to their understanding of self-management, healthcare team members responsible for depressed older persons can experience an ethical dilemma. Each team member contributes important knowledge and experience pertaining to the management of depression, which should be reflected in the management plan. The aim of this study was to explore healthcare team members’ reflections on the ethical dilemmas involved in promoting self-management among depressed older persons. A qualitative design was used and data were collected by means of focus group interviews. The results revealed one main theme: ‘Lack of trust in the community health care system’s commitment to bringing about effectiveness and change, based on three themes; ‘Struggling to ensure the reliable transfer of information about depressed older persons to professionals and family members’, ‘Balancing autonomy, care and dignity’ and ‘Differences in the understanding of responsibility’. Lack of engagement on the part of and trust between the various professional categories who work in the community are extremely counterproductive and have serious implications for patient dignity as well as safety. In conclusion, ethical dilemmas occur when staff members are unable to act in accordance with their professional ethical stance and deliver an appropriate standard of care. PMID:24106261

  19. Clinical and ethical dilemmas in the psychiatric care of patients who border on the edge of being able to live safely and independently.

    PubMed

    Kwok, Stephanie I; Matorin, Anu A; Kahn, David A

    2012-05-01

    In the current economic environment and era of health care finance reform, mental health budgets have faced cutbacks across the nation, and they may face even deeper reductions in the future. Diminished funding for care of patients with severe psychiatric illness creates significant ethical and clinical dilemmas. Throughout medicine, physicians' professional virtues and obligations of beneficence may conflict with the need to balance respect for patient autonomy and deliver clinically appropriate, humane, and ethical care within a limited budget. This article uses a case presentation to highlight this struggle at the interface of psychiatry, ethics, and the emergency room in the care of people with severe mental illness. PMID:22617087

  20. Ethical dilemmas in a cross-cultural context. A Chinese example.

    PubMed Central

    Muller, J H; Desmond, B

    1992-01-01

    Considerable attention is now being given to ethical conflicts raised by such issues as the disclosure of diagnosis and prognosis, the role of the family in making medical decisions, and the withholding or withdrawing of treatment of terminally ill patients. Already complicated, these issues take on added complexity in contexts where medical professionals and patients have differing cultural beliefs and practices. Ethical dilemmas that develop in multicultural settings have been largely unaddressed. Through the analysis of a case involving the hospital admission and death of a Chinese woman with metastatic lung cancer, we examine some of these dilemmas and their effect on the patient, family, and physicians. Many issues were raised by this case regarding the relationships among ethnic background, bioethics, and medical care. PMID:1413778

  1. Early Introduction to Professional and Ethical Dilemmas in a Pharmaceutical Care Laboratory Course

    PubMed Central

    2015-01-01

    Objective. To study the effects of an early professional development series in a pharmaceutical care laboratory (PCL) course on first-year pharmacy students’ perceptions of the importance of professional attitudes and action. Design. Three hundred thirty-four first-year students enrolled in a PCL course participated in a new required learning activity centered on development of professional attitudes and behaviors. Students discussed situational dilemmas in pharmacy practice in small groups, highlighting application of the Oath of a Pharmacist and the Pharmacists’ Code of Ethics. Assessment. Students completed an optional questionnaire at the beginning and end of the semester to assess change in their attitudes and behaviors related to professionalism in pharmacy practice. Conclusion. While students entered their training with a strong appreciation for professionalism, they felt more confident in applying the Oath of a Pharmacist and the Pharmacists Code of Ethics to dilemmas in practice following the new learning activity. PMID:26889068

  2. Hospital Consumer Assessment of Healthcare Providers and Systems: An Ethical Leadership Dilemma to Satisfy Patients.

    PubMed

    Piper, Llewellyn E; Tallman, Erin

    2016-01-01

    This article examines the parameters and the dynamics of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that create an ethical leadership dilemma to satisfy patients in the hospital setting while still ensuring appropriate care for quality clinical outcomes. Under the Affordable Care Act, hospitals and health care systems are in a high-stakes struggle of winners and losers based on HCAHPS scores. This high-stakes struggle creates unintended consequences of an ethical dilemma of doing what is right for the patient versus doing whatever it takes to please the patient in order to achieve high scores of satisfaction that are tied to better reimbursements. This article also reports the results of a national survey of 500 chief executive officers by the authors about the attitudes and frustrations of chief executive officers confronting the wild unrest caused by HCAHPS. PMID:27111687

  3. Ethical dilemmas in the care of the ill. I. What is the physician's service?

    PubMed

    Kass, L R

    1980-10-17

    Physicians must continue to rely on their own powers of discernment and prudent judgment and not look to external "expert" guidance or expect simple solutions in facing the myriad ethical dilemmas in caring for the ill. Their ability to exercise the requisite virtues in particular cases requires, however, greater self-consciousness and thoughtfulness about the nature and purpose of medicine, including such questions as the following: Who and what is the physician? Whom and what does he serve? What is his relation to his patient and society? In exploring these questions, this article discusses how and why the medical profession's perception of its ethical dilemmas may differ from that of the broader American society and how physicians must respond to protect and preserve the integrity of their profession. PMID:7420682

  4. Ethical dilemmas among dental professionals in Davangere city- a cross-sectional survey.

    PubMed

    Priyanka, S G; Singla, Hitashi; Lawrence, Denzy; Veeresh, D J

    2016-01-01

    To determine the ethical problems faced by dental practitioners, a cross-sectional survey was conducted in Bapuji Dental College and Hospital, College of Dental Sciences and private dental clinics in the city of Davangere. A questionnaire with close-ended questions on eight scenarios was administered to the 135 study participants. In the case of scenario 1, 81.4% of the participants said that the doctor had violated the principle of truthfulness. As for scenario 2, less than 50% of the participants replied that the doctor had breached ethical principles. In case scenario 3, 93% felt that the doctor should have taken the physician's opinion before extracting a tooth. Most dental practitioners faced ethical dilemmas because of the lack of awareness, and there is a need to introduce certain programmes to promote knowledge of ethics. PMID:27260818

  5. The Changes of Ethical Dilemmas in Palliative Care A Lesson Learned from Comparison Between 1998 and 2013 in Taiwan

    PubMed Central

    Chih, An-Hsuan; Su, Peijen; Hu, Wen-Yu; Yao, Chien-An; Cheng, Shao-Yi; Lin, Yen-Chun; Chiu, Tai-Yuan

    2016-01-01

    Abstract The current ethical dilemmas met by healthcare professionals were never compared with those 15 years ago when the palliative care system was newly developing in Taiwan. The aim of the study was to investigate the ethical dilemmas met by palliative care physicians and nurses in 2013 and compare the results with the survey in 1998. This cross-sectional study surveyed 213 physicians and nurses recruited from 9 representative palliative care units across Taiwan in 2013. The compared survey in 1998 studied 102 physicians and nurses from the same palliative care units. All participants took a questionnaire to survey the “frequency” and “difficulty” of 20 frequently encountered ethical dilemmas, which were grouped into 4 domains by factor analysis. The “ethical dilemma” scores were calculated and then compared across 15 years by Student's t tests. A general linear model analysis was used to identify significant factors relating to a high average “ethical dilemma” score in each domain. All of the highest-ranking ethical dilemmas in 2013 were related to insufficient resources. Physicians with less clinical experience had a higher average “ethical dilemma” score in clinical management. Physicians with dissatisfaction in providing palliative care were associated a higher average “ethical dilemma” score in communication. Nurses reported higher “ethical dilemma” scores in all items of resource allocation in 2013. Further analysis confirmed that, in 2013, nurses had a higher average “ethical dilemma” score in resource allocation after adjustment for other relating factors. Palliative care nursing staff in Taiwan are more troubled by ethical dilemmas related to insufficient resources than they were 15 years ago. Training of decision making in nurses under the framework of ethical principles and community palliative care programs may improve the problems. To promote the dignity of terminal cancer patients, long-term fundraising plans are

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

    PubMed Central

    Singh, Hardeep

    2011-01-01

    Electronic health records (EHRs) facilitate several innovations capable of reforming health care. Despite their promise, many currently unanswered legal, ethical, and financial questions threaten the widespread adoption and use of EHRs. Key legal dilemmas that must be addressed in the near-term pertain to the extent of clinicians' responsibilities for reviewing the entire computer-accessible clinical synopsis from multiple clinicians and institutions, the liabilities posed by overriding clinical decision support warnings and alerts, and mechanisms for clinicians to publically report potential EHR safety issues. Ethical dilemmas that need additional discussion relate to opt-out provisions that exclude patients from electronic record storage, sale of deidentified patient data by EHR vendors, adolescent control of access to their data, and use of electronic data repositories to redesign the nation's health care delivery and payment mechanisms on the basis of statistical analyses. Finally, one overwhelming financial question is who should pay for EHR implementation because most users and current owners of these systems will not receive the majority of benefits. The authors recommend that key stakeholders begin discussing these issues in a national forum. These actions can help identify and prioritize solutions to the key legal, ethical, and financial dilemmas discussed, so that widespread, safe, effective, interoperable EHRs can help transform health care. PMID:21422090

  7. Ethical dilemmas in providing tobacco to developing countries: the case of China.

    PubMed

    Richmond, R

    1997-09-01

    We should recognize that we have a responsibility to people who live outside our own borders, and view ourselves as part of the global community. Looking at China we are faced with ethical dilemmas which require consideration. First, there is the ethical dilemma of business versus health. The opening and development of the tobacco business in China, which includes vigorous marketing, is considered against the health consequences of tobacco use which is estimated to cost 600,000 lives annually in China, rising to 2 million by 2,025 without effective tobacco control programmes. A second ethical dilemma is employment versus impoverishment, in which the opportunities for work in the tobacco industry are considered against a background of malnutrition caused in part by a proportion of household budgets used to buy tobacco, and the erosion of the land, as trees are used to produce tobacco. Gains have already been made in tobacco control in China, with the way open for much development in the future. PMID:9374011

  8. Legal, ethical, and financial dilemmas in electronic health record adoption and use.

    PubMed

    Sittig, Dean F; Singh, Hardeep

    2011-04-01

    Electronic health records (EHRs) facilitate several innovations capable of reforming health care. Despite their promise, many currently unanswered legal, ethical, and financial questions threaten the widespread adoption and use of EHRs. Key legal dilemmas that must be addressed in the near-term pertain to the extent of clinicians' responsibilities for reviewing the entire computer-accessible clinical synopsis from multiple clinicians and institutions, the liabilities posed by overriding clinical decision support warnings and alerts, and mechanisms for clinicians to publically report potential EHR safety issues. Ethical dilemmas that need additional discussion relate to opt-out provisions that exclude patients from electronic record storage, sale of deidentified patient data by EHR vendors, adolescent control of access to their data, and use of electronic data repositories to redesign the nation's health care delivery and payment mechanisms on the basis of statistical analyses. Finally, one overwhelming financial question is who should pay for EHR implementation because most users and current owners of these systems will not receive the majority of benefits. The authors recommend that key stakeholders begin discussing these issues in a national forum. These actions can help identify and prioritize solutions to the key legal, ethical, and financial dilemmas discussed, so that widespread, safe, effective, interoperable EHRs can help transform health care. PMID:21422090

  9. The case of juvenile polygraphy as a clinical ethics dilemma.

    PubMed

    Chaffin, Mark

    2011-09-01

    Polygraph interrogations are used by half of all surveyed juvenile sex offender (JSO) treatment programs in the United States. This is a distinctive and controversial practice that is rarely if ever used with other juvenile delinquent populations, and that is rarely used or is banned from JSO treatment programs in other countries. Clinical polygraphy is an ethically sensitive issue because it involves mental health therapists in involuntary coercive interrogations of minors. This article reviews core mental health professional ethics principles for juveniles. JSO polygraphy is used as an illustrative issue for applying human rights principles to a practice in light of its benefits, risks, and available alternatives. PMID:20944059

  10. A Right to Die?: Ethical Dilemmas of Euthanasia.

    ERIC Educational Resources Information Center

    Albright, Dianne E.; Hazler, Richard J.

    1992-01-01

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

  11. Teaching and Learning about Ethical Dilemmas in Pharmacy.

    ERIC Educational Resources Information Center

    Lowenthal, Werner

    1991-01-01

    A discussion of ethics instruction in pharmacy practice argues that, because pharmacy students are still rapidly developing cognitively, faculty has an opportunity to help students mature and become socially conscious critical thinkers. The problem-solving process, dealing with alternative solutions, ambiguity, and flexible curriculum construction…

  12. Accountability to Research Participants: Unresolved Dilemmas and Unravelling Ethics

    ERIC Educational Resources Information Center

    Levinson, Martin P.

    2010-01-01

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

  13. Promises to Practice: Learning a PROactive Approach to Ethical Dilemmas

    ERIC Educational Resources Information Center

    Ambery, Mary Elizabeth; Steinbrunner, Ruth K.

