Medical ethics and ethical dilemmas.

PubMed

Iyalomhe, G B S

2009-01-01

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

Incompetent Patients, Substitute Decision Making, and Quality of Life: Some Ethical Considerations

PubMed Central

Kluge, Eike-Henner W.

2008-01-01

One of the most difficult situations facing physicians involves decision making by substitute decision makers for patients who have never been competent. This paper begins with a brief examination of the ethics of substitute decision making for previously competent patients. It then applies the results to substitute decision making for patients who have never been competent, and critically analyzes 5 models of substitute decision making for such patients, showing why each either contravenes basic ethical principles or fails to guarantee the use of ethically appropriate values. It concludes by sketching a modified objective reasonable person standard for substitute decision making that avoids valuational difficulties and allows for a protocol that satisfies ethical principles. PMID:19099031

Research and Development for a Course in Ethics in Nursing Practice for Community College Associate Degree Nursing Students. Final Report.

ERIC Educational Resources Information Center

Roediger, Jeanette

A project was undertaken to research and acquire the instructional sources needed for a course in ethics for community college associate degree nursing students and to develop such a course. Addressed in the individual units of the course were the following topics: bioethics and ethical decision making, basic ethical concepts and principles,…

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

PubMed

Serour, G I

2015-01-01

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

CEP's Eleven Principles of Effective Character Education

ERIC Educational Resources Information Center

Lickona, Tom; Schaps, Eric; Lewis, Catherine

2007-01-01

There is no single script for effective character education, but there are some important basic principles. This document presents eleven principles that schools and other groups can use to plan a character education effort and to evaluate available character education programs: (1) Promotes core ethical values and supportive performance values as…

Case-Based Learning as Pedagogy for Teaching Information Ethics Based on the Dervin Sense-Making Methodology

ERIC Educational Resources Information Center

Dow, Mirah J.; Boettcher, Carrie A.; Diego, Juana F.; Karch, Marziah E.; Todd-Diaz, Ashley; Woods, Kristine M.

2015-01-01

The purpose of this mixed methods study is to determine the effectiveness of case-based pedagogy in teaching basic principles of information ethics and ethical decision making. Study reports results of pre- and post-assessment completed by 49 library and information science (LIS) graduate students at a Midwestern university. Using Creswell's…

Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics.

PubMed

Gillon, Raanan

2015-01-01

This paper argues that the four prima facie principles-beneficence, non-maleficence, respect for autonomy and justice-afford a good and widely acceptable basis for 'doing good medical ethics'. It confronts objections that the approach is simplistic, incompatible with a virtue-based approach to medicine, that it requires respect for autonomy always to have priority when the principles clash at the expense of clinical obligations to benefit patients and global justice. It agrees that the approach does not provide universalisable methods either for resolving such moral dilemmas arising from conflict between the principles or their derivatives, or universalisable methods for resolving disagreements about the scope of these principles-long acknowledged lacunae but arguably to be found, in practice, with all other approaches to medical ethics. The value of the approach, when properly understood, is to provide a universalisable though prima facie set of moral commitments which all doctors can accept, a basic moral language and a basic moral analytic framework. These can underpin an intercultural 'moral mission statement' for the goals and practice of medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

An Interdisciplinary Code of Ethics for Adult Education.

ERIC Educational Resources Information Center

Connelly, Robert J.; Light, Kathleen M.

1991-01-01

Proposes five basic principles of a code of ethics for adult educators: social responsibility, an inclusive philosophy of education, pluralism as a strength but consensus as a goal, respect for learners, and respect for fellow educators. The wisdom of developing such a code is addressed. (SK)

Science ethics education part II: changes in attitude toward scientific fraud among medical researchers after a short course in science ethics.

PubMed

Vuckovic-Dekic, L; Gavrilovic, D; Kezic, I; Bogdanovic, G; Brkic, S

2012-01-01

To determine the impact of the short science ethics courses on the knowledge of basic principles of responsible conduct of research (RCR), and on the attitude toward scientific fraud among young biomedical researchers. A total of 361 attendees of the course on science ethics answered a specially designed anonymous multiple- choice questionnaire before and after a one-day course in science ethics. The educational course consisted of 10 lectures: 1) Good scientific practice - basic principles; 2) Publication ethics; 3) Scientific fraud - fabrication, falsification, plagiarism; 4) Conflict of interests; 5) Underpublishing; 6) Mentorship; 7) Authorship; 8) Coauthorship; 9) False authorship; 10) Good scientific practice - ethical codex of science. In comparison to their answers before the course, a significantly higher (p<0.001) number of students qualified their knowledge of science ethics as sufficient after the course was completed. That the wrongdoers deserve severe punishment for all types of scientific fraud, including false authorship, thought significantly (p<0.001) more attendees than before the course, while notably fewer attendees (p<0.001) would give or accept undeserved authorship Even a short course in science ethics had a great impact on the attendees, enlarging their knowledge of responsible conduct of research and changing their previous, somewhat opportunistic, behavior regarding the reluctance to react publicly and punish the wrongdoers.

Virtue ethics – an old answer to a new dilemma? Part 2. The case for inclusive virtue ethics

PubMed Central

2015-01-01

Summary While Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges. This two-part paper proposes a version of virtue theory as a more grounded system of moral analysis. Part 2 examines the role of basic moral theory as the foundation to ethics and suggests how virtue theory can be used as a central framework for ethics while being inclusive of insights from deontology and consequentialism. PMID:25792615

What is the responsibility of national government with respect to vaccination?

PubMed

Verweij, Marcel F; Houweling, Hans

2014-12-12

Given the ethical aspects of vaccination policies and current threats to public trust in vaccination, it is important that governments follow clear criteria for including new vaccines in a national programme. The Health Council of the Netherlands developed such a framework of criteria in 2007, and has been using this as basis for advisory reports about several vaccinations. However, general criteria alone offer insufficient ground and direction for thinking about what the state ought to do. In this paper, we present and defend two basic ethical principles that explain why certain vaccinations are the state's moral-political responsibility, and that may further guide decision-making about the content and character of immunisation programmes. First and foremost, the state is responsible for protecting the basic conditions for public health and societal life. Secondly, states are responsible for promoting and securing equal access to basic health care, which may also include certain vaccinations. We argue how these principles can find reasonable support from a broad variety of ethical and political views, and discuss several implications for vaccination policies. Copyright © 2014 Elsevier Ltd. All rights reserved.

When Ethics Survive Where People Do Not

PubMed Central

Hussein, Ghaiath M. A.

2010-01-01

The provision of health care service in resource-poor settings is associated with a broad set of ethical issues. Devakumar's case discusses the ethical issues related to the inability to treat in a cholera clinic patients who do not have cholera. This paper gives a closer look on the context in which Devakumar's case took place. It also analyses the potential local and organizational factors that gives rise to ethical dilemmas and aggravate them. It also proposes a framework to help in the proactive handling of the factors that leads to ethical dilemmas and resolving the ethical issues as they appear. It adopts the four principles of autonomy, beneficence, non-maleficence and justice as universal and prima facie principles, but with the inclusion of a local understanding of what of each of these principles means. It is based on a collaborative approach that involves the beneficiaries and other partners in the field to help share information and resources, as well as adopting the provision of a wider service to the whole community. This is done by asking three basic questions: (a) who are the relevant stakeholders? (b) what ought to be the ethical principles in place? and (c) how should we take, implement and follow the decision about service provision? PMID:20336229

Managed care's Achilles heel: ethical immaturity.

PubMed

Thompson, R E

2000-01-01

How can physician executives determine the prevailing values in the managed care arena? What are the consequences when values statements are ignored during decision-making? These questions can be answered using a process called ethical reasoning, which is different and more productive than making moral judgments, such as "is managed care good or bad?" Failing to include ethical reasoning in executive offices and boardrooms is a form of ethical immaturity. It fuels public suspicion that managed care's goal may be maximizing profit at all costs, as opposed to seeking reasonable profit through provision of dependable and accessible health care services. One outcome of ethical reasoning is rediscovering the basic truth that running one's business on competitive rather than altruistic principles is ethical whenever greater efficiencies and economic growth enlarge the size of the pie for everyone. Reasonable self-interest is a perfectly acceptable reason to act ethically. The time has come for physician executives to develop a basic understanding of pragmatic ethics, and to appreciate the value of adding ethical reasoning to the decision-making process.

[Some ethical aspects of donation and transplantation].

PubMed

Martínez, K

2006-01-01

Ethical and legal consensus in our country bases the practice of donations and transplants on different ethical principles, which are contained in the legislation, closely conforming to the four principles of principialist bioethics: autonomy, beneficence, non-maleficence, and justice. The level of donations achieved in our milieu might, in fact, be related to a strict respect for these principles by the health professionals, as well as to the excellent organisation of the transplant world. Many scientific, technical and ethical challenges have had to be met to reach the present state of the transplant. And there are many current challenges. The article only analyses some of these due to their technical, ethical and social repercussions: organ transplants involving a live donor, the public request for organs, the organ market, the transplant of non-vital organs (basically the face transplant), the use of stem cells and the banks of umbilical cord cells. The aim of the article is to state the ethical problems raised by these new practices, in order to lay the foundations for a moral deliberation that must necessarily involve the whole of society.

Correction.

PubMed

2015-06-01

Gillon R. Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics. J Med Ethics 2015;41:111–6. The author misrepresented Beauchamp and Childress when he wrote: ‘My own view (unlike Beauchamp and Childress who explicitly state that they make no such claim ( p. 421)1, is that all moral agents whether or not they are doctors or otherwise involved in healthcare have these prima facie moral obligations; but in the context of answering the question ‘what is it to do good medical ethics ?’ my claim is limited to the ethical obligations of doctors’. The author intended and should have written the following: ‘My own view, unlike Beauchamp and Childress who explicitly state that they make no such claim (p.421)1 is that these four prima facie principles can provide a basic moral framework not only for medical ethics but for ethics in general’.

Virtue ethics--an old answer to a new dilemma? Part 2. The case for inclusive virtue ethics.

PubMed

Misselbrook, David

2015-03-01

While Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges. This two-part paper proposes a version of virtue theory as a more grounded system of moral analysis. Part 2 examines the role of basic moral theory as the foundation to ethics and suggests how virtue theory can be used as a central framework for ethics while being inclusive of insights from deontology and consequentialism. © The Royal Society of Medicine.

Organizational ethics in Catholic health care: honoring stewardship and the work environment.

PubMed

Magill, G

2001-04-01

Organizational ethics refers to the integration of values into decision making, policies, and behavior throughout the multi-disciplinary environment of a health care organization. Based upon Catholic social ethics, stewardship is at the heart of organizational ethics in health care in this sense: stewardship provides the hermeneutic filter that enables basic ethical principles to be realized practically, within the context of the Catholic theology of work, to concerns in health care. This general argument can shed light on the specific topic of non-executive compensation programs as an illustration of organizational ethics in health care.

Reflections on bioethics: consolidation of the principle of autonomy and legal aspects.

PubMed

Segre, M

1999-01-01

The author highlights the importance of emotions in all ethical reflections. He describes the most common positions of ethicists employing duties and rights as the basis for ethical thought. The author, goes to Freudian theory as viewed by the utilitarians, stating that the 'quest for pleasure' is not necessarily egocentric, especially for adults. For example, the feeling of solidarity emerges 'from the inside out', making irrelevant all the emphasis laid on obedience to duty (from the outside in). The article questions the essence of Kantian theory, based exclusively on 'reason' with disregard for feelings, by establishing what he considers a 'positivist' view of rational thought. It emphasizes the principle of autonomy, which it seen as basically opposing the principles of beneficence and fairness. It is proposed that the latter should be seen as what he calls heteronomy (a concept different from that of the rational ethicists). In theory, autonomy is not assigned to anyone on the basis of an external assessment. Any intervention in individual autonomy must be made (by the intervenor) when it becomes imperative in the defense of social or cultural values. The article distinguishes between ethics and morals) and states that the sole acceptable ethical principle is that ethics (theoretically) has no principle.

Ethics and interpreting in psychotherapy with refugee children and families.

PubMed

Björn, Gunilla Jarkman

2005-01-01

Basic ethical principles like autonomy, non-maleficence, beneficence and justice should be taken into consideration step by step when treating refugee children and their families. These principles may be considered from the point of view of each of the actors involved--patient, therapist and interpreter. This paper is focused on the role of the interpreter and on different aspects to be considered by the therapist when working with interpreters in psychotherapeutic treatment of refugee children and families. Elements of case histories are used to illustrate situations faced in working with an interpreter. An ethical analysis of a case where a teenage refugee received therapeutic treatment using an interpreter is made.

Ethical consequences for professionals from the globalization of food, nutrition and health.

PubMed

Solomons, Noel W

2002-01-01

Globalization is the process of increasing interconnections and linkages, within societies and across geography, due to improved communication and expanded world trade. It limits the differentiation wrought by human cultural evolution, and homogenizes health practices, diet and lifestyle. There are both beneficial and adverse consequences of the globalization process. Globalization also presents a challenge to the development of ethics for practice and advocacy by food and nutrition professionals. Among the related terms, 'morals', 'values' and 'ethics', the latter connotes the basic rules of conduct for interactions within society and with the inanimate environment; rules based on recognized principles (ethical principles). The application of these principles is to resolve ethical dilemmas that arise when more than one interest is at play. Recognized ethical principles include autonomy, beneficence, non-maleficence, justice, utility and stewardship. These can be framed in the context of issues that arise during advocacy for material and behavioural changes to improve the nutritional health of populations. Clearly, at the global level, codes of good conduct and the construction of good food governance can be useful in institutionalizing ethical principles in matters of human diets and eating practices. Ethical dilemmas arise in the context of innate diversity among populations (some individuals benefit, whereas others suffer from the same exposures), and due to the polarity of human physiology and metabolism (practices that prevent some diseases will provoke other maladies). Moreover, the autonomy of one individual to exercise independent will in addressing personal health or treatment of the environment may compromise the health of the individual's neighbours. The challenges for the professional in pursuit of ethical advocacy in a globalized era are to learn the fundamentals of ethical principles; to bear in mind a respect for difference and differentiation that continues to exist, and which should exist, among individuals and societies; and to avoid a total homogenization of agriculture and food supplies.

Healthcare ethics: the experience after the Haitian earthquake.

PubMed

Etienne, Mill; Powell, Clydette; Amundson, Dennis

2010-01-01

On January 12, 2010, a 7.0 Richter earthquake devastated Haiti and its public health infrastructure leading to a worldwide humanitarian effort. The United States sent forces to Haiti's assistance including the USNS Comfort, a tertiary care medical center on board a ship. Besides setting a transparent triage and medical regulating system, the leadership on the Comfort instituted a multidisciplinary Healthcare Ethics Committee to assist in delivering the highest level efficient care to the largest number of victims. Allocation of resources was based on time-honored ethics principles, the concept of mass casualty triage in the setting of resource constraints, and constructs developed by the host nation's Ministry of Health. In offering aid in austere circumstances, healthcare practitioners must not only adhere to the basic healthcare ethics principles but also practice respect for communities, cultures, and traditions, as well as demonstrate respect for the sovereignty of the host nation. The principles outlined herein should serve as guidance for future disaster relief missions. This work is in accordance with BUMEDINST 6010.25, Establishment of Healthcare Ethics Committees.

Principles and ethics in scientific communication in biomedicine.

PubMed

Donev, Doncho

2013-12-01

To present the basic principles and standards of scientific communication and writing a paper, to indicate the importance of honesty and ethical approach to research and publication of results in scientific journals, as well as the need for continuing education in the principles and ethics in science and publication in biomedicine. An analysis of relevant materials and documents, sources from the internet and published literature and personal experience and observations of the author. In the past more than 20 years there is an increasingly emphasized importance of respecting fundamental principles and standards of scientific communication and ethical approach to research and publication of results in peer review journals. Advances in the scientific community is based on honesty and equity of researchers in conducting and publishing the results of research and to develop guidelines and policies for prevention and punishment of publishing misconduct. Today scientific communication standards and definitions of fraud in science and publishing are generally consistent, but vary considerably policies and approach to ethics education in science, prevention and penal policies for misconduct in research and publication of results in scientific journals. It is necessary to further strengthen the capacity for education and research, and raising awareness about the importance and need for education about the principles of scientific communication, ethics of research and publication of results. The use of various forms of education of the scientific community, in undergraduate teaching and postgraduate master and doctoral studies, in order to create an ethical environment, is one of the most effective ways to prevent the emergence of scientific and publication dishonesty and fraud.

Principles and Ethics in Scientific Communication in Biomedicine

PubMed Central

Donev, Doncho

2013-01-01

Introduction and aim: To present the basic principles and standards of scientific communication and writing a paper, to indicate the importance of honesty and ethical approach to research and publication of results in scientific journals, as well as the need for continuing education in the principles and ethics in science and publication in biomedicine. Methods: An analysis of relevant materials and documents, sources from the internet and published literature and personal experience and observations of the author. Results: In the past more than 20 years there is an increasingly emphasized importance of respecting fundamental principles and standards of scientific communication and ethical approach to research and publication of results in peer review journals. Advances in the scientific community is based on honesty and equity of researchers in conducting and publishing the results of research and to develop guidelines and policies for prevention and punishment of publishing misconduct. Today scientific communication standards and definitions of fraud in science and publishing are generally consistent, but vary considerably policies and approach to ethics education in science, prevention and penal policies for misconduct in research and publication of results in scientific journals. Conclusion: It is necessary to further strengthen the capacity for education and research, and raising awareness about the importance and need for education about the principles of scientific communication, ethics of research and publication of results. The use of various forms of education of the scientific community, in undergraduate teaching and postgraduate master and doctoral studies, in order to create an ethical environment, is one of the most effective ways to prevent the emergence of scientific and publication dishonesty and fraud. PMID:24505166

Law and Foreign Policy: Problems in Intercultural Communications.

ERIC Educational Resources Information Center

Bozeman, Adda B.

The values and norms of Western law are not universally accepted as basic values and norms in other cultures. Therefore, the contractual processes of Western law should not be considered the basic foundation for all foreign policy negotiations. In Western cultures, principles of law are differentiated from other values based on religion, ethics,…

Health Care Decisions at the End of Life: Theological and Ethical Foundations for Decision Making.

ERIC Educational Resources Information Center

Allegretti, Joseph G.

This paper provides a framework for making sense of perplexing problems surrounding issues of death and dying by exploring the theological and ethical background to health care decision making at the end of life. The paper first examines several of the basic principles that theologians and secular ethicists employ when analyzing such questions.…

Ethics in clinical research: the Indian perspective.

PubMed

Sanmukhani, J; Tripathi, C B

2011-03-01

Ethics in clinical research focuses largely on identifying and implementing the acceptable conditions for exposure of some individuals to risks and burdens for the benefit of society at large. Ethical guidelines for clinical research were formulated only after discovery of inhumane behaviour with participants during research experiments. The Nuremberg Code was the first international code laying ethical principles for clinical research. With increasing research all over, World Health Organization formulated guidelines in the form of Declaration of Helsinki in 1964. The US laid down its guidelines for ethical principles in the Belmont Report after discovery of the Tuskegee's Syphilis study. The Indian Council of Medical Research has laid down the 'Ethical Guidelines for Biomedical Research on Human Subjects' in the year 2000 which were revised in 2006. It gives twelve general principles to be followed by all biomedical researchers working in the country. The Ethics Committee stands as the bridge between the researcher and the ethical guidelines of the country. The basic responsibility of the Ethics Committee is to ensure an independent, competent and timely review of all ethical aspects of the project proposals received in order to safeguard the dignity, rights, safety and well-being of all actual or potential research participants. A well-documented informed consent process is the hallmark of any ethical research work. Informed consent respects individual's autonomy, to participate or not to participate in research. Concepts of vulnerable populations, therapeutic misconception and post trial access hold special importance in ethical conduct of research, especially in developing countries like India, where most of the research participants are uneducated and economically backward.

How "moral" are the principles of biomedical ethics?--a cross-domain evaluation of the common morality hypothesis.

PubMed

Christen, Markus; Ineichen, Christian; Tanner, Carmen

2014-06-17

The principles of biomedical ethics - autonomy, non-maleficence, beneficence, and justice - are of paradigmatic importance for framing ethical problems in medicine and for teaching ethics to medical students and professionals. In order to underline this significance, Tom L. Beauchamp and James F. Childress base the principles in the common morality, i.e. they claim that the principles represent basic moral values shared by all persons committed to morality and are thus grounded in human moral psychology. We empirically investigated the relationship of the principles to other moral and non-moral values that provide orientations in medicine. By way of comparison, we performed a similar analysis for the business & finance domain. We evaluated the perceived degree of "morality" of 14 values relevant to medicine (n1 = 317, students and professionals) and 14 values relevant to business & finance (n2 = 247, students and professionals). Ratings were made along four dimensions intended to characterize different aspects of morality. We found that compared to other values, the principles-related values received lower ratings across several dimensions that characterize morality. By interpreting our finding using a clustering and a network analysis approach, we suggest that the principles can be understood as "bridge values" that are connected both to moral and non-moral aspects of ethical dilemmas in medicine. We also found that the social domain (medicine vs. business & finance) influences the degree of perceived morality of values. Our results are in conflict with the common morality hypothesis of Beauchamp and Childress, which would imply domain-independent high morality ratings of the principles. Our findings support the suggestions by other scholars that the principles of biomedical ethics serve primarily as instruments in deliberated justifications, but lack grounding in a universal "common morality". We propose that the specific manner in which the principles are taught and discussed in medicine - namely by referring to conflicts requiring a balancing of principles - may partly explain why the degree of perceived "morality" of the principles is lower compared to other moral values.

How “moral” are the principles of biomedical ethics? – a cross-domain evaluation of the common morality hypothesis

PubMed Central

2014-01-01

Background The principles of biomedical ethics – autonomy, non-maleficence, beneficence, and justice – are of paradigmatic importance for framing ethical problems in medicine and for teaching ethics to medical students and professionals. In order to underline this significance, Tom L. Beauchamp and James F. Childress base the principles in the common morality, i.e. they claim that the principles represent basic moral values shared by all persons committed to morality and are thus grounded in human moral psychology. We empirically investigated the relationship of the principles to other moral and non-moral values that provide orientations in medicine. By way of comparison, we performed a similar analysis for the business & finance domain. Methods We evaluated the perceived degree of “morality” of 14 values relevant to medicine (n1 = 317, students and professionals) and 14 values relevant to business & finance (n2 = 247, students and professionals). Ratings were made along four dimensions intended to characterize different aspects of morality. Results We found that compared to other values, the principles-related values received lower ratings across several dimensions that characterize morality. By interpreting our finding using a clustering and a network analysis approach, we suggest that the principles can be understood as “bridge values” that are connected both to moral and non-moral aspects of ethical dilemmas in medicine. We also found that the social domain (medicine vs. business & finance) influences the degree of perceived morality of values. Conclusions Our results are in conflict with the common morality hypothesis of Beauchamp and Childress, which would imply domain-independent high morality ratings of the principles. Our findings support the suggestions by other scholars that the principles of biomedical ethics serve primarily as instruments in deliberated justifications, but lack grounding in a universal “common morality”. We propose that the specific manner in which the principles are taught and discussed in medicine – namely by referring to conflicts requiring a balancing of principles – may partly explain why the degree of perceived “morality” of the principles is lower compared to other moral values. PMID:24938295

The ethics and economics of consuming Canadian drugs.

PubMed

Seaman, Rachel M H

2005-01-01

Many U.S. citizens are unable to afford prescription medication in their own country, so they purchase them from Canadian pharmacies. This paper examines the ethics of importing drugs from Canada, including economic implications and how physicians should respond to this dilemma. The four basic principles of ethics are balanced by examining financial incentives, current Canadian and U.S. law, safety issues, the burden of research and development, the impact on Canadian physicians, and issues of liability. The paper concludes that the principle of autonomy permits individuals to cross the border and purchase drugs for personal use; however, nonmaleficence prohibits the purchase of these drugs through third parties. In addition, the U.S. government has special obligations to justice and beneficence and may not ethically sponsor the importation of Canadian drugs. Finally, the paper shows that U.S. doctors must not recommend importation on the basis of beneficence and autonomy.

Risk Assessment and Management for Medically Complex Potential Living Kidney Donors: A Few Deontological Criteria and Ethical Values

PubMed Central

Petrini, Carlo

2011-01-01

A sound evaluation of every bioethical problem should be predicated on a careful analysis of at least two basic elements: (i) reliable scientific information and (ii) the ethical principles and values at stake. A thorough evaluation of both elements also calls for a careful examination of statements by authoritative institutions. Unfortunately, in the case of medically complex living donors neither element gives clear-cut answers to the ethical problems raised. Likewise, institutionary documents frequently offer only general criteria, which are not very helpful when making practical choices. This paper first introduces a brief overview of scientific information, ethical values, and institutionary documents; the notions of “acceptable risk” and “minimal risk” are then briefly examined, with reference to the problem of medically complex living donors. The so-called precautionary principle and the value of solidarity are then discussed as offering a possible approach to the ethical problem of medically complex living donors. PMID:22174982

[Patents and scientific research: an ethical-legal approach].

PubMed

Darío Bergel, Salvador

2014-01-01

This article aims to review the relationship between patents and scientific research from an ethical point of view. The recent developments in the law of industrial property led in many cases to patent discoveries, contributions of basic science, and laws of nature. This trend, which denies the central principles of the discipline, creates disturbances in scientific activity, which requires the free movement of knowledge in order to develop their potentialities.

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

PubMed

Kluge, Eike-Henner W

2003-01-01

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

Nursing and justice as a basic human need.

PubMed

Johnstone, Megan-Jane

2011-01-01

This paper explores the idea that justice is a basic human need akin to those famously depicted in Maslow's hierarchy of human needs and, as such, warrants recognition as a core element in representative ideas about nursing. Early nurse theorists positioned the principles and practice of nursing as having their origins in 'universal human needs'. The principle of deriving nursing care from human needs was thought to provide a guide not only for promoting health, but for preventing disease and illness. The nursing profession has had a longstanding commitment to social justice as a core professional value and ideal, obligating nurses to address the social conditions that undermine people's health. The idea of justice as a universal human need per se and its possible relationship to people's health outcomes has, however, not been considered. One reason for this is that justice in nursing discourse has more commonly been associated with law and ethics, and the legal and ethical responsibilities of nurses in relation to individualized patient care and, more recently, changing systems of care to improve health and health outcomes. Although this association is not incorrect, it is incomplete. A key aim of this paper is to redress this oversight and to encourage a broader conceptualization of justice as necessary for human survival, health and development, not merely as a professional value, or legal or ethical principle for guiding human conduct. © 2010 Blackwell Publishing Ltd.

Life-centered ethics, and the human future in space.