    2007-01-01

    Learning to be PROactive, as the title of this article suggests, means Pooling one's knowledge, Reflecting respect, and Opening oneself to action. It recognizes early childhood educators' promises to their field of practice, based on widely held beliefs and principles. Educators can apply professional ethics to everyday problem solving and their…

  14. Exploring Some Ethical Dilemmas and Obligations of the Ethnographer

    ERIC Educational Resources Information Center

    Barbour, Andrew

    2010-01-01

    This paper focuses on the ethical position of the ethnographer when encountering unethical activities. Ethnography affords a rich insight into cultures, often behind previously secure doors but it is also a demanding science. Our gatekeepers control our access and our relationships with them can determine our destiny. This paper offers an exchange…

  15. Ethical dilemmas in medical humanitarian practice: cases for reflection from Médecins Sans Frontières.

    PubMed

    Sheather, Julian; Shah, Tejshri

    2011-03-01

    Médecins Sans Frontières (MSF) is an independent medical humanitarian organisation working in over 70 countries. It has provided medical assistance for over 35 years to populations vulnerable through conflict, disease and inadequate health systems. Medical ethics define the starting point of the relationship between medical staff and patients. The ethics of humanitarian interventions and of research in conflict settings are much debated. However, less is known about the ethical dilemmas faced by medical humanitarian staff in their daily work. Ethical dilemmas can be intensified in humanitarian contexts by insecure environments, lack of optimum care, language barriers, potentially heightened power discrepancies between care providers and patients, differing cultural values and perceptions of patients, communities and medical staff. Time constraints, stressful conditions and lack of familiarity with ethical frameworks can prevent reflection on these dilemmas, as can frustration that such reflection does not necessarily provide instant solutions. Lack of reflection, however, can be distressing for medical practitioners and can reduce the quality of care. Ethical reflection has a central role in MSF, and the organisation uses ethical frameworks to help with clinical and programmatic decisions as well as in deliberations over operational research. We illustrate and discuss some real ethical dilemmas facing MSF teams. Only by sharing and seeking guidance can MSF and similar actors make more thoughtful and appropriate decisions. Our aim in sharing these cases is to invite discussion and dialogue in the wider medical community working in crisis, conflict or with severe resource limitations. PMID:21084354

  16. 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…

  17. The Fossil Fuel Divestment Movement: An Ethical Dilemma for the Geosciences?

    NASA Astrophysics Data System (ADS)

    Greene, C. H.; Kammen, D. M.

    2014-12-01

    For over 200 years, fossil fuels have been the basis for an industrial revolution that has delivered a level of prosperity to modern society unimaginable during the previous 5000 years of human civilization. However, society's dependence on fossil fuels is coming to an end for two reasons. The first reason is because our fossil fuel reserves are running out, oil in this century, natural gas during the next century, and coal a few centuries later. The second reason is because fossil fuels are having a devastating impact on the habitability of our planet, disrupting our climate system and acidifying our oceans. So the question is not whether we will discontinue using fossil fuels, but rather whether we will stop using them before they do irreparable damage to the Earth's life-support systems. Within our geoscience community, climate scientists have determined that a majority of existing fossil fuel reserves must remain unburned if dangerous climate change and ocean acidification are to be avoided. In contrast, Exxon-Mobil, Shell, and other members of the fossil fuel industry are pursuing a business model that assumes all of their reserves will be burned and will not become stranded assets. Since the geosciences have had a long and mutually beneficial relationship with the fossil fuel industry, this inherent conflict between climate science and industrial interests presents an ethical dilemma for many geoscientists. This conflict is further heightened by the fossil fuel divestment movement, which is underway at over 400 college and university campuses around the world. This presentation will explore some of the ethical and financial issues being raised by the divestment movement from a geoscientist's perspective.

  18. The ethical dilemmas of the Oregon health plan.

    PubMed

    Burton, L

    1996-02-01

    Escalating health care costs place our country at an economic disadvantage in the world marketplace. Currently, a mixture of rationing methods in the health care system limits access to control costs. Federal and state moneys fund the state Medicaid programs. States on limited budgets often tighten eligibility to far below the poverty level; those with benefits get unlimited care and those without get none. The state of Oregon has a different idea: Medicaid covers everyone below the poverty level but limits services to those with the "best cost-to-benefit ratio." Many people consider the distribution and finance of health care an ethical issue. The Oregon plan raises some ethical concerns and several arguments. The federal government waived Title XIX of the Social Security Act to allow implementation of the plan. Many providers believe universal access is important; however, the drive to see more patients may limit visit time. PMID:8907784

  19. Bio-ethical dilemmas related to medical treatment in pre-modern Jewish society, as a portal for raising current ethical issues.

    PubMed

    Mack, Tamar Salmon; Shaham, Dorith; Marcus, Esther-Lee

    2013-09-01

    Real-life ethical issues that concern those engaged in medical practice existed and were discussed in earlier ages. It seems that many of the same dilemmas that we face today occupied our ancestors as well. An investigation of historical sources may be useful in showing earlier methods of coping with the dilemmas relating to health and illness. In this article we will present several such topics taken from the sources of Jewish society in pre-modern Europe. These sources served as the basis for a course given to medical students as part of the Medical Humanities track. The "raw materials" are historical, written Hebrew and Yiddish sources from Jewish society. Genres include Minute books, the huge corpus of Responsa, historical elegies written about epidemics, memoirs, and instruction books written by Jewish physicians. Profound bio-ethical issues can be found in historical sources. Main issues discussed are: physician's fees, obligations, and rights; personal characteristics expected of physicians; physician's obligations when his/her own life is endangered; medicalization of certain human conditions; and ideological questions regarding the relationship between traditional folk medicine and modern, academic medicine. The historical distance facilitates a freer discussion about distant people, while getting in touch with our own attitudes. PMID:24340482

  20. The clinician's dilemma: two dimensions of ethical care.

    PubMed

    Gillett, Grant; Chamberlain, Joshua

    2013-01-01

    There is a continuing intense medico-ethico-legal debate around legalized euthanasia and physician assisted suicide such that ethically informed clinicians often agree with the arguments but feel hesitant about the conclusion, especially when it may bring about a change in law. We argue that this confusion results from the convergence of two continua that underpin the conduct of a clinician and are especially prominent in psychiatry. The two continua concern the duty of care and the importance of patient autonomy and they do not quite map into traditional divides in debates about sanctity of life, paternalism, and autonomy. As ethical dimensions, they come into sharp focus in the psychological complexities of end-of-life care and they form two key factors in most ethical and legal or disciplinary deliberations about a clinician's actions. Whereas both dimensions are important when a clinician reflects on what s/he has done or should do, they need careful balancing in a request for euthanasia or physician assisted suicide where the patient wants to take a decisive role in his or her own end-of-life care. However, end-of-life is also a situation where clinicians often encounter 'cries for help' so that both continua are importantly in play. Balancing these two continua without using blunt legal instruments is often required in psychiatric care in such a way as to problematize the idea that patient decisions should dominate the care options available. A simplistic approach to that issue arguably plays into what has been called an 'impoverished construction of life and death' and, some would say, devalues the basic commitments fundamental to medical care. PMID:23830641

  1. The ethical dilemma of embryonic stem cell research.

    PubMed

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

    2013-03-01

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

  2. Ethics and the psychiatry journal editor: responsibilities and dilemmas.

    PubMed

    Greenberg, David; D Strous, Rael

    2014-01-01

    An array of potential ethical stumbling blocks awaits the editors of scientific journals. There are issues of particular relevance to mental health journals, and others unique to local journals with a relatively small circulation and low impact factor. The blind review system, conflict of interests, redundant publication, fraud and plagiarism, guest and ghost authorship and ghost writing, advertising, language and stigma, patient consent, and "rigging" the Impact Factor are all issues of importance. It is critical that editors are aware and informed of these important issues, and have an accessible forum for evaluating problems as they arise. PMID:25618285

  3. Students' responses to scenarios depicting ethical dilemmas: a study of pharmacy and medical students in New Zealand.

    PubMed

    Henning, Marcus A; Malpas, Phillipa; Ram, Sanya; Rajput, Vijay; Krstić, Vladimir; Boyd, Matt; Hawken, Susan J

    2016-07-01

    One of the key learning objectives in any health professional course is to develop ethical and judicious practice. Therefore, it is important to address how medical and pharmacy students respond to, and deal with, ethical dilemmas in their clinical environments. In this paper, we examined how students communicated their resolution of ethical dilemmas and the alignment between these communications and the four principles developed by Beauchamp and Childress. Three hundred and fifty-seven pharmacy and medical students (overall response rate=63%) completed a questionnaire containing four clinical case scenarios with an ethical dilemma. Data were analysed using multiple methods. The findings revealed that 73% of the qualitative responses could be exclusively coded to one of the 'four principles' determined by the Beauchamp and Childress' framework. Additionally, 14% of responses overlapped between the four principles (multiple codes) and 13% of responses could not be coded using the framework. The subsequent subgroup analysis revealed different response patterns depending on the case being reviewed. The findings showed that when students are faced with challenging ethical dilemmas their responses can be aligned with the Beauchamp and Childress framework, although more contentious dilemmas involving issues of law are less easily categorised. The differences between year and discipline groups show students are developing ethical frames of reference that may be linked with their teaching environments and their levels of understanding. Analysis of these response patterns provides insight into the way students will likely respond in 'real' settings and this information may help educators prepare students for these clinical ethical dilemmas. PMID:27154898

  4. Using fertile couples as embryo donors: An ethical dilemma

    PubMed Central

    Alizadeh, Leila; Omani Samani, Reza

    2014-01-01

    The use of donated embryos has offered hope for infertile couples who have no other means to have children. In Iran, fertility centers use fertile couples as embryo donors. In this paper, the advantages and disadvantages of this procedure will be discussed. We conclude that embryo-donation should be performed with frozen embryos thus preventing healthy donors from being harmed by fertility drugs. There must be guidelines for choosing the appropriate donor families. In countries where commercial egg donation is acceptable, fertile couples can be procured as embryo donors thus fulfilling the possible shortage of good quality embryos. Using frozen embryos seems to have less ethical, religious and legal problems when compared to the use of fertile embryo donors. PMID:24799876

  5. Futility and the care of surgical patients: ethical dilemmas.

    PubMed

    Grant, Scott B; Modi, Parth K; Singer, Eric A

    2014-07-01

    Futility has been a contentious topic in medicine for several decades. Surgery in critical or end-of-life situations often raises difficult questions about futility. In this article, we discuss the definition of futility, methods for resolving futility disputes, and some ways to reframe the futility debate to a more fruitful discussion about the goals of care, better communication between surgeon and patient/surrogate, and palliative surgical care. Many definitions of futile therapy have been discussed. The most controversial of these is "qualitative futility" which describes a situation in which the treatment provided is likely to result in an unacceptable quality of life. This is an area of continued controversy because it has been impossible to identify universally held beliefs about acceptable quality of life. Many authors have described methods for resolving futility disputes, including community standards and legalistic multi-step due process protocols. Others, however, have abandoned the concept of futility altogether as an unhelpful term. Reframing the issue of futility as one of inadequate physician-patient communication, these authors have advocated for methods of improving communication and strengthening the patient-physician relationship. Finally, we discuss the utilization of consultants who may be of use in resolving futility disputes: ethics committees, palliative care specialists, pastoral care teams, and dedicated patient advocates. Involving these specialists in a futility conflict can help improve communication and provide invaluable assistance in arriving at the appropriate treatment decision. PMID:24849199

  6. Ethical dilemmas and solutions for risk assessment scientists.

    PubMed

    Greenberg, M R; Martell, J

    1992-01-01

    A sample survey of U.S. scientists who belong to the Society for Risk Analysis (SRA) was made to ascertain their observations of unethical behavior in the workplace and their opinions of the likely success of programs to prevent misconduct. SRA, an international organization with almost 1,700 U.S. members, includes toxicologists, epidemiologists, industrial hygienists, engineers, and social scientists, as well as experts in exposure assessment, statistics, and risk communications. Respondents reported relatively low rates of clearly unethical acts such as data destruction and fabrication (7%); however, 21% reported at least one observation of plagiarism. Reporting of other problematic behaviors ranged from less than 4% for human subjects violations to 51% observing deliberate overstatement of positive and deliberate understatement of negative results. SRA members did not think that government intervention would be effective in reducing misconduct. They were more supportive of formal education, seminars, videotapes, and a hotline that could be called for advice. We offer suggestions to ISEA and its members for developing a proactive approach to ethical misconduct. PMID:1483027

  7. 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

  8. 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

  9. Using Case Studies of Ethical Dilemmas for the Development of Moral Literacy: Towards Educating for Social Justice

    ERIC Educational Resources Information Center

    Shapiro, Joan Poliner; Hassinger, Robert E.

    2007-01-01

    Purpose: The purpose of this paper is to focus on a case study, framed as an ethical dilemma. It serves as an illustration for the teaching of moral literacy, with a special emphasis on social justice. Design/methodology/approach: Initially, the paper provides a rationale for the inclusion of case studies, emphasizing moral problems in university…

  10. Methodological and Ethical Dilemmas Encountered during Field Research of Family Violence Experienced by Adolescent Women in Buenos Aires

    ERIC Educational Resources Information Center

    Luxardo, Natalia; Colombo, Graciela; Iglesias, Gabriela

    2011-01-01

    The purpose of this article is to examine some obstacles and dilemmas related to methodological strategies and ethical considerations that arose during the fieldwork of research focused on family violence during the stages of pregnancy and childbirth in adolescent females in Buenos Aires during 2007. From this study, we are able to contribute some…

  11. Gaming as a Method for Learning to Resolve Ethical Dilemmas in Long Term Care.

    ERIC Educational Resources Information Center

    Wilson, Cindy C.; And Others

    1988-01-01

    The Simulation Game is proposed as a means of sensitizing professionals to problems and dilemmas of key team members (social workers, nurses, health educators, physicians, and clinical psychologists) in geriatric health care. The game involves role playing from cards which present difficult issues and cases in such care. (CB)

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

    PubMed

    Misselbrook, David

    2015-02-01

    The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis. PMID:25721113

  13. [Ethical dilemmas in medicine. The interruption of pregnancy in woman].

    PubMed

    Gual-Castro, Carlos

    2016-01-01

    Pregnancy interruption or abortion may be spontaneous or induced for medical, legal, demographic, and personal reasons. Different events that are present during the woman´s gravid period were described, paying attention to the differences in between fertilization and conception. These issues are very important because people or institutions mix these concepts and posit that pregnancy or conception starts at fertilization in opposition to the actual medical and scientific knowledge. In Mexico there are several millions of spontaneous and induced abortions without medical care, responsible for the high maternal-infant mortality rates. To avoid this undesirable situation, it has been proposed to follow the established WHO guidelines and adopt national health policies to re-orientate population goals on life quality, gender equity, universal public health services, and to promote the new holistic concepts of reproductive and sexual health such as: family planning, use of anti-fertility methods, adolescent reproductive health, sexually transmitted diseases, maternal and newborn health, peri- and post-menopausal women's health, and prevention, diagnosis, and opportune treatment of mammary, cervical-uterine, and ovarian cancers. Finally, it is recommended to revise our national health policies and existing laws on abortion de-penalization. PMID:27595258

  14. Advertising Ethics: Student Attitudes and Behavioral Intent

    ERIC Educational Resources Information Center

    Fullerton, Jami A.; Kendrick, Alice; McKinnon, Lori Melton

    2013-01-01

    A national survey of 1,045 advertising students measured opinions about the ethical nature of advertising and ethical dilemmas in the advertising business. More than nine out of ten students agreed that working for a company with high ethical standards was important. Students rated all twelve workplace dilemmas presented as somewhat unethical. For…

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

    PubMed

    Cattorini, Paolo

    2009-01-01

    Three controversial ethical issues, among others, stir the debate in health care institutions, in medical associations, and in the whole society: the care of patients in persistent vegetative state, the regulation of artificial procreation, some individual requests for reshaping an healthy body. Dealing with these dilemmas, typical of advanced medical science and technological practice, implies not only balancing carefully the burdens and benefits for suffering persons, families, equipes, hospitals, cultural and religious communities, but also imaging and realizing new visions of a just society, of a beneficent (without paternalism) medicine and generally of a good life, where each moral agent could write in front of all and in worthy, convincing ways, the next chapter of the book of his/her own life. PMID:21560776

  16. 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…

  17. Ethical dilemmas in choosing a healthful diet: vote with your fork!

    PubMed

    Nestle, M

    2000-11-01

    Dietary guidelines for health promotion and disease prevention in the USA recommend a consumption pattern based largely on grains, fruit and vegetables, with smaller amounts of meat and dairy foods, and even smaller amounts of foods high in fat and sugar. Such diets are demonstrably health promoting, but following them raises ethical issues related to the role of nutritionists in advising the public about healthful dietary choices, as well as to the role of the food industry in food production and marketing. In the USA a shift towards a more plant-based diet would affect the economic interests of producers of food commodities, food products and meals prepared outside the home; it would also affect the environment, food prices, trade with other countries (developing as well as industrialized) and relationships among the food industry, government agencies (domestic and international) and food and nutrition professionals. In a free-market economy any dietary choice has consequences for food producers. Thus, considerations of ethical dilemmas in choosing healthful diets suggest that food choices are political acts that offer opportunities for all parties concerned to examine the consequences of such choices and 'vote with forks'. PMID:11115798

  18. Cases of conscience: casuistic analysis of ethical dilemmas in expanded role settings.

    PubMed

    Dimmitt, J H; Artnak, K E

    1994-12-01

    In the absence of a well articulated conceptual framework for nursing ethics, this article argues for a theory of applied ethics--casuistics--used within a clinical reasoning model, to analyse the complicated issues presented in three cases involving adolescents receiving treatment for abuse through a rural alternative learning centre. The clinical nurse specialist, as an independent practitioner within the community, is presented with many ethical challenges arising from cultural diversity. The inherent independent nature of such practice environments combined with the pluralism which exists in today's multicultural society demands that professional nurses working in these circumstances develop and utilize an ethical framework for the analysis of patient care in situations that involve moral conflict. PMID:7850509

  19. Uncertain diagnosis after newborn screening for cystic fibrosis: An ethics-based approach to a clinical dilemma.

    PubMed

    Massie, John; Gillam, Lynn

    2014-01-01

    There is uncertainty about the diagnosis of cystic fibrosis after newborn screening (NBS) for some babies, either because of an intermediate sweat chloride test or inconclusive gene mutation analysis. There is considerable difficulty knowing how best to manage these babies, some of whom will develop cystic fibrosis, but many not. This article offers an ethics-based approach to this clinical dilemma that should be helpful to clinicians managing the baby with an uncertain diagnosis of cystic fibrosis after NBS. PMID:24166986

  20. Ethical dilemmas, work-related guilt, and posttraumatic stress reactions of news journalists covering the terror attack in Norway in 2011.

    PubMed

    Backholm, Klas; Idås, Trond

    2015-04-01

    News journalists working on crisis-related assignments may experience dilemmas with regard to how to conduct their work without causing additional harm to first-hand victims. In this study, we investigated how exposure to journalistic ethical dilemmas during the Oslo/Utøya terror attack in 2011 and subsequent work-related guilt were related to the development of posttraumatic stress (PTS) reactions. Norwegian journalists (N = 371) covering the terror attack participated in a web-based survey 8-9 months after the incident. We found that females reported more ethical dilemmas during the assignment than males (n = 356, d = 0.51). We also found that being on the scene was not related to more exposure to dilemmas (n = 311, d = 0.01). Moreover, we discovered that work-related guilt had a significant indirect effect on the relationship between exposure to ethical dilemmas and severity of PTS reactions (n = 344, completely standardized indirect effect size = .11, 95% CI [.04, .19]. The results showed that exposure to ethical dilemmas may affect the development of long-term psychological impairment. We concluded that media organizations can prevent postcrisis impairment by preparing employees for possible exposure to dilemmas during crisis-related assignments. PMID:25864505

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

    PubMed

    Nama, Nosisana; Swartz, Leslie

    2002-01-01

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

  2. Evaluation of Viewpoints of Health Care Professionals on the Role of Ethics Committees and Hospitals in the Resolution of Clinical Ethical Dilemmas Based on Practice Environment.

    PubMed

    Marcus, Brian S; Carlson, Jestin N; Hegde, Gajanan G; Shang, Jennifer; Venkat, Arvind

    2016-03-01

    We sought to evaluate whether health care professionals' viewpoints differed on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas based on practice location. We conducted a survey study from December 21, 2013 to March 15, 2014 of health care professionals at six hospitals (one tertiary care academic medical center, three large community hospitals and two small community hospitals). The survey consisted of eight clinical ethics cases followed by statements on whether there was a role for the ethics committee or hospital in their resolution, what that role might be and case specific queries. Respondents used a 5-point Likert scale to express their degree of agreement with the premises posed. We used the ANOVA test to evaluate whether respondent views significantly varied based on practice location. 240 health care professionals (108-tertiary care center, 92-large community hospitals, 40-small community hospitals) completed the survey (response rate: 63.6 %). Only three individual queries of 32 showed any significant response variations across practice locations. Overall, viewpoints did not vary across practice locations within question categories on whether the ethics committee or hospital had a role in case resolution, what that role might be and case specific queries. In this multicenter survey study, the viewpoints of health care professionals on the role of ethics committees or hospitals in the resolution of clinical ethics cases varied little based on practice location. PMID:25519957

  3. A Transcultural Integrative Model for Ethical Decision Making in Counseling.

    ERIC Educational Resources Information Center

    Garcia, Jorge, G.; Cartwright, Brenda; Winston, Stacey M.; Borzuchowska, Barbara

    2003-01-01

    The Transcultural Integrative Ethical Decision-Making Model in counseling addresses the need for including cultural factors in the process of ethical dilemma resolution. The proposed model is presented in a step-by-step, linear format that can be used by counselors facing ethical dilemmas in a variety of settings and with different cultural…

  4. Effects of brain lesions on moral agency: ethical dilemmas in investigating moral behavior.

    PubMed

    Christen, Markus; Müller, Sabine

    2015-01-01

    Understanding how the "brain produces behavior" is a guiding idea in neuroscience. It is thus of no surprise that establishing an interrelation between brain pathology and antisocial behavior has a long history in brain research. However, interrelating the brain with moral agency--the ability to act in reference to right and wrong--is tricky with respect to therapy and rehabilitation of patients affected by brain lesions. In this contribution, we outline the complexity of the relationship between the brain and moral behavior, and we discuss ethical issues of the neuroscience of ethics and of its clinical consequences. First, we introduce a theory of moral agency and apply it to the issue of behavioral changes caused by brain lesions. Second, we present a typology of brain lesions both with respect to their cause, their temporal development, and the potential for neural plasticity allowing for rehabilitation. We exemplify this scheme with case studies and outline major knowledge gaps that are relevant for clinical practice. Third, we analyze ethical pitfalls when trying to understand the brain-morality relation. In this way, our contribution addresses both researchers in neuroscience of ethics and clinicians who treat patients affected by brain lesions to better understand the complex ethical questions, which are raised by research and therapy of brain lesion patients. PMID:25120025

  5. Bedside resource stewardship in disasters: a provider's dilemma practicing in an ethical gap.

    PubMed

    Daniel, Michelle

    2012-01-01

    During disasters, clinicians may be forced to play dual roles, as both a provider and an allocator of scarce resources. At present, a clear framework to govern resource stewardship at the bedside is lacking. Clinicians who find themselves practicing in this ethical gap between clinical and public health ethics can experience significant moral distress. One provider describes her experience allocating an oxygen tank in the intensive care unit at a hospital in Port-au-Prince, Haiti, immediately following the 2010 earthquake. Using a clinical vignette and reflective narrative she attempts to identify the factors that influenced her allocation decision, opening up the factors for commentary and debate by an ethicist. A better paradigm for the ethical care of patients during disasters is needed to better guide provider choices in the future. PMID:23469693

  6. Ethical Dilemmas in Protecting Individual Rights Versus Public Protection in the Case of Infectious Diseases

    PubMed Central

    Phua, Kai-Lit

    2013-01-01

    Infectious diseases—including emerging and re-emerging diseases such as Ebola and tuberculosis—continue to be important causes of morbidity and mortality in the globalizing, contemporary world. This article discusses the ethical issues associated with protecting the rights of individuals versus the protection of the health of populations in the case of infectious diseases. The discussion uses the traditional medical ethics approach together with the public health approach presented by Faden and Shebaya.3 Infectious diseases such as Ebola hemorrhagic fever, Nipah virus and HIV/AIDS (together with tuberculosis) will be used to illustrate particular points in the discussion. PMID:24847171

  7. Facing Ethical Dilemmas in the Workplace: A Qualitative Study of HR Managers' Perceptions of the Influences on Their Behavior and the Implications for Building an Ethical Culture in Organizations

    ERIC Educational Resources Information Center

    LaMontagne, Ramona Marie

    2012-01-01

    This qualitative study examined the perceptions of human resource managers who had faced ethical dilemmas in the workplace, to gain an understanding of how they felt their life experiences shaped their values in making ethical decisions. The experiences of ten human resource managers who believed they chose a right course of action when faced with…

  8. Seven Basic Steps to Solving Ethical Dilemmas in Special Education: A Decision-Making Framework

    ERIC Educational Resources Information Center

    Stockall, Nancy; Dennis, Lindsay R.