PubMed

Mautner, Michael N

2009-10-01

In the future, human destiny may depend on our ethics. In particular, biotechnology and expansion in space can transform life, raising profound questions. Guidance may be found in Life-centered ethics, as biotic ethics that value the basic patterns of organic gene/protein life, and as panbiotic ethics that always seek to expand life. These life-centered principles can be based on scientific insights into the unique place of life in nature, and the biological unity of all life. Belonging to life then implies a human purpose: to safeguard and propagate life. Expansion in space will advance this purpose but will also raise basic questions. Should we expand all life or only intelligent life? Should we aim to create populations of trillions? Should we seed other solar systems? How far can we change but still preserve the human species, and life itself? The future of all life may be in our hands, and it can depend on our guiding ethics whether life will fulfil its full potentials. Given such profound powers, life-centered ethics can best secure future generations. Our descendants may then understand nature more deeply, and seek to extend life indefinitely. In that future, our human existence can find a cosmic purpose.

Controlling pain and reducing misuse of opioids

PubMed Central

Kotalik, Jaro

2012-01-01

Abstract Objective To help family physicians achieve an ethical balance in their opioid prescribing practices. Quality of evidence MEDLINE was searched for English-language articles published between 1985 and 2011. Most available evidence was level III. Main message It is essential to follow practice guidelines when prescribing opioids, except when another course of action is demonstrably justified. In addition, when considering the appropriateness of an opioid prescription, with its many ethical implications, the decision can be usefully guided by the application of the ethical principles of beneficence, nonmaleficence, respect for autonomy, and justice. As well, it is essential to keep current about legal and regulatory changes and provincial electronic registries of opioid prescriptions. Conclusion Physicians need to ensure that their patients’ pain is properly assessed and managed. Reaching optimal pain control might necessitate prescribing opioids. But the obligation to provide pain relief needs to be balanced with an equally important responsibility not to expose patients to risk of addiction and not to create opportunities for drug diversion, trafficking, and the addiction of others. Basic ethical principles can provide a framework to help physicians make ethically appropriate decisions about opioid prescribing. PMID:22611604

[Self-reflection, interpersonal behavior and psychoanalytic ethics].

PubMed

Bürgy, M

1997-05-01

In the middle ages, ethical practice included a metaphysical theory of value. In comparison with that, self-reflection and interpersonality should be described as principles of more individual ethics and proceeding from philosophy to psychoanalysis in modern times. Drawing a borderline between human philosophy and metaphysies, Kant defined his so-called categorial imperative as a basic phenomenon of human reciprocity. Ethical relationship to another person, however, requires realization of one's own self, i.e. self-reflection. Hegel's subsequent association of intersubjectivity and selfreflection supplied the basis for Sarte's constitution of consciousness: Existence as existing for the good of the fellow-being. Self-reflection, basing on the sight of one's own self by the other person, leads to Sartre's concept of existential psychoanalysis and to his understanding of ethics. His concept illustrates the decline of significance of philosophy for the analysis of human relationship. Habermas describes self-reflection and interpersonality as fundamental principles of the psychoanalytic therapy and its ethical demands. With the historical concept of the super-ego, Freud established therapeutical one-sidedness and abstinence from ethics; however, as therapeutical interrelationship continued to intensity, ethics of depth psychology also began to develop. This ethical demand was not expressly formulated within the context of psychoanalysis, with the exception of jung and his epigones. Nevertheless, psychoanalytic interaction implies the development of self-reflection, which definitely represents a step forward in the sense of "ethical enlightenment" represented by Kant.

Ethics of animal research in human disease remediation, its institutional teaching; and alternatives to animal experimentation.

PubMed

Cheluvappa, Rajkumar; Scowen, Paul; Eri, Rajaraman

2017-08-01

Animals have been used in research and teaching for a long time. However, clear ethical guidelines and pertinent legislation were instated only in the past few decades, even in developed countries with Judeo-Christian ethical roots. We compactly cover the basics of animal research ethics, ethical reviewing and compliance guidelines for animal experimentation across the developed world, "our" fundamentals of institutional animal research ethics teaching, and emerging alternatives to animal research. This treatise was meticulously constructed for scientists interested/involved in animal research. Herein, we discuss key animal ethics principles - Replacement/Reduction/Refinement. Despite similar undergirding principles across developed countries, ethical reviewing and compliance guidelines for animal experimentation vary. The chronology and evolution of mandatory institutional ethical reviewing of animal experimentation (in its pioneering nations) are summarised. This is followed by a concise rendition of the fundamentals of teaching animal research ethics in institutions. With the advent of newer methodologies in human cell-culturing, novel/emerging methods aim to minimise, if not avoid the usage of animals in experimentation. Relevant to this, we discuss key extant/emerging alternatives to animal use in research; including organs on chips, human-derived three-dimensional tissue models, human blood derivates, microdosing, and computer modelling of various hues. © 2017 The Authors. Pharmacology Research & Perspectives published by John Wiley & Sons Ltd, British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics.

Medical marijuana: should minors have the same rights as adults?

PubMed

Clark, Peter A

2003-06-01

After reviewing the pertinent scientific data, it is clear that there is more than sufficient medical and ethical evidence to warrant the Bush Administration to authorize the Drug Enforcement Agency to reclassify marijuana as a Schedule II drug so that it can be used for medical purposes. Failure to give an effective therapy to seriously ill patients, either adults or children, violates the core principles of both medicine and ethics. Medically, to deny physicians the right to prescribe to their patients a therapy that relieves pain and suffering violates the physician-patient relationship. Ethically, failure to offer an available therapy that has proven to be effective violates the basic ethical principle of nonmaleficence, which prohibits the infliction of harm, injury, or death and is related to the maxim primum non nocere ('above all, or first, do no harm'), which is widely used to describe the duties of a physician. Therefore, in the patient's best interest, patients and parents/surrogates, have the right to request medical marijuana under certain circumstances and physicians have the duty to disclose medical marijuana as an option and prescribe it when appropriate. The right to an effective medical therapy, whose benefits clearly outweigh the burdens, must be available to all patients including children. To deny children the use of medical marijuana when appropriate is a grave injustice which violates the basic foundational beliefs of both medicine and

Business ethics: the materiel/manufacturing perspective.

PubMed

Marucheck, A S; Robbins, L B

1990-08-01

The discussion of purchasing practices and product integrity, which have ethical implications for materiel/manufacturing management, serves to illustrate how routine decisions can have larger implications for the firm as a whole. Management needs to take a proactive role in confronting ethical issues by (1) demonstrating a corporate commitment to sound ethics in business practices, (2) providing written policies where appropriate to provide a basis for sound ethical conducts, (3) educating various functional areas to understand their responsibility in seeming unrelated ethical problems, (4) delegating authority in ethical issues where such issues are considered in decision making, and (5) fostering interfunctional communication as a means in establishing corporatewide responsibility. The basic philosophical principles of JIT serve as a blueprint for recognizing and managing ethical responsibility. The unexpected by-products of a JIT implementation may be vendor/customer good will and an excellent reputation for the firm.

Research ethics and case studies in psychology: a commentary on Taus v. Loftus.

PubMed

Cheit, Ross E

2014-12-01

Loftus and Guyer have been criticized for the methods they employed in investigating an anonymous case study published by Corwin and Olafson. This article examines the ethical dimensions of their investigation. Loftus and Guyer have offered three defenses for their actions. All three of those defenses lack merit. Their investigation did not constitute oral history because it failed to comport with the basic requirements of that practice. Their investigation did not constitute ethical journalism because of the unjustified use of anonymous sources and the clear violation of basic fairness. Their investigation did not constitute justified medical research because of a failure to analyze or weigh the harms against the benefits. Their methods also violated ethical principles for psychologists, including the rule against activities that could reasonably be expected to impair the psychologist's objectivity. This case demonstrates that there is no ethical way to investigate a clinical case, without the patient's approval, that is both comprehensive enough to provide strong scholarship and yet respectful enough of privacy and medical confidentiality to honor important professional norms. © The Author(s) 2014.

What deserves our respect? Reexamination of respect for autonomy in the context of the management of chronic conditions.

PubMed

Enzo, Aya; Okita, Taketoshi; Asai, Atsushi

2018-05-29

The global increase in patients with chronic conditions has led to increased interest in ethical issues regarding such conditions. A basic biomedical principle-respect for autonomy-is being reexamined more critically in its clinical implications. New accounts of this basic principle are being proposed. While new accounts of respect for autonomy do underpin the design of many public programs and policies worldwide, addressing both chronic disease management and health promotion, the risk of applying such new accounts to clinical setting remain understudied. However, the application of new accounts of respect for autonomy to clinical settings could support disrespectful attitudes toward or undue interference with patients with chronic conditions. Reconsidering autonomy and respect using Kantian accounts, this paper proposes respect for persons as an alternative basic bioethical principle to respect for autonomy. Unlike the principle of respect for persons in the Belmont Report, our principle involves respecting any patient's decisions, behaviors, emotions, or life-style regardless of his or her "autonomous" capabilities. Thus, attitudes toward patients should be no different irrespective of the assessment of their decisional or executive capabilities.

Medical ethics at Guantanamo Bay and Abu Ghraib: the problem of dual loyalty.

PubMed

Clark, Peter A

2006-01-01

Although knowledge of torture and physical and psychological abuse was widespread at both the Guantanamo Bay detention facility and Abu Ghraib prison in Iraq, and known to medical personnel, there was no official report before the January 2004 Army investigation of military health personnel reporting abuse, degradation or signs of torture. Military medical personnel are placed in a position of a "dual loyalty" conflict. They have to balance the medical needs of their patients, who happen to be detainees, with their military duty to their employer. The United States military medical system failed to protect detainee's human rights, violated the basic principles of medical ethics and ignored the basic tenets of medical professionalism.

Evaluation of EU legislation on blood: a bioethical point of view.

PubMed

Petrini, Carlo

2017-01-01

A review of the European Union (EU) regulations concerning blood, tissues, and cells of human origin is under way in the EU. From the ethical point of view, the non-remuneration of donations and the ban on deriving gain from human biological materials are of particular significance. While the basic ethical principles involved in the procurement, preservation, and use of these materials are the same, their practical application should be adapted to the specific context of each material. In the case of donation and use of blood, in particular, the issue of legitimate reimbursements to donors and for transfusion centers has to be managed in accordance with the principle of non-commercialization. There is also a need for strict rules to avoid possible commercial spillover effects from blood-derived products. The author proposes ethical criteria regarding reimbursements to donors, costs associated with processing, and the development (and possible marketing) of products.

[Bioethics in catastrophe situations such as earthquakes].

PubMed

León, C Francisco Javier

2012-01-01

A catastrophe of the magnitude of the earthquake and tsunami that hit Chile not long ago, forces us to raise some questions that we will try to answer from a philosophical, ethical and responsibility viewpoints. An analysis of the basic principles of bioethics is also justified. A natural catastrophe is not, by itself, moral or immoral, fair or unfair. However, its consequences could certainly be regarded as such, depending on whether they could have been prevented or mitigated. We will identify those individuals, who have the ethical responsibility to attend the victims and the ethical principles that must guide the tasks of healthcare and psychological support teams. The minimal indispensable actions to obtain an adequate social and legal protection of vulnerable people, must be defined according to international guidelines. These reflections are intended to improve the responsibility of the State and all the community, to efficiently prevent and repair the material and psychological consequences of such a catastrophe.

Some Ethical Considerations in Astronomy Research and Practice

NASA Astrophysics Data System (ADS)

Koepsell, David

2012-08-01

Research ethics as an applied field has evolved due to a number of contentious and public lapses in ethical judgment over the past hundred years. But the main principles underlying good, ethical behavior in all of the sciences are rooted in what Robert Merton calls the ethos of science. Values and virtues, including the universal nature of its underlying objects, communal nature of scientific research, the necessity for individual disinterestedness on the part of researchers, and science's nature as organized skepticism, provide a foundation for conducting ethical research. Scientific integrity, the relation between basic science and the general public, and the social role of science all argue for adopting virtues, guiding behavior, and pursing science in ways we can now characterize as ethical in themselves. Being a good scientist and doing good science overlaps significantly with being a good person.

Eli Lilly and Company's bioethics framework for human biomedical research.

PubMed

Van Campen, Luann E; Therasse, Donald G; Klopfenstein, Mitchell; Levine, Robert J

2015-11-01

Current ethics and good clinical practice guidelines address various aspects of pharmaceutical research and development, but do not comprehensively address the bioethical responsibilities of sponsors. To fill this void, in 2010 Eli Lilly and Company developed and implemented a Bioethics Framework for Human Biomedical Research to guide ethical decisions. (See our companion article that describes how the framework was developed and implemented and provides a critique of its usefulness and limitations.) This paper presents the actual framework that serves as a company resource for employee education and bioethics deliberations. The framework consists of four basic ethical principles and 13 essential elements for ethical human biomedical research and resides within the context of our company's mission, vision and values. For each component of the framework, we provide a high-level overview followed by a detailed description with cross-references to relevant well regarded guidance documents. The principles and guidance described should be familiar to those acquainted with research ethics. Therefore the novelty of the framework lies not in the foundational concepts presented as much as the attempt to specify and compile a sponsor's bioethical responsibilities to multiple stakeholders into one resource. When such a framework is employed, it can serve as a bioethical foundation to inform decisions and actions throughout clinical planning, trial design, study implementation and closeout, as well as to inform company positions on bioethical issues. The framework is, therefore, a useful tool for translating ethical aspirations into action - to help ensure pharmaceutical human biomedical research is conducted in a manner that aligns with consensus ethics principles, as well as a sponsor's core values.

Toward ethical norms and institutions for climate engineering research

NASA Astrophysics Data System (ADS)

Morrow, David R.; Kopp, Robert E.; Oppenheimer, Michael

2009-10-01

Climate engineering (CE), the intentional modification of the climate in order to reduce the effects of increasing greenhouse gas concentrations, is sometimes touted as a potential response to climate change. Increasing interest in the topic has led to proposals for empirical tests of hypothesized CE techniques, which raise serious ethical concerns. We propose three ethical guidelines for CE researchers, derived from the ethics literature on research with human and animal subjects, applicable in the event that CE research progresses beyond computer modeling. The Principle of Respect requires that the scientific community secure the global public's consent, voiced through their governmental representatives, before beginning any empirical research. The Principle of Beneficence and Justice requires that researchers strive for a favorable risk-benefit ratio and a fair distribution of risks and anticipated benefits, all while protecting the basic rights of affected individuals. Finally, the Minimization Principle requires that researchers minimize the extent and intensity of each experiment by ensuring that no experiments last longer, cover a greater geographical extent, or have a greater impact on the climate, ecosystem, or human welfare than is necessary to test the specific hypotheses in question. Field experiments that might affect humans or ecosystems in significant ways should not proceed until a full discussion of the ethics of CE research occurs and appropriate institutions for regulating such experiments are established.

Ethical Principles for Physician Rating Sites

PubMed Central

2011-01-01

During the last 5 years, an ethical debate has emerged, often in public media, about the potential positive and negative effects of physician rating sites and whether physician rating sites created by insurance companies or government agencies are ethical in their current states. Due to the lack of direct evidence of physician rating sites’ effects on physicians’ performance, patient outcomes, or the public’s trust in health care, most contributions refer to normative arguments, hypothetical effects, or indirect evidence. This paper aims, first, to structure the ethical debate about the basic concept of physician rating sites: allowing patients to rate, comment, and discuss physicians’ performance, online and visible to everyone. Thus, it provides a more thorough and transparent starting point for further discussion and decision making on physician rating sites: what should physicians and health policy decision makers take into account when discussing the basic concept of physician rating sites and its possible implications on the physician–patient relationship? Second, it discusses where and how the preexisting evidence from the partly related field of public reporting of physician performance can serve as an indicator for specific needs of evaluative research in the field of physician rating sites. This paper defines the ethical principles of patient welfare, patient autonomy, physician welfare, and social justice in the context of physician rating sites. It also outlines basic conditions for a fair decision-making process concerning the implementation and regulation of physician rating sites, namely, transparency, justification, participation, minimization of conflicts of interest, and openness for revision. Besides other issues described in this paper, one trade-off presents a special challenge and will play an important role when deciding about more- or less-restrictive physician rating sites regulations: the potential psychological and financial harms for physicians that can result from physician rating sites need to be contained without limiting the potential benefits for patients with respect to health, health literacy, and equity. PMID:22146737

Ethics in the practice of speech-language pathology in health care settings.

PubMed

Kummer, Ann W; Turner, Jan

2011-11-01

ETHICS refers to a moral philosophy or a set of moral principles that determine appropriate behavior in a society. Medical ethics includes a set of specific values that are considered in determining appropriate conduct in the practice of medicine or health care. Because the practice of medicine and medical speech-language pathology affects the health, well-being, and quality of life of individuals served, adherence to a code of ethical conduct is critically important in the health care environment. When ethical dilemmas arise, consultation with a bioethics committee can be helpful in determining the best course of action. This article will help to define medical ethics and to discuss the six basic values that are commonly considered in discussions of medical ethics. Common ethical mistakes in the practice of speech-language pathology will be described. Finally, the value of a bioethics consultation for help in resolving complex ethical issues will be discussed. © Thieme Medical Publishers.

[Cost-conscious medical decisions. Normative guidance within the conflicting demands of ethics and economics].

PubMed

Marckmann, G; In der Schmitten, J

2014-05-01

Under the current conditions in the health care system, physicians inevitably have to take responsibility for the cost dimension of their decisions on the level of single cases. This article, therefore, discusses the question how physicians can integrate cost considerations into their clinical decisions at the microlevel in a medically rational and ethically justified way. We propose a four-step model for "ethical cost-consciousness": (1) forego ineffective interventions as required by good evidence-based medicine, (2) respect individual patient preferences, (3) minimize the diagnostic and therapeutic effort to achieve a certain treatment goal, and (4) forego expensive interventions that have only a small or unlikely (net) benefit for the patient. Steps 1-3 are ethically justified by the principles of beneficence, nonmaleficence, and respect for autonomy, step 4 by the principles of justice. For decisions on step 4, explicit cost-conscious guidelines should be developed locally or regionally. Following the four-step model can contribute to ethically defensible, cost-conscious decision-making at the microlevel. In addition, physicians' rationing decisions should meet basic standards of procedural fairness. Regular cost-case discussions and clinical ethics consultation should be available as decision support. Implementing step 4, however, requires first of all a clear political legitimation with the corresponding legal framework.

Ethical principles and concepts in medicine.

PubMed

Taylor, Robert M

2013-01-01

Clinical ethics is the application of ethical theories, principles, rules, and guidelines to clinical situations in medicine. Therefore, clinical ethics is analogous to clinical medicine in that general principles and concepts must be applied intelligently and thoughtfully to unique clinical circumstances. The three major ethical theories are consequentialism, whereby the consequences of an action determine whether it is ethical; deontology, whereby to be ethical is to do one's duty, and virtue ethics, whereby ethics is a matter of cultivating appropriate virtues. In the real world of medicine, most people find that all three perspectives offer useful insights and are complementary rather than contradictory. The most common approach to clinical ethical analysis is principlism. According to principlism, the medical practitioner must attempt to uphold four important principles: respect for patient autonomy, beneficence, nonmaleficence, and justice. When these principles conflict, resolving them depends on the details of the case. Alternative approaches to medical ethics, including the primacy of beneficence, care-based ethics, feminist ethics, and narrative ethics, help to define the limitations of principlism and provide a broader perspective on medical ethics. © 2013 Elsevier B.V. All rights reserved.

Can one do good medical ethics without principles?

PubMed

Macklin, Ruth

2015-01-01

The criteria for determining what it is to do good medical ethics are the quality of ethical analysis and ethical justifications for decisions and actions. Justifications for decisions and actions rely on ethical principles, be they the 'famous four' or subsidiary ethical principles relevant to specific contexts. Examples from clinical ethics, research ethics and public health ethics reveal that even when not stated explicitly, principles are involved in ethical justifications. Principles may come into conflict, however, and the resolution of an ethical dilemma requires providing good reasons for preferring one principle over another. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Access to Electronic Information, Services, and Networks: An Interpretation of the Library Bill of Rights.

ERIC Educational Resources Information Center

American Library Association, Chicago, IL. Office of Intellectual Freedom.

The American Library Association (ALA) expresses the basic principles of librarianship in its "Code of Ethics" and in the "Library Bill of Rights" and its interpretations. All library system and network policies, procedures or regulations relating to electronic resources and services should be scrutinized for potential…

From bench to bedside and to health policies (and back): ethics in translational research.

PubMed

Petrini, Carlo

2014-01-01

The medical aim of translational research is to smooth the transition of discoveries made through basic research from the laboratory bench to their diagnostic or therapeutic applications for patients. These applications may be extended to current clinical practice and to health policies. The converse is also important: health policies should provide a point of departure when identifying research priorities. Translational research poses the same ethical problems as trials with human subjects - albeit in different ways. One of the more significant problems is the risk for participants in trials: it is thus necessary to ensure that the risks to which these subjects are exposed are not out of proportion to the expected benefits. Translational research does not require new ethical principles, but existing biomedical principles need to be adjusted to the specific context. The well-being of participants should always be the primary objective; these persons should never be considered as means for the advancement of knowledge or for the improvement of applications.

Ethics and regulation in organ procurement research.

PubMed

Ackerman, Terrence F; Winsett, Rebecca P

2002-12-01

This article explores the role of ethics and regulation in human research conducted by organ procurement agencies; basic ethical principles for human research are outlined. Organ procurement agencies are not required to observe federal regulations; however, voluntary adherence will ensure that procurement research is conducted according to current standards of ethical practice. Although most organ procurement research will qualify for exempt status, this determination should be made by an institutional review board. Even if studies qualify for exempt status, there is a moral presumption that informed consent should be sought, unless certain narrow conditions for waiver of consent are satisfied. Finally, when future research utilizing organ procurement records is anticipated, procurement coordinators should provide sufficiently detailed information to families about such plans to permit their advance informed consent to research activities.

Incidental Findings in Neuroimaging: Ethical and Medicolegal Considerations

PubMed Central

Leung, Lawrence

2013-01-01

With the rapid advances in neurosciences in the last three decades, there has been an exponential increase in the use of neuroimaging both in basic sciences and clinical research involving human subjects. During routine neuroimaging, incidental findings that are not part of the protocol or scope of research agenda can occur and they often pose a challenge as to how they should be handled to abide by the medicolegal principles of research ethics. This paper reviews the issue from various ethical (do no harm, general duty to rescue, and mutual benefits and owing) and medicolegal perspectives (legal liability, fiduciary duties, Law of Tort, and Law of Contract) with a suggested protocol of approach. PMID:26317093

Incidental Findings in Neuroimaging: Ethical and Medicolegal Considerations.

PubMed

Leung, Lawrence

2013-01-01

With the rapid advances in neurosciences in the last three decades, there has been an exponential increase in the use of neuroimaging both in basic sciences and clinical research involving human subjects. During routine neuroimaging, incidental findings that are not part of the protocol or scope of research agenda can occur and they often pose a challenge as to how they should be handled to abide by the medicolegal principles of research ethics. This paper reviews the issue from various ethical (do no harm, general duty to rescue, and mutual benefits and owing) and medicolegal perspectives (legal liability, fiduciary duties, Law of Tort, and Law of Contract) with a suggested protocol of approach.

Effect of Simulation on Undergraduate Nursing Students' Knowledge of Nursing Ethics Principles.

PubMed

Donnelly, Mary Broderick; Horsley, Trisha Leann; Adams, William H; Gallagher, Peggy; Zibricky, C Dawn

2017-12-01

Background Undergraduate nursing education standards include acquisition of knowledge of ethics principles and the prevalence of health-care ethical dilemmas mandates that nursing students study ethics. However, little research has been published to support best practices for teaching/learning ethics principles. Purpose This study sought to determine if participation in an ethics consultation simulation increased nursing students' knowledge of nursing ethics principles compared to students who were taught ethics principles in the traditional didactic format. Methods This quasi-experimental study utilized a pre-test/post-test design with randomized assignment of students at three universities into both control and experimental groups. Results Nursing students' knowledge of nursing ethics principles significantly improved from pre-test to post-test ( p = .002); however, there was no significant difference between the experimental and control groups knowledge scores ( p = .13). Conclusion Further research into use of simulation to teach ethics principles is indicated.

Ethical issues in neonatal intensive care units.

PubMed

Liu, Jing; Chen, Xin-Xin; Wang, Xin-Ling

2016-01-01

On one hand, advances in neonatal care and rescue technology allow for the healthy survival or prolonged survival time of critically ill newborns who, in the past, would have been non-viable. On the other hand, many of the surviving critically ill infants have serious long-term disabilities. If an infant eventually cannot survive or is likely to suffer severe disability after surviving, ethical issues in the treatment process are inevitable, and this problem arises not only in developed countries but is also becoming increasingly prominent in developing countries. In addition, ethical concerns cannot be avoided in medical research. This review article introduces basic ethical guidelines that should be followed in clinical practice, including respecting the autonomy of the parents, giving priority to the best interests of the infant, the principle of doing no harm, and consent and the right to be informed. Furthermore, the major ethical concerns in neonatal intensive care units (NICUs) in China are briefly introduced.

The tuskegee experiment: an introduction in ethics for pre-healthcare professional students.

PubMed

Miranda, Daniel; Sanchez, David Jesse

2014-12-01

Over the past years, professional students have had extensive exposure to clinical cases during basic science classes. With this in mind, we have taken this clinical case exposure moment to be an opportune time to introduce the ethics of working with patients during biomedical research. Our goal is to present a straightforward assignment that allows for active student research into the facts of the Tuskegee Experiment of the 1900s. The assignment provides the necessary background to allow for a student-centered discussion on the ethical issues of the events and ramifications of what happened. Thus, in educating a class on the event's happenings, one concomitantly creates a platform for meaningful discussion on the principles and ethics of patient care. We have found that an ethics-infused event such as the Tuskegee Experiment is an excellent way to introduce students to these topics.

The Tuskegee Experiment: An Introduction in Ethics for Pre-Healthcare Professional Students†

PubMed Central

Miranda, Daniel; Sanchez, David Jesse

2014-01-01

Over the past years, professional students have had extensive exposure to clinical cases during basic science classes. With this in mind, we have taken this clinical case exposure moment to be an opportune time to introduce the ethics of working with patients during biomedical research. Our goal is to present a straightforward assignment that allows for active student research into the facts of the Tuskegee Experiment of the 1900s. The assignment provides the necessary background to allow for a student-centered discussion on the ethical issues of the events and ramifications of what happened. Thus, in educating a class on the event’s happenings, one concomitantly creates a platform for meaningful discussion on the principles and ethics of patient care. We have found that an ethics-infused event such as the Tuskegee Experiment is an excellent way to introduce students to these topics. PMID:25574286

The Principle-Based Method of Practical Ethics.

PubMed

Spielthenner, Georg

2017-09-01

This paper is about the methodology of doing practical ethics. There is a variety of methods employed in ethics. One of them is the principle-based approach, which has an established place in ethical reasoning. In everyday life, we often judge the rightness and wrongness of actions by their conformity to principles, and the appeal to principles plays a significant role in practical ethics, too. In this paper, I try to provide a better understanding of the nature of principle-based reasoning. To accomplish this, I show in the first section that these principles can be applied to cases in a meaningful and sufficiently precise way. The second section discusses the question how relevant applying principles is to the resolution of ethical issues. This depends on their nature. I argue that the principles under consideration in this paper should be interpreted as presumptive principles and I conclude that although they cannot be expected to bear the weight of definitely resolving ethical problems, these principles can nevertheless play a considerable role in ethical research.