    2015-01-01

    This article presents a seven-step framework for decision making to solve ethical issues in special education. The authors developed the framework from the existing literature and theoretical frameworks of justice, critique, care, and professionalism. The authors briefly discuss each theoretical framework and then describe the decision-making…

  9. Psychotropic Medication Consultation in Schools: An Ethical and Legal Dilemma for School Psychologists

    ERIC Educational Resources Information Center

    Carlson, John S.; Thaler, Cara L.; Hirsch, Amanda J.

    2006-01-01

    Assessing, consulting, and intervening with students being treated with psychotropic medications is an increasingly common activity for school psychologists. This article reviews some of the literature providing evidence for the greater need for training in school psychopharmacology. A legal and ethical case study is presented that highlights the…

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

    PubMed

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

    1999-01-01

    .9% of men (p < 0.05) indicate HIV screening test without any explanation to the patient because "he could transmit a fatal disease". In this same case, time from graduation was related to differences in option selection: 80.9% in the group > 20 years of professional exercise asked for patient consent and accepted his decision, versus 52.7 and 27.5% in 0-9 and 10-19 years group respectively (p < 0.05). Usual medical and social worries as communication (truth, informed consent), the autonomic decision of biological death versus the sacrament of life, justice in allocation resources, confidentiality and social concern, abortion, and many other controversies linked to tecno-scientific development, impact the practice of Gastroenterology in latinoamerican countries. However medical answers to ethical dilemmas are not uniform. Although our results ought to be verified by other studies they clearly suggest the needs for systematic incorporation of applicated Ethics in pre and postgraduate Gastroenterology curricula, besides the regular activities of our regional institutions. PMID:10491718

  11. The Ethical Challenges of Socially Responsible Science.

    PubMed

    Resnik, David B; Elliott, Kevin C

    2016-01-01

    Social responsibility is an essential part of the responsible conduct of research that presents difficult ethical questions for scientists. Recognizing one's social responsibilities as a scientist is an important first step toward exercising social responsibility, but it is only the beginning, since scientists may confront difficult value questions when deciding how to act responsibly. Ethical dilemmas related to socially responsible science fall into at least three basic categories: 1) dilemmas related to problem selection, 2) dilemmas related to publication and data sharing, and 3) dilemmas related to engaging society. In responding to these dilemmas, scientists must decide how to balance their social responsibilities against other professional commitments and how to avoid compromising their objectivity. In this article, we will examine the philosophical and ethical basis of social responsibility in science, discuss some of the ethical dilemmas related to exercising social responsibility, and make five recommendations to help scientists deal with these issues. PMID:26193168

  12. The Ethical Challenges of Socially Responsible Science

    PubMed Central

    Resnik, David B.; Elliott, Kevin C.

    2015-01-01

    Social responsibility is an essential part of the responsible conduct of research that presents difficult ethical questions for scientists. Recognizing one’s social responsibilities as a scientist is an important first step toward exercising social responsibility, but it is only the beginning, since scientists may confront difficult value questions when deciding how to act responsibly. Ethical dilemmas related to socially responsible science fall into at least three basic categories: 1) dilemmas related to problem selection, 2) dilemmas related to publication and data sharing, and 3) dilemmas related to engaging society. In responding to these dilemmas, scientists must decide how to balance their social responsibilities against other professional commitments and how to avoid compromising their objectivity. In this article, we will examine the philosophical and ethical basis of social responsibility in science, discuss some of the ethical dilemmas related to exercising social responsibility, and make five recommendations to help scientists deal with these issues. PMID:26193168

  13. The "Other Voices" in Contemporary Ethical Dilemmas: The Value of the New Scholarship on Women in the Teaching of Ethics.

    ERIC Educational Resources Information Center

    Shapiro, Joan Poliner; Smith-Rosenberg, Carroll

    This paper indicates the need for women's studies ethics courses and the examination of student concepts of morality. It proposes the ethical study of social problems not usually considered in undergraduate classes and illustrates the importance of the study of historical perspectives and situational ethics in the teaching of complex contemporary…

  14. Ethical issues in rare diseases.

    PubMed

    Borski, Krzysztof

    2015-01-01

    Scientific, technical and medical advances continue to raise consequential ethical questions and dilemmas also in the field of rare diseases. Difficult and complex issues of medical ethics in rare diseases are presented and several different ethical problems, like those regarding inborn errors of metabolism, are discussed. PMID:26982768

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

    PubMed Central

    Umeora, OUJ; Chukwuneke, FN

    2013-01-01

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

  16. Evolving friendships and shifting ethical dilemmas: fieldworkers' experiences in a short term community based study in Kenya.

    PubMed

    Kamuya, Dorcas M; Theobald, Sally J; Munywoki, Patrick K; Koech, Dorothy; Geissler, Wenzel P; Molyneux, Sassy C

    2013-04-01

    Fieldworkers (FWs) are community members employed by research teams to support access to participants, address language barriers, and advise on culturally appropriate research conduct. The critical role that FWs play in studies, and the range of practical and ethical dilemmas associated with their involvement, is increasingly recognised. In this paper, we draw on qualitative observation and interview data collected alongside a six month basic science study which involved a team of FWs regularly visiting 47 participating households in their homes. The qualitative study documented how relationships between field workers and research participants were initiated, developed and evolved over the course of the study, the shifting dilemmas FWs faced and how they handled them. Even in this one case study, we see how the complex and evolving relationships between fieldworkers and study participants had important implications for consent processes, access to benefits and mutual understanding and trust. While the precise issues that FWs face are likely to depend on the type of research and the context in which that research is being conducted, we argue that appropriate support for field workers is a key requirement to strengthen ethical research practice and for the long term sustainability of research programmes. PMID:23433316

  17. An ethics dilemma: when parents and doctors disagree on the best treatment for the child.

    PubMed

    Oppenheim, Daniel; Brugières, Laurence; Corradini, Nadège; Vivant, Florence; Hartmann, Olivier

    2004-09-01

    The increasing complexity of present day medicine--with highly effective and yet risky treatments, individual and collective expectations, and evolving ideological and cultural landmarks--often gives rise to difficult ethical problems. Specific meetings are valuable for understanding such problems, acquiring the relevant skills and for gaining and transmitting experience on how to solve them. Parents and doctors may disagree about what is the best treatment. Such a difference of opinion is not rare but usually a solution can easily be found. This is not the case when the child is treated for a severe illness and when there is no clearly defined or satisfactory treatment for him\\her. We present how a dramatic conflict arose between the parents and the doctors faced with such a case (mostly because the staff failed to understand early enough the psychological factors at the root of the father's demands), how clinical, institutional and ethical problems were analysed during a meeting, and how they were solved. PMID:15545000

  18. Workplace Literacy: Ethical Issues through the Lens of Experience

    ERIC Educational Resources Information Center

    Folinsbee, Sue

    2009-01-01

    Even though principles to guide practice are crucial, there are no hard-and-fast rules for resolving ethical issues--dilemmas that are not easily resolvable because they present opposing values and outcomes that may harm to certain groups of people if not properly considered. This article describes a number of ethical dilemmas faced as a workplace…

  19. Direct-to-consumer genetic testing in Slovenia: availability, ethical dilemmas and legislation

    PubMed Central

    Vrecar, Irena; Peterlin, Borut; Teran, Natasa

    2015-01-01

    Introduction Over the last few years, many private companies are advertising direct-to-consumer genetic testing (DTC GT), mostly with no or only minor clinical utility and validity of tests and without genetic counselling. International professional community does not approve provision of DTC GT and situation in some EU countries has been analysed already. The aim of our study was to analyse current situation in the field of DTC GT in Slovenia and related legal and ethical issues. Materials and methods Information was retrieved through internet search, performed independently by two authors, structured according to individual private company and the types of offered genetic testing. Results Five private companies and three Health Insurance Companies offer DTC GT and it is provided without genetic counselling. Available tests include testing for breast cancer, tests with other health-related information (complex diseases, drug responses) and other tests (nutrigenetic, ancestry, paternity). National legislation is currently being developed and Council of Experts in Medical Genetics has issued an opinion about Genetic Testing and Commercialization of Genetic Tests in Slovenia. Conclusions Despite the fact that Slovenia has signed the Additional protocol to the convention on human rights and biomedicine, concerning genetic testing for health purposes, DTC GT in Slovenia is present and against all international recommendations. There is lack of or no medical supervision, clinical validity and utility of tests and inappropriate genetic testing of minors is available. There is urgent need for regulation of ethical, legal, and social aspects. National legislation on DTC GT is being prepared. PMID:25672471

  20. HIV/AIDS in Early Childhood Centers: The Ethical Dilemma of Confidentiality versus Disclosure.

    ERIC Educational Resources Information Center

    Black, Sandra M.

    1999-01-01

    Discusses the privacy dilemma encountered by early childhood practitioners when they find out that a child in their program or one of the child's family members has HIV/AIDS. Provides general and specific guidelines regarding HIV/AIDS, describes universal precautions in child care settings, and delineates myths and facts about HIV/AIDS. (KB)

  1. Faculty Ethics: New Dilemmas, New Choices. AAHE-ERIC/Higher Education Research Currents, June 1980.

    ERIC Educational Resources Information Center

    Shulman, Carol Herrnstadt

    Faculty ethics are considered in relation to conflict of interest between academic work and nonacademic consulting jobs, confidentiality of research, the employment of faculty by intelligence agencies, and the need for self-regulation by the academic community. For faculty members who serve as consultants, ethical issues arise concerning the use…

  2. Resolving Ethical Dilemmas in Suicide Prevention: The Case of Telephone Helpline Rescue Policies

    ERIC Educational Resources Information Center

    Mishara, Brian L.; Weisstub, David N.

    2010-01-01

    The ethical basis of suicide prevention is illustrated by contrasting helpline emergency rescue policies of the Samaritans and the AAS and the U.S. National Suicide Prevention Lifeline network. We contrast moralist, relativist, and libertarian ethical premises and question whether suicide can be rational. Samaritans respect a caller's right to…

  3. Genomic medicine: health care issues and the unresolved ethical and social dilemmas.

    PubMed

    Idemyor, Vincent

    2014-01-01

    Our perception of the mechanism by which single genes can cause disease is evolving. This has led to the understanding of the pathophysiological basis of common diseases. Genomic Medicine continues to contribute to the understanding of the molecular basis of disease. Medicine has strived to achieve the goal of tailoring interventions to individual variations in risk and treatment response and advances in medical genomics will facilitate this process. Relevant to present-day practice is the use of genomic information to classify individuals according to disease susceptibility or expected responsiveness to a pharmacologic treatment and to provide targeted interventions. By investigating the genetic profile of individuals, medical professionals are able to select patients and use the information obtained to plan out a course of treatment that is much more in step with the way their body works. However, society is concerned about the effect genetic knowledge will have on ethnic or racial groups. Currently, the Health Insurance Portability and Accountability Act prohibits discrimination based on genetics. There is a need to increase the understanding of the social and ethical challenges that genomics information may pose to clinicians and scientists. This review is not meant to be exhaustive; rather, clinically relevant examples are used to illustrate how genomic medicine can facilitate the provision of molecular diagnostic methods that improve drug therapy. Finally, the rapid pace of change in genomics may likely make my conclusions today obsolete tomorrow. PMID:22713532

  4. Health Care Ethics: Dilemmas, Issues and Conflicts. Midwest Alliance in Nursing Annual Fall Workshop (6th, Indianapolis, Indiana, September 5-6, 1985).

    ERIC Educational Resources Information Center

    Prock, Valencia N., Ed.; And Others

    A variety of ethical issues confronting the nursing profession are examined in these proceedings. The following papers are presented: (1) "Ethics: Care & Conflict," by Leah Curtin; (2) "The Interface of Politics and Ethics in Nursing," by Mila Aroskar; (3) "Pluralistic Ethical Decision-Making," by Rita Payton; (4) "Compassion, Technology & the…

  5. Casuistry: A Complement to Principle Ethics and a Foundation for Ethical Decisions

    ERIC Educational Resources Information Center

    Freeman, Stephen J.; Francis, Perry C.