The Virtue of Principle Ethics.

ERIC Educational Resources Information Center

Bersoff, Donald N.

1996-01-01

Presents arguments against adopting virtue ethics as a guiding concept in developing counseling guidelines: (1) virtue ethics is irrelevant in the resolution of most ethics cases; (2) virtue and principle ethics overlap; (3) principle ethics are more suited to acting and deciding; (4) the emphasis on virtue ethics increases the possibility of…

What do international ethics guidelines say in terms of the scope of medical research ethics?

PubMed

Bernabe, Rosemarie D L C; van Thiel, Ghislaine J M W; van Delden, Johannes J M

2016-04-26

In research ethics, the most basic question would always be, "which is an ethical issue, which is not?" Interestingly, depending on which ethics guideline we consult, we may have various answers to this question. Though we already have several international ethics guidelines for biomedical research involving human participants, ironically, we do not have a harmonized document which tells us what these various guidelines say and shows us the areas of consensus (or lack thereof). In this manuscript, we attempted to do just that. We extracted the imperatives from five internationally-known ethics guidelines and took note where the imperatives came from. In doing so, we gathered data on how many guidelines support a specific imperative. We found that there is no consensus on the majority of the imperatives and that in only 8.2% of the imperatives were there at least moderate consensus (i.e., consensus of at least 3 of the 5 ethics guidelines). Of the 12 clusters (Basic Principles; Research Collaboration; Social Value; Scientific Validity; Participant Selection; Favorable Benefit/Risk Ratio; Independent Review; Informed Consent; Respect for Participants; Publication and Registration; Regulatory Sanctions; and Justified Research on the Vulnerable Population), Informed Consent has the highest level of consensus and Research Collaboration and Regulatory Sanctions have the least. There was a lack of consensus in the majority of imperatives from the five internationally-known ethics guidelines. This may be partly explained by the differences among the guidelines in terms of their levels of specification as well as conceptual/ideological differences.

Empirical investigation of the ethical reasoning of physicians and molecular biologists - the importance of the four principles of biomedical ethics.

PubMed

Ebbesen, Mette; Pedersen, Birthe D

2007-10-25

This study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups. This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. In this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology physicians and molecular biologists from the private biopharmaceutical company. Molecular biologists employed at a public university are, in this study, concerned with allocation, however, they do not propose a specific theory of justice. This study demonstrates that each of the four bioethical principles of the American bioethicists Tom L. Beauchamp & James F. Childress - respect for autonomy, beneficence, nonmaleficence and justice - are reflected in the daily work of physicians and molecular biologists in Denmark. Consequently, these principles are applicable in the Danish biomedical setting.

Empirical investigation of the ethical reasoning of physicians and molecular biologists – the importance of the four principles of biomedical ethics

PubMed Central

Ebbesen, Mette; Pedersen, Birthe D

2007-01-01

Background This study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups. Method This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. Results In this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology physicians and molecular biologists from the private biopharmaceutical company. Molecular biologists employed at a public university are, in this study, concerned with allocation, however, they do not propose a specific theory of justice. Conclusion This study demonstrates that each of the four bioethical principles of the American bioethicists Tom L. Beauchamp & James F. Childress – respect for autonomy, beneficence, nonmaleficence and justice – are reflected in the daily work of physicians and molecular biologists in Denmark. Consequently, these principles are applicable in the Danish biomedical setting. PMID:17961251

A human rights framework for midwifery care.

PubMed

Thompson, Joyce Beebe

2004-01-01

This article presents a rights-based model for midwifery care of women and childbearing families. Salient features include discussion of the influence of values on how women are viewed within cultures and societies, universal ethical principles applicable to health care services, and human rights based on the view of women as persons rather than as objects or chattel. Examples of the health impact on women of persistent violation of basic human rights are used to support the need for using a human rights framework for midwifery care--a model supported by codes of ethics, the midwifery philosophy of care, and standards of practice.

The four principles: Can they be measured and do they predict ethical decision making?

PubMed Central

2012-01-01

Background The four principles of Beauchamp and Childress - autonomy, non-maleficence, beneficence and justice - have been extremely influential in the field of medical ethics, and are fundamental for understanding the current approach to ethical assessment in health care. This study tests whether these principles can be quantitatively measured on an individual level, and then subsequently if they are used in the decision making process when individuals are faced with ethical dilemmas. Methods The Analytic Hierarchy Process was used as a tool for the measurement of the principles. Four scenarios, which involved conflicts between the medical ethical principles, were presented to participants who then made judgments about the ethicality of the action in the scenario, and their intentions to act in the same manner if they were in the situation. Results Individual preferences for these medical ethical principles can be measured using the Analytic Hierarchy Process. This technique provides a useful tool in which to highlight individual medical ethical values. On average, individuals have a significant preference for non-maleficence over the other principles, however, and perhaps counter-intuitively, this preference does not seem to relate to applied ethical judgements in specific ethical dilemmas. Conclusions People state they value these medical ethical principles but they do not actually seem to use them directly in the decision making process. The reasons for this are explained through the lack of a behavioural model to account for the relevant situational factors not captured by the principles. The limitations of the principles in predicting ethical decision making are discussed. PMID:22606995

The four principles: can they be measured and do they predict ethical decision making?

PubMed

Page, Katie

2012-05-20

The four principles of Beauchamp and Childress--autonomy, non-maleficence, beneficence and justice--have been extremely influential in the field of medical ethics, and are fundamental for understanding the current approach to ethical assessment in health care. This study tests whether these principles can be quantitatively measured on an individual level, and then subsequently if they are used in the decision making process when individuals are faced with ethical dilemmas. The Analytic Hierarchy Process was used as a tool for the measurement of the principles. Four scenarios, which involved conflicts between the medical ethical principles, were presented to participants who then made judgments about the ethicality of the action in the scenario, and their intentions to act in the same manner if they were in the situation. Individual preferences for these medical ethical principles can be measured using the Analytic Hierarchy Process. This technique provides a useful tool in which to highlight individual medical ethical values. On average, individuals have a significant preference for non-maleficence over the other principles, however, and perhaps counter-intuitively, this preference does not seem to relate to applied ethical judgements in specific ethical dilemmas. People state they value these medical ethical principles but they do not actually seem to use them directly in the decision making process. The reasons for this are explained through the lack of a behavioural model to account for the relevant situational factors not captured by the principles. The limitations of the principles in predicting ethical decision making are discussed.

How Many Principles for Public Health Ethics?

PubMed Central

Coughlin, Steven S.

2009-01-01

General moral (ethical) principles play a prominent role in certain methods of moral reasoning and ethical decision-making in bioethics and public health. Examples include the principles of respect for autonomy, beneficence, nonmaleficence, and justice. Some accounts of ethics in public health have pointed to additional principles related to social and environmental concerns, such as the precautionary principle and principles of solidarity or social cohesion. This article provides an overview of principle-based methods of moral reasoning as they apply to public health ethics including a summary of advantages and disadvantages of methods of moral reasoning that rely upon general principles of moral reasoning. Drawing upon the literature on public health ethics, examples are provided of additional principles, obligations, and rules that may be useful for analyzing complex ethical issues in public health. A framework is outlined that takes into consideration the interplay of ethical principles and rules at individual, community, national, and global levels. Concepts such as the precautionary principle and solidarity are shown to be useful to public health ethics to the extent that they can be shown to provide worthwhile guidance and information above and beyond principles of beneficence, nonmaleficence, and justice, and the clusters of rules and maxims that are linked to these moral principles. Future directions likely to be productive include further work on areas of public health ethics such as public trust, community empowerment, the rights of individuals who are targeted (or not targeted) by public health interventions, individual and community resilience and wellbeing, and further clarification of principles, obligations, and rules in public health disciplines such as environmental science, prevention and control of chronic and infectious diseases, genomics, and global health. PMID:20072707

The job of 'ethics committees'.

PubMed

Moore, Andrew; Donnelly, Andrew

2015-11-13

What should authorities establish as the job of ethics committees and review boards? Two answers are: (1) review of proposals for consistency with the duly established and applicable code and (2) review of proposals for ethical acceptability. The present paper argues that these two jobs come apart in principle and in practice. On grounds of practicality, publicity and separation of powers, it argues that the relevant authorities do better to establish code-consistency review and not ethics-consistency review. It also rebuts bad code and independence arguments for the opposite view. It then argues that authorities at present variously specify both code-consistency and ethics-consistency jobs, but most are also unclear on this issue. The paper then argues that they should reform the job of review boards and ethics committees, by clearly establishing code-consistency review and disestablishing ethics-consistency review, and through related reform of the basic orientation, focus, name, and expertise profile of these bodies and their actions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Part of the fabric and mostly right: an ethnography of ethics in clinical practice.

PubMed

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

2015-06-15

To describe how ethics is practised in a health care setting, and to ascertain whether there was interest in establishing clinical ethics support services. Observations and interviews undertaken between April and November 2012 in a large NSW urban hospital with newborn care, maternity and oncology departments and analysed by coding and categorising the data. Key themes in the participants' attitudes to professional ethics were identified. Ethics is not typically an explicit feature of clinical deliberations, and clinicians tend to apply basic ethical principles when ethical problems are identified. They also discuss difficult decisions with colleagues, and try to resolve ethical differences by discussion. Participants judged the ethics of clinical practice to be "mostly right", primarily because ethics is "part of the fabric" of everyday clinical work that aspires to "optimising care". Nevertheless, most clinicians would welcome ethics support because ethics is integral to health care practice, is not always "done well", and may be the source of conflict. Ethics is very much a part of the fabric of clinical practice, and the ethical challenges that arise in patient care in this particular setting are generally managed adequately. However, many clinicians have concerns about the ethical aspects of some practices and decisions, and believe that access to expert ethics support would be useful. Helping clinicians to provide ethically sound patient care should be a priority for health care providers across Australia.

Ethics in age estimation of unaccompanied minors.

PubMed

Thevissen, P W; Kvaal, S I; Willems, G

2012-11-30

Children absconding from countries of conflict and war are often not able to document their age. When an age is given, it is frequently untraceable or poorly documented and therefore questioned by immigration authorities. Consequently many countries perform age estimations on these children. Provision of ethical practice during the age estimation investigation of unaccompanied minors is considered from different angles: (1) The UN convention on children's rights, formulating specific rights, protection, support, healthcare and education for unaccompanied minors. (2) Since most age estimation investigations are based on medical examination, the four basic principles of biomedical ethics, namely autonomy, beneficence, non-malevolence, justice. (3) The use of medicine for non treatment purposes. (4) How age estimates with highest accuracy in age prediction can be obtained. Ethical practice in age estimation of unaccompanied minors is achieved when different but related aspects are searched, evaluated, weighted in importance and subsequently combined. However this is not always feasible and unanswered questions remain.

Culpability and pain management/control in peripheral vascular disease using the ethics of principles and care.

PubMed

Omery, A

1991-09-01

The purposes of this article were to provide insight into the process of ethics and ethical inquiry and to explore the ethical issues of culpability and pain management/control. Critical care nurses who currently care for vascular patients identified these issues as occurring frequently in their practice. Authors in critical care nursing generally have limited the process of ethical inquiry to a theoretical framework built around an ethic of principles. The message many critical care nurses heard was that this one type of theoretical ethical framework was the totality of ethics. The application of these principles was ethical inquiry. For some nurses, the ethic of principles is sufficient. For others, an ethic of principles is either incomplete or foreign. This second group of nurses may believe that they have no moral voice if the language of ethics is only the language of principles. The language of principles, however, is not the only theoretical framework available. There is also the ethic of care, and ethical inquiry can include the application of that framework. Indeed, the language of the ethic of care may give a voice to nurses who previously felt morally mute. In fact, these two theoretical frameworks are not the only frameworks available to nurses. There is also virtue ethics, a framework not discussed in this article. A multiplicity of ethical frameworks is available for nurses to use in analyzing their professional and personal dilemmas. Recognizing that multiplicity, nurses can analyze their ethical dilemmas more comprehensively and effectively. Applying differing ethical frameworks can result in the same conclusions. This was the case for the issue of culpability.(ABSTRACT TRUNCATED AT 250 WORDS)

Ethical Principles of Psychologists and Code of Conduct.

ERIC Educational Resources Information Center

American Psychologist, 2002

2002-01-01

Describes the American Psychological Association's Ethical Principles of Psychologists and Code of Conduct, focusing on introduction and applicability; preamble; general principles; and ethical standards (resolving ethical issues, competence, human relations, privacy and confidentiality, advertising and other public statements, record keeping and…

Ethical evaluation of research proposals by ethics panels advising the European Commission.

PubMed

Kolar, Roman

2004-06-01

Ethical principles with regard to animal experimentation are referred to in European Union (EU) legislation and other official documents. Therefore, applications for funding of research under the EU's research programme may undergo an ethical review that is carried out by so-called ethics panels, consisting of experts chosen by the European Commission. The work of these panels differs substantially from that of other ethical committees, as they exist on the institutional, local, regional or national level. Their main purpose is not to decide whether a proposed research can be regarded legal, and therefore should be endorsed or licensed; instead, it is to help the Commission in prioritising its funding. The panels may examine other ethical aspects than those of animal experimentation or animal welfare alone, such as the use of human volunteers. This is reflected by the composition of the panels. Their decisions are normally based on consensus. Even though these decisions may refer to EU legislation, the criteria applied are not restricted to those provided by this legislation. Nevertheless, the various aspects of the Commission's ethical evaluation system (e.g. formal and practical basic conditions, information content of applications, type of decisions taken, lacking of any quality control) offers opportunities for improvement.

The ethics of promulgating principles of research ethics: the problem of diversion effects

PubMed Central

Wertheimer, Alan

2015-01-01

There is an important distinction between ethical standards for the conduct of research with human subjects and the ethics of promulgating principles of research ethics. Those who promulgate ethical standards for the conduct of research have an ethical responsibility to consider the consequences to which those promulgations give rise. In particular, they must consider whether their promulgations will give researchers incentives not to conduct research or not to conduct research in locales in which participants would benefit from participation. I first show how such ‘diversion effects’ are possible and then examine four principles of research ethics in that light. I then consider several objections to the argument that those who promulgate principles of research ethics should consider diversion effects. PMID:25937934

Ethical principles in the work of nurse educator-A cross-sectional study.

PubMed

Salminen, Leena; Stolt, Minna; Metsämäki, Riikka; Rinne, Jenni; Kasen, Anne; Leino-Kilpi, Helena

2016-01-01

The application of ethical principles within the teaching profession and nursing practice forms the core of the nurse educator's professional ethics. However, research focusing on the professional ethics of nurse educators is scarce. To describe ethical principles and issues relating to the work of nurse educators from the perspectives of both nurse educators themselves and nursing students. A descriptive study using cross-sectional data and content analysis. Nursing education program involving students from nine polytechnics in Finland. Nursing students (n=202) and nurse educators (n=342). Data were derived from an online survey, with two open-ended questions: Nursing students and nurse educators were asked to name the three main ethical principles that guide the work of nurse educators and also to describe ethical issues involved in the work. Students most often named professionalism, justice, and equality as the main ethical principles for a nurse educator. Nurse educators considered justice, equality, and honesty as the main ethical principles. The content analysis showed that professionalism and the relationship between educator and student were the key categories for ethical issues as perceived by nursing students. Nursing students most often identified inequality between the nurse educator and nursing student as the ethical issue faced by the nurse educator. Nursing students and nurse educators differed somewhat both in their views of the ethical principles guiding an educator's work and in the ethical issues arising in the work. Copyright © 2015 Elsevier Ltd. All rights reserved.

Living organ donation: an ethical evolution or evolution of ethics?

PubMed

Ghahramani, N

2010-01-01

The disparity between available and needed organs is rapidly increasing, and the number of patients dying while still on the waiting list is growing exponentially. As a partial solution to this disparity, living unrelated transplantation is being performed more frequently, and some have proposed providing financial incentives to donors. The aim of this discussion is to illustrate that with an ever-increasing number of living unrelated transplantations, society and the transplant community should adopt a more active role in developing specific strategies to scrutinize the process. The current paper will also examine the viewpoint that medical ethics is not separable from the prevailing needs of society and involves a constant balancing of often opposing goods. Issues surrounding living unrelated donor transplantation illustrate ethics as a dynamically evolving field, which is often influenced by necessity and which evolves with progression of science and society. As part of this evolution, it is the collective responsibility of society and the transplant community to devise safeguards to guarantee adherence to basic principles of ethics and to avoid "situational ethics."

Legal & ethical compliance when sharing biospecimen.

PubMed

Klingstrom, Tomas; Bongcam-Rudloff, Erik; Reichel, Jane

2018-01-01

When obtaining samples from biobanks, resolving ethical and legal concerns is a time-consuming task where researchers need to balance the needs of privacy, trust and scientific progress. The Biobanking and Biomolecular Resources Research Infrastructure-Large Prospective Cohorts project has resolved numerous such issues through intense communication between involved researchers and experts in its mission to unite large prospective study sets in Europe. To facilitate efficient communication, it is useful for nonexperts to have an at least basic understanding of the regulatory system for managing biological samples.Laws regulating research oversight are based on national law and normally share core principles founded on international charters. In interview studies among donors, chief concerns are privacy, efficient sample utilization and access to information generated from their samples. Despite a lack of clear evidence regarding which concern takes precedence, scientific as well as public discourse has largely focused on privacy concerns and the right of donors to control the usage of their samples.It is therefore important to proactively deal with ethical and legal issues to avoid complications that delay or prevent samples from being accessed. To help biobank professionals avoid making unnecessary mistakes, we have developed this basic primer covering the relationship between ethics and law, the concept of informed consent and considerations for returning findings to donors. © The Author 2017. Published by Oxford University Press.

Legal & ethical compliance when sharing biospecimen

PubMed Central

Klingstrom, Tomas; Bongcam-Rudloff, Erik; Reichel, Jane

2018-01-01

Abstract When obtaining samples from biobanks, resolving ethical and legal concerns is a time-consuming task where researchers need to balance the needs of privacy, trust and scientific progress. The Biobanking and Biomolecular Resources Research Infrastructure-Large Prospective Cohorts project has resolved numerous such issues through intense communication between involved researchers and experts in its mission to unite large prospective study sets in Europe. To facilitate efficient communication, it is useful for nonexperts to have an at least basic understanding of the regulatory system for managing biological samples. Laws regulating research oversight are based on national law and normally share core principles founded on international charters. In interview studies among donors, chief concerns are privacy, efficient sample utilization and access to information generated from their samples. Despite a lack of clear evidence regarding which concern takes precedence, scientific as well as public discourse has largely focused on privacy concerns and the right of donors to control the usage of their samples. It is therefore important to proactively deal with ethical and legal issues to avoid complications that delay or prevent samples from being accessed. To help biobank professionals avoid making unnecessary mistakes, we have developed this basic primer covering the relationship between ethics and law, the concept of informed consent and considerations for returning findings to donors. PMID:28460118

Insurance and genetic testing: where are we now?

PubMed Central

Ostrer, H; Allen, W; Crandall, L A; Moseley, R E; Dewar, M A; Nye, D; McCrary, S V

1993-01-01

Basic research will spur development of genetic tests that are capable of presymptomatic prediction of disease, disability, and premature death in presently asymptomatic individuals. Concerns have been expressed about potential harms related to the use of genetic test results, especially loss of confidentiality, eugenics, and discrimination. Existing laws and administrative policies may not be sufficient to assure that genetic information is used fairly. To provide factual information and conceptual principles upon which sound social policy can be based, the Human Genome Initiative established an Ethical, Legal, and Social Issues Program. Among the first areas to be identified as a priority for study was insurance. This paper provides a review of life, health, and disability insurance systems, including basic principles, risk classification, and market and regulatory issues, and examines the potential impact of genetic information on the insurance industry. PMID:8447322

Measuring biotechnology employees' ethical attitudes towards a controversial transgenic cattle project: the ethical valance matrix.

PubMed

Small, Bruce H; Fisher, Mark W

2005-01-01

What is the relationship between biotechnology employees' beliefs about the moral outcomes of a controversial transgenic research project and their attitudes of acceptance towards the project? To answer this question, employees (n=466) of a New Zealand company, AgResearch Ltd., were surveyed regarding a project to create transgenic cattle containing a synthetic copy of the human myelin basic protein gene (hMBP). Although diversity existed amongst employees' attitudes of acceptance, they were generally: in favor of the project, believed that it should be allowed to proceed to completion, and that it is acceptable to use transgenic cattle to produce medicines for humans. These three items were aggregated to form a project acceptance score. Scales were developed to measure respondents' beliefs about the moral outcomes of the project for identified stakeholders in terms of the four principles of common morality (benefit, non-harm, justice, and autonomy). These data were statistically aggregated into an Ethical Valence Matrix fo the project. The respondents' project Ethical Valence Scores correlated significantly with their project acceptance scores (r=0.64, p<0.001), accounting for 41% of the variance in respondents' acceptance attitudes. Of the four principles, non-harm had the strongest correlation with attitude to the project (r=0.59), followed by benefit and justice (both r=0.54), then autonomy (r=0.44). These results indicate that beliefs about the moral outcomes of a research project, in terms of the four principles approach, are strongly related to, and may be significant determinants of, attitudes to the research project. This suggests that, for employees of a biotechnology organization, ethical reasoning could be a central mechanism for the evaluation of the acceptability of a project. We propose that the Ethical Valence Matrix may be used as a tool to measure ethical attitudes towards controversial issues, providing a metric for comparison of perceived ethical consequences for multiple stakeholder groups and for the evaluation and comparison of the ethical consequences of competing alternative issues or projects. The tool could be used to measure both public and special interest groups' ethical attitudes and results used for the development of socially responsible policy or by science organizations as a democratizing decision aid to selection amongst projects competing for scarce research funds.

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

PubMed

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

2013-01-01

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

Reflexive Principlism as an Effective Approach for Developing Ethical Reasoning in Engineering.

PubMed

Beever, Jonathan; Brightman, Andrew O

2016-02-01

An important goal of teaching ethics to engineering students is to enhance their ability to make well-reasoned ethical decisions in their engineering practice: a goal in line with the stated ethical codes of professional engineering organizations. While engineering educators have explored a wide range of methodologies for teaching ethics, a satisfying model for developing ethical reasoning skills has not been adopted broadly. In this paper we argue that a principlist-based approach to ethical reasoning is uniquely suited to engineering ethics education. Reflexive Principlism is an approach to ethical decision-making that focuses on internalizing a reflective and iterative process of specification, balancing, and justification of four core ethical principles in the context of specific cases. In engineering, that approach provides structure to ethical reasoning while allowing the flexibility for adaptation to varying contexts through specification. Reflexive Principlism integrates well with the prevalent and familiar methodologies of reasoning within the engineering disciplines as well as with the goals of engineering ethics education.

The importance of meta-ethics in engineering education.

PubMed

Haws, David R

2004-04-01

Our shared moral framework is negotiated as part of the social contract. Some elements of that framework are established (tell the truth under oath), but other elements lack an overlapping consensus (just when can an individual lie to protect his or her privacy?). The tidy bits of our accepted moral framework have been codified, becoming the subject of legal rather than ethical consideration. Those elements remaining in the realm of ethics seem fragmented and inconsistent. Yet, our engineering students will need to navigate the broken ground of this complex moral landscape. A minimalist approach would leave our students with formulated dogma--principles of right and wrong such as the National Society for Professional Engineers (NSPE) Code of Ethics for Engineers--but without any insight into the genesis of these principles. A slightly deeper, micro-ethics approach would teach our students to solve ethical problems by applying heuristics--giving our students a rational process to manipulate ethical dilemmas using the same principles simply referenced a priori by dogma. A macro-ethics approach--helping students to inductively construct a posteriori principles from case studies--goes beyond the simple statement or manipulation of principles, but falls short of linking personal moral principles to the larger, social context. Ultimately, it is this social context that requires both the application of ethical principles, and the negotiation of moral values--from an understanding of meta-ethics. The approaches to engineering ethics instruction (dogma, heuristics, case studies, and meta-ethics) can be associated with stages of moral development. If we leave our students with only a dogmatic reaction to ethical dilemmas, they will be dependent on the ethical decisions of others (a denial of their fundamental potential for moral autonomy). Heuristics offers a tool to deal independently with moral questions, but a tool that too frequently reduces to casuistry when rigidly applied to "simplified" dilemmas. Case studies, while providing a context for engineering ethics, can encourage the premature analysis of specific moral conduct rather than the development of broad moral principles--stifling our students' facility with meta-ethics. Clearly, if a moral sense is developmental, ethics instruction should lead our students from lower to higher stages of moral development.

Science ethics education part I. Perception and attitude toward scientific fraud among medical researchers.

PubMed

Vuckovic-Dekic, L; Gavrilovic, D; Kezic, I; Bogdanovic, G; Brkic, S

2011-01-01

To assess the knowledge of basic principles of responsible conduct of research and attitude toward the violations of good scientific practice among graduate biomedical students. A total of 361 subjects entered the study. The study group consisted mainly of graduate students of Medicine (85%), and other biomedical sciences (15%). Most participants were on PhD training or on postdoctoral training. A specially designed anonymous voluntary multiple-choice questionnaire was distributed to them. The questionnaire consisted of 43 questions divided in 7 parts, each aimed to assess the participants' previous knowledge and attitudes toward ethical principles of science and the main types of scientific fraud, falsification, fabrication of data, plagiarism, and false authorship. Although they considered themselves as insufficiently educated on science ethics, almost all participants recognized all types of scientific fraud, qualified these issues as highly unethical, and expressed strong negative attitude toward them. Despite that, only about half of the participants thought that superiors-violators of high ethical standards of science deserve severe punishment, and even fewer declared that they would whistle blow. These percentages were much greater in cases when the students had personally been plagiarized. Our participants recognized all types of scientific fraud as violation of ethical standards of science, expressed strong negative attitude against fraud, and believed that they would never commit fraud, thus indicating their own high moral sense. However, the unwillingness to whistle blow and to punish adequately the violators might be characterized as opportunistic behavior.

Flexner's ethical oversight reprised? Contemporary medical education and the health impacts of corporate globalisation.

PubMed

Faunce, Thomas A; Gatenby, Paul

2005-10-01

Abraham Flexner's famous reports of 1910 and 1912, Medical Education in the United States and Canada and Medical Education in Europe, were written to assist the development of a positive response in university curricula to a revolution in understanding about the scientific foundations of clinical medicine. Flexner pointed out many deficiencies in medical education that retain contemporary resonance. Generally underemphasised in Flexner's reports, however, were recommendations promoting a firm understanding of and commitment to medical ethics as a basis of medical professionalism. Indeed, Flexner's praise for the scholastic basic of German medical education appeared somewhat ironic when the ethical inadequacies of prominent Nazi doctors were revealed at the Nuremberg Trials. This article suggests that contemporary medical educators, like Flexner, may be at risk of inadequately addressing a major challenge to evolving medical professionalism. Medical ethics, health law and even the international right to health are now increasingly emphasised in medical curricula. The same cannot be said, however, of lobbying principles arising from the structures of corporate globalisation, although these are rapidly becoming an even more dominant force in shaping medical practice around the globe. Conclusion Today it is the normative tension between medical ethics, health law and international human rights on the one hand and the lobbying principles and strategies of corporate globalisation that must urgently become the focus of major recommendations for reshaping the teaching of medical professionalism. Suggestions are made as to how this might practically be achieved.

Research ethics in the context of humanitarian emergencies.

PubMed

O'Mathúna, Dónal

2015-02-01

Research is needed to make responses to disasters and humanitarian emergencies more evidence-based. Such research must also adhere to the generally accepted principles of research ethics. While research into health interventions used in disasters raises distinctive ethical concerns, seven ethical principles developed for clinical research are applied here to disaster research. Practical examples from disaster settings are used to demonstrate how these ethical principles can be applied. This reveals that research ethics needs to be seen as much more than a mechanism to obtain ethical approval for research. Research ethics involves ethical principles and governance frameworks, but must also consider the role of ethical virtues in research. Virtues are essential to ensure that researchers do what they believe is ethically right and resist what is unethical. Research ethics that truly protects participants and promotes respect needs to include training in ethical virtues to ensure disaster research is carried out to the highest ethical standards. This article is based on a presentation at the Evidence Aid Symposium on 20 September 2014, in Hyderabad, India. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Nurse educators and professional ethics--ethical principles and their implementation from nurse educators' perspectives.

PubMed

Salminen, Leena; Metsämäki, Riikka; Numminen, Olivia H; Leino-Kilpi, Helena

2013-02-01

This study describes nurse educators' knowledge of the ethical principles of professional codes of ethics and educators' assessment of the implementation of principles of fairness and human respect. Data for this study was collected from nurse educators in Finland. The data was analyzed by SPSS (15.0) for Windows. A total of 342 nurse educators participated. The response rate was 46%. Nurse educators knew well the ethical principles of professional codes governing their work. Older and more experienced educators knew the principles better than younger and less experienced. According to the educators the principle of fairness was implemented the best whereas fair treatment of nurse educators and respect for educators' opinions in the society were implemented the weakest. Educators who knew the principles well assessed themselves to act in a fairer way and to respect other persons' opinions in a better way than educators who knew these principles less well. They also felt themselves to be better treated than educators having less knowledge of the principles. These findings can be utilized to develop nurse educators' ethics education. Further research should focus on students', colleagues' and superiors' assessments of nurse educators' ethical knowledge base to gain comparative data on the phenomenon. Copyright © 2011 Elsevier Ltd. All rights reserved.

The role of the chief ethics officer in a physician's office.

PubMed

Guten, Gary N; Kohn, Harvey S; Zoltan, Donald J; Black, Brian B; Coran, David L; Schneider, John A; Pauers, William

2004-04-01

The unique role of the chief ethics officer in a sports medicine office is described and guided by the four principles of ethics, as well as the principles and codes of ethics of the American Medical Association, the International Sports Medicine Federation, and the American Academy of Orthopaedic Surgeons. The chief ethics officer should understand and be conversant with these principles and these codes of medical ethics, and transmit this information in order to further patient goals, physician goals, and employee goals.

Public health accreditation and metrics for ethics: a case study on environmental health and community engagement.

PubMed

Bernheim, Ruth Gaare; Stefanak, Matthew; Brandenburg, Terry; Pannone, Aaron; Melnick, Alan

2013-01-01

As public health departments around the country undergo accreditation using the Public Health Accreditation Board standards, the process provides a new opportunity to integrate ethics metrics into day-to-day public health practice. While the accreditation standards do not explicitly address ethics, ethical tools and considerations can enrich the accreditation process by helping health departments and their communities understand what ethical principles underlie the accreditation standards and how to use metrics based on these ethical principles to support decision making in public health practice. We provide a crosswalk between a public health essential service, Public Health Accreditation Board community engagement domain standards, and the relevant ethical principles in the Public Health Code of Ethics (Code). A case study illustrates how the accreditation standards and the ethical principles in the Code together can enhance the practice of engaging the community in decision making in the local health department.

Research Experience and Agreement with Selected Ethics Principles from Canada's "Tri-Council Policy Statement--Ethical Conduct for Research Involving Humans"

ERIC Educational Resources Information Center

Fahy, Pat; Spencer, Bob

2004-01-01

An online survey was conducted of students, instructors, and researchers in distance education regarding principles for the ethical treatment of human research subjects. The study used an online questionnaire based on principles drawn from Canada's "Tri-Council Policy Statement, Ethical Conduct for Research Involving Humans" (TCPS,…

Assessing the Awareness of Egyptian Medical Students about Responsible Conduct of Research and Research Ethics: Impact of an Educational Campaign.

PubMed

El-Shinawi, Mohamed; Mohamed, Karim Osama; Fouad, Yousef Ahmed; Fahmy, Yara Mohamed; Asar, Hadeel Abdulwahed; Khalil, Mohamed Gomaa; Anestidou, Lida; El-Kamary, Samer S; Mohamed, Mona Mostafa

2016-01-01

This is a quasi-experimental pre-post assessment study utilizing an anonymous self-administered questionnaire to assess Egyptian medical students' awareness about responsible conduct of research (RCR) and research ethics. Students' were assessed before and after an RCR awareness campaign. Our results showed that most of the pre-campaign respondents were not familiar with the basic principles and terms of RCR. An increase in the awareness about RCR across all discussed topics was noted following the campaign. We concluded that an educational awareness campaign is effective in increasing medical students' awareness about RCR and should be incorporated into current medical school curricula in Egypt.

[The ethics of principles and ethics of responsibility].

PubMed

Cembrani, Fabio

2016-01-01

In his brief comment, the author speculates if ethics in health-care relationship it still has a practical sense.The essay points out the difference between principles ethics and ethics of responsibility, supporting the latter and try to highlight its constitutive dimensions.

[Basic ethical aspects of living organ donation].

PubMed

Nagel, E; Mayer, J

2003-06-01

A characteristic feature of transplanting organs from living donors is that not only patients in need for treatment but also healthy individuals are submitted to medical interventions. Ethical considerations in this field have to deal with the question of property attributes of the human body and conflicts with traditional medical principles. Altruistic organ donation, appreciated by Christianity as a sign of charity, is indeed contradictory to the classic maxim of medical ethics "primum nihil nocere, " meaning "first of all, do not harm." The autonomous choice of a potential donor has to be balanced thoroughly against his personal physical and psychological risks. Apart from organ donation with altruistic motives, commercial incentives or payment for organ donation, which are increasingly under discussion in many nations, need profound ethical reflection. Organ selling does not lead to long-term economic benefit for individual donors in developing countries and is associated with a decline in health. A market system of organ sales would foster exploitation of the poor, and it is substantially doubtful whether autonomy and self determination are valid under circumstances of poverty and coercion. Commodification of the human body risks viewing persons as marketable objects. The human body,however, is an integral element of an individual's personality and not a resource to be removed. It is therefore fundamental that the social good of altruism is preserved as the major principle in organ donation.

Ethics education in chiropractic colleges: a North American survey.

PubMed

Kinsinger, Stuart; Soave, David

2012-07-01

The purposes of this study were to survey Council on Chiropractic Education-accredited chiropractic colleges in North America and to describe curricular details on the teaching of bioethics. A custom-designed survey was sent to chiropractic colleges. Total number of contact hours, whether the ethics was a stand-alone course or integrated elsewhere, type of instructor, and if there was a required or recommended course text were queried. Of 19 surveys sent by mail, 15 surveys were returned. The average time in ethics instruction was 18.7 hours including lecture format, small group tutorial, and self-study. Chiropractic ethics education includes 8 areas of content (boundaries, law and jurisprudence, professionalism, basic ethic tenets/principles, ethical codes of conduct, prevention of financial and of sexual abuse, and resolving an ethical dilemma). Some colleges include content taught to students under the domain of law and jurisprudence. The results of this survey indicate that there are opportunities to further develop the educational ethics program at Council on Chiropractic Education-accredited colleges. All colleges currently offer bioethics teaching. An expanded role for this content is recommended so as to offer optimal benefit for students and practitioners. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Ethical aspects of limiting residents' work hours.

PubMed

Wiesing, Urban

2007-09-01

The regulation of residents' work hours involves several ethical conflicts which need to be systematically analysed and evaluated. ARGUMENTS AND CONCLUSION: The most important ethical principle when regulating work hours is to avoid the harm resulting from the over-work of physicians and from an excessive division of labour. Additionally, other ethical principles have to be taken into account, in particular the principles of nonmaleficence and beneficence for future patients and for physicians. The article presents arguments for balancing the relevant ethical principles and analyses the structural difficulties that occur unavoidably in any regulation of the complex activities of physicians.

Commented review of the Colombian legislation regarding the ethics of health research.

PubMed

Lopera, Mónica María

2017-12-01

The scope of ethics in health research transcends its legal framework and the regulations established in Resolution 8430 of 1993. These norms represent a fundamental tool to determine the minimum protection standards for research subjects, and, therefore, they should be known, applied properly, and reflect upon by all researchers in the field.Here I present and discuss from an analytical point of view the regulations that guide research in health. In this framework, health is understood as a multidimensional process, and research in health as a multidisciplinary exercise involving basic, clinical and public health research, collective health, and other related sciences.The main analytical categories are related to the principles and actors involved in research (regulatory authorities, ethical committees, and special or vulnerable subjects and populations), and to professional ethics codes, in addition to informed consents and data management.Despite the contribution of this legislation to the qualification of health research, my conclusion is that the national legislation in ethics for health research requires updating regarding technological and scientific developments, as well as specifications from the multiple types of health studies.

Medicine and the Holocaust: a visit to the Nazi death camps as a means of teaching medical ethics in the Israel Defense Forces Medical Corps.

PubMed

Oberman, Anthony S; Brosh-Nissimov, Tal; Ash, Nachman

2010-12-01

A novel method of teaching military medical ethics, medical ethics and military ethics in the Israel Defense Force (IDF) Medical Corps, essential topics for all military medical personnel, is discussed. Very little time is devoted to medical ethics in medical curricula, and even less to military medical ethics. Ninety-five per cent of American students in eight medical schools had less than 1 h of military medical ethics teaching and few knew the basic tenets of the Geneva Convention. Medical ethics differs from military medical ethics: the former deals with the relationship between medical professional and patient, while in the latter military physicians have to balance between military necessity and their traditional priorities to their patients. The underlying principles, however, are the same in both: the right to life, autonomy, dignity and utility. The IDF maintains high moral and ethical standards. This stems from the preciousness of human life in Jewish history, tradition and religious law. Emphasis is placed on these qualities within the Israeli education system; the IDF teaches and enforces moral and ethical standards in all of its training programmes and units. One such programme is 'Witnesses in Uniform' in which the IDF takes groups of officers to visit Holocaust memorial sites and Nazi death camps. During these visits daily discussions touch on intricate medical and military ethical issues, and contemporary ethical dilemmas relevant to IDF officers during active missions.

The man-nature relationship and environmental ethics.

PubMed

Bourdeau, Ph

2004-01-01

Our behaviour and policies with regard to nature and the environment should be guided by a code of ethics, which is to be derived from basic principles and from a pragmatic consideration of the issues at stake. The man-nature relationship has always been ambiguous, nature being seen as both a provider and an enemy. In the Judeo-Christian tradition, man is set apart from nature and called to dominate it, although this attitude has been revised to become one of stewardship. Oriental religions, on the other hand, have a more holistic view and consider humans as an integral part of nature. Modern philosophers have views ranging from anthropocentrism to biocentrism and egocentrism. It is suggested to take a pragmatic approach by which primary human needs are met first and foremost whereas the needs of other living organisms and ecosystems are allowed to prevail over secondary human needs. A plea is made to support the Earth Charter, which embodies in its principles and prescriptions a balanced respect for nature and future human generations.

Publication ethics from the ground up.

PubMed

DeTora, Lisa; Foster, Cate; Nori, Mukund; Simcoe, Donna; Skobe, Catherine; Toroser, Dikran

2018-02-01

It is relatively easy to begin policy documents with a general assertion that ethics will be followed. Less obvious is how to ensure that day-to-day activities are consonant with ethical standards. We suggest that using day-to-day publication activities as the driver for building policies and procedures can promote ethical practices from the ground up. Although basic principles of ethical publication practice may seem straightforward to some, for others this information may require explanation, interpretation and context. Effective policy development includes big-picture items as well as more day-to-day tactical responsibilities such as those discussed below. Research questions, disciplinary practices, applications and team structures may vary. Thus, no single publication plan or policy solution is right for all teams. It is up to team members to review guidelines for best practices and find the optimal implementation for their situations. Experts in publication management, planning and writing can help large teams manage publication activities. These experts have an obligation to maintain and enhance their skills continually. A strong acumen in publication best practices will allow these publication professionals to better address any possible ethical dilemmas in the future. © 2018 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

Principles, values, and ethics set the stage for managed care nursing.

PubMed

Moss, M T

1995-01-01

Principles, values, and ethics constitute an ethical system that provides nurses a context in which to make ethical decisions. As the managed care environment generates new ethical issues and intensifies already existing ones, ethical education and decision-making skills become even more critical to nursing professionals, as well as physicians and hospital administrators.

78 FR 75515 - Veterinary Feed Directive

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

...) and its Principles of Veterinary Medical Ethics,\\1\\ which acts as a unifying standard for all veterinarians. AVMA's Principles of Veterinary Medical Ethics include an explicit VCPR provision. \\1\\ https://www.avma.org/KB/Policies/Pages/Principles-of-Veterinary-Medical-Ethics-of-the-AVMA.aspx . As noted...

Are the core values of the radiological protection system shared across cultures?

PubMed

Zölzer, F

2016-06-01

In spite of ongoing globalisation in many fields, the ethics of radiological protection have long been discussed almost exclusively in terms of 'Western' moral philosophy concepts such as utilitarianism or deontology. A cross-cultural discourse in this field is only just beginning. In 'Principles of Biomedical Ethics', Beauchamp and Childress suggested that there exists a 'common morality' which is 'not relative to cultures or individuals, because it transcends both'. They proposed four cross-culturally valid principles for decision making in medicine: respect for autonomy, non-maleficence, beneficence, and justice. A similar approach is being developed by the International Commission on Radiological Protection Task Group 94 on the ethics of radiological protection. Here, the core values are: human dignity, beneficence/non-maleficence, prudence, and justice. Other values could be added, such as consideration for the interests of society as a whole or the interests of future generations, or procedural values such as transparency and accountability; this paper will include a brief discussion on how they relate to the four basic principles. The main question to be addressed here, however, is whether the proposed core values are indeed part of a 'common morality'. This, as it will be argued, cannot be decided by a global opinion poll, but has to be based on an analysis of the written and oral traditions that have provided ethical orientation throughout history, and are still considered seminal by the majority of people. It turns out that there are indeed many commonalities across cultures, and that the concept of globally shared core values for the radiological protection system is not hopelessly idealistic. © The International Society for Prosthetics and Orthotics.

Medical confidentiality versus disclosure: Ethical and legal dilemmas.

PubMed

Agyapong, V I O; Kirrane, R; Bangaru, R

2009-02-01

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

Professional ethics and collective professional autonomy: a conceptual analysis.

PubMed

Kasher, Asa

2005-03-01

In the first section, it is argued that a professional activity involves systematic knowledge and proficiency, a form of continuous improvement of the related bodies of knowledge and proficiency, as well as two levels of understanding: a local one, which is the ability to justify and explain professional acts, and a global one, which involves a conception of the whole profession and its ethical principles. The second section is devoted to a conceptual analysis of professional ethics. It is argued that it consists of a general conception of professionality, a particular conception of the profession under consideration, and a conception of the normative requirements made by the societal envelope of the professional activity, in particular basic norms of democracy. The third section draws conclusions with respect to the nature and limits of professional autonomy. It is shown that such autonomy is much more restricted than its apparent extent. Examples from engineering and other professions are provided.

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.

Ethical Virtues in Scientific Research

PubMed Central

Resnik, David B.

2012-01-01

Most approaches to promoting integrity in research are principle-based in that they portray ethical conduct as consisting of adherence to ethical rules, duties, or responsibilities. Bruce MacFarlane has recently criticized the principle-based approach to promoting integrity in research and offered a virtue-based alternative. MacFarlane argues that principle-based approaches do not provide adequate guidance for ethical decision-making and are not very useful in moral education. In this article, I examine and critique MacFarlane’s defense of the virtue-based approach. I argue that virtue-based and principle-based approaches to ethics are complementary and that they both can help promote research integrity. PMID:23074991

Ethical virtues in scientific research.

PubMed

Resnik, David B

2012-01-01

Most approaches to promoting integrity in research are principle-based in that they portray ethical conduct as consisting of adherence to ethical rules, duties, or responsibilities. Bruce MacFarlane has recently criticized the principle-based approach to promoting integrity in research and offered a virtue-based alternative. MacFarlane argues that principle-based approaches do not provide adequate guidance for ethical decision-making and are not very useful in moral education. In this article, I examine and critique MacFarlane's defense of the virtue-based approach. I argue that virtue-based and principle-based approaches to ethics are complementary and that they both can help promote research integrity.

Ethical principles of informed consent: exploring nurses' dual role of care provider and researcher.

PubMed

Judkins-Cohn, Tanya M; Kielwasser-Withrow, Kiersten; Owen, Melissa; Ward, Jessica

2014-01-01

This article describes the ethical principles of autonomy, beneficence, and justice within the nurse researcher-participant relationship as these principles relate to the informed consent process for research. Within this process, the nurse is confronted with a dual role. This article describes how nurses, who are in the dual role of care provider and researcher, can apply these ethical principles to their practice in conjunction with the American Nurses Association's code of ethics for nurses. This article also describes, as an element of ethical practice, the importance of using participant-centered quality measures to aid informed decision making of participants in research. In addition, the article provides strategies for improving the informed consent process in nursing research. Finally, case scenarios are discussed, along with the application of ethical principles within the awareness of the dual role of the nurse as care provider and researcher. Copyright 2014, SLACK Incorporated.

Ethical Perceptions of Customers Towards the Services of Foreign Branch Banks in Northern Cyprus

NASA Astrophysics Data System (ADS)

Veli Safakli, Okan

Nowadays, the ethical principles, which are institutionalized as generally accepted principles like the human rights, have become very popular in the banking sector like in many other sectors. The implementation of these principles provides public trust and reputation as well as competitive edge to the banks. The branches of the foreign banks, which have their head offices in foreign countries, are expected to be in harmony with the ethical principles more than the local banks. Therefore, ethical perceptions of customers towards the services of the foreign branch banks in Northern Cyprus have been researched in this study. According to this survey, it was found out that the foreign branch banks, generally, respect the ethical principles as expected. However, there is a necessity of institutional and administrative restructuring in the direction of improving the quality of the ethic standards used in these banks.

Islam and the four principles of medical ethics.

PubMed

Mustafa, Yassar

2014-07-01

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

Ethical principles in health research and review process.

PubMed

Tangwa, Godfrey B

2009-11-01

In this paper I want to reflect on the fundamental ethical principles and their application in different particular contexts, especially in health research and the ethics review process. Four fundamental ethical principles have been identified and widely discussed in bioethical literature. These principles namely are: autonomy or respect for others, beneficence, non-maleficence and justice. These principles have cross-cultural validity, relevance and applicability. Every real-life situation and every concrete particular case in which ethical decision-making is called-for is unique and different from all others; but the same fundamental ethical principles are relevant and used in addressing all such cases and situations. Very often ethical problems will present themselves in the form of dilemmas and it is then necessary to use the same fundamental principles to analyze the situations, to argue persuasively and cogently with competence for the best options or choices in such situations. The issues I will be dealing with in this paper are necessarily more abstract and theoretical, but we will be discussing them from a very practical viewpoint and impulse, with a view to application in concrete real-life situations. The paper ends with some sample practical examples of cases that the reader can use to test his/her grasp of the principles, how to apply them, how to balance them in differing situations and contexts and how to adjudicate between them when they seem to be in conflict.

The Use of Informational Formats to Implement APA Ethical Principles in Collecting Classroom Data.

ERIC Educational Resources Information Center

Dolly, John P.; And Others

1978-01-01

Providing more information about experimental studies than required under the ethical principles formulated by the American Psychological Association can result in data bias on a specific task; overall, however, the implementation of ethical principles has little effect on data collected in classroom settings. (RL)

Evaluation of Professional Ethics Principles by Candidate Teachers

ERIC Educational Resources Information Center

Sahan, Gülsün

2018-01-01

The aim of this study is to evaluate the teaching ethics principles according to the opinions of the prospective teachers. From the teaching profession ethics principles of the students, the positive and negative aspects of professionalism, service, responsibility, justice, equality, ensuring a healthy and safe environment, morality, honesty,…

Basing Science Ethics on Respect for Human Dignity.

PubMed

Aközer, Mehmet; Aközer, Emel

2016-12-01

A "no ethics" principle has long been prevalent in science and has demotivated deliberation on scientific ethics. This paper argues the following: (1) An understanding of a scientific "ethos" based on actual "value preferences" and "value repugnances" prevalent in the scientific community permits and demands critical accounts of the "no ethics" principle in science. (2) The roots of this principle may be traced to a repugnance of human dignity, which was instilled at a historical breaking point in the interrelation between science and ethics. This breaking point involved granting science the exclusive mandate to pass judgment on the life worth living. (3) By contrast, respect for human dignity, in its Kantian definition as "the absolute inner worth of being human," should be adopted as the basis to ground science ethics. (4) The pathway from this foundation to the articulation of an ethical duty specific to scientific practice, i.e., respect for objective truth, is charted by Karl Popper's discussion of the ethical principles that form the basis of science. This also permits an integrated account of the "external" and "internal" ethical problems in science. (5) Principles of the respect for human dignity and the respect for objective truth are also safeguards of epistemic integrity. Plain defiance of human dignity by genetic determinism has compromised integrity of claims to knowledge in behavioral genetics and other behavioral sciences. Disregard of the ethical principles that form the basis of science threatens epistemic integrity.

Valuing Our Communities: Ethical Considerations for Economic Evaluation of Community-Based Prevention.

PubMed

Crowley, Max; Jones, Damon

2017-12-01

Restricted public budgets and increasing efforts to link the impact of community interventions to public savings have increased the use of economic evaluation. While this type of evaluation can be important for program planning, it also raises important ethical issues about how we value the time of local stakeholders who support community interventions. In particular, researchers navigate issues of scientific accuracy, institutional inequality, and research utility in their pursuit of even basic cost estimates. We provide an example of how we confronted these issues when estimating the costs of a large-scale community-based intervention. Principles for valuing community members' time and conducting economic evaluations of community programs are discussed. © Society for Community Research and Action 2017.

Lies and coercion: why psychiatrists should not participate in police and intelligence interrogations.

PubMed

Janofsky, Jeffrey S

2006-01-01

Police interrogators routinely use deceptive techniques to obtain confessions from criminal suspects. The United States Executive Branch has attempted to justify coercive interrogation techniques in which physical or mental pain and suffering may be used during intelligence interrogations of persons labeled unlawful combatants. It may be appropriate for law enforcement, military, or intelligence personnel who are not physicians to use such techniques. However, forensic psychiatry ethical practice requires honesty, striving for objectivity, and respect for persons. Deceptive and coercive interrogation techniques violate these moral values. When a psychiatrist directly uses, works with others who use, or trains others to use deceptive or coercive techniques to obtain information in police, military, or intelligence interrogations, the psychiatrist breaches basic principles of ethics.

Public health ethics theory: review and path to convergence.

PubMed

Lee, Lisa M

2012-01-01

Public health ethics is a nascent field, emerging over the past decade as an applied field merging concepts of clinical and research ethics. Because the "patient" in public health is the population rather than the individual, existing principles might be weighted differently, or there might be different ethical principles to consider. This paper reviewed the evolution of public health ethics, the use of bioethics as its model, and the proposed frameworks for public health ethics through 2010. Review of 13 major public health ethics frameworks published over the past 15 years yields a wide variety of theoretical approaches, some similar foundational values, and a few similar operating principles. Coming to a consensus on the reach, purpose, and ends of public health is necessary if we are to agree on what ethical underpinnings drive us, what foundational values bring us to these underpinnings, and what operating principles practitioners must implement to make ethical decisions. If public health is distinct enough from clinical medicine to warrant its own set of ethical and philosophical underpinnings, then a decision must be made as to whether a single approach is warranted or we can tolerate a variety of equal but different perspectives. © 2012 American Society of Law, Medicine & Ethics, Inc.

Towards a Sexual Ethics for Adolescence

ERIC Educational Resources Information Center

Steutel, Jan

2009-01-01

Which moral principles should guide us in evaluating sexual contacts of adolescents? This paper tries to answer this question by taking two steps. First, the implications of a liberal sexual ethics for adolescence are spelled out, assessed and refuted. The core principle of the liberal ethical view, the principle of valid consent, takes competence…

Transnational pharmaceutical corporations and neo-liberal business ethics in India.

PubMed

D'Mello, Bernard

2002-03-01

The author critiques the expedient application of market valuation principles by the transnational corporations and other large firms in the Indian pharmaceutical industry on a number of issues like patents, pricing, irrational drugs, clinical trials, etc. He contends that ethics in business is chiseled and etched within the confines of particular social structures of accumulation. An ascendant neo-liberal social structure of accumulation has basically shaped these firms' sharp opposition to the Indian Patents Act, 1970, government administered pricing, etc. The author contents that the practice of neo-liberal economics is strongly associated with a "one-dimensional" ethics that privileges market valuation principles over all others. This seems to inevitably generate a social counter-movement that struggles for social protections. He critiques neo-liberal business practices from a perspective that derives from the work of the economic anthropologist Karl Polanyi. Before the present phase of liberalization in India, markets were "managed", but without a "welfare state" in place. Moving toward deregulation of the markets without a welfare state in place is unethical. Keeping the debilities of the institutional framework of public policy in mind, the author adopts a Polanyian perspective that places its trust and hope in the growing social legitimacy of the counter-movement in opposition to both neo-liberal business practices and the degenerate behavior of state agencies.

Keeping it Ethically Real

PubMed Central

Ho, Dien

2016-01-01

Many clinical ethicists have argued that ethics expertise is impossible. Their skeptical argument usually rests on the assumptions that to be an ethics expert is to know the correct moral conclusions, which can only be arrived at by having the correct ethical theories. In this paper, I argue that this skeptical argument is unsound. To wit, ordinary ethical deliberations do not require the appeal to ethical or meta-ethical theories. Instead, by agreeing to resolve moral differences by appealing to reasons, the participants agree to the Default Principle—a substantive rule that tells us how to adjudicate an ethical disagreement. The Default Principle also entails a commitment to arguments by parity, and together these two methodological approaches allow us to make genuine moral progress without assuming any deep ethical principles. Ethical expertise, in one sense, is thus the ability and knowledge to deploy the Default Principle and arguments by parity. PMID:27256847

Canadian University Ethics Review: Cultural Complications Translating Principles into Practice

ERIC Educational Resources Information Center

Tilley, Susan; Gormley, Louise

2007-01-01

Drawing from educational research conducted in Canada and Mexico, university researchers explore how culture complicates both the ethics review process and the translation of ethical research principles into practice. University researchers in Canadian contexts seek approval from university Research Ethics Boards to conduct research, following…

The historical, ethical, and legal background of human-subjects research.