    2006-01-01

    Ethical dilemmas within any system are created when moral/ethical principles, rules, or guidelines can be cited for opposing actions with neither side presenting the obvious, right course to follow. This condition exposes the intricate interrelationship between abstract moral/ethical principles and the description and evaluation of real-life…

  6. The ethics of human volunteer studies involving experimental exposure to pesticides: unanswered dilemmas

    PubMed Central

    2010-01-01

    The controversy about the use of data from human volunteer studies involving experimental exposure to pesticides as part of regulatory risk assessment has been widely discussed, but the complex and interrelated scientific and ethical issues remain largely unresolved. This discussion paper, generated by authors who comprised a workgroup of the ICOH Scientific Committee on Rural Health, reviews the use of human experimental studies in regulatory risk assessment for pesticides with a view to advancing the debate as to when, if ever, such studies might be ethically justifiable. The discussion is based on three elements: (a) a review of discussion papers on the topic of human testing of pesticides and the positions adopted by regulatory agencies in developed countries; (b) an analysis of published and unpublished studies involving human testing with pesticides, both in the peer-reviewed literature and in the JMPR database; and (c) application of an ethical analysis to the problem. The paper identifies areas of agreement which include general principles that may provide a starting point on which to base criteria for judgements as to the ethical acceptability of such studies. However, the paper also highlights ongoing unresolved differences of opinion inherent in ethical analysis of contentious issues, which we propose should form a starting point for further debate and the development of guidelines to achieve better resolution of this matter. PMID:20718963

  7. Using NAEYC's Code of Ethics.

    ERIC Educational Resources Information Center

    Young Children, 1995

    1995-01-01

    Considers how to deal with an ethical dilemma concerning a caregiver's dislike for a child. Recognizes that no statement in NAEYC's Code of Ethical Conduct requires that a professional must like each child, and presents some ideals and principles from the code that may guide professionals through similar situations. (BAC)

  8. The impending financial healthcare burden and ethical dilemma of systemic therapy in metastatic cancer.

    PubMed

    Riaz, Muhammad Kashif; Bal, Susan; Wise-Draper, Trisha

    2016-09-01

    Metastatic cancer remains a devastating disease that threatens to disrupt entire family structures creating economic and psychosocial stress. Fortunately, great strides have resulted in improved therapies over the years but at a huge social-economic cost. The economic burden has risen greatly and carries with it new ethical concerns when deciding treatment. Here, we discuss the financial and ethical challenges that oncologists and their patients face in the era of novel treatment strategies. J. Surg. Oncol. 2016;114:323-328. © 2016 Wiley Periodicals, Inc. PMID:27377825

  9. The Conceptual and Practical Ethical Dilemmas of Using Health Discussion Board Posts as Research Data

    PubMed Central

    Hind, Martin; Thomas, Bronwen; Hewitt-Taylor, Jaqui

    2013-01-01

    Background Increasing numbers of people living with a long-term health condition are putting personal health information online, including on discussion boards. Many discussion boards contain material of potential use to researchers; however, it is unclear how this information can and should be used by researchers. To date there has been no evaluation of the views of those individuals sharing health information online regarding the use of their shared information for research purposes. Objective To explore the views of contributors to online diabetes discussion boards with regards to if (and how) they feel their contributions to boards should be used by health researchers. Methods A qualitative approach was employed using online semistructured asynchronous (email) interviews. Interpretative description methodology was used to assess the interview transcripts, and quotations were extracted and anonymized to support each theme. Results 26 interviews were carried out. Participants agreed that forum posts are in the public domain and that aggregated information could be freely used by researchers. This was agreed to be a good way of ensuring that the view of people living with diabetes is being heard in research. There was no consensus on the need for permission to use individual information, such as quotations, with some people happy for this to be freely used and others feeling that permission is necessary. Conclusions Participants acknowledged the dichotomy of having placed information into the public domain in an unrestricted way, with some interviewees also wanting to retain control of its use. The Internet is a new research location, and rather than trying to apply traditional ethical norms to this new genre, a new modus operandi is required. The authors propose introducing new norms for presenting research carried out with online discussion boards. PMID:23748147

  10. Learned Ethical Behavior: An Academic Perspective

    ERIC Educational Resources Information Center

    Gundersen, David E.; Capozzoli, Ernest A.; Rajamma, Rajasree K.

    2008-01-01

    The authors analyzed the reactions of various academic-level respondent groups to 14 short scenarios reflecting ethical dilemmas in higher education and research. As the authors hypothesized, groups differed in their views of the dilemmas presented. The results did not support a 2nd hypothesis predicting a linear relationship between academic…

  11. Pedagogical Ethical Dilemmas in a Responsive Evaluation of a Leadership Program for Youth

    ERIC Educational Resources Information Center

    Freeman, Melissa; Preissle, Judith

    2010-01-01

    How do responsive evaluators provide input to program planners when competing ethical principles point to different choices of effective feedback? A team of three evaluators used participant observation, individual and focus group interviews, and analysis of documents to provide input on the development and outcome of a summer program for high…

  12. Assessing the Role of Business Faculty Values and Background in the Recognition of an Ethical Dilemma

    ERIC Educational Resources Information Center

    Van Auken, Stuart

    2016-01-01

    The author sought to determine whether business faculty values and background can discriminate between a yes or no response to the introduction of an ethically challenged product. The results reveal that two competing views of the enterprise (stakeholder vs. stockholder) along with a faculty member's departmental membership do discriminate in the…

  13. An Ethical Exercise for the Social Studies Classroom: The Trolley Dilemma

    ERIC Educational Resources Information Center

    Lennon, Sean M.; Byford, Jeffrey M.; Cox, J. T.

    2015-01-01

    The Trolley Problem as defined in this paper is a series, or continuation, of increasingly difficult ethical riddles successfully implemented in a classroom environment to spur complex, critical thinking and dialogue. The activity is designed upon the scenario of a runaway train with different and challenging choices, segueing neatly into group…

  14. Caring for 'Very Important Patients'--Ethical Dilemmas and Suggestions for Practical Management.

    PubMed

    Alfandre, David; Clever, Sarah; Farber, Neil J; Hughes, Mark T; Redstone, Paul; Lehmann, Lisa Soleymani

    2016-02-01

    The care of Very Important Patients (VIPs) is different from other patients because they may receive greater access, attention, and resources from health care staff. Although the term VIP is used regularly in the medical literature and is implicitly understood, in practice it constitutes a wide and heterogeneous group of patients that have a strong effect on health care providers. We define a VIP as a very influential patient whose individual attributes and characteristics (eg, social status, occupation, position), coupled with their behavior, have the potential to significantly influence a clinician's judgment or behavior. Physicians, celebrities, the politically powerful, and philanthropists, may all become VIPs in the appropriate context. The quality of care may be inferior because health care professionals may deviate from standard practices when caring for them. Understanding the common features among what may otherwise be very different groups of patients can help health care providers manage ethical concerns when they arise. We use a series of vignettes to demonstrate how VIPs behavior and status can influence a clinician's judgment or actions. Appreciating the ethical principles in these varied circumstances provides health care professionals with the tools to manage ethical conflicts that arise in the care of VIPs. We conclude each vignette with guidance for how health care providers and administrators can manage the ethical concern. PMID:26522793

  15. COVER It: A Comprehensive Framework for Guiding Students through Ethical Dilemmas

    ERIC Educational Resources Information Center

    Mitchell, Jennifer M.; Yordy, Eric D.

    2010-01-01

    This article describes a model that aims to create a greater ability to recognize the negative aspects of making unethical decisions. To this end, the authors developed an ethical decision-making model to aid students through the process of analyzing these situations--a model that is easy to remember and apply. Through this model, the COVER model,…

  16. Students' Perceptions of Ethical Dilemmas Involving Professors: Examining the Impact of the Professor's Gender

    ERIC Educational Resources Information Center

    Oldenburg, Christopher M.

    2005-01-01

    Three hundred sixteen undergraduate students from two liberal arts colleges rated the ethical nature of six different fictional scenarios. Each scenario described interactions between a professor and student. The gender of the fictional professor was varied randomly. Thus, for any particular scenario, a participant may be rating the behavior of a…

  17. The Mole's Dilemma: Ethical Aspects of Public Internet Access in Academic Libraries.

    ERIC Educational Resources Information Center

    Still, Julie; Kassabian, Vibiana

    1999-01-01

    Discusses ethical issues concerning public Internet access in academic libraries. Highlights include intellectual freedom, censorship, technical aspects of limiting or restricting use, legal liability for public use of computers for illegal purposes such as child pornography, and the importance of priority use of terminals by the primary academic…

  18. Ethical and Epistemic Dilemmas in Knowledge Production: Addressing Their Intersection in Collaborative, Community-Based Research

    ERIC Educational Resources Information Center

    Glass, Ronald David; Newman, Anne

    2015-01-01

    Collaborative community-based research can bring a range of benefits to universities, communities, and the public more broadly. A distinct virtue of collaborative community-based research is that it makes the ethical-epistemic intersections and challenges in research a focal point of its methodology. This makes collaborative community-based…

  19. International Ethical Dilemmas Confronting Australian Managers: Implications for the Training and Development of Employees Working Overseas

    ERIC Educational Resources Information Center

    Pedigo, Kerry; Marshall, Verena

    2004-01-01

    Globalisation has seen diverse cultures becoming increasingly entwined and interdependent as business organisations operate in a borderless world. When organisations operate internationally they often find that countries differ in what is considered wrong or right. The objectives of the research were to identify cross-cultural ethical dilemmas…

  20. Ethical Dilemmas and Emergent Values Encountered by Working College Students: Implications for Marketing Educators

    ERIC Educational Resources Information Center

    Bush, Victoria D.; Smith, Rachel Korthage; Bush, Alan J.

    2013-01-01

    A large body of pedagogical research exists on developing curricula and ethics training tools to prepare college graduates for entering the workforce. However, many college students are "already" in the workforce while they attend school. Many of these jobs are entry-level or frontline employee positions in retail or service industries,…

  1. On Tour with the "Accidental" Expert: Ethical Dilemmas of the Development Consultant.

    ERIC Educational Resources Information Center

    Basile, Michael L.

    This paper explores Max Weber's study of the origins of the secularization of the Puritan work ethic and examines the hybridized category of secular science expert. The hybrid construct provides an opening for the critical analysis of the concrete activity of development from two perspectives, the structural and the individual. The individual…

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

    ERIC Educational Resources Information Center

    Kauffman, James M.; Hallahan, Daniel P.

    2009-01-01

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

  3. Ethical and Epistemic Dilemmas in Empirically-Engaged Philosophy of Education

    ERIC Educational Resources Information Center

    Newman, Anne; Glass, Ronald David

    2015-01-01

    This essay examines several ethical and epistemological issues that arise when philosophers conduct empirical research focused on, or in collaboration with, community groups seeking to bring about systemic change. This type of research can yield important policy lessons about effective community-driven reform and how to incorporate the voices of…

  4. Ethical issues in rehabilitation: a qualitative analysis of dilemmas identified by occupational therapists.

    PubMed

    Foye, Sarah Jajesnica; Kirschner, Kristi L; Brady Wagner, Lynne C; Stocking, Carol; Siegler, Mark

    2002-01-01

    Little available research exists to address the range of ethical issues encountered by occupational therapists (OTs) in their daily clinical work. The few articles in the literature have tended to be case-based or anecdotal or have focused on professional issues rather than clinical issues. To characterize the array of clinical ethical issues in occupational therapy, we asked OTs in a free-standing academic rehabilitation hospital to describe in some detail up to three scenarios or situations from their clinical practice that raised morally troubling questions. A coding system was developed to preserve the richness of the detail but to allow for some categorization of the topics. A second section of the survey asked the therapists to rate whether various traditional ethics topics were of high, medium, or low interest to them. A third section asked that they identify the formats that would be most appealing to them for future educational interventions. Of the 56 therapists surveyed, 38 (or 68%) responded. The three self-generated topics mentioned most frequently by the therapists were (in decreasing order of frequency): reimbursement pressures, conflicts around goal setting, and patient/family refusal of team recommendations. The respondents were particularly interested in knowing more about patient-centered ethics topics, such as conflict resolution between teams and patients and the patient's role in decision making. Furthermore, they indicated a strong preference for interdisciplinary and interactive educational formats. PMID:14523711

  5. Exploring Ethical Dilemmas for Principals Arising from Role Conflict with School Counsellors

    ERIC Educational Resources Information Center

    Kimber, Megan; Campbell, Marilyn

    2014-01-01

    Acting in the best interests of students is central to the moral and ethical work of schools. Yet tensions can arise between principals and school counsellors as they work from at times opposing professional paradigms. In this article we report on principals' and counsellors' responses to scenarios covering confidentiality and the law,…

  6. [Toward a practical ethic].