PubMed

Rice, Todd W

2008-10-01

The current system of human-subject-research oversight and protections has developed over the last 5 decades. The principles of conducting human research were first developed as the Nuremberg code to try Nazi war criminals. The 3 basic elements of the Nuremberg Code (voluntary informed consent, favorable risk/benefit analysis, and right to withdraw without repercussions) became the foundation for subsequent ethical codes and research regulations. In 1964 the World Medical Association released the Declaration of Helsinki, which built on the principles of the Nuremberg Code. Numerous research improprieties between 1950 and 1974 in the United States prompted Congressional deliberations about human-subject-research oversight. Congress's first legislation to protect the rights and welfare of human subjects was the National Research Act of 1974, which created the National Commission for Protection of Human Subjects of Biomedical and Behavioral Research, which issued the Belmont Report. The Belmont Report stated 3 fundamental principles for conducting human-subjects research: respect for persons, beneficence, and justice. The Office of Human Research Protections oversees Title 45, Part 46 of the Code for Federal Regulations, which pertains to human-subjects research. That office indirectly oversees human-subjects research through local institutional review boards (IRB). Since their inception, the principles of conducting human research, IRBs, and the Code for Federal Regulations have all advanced substantially. This paper describes the history and current status of human-subjects-research regulations.

Ethical principles in federal regulations: the case of children and research risks.

PubMed

Williams, P C

1996-04-01

Ethical principles play an important part not only in the promulgation of regulations but also in their application, i.e., enforcement and adjudication. while traditional ethical principles--promotion of welfare, freedom, and fairness--play an important role in both elements of regulation, some other kinds of ethical principles are significant as well. Principles governing the structure of decision processes should shape the structure and actions of agencies; principles of wise application should govern the work of those whose responsibility it is to apply regulatory language to particular situations. These points are demonstrated by investigating a case study: federal regulations designed to protect children involved in scientific research applied to a placebo study of the effects of recombinant human growth hormone on children of extremely short stature.

Ethical Decisions in Experience-Based Training and Development Programs.

ERIC Educational Resources Information Center

Gass, Michael A.; Wurdinger, Scott

1993-01-01

Illustrates how principle and virtue ethics can be applied to decision-making processes in experience-based training and development programs. Principle ethics is guided by predetermined rules and assumes that issues being examined are somewhat similar in context, whereas virtue ethics assumes that "correct behavior" is determined from…

Research ethics in dissertations: ethical issues and complexity of reasoning.

PubMed

Kjellström, S; Ross, S N; Fridlund, B

2010-07-01

Conducting ethically sound research is a fundamental principle of scientific inquiry. Recent research has indicated that ethical concerns are insufficiently dealt with in dissertations. To examine which research ethical topics were addressed and how these were presented in terms of complexity of reasoning in Swedish nurses' dissertations. Analyses of ethical content and complexity of ethical reasoning were performed on 64 Swedish nurses' PhD dissertations dated 2007. A total of seven ethical topics were identified: ethical approval (94% of the dissertations), information and informed consent (86%), confidentiality (67%), ethical aspects of methods (61%), use of ethical principles and regulations (39%), rationale for the study (20%) and fair participant selection (14%). Four of those of topics were most frequently addressed: the majority of dissertations (72%) included 3-5 issues. While many ethical concerns, by their nature, involve systematic concepts or metasystematic principles, ethical reasoning scored predominantly at lesser levels of complexity: abstract (6% of the dissertations), formal (84%) and systematic (10%). Research ethics are inadequately covered in most dissertations by nurses in Sweden. Important ethical concerns are missing, and the complexity of reasoning on ethical principles, motives and implications is insufficient. This is partly due to traditions and norms that discount ethical concerns but is probably also a reflection of the ability of PhD students and supervisors to handle complexity in general. It is suggested that the importance of ethical considerations should be emphasised in graduate and post-graduate studies and that individuals with capacity to deal with systematic and metasystematic concepts are recruited to senior research positions.

Communicating with Muslim parents: "the four principles" are not as culturally neutral as suggested.

PubMed

Westra, Anna E; Willems, Dick L; Smit, Bert J

2009-11-01

The "four principles approach" has been popularly accepted as a set of universal guidelines for biomedical ethics. Based on four allegedly trans-cultural principles (respect for autonomy, nonmaleficence, beneficence and justice), it is supposed to fulfil the need of a 'culturally neutral approach to thinking about ethical issues in health care'. On the basis of a case-history, this paper challenges the appropriateness of communicating in terms of these four principles with patients with a different background. The case describes the situation in which Muslim parents bring forward that their religion keeps them from consenting to end-of-life decisions by non-religious paediatricians. In a literature analysis, the different meanings and roles of the relevant principles in non-religious and Islamic ethics are compared. In non-religious ethics, the principle of nonmaleficence may be used to justify withholding or withdrawing futile or damaging treatments, whereas Islamic ethics applies this principle to forbid all actions that may harm life. And while the non-religious version of the principle of respect for autonomy emphasises the need for informed consent, the Islamic version focuses on "respect for the patient". We conclude that the parties involved in the described disagreement may feel committed to seemingly similar, but actually quite different principles. In such cases, communication in terms of these principles may create a conflict within an apparently common conceptual framework. The four principles approach may be very helpful in analysing ethical dilemmas, but when communicating with patients with different backgrounds, an alternative approach is needed that pays genuine attention to the different backgrounds.

Aristotle's ethical theory & modern health care.

PubMed

Majumdar, S K

1996-01-01

The Greek physician of antiquity - Hippocrates (460-356 B.C.) is called the Father of Modern Medicine and the Hippocratic Oath to which doctors of modern medicine traditionally and formally express their allegiance, forms the basic foundation of medical ethics. The tradition of Western ethical philosophy began with the ancient Greeks. From Socrates (469-399 B.C.) and his immediate successors, Plato (427-347 B.C.) and Aristotle (384-322 B.C.), there is a clear line of continuity, through Hellenistic period (from the death of Alexander the Great (323 B.C.) to the end of Ptolemic dynasty (30 B.C.) and the Roman annexation of Egypt - broadly post-Aristotelian and medieval thought to the present day. But the society has qualitatively and quantitatively changed since the Industrial Revolution in the late 18th and 19th centuries. Society, today, is just a collection of discrete individuals, each with his or her own purposes and interests. Hence it has become almost imperative to apply the principle of autonomy to issues in the ethics of health care. The aim of this short essay is, therefore, an attempt to explore the relevance, if any, of Aristotelian ethical theory to the modern health care.

Ethics needs principles--four can encompass the rest--and respect for autonomy should be "first among equals".

PubMed

Gillon, R

2003-10-01

It is hypothesised and argued that "the four principles of medical ethics" can explain and justify, alone or in combination, all the substantive and universalisable claims of medical ethics and probably of ethics more generally. A request is renewed for falsification of this hypothesis showing reason to reject any one of the principles or to require any additional principle(s) that can't be explained by one or some combination of the four principles. This approach is argued to be compatible with a wide variety of moral theories that are often themselves mutually incompatible. It affords a way forward in the context of intercultural ethics, that treads the delicate path between moral relativism and moral imperialism. Reasons are given for regarding the principle of respect for autonomy as "first among equals", not least because it is a necessary component of aspects of the other three. A plea is made for bioethicists to celebrate the approach as a basis for global moral ecumenism rather than mistakenly perceiving and denigrating it as an attempt at global moral imperialism.

What really separates casuistry from principlism in biomedical ethics.

PubMed

Cudney, Paul

2014-06-01

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

An Analysis of Ethics Laws, Compliance with Ethical Standards, and Ethical Core Competency within the Department of the Army

DTIC Science & Technology

2016-06-15

laws and ethical principles above private gain. (2) Employees shall not hold financial interests that conflict with the conscientious...applying ethical principles to decision-making. We analyze the DA ethics training courses, policies, and procedures. The project explores the...leveraging the Enterprises buying power to obtain goods and services more efficiently. Ms. Lyons earned her Bachelor of Science degree in Accounting in

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

PubMed

Brabender, Virginia M; Fallon, April

2009-01-01

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

The philosophical moment of the medical decision: revisiting emotions felt, to improve ethics of future decisions.

PubMed

Le Coz, Pierr; Tassy, Sebastien

2007-08-01

The present investigation looks for a solution to the problem of the influence of feelings and emotions on our ethical decisions. This problem can be formulated in the following way. On the one hand, emotions (fear, pity and so on) can alter our sense of discrimination and lead us to make our wrong decisions. On the other hand, it is known that lack of sensitivity can alter our judgment and lead us to sacrifice basic ethical principles such as autonomy, beneficence, non-maleficence and justice. Only emotions can turn a decision into an ethical one, but they can also turn it into an unreasonable one. To avoid this contradiction, suggest integrating emotions with the decisional factors of the process of "retrospective thinking". During this thinking, doctors usually try to identify the nature and impact of feelings on the decision they have just made. In this retrospective moment of analysis of the decision, doctors also question themselves on the feelings they did not experience. They do this to estimate the consequences of this lack of feeling on the way they behaved with the patient.

A principled and cosmopolitan neuroethics: considerations for international relevance.

PubMed

Shook, John R; Giordano, James

2014-01-03

Neuroethics applies cognitive neuroscience for prescribing alterations to conceptions of self and society, and for prescriptively judging the ethical applications of neurotechnologies. Plentiful normative premises are available to ground such prescriptivity, however prescriptive neuroethics may remain fragmented by social conventions, cultural ideologies, and ethical theories. Herein we offer that an objectively principled neuroethics for international relevance requires a new meta-ethics: understanding how morality works, and how humans manage and improve morality, as objectively based on the brain and social sciences. This new meta-ethics will simultaneously equip neuroethics for evaluating and revising older cultural ideologies and ethical theories, and direct neuroethics towards scientifically valid views of encultured humans intelligently managing moralities. Bypassing absolutism, cultural essentialisms, and unrealistic ethical philosophies, neuroethics arrives at a small set of principles about proper human flourishing that are more culturally inclusive and cosmopolitan in spirit. This cosmopolitanism in turn suggests augmentations to traditional medical ethics in the form of four principled guidelines for international consideration: empowerment, non-obsolescence, self-creativity, and citizenship.

A principled and cosmopolitan neuroethics: considerations for international relevance

PubMed Central

2014-01-01

Neuroethics applies cognitive neuroscience for prescribing alterations to conceptions of self and society, and for prescriptively judging the ethical applications of neurotechnologies. Plentiful normative premises are available to ground such prescriptivity, however prescriptive neuroethics may remain fragmented by social conventions, cultural ideologies, and ethical theories. Herein we offer that an objectively principled neuroethics for international relevance requires a new meta-ethics: understanding how morality works, and how humans manage and improve morality, as objectively based on the brain and social sciences. This new meta-ethics will simultaneously equip neuroethics for evaluating and revising older cultural ideologies and ethical theories, and direct neuroethics towards scientifically valid views of encultured humans intelligently managing moralities. Bypassing absolutism, cultural essentialisms, and unrealistic ethical philosophies, neuroethics arrives at a small set of principles about proper human flourishing that are more culturally inclusive and cosmopolitan in spirit. This cosmopolitanism in turn suggests augmentations to traditional medical ethics in the form of four principled guidelines for international consideration: empowerment, non-obsolescence, self-creativity, and citizenship. PMID:24387102

A Code of Ethics and Standards for Outer-Space Commerce

NASA Astrophysics Data System (ADS)

Livingston, David M.

2002-01-01

Now is the time to put forth an effective code of ethics for businesses in outer space. A successful code would be voluntary and would actually promote the growth of individual companies, not hinder their efforts to provide products and services. A properly designed code of ethics would ensure the development of space commerce unfettered by government-created barriers. Indeed, if the commercial space industry does not develop its own professional code of ethics, government- imposed regulations would probably be instituted. Should this occur, there is a risk that the development of off-Earth commerce would become more restricted. The code presented in this paper seeks to avoid the imposition of new barriers to space commerce as well as make new commercial space ventures easier to develop. The proposed code consists of a preamble, which underscores basic values, followed by a number of specific principles. For the most part, these principles set forth broad commitments to fairness and integrity with respect to employees, consumers, business transactions, political contributions, natural resources, off-Earth development, designated environmental protection zones, as well as relevant national and international laws. As acceptance of this code of ethics grows within the industry, general modifications will be necessary to accommodate the different types of businesses entering space commerce. This uniform applicability will help to assure that the code will not be perceived as foreign in nature, potentially restrictive, or threatening. Companies adopting this code of ethics will find less resistance to their space development plans, not only in the United States but also from nonspacefaring nations. Commercial space companies accepting and refining this code would demonstrate industry leadership and an understanding that will serve future generations living, working, and playing in space. Implementation of the code would also provide an off-Earth precedent for a modified free-market economy. With the code as a backdrop, a colonial or Wild West mentality would become less likely. Off-Earth resources would not be as susceptible to plunder and certain areas could be designated as environmental reserves for the benefit of all. Companies would find it advantageous to balance the goal of wealth maximization with ethical principles if such a strategy enhances the long-term prospects for success.

Principles of Biomedical Ethics

PubMed Central

Athar, Shahid

2012-01-01

In this presentation, I will discuss the principles of biomedical and Islamic medical ethics and an interfaith perspective on end-of-life issues. I will also discuss three cases to exemplify some of the conflicts in ethical decision-making. PMID:23610498

Ethical Challenges in Psychiatric Administration and Leadership.

PubMed

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

2015-09-01

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

How bioethics principles can aid design of electronic health records to accommodate patient granular control.

PubMed

Meslin, Eric M; Schwartz, Peter H

2015-01-01

Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was recently adopted by a team of informaticists who are designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, especially when principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and nonmaleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper, we show how using ethical principles can help in the design of EHRs by first explaining how ethical principles can and should be used generally, and then by discussing how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest.

Ethical Issues in Paediatric Practice - Part I: General Principles

PubMed Central

Attard-Montalto, S

2001-01-01

Clinical problems with ethical implications pose an ever increasing dilemma in everyday medical practice, and this is particularly the case with ethical issues involving children and those unable to take their own decisions. In this editorial we shall review some of the general principles that guide medical ethical problems. PMID:22368603

Learning by Doing: Teaching Decision Making through Building a Code of Ethics.

ERIC Educational Resources Information Center

Hawthorne, Mark D.

2001-01-01

Notes that applying abstract ethical principles to the practical business of building a code of applied ethics for a technical communication department teaches students that they share certain unarticulated or unconscious values that they can translate into ethical principles. Suggests that combining abstract theory with practical policy writing…

Violation of ethical principles in clinical research. Influences and possible solutions for Latin America.

PubMed

Cornejo Moreno, Borys Alberto; Gómez Arteaga, Gress Marissell

2012-12-16

Even though we are now well into the 21st century and notwithstanding all the abuse to individuals involved in clinical studies that has been documented throughout History, fundamental ethical principles continue to be violated in one way or another. Here are some of the main factors that contribute to the abuse of subjects participating in clinical trials: paternalism, improper use of informed consent, lack of strict ethical supervision, pressure exerted by health institutions to increase the production of scientific material, and the absence of legislation regarding ethics in terms of health care and research. Are researchers ready to respect fundamental ethical principles in light of the ample window of information provided by individual genomes, while defending the rights of the subjects participating in clinical studies as a major priority? As one of the possible solutions to this problem, education regarding fundamental ethical principles is suggested for participants in research studies as an initial method of cognitive training in ethics, together with the promotion of ethical behavior in order to encourage the adoption of reasonable policies in the field of values, attitudes and behavior.

Psychiatric/ psychological forensic report writing.

PubMed

Young, Gerald

Approaches to forensic report writing in psychiatry, psychology, and related mental health disciplines have moved from an organization, content, and stylistic framework to considering ethical and other codes, evidentiary standards, and practice considerations. The first part of the article surveys different approaches to forensic report writing, including that of forensic mental health assessment and psychiatric ethics. The second part deals especially with psychological ethical approaches. The American Psychological Association's Ethical Principles and Code of Conduct (2002) provide one set of principles on which to base forensic report writing. The U.S. Federal Rules of Evidence (2014) and related state rules provide another basis. The American Psychological Association's Specialty Guidelines for Forensic Psychology (2013) provide a third source. Some work has expanded the principles in ethics codes; and, in the third part of this article, these additions are applied to forensic report writing. Other work that could help with the question of forensic report writing concerns the 4 Ds in psychological injury assessments (e.g., conduct oneself with Dignity, avoid the adversary Divide, get the needed reliable Data, Determine interpretations and conclusions judiciously). One overarching ethical principle that is especially applicable in forensic report writing is to be comprehensive, scientific, and impartial. As applied to forensic report writing, the overall principle that applies is that the work process and product should reflect integrity in its ethics, law, and science. Four principles that derive from this meta-principle concern: Competency and Communication; Procedure and Protection; Dignity and Distance; and Data Collection and Determination. The standards or rules associated with each of these principles are reviewed. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

[Re]considering Respect for Persons in a Globalizing World.

PubMed

Padela, Aasim I; Malik, Aisha Y; Curlin, Farr; De Vries, Raymond

2015-08-01

Contemporary clinical ethics was founded on principlism, and the four principles: respect for autonomy, nonmaleficence, beneficence and justice, remain dominant in medical ethics discourse and practice. These principles are held to be expansive enough to provide the basis for the ethical practice of medicine across cultures. Although principlism remains subject to critique and revision, the four-principle model continues to be taught and applied across the world. As the practice of medicine globalizes, it remains critical to examine the extent to which both the four-principle framework, and individual principles among the four, suffice patients and practitioners in different social and cultural contexts. Using the four-principle model we analyze two accounts of surrogate decision making - one from the developed and one from the developing world - in which the clinician undertakes medical decision-making with apparently little input from the patient and/or family. The purpose of this analysis is to highlight challenges in assessing ethical behaviour according to the principlist model. We next describe cultural expectations and mores that inform both patient and clinician behaviors in these scenarios in order to argue that the principle of respect for persons informed by culture-specific ideas of personhood may offer an improved ethical construct for analyzing and guiding medical practice in a globalized and plural world. © 2014 John Wiley & Sons Ltd.

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

PubMed

Macrae, Duncan J

2007-05-01

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

Foucault at the bedside: a critical analysis of empowering a healthy lifestyle.

PubMed

Devisch, Ignaas; Vanheule, Stijn

2015-06-01

Since quite a few years, philosophy is heading towards the bedside of the patient: the practice of philosophy has stepped out of its ivory tower, it seems, to deal with empirical or practical questions. Apart from the advantages, we should keep in mind the importance of a critical analysis of medical or clinical practice as such. If ethics partakes the clinical stage, it runs the risk only to discuss the how question and to forget the more fundamental what or why questions: what are we doing exactly and why is it good for? Starting from the principle of the empowerment of the patient, we will demonstrate how the discourse on empowerment in health care seems to forget a profound reflection upon this principle as such. By rehearsing some basics from the governmentality theory of Michel Foucault and the actualization of it by Nicolas Rose, we will argue how philosophical investigation in medical-ethical evolutions such as empowerment of the patient is still needed to understand what is really going on in today's clinical practice. © 2015 John Wiley & Sons, Ltd.

Forensic psychiatry, one subspecialty with two ethics? A systematic review.

PubMed

Niveau, Gérard; Welle, Ida

2018-04-10

Forensic psychiatry is a particular subspecialty within psychiatry, dedicated in applying psychiatric knowledge and psychiatric training for particular legal purposes. Given that within the scope of forensic psychiatry, a third party usually intervenes in the patient-doctor relationship, an amendment of the traditional ethical principles seems justified. Thus, 47 articles, two book chapters and the guidelines produced by the World Psychiatric Association, the American Association of Psychiatry and the Law, as well as by the Royal Australian and New Zealand College of psychiatrists, were analyzed. The review revealed that the ethics of correctional forensic psychiatry and those of legal forensic psychiatry do not markedly differ from each other, but they are incongruent in terms of implementation. In an effort to better understand which ethical principles apply to forensic psychiatry, a chronological review of the literature published from 1950 to 2015 was carried out. The ethics of correctional forensic psychiatry are primarily deontological. The principle of justice translates into the principle of health care equivalence, the principle of beneficence into providing the best possible care to patients, and the principle of respect of autonomy into ensuring confidentiality and informed consent. The ethics of legal forensic psychiatry are rather consequentialist. In this latter setting, the principle of justice is mainly characterized by professionalism, the principle of beneficence by objectivity and impartiality, and the principle of respect of autonomy by informed consent. However, these two distinct fields of forensic psychiatry share in common the principle of non maleficence, defined as the non collaboration of the psychiatrist in any activity leading to inhuman and degrading treatment or to the death penalty.

From Nuremberg to bioethics: an educational project for students of dentistry and dental prosthesis

PubMed Central

Marinozzi, Silvia; Corbellini, Gilberto; Ottolenghi, Livia; Ripari, Francesca; Pizzuti, Antonio; Pezzetti, Marcello; Gaj, Fabio

2013-01-01

Summary In the lessons of medical-scientific methodologies of the medical faculty at the Sapienza University of Rome, basic notions on the ethical and deontologic aspects characterizing the history of the medical profession are provided, including the formulation and application of bioethical principles to clinics and biomedical research. Within such framework, an educational project has been initiated on the historical origin of the current normative and juridic dispositions in the regulation of experimental biomedical research and the relationship between health operators and patients, with particular attention to the procedure, the meaning the value either professional or deontologic, of ethics and the legality of the informed consensus. Emphasis is put on medical and experimental abuses that occurred in Germany during the nazi regime. PMID:23741533

Preferences for Key Ethical Principles that Guide Business School Students

ERIC Educational Resources Information Center

Guyette, Roger; Piotrowski, Chris

2010-01-01

Business ethics is presently a major component of the business school curriculum. Although there has been much attention focused on the impact of such coursework on instilling ethical decision-making (Nguyen et al., 2008), there is sparse research on how business students view the major ethical principles that serve as the foundation of business…

Reasons Preventing Teachers from Acting within the Framework of Ethical Principles

ERIC Educational Resources Information Center

Dag, Nilgün; Arslantas, Halis Adnan

2015-01-01

This study aims at putting forth the reasons preventing teachers from acting ethically, acting within the framework of ethical principles and having an ethical tendency. This study featuring a qualitative research model taking as a basis the case study approach followed a path of selecting people that can be a rich source of information for…

[Ethics, culture and psychiatry: the ethics of Mediterranean Europe].

PubMed

López-Ibor, Juan-José; Crespo, Hervás

2003-09-01

The defence of the rights of the person, in Mediterranean ethics, is based on a synthesis of civic humanism and liberalism, derived from the spirit of Greek democracy and Enlightenment, and including the achievements of the XIX and XX centuries. It tempers liberalism with the principles of social welfare. Present bioethics, specialy in European countries, try to integrate both the mediterranean ethics of virtues and the anglosaxon ethics of principles, further adding and integrating a social element, the principle of solidarity and distributive justice (equity). Therefore, European ethics do not proclaim the autonomy of persons and the independence of the individual from society, but the interdependency of persons and nations. They advocate a greater equity and a better management of resources in health care.

When four principles are too many: bloodgate, integrity and an action-guiding model of ethical decision making in clinical practice.

PubMed

Muirhead, William

2012-04-01

Medical ethical analysis remains dominated by the principlist account first proposed by Beauchamp and Childress. This paper argues that the principlist model is unreflective of how ethical decisions are taken in clinical practice. Two kinds of medical ethical decisions are distinguished: biosocial ethics and clinical ethics. It is argued that principlism is an inappropriate model for clinical ethics as it is neither sufficiently action-guiding nor does it emphasise the professional integrity of the clinician. An alternative model is proposed for decision making in the realm of clinical ethics.

The method of 'principlism': a critique of the critique.

PubMed

Lustig, B A

1992-10-01

Several scholars have recently criticized the dominant emphasis upon mid-level principles in bioethics best exemplified by Beauchamp and Childress's Principles of Biomedical Ethics. In Part I of this essay, I assess the fairness and cogency of three broad criticisms raised against 'principlism' as an approach: (1) that principlism, as an exercise in applied ethics, is insufficiently attentive to the dialectical relations between ethical theory and mortal practice; (2) that principlism fails to offer a systematic account of the principles of non-maleficence, beneficence, respect for autonomy, and justice; and (3) that principlism, as a version of moral pluralism, is fatally flawed by its theoretical agnosticism. While acknowledging that Beauchamp and Childress's reliance upon Ross's version of intuitionism is problematic, I conclude that the critics of principlism have failed to make a compelling case against its theoretical or practical adequacy as an ethical approach. In Part II, I assess the moral theory developed by Bernard Gert in Mortality: A New Justification of the Moral Rules, because Gert has recommended his approach as a systematic alternative to principlism. I judge Gert's theory to be seriously incomplete and, in contrast to principlism, unable to generate coherent conclusions about cases of active euthanasia and paternalism.

[Moral responsibility of hospital management].

PubMed

Schmidt-Wilcke, Heinrich Alyosius

2009-03-15

The self-concept of hospitals today includes the role of service providers, and so they act accordingly. This attitude is chiefly held by hospital administrators. It means that at management level there is a shift of values toward business ethics. However, hospital management is responsible not only for the business aspects of the hospital but also for the provision of adequate medical care to patients. Therefore, hospitals as service providers must be governed by the principles of medical as well as of business ethics. These principles, although from different areas, can be made to largely coincide, but can also lead to divergent positions within a hospital. The result is what within the scope of medical ethics, too, is experienced as a conflict of principles, e.g., the principle of beneficence versus the principle of autonomy. A reconciliation of such divergent moral positions can often be effected by analyzing the actual conflict situation and thus reaching consensus. The conflict between the principles of medical ethics and business ethics takes place chiefly within the sphere of activity of those providing medical and nursing care. As a consequence, a necessary business decision taken by the management to improve the productivity of medical and nursing activities can lead to serious deficits on the staff side. In terms of business ethics, this is a lack of beneficence toward individual staff members that are perhaps overtaxed, and at the same time, in terms of medical ethics, a potential lack of beneficence toward hospital patients is implicitly accepted. In general, management has the responsibility for bringing about, in the day-to-day operation of a hospital, a plausible reconciliation of the ethical principles of two spheres of activity that are only apparently independent of each other.

Moral reasoning among professional caregivers in nursing homes.

PubMed

Mattiasson, A C; Andersson, L

1995-06-01

This article examines the responses from a sample of Swedish nursing home staff workers to a hypothetical ethical conflict highlighting the issue of restraint. The responses were analyzed in two ways: first, Piaget's theory of moral development was used to differentiate between "autonomous" and "heteronomous" awareness, and second, the responses were analyzed from the perspective of ethical principles, that is, autonomy, beneficence, nonmaleficence, and justice. The findings indicate that autonomous ethical awareness took precedence over heteronomous ethical awareness. The dominant moral values were the principle of beneficence, followed by the principle of autonomy.

Ethics needs principles—four can encompass the rest—and respect for autonomy should be "first among equals"

PubMed Central

Gillon, R

2003-01-01

It is hypothesised and argued that "the four principles of medical ethics" can explain and justify, alone or in combination, all the substantive and universalisable claims of medical ethics and probably of ethics more generally. A request is renewed for falsification of this hypothesis showing reason to reject any one of the principles or to require any additional principle(s) that can't be explained by one or some combination of the four principles. This approach is argued to be compatible with a wide variety of moral theories that are often themselves mutually incompatible. It affords a way forward in the context of intercultural ethics, that treads the delicate path between moral relativism and moral imperialism. Reasons are given for regarding the principle of respect for autonomy as "first among equals", not least because it is a necessary component of aspects of the other three. A plea is made for bioethicists to celebrate the approach as a basis for global moral ecumenism rather than mistakenly perceiving and denigrating it as an attempt at global moral imperialism. PMID:14519842

Nuclear weapons and medicine: some ethical dilemmas.

PubMed Central

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

1983-01-01

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

[Selected ethical problems of oncologic patients during the terminal period].

PubMed

Iwaszczyszyn, J; Kwiecińska, A

2001-01-01

Patient suffering from terminal disease is depended on his environment more than any other one. He often suffers from nervous break down, anxiety and fear and he is usually unprotected from the environment. Fast development of medical science and its technicisation can lead towards dehumanization and lack of psychological and spiritual care, which should be based on clear ethical principles. Main lines of ethical principles of Health Service which are included in Deontological Code of Physicians and Collection of ethical principles for a qualified nurse are the main rules how to proceed as to fulfill the rule: "benefit of a patient is the superior law." According to its speciality Palliative Medicine introduces also four general ethical principles: 1. Patient will is a rule of treatment. 2. The principle of proportion--benefits from the treatment should be higher than losses and suffering from iatrogenic acting. 3. The principle of equality--stop taking a cure does not differ from not undertaking treatment. 4. The principle of relativity--life is not an absolute good, death is not an absolute evil. Holistic acts of Palliative Medicine determines also specific ethical attitudes, especially in the following: 1. Communication between a therapist and a patient and his family (interpersonal attitudes). 2. Procedures how to lessen suffering and its interpretation according to culture, tradition and religion ("nonsense and significance of suffering"). 3. Negation of euthanasia. 4. Spiritual, psychological and social care of patients.

Translational research-the need of a new bioethics approach.

PubMed

Hostiuc, Sorin; Moldoveanu, Alin; Dascălu, Maria-Iuliana; Unnthorsson, Runar; Jóhannesson, Ómar I; Marcus, Ioan

2016-01-15

Translational research tries to apply findings from basic science to enhance human health and well-being. Many phases of the translational research may include non-medical tasks (information technology, engineering, nanotechnology, biochemistry, animal research, economy, sociology, psychology, politics, and so on). Using common bioethics principles to these areas might sometimes be not feasible, or even impossible. However, the whole process must respect some fundamental, moral principles. The purpose of this paper is to argument the need for a different approach to the morality in translational bioethics, and to suggest some directions that might be followed when constructing such a bioethics. We will show that a new approach is needed and present a few ethical issues that are specific to the translational research.

Psychotherapy of the victims of massive violence: countertransference and ethical issues.

PubMed

Kinzie, J D; Boehnlein, J K

1993-01-01

Psychotherapy with severely traumatized patients is a long, draining process that often produces strong countertransference reactions. It is difficult to therapeutically and ethically handle these personal responses. We feel that at different stages in therapy different ethical principles should guide the therapy. At the early stages, fidelity and nonmaleficence should be the guiding principles. As trust and confidence develop, therapists may have more personal freedom to act; beneficence, i.e., providing specific confident care then becomes the primary ethical principle. In later stages of therapy, promoting the principles of autonomy and justice come into play. As therapy further progresses, therapists' own needs, the principle of self-interest, may be utilized in the therapeutic relationship. Throughout therapeutic contacts with traumatized patients, therapists need to monitor their own needs, and find appropriate ways outside of therapy to cope with these often intense feelings. Continuing to feel therapeutically competent and ethically grounded, yet maintaining the personal strength and balance to treat traumatized patients, pose major challenges for therapists.

The ethics of research using electronic mail discussion groups.

PubMed

Kralik, Debbie; Warren, Jim; Price, Kay; Koch, Tina; Pignone, Gino

2005-12-01

The aim of this paper is to identify and discuss the ethical considerations that have confronted and challenged the research team when researchers facilitate conversations using private electronic mail discussion lists. The use of electronic mail group conversations, as a collaborative data generation method, remains underdeveloped in nursing. Ethical challenges associated with this approach to data generation have only begun to be considered. As receipt of ethics approval for a study titled; 'Describing transition with people who live with chronic illness' we have been challenged by many ethical dilemmas, hence we believe it is timely to share the issues that have confronted the research team. These discussions are essential so we can understand the possibilities for research interaction, communication, and collaboration made possible by advanced information technologies. Our experiences in this study have increased our awareness for ongoing ethical discussions about privacy, confidentiality, consent, accountability and openness underpinning research with human participants when generating data using an electronic mail discussion group. We describe how we work at upholding these ethical principles focusing on informed consent, participant confidentiality and privacy, the participants as threats to themselves and one another, public-private confusion, employees with access, hackers and threats from the researchers. A variety of complex issues arise during cyberspace research that can make the application of traditional ethical standards troublesome. Communication in cyberspace alters the temporal, spatial and sensory components of human interaction, thereby challenging traditional ethical definitions and calling to question some basic assumptions about identity and ones right to keep aspects of it confidential. Nurse researchers are bound by human research ethics protocols; however, the nature of research by electronic mail generates moral issues as well as ethical concerns. Vigilance by researchers is required to ensure that data are viewed within the scope of the enabling ethics approval.

[AN EVALUATION OF JUSTICE AND RIGHT TO HEALTH CONCEPTS IN THE PERSPECTIVES OF ETHICAL THEORIES].

PubMed

Ekmekçi, Perihan Elif; Arda, Berna

Right to health is considered as a fundamental human right. However the realization of right to health is facing obstacles due to the scarce resources which are needed for the provision of health services. Besides the vast technological improvements in medical area leads to the development of diagnosis and treatment possibilities each and every day. Thus, the provision of health services becomes a subject of distributive justice. To define the concept of justice, first one should identify the conditions of demanding right to have something and then determine how and who is obliged to give the deserved. Ethical theories form their own paradigms of acting right regarding their anchor points and priority values. The basic concepts such as justice or right to health are considered and conceptualized within the paradigms of the ethical theories. Thus some ethical theories consider right to health as a natural constituent of human being, while some may consider it contextual and others may reject it completely. In a similar vein, justice and related concepts of justice such as formal and material principles of justice differ regarding the paradigm of the ethical theory in which we position ourselves. The paradigms of ethical theories demand different approaches from each other both in defining the concepts and implementations in practical life. This paper sets forth how justice and right to health is conceptualized in the virtue ethics, deontological ethics, liberal ethical theory and communitarian ethical theories. To this end first the general frame of each ethical theory and how justice is conceptualized within this frame is defined. Following that a discussion of the possibility of justification of the right to health within the context of ethical theory is perused.

The unethical focus on access: a study of medical ethics and the waiting-time guarantee.

PubMed

Karlberg, H I; Brinkmo, B-M

2009-03-01

All civilized societies favour ethical principles of equity. In healthcare, these principles generally focus on needs for medical care. Methods for establishing priorities among such needs are instrumental in this process. In this study, we analysed whether rules on access to healthcare, waiting-time guarantees, conflict with ethical principles of distributive justice. We interviewed directors, managers and other decision-makers of various healthcare providers of hospitals, primary care organizations and purchasing offices. We also conducted focus group interviews with professionals from a number of distinct medical areas. Our informants and their co-workers were reasonably familiar with the ethical platforms for priority-setting established by the Swedish parliament, giving the sickest patients complete priority. However, to satisfy the waiting-time guarantees, the informants often had to make priority decisions contrary to the ethical principles by favouring access before needs to keep waiting times within certain limits. The common opinion was that the waiting-time guarantee leads to crowding-out effects, overruling the ethical principles based on needs. For more than a decade, the interpretation in Sweden of the equitable principle based on medical needs has been distorted through political decisions, leading to healthcare providers giving priority to access rather than needs for care.

Differences in Moral Judgment on Animal and Human Ethics Issues between University Students in Animal-Related, Human Medical and Arts Programs.

PubMed

Verrinder, Joy M; Ostini, Remo; Phillips, Clive J C

2016-01-01

Moral judgment in relation to animal ethics issues has rarely been investigated. Among the research that has been conducted, studies of veterinary students have shown greater use of reasoning based on universal principles for animal than human ethics issues. This study aimed to identify if this was unique to students of veterinary and other animal-related professions. The moral reasoning of first year students of veterinary medicine, veterinary technology, and production animal science was compared with that of students in non-animal related disciplines of human medicine and arts. All students (n = 531) completed a moral reasoning test, the VetDIT, with animal and human scenarios. When compared with reasoning on human ethics issues, the combined group of students evaluating animal ethics issues showed higher levels of Universal Principles reasoning, lower levels of Personal Interest reasoning and similar levels of Maintaining Norms reasoning. Arts students showed more personal interest reasoning than students in most animal-related programs on both animal and human ethics issues, and less norms-based reasoning on animal ethics issues. Medical students showed more norms-based reasoning on animal ethics issues than all of the animal-related groups. There were no differences in principled reasoning on animal ethics issues between program groups. This has implications for animal-related professions and education programs showing that students' preference for principled reasoning on animal ethics issues is not unique to animal-related disciplines, and highlighting the need to develop student (and professional) capacity to apply principled reasoning to address ethics issues in animal industries to reduce the risk of moral distress.

Minors and euthanasia: a systematic review of argument-based ethics literature.

PubMed

Cuman, Giulia; Gastmans, Chris

2017-07-01

Euthanasia was first legalised in the Netherlands in 2002, followed by similar legislation in Belgium the same year. Since the beginning, however, only the Netherlands included the possibility for minors older than 12 years to request euthanasia. In 2014, the Belgian Act legalising euthanasia was amended to include requests by minors who possess the capacity of discernment. This amendment sparked great debate, and raised difficult ethical questions about when and how a minor can be deemed competent. We conducted a systematic review of argument-based literature on euthanasia in minors. The search process followed PRISMA guidelines. Thirteen publications were included. The four-principle approach of medical ethics was used to organise the ethical arguments underlying this debate. The justification for allowing euthanasia in minors is buttressed mostly by the principles of beneficence and respect for autonomy. Somewhat paradoxically, both principles are also used in the literature to argue against the extension of legislation to minors. Opponents of euthanasia generally rely on the principle of non-maleficence. The present analysis reveals that the debate surrounding euthanasia in minors is at an early stage. In order to allow a more in-depth ethical discussion, we suggest enriching the four-principle approach by including a care-ethics approach. What is Known: • The Netherlands and Belgium are the only two countries in the world with euthanasia legislation making it possible for minors to receive euthanasia. • This legislation provoked great debate globally, with ethical arguments for and against this legislation. What is New: • A systematic description of the ethical concepts and arguments grounding the debate on euthanasia in minors, as reported in the argument-based ethics literature. • A need has been identified to enrich the debate with a care-ethics approach to avoid oversimplifying the ethical decision-making process.

Differences in Moral Judgment on Animal and Human Ethics Issues between University Students in Animal-Related, Human Medical and Arts Programs

PubMed Central

Verrinder, Joy M.; Ostini, Remo; Phillips, Clive J. C.

2016-01-01

Moral judgment in relation to animal ethics issues has rarely been investigated. Among the research that has been conducted, studies of veterinary students have shown greater use of reasoning based on universal principles for animal than human ethics issues. This study aimed to identify if this was unique to students of veterinary and other animal-related professions. The moral reasoning of first year students of veterinary medicine, veterinary technology, and production animal science was compared with that of students in non-animal related disciplines of human medicine and arts. All students (n = 531) completed a moral reasoning test, the VetDIT, with animal and human scenarios. When compared with reasoning on human ethics issues, the combined group of students evaluating animal ethics issues showed higher levels of Universal Principles reasoning, lower levels of Personal Interest reasoning and similar levels of Maintaining Norms reasoning. Arts students showed more personal interest reasoning than students in most animal-related programs on both animal and human ethics issues, and less norms-based reasoning on animal ethics issues. Medical students showed more norms-based reasoning on animal ethics issues than all of the animal-related groups. There were no differences in principled reasoning on animal ethics issues between program groups. This has implications for animal-related professions and education programs showing that students’ preference for principled reasoning on animal ethics issues is not unique to animal-related disciplines, and highlighting the need to develop student (and professional) capacity to apply principled reasoning to address ethics issues in animal industries to reduce the risk of moral distress. PMID:26934582

Ethical Considerations of Community-based Participatory Research: Contextual Underpinnings for Developing Countries

PubMed Central

Jamshidi, Ensiyeh; Morasae, Esmaeil Khedmati; Shahandeh, Khandan; Majdzadeh, Reza; Seydali, Elham; Aramesh, Kiarash; Abknar, Nina Loori

2014-01-01

Background: The nature of community-based participatory research (CBPR) poses distinctive ethical challenges. In the absence of organized guidelines, a remarkable amount of researchers’ time and energy will be spent tackling these ethical challenges. The study aimed to explore ethical issues and principles potentially arising when conducting CBPR. Methods: This qualitative study conducted in CBPR Center of Tehran University of Medical Sciences. Required data were gathered through systematic literature review and semi-structured interviews. Representatives of community, academia, and nongovernmental organizations (NGOs) participated in our study. Ten interviews with representatives of partner organizations, four group interviews with academic staff, and four with representatives of community were conducted. Repeated thematic analysis was used to elicit ethics-related overarching themes from transcribed interviews. As recommendations, these themes were then organized into a set of CBPR-related ethical issues and principles. Results: Four CBPR ethical guidelines (including 173 articles) were selected from a systematic review. Overarching themes relating to ethical principles which emerged from interviews were as follows: Trust, transparency and accountability, equity and inclusion, power imbalance, tolerance and conflict management, and attention to cultural sensitivity. Practical principles that emerged included: Consensus rather than informed consent, ownership of data and research achievements, and sustainability and maintenance of relationships. According to findings and in comparison to international guidelines, the present study put more emphasis on cultural sensitivity and sustainability as CBPR ethical tangles. Conclusions: Community-based participatory research ethical challenges are of the same kind in most parts of the world. However, some discrepancies exist that calls for local scrutiny. Future use and critic of current explored ethical issues and principles are highly encouraged. PMID:25400893

5 CFR 2635.101 - Basic obligation of public service.

Code of Federal Regulations, 2010 CFR

2010-01-01

....101 Section 2635.101 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.101 Basic... United States Government and its citizens to place loyalty to the Constitution, laws and ethical...

5 CFR 2635.101 - Basic obligation of public service.

Code of Federal Regulations, 2011 CFR

2011-01-01

....101 Section 2635.101 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.101 Basic... United States Government and its citizens to place loyalty to the Constitution, laws and ethical...

5 CFR 2635.101 - Basic obligation of public service.

Code of Federal Regulations, 2013 CFR

2013-01-01

....101 Section 2635.101 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.101 Basic... United States Government and its citizens to place loyalty to the Constitution, laws and ethical...

5 CFR 2635.101 - Basic obligation of public service.

Code of Federal Regulations, 2012 CFR

2012-01-01

....101 Section 2635.101 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.101 Basic... United States Government and its citizens to place loyalty to the Constitution, laws and ethical...

5 CFR 2635.101 - Basic obligation of public service.

Code of Federal Regulations, 2014 CFR

2014-01-01

....101 Section 2635.101 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.101 Basic... United States Government and its citizens to place loyalty to the Constitution, laws and ethical...

A Basic Unit on Ethics for Technical Communicators.

ERIC Educational Resources Information Center

Markel, Mike

1991-01-01

Describes a basic unit on ethics for technical communicators and offers suggestions on how to go about teaching the unit. Includes a brief definition of ethics, an explanation of the employee's three basic obligations, ways to analyze common dilemmas in technical communication, the role of the code of conduct, and a case study. (SR)

Teaching ethical analysis in occupational therapy.

PubMed

Haddad, A M

1988-05-01

Ethical decision making is a cognitive skill requiring education in ethical principles and an understanding of specific ethical issues. It is also a psychodynamic process involving personalities, values, opinions, and perceptions. This article proposes the use of case studies and role-playing techniques in teaching ethics in occupational therapy to supplement conventional methods of presenting ethical theories and principles. These two approaches invite students to discuss and analyze crucial issues in occupational therapy from a variety of viewpoints. Methodology of developing case studies and role-playing exercises are discussed. The techniques are evaluated and their application to the teaching of ethics is examined.

Measuring 'virtue' in medicine.

PubMed

Kotzee, Ben; Ignatowicz, Agnieszka

2016-06-01

Virtue-approaches to medical ethics are becoming ever more influential. Virtue theorists advocate redefining right or good action in medicine in terms of the character of the doctor performing the action (rather than adherence to rules or principles). In medical education, too, calls are growing to reconceive medical education as a form of character formation (rather than instruction in rules or principles). Empirical studies of doctors' ethics from a virtue-perspective, however, are few and far between. In this respect, theoretical and empirical study of medical ethics are out of alignment. In this paper, we survey the empirical study of medical ethics and find that most studies of doctors' ethics are rules- or principles-based and not virtue-based. We outline the challenges that exist for studying medical ethics empirically from a virtue-based perspective and canvas the runners and riders in the effort to find virtue-based assessments of medical ethics.

Ethical Principles, Practices, and Problems in Higher Education.

ERIC Educational Resources Information Center

Baca, M. Carlota, Ed.; Stein, Ronald H., Ed.

Eighteen professionals analyze the ethical principles, practices, and problems in institutions of higher learning by examining the major issues facing higher education today. Focusing on ethical standards and judgements that affect decision-making and problem-solving, the contributors review the rights and responsibilities of academic freedom,…

Ethical issues in research.

PubMed

Artal, Raul; Rubenfeld, Sheldon

2017-08-01

Biomedical research is currently guided by ethical standards that have evolved over many centuries. Historical and political events, social and legal considerations, and continuous medical and technological advances have led to the prevailing research ethics and practice. Currently, patients and research subjects have complete autonomy while under medical care or when volunteering as research subjects. Enrolling volunteers in human subjects research includes a detailed and meaningful informed consent process that follows the cardinal principles of ethics: autonomy, beneficence, nonmaleficence, and justice. These principles were gradually adopted after World War II, primarily in response to the unethical behavior of German physicians and scientists during the Third Reich. This review emphasizes the importance of historical milestones and the essential role that ethics has in contemporary medical research. Research protocols should achieve maximum benefits for the society, have clinical and scientific value, be subject to independent review, respect human dignity, and follow the principles of informed consent, and most importantly, subjects should have complete autonomy. However, current principles and regulations cannot cover every conceivable situation, particularly in view of the new advances in science and technology. New and evolving medical technology, genetic research, therapeutic interventions, and innovations challenge society to maintain the highest moral and ethical principles. Copyright © 2017. Published by Elsevier Ltd.

Research Ethics in the Era of Personalized Medicine: Updating Science's Contract with Society

PubMed Central

Meslin, Eric M.; Cho, Mildred K.

2010-01-01

With the completed sequence of the human genome has come the prospect of substantially improving the quality of life for millions through personalized medicine approaches. Still, any advances in this direction require research involving human subjects. For decades science and ethics have enjoyed an allegiance reflected in a common set of ethical principles and procedures guiding the conduct of research with human subjects. Some of these principles emphasize avoiding harm over maximizing benefit. In this paper we revisit the priority given to these ethical principles – particularly the principles that support a cautious approach to science – and propose a reframing of the ‘social contract’ between science and society that emphasizes reciprocity and meeting public needs. PMID:20805701

Ethics Teaching in Higher Education for Principled Reasoning: A Gateway for Reconciling Scientific Practice with Ethical Deliberation.

PubMed

Aközer, Mehmet; Aközer, Emel

2017-06-01

This paper proposes laying the groundwork for principled moral reasoning as a seminal goal of ethics interventions in higher education, and on this basis, makes a case for educating future specialists and professionals with a foundation in philosophical ethics. Identification of such a seminal goal is warranted by (1) the progressive dissociation of scientific practice and ethical deliberation since the onset of a problematic relationship between science and ethics around the mid-19th century, and (2) the extensive mistrust of integrating ethics in science and engineering curricula beyond its "applied," "practical," or "professional" implications. Although calls by international scientific and educational bodies to strengthen ethics teaching in scientific education over the past quarter century have brought about a notion of combining competence in a certain field with competence in ethics, this is neither entrenched in the academic community, nor fleshed out as regards its core or instruments to realize it. The legitimate goals of ethics teaching in higher education, almost settled since the 1980s, can be subsumed under the proposed seminal goal, and the latter also would safeguard content and methods of ethics interventions against the intrusion of indoctrinative approaches. In this paper, derivation of the proposed seminal goal rests on an interpretation of the Kohlbergian cognitive-developmental conception of moral adulthood consisting in autonomous principled moral reasoning. This interpretation involves, based on Kant's conception of the virtuous person, integrating questions about the "good life" into the domain of principled reasoning.

Research Ethics: Institutional Review Board Oversight of Art Therapy Research

ERIC Educational Resources Information Center

Deaver, Sarah P.

2011-01-01

By having their research proposals reviewed and approved by Institutional Review Boards (IRBs), art therapists meet important ethical principles regarding responsibility to research participants. This article provides an overview of the history of human subjects protections in the United States; underlying ethical principles and their application…

Ethical and Legal Issues Regarding Selective Abortion of Fetuses with Down Syndrome.

ERIC Educational Resources Information Center

Glover, Noreen M.; Glover, Samuel J.

1996-01-01

Selective abortion of fetuses with Down syndrome is discussed in terms of abortion perspectives, genetic testing, legislation, and ethical principles. The ethical principles of autonomy, beneficence, nonmaleficence, fidelity, and justice are offered as guidelines for the examination of legal standards imposed by legislation. (Author/PB)

Core ethical values of radiological protection applied to Fukushima case: reflecting common morality and cultural diversities.

PubMed

Kurihara, Chieko; Cho, Kunwoo; Toohey, Richard E

2016-12-01

The International Commission on Radiological Protection (ICRP) has established Task Group 94 (TG94) to develop a publication to clarify the ethical foundations of the radiological protection system it recommends. This TG identified four core ethical values which structure the system: beneficence and non-maleficence, prudence, justice, and dignity. Since the ICRP is an international organization, its recommendations and guidance should be globally applicable and acceptable. Therefore, first this paper presents the basic principles of the ICRP radiological protection system and its core ethical values, along with a reflection on the variation of these values in Western and Eastern cultural traditions. Secondly, this paper reflects upon how these values can be applied in difficult ethical dilemmas as in the case of the emergency and post-accident phases of a nuclear power plant accident, using the Fukushima case to illustrate the challenges at stake. We found that the core ethical values underlying the ICRP system of radiological protection seem to be quite common throughout the world, although there are some variations among various cultural contexts. Especially we found that 'prudence' would call for somewhat different implementation in each cultural context, balancing and integrating sometime conflicting values, but always with objectives to achieve the well-being of people, which is itself the ultimate aim of the radiological protection system.

Emergency department triage: an ethical analysis

PubMed Central

2011-01-01

Background Emergency departments across the globe follow a triage system in order to cope with overcrowding. The intention behind triage is to improve the emergency care and to prioritize cases in terms of clinical urgency. Discussion In emergency department triage, medical care might lead to adverse consequences like delay in providing care, compromise in privacy and confidentiality, poor physician-patient communication, failing to provide the necessary care altogether, or even having to decide whose life to save when not everyone can be saved. These consequences challenge the ethical quality of emergency care. This article provides an ethical analysis of "routine" emergency department triage. The four principles of biomedical ethics - viz. respect for autonomy, beneficence, nonmaleficence and justice provide the starting point and help us to identify the ethical challenges of emergency department triage. However, they do not offer a comprehensive ethical view. To address the ethical issues of emergency department triage from a more comprehensive ethical view, the care ethics perspective offers additional insights. Summary We integrate the results from the analysis using four principles of biomedical ethics into care ethics perspective on triage and propose an integrated clinically and ethically based framework of emergency department triage planning, as seen from a comprehensive ethics perspective that incorporates both the principles-based and care-oriented approach. PMID:21982119

Reflections on the EPSRC Principles of Robotics from the new far-side of the law

NASA Astrophysics Data System (ADS)

Voiculescu, Aurora

2017-04-01

The thought-provoking EPSRC Principles of Robotics stem largely from the reflection on the extent to which robots can affect our lives. These comments highlight the fact that, while the principles may address to a good extent the present technological challenges, they appear to be less immediately suited for future technological and conceptual dares. The first part of the paper is dedicated to the search of the definition of what a robot is. Such a definition should offer the basic conceptual platform on which a normative endeavour, aiming to regulate robots in society, should be based. Concluding that the Principles offer no clear yet flexible insight into such a (meta-) definition, which would allow one to take into account the parameters of informed technological imagination and of envisaged social transformation, the second half of the paper highlights a number of regulatory points of tension. Such tensions, it is argued, stem largely from the absence of an appropriate conceptual platform, influencing negatively the extent to which the principles can be effective in guiding social, ethical, legal and scientific conduct.

Ethical Standards of the American Association for Counseling and Development.

ERIC Educational Resources Information Center

Journal of Counseling and Development, 1988

1988-01-01

Presents principles that define the ethical behavior of American Association for Counseling and Development members. In addition to 11 general principles, includes principles on the counseling relationship, measurement and evaluation, research and publication, consulting, private practice, personnel administration, and preparation standards. (ABL)

Global ethics and principlism.

PubMed

Gordon, John-Stewart

2011-09-01

This article examines the special relation between common morality and particular moralities in the four-principles approach and its use for global ethics. It is argued that the special dialectical relation between common morality and particular moralities is the key to bridging the gap between ethical universalism and relativism. The four-principles approach is a good model for a global bioethics by virtue of its ability to mediate successfully between universal demands and cultural diversity. The principle of autonomy (i.e., the idea of individual informed consent), however, does need to be revised so as to make it compatible with alternatives such as family- or community-informed consent. The upshot is that the contribution of the four-principles approach to global ethics lies in the so-called dialectical process and its power to deal with cross-cultural issues against the background of universal demands by joining them together.

Communicative Management in Ambulatory Services: Prehospital Management Communication--Limits and Possibilities.

PubMed

Nordby, Halvor

2015-01-01

Poor management communication in healthcare services affects employees' motivation, commitment, and, in the final instance, organizational performance and the quality of patient care. In any area of health management, good communication is, therefore, key to successful management. This article discusses how managers of ambulance stations should secure communication with their paramedic crews. The first part uses ethical concepts to analyze communicative disagreement in interactive dialogue between managers and paramedics. The second part outlines basic communication principles that can serve as conceptual tools for avoiding misinterpretation in prehospital manager-employee interaction.

Ethics of clinical trials.