    PubMed

    Vanbelle, Guido

    2007-01-01

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

  7. 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. PMID:26833626

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

    PubMed

    Giubilini, Alberto; Milnes, Sharyn; Savulescu, Julian

    2016-01-01

    In this review article we describe the current scope, methods, and contents of medical ethics education in medical schools in Western English speaking countries (mainly the United Kingdom, the United States, and Australia). We assess the strengths and weaknesses of current medical ethics curricula, and students' levels of satisfaction with different teaching approaches and their reported difficulties in learning medical ethics concepts and applying them in clinical practice. We identify three main challenges for medical ethics education: counteracting the bad effects of the "hidden curriculum," teaching students how to apply ethical knowledge and critical thinking to real cases in clinical practice, and shaping future doctors' right character through ethics education. We suggest ways in which these challenges could be addressed. On the basis of this analysis, we propose practical guidelines for designing, implementing, teaching, and assessing a medical ethics program within a four-year medical course. PMID:27333063

  9. Treatment decisions for newborns at the threshold of viability: an ethical dilemma.

    PubMed

    Doroshow, R W; Hodgman, J E; Pomerance, J J; Ross, J W; Michel, V J; Luckett, P M; Shaw, A

    2000-09-01

    The major ethical issues involved in decision-making in the care of extremely low birth weight newborns are analyzed here. We propose a schema for assessment and management of these infants that is consistent with ethical principles broadly accepted by the pediatric community, and which takes into account mortality risk at any given institution rather than arbitrary weight limits, with a major decision-making role for the infant's parents. When possible, the decision of whether or not to resuscitate should be made before delivery; when not possible, delivery room resuscitation is recommended, and the decision to continue or withdraw care should be made subsequently based on likelihood of survival and the wishes of the parents. PMID:11002878

  10. Alternative sources of pluripotent stem cells: scientific solutions to an ethical dilemma.

    PubMed

    Rao, Mahendra; Condic, Maureen L

    2008-02-01

    Stem cell researchers in the United States have faced a quagmire of uncertainty due to multiple factors: the ethical divide over the use of embryos for research, the lack of clarity in federal guidelines governing this research, the restrictive patent situation surrounding the generation of new human embryonic stem (HES) cell lines; and the limits on types of research eligible for federal funding. In this commentary, we describe how recent advances in derivation of hES cell-like lines may allow at least some of these uncertainties to be resolved. More importantly, we suggest that the derivation of hES cell-like lines by morally acceptable methods would not only avoid the corrosive effects of a protracted ethical debate over stem cell research, but would also allow U.S. researchers to access federal funds and compete on a more level international playing field. PMID:18271697

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

    PubMed

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

    2007-09-01

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

  12. The Ethics of Abstinence-Only and Abstinence-Plus Sexuality Education.

    ERIC Educational Resources Information Center

    Wiley, David C.

    2002-01-01

    Highlights some of the ethical dilemmas present in the debate over abstinence-only and abstinence-plus sexuality education in the schools, discussing issues related to: morality, ethics, and values; limitations to codes of ethics; questions about abstinence-only sexuality education; ethics and abstinence- only sexuality education; and sexuality…

  13. Quality of life and ethical and legal dilemmas in children during and after hematopoietic SCT procedure.

    PubMed

    Chybicka, A

    2008-10-01

    There is not any doubt that the SCT procedure involves important ethical and legal aspects. The expectations of patients concerning the quality of life and the new way of treatment are certainly an important motivation for researchers and physicians. Societies in Europe seem to accept the idea of using their own or allogeneic stem cells for tissue engineering and transplantation. A physician should be aware of the standards established by tradition and act within the general principles that have governed professional conduct. The International Code of Ethics and the Declaration of Geneva (1948), developed and approved by the World Medical Association, have modernized the ancient codes. They have been endorsed by each member organization, including The Polish Medical Association, as a general guide with nationwide application. The Polish Chamber of Physicians accepts the responsibility of delineating the standard of ethical behavior expected of Polish physicians. An interpretation of the principles concerning SCT is developed in the following pages as a guide for individual SCT physicians. PMID:18978753

  14. Leadership Tensions and Dilemmas

    ERIC Educational Resources Information Center

    Edmunds, Bill; Mulford, Bill; Kendall, Diana; Kendall, Lawrie

    2008-01-01

    Results from the Tasmanian Successful School Principal Project (SSPP) survey concur with the four major leadership tensions and dilemmas identified in a background literature review. These tensions and dilemmas relate to internal/external control, ethic of care/responsibility, and an emphasis on professional/personal as well as…

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

    PubMed Central

    Masic, Izet

    2012-01-01

    surrounding the reporting of COI that should be progressively overcome. Further actions are required to increase awareness of the importance of COI disclosure and to promote policies aimed to enhance transparency in biomedical research. In this article author discuss about important ethical dilemmas in preparing, writing and publishing of scientific manuscripts in biomedical journals. PMID:23322969

  16. Case managers discuss ethics: dilemmas of an emerging occupation in long-term care in the United States.

    PubMed

    Kane, R A; Penrod, J D; Kivnick, H Q

    1994-01-01

    As case management programs mature, ethical questions undoubtedly arise. Yet there are few, if any, standards by which case managers can guide their actions and decisions. In this article, the authors present the results of a survey of 251 frontline case managers in 10 states who were asked to describe the ethical challenges they face. The respondents were conscious of struggling with difficult, even life-and-death decisions involving important choices in their clients' lives. Generally, the case managers were committed to the ideology of respect for client autonomy but found themselves making uneasy compromises with the concept at every turn. Ethical issues arose not only with the client but also with the client's family, colleagues, and providers. Case managers, long-term care providers, and governmental policymakers could all benefit from both theoretical and practical explorations of desirable approaches to individual and societal long-term care decisions. PMID:8000320

  17. `I Don't Even Have Time to be Their Friend!' Ethical Dilemmas in Ph.D. Supervision in the Hard Sciences

    NASA Astrophysics Data System (ADS)

    Löfström, Erika; Pyhältö, Kirsi

    2015-11-01

    This study focused on exploring students' and supervisors' perceptions of ethical problems in doctoral supervision in the natural sciences. Fifteen supervisors and doctoral students in one research community in the natural sciences were interviewed about their practices and experiences in the doctoral process and supervision. We explored to what extent doctoral students and supervisors experienced similar or different ethical challenges in the supervisory relationship and analyzed how the experiences of ethical dilemmas in supervision could be understood in light of the structure and practices of natural science research groups. The data were analyzed by theory-driven content analysis. Five ethical principles, namely non-maleficence, beneficence, autonomy, fidelity and justice, were used as a framework for identifying ethical issues. The results show that one major question that appears to underpin many of the emerging ethical issues is that the supervisors and students have different expectations of the supervisory role. The second important observation is that doctoral students primarily described their own experiences, whereas the supervisors described their activities as embedded in a system and elaborated on the causes and consequences at a system level.

  18. Ethical Considerations in Maintaining Confidentiality with Dangerous Clients.

    ERIC Educational Resources Information Center

    Yost, J. Kelley

    This paper discusses ethical considerations involved in breach of confidentiality in counseling dangerous clients, i.e., those who have the potential to inflict bodily harm on others. The ethical basis for confidentiality is presented in a model for decision making in ethical dilemmas which encompasses three evaluative levels or tiers: ethical…

  19. Health Ethics Education for Health Administration Chaplains

    ERIC Educational Resources Information Center

    Porter, Russell; Broussard, Amelia; Duckett, Todd

    2008-01-01

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

  20. Brain Science of Ethics: Present Status and the Future

    ERIC Educational Resources Information Center

    Aoki, Ryuta; Funane, Tsukasa; Koizumi, Hideaki

    2010-01-01

    Recent advances in technologies for neuroscientific research enable us to investigate the neurobiological substrates of the human ethical sense. This article introduces several findings in "the brain science of ethics" obtained through "brain-observation" and "brain-manipulation" approaches. Studies over the past decade have revealed that several…

  1. Ethical dilemmas related to predictions and warnings of impending natural disaster.

    PubMed

    Phua, Kai-Lit; Hue, J W

    2013-01-01

    Scientists and policy makers issuing predictions and warnings of impending natural disaster are faced with two major challenges, that is, failure to warn and issuing a false alarm. The consequences of failure to warn can be serious for society overall, for example, significant economic losses, heavy infrastructure and environmental damage, large number of human casualties, and social disruption. Failure to warn can also have serious for specific individuals, for example, legal proceedings against disaster research scientists, as in the L'Aquila earthquake affair. The consequences of false alarms may be less serious. Nevertheless, false alarms may violate the principle of nonmaleficence (do no harm), affect individual autonomy (eg, mandatory evacuations), and may result in the "cry wolf" effect. Other ethical issues associated with natural disasters include the promotion of global justice through international predisaster technical assistance and postdisaster aid. Social justice within a particular country is promoted through greater postdisaster aid allocation to the less privileged. PMID:24481888

  2. Ethical issues, dilemmas and controversies in 'cosmetic' or aesthetic dentistry. A personal opinion.

    PubMed

    Kelleher, M

    2012-04-01

    Stephen Hancocks' elegant editorial of 11 December 2011 raises interesting questions which deserve discussion. Most experienced dentists would agree that the less that is done to teeth for cosmetic reasons, the lesser are the risks of disappointment, failure of expectation, or threat of litigation. Yet there is an increasing number of cases where aesthetics are the primary concern for dentists and patients alike and some patients are consenting to treatment without being properly informed of the destructive nature of the procedures to their sound tooth tissue and structures to achieve the desired 'cosmetic' outcome. This raises ethical issues, as much of this overtreatment is unnecessarily destructive and goes against the healing and caring principles of the dental profession. PMID:22538895

  3. A code of ethics for health care ethics consultants: journey to the present and implications for the field.

    PubMed

    Tarzian, Anita J; Wocial, Lucia D

    2015-01-01

    For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here. PMID:25970392

  4. Medical geneticists confront ethical dilemmas: cross-cultural comparisons among 18 nations.

    PubMed

    Wertz, D C; Fletcher, J C; Mulvihill, J J

    1990-06-01

    To provide a basis for international discussion of ethical problems, we studied responses of medical geneticists in 18 countries to questionnaires about 14 clinical cases and five screening situations. Of 1,053 asked to participate, 677 (64%) responded. There was greater than or equal to 75% consensus on five cases involving (1) disclosure of (1) conflicting diagnostic findings, (2) disclosure of ambiguous results, (3) disclosure of controversial interpretations, (4) protection of mother's confidentiality in cases of false paternity, and (5) nondirective counseling about 45,X and XYY syndrome. A majority (51%-60%) would disclose the diagnosis to relatives at risk for Huntington disease or hemophilia A, against the patient's wishes; would disclose which parent carries a translocation causing Down syndrome; and would disclose XY genotype in a female. As reproductive options for patients with disorders not diagnosable prenatally, 84% would discuss artificial insemination by a donor, 66% would discuss in vitro fertilization with donor egg, and 46% would discuss surrogate motherhood. In all, 85% would perform prenatal diagnosis for (or would refer) parents who refuse abortion, 75% for maternal anxiety, and 42% for selection of fetal sex. Screening questions showed that 72% believed that workplace screening should be voluntary and that results should be confidential. PMID:2339711

  5. Medical geneticists confront ethical dilemmas: cross-cultural comparisons among 18 nations.

    PubMed Central

    Wertz, D C; Fletcher, J C; Mulvihill, J J

    1990-01-01

    To provide a basis for international discussion of ethical problems, we studied responses of medical geneticists in 18 countries to questionnaires about 14 clinical cases and five screening situations. Of 1,053 asked to participate, 677 (64%) responded. There was greater than or equal to 75% consensus on five cases involving (1) disclosure of (1) conflicting diagnostic findings, (2) disclosure of ambiguous results, (3) disclosure of controversial interpretations, (4) protection of mother's confidentiality in cases of false paternity, and (5) nondirective counseling about 45,X and XYY syndrome. A majority (51%-60%) would disclose the diagnosis to relatives at risk for Huntington disease or hemophilia A, against the patient's wishes; would disclose which parent carries a translocation causing Down syndrome; and would disclose XY genotype in a female. As reproductive options for patients with disorders not diagnosable prenatally, 84% would discuss artificial insemination by a donor, 66% would discuss in vitro fertilization with donor egg, and 46% would discuss surrogate motherhood. In all, 85% would perform prenatal diagnosis for (or would refer) parents who refuse abortion, 75% for maternal anxiety, and 42% for selection of fetal sex. Screening questions showed that 72% believed that workplace screening should be voluntary and that results should be confidential. PMID:2339711

  6. Publishing Ethics and Predatory Practices: A Dilemma for All Stakeholders of Science Communication

    PubMed Central

    Yessirkepov, Marlen; Diyanova, Svetlana N.; Kitas, George D.