PubMed

Palter, S F

1996-05-01

The modern clinical trial is a form of human experimentation. There is a long history of disregard for individual rights of the patient in this context, and special attention must be paid to ethical guidelines for these studies. Clinical trials differ in basic ways from clinical practice. Foremost is the introduction of outside interests, beyond those of the patient's health, into the doctor-patient therapeutic alliance. Steps must be taken to protect the interests of the patient when such outside influence exists. Kantian moral theory and the Hippocratic oath dictate that the physician must respect the individual patient's rights and hold such interests paramount. These principles are the basis for informed consent. Randomization of patients is justified when a condition of equipoise exists. The changing nature of health care delivery in the United States introduces new outside interests into the doctor-patient relationship.

The philosophical moment of the medical decision: revisiting emotions felt, to improve ethics of future decisions

PubMed Central

Coz, Pierre Le; Tassy, Sebastien

2007-01-01

The present investigation looks for a solution to the problem of the influence of feelings and emotions on our ethical decisions. This problem can be formulated in the following way. On the one hand, emotions (fear, pity and so on) can alter our sense of discrimination and lead us to make our wrong decisions. On the other hand, it is known that lack of sensitivity can alter our judgment and lead us to sacrifice basic ethical principles such as autonomy, beneficence, non‐maleficence and justice. Only emotions can turn a decision into an ethical one, but they can also turn it into an unreasonable one. To avoid this contradiction, suggest integrating emotions with the decisional factors of the process of “retrospective thinking”. During this thinking, doctors usually try to identify the nature and impact of feelings on the decision they have just made. In this retrospective moment of analysis of the decision, doctors also question themselves on the feelings they did not experience. They do this to estimate the consequences of this lack of feeling on the way they behaved with the patient. PMID:17664307

Ethical Principles of Psychologists (Amended June 2, 1989).

ERIC Educational Resources Information Center

American Psychologist, 1990

1990-01-01

Reports the amended ethical principles of psychologists (June 2, 1989). The following principles are covered: (1) responsibility; (2) competence; (3) moral and legal standards; (4) public statements; (5) confidentiality; (6) welfare of the consumer; (7) professional relationships; (8) assessment techniques; (9) research with human participants;…

Ethical Principles: Guiding the Use of Animals in Research.

ERIC Educational Resources Information Center

Morrison, Adrian R.

2003-01-01

Presents arguments on the use of animals in biological and medical research. Discusses ethical considerations, principles, and animal rights in scientific research. (Contains 21 references.) (Author/YDS)

A Life Below the Threshold?: Examining Conflict Between Ethical Principles and Parental Values in Neonatal Treatment Decision Making.

PubMed

Cunningham, Thomas V

2016-01-01

Three common ethical principles for establishing the limits of parental authority in pediatric treatment decision-making are the harm principle, the principle of best interest, and the threshold view. This paper considers how these principles apply to a case of a premature neonate with multiple significant co-morbidities whose mother wanted all possible treatments, and whose health care providers wondered whether it would be ethically permissible to allow him to die comfortably despite her wishes. Whether and how these principles help in understanding what was morally right for the child is questioned. The paper concludes that the principles were of some value in understanding the moral geography of the case; however, this case reveals that common bioethical principles for medical decision-making are problematically value-laden because they are inconsistent with the widespread moral value of medical vitalism.

Ethical issues and accountability in pressure ulcer prevention.

PubMed

Welsh, Lynn

2014-10-28

Pressure ulcers represent a considerable cost, both in terms of healthcare spending and quality of life. They are increasingly viewed in terms of patient harm. For clinicians involved in pressure ulcer prevention, ethical issues surrounding accountability may arise from both policy and practice perspectives. It may be useful for clinicians to refer to ethical theories and principles to create frameworks when addressing ethical dilemmas. However, such theories and principles have been criticised for their simplicity and over-generalisation. Alternative theories, for example, virtue ethics and experiential learning, can provide more comprehensive guidance and promote a pluralistic approach to tackling ethical dilemmas.

EcoWellness & Guiding Principles for the Ethical Integration of Nature into Counseling

ERIC Educational Resources Information Center

Reese, Ryan F.

2016-01-01

Connection with nature impacts human wellness, yet few resources currently exist in the international literature to help guide clinicians in the ethical integration of EcoWellness into therapeutic processes. Ethical principles for EcoWellness practice are introduced and linked to applicable portions of the American Counseling Association's (2014)…

Human Resource Development (HRD) Evaluation and Principles Related to the Public Interest

ERIC Educational Resources Information Center

Russ-Eft, Darlene F.

2009-01-01

This paper examines the issues involved in the use of ethical standards related to social responsibility using the two ethical codes: the American Evaluation Association "Guiding Principles for Evaluators" and the Academy of Human Resource Development "Standards on Ethics and Integrity." This examination will take the perspective of an internal…

Ethical Issues in the Use of Humans for Research.

ERIC Educational Resources Information Center

Bashaw, W. L.

The APA Ethical Principles, the University of Georgia policy, standard research texts, and research literature on specific methodologies, all in relation to ethical issues in human research, are discussed. The 10 APA principles state, in essence, that the investigator is responsible for what happens, that confidentiality and the protection of the…

Principles and Ethics for Elementary and Junior High School Teachers

ERIC Educational Resources Information Center

Howard, Kiffany

2010-01-01

The rules and principles approach for developing educators' ethical judgment may be less effective than a centered approach. A centered approach being one that focuses solely on the elementary and junior high teachers. Educators understand the moral and ethical convolution of their role; possess expertise in interpreting their behavior and…

Pharmacovigilance and principle of nonmaleficence in sex reassignment.

PubMed

Zamarytė, Kristina; Stakišaitis, Donatas; Širinskienė, Agnė; Narbekovas, Andrius; Juškevičius, Jonas

2012-01-01

Physicians are obliged to provide treatment that is consistent with their commitment to avoid or minimize harm (nonmaleficence) and their commitment to do good (beneficence). Therefore, if patient's desires were contradictory to the primary aim of medicine, the doctor's calling would require him/her to thoroughly analyze the cause of the disease and provide an adequate as well as ethical treatment rather than obediently follow patient's requests. Yet, chemical and surgical sex reassignment is one of the areas where some physicians surrender to the desire of their patients instead of finding out what their real condition is and trying to manage it in a way the essence of medicine would require. The objective of this article was to provide specific pharmacovigilance search details for the evaluation of the current situation and the scientific background of the treatment of gender dysphoria and to analyze its conformity with one of the two main ethical principles of medicine - nonmaleficence. Literature retrieval was accessed through Medline (1979-2011) using the terms "gender dysphoria," "replacement hormonal therapy," and "pharmacovigilance." The article concludes that hormonal and surgical interventions have not proven to be medically justified and could be harmful, not treating the cause, but resulting in irreversible disability. Thus, these interventions contradict the principle of nonmaleficence and goals of basic therapeutics and pharmacovigilance. They are not based on clinical trials and are lacking a thorough follow-up assessment.

Using routinely collected health data for surveillance, quality improvement and research: Framework and key questions to assess ethics, privacy and data access.

PubMed

De Lusignan, Simon; Liyanage, Harshana; Di Iorio, Concetta Tania; Chan, Tom; Liaw, Siaw-Teng

2016-01-19

The use of health data for public health, surveillance, quality improvement and research is crucial to improve health systems and health care. However, bodies responsible for privacy and ethics often limit access to routinely collected health data. Ethical approvals, issues around protecting privacy and data access are often dealt with by different layers of regulations, making approval processes appear disjointed. To create a comprehensive framework for defining the ethical and privacy status of a project and for providing guidance on data access. The framework comprises principles and related questions. The core of the framework will be built using standard terminology definitions such as ethics-related controlled vocabularies and regional directives. It is built in this way to reduce ambiguity between different definitions. The framework is extensible: principles can be retired or added to, as can their related questions. Responses to these questions should allow data processors to define ethical issues, privacy risk and other unintended consequences. The framework contains three steps: (1) identifying possible ethical and privacy principles relevant to the project; (2) providing ethics and privacy guidance questions that inform the type of approval needed; and (3) assessing case-specific ethics and privacy issues. The outputs from this process should inform whether the balance between public interests and privacy breach and any ethical considerations are tipped in favour of societal benefits. If they are then this should be the basis on which data access is permitted. Tightly linking ethical principles to governance and data access may help maintain public trust.

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.

American College of Emergency Physicians Ethics Manual.

PubMed

1991-10-01

Ethical concerns are a major part of the clinical practice of emergency medicine. The emergency physician must make hard choices, not only with regard to the scientific/technical aspects but also with regard to the moral aspects of caring for emergency patients. By the nature of the specialty, emergency physicians face ethical dilemmas often requiring prompt decisions with limited information. This manual identifies important moral principles and values in emergency medicine. The underlying assumption is that a knowledge of moral principles and ethical values helps the emergency physician make responsible moral choices. Neither the scientific nor the moral aspects of clinical decision making can be reduced to simple formulas. Nevertheless, decisions must be made. Emergency physicians should, therefore, be cognizant of the ethical principles that are important for emergency medicine, understand the process of ethical reasoning, and be capable of making rational moral decisions based on a stable framework of values.

An Ethical Principle for Social Justice in Community Development Practice.

ERIC Educational Resources Information Center

Sabre, Ru Michael

1980-01-01

Defines community development and shows how community development as an educational process embodies an ethical principle which, when applied to the analysis of community practices, promotes justice. (JOW)

Knowledge, awareness and practice of ethics among doctors in tertiary care hospital.

PubMed

Singh, Surjit; Sharma, Pramod Kumar; Bhandari, Bharti; Kaur, Rimplejeet

2016-10-01

With the advancement of healthcare and medical research, doctors need to be aware of the basic ethical principles. This cross-sectional study is an attempt to assess the knowledge, awareness, and practice of health-care ethics among health-care professionals. After taking written informed consent, a standard questionnaire was administered to 117 doctors. No personal information was recorded on the questionnaire so as to ensure the confidentiality and anonymity of participants. Data analysis was done using SPSS version 21 (IBM Corp., Armonk, NY, USA). Statistically significant difference observed between the opinions of consultant and senior resident (SRs) on issues like, adherence to confidentiality; paternalistic attitude of doctors (doctors should do their best for the patient irrespective of patient's opinion); doctor's decision should be final in case of disagreement and interest in learning ethics ( P < 0.05). However, no difference reported among them with respect to patient wishes, informing patient regarding wrongdoing, informing close relatives, seeking consent for children and patients' consent for procedures. Furthermore, no significant difference observed between the two with respect to the practice of health-care ethics. Surprisingly, the response of clinical and nonclinical faculty did not differ as far as awareness and practice of ethics were concerned. The significant difference is observed in the knowledge, awareness, and practice of ethics among consultants and SRs. Conferences, symposium, and workshops, on health-care ethics, may act as a means of sensitizing doctors and thus will help to bridge this gap and protect the well-being and confidentiality of the patients. Such an effort may bring about harmonious change in the doctor-patient relationship.

[Fundamental principles of social work--(also) a contribution to public health ethics].

PubMed

Lob-Hüdepohl, A

2009-05-01

Social work and public health are different but mutually connected. Both are professions with their own ethical foundations. Despite all differences, they have the same goal: to protect and to enhance the well-being of people. This is, in part, why the fundamental ethical principles of social work are salient for developing public health ethics. As a human rights profession, social work respects the personal autonomy of clients, supports solidarity-based relationships in families, groups or communities, and attempts to uphold social justice in society. Social workers need to adopt special professional attitudes: sensibility for the vulnerabilities of clients, care and attentiveness for their resources and strengths, assistance instead of paternalistic care and advocacy in decision making for clients' well-being when clients are not able to decide for themselves. These fundamental ethical principles are the basis for discussion of special topics of social work ethics as public health ethics, for example, in justifying intervention in individual lifestyles by public services without the participation or consent of the affected persons.

Sustainability as an Ethical Principle: Ensuring Its Systematic Place in Professional Nursing Practice

PubMed Central

Riedel, Annette

2015-01-01

Alongside the central focus on the persons requiring nursing care in professional nursing practice, the perspective of the sustainability of interventions and the use of materials (for example, nursing aids and hygiene articles) is gaining prominence in nursing decision-making processes. This contribution makes the principle of sustainability concrete and delineates its importance in the context of professional nursing practice and decision-making. It further suggests the development of an ethical policy in order to systematically ensure that sustainability has a place in ethical reflection and decision-making, and describes the elements involved. Finally, a synthesis is made between the importance of the principle of sustainability, suggested ethical policies (system of ethical reflection) as they affect nursing practice and professional reflection, decision-making, and practice. PMID:27417590

Sustainability as an Ethical Principle: Ensuring Its Systematic Place in Professional Nursing Practice.

PubMed

Riedel, Annette

2015-12-30

Alongside the central focus on the persons requiring nursing care in professional nursing practice, the perspective of the sustainability of interventions and the use of materials (for example, nursing aids and hygiene articles) is gaining prominence in nursing decision-making processes. This contribution makes the principle of sustainability concrete and delineates its importance in the context of professional nursing practice and decision-making. It further suggests the development of an ethical policy in order to systematically ensure that sustainability has a place in ethical reflection and decision-making, and describes the elements involved. Finally, a synthesis is made between the importance of the principle of sustainability, suggested ethical policies (system of ethical reflection) as they affect nursing practice and professional reflection, decision-making, and practice.

The problem of 'thick in status, thin in content' in Beauchamp and Childress' principlism.

PubMed

Lee, Marvin J H

2010-09-01

For many, Thomas Beauchamp and James Childress have elaborated moral reasoning by using the four principles whereby all substantive problems of medical ethics (and of ethics more generally) can be properly analysed and cogent philosophical solutions for the problems can be found. It seems that their 'principlism' gets updated, with better features being added during the course of the six editions of Principles of Biomedical Ethics. Nonetheless, Beauchamp and Childress seem to have been losing their way when it comes to the common-morality justification, which is the epistemological (and perhaps metaphysical) backbone of their method, and this is shown more vividly in their most recent (2009) edition of Principles of Biomedical Ethics. The author points out what he calls the problem of 'thick in status, thin in content' in principlism. The problem exists because principlism cannot adequately explain how the prescriptive sense of common morality it supports is consistent with the existence of what Beauchamp and Childress call the 'legitimate moral diversity in the world'. Because of this problem, first, the practical end that principlism allegedly accomplishes (ie, providing practical moral guidelines in a relatively 'thick' content, based on common morality) is frustrated, and, second, principlism makes itself the method of common morality de jure and of moral pluralism de facto.

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

Hourdequin, Marion, E-mail: Marion.Hourdequin@ColoradoCollege.edu; Department of Philosophy, Colorado College, 14 E. Cache La Poudre St., Colorado Springs, CO 80903; Landres, Peter

Traditional mechanisms for public participation in environmental impact assessment under U.S. federal law have been criticized as ineffective and unable to resolve conflict. As these mechanisms are modified and new approaches developed, we argue that participation should be designed and evaluated not only on practical grounds of cost-effectiveness and efficiency, but also on ethical grounds based on democratic ideals. In this paper, we review and synthesize modern democratic theory to develop and justify four ethical principles for public participation: equal opportunity to participate, equal access to information, genuine deliberation, and shared commitment. We then explore several tensions that are inherentmore » in applying these ethical principles to public participation in EIA. We next examine traditional NEPA processes and newer collaborative approaches in light of these principles. Finally, we explore the circumstances that argue for more in-depth participatory processes. While improved EIA participatory processes do not guarantee improved outcomes in environmental management, processes informed by these four ethical principles derived from democratic theory may lead to increased public engagement and satisfaction with government agency decisions. - Highlights: Black-Right-Pointing-Pointer Four ethical principles based on democratic theory for public participation in EIA. Black-Right-Pointing-Pointer NEPA and collaboration offer different strengths in meeting these principles. Black-Right-Pointing-Pointer We explore tensions inherent in applying these principles. Black-Right-Pointing-Pointer Improved participatory processes may improve public acceptance of agency decisions.« less

In praise of unprincipled ethics.

PubMed

Harris, J

2003-10-01

In this paper a plea is made for an unprincipled approach to biomedical ethics, unprincipled of course just in the sense that the four principles are neither the start nor the end of the process of ethical reflection. While the four principles constitute a useful "checklist" approach to bioethics for those new to the field, and possibly for ethics committees without substantial ethical expertise approaching new problems, it is an approach which if followed by the bioethics community as a whole would, the author believes, lead to sterility and uniformity of approach of a quite mindbogglingly boring kind. Moreover, much of bioethics is not concerned with identifying the principles or values appropriate to a particular issue, but rather involves analysing the arguments that are so often already in play and which present themselves as offering solutions in one direction or another. Here, as I try to show in discussion of these four scenarios, the principles allow massive scope in interpretation and are, frankly, not wonderful as a means of detecting errors and inconsistencies in argument.

In praise of unprincipled ethics

PubMed Central

Harris, J

2003-01-01

In this paper a plea is made for an unprincipled approach to biomedical ethics, unprincipled of course just in the sense that the four principles are neither the start nor the end of the process of ethical reflection. While the four principles constitute a useful "checklist" approach to bioethics for those new to the field, and possibly for ethics committees without substantial ethical expertise approaching new problems, it is an approach which if followed by the bioethics community as a whole would, the author believes, lead to sterility and uniformity of approach of a quite mindbogglingly boring kind. Moreover, much of bioethics is not concerned with identifying the principles or values appropriate to a particular issue, but rather involves analysing the arguments that are so often already in play and which present themselves as offering solutions in one direction or another. Here, as I try to show in discussion of these four scenarios, the principles allow massive scope in interpretation and are, frankly, not wonderful as a means of detecting errors and inconsistencies in argument. PMID:14519841

The place for emotions in professional carers' thinking: reflections on two cases.

PubMed

Koren, E

2010-12-01

How do carers know what is right for their patient? What can they do further to relying on the two pillars of knowledge and ethics? Knowledge foregrounds rational decision-making based on scientific evidence. It allows cost-benefit rationalization and the choice of the best feasible objective. The steady advance of medical science drives responsible carers to keep their knowledge and skills up-to-date. Bioethics grants primary attention to the prevention of causing harm in general, to pursuant of patients' subjective wellbeing and to allow the latter enjoy their autonomy and to guarantee them the sense of justice. There are, however, cases where these values collide and any care decision violates one principle or another. How are carers expected to act then? This article concerns the choices made by carers, as presented and discussed in two cases. These cases deal with a clash between two principles: parenthood vs. fertility, religious rite vs. social affiliation. This class has generated an ethical dilemma. In each case carers try to justify their choices by expert knowledge and other ethical values, but later reflection reveals that the predominant element in 'solving' these dilemmas was "emotions." Professional training submits that: 'Set aside feelings in order to keep your thinking 'straight.' However, reality proves this simply infeasible. The more complex the medical-ethical situation, it is more likely that "emotions" take over. We have no choice as responsible carers but to allow our emotions the status of a factor of influence in their own right. Nowadays, a basic medical training for doctors and nurses offers an integrated body of knowledge and therapeutic skills. In addition, trainees are introduced to bioethics, supposedly sufficient to guide their future steps in their chosen profession. But how does this training in fact shape their future ethical conduct, if at all? How does it affect their ability to maintain ethical responsibility throughout therapeutic interactions? Perhaps there are other factors which govern the individual's conduct and his/her ethical responsibility? Simulation exercises were conducted, designed to induce healthcare professionals to reflect on the ethics of their own decision-making. The results demonstrated that therapeutic skills and familiarity with bioethical principles are not the sole factors governing the individual's ethical conduct. It turns out that emotions and feelings play a key part; this at once raises the question as to whether a medical training for doctors and nurses, in its current format, concerns itself with emotions and with how emotions shape a therapeutic personality. If not, then our training designers have food for thought. How can such training make trainees more aware of the power of their emotions? And, what are the ramifications on daily practice concerning ethical responsibility? Another question concerns the possible proper methods for mastering the theoretical materials and the practical techniques that promote emotional self-development?

Advancing an ethical framework for long-term care.

PubMed

Carter, Mary Whelan

2002-02-01

This article represents an effort to formulate an ethical framework for long-term care with the explicit purpose of providing a catalyst to promote further discourse and expand consideration of what an ethic of long-term care might entail. Grounding the discussion, an introduction to traditional ethical philosophy is presented, focusing mainly on the fundamentals of deontological and teleological ethical theories. Attention then shifts to a review of the more frequently cited principles found in the long-term care ethics literature, followed by a critique of the current reliance upon principlism to resolve ethical dilemmas in long-term care. In response to this criticism, an agent-driven ethical framework stressing dignity and respect for personhood, drawn from the philosophy of Immanuel Kant, is advanced.

Don't blame the 'bio'--blame the 'ethics': varieties of (bio)ethics and the challenge of pluralism.

PubMed

Charlesworth, Max

2005-01-01

We tend to think that the difficulties in bioethics spring from the novel and alarming issues that arise due to discoveries in the new biosciences and biotechnologies. But many of the crucial difficulties in bioethics arise from the assumption we make about ethics. This paper offers a brief overview of bioethics, and relates ethical 'principlism' to 'ethical fundamentalism.' It then reviews some alternative approaches that have emerged during the second phase of bioethics and argues for a neo-Aristotelian approach. Misconceptions about ethical principles and ethical reasoning not only distort our views of the business of bioethics, but they also prevent us from facing up to the formidable problems posed by ethical pluralism in so-called liberal societies.

Global Bioethics and Culture in a Pluralistic World: How does Culture influence Bioethics in Africa?

PubMed Central

Chukwuneke, FN; Umeora, OUJ; Maduabuchi, JU; Egbunike, N

2014-01-01

Bioethics principles and practice can be influenced by different cultural background. This is because the four globally accepted bioethics principles are often based on basic ethical codes such as autonomy, beneficence, nonmaleficence and justice. Beneficence/nonmaleficence requires us to maximize possible benefits, while minimizing possible harms and consequently secure the well-being of others by refraining from harming them. Autonomy gives individuals the right to self-actualization and decision-making, while justice is concerned with the fair selection and distribution of the burdens and benefits of research among participants. Applications of these principles in cultural settings vary more often from one cultural perspective to the other because of the different understanding and practices of “what is good.” The proponents of global ethics may argue that these principles should be universally generalizable and acceptable, but this is not possible because of the existing cultural diversities. In the African set-up, despite the existence of major common cultural practices, there are other norms and practices, which differ from one society to the other within the communities. Therefore, the word “global” bioethics may not be applicable generally in practice except if it can account for the structural dynamics and cultural differences within the complex societies in which we live in. However, the extent to which cultural diversity should be permitted to influence bioethical judgments in Africa, which at present is burdened with many diseases, should be of concern to researchers, ethicist and medical experts taking into considerations the constantly transforming global society. This topic examines the cultural influence on principles and practice of bioethics in Africa. PMID:25328772

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

PubMed

Greenfield, Bruce; Jensen, Gail M

2010-06-01

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

Audiology: student perception of preceptor and fellow student ethics.

PubMed

Franklin, Clifford; Vesely, Brian; White, Letitia; Mantie-Kozlowski, Alana; Franklin, Clay

2014-01-01

Health care professionals are expected to uphold high ethical standards. Recently, ethical practices in health care have received increased scrutiny and study in an effort to ensure that clinicians meet such high ethical standards in serving their patients and clients. The American Academy of Audiology's Code of Ethics establishes professional standards that allow for the proper discharge of an audiologist's responsibilities while maintaining the integrity of the profession. Under this code, student academy members are included and required to abide by the code, the same as practicing members. The code is composed of a preamble and eight principles. The present study provides an overview of students' perceptions across a broad spectrum of ethical topics governing our profession. Specifically, this study examined audiology students' perceptions of preceptor ethics relating to these eight principles using an online survey. Responses were collected from 143 of 600 audiology students contacted and indicated that they believed that their preceptors consistently followed each of the eight principles. Results also indicated that students believe fellow students also behave ethically and that it is the primary responsibility of academic faculty, not preceptors, to teach ethics. It can be concluded that preceptors are perceived by their students to be acting with high ethical standards. However, more research and discussion may be needed to determine who should teach these ethics to students.

Principles of robotics: regulating robots in the real world

NASA Astrophysics Data System (ADS)

Boden, Margaret; Bryson, Joanna; Caldwell, Darwin; Dautenhahn, Kerstin; Edwards, Lilian; Kember, Sarah; Newman, Paul; Parry, Vivienne; Pegman, Geoff; Rodden, Tom; Sorrell, Tom; Wallis, Mick; Whitby, Blay; Winfield, Alan

2017-04-01

This paper proposes a set of five ethical principles, together with seven high-level messages, as a basis for responsible robotics. The Principles of Robotics were drafted in 2010 and published online in 2011. Since then the principles have influenced, and continue to influence, a number of initiatives in robot ethics but have not, to date, been formally published. This paper remedies that omission.

The role of ethical principles in health care and the implications for ethical codes.

PubMed Central

Limentani, A E

1999-01-01

A common ethical code for everybody involved in health care is desirable, but there are important limitations to the role such a code could play. In order to understand these limitations the approach to ethics using principles and their application to medicine is discussed, and in particular the implications of their being prima facie. The expectation of what an ethical code can do changes depending on how ethical properties in general are understood. The difficulties encountered when ethical values are applied reactively to an objective world can be avoided by seeing them as a more integral part of our understanding of the world. It is concluded that an ethical code can establish important values and describe a common ethical context for health care but is of limited use in solving new and complex ethical problems. PMID:10536764

A personalist approach to public-health ethics.

PubMed

Petrini, Carlo; Gainotti, Sabina

2008-08-01

First we give an overview of the historical development of public health. Then we present some public-health deontology codes and some ethical principles. We highlight difficulties in defining ethics for public health, with specific reference to three of them that concern: (i) the adaptability to public health of the classical principles of bioethics; (ii) the duty to respect and safeguard the individual while acting within the community perspective that is typical of public health; and (iii) the application-oriented nature of public health and the general lack of attention towards the ethical implications of collective interventions (compared with research). We then mention some proposals drafted from North American bioethics "principles" and utilitarian, liberal and communitarian views. Drawing from other approaches, personalism is outlined as being the theory that offers a consistent set of values and alternative principles that are relevant for public health.

Learning from the legal history of billing for medical fees.

PubMed

Hall, Mark A; Schneider, Carl E

2008-08-01

When patients pay for care out-of-pocket, physicians must balance their professional obligations to serve with the commercial demands of medical practice. Consumer-directed health care makes this problem newly pressing, but law and ethics have thought for millennia about how doctors should bill patients. At various points in European history, the law restricted doctors' ability to bill for their services, but this legal aversion to commercializing medicine did not take root in the American colonies. Rather, US law has always treated selling medical services the way it treats other sales. Yet doctors acted differently in a crucial way. Driven by the economics of medical practice before the spread of health insurance, doctors charged patients according to what they thought each patient could afford. The use of sliding fee scales persisted until widespread health insurance drove a standardization of fees. CURRENT PRACTICE: Today, encouraged by Medicare rules and managed care discounts, providers use a perverse form of a sliding scale that charges the most to patients who can afford the least. Primary care physicians typically charge uninsured patients one third to one half more than they receive from insurers for basic office or hospital visits, and markups are substantially higher (2 to 2.5 times) for high-tech tests and specialists' invasive procedures. Ethical and professional principles might require providers to return to discounting fees for patients in straitened circumstances, but imposing such a duty formally (by law or by ethical code) on doctors would be harder both in principle and in practice than to impose such a duty on hospitals. Still, professional ethics should encourage physicians to give patients in economic trouble at least the benefit of the lowest rate they accept from an established payer.