    2015-01-01

    Publishing scholarly articles in traditional and newly-launched journals is a responsible task, requiring diligence from authors, reviewers, editors, and publishers. The current generation of scientific authors has ample opportunities for publicizing their research. However, they have to selectively target journals and publish in compliance with the established norms of publishing ethics. Over the past few years, numerous illegitimate or predatory journals have emerged in most fields of science. By exploiting gold Open Access publishing, these journals paved the way for low-quality articles that threatened to change the landscape of evidence-based science. Authors, reviewers, editors, established publishers, and learned associations should be informed about predatory publishing practices and contribute to the trustworthiness of scholarly publications. In line with this, there have been several attempts to distinguish legitimate and illegitimate journals by blacklisting unethical journals (the Jeffrey Beall's list), issuing a statement on transparency and best publishing practices (the Open Access Scholarly Publishers Association's and other global organizations' draft document), and tightening the indexing criteria by the Directory of Open Access Journals. None of these measures alone turned to be sufficient. All stakeholders of science communication should be aware of multiple facets of unethical practices and publish well-checked and evidence-based articles. PMID:26240476

  7. Publishing Ethics and Predatory Practices: A Dilemma for All Stakeholders of Science Communication.

    PubMed

    Gasparyan, Armen Yuri; Yessirkepov, Marlen; Diyanova, Svetlana N; Kitas, George D

    2015-08-01

    Publishing scholarly articles in traditional and newly-launched journals is a responsible task, requiring diligence from authors, reviewers, editors, and publishers. The current generation of scientific authors has ample opportunities for publicizing their research. However, they have to selectively target journals and publish in compliance with the established norms of publishing ethics. Over the past few years, numerous illegitimate or predatory journals have emerged in most fields of science. By exploiting gold Open Access publishing, these journals paved the way for low-quality articles that threatened to change the landscape of evidence-based science. Authors, reviewers, editors, established publishers, and learned associations should be informed about predatory publishing practices and contribute to the trustworthiness of scholarly publications. In line with this, there have been several attempts to distinguish legitimate and illegitimate journals by blacklisting unethical journals (the Jeffrey Beall's list), issuing a statement on transparency and best publishing practices (the Open Access Scholarly Publishers Association's and other global organizations' draft document), and tightening the indexing criteria by the Directory of Open Access Journals. None of these measures alone turned to be sufficient. All stakeholders of science communication should be aware of multiple facets of unethical practices and publish well-checked and evidence-based articles. PMID:26240476

  8. 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. PMID:24766620

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

    PubMed

    Cain, Joanna M; Iglesia, Cheryl B; Dickens, Bernard; Montgomery, Owen

    2013-08-01

    Female genital cosmetic surgery is surgery performed on a woman within a normal range of variation of human anatomy. The issues are heightened by a lack of long-term and substantive evidence-based literature, conflict of interest from personal financial gain through performing these procedures, and confusion around macroethical and microethical domains. It is a source of conflict and controversy globally because the benefit and harm of offering these procedures raise concerns about harmful cultural views, education, and social vulnerability of women with regard to both ethics and human rights. The rights issues of who is defining normal female anatomy and function, as well as the economic vulnerability of women globally, bequeath the profession a greater responsibility to ensure that there is adequate health and general education-not just among patients but broadly in society-that there is neither limitation nor interference in the decision being made, and that there are no psychological disorders that could be influencing such choices. PMID:23735570

  10. Ethics in egg donation: past, present, and future.

    PubMed

    Klein, Joshua U; Sauer, Mark V

    2010-07-01

    Since the advent of clinical human egg donation just over 25 years ago, ethical considerations have been central to its successful application and popular acceptance. Early in its history, "essentialist" arguments questioning the moral validity of the practice altogether were commonplace. More recently, most academic discussion has been focused on "consequentialist" issues relating to practical approaches to egg donation that minimize ethically troublesome consequences. Three issues that have attracted a bulk of the attention in this regard are compensation, postmenopausal pregnancy, and egg sharing. Although much consensus has been reached on some very controversial issues, the enormous potential of increasingly successful oocyte cryopreservation, as well as emerging stem cell technologies, is very likely to provide abundant fuel for the continued debate of provocative and contentious ethical issues in human egg donation. PMID:20683796

  11. Environmental Education and Environmental Ethics: Theory, Practice, and Mixed Messages (1).

    ERIC Educational Resources Information Center

    Simmons, Deborah A.

    1988-01-01

    Presented is a review of environmental ethics since the Belgrade Charter of 1976. Outlines seven ethical positions to be considered. Discusses ethics in environmental education practice. Focuses on four ways to lessen the dilemma of the presentation of values in environmental education. (CW)

  12. Social and Ethical Issues. Paper Presentations: Session A.

    ERIC Educational Resources Information Center

    2000

    This document contains nine papers from the social and ethical issues section of an international conference on vocational education and training (VET) for lifelong learning in the information era. The following papers are included: "Attitudes of University Faculty Members toward Students with Disabilities" (Marie F. Kraska); "Attitude of Gaming…

  13. The Prevent programme: an ethical dilemma for teachers as well as psychiatrists

    PubMed Central

    Reed, Stephanie

    2016-01-01

    The UK government's Prevent programme affects professionals and the people who rely on their services across the public sector, particularly now that workers are legally bound to report their concerns about individuals they believe to be at risk of radicalisation. This article discusses the risks that the strategy presents to the work of teachers and the bonds of trusts between staff and students. PMID:27087992

  14. ETHICAL DILEMMAS IN PHYSICIAN-PATIENT RELATIONSHIP IN A MULTI-CULTURAL SOCIETY.

    PubMed

    Waitzman, Rotem

    2014-12-01

    Israel is a multicultural state that has absorbed, and is continually absorbing people of different cultures who immigrate to Israel, a situation that could create conflicts in the physician-patient relationship. In this article, I will present several cases in which diversity of culture can lead to conflict, and suggest a way of communication that can help prevent the conflicts arising from those situations. PMID:27351044

  15. Ethical Decision Making: Basic Issues

    ERIC Educational Resources Information Center

    Bradley, Loretta J.; Hendricks, C. Bret

    2008-01-01

    Among counselors, ethical dilemmas occur often. Although ethical dilemmas are challenging, they can be solved by implementing a code of ethics and/or an ethical decision-making model. Using case studies, the authors illustrate how counselors can make informed, accurate decisions that are made to protect the welfare of the client. It also helps…

  16. Ethics of community psychiatry.

    PubMed

    Adshead, G

    1999-09-01

    Psychiatric care in the community gives rise to ethical dilemmas which resemble those associated with predominantly institutional care. However, there are also dilemmas specifically associated with community care, many of which are conceptual as well as practical. Papers addressing both conceptual and practical ethical dilemmas are reviewed including some papers which deal with the ethical issues associated with violence in the community by the mentally ill. PMID:15719521

  17. "Walk the Talk": Developing Personal Ethical Agency through a Business Partnership Program

    ERIC Educational Resources Information Center

    Matherne, Brett P.; Gove, Steve; Forlani, Victor; Janney, Jay J.

    2006-01-01

    This article proposes a pedagogical approach dedicated to help students develop personal ethical agency--the ability to make decisions that involve ethical dilemmas consistent with an individual's ethical standards and professional standards of practice. The approach presented involves a tripartite gathering of students, business executives, and…

  18. Professionalism vs. unionism: a dual loyalty dilemma.

    PubMed

    Schillinger, K E

    1988-01-01

    Present economic conditions are causing growing uncertainty surrounding employment. This is a concern in all fields, including the health care industry. Guarantees negotiated into union contracts address job security, wages and benefits, and present tantalizing solutions to employee problems. Consequently, serious questions are raised for the professional. Can unionization and professionalism be compatible? This paper attempts to examine several ethical dilemma facing the therapeutic recreation professional and all other health care professionals. PMID:10296862

  19. Who pays for providing spiritual care in healthcare settings? The ethical dilemma of taxpayers funding holistic healthcare and the first amendment requirement for separation of church and state.

    PubMed

    Warnock, Carla Jean Pease

    2009-12-01

    All US governmental, public, and private healthcare facilities and their staff fall under some form of regulatory requirement to provide opportunities for spiritual health assessment and care as a component of holistic healthcare. As often the case with regulations, these facilities face the predicament of funding un-reimbursable care. However, chaplains and nurses who provide most patient spiritual care are paid using funds the facility obtains from patients, private, and public sources. Furthermore, Veteran healthcare services, under the United States Department of Veterans Affairs (VA), are provided with taxpayer funds from local, state, and federal governments. With the recent legal action by the Freedom From Religion Foundation, Inc. (FFRF) against the Veterans Administration, the ethical dilemma surfaces between taxpayers funding holistic healthcare and the first amendment requirement for separation of church and state. PMID:19890722

  20. A systematic format for resolving ethical issues in clinical periodontics.

    PubMed

    Schloss, Alexander J

    2012-01-01

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

  1. The human face behind an ethical dilemma: reflecting on attempted suicide and outcomes of a case study.

    PubMed

    Sneesby, Ludmilla

    2009-09-01

    This paper presents a challenging case study that reflects on the ethical and legal obligations of health-care workers. The case raised issues about the rights of terminally ill patients to refuse or reject treatment, and changed practice with the formulation of procedures and guidelines about self-harm, the wider issue of euthanasia, and the responsibilities of health-care workers in such cases. This case study is the story of Bernie (pseudonym), an 84-year-old man, from his admission to the palliative care outreach service, to his death. At the time of his attempted suicide, he was a patient of a palliative care outreach team at an Austalian hospital. The right of a person to take their own life, respect for autonomy and the actions of health-care workers are the basis of discussion. PMID:19957456

  2. Ethical Dilemmas in Individual and Collective Rights-Based Approaches to Tertiary Education Scholarships: The Cases of Canada and Cuba

    ERIC Educational Resources Information Center

    Lehr, Sabine

    2008-01-01

    One of the ongoing debates in Canadian higher education is the dilemma of the brain drain and the seemingly conflicting goals between the strategies and intentions of various government departments. While Citizenship and Immigration Canada aims to recruit the brightest students from across the globe to study in Canada and to enable their long-term…

  3. ‘THEY SAY ISLAM HAS A SOLUTION FOR EVERYTHING, SO WHY ARE THERE NO GUIDELINES FOR THIS?’ ETHICAL DILEMMAS ASSOCIATED WITH THE BIRTHS AND DEATHS OF INFANTS WITH FATAL ABNORMALITIES FROM A SMALL SAMPLE OF PAKISTANI MUSLIM COUPLES IN BRITAIN

    PubMed Central

    SHAW, ALISON

    2012-01-01

    This paper presents ethical dilemmas concerning the termination of pregnancy, the management of childbirth, and the withdrawal of life-support from infants in special care, for a small sample of British Pakistani Muslim parents of babies diagnosed with fatal abnormalities. Case studies illustrating these dilemmas are taken from a qualitative study of 66 families of Pakistani origin referred to a genetics clinic in Southern England. The paper shows how parents negotiated between the authoritative knowledge of their doctors, religious experts, and senior family members in response to the ethical dilemmas they faced. There was little knowledge or open discussion of the view that Islam permits the termination of pregnancy for serious or fatal abnormality within 120 days and there was considerable disquiet over the idea of ending a pregnancy. For some parents, whether their newborn baby would draw breath was a main worry, with implications for the baby's Muslim identity and for the recognition of loss the parents would receive from family and community. This concern sometimes conflicted with doctors' concerns to minimize risk to future pregnancies by not performing a Caesarean delivery if a baby is sure to die. The paper also identifies parents' concerns and feelings of wrong-doing regarding the withdrawal of artificial life-support from infants with multiple abnormalities. The conclusion considers some of the implications of these observations for the counselling and support of Muslim parents following the pre- or neo-natal diagnosis of fatal abnormalities in their children. PMID:21649685

  4. Dilemmas in Medicine, 2nd Edition 1977. CEM Probe.

    ERIC Educational Resources Information Center

    Undy, Harry, Ed.

    Published for secondary school youth in England, the PROBE series presents provocative information and discussion questions on topical themes. The focus of this issue is on aspects of medicine which raise moral dilemmas for doctors, patients, and society in general. This issue contains case studies which illustrate ethical questions raised by the…

  5. A child in detention: dilemmas faced by health professionals.

    PubMed

    Zwi, Karen J; Herzberg, Brenda; Dossetor, David; Field, Jyotsna

    2003-09-15

    A 6-year-old child, held in detention with his parents pending the outcome of their application for refugee status, manifested psychological distress by repeated episodes of refusing to eat or drink. This case presented clinical and ethical dilemmas for health professionals who were constrained from acting in the child's best interests by government policy of mandatory detention. PMID:12964917

  6. Ethical Issues Related to Restructuring.

    ERIC Educational Resources Information Center

    Mielke, Patricia L.; Schuh, John H.

    1995-01-01

    Offers a framework for thinking about ethical principles through the use of codes of ethics. Examines the ethical issues of restructuring and discusses specific ethical dilemmas. Specifically outlines ethics related to resources allocation and management, and details critical points in restructuring. Argues that ethical guidelines help shape…

  7. Improving Ethical Attitudes or Simply Teaching Ethical Codes? The Reality of Accounting Ethics Education

    ERIC Educational Resources Information Center

    Cameron, Robyn Ann; O'Leary, Conor

    2015-01-01

    Ethical instruction is critical in accounting education. However, does accounting ethics teaching actually instil core ethical values or simply catalogue how students should act when confronted with typical accounting ethical dilemmas? This study extends current literature by distinguishing between moral/ethical and legal/ethical matters and then…

  8. Iconoclastic ethics.

    PubMed

    Black, D

    1984-12-01

    Arguments are advanced, on a pragmatic basis, for preferring a 'situational' approach to medical ethical problems, rather than an approach based on any one of the dogmatic formulations on offer. The consequences of such a preference are exemplified in relation to confidentiality; and in relation to the ethical dilemmas which surround the beginning and the end of terrestrial human life. PMID:6520850

  9. Casuistry, care, compassion, and ethics data analysis.

    PubMed

    Gaul, A L

    1995-03-01

    Traditional approaches to descriptive ethics data analysis do not explicate the nature of ethical dilemmas in critical care and emergency nursing. Using sensitizing concepts of causes of nurse compassion, 168 stories of ethical dilemmas were categorized. They were analyzed from the theoretical perspective of an ethic of care using casuistry. Paradigm cases for each sensitizing concept were constructed. The nature of ethical dilemmas is in the disparity between actual and ideal nursing practice. PMID:7778890

  10. Ethical issues in integrative oncology.

    PubMed

    Ben-Arye, Eran; Schiff, Elad; Golan, Ofra

    2008-08-01

    Integrative oncology relates to an emerging dialog between complementary and alternative medicine (CAM) scholars, oncologists, family practitioners, and other health care providers who envision an extended and holistic patient-centered approach to oncology care. The multiple commitments of integrative oncology to a medical humanistic approach and to a strong evidence-based foundation may impose considerable ethical concerns and dilemmas. The authors use narrative ethics to present a case study that exemplifies the ethical challenges confronting physicians and health care providers who wish to provide an integrative approach for their patients. An ethical analysis of the narrative is provided to help clarify the ethical issues and conflicts within it. Finally, a framework that may transform ethical constraints to a communication tool is proposed. PMID:18638699

  11. Impression Management in the Ethical Self-Presentation of Offenders Undergoing Presentence Evaluation

    ERIC Educational Resources Information Center

    Holland, Terrill R.; Boik, Robert J.

    1978-01-01

    Ethical choices were assessed for offenders instructed to produce favorable versus unfavorable impressions. Pronounced impression management effects were obtained for prosocial and antisocial responses, and high scores on a dimension of change defined by these variables were related to sociopathic features on the MMPI. (Author)

  12. Do the Right Thing: Ethical Decision-Making in Professional & Business Practice.

    ERIC Educational Resources Information Center

    Zinn, Lorraine M.

    1993-01-01

    Explains how to recognize ethical dilemmas and reviews steps in making ethical decisions: information gathering, ethical codes, values and beliefs, critical reflection, peer consultation, and intuition. (SK)

  13. Identifying Unique Ethical Challenges of Indigenous Field-Workers: A Commentary on Alexander and Richman's "Ethical Dilemmas in Evaluations Using Indigenous Research Workers"

    ERIC Educational Resources Information Center

    Smith, Nick L.

    2008-01-01

    In contrast with nonindigenous workers, to what extent do unique ethical problems arise when indigenous field-workers participate in field studies? Three aspects of study design and operation are considered: data integrity issues, risk issues, and protection issues. Although many of the data quality issues that arise with the use of indigenous…

  14. The Impact of the Nurse-Physician Professional Relationship on Nurses' Experience of Ethical Dilemmas in Effective Pain Management.

    ERIC Educational Resources Information Center

    Van Niekerk, Leesa Micole; Martin, Frances

    2002-01-01

    A survey of 1,015 Australian registered nurses found that those who felt adequately consulted by physicians were significantly more likely to initiate consultation. Nurses dissatisfied with their relationship with physicians were more likely to experience ethical conflicts related to pain management. Level of satisfaction with this relationship…

  15. Ethics: A Matter of Moral Development

    ERIC Educational Resources Information Center

    Krawczyk, Rosemary; Kudzma, Elizabeth

    1978-01-01

    Courses in theoretical ethics are unrelated to the moral delemmas that nurses encounter in practice, according to the authors. They present a method for moral education in nursing curricula utilizing seminars for dilemma discussion that can help students to progress in moral judgment. (MF)

  16. Social Media Use and Teacher Ethics

    ERIC Educational Resources Information Center

    Warnick, Bryan R.; Bitters, Todd A.; Falk, Thomas M.; Kim, Sang Hyun

    2016-01-01

    Teacher use of social networking sites such as Facebook has presented some ethical dilemmas for policy makers. In this article, we argue that schools are justified in taking action against teachers when evidence emerges from social networking sites that teachers are (a) doing something that is illegal, (b) doing something that reflects badly on…

  17. Ethics and the professional practice of psychologists: the role of virtues and principles.

    PubMed

    Jordan, A E; Meara, N M

    1990-04-01

    We evaluate the potential relevance of virtue ethics to the training and practice of professional psychologists, and we contrast them with principle ethics. Typically, principles are used to facilitate the selection of socially and historically acceptable answers to the question "What shall I do?" when confronted by ethical dilemmas. Virtue ethics, however, generally focus on the question "Who shall I be?" Strengths and weaknesses of each approach are presented. The impact of each is discussed with respect to informed consent and the therapeutic construct "genuineness." We conclude that virtue ethics are an essential component of responsible ethical training and practice. PMID:16047427

  18. NAEYC Code of Ethical Conduct. Revised = Codigo de Conducta Etica. Revisada

    ERIC Educational Resources Information Center

    National Association of Elementary School Principals (NAESP), 2005

    2005-01-01

    This document presents a code of ethics for early childhood educators that offers guidelines for responsible behavior and sets forth a common basis for resolving ethical dilemmas encountered in early education. It represents the English and Spanish versions of the revised code. Its contents were approved by the NAEYC Governing Board in April 2005…

  19. School Psychologists Ethical Decision Making: Implications from Selected Social Psychological Phenomena

    ERIC Educational Resources Information Center

    Lasser, Jon; Klose, Laurie McGarry

    2007-01-01

    School psychologists routinely engage in ethical decision making, and existing models have served as useful tools for systematically approaching ethical dilemmas. However, a few of these models have taken account of the rich and salient body of social psychology research. This article reviews social psychological phenomena that present clear…

  20. 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…

  1. The Ethics of Legislative Life. A Report by the Hastings Center.

    ERIC Educational Resources Information Center

    Hastings Center, Hastings-on-Hudson, NY.

    Results of a two-year research project (1982-84) on Legislative and Representative Ethics are presented in this report, which analyzes the basic principles of legislative ethics, discusses the special dilemmas and obligations of legislators, and offers conclusions about future steps that could be taken to enhance public discussion and to reinforce…

  2. An interesting case of systemic lupus erythematosus presenting with hypercalcemia: A diagnostic dilemma

    PubMed Central

    Abdul Gafor, Abdul Halim; Cader, Rizna Abdul; Das, Srijit; Masir, Noraidah; Wahid, Fadilah Abdul

    2013-01-01

    Background Hypercalcemia is common in primary hyperparathyroidism malignancies and even in tuberculosis. Interestingly, systemic lupus erythematosus (SLE) rarely presents with hypercalcemia. Case Report: We describe an interesting case of SLE in a patient who was otherwise thought to have either tuberculosis or a malignancy. The patient initially presented with feeling unwell, with generalized lymphadenopathy, bilateral pleural effusion, and bilateral corneal calcium deposits secondary to severe hypercalcemia. The diagnosis of SLE was made based on positivity of antinuclear antibodies (ANA) and anti-dsDNA, the presence of serositis, lymphadenopathy, autoimmune hemolytic anemia, and constitutional symptoms. She was treated with steroids, with tremendous improvement in her general well-being, resolution of lymphadenopathy and pleural effusion, and normalization of her hemoglobin and serum calcium. The atypical presentation of SLE with hypercalcemia with pleural effusion is discussed. Conclusions: SLE should be one of the differential diagnoses in patients presenting with severe hypercalcemia. PMID:23569551

  3. Unicentric Castleman’s Disease Presenting as a Pulmonary Mass: A Diagnostic Dilemma

    PubMed Central

    Rawashdeh, Badi; Meyer, Mark; Yimin, Dong; Anthony, Colon; Nguyen, Duy; Moslemi, Mohammad; Golestani, Simin; Richard, Sobonya; Kim, Samuel

    2015-01-01

    Patient: Female, 16 Final Diagnosis: Castleman’s Disease Symptoms: Chest pain • cough non-productive Medication: — Clinical Procedure: — Specialty: Oncology Objective: Rare disease Background: Castleman’s disease, or angiofollicular lymphoid hyperplasia, is a rare disorder and can be easily misdiagnosed as lymphoma, neoplasm, or infection. The diagnosis is challenging due to the nonspecific signs and symptoms as well as the rarity of the disease. We present an unusual case of a young girl presenting with an enlarging pulmonary mass that was believed to be infectious in origin. Case Report: A 16-year-old Native American female from Arizona initially presented with occasional non-productive cough and chest pain. Imaging revealed a 3-cm left upper lobe lobulated mass. This mass was thought to be due to coccidioidomycosis and was treated with fluconazole. Follow-up imaging demonstrated growth of the mass to 4.8 cm. The patient underwent a left video-assisted thoracoscopic left upper lobectomy and mediastinal lymphadenectomy. Histopathological examination revealed Castleman’s disease. Conclusions: Pulmonary masses in young patients can be easily misdiagnosed as infections or cancer. We present the case of a 16-year-old female misdiagnosed as having a fungal infection of the lung, which was later revealed to be Castleman’s disease of the left upper lobe. PMID:25928278

  4. Multiple Abdominal Cocoons: An Unusual Presentation of Intestinal Obstruction and a Diagnostic Dilemma

    PubMed Central

    Sohail, Mohammad Zain; Dala-Ali, Benan; Ali, Shahanoor; Hashmi, M. A.

    2015-01-01

    Sclerosing encapsulating peritonitis (SEP) or abdominal cocoon is a rare acquired condition with an unknown aetiology. It is characterized by encapsulation of the small bowel by a fibrous membrane and can lead to intestinal obstruction. We present the case of a 42-year-old gentleman with a history of hepatitis C, tuberculosis, and previous abdominal surgery, who presented with subacute intestinal obstruction. Surgical exploration of the abdomen revealed that the entire contents were enclosed into three distinct sacs by a dense fibrous membrane. Excision of the sacs was performed followed by adhesiolysis. This is believed to be the first reported case of multiple cocoons within the abdominal cavity. The case is discussed with reference to the literature. PMID:25893128

  5. Ethics and Special Education.

    ERIC Educational Resources Information Center

    Paul, James; French, Peter; Cranston-Gingras, Ann

    2001-01-01

    Discussion of ethics in special education focuses on four challenges: (1) examination of special education's history within an ethical framework; (2) articulation of character morality as well as choice morality in special education ethical dilemmas; (3) examination of special education in a liberal democracy; and (4) development of an ethical…

  6. The Evolution of Ethics.

    PubMed

    Powell, Suzanne K

    2016-01-01

    Ethical issues and dilemmas span from conception to the grave. The interconnectedness of advocacy, ethics, and end of life/death with dignity are woven into this issue of the Professional Case Management journal. Case management is a critical member of the team when these discussions arise. And knowledge of the issues, along with legal, ethical, and professional codes, is highlighted. PMID:27231955

  7. Ethical Issues in Gerocounseling.

    ERIC Educational Resources Information Center

    Cavallaro, Marion L.; Ramsey, Marylou

    1988-01-01

    Combines areas of counseling older adults and maintaining sound ethical practices in professional counseling by enumerating some ethical dilemmas encountered in gerocounseling, examining the American Association for Counseling and Development Ethical Standards (1981), and suggesting options for handling conflicts that may arise. (Author/NB)

  8. Designing an Ethics Class.

    ERIC Educational Resources Information Center

    Prager, Richard

    1993-01-01

    Describes a required ethics course designed for juniors and seniors at a small Connecticut boarding school. Students explore the ethics of care and justice, examine ethical assumptions behind the school's disciplinary system, consider a series of dilemmas, and discuss complex topics such as abortion, euthanasia, and racism. A sidebar outlines…

  9. 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…

  10. Ethical issues and addiction.

    PubMed

    Lambert, Binta; Scheiner, Melissa; Campbell, Deborah

    2010-04-01

    The epidemic of substance abuse continues to pose a significant challenge to clinicians nationwide. Although there is a tendency to simply associate drug abuse with poverty, the problem affects every social stratum gender and race; and pregnant women are no exception. Caring for pregnant, substance-using women and their infants presents complex legal and ethical issues. Debate is ongoing about whether criminal penalties should be imposed on women based solely on their use of alcohol and other drugs during pregnancy. Furthermore, controversies persist about the rights and wishes of pregnant women versus the interests of their fetuses. For health professionals, conflict arises when the pregnant woman chooses behaviors that have the potential to harm the developing fetus. The ethical dilemma arises from competing autonomy-based and beneficence-based obligations to the maternal-fetal dyad. This chapter explores the ethics-based conflicts in the delivery of health care to drug abusing pregnant women. PMID:20407974