Learning from the Legal History of Billing for Medical Fees

PubMed Central

Schneider, Carl E.

2008-01-01

INTRODUCTION When patients pay for care out-of-pocket, physicians must balance their professional obligations to serve with the commercial demands of medical practice. Consumer-directed health care makes this problem newly pressing, but law and ethics have thought for millennia about how doctors should bill patients. Historical Background At various points in European history, the law restricted doctors’ ability to bill for their services, but this legal aversion to commercializing medicine did not take root in the American colonies. Rather, US law has always treated selling medical services the way it treats other sales. Yet doctors acted differently in a crucial way. Driven by the economics of medical practice before the spread of health insurance, doctors charged patients according to what they thought each patient could afford. The use of sliding fee scales persisted until widespread health insurance drove a standardization of fees. Current Practice Today, encouraged by Medicare rules and managed care discounts, providers use a perverse form of a sliding scale that charges the most to patients who can afford the least. Primary care physicians typically charge uninsured patients one third to one half more than they receive from insurers for basic office or hospital visits, and markups are substantially higher (2 to 2.5 times) for high-tech tests and specialists’ invasive procedures. CONCLUSION Ethical and professional principles might require providers to return to discounting fees for patients in straitened circumstances, but imposing such a duty formally (by law or by ethical code) on doctors would be harder both in principle and in practice than to impose such a duty on hospitals. Still, professional ethics should encourage physicians to give patients in economic trouble at least the benefit of the lowest rate they accept from an established payer. PMID:18414955

Ethics and maternity care: from principles to practice.

PubMed

Lothian, Judith A

2009-01-01

In this column, the associate editor of The Journal of Perinatal Education (JPE) discusses the decision to devote an issue of JPE to the ethics of childbirth and maternity care. The current crisis in maternity care mandates a careful look at the ethical principles that provide the foundation for practice. The contents of this special issue include: a broad overview of ethics of childbearing, historical perspectives and contemporary understanding of informed decision making, the ethical issues faced by childbirth educators, and the challenges and moral distress experienced by childbirth educators and other maternity care providers when their values, beliefs, and ethical standards are in conflict with standard maternity care practices.

Living Donor Uterus Transplant and Surrogacy: Ethical Analysis According to the Principle of Equipoise.

PubMed

Testa, G; Koon, E C; Johannesson, L

2017-04-01

The uterus is the most recent addition to the list of organs that can be successfully transplanted in humans. This article analyzes living donor uterus transplantation according to the ethical principle of equipoise. A comparison is made between living donor uterus transplantation and gestational surrogate motherhood. Both are solutions to absolute uterine infertility that allow the transfer of genetic material from intended parents to a child. The analysis concludes that living donor uterus transplantation does not violate the ethical principle of equipoise and should be considered an ethically acceptable solution to absolute uterine infertility. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Ethical issues in human reproduction: Islamic perspectives.

PubMed

Serour, G I

2013-11-01

Sexual and reproductive rights of women are essential components of human rights. They should never be transferred, renounced or denied for any reason based on race, religion, origin, political opinion or economic conditions. Women have the right to the highest attainable standard of health care for all aspects of their reproductive and sexual health (RSH). The principle of autonomy emphasizes the important role of women in the decision-making. Choices of women in reproduction, after providing evidence based information, should be respected. Risks, benefits and alternatives should be clearly explained before they make their free informed consent. Justice requires that all be treated with equal standard and have equal access to their health needs without discrimination or coercion. When resources are limited there is tension between the principle of justice and utility. Islamic perspectives of bioethics are influenced by primary Sharia namely the Holy Quran, authenticated traditions and saying of the Profit Mohamed (PBUH), Igmaa and Kias (analogy). All the contemporary ethical principles are emphasized in Islamic Shariaa, thus these principles should be observed when providing reproductive and sexual health services for Muslim families or communities. The Family is the basic unit in Islam. Safe motherhood, family planning, and quality reproductive and sexual health information and services and assisted reproductive technology are all encouraged within the frame of marriage. While the Shiaa sect permits egg donation, and surrogacy the Sunni sect forbids a third party contribution to reproduction. Harmful practices in RSH as FGM, child marriage and adolescent pregnancy are prohibited in Islam. Conscientious objection to treatment should not refrain the physician from appropriate referral.

Ethical issues in public health surveillance: a systematic qualitative review.

PubMed

Klingler, Corinna; Silva, Diego Steven; Schuermann, Christopher; Reis, Andreas Alois; Saxena, Abha; Strech, Daniel

2017-04-04

Public health surveillance is not ethically neutral and yet, ethics guidance and training for surveillance programmes is sparse. Development of ethics guidance should be based on comprehensive and transparently derived overviews of ethical issues and arguments. However, existing overviews on surveillance ethics are limited in scope and in how transparently they derived their results. Our objective was accordingly to provide an overview of ethical issues in public health surveillance; in addition, to list the arguments put forward with regards to arguably the most contested issue in surveillance, that is whether to obtain informed consent. Ethical issues were defined based on principlism. We assumed an ethical issue to arise in surveillance when a relevant normative principle is not adequately considered or two principles come into conflict. We searched Pubmed and Google Books for relevant publications. We analysed and synthesized the data using qualitative content analysis. Our search strategy retrieved 525 references of which 83 were included in the analysis. We identified 86 distinct ethical issues arising in the different phases of the surveillance life-cycle. We further identified 20 distinct conditions that make it more or less justifiable to forego informed consent procedures. This is the first systematic qualitative review of ethical issues in public health surveillance resulting in a comprehensive ethics matrix that can inform guidelines, reports, strategy papers, and educational material and raise awareness among practitioners.

The patient perspective in health care networks.

PubMed

Raus, Kasper; Mortier, Eric; Eeckloo, Kristof

2018-06-05

Health care organization is entering a new age. Focus is increasingly shifting from individual health care institutions to interorganizational collaboration and health care networks. Much hope is set on such networks which have been argued to improve economic efficiency and quality of care. However, this does not automatically mean they are always ethically justified. A relevant question that remains is what ethical obligations or duties one can ascribe to these networks especially because networks involve many risks. Due to their often amorphous and complex structure, collective responsibility and accountability may increase while individual responsibility goes down. We argue that a business ethics approach to ethical obligations for health care networks, is problematic and we propose to opt for a patient perspective. Using the classic four principles of biomedical ethics (justice, nonmaleficence, beneficence and autonomy) it is possible to identify specific ethical duties. Based on the principle of justice, health care networks have an ethical duty to provide just and fair access for all patients and to be transparent to patients about how access is regulated. The principle of nonmaleficence implies an obligation to guarantee patient safety, whereas the principle of beneficence implies an obligation for health care networks to guarantee continuity of care in all its dimensions. Finally, the principle of autonomy is translated into a specific obligation to promote and respect patient choice. Networks that fail to meet any of these conditions are suspect and cannot be justified ethically. Faced with daunting challenges, the health care system is changing rapidly. Currently many hopes ride on integrated care and broad health care networks. Such networks are the topic of empirical debate, but more attention should be given to the ethical aspects. Health care networks raise new and pressing ethical issues and we are in need of a framework for assessing how and when such networks are justified.

A virtue ethics approach to moral dilemmas in medicine

PubMed Central

Gardiner, P

2003-01-01

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

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.

The anthropological approach challenges the conventional approach to bioethical dilemmas: a Kenyan Maasai perspective.

PubMed

Sharif, Thikra; Bugo, John

2015-06-01

The cultural background, religion and societal norms have a huge influence on the decision making process for physicians, patients and their families, when faced with medical ethical dilemmas. While the medical professionals, through their training, can rely on the principles of autonomy, justice, beneficence and non-maleficence to guide them, the patients can only draw from their personal and cultural experiences. To explore some of the challenges that face physicians when presented with ethical dilemmas. A review of the literature on the principles of medical ethics and the cultural practices of the Maasai tribe, as well as, interview, interaction and observation of the patients and family during patient. management. In the Maasai community in Kenya, where family is the center of all attention and decision-making, the listed ethical principles and rules have a very different understanding of the self-determination, and autonomy becomes collective rather than individualistic. Medical practitioners when faced with ethical medical dilemmas are neither comfortable in adopting the conventional bioethical guidelines, nor in offering a health care purely based on cultural and historical practice. In our set up, developing culturally relevant principles of bioethics appears to be the most effective solution in addressing medical ethical dilemmas.

From subject to participant: ethics and the evolving role of community in health research.

PubMed

Bromley, Elizabeth; Mikesell, Lisa; Jones, Felica; Khodyakov, Dmitry

2015-05-01

Belmont Report principles focus on the well-being of the research subject, yet community-engaged investigators often eschew the role of subject for that of participant. We conducted semistructured interviews with 29 community and academic investigators working on 10 community-engaged studies. Interviews elicited perspectives on ethical priorities and ethical challenges. Interviewees drew on the Belmont Report to describe 4 key principles of ethical community-engaged research (embodying ethical action, respecting participants, generalizing beneficence, and negotiating justice). However, novel aspects of the participant role were the source of most ethical challenges. We theorize that the shift in ethical focus from subject to participant will pose new ethical dilemmas for community-engaged investigators and for other constituents interested in increasing community involvement in health research.

From Subject to Participant: Ethics and the Evolving Role of Community in Health Research

PubMed Central

Mikesell, Lisa; Jones, Felica; Khodyakov, Dmitry

2015-01-01

Belmont Report principles focus on the well-being of the research subject, yet community-engaged investigators often eschew the role of subject for that of participant. We conducted semistructured interviews with 29 community and academic investigators working on 10 community-engaged studies. Interviews elicited perspectives on ethical priorities and ethical challenges. Interviewees drew on the Belmont Report to describe 4 key principles of ethical community-engaged research (embodying ethical action, respecting participants, generalizing beneficence, and negotiating justice). However, novel aspects of the participant role were the source of most ethical challenges. We theorize that the shift in ethical focus from subject to participant will pose new ethical dilemmas for community-engaged investigators and for other constituents interested in increasing community involvement in health research. PMID:25790380

Elective ventilation for organ donation: law, policy and public ethics.

PubMed

Coggon, John

2013-03-01

This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: 'basic elective ventilation'; 'epistemically complex elective ventilation'; 'practically complex elective ventilation'; and 'epistemically and practically complex elective ventilation'. I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation.

Juridical and ethical peculiarities in doping policy.

PubMed

McNamee, Mike J; Tarasti, Lauri

2010-03-01

Criticisms of the ethical justification of antidoping legislation are not uncommon in the literatures of medical ethics, sports ethics and sports medicine. Critics of antidoping point to inconsistencies of principle in the application of legislation and the unjustifiability of ethical postures enshrined in the World Anti-Doping Code, a new version of which came into effect in January 2009. This article explores the arguments concerning the apparent legal peculiarities of antidoping legislation and their ethically salient features in terms of: notions of culpability, liability and guilt; aspects of potential duplication of punishments and the limitations of athlete privacy in antidoping practice and policy. It is noted that tensions still exist between legal and ethical principles and norms that require further critical attention.

American College of Physicians Ethics Manual: sixth edition.

PubMed

Snyder, Lois

2012-01-03

Medicine, law, and social values are not static. Reexamining the ethical tenets of medicine and their application in new circumstances is a necessary exercise. The sixth edition of the American College of Physicians (ACP) Ethics Manual covers emerging issues in medical ethics and revisits older ones that are still very pertinent. It reflects on many of the ethical tensions in medicine and attempts to shed light on how existing principles extend to emerging concerns. In addition, by reiterating ethical principles that have provided guidance in resolving past ethical problems, the Manual may help physicians avert future problems. The Manual is not a substitute for the experience and integrity of individual physicians, but it may serve as a reminder of the shared duties of the medical profession.

Ethical implications of location and accelerometer measurement in health research studies with mobile sensing devices.

PubMed

Fuller, Daniel; Shareck, Martine; Stanley, Kevin

2017-10-01

Quantification of individual behaviours using mobile sensing devices, including physical activity and spatial location, is a rapidly growing field in both academic research and the corporate world. In this case study, we summarize the literature examining the ethical aspects of mobile sensing and argue that a robust discussion about the ethical implications of mobile sensing for research purposes has not occurred sufficiently in the literature. Based on our literature summary and guided by basic ethical principles set out in Canadian, US, and International Ethics documents we propose four areas where further discussion should occur: consent, privacy and confidentiality, mitigating risk, and consideration of vulnerable populations. We argue that ongoing consent is crucial for participants to be aware of the precision and volume of data that is collected with mobile sensing devices. Related to privacy we discuss that participants may not agree that anonymized data is sufficient for privacy and confidentiality when mobile sensing data are collected. There has been some discussion about mitigating risk in the literature. We highlight that the researchers' obligations toward mitigating risks that are not directly related to the study purpose are unclear and require considerable discussion. Finally, using mobile sensing devices to study vulnerable populations requires careful consideration, particularly with respect to balancing research needs with participant burden. Based on our discussion, we identify a broad set of unanswered questions about the ethics of mobile sensing that should be addressed by the research community. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Justification, after the Postmodern Turn, of Universal Ethical Principles and Educational Ideals

ERIC Educational Resources Information Center

Mason, Mark

2005-01-01

The implementation of education programmes in different cultures invites the question whether we are justified in doing so in cultures that may reject the programmes' underlying principles. Are there indeed ethical principles and educational ideals that can be justified as applicable to all cultures? After a consideration of Zygmunt Bauman's…

Mental health research, ethics and multiculturalism.

PubMed

Bailes, Marion J; Minas, I Harry; Klimidis, Steven

2006-01-01

In this paper we examine ethical issues relevant to conducting mental health research with refugees and immigrant communities that have cultural orientations and social organisation that are substantially different to those of the broader Australian community, and we relate these issues to NH&MRC Guidelines. We describe the development and conduct of a mental health research project carried out recently in Melbourne with the Somali community, focusing on ethical principles involved, and relating these to the NH&MRC National Statement on Ethical Conduct in Research Involving Humans, and the NH&MRC document Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. The experience of conducting mental health research with the Somali community highlights the fact that the principles of inclusion and benefit enunciated in the NH&MRC document Values and Ethics are particularly pertinent when conducting research with refugees and immigrant communities that are culturally distant to those of the broader Australian community. These principles inform issues of research design and consent, as well as guiding respectful engagement with the participating community and communication of the research findings.

Psychiatry and online social media: potential, pitfalls and ethical guidelines for psychiatrists and trainees.

PubMed

Frankish, Katherine; Ryan, Christopher; Harris, Anthony

2012-06-01

This paper proposes ethical guidelines for psychiatrists and psychiatry trainees when interacting with social media. A three-stage process was followed in the development of these guidelines. A literature review provided situations and possible broad rules as to how social media could be ethically engaged. A roundtable discussion by a panel of invited psychiatrists, psychiatry trainees, psychologists, e-health practitioners, lawyers and consumers was held to discuss the situations and to better formulate the ethical principles upon which psychiatrists could act. These vignettes and principles were then broadly discussed at a seminar held at the 2011 RANZCP Congress. Finally, this paper was circulated to the original invitees for final comment. A set of recommendations for working with social media were developed. The new social media provides important avenues for communication, education and treatment. These avenues pose ethical and practical dilemmas that can be resolved by the application of established ethical principles. Practical recommendations for navigating social media are proposed.

Focus on Teaching: Ethics.

ERIC Educational Resources Information Center

Worley, Rebecca B.; Dyrud, Marilyn A.

1998-01-01

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

Comparing the Principle-Based SBH Maieutic Method to Traditional Case Study Methods of Teaching Media Ethics

ERIC Educational Resources Information Center

Grant, Thomas A.

2012-01-01

This quasi-experimental study at a Northwest university compared two methods of teaching media ethics, a class taught with the principle-based SBH Maieutic Method (n = 25) and a class taught with a traditional case study method (n = 27), with a control group (n = 21) that received no ethics training. Following a 16-week intervention, a one-way…

Contributions from Christian ethics and Buddhist philosophy to the management of compassion fatigue in nurses.

PubMed

Pembroke, Neil

2016-03-01

The aim in the article is to demonstrate how insights from Christian ethics and Buddhist philosophy can make contributions to the management of compassion fatigue. There are already helpful resources available that provide principles, tips, and practical guidelines for self-care. The approach here is centered on attitudinal, ethical, and philosophical issues. From the Christian tradition, the ethical principle of "equal regard" is employed. Equal regard is the notion that agape (disinterested, universal love) requires of a people that they love others neither more nor less than they love themselves. When the ethical principle that a nurse operates out of in her everyday life is self-sacrifice, self-care is much less likely to be set as a personal priority. From the Buddhist tradition, the principle of compassion with equanimity is engaged. The Buddhist ideal is opening oneself to the pain of the other while maintaining calmness or stillness of mind. It is contended that inculcation of this skill means that a nurse can be exposed to suffering without running down their store of compassion. © 2015 Wiley Publishing Asia Pty Ltd.

Ethics curriculum for emergency medicine graduate medical education.

PubMed

Marco, Catherine A; Lu, Dave W; Stettner, Edward; Sokolove, Peter E; Ufberg, Jacob W; Noeller, Thomas P

2011-05-01

Ethics education is an essential component of graduate medical education in emergency medicine. A sound understanding of principles of bioethics and a rational approach to ethical decision-making are imperative. This article addresses ethics curriculum content, educational approaches, educational resources, and resident feedback and evaluation. Ethics curriculum content should include elements suggested by the Liaison Committee on Medical Education, Accreditation Council for Graduate Medical Education, and the Model of the Clinical Practice of Emergency Medicine. Essential ethics content includes ethical principles, the physician-patient relationship, patient autonomy, clinical issues, end-of-life decisions, justice, education in emergency medicine, research ethics, and professionalism. The appropriate curriculum in ethics education in emergency medicine should include some of the content and educational approaches outlined in this article, although the optimal methods for meeting these educational goals may vary by institution. Copyright © 2011 Elsevier Inc. All rights reserved.

[Ethics versus economics in public health? On the integration of economic rationality in a discourse of public health ethics].

PubMed

Rothgang, H; Staber, J

2009-05-01

In the course of establishing the discourse of public health ethics in Germany, we discuss whether economic efficiency should be part of public health ethics and, if necessary, how efficiency should be conceptualized. Based on the welfare economics theory, we build a theoretical framework that demands an integration of economic rationality in public health ethics. Furthermore, we consider the possible implementation of welfare efficiency against the background of current practice in an economic evaluation of health care in Germany. The indifference of the welfare efficiency criterion with respect to distribution leads to the conclusion that efficiency must not be the only criteria of public health ethics. Therefore, an ethical approach of principles should be chosen for public health ethics. Possible conflicts between principles of such an approach are outlined.

Captain America, Tuskegee, Belmont, and Righteous Guinea Pigs: Considering Scientific Ethics through Official and Subaltern Perspectives

NASA Astrophysics Data System (ADS)

Weinstein, Matthew

2008-09-01

With an eye towards a potential scientific ethics curriculum, this paper examines four contrasting discourses regarding the ethics of using human subjects in science. The first two represent official statements regarding ethics. These include the U.S.’s National Science Education Standards, that identify ethics with a professional code, and the Belmont Report, that conceptualizes ethics in three principles to guide research oversight boards. Contrasting this view of ethics as decorum and practice in line with a priori principles is the conception of ethics from unofficial sources representing populations who have been human subjects. The first counter-discourse examined comes from Guinea Pig Zero, an underground magazine for professional human subjects. Here ethics emerges as a question of politics over principle. The good behavior of the doctors and researchers is an effect of the politics and agency of the communities that supply science with subjects. The second counter-discourse is a comic book called Truth, which tells the story of Black soldiers who were used as guinea pigs in World War II. Ethics is both more political and more uncertain in this narrative. Science is portrayed as complicit with the racism of NAZI Germany; at the same time, and in contrast to the professional guinea pigs, neither agency nor politics are presented as effective tools for forcing the ethical conduct of the scientific establishment. The conclusion examines the value of presenting all of these views of scientific ethics in science education.

On using ethical principles of community-engaged research in translational science.

PubMed

Khodyakov, Dmitry; Mikesell, Lisa; Schraiber, Ron; Booth, Marika; Bromley, Elizabeth

2016-05-01

The transfer of new discoveries into both clinical practice and the wider community calls for reliance on interdisciplinary translational teams that include researchers with different areas of expertise, representatives of health care systems and community organizations, and patients. Engaging new stakeholders in research, however, calls for a reconsideration or expansion of the meaning of ethics in translational research. We explored expert opinion on the applicability of ethical principles commonly practiced in community-engaged research (CEnR) to translational research. To do so, we conducted 2 online, modified-Delphi panels with 63 expert stakeholders who iteratively rated and discussed 9 ethical principles commonly used in CEnR in terms of their importance and feasibility for use in translational research. The RAND/UCLA appropriateness method was used to analyze the data and determine agreement and disagreement among participating experts. Both panels agreed that ethical translational research should be "grounded in trust." Although the academic panel endorsed "culturally appropriate" and "forthcoming with community about study risks and benefits," the mixed academic-community panel endorsed "scientifically valid" and "ready to involve community in interpretation and dissemination" as important and feasible principles of ethical translational research. These findings suggest that in addition to protecting human subjects, contemporary translational science models need to account for the interests of, and owe ethical obligations to, members of the investigative team and the community at large. Copyright © 2016 Elsevier Inc. All rights reserved.

On Using Ethical Principles of Community-Engaged Research in Translational Science

PubMed Central

Mikesell, Lisa; Schraiber, Ron; Booth, Marika; Bromley, Elizabeth

2015-01-01

The transfer of new discoveries into both clinical practice and the wider community calls for reliance on interdisciplinary translational teams that include researchers with different areas of expertise, representatives of healthcare systems and community organizations, and patients. Engaging new stakeholders in research, however, calls for a re-consideration or expansion of the meaning of ethics in translational research. We explored expert opinion on the applicability of ethical principles commonly practiced in community-engaged research (CEnR) to translational research. To do so, we conducted two online, modified-Delphi panels with 63 expert stakeholders who iteratively rated and discussed nine ethical principles commonly used in CEnR in terms of their importance and feasibility for use in translational research. The RAND/UCLA Appropriateness Method was used to analyze the data and determine agreement and disagreement among participating experts. Both panels agreed that ethical translational research should be “grounded in trust.” While the academic panel endorsed “culturally appropriate” and “forthcoming with community about study risks and benefits,” the mixed academic-community panel endorsed “scientifically valid” and “ready to involve community in interpretation and dissemination” as important and feasible principles of ethical translational research. These findings suggest that in addition to protecting human subjects, contemporary translational science models need to account for the interests of, and owe ethical obligations to, members of the investigative team and the community at large. PMID:26773561

Principled leadership in public health: integrating ethics into practice and management.

PubMed

Bernheim, Ruth Gaare; Melnick, Alan

2008-01-01

Public health officials frequently face ethical tensions and conflicting obligations when making decisions and managing health departments. Leadership requires an ongoing approach to ethics that focuses on two dimensions of practice: the professional relationships of officials developed over time with their communities and the ethical aspects of day-to-day public health activities. Education and competencies in ethics may be helpful in practice, by providing, at a minimum, frameworks and ethical principles to help structure analysis, discussion, and decision making in health departments and with community stakeholders. Such a "practical ethics" approach in public health practice begins with a focus on public health values and an agency mission statement and integrates ethics throughout the organization by, for example, setting performance measures based on them. Using a case in emergency preparedness, this article describes ways in which ethical frameworks and the Code of Ethics can be used as tools for education and to integrate ethics into agency activities and programs.

Judgement and the role of the metaphysics of values in medical ethics

PubMed Central

Thornton, T

2006-01-01

Despite its authors' intentions, the four principles approach to medical ethics can become crudely algorithmic in practice. The first section sets out the bare bones of the four principles approach drawing out those aspects of Beauchamp and Childress's Principles of biomedical ethics that encourage this misreading. The second section argues that if the emphasis on the guidance of moral judgement is augmented by a particularist account of what disciplines it, then the danger can be reduced. In the third section, I consider how much the resultant picture diverges from Beauchamp and Childress's actual position. PMID:16731739

Judgement and the role of the metaphysics of values in medical ethics.

PubMed

Thornton, T

2006-06-01

Despite its authors' intentions, the four principles approach to medical ethics can become crudely algorithmic in practice. The first section sets out the bare bones of the four principles approach drawing out those aspects of Beauchamp and Childress's Principles of biomedical ethics that encourage this misreading. The second section argues that if the emphasis on the guidance of moral judgement is augmented by a particularist account of what disciplines it, then the danger can be reduced. In the third section, I consider how much the resultant picture diverges from Beauchamp and Childress's actual position.

Screening for infectious diseases of asylum seekers upon arrival: the necessity of the moral principle of reciprocity.

PubMed

Beeres, Dorien T; Cornish, Darren; Vonk, Machiel; Ravensbergen, Sofanne J; Maeckelberghe, Els L M; Boele Van Hensbroek, Pieter; Stienstra, Ymkje

2018-03-02

With a large number of forcibly displaced people seeking safety, the EU is facing a challenge in maintaining solidarity. Europe has seen millions of asylum seekers crossing European borders, the largest number of asylum seekers since the second world war. Endemic diseases and often failing health systems in their countries of origin, and arduous conditions during transit, raise questions around how to meet the health needs of this vulnerable population on arrival in terms of screening, vaccination, and access to timely and appropriate statutory health services. This paper explores the potential role of the principle of reciprocity, defined as the disposition 'to return good in proportion to the good we receive, and to make reparations for the harm we have done', as a mid-level principle in infectious disease screening policies. More than half of the European countries implemented screening programmes for newly arrived asylum seekers. Screening may serve to avoid potential infectious disease risks in the receiving countries as well as help identify health needs of asylum seekers. But screening may infringe upon basic rights of those screened, thus creating an ethical dilemma. The use of the principle of reciprocity can contribute to the identification of potential improvements for current screening programmes and emphasizes the importance of certain rights into guidelines for screening. It may create a two way moral obligation, upon asylum seekers to actively participate in the programme, and upon authorities to reciprocate the asylum seekers' participation and the benefits for the control of public health. The authors argue that the reciprocity principle leads to a stronger ethical justification of screening programmes and help achieve a balance between justifiable rights claims of the host population and the asylum seekers. The principle deserves a further and more thorough exploration of its potential use in the field of screening, migration and infectious diseases.

Ethical challenges in connection with the use of coercion: a focus group study of health care personnel in mental health care.

PubMed

Hem, Marit Helene; Molewijk, Bert; Pedersen, Reidar

2014-12-04

In recent years, the attention on the use of coercion in mental health care has increased. The use of coercion is common and controversial, and involves many complex ethical challenges. The research question in this study was: What kind of ethical challenges related to the use of coercion do health care practitioners face in their daily clinical work? We conducted seven focus group interviews in three mental health care institutions involving 65 multidisciplinary participants from different clinical fields. The interviews were recorded and transcribed verbatim. We analysed the material applying a 'bricolage' approach. Basic ethical principles for research ethics were followed. We received permission from the hospitals' administrations and all health care professionals who participated in the focus group interviews. Health care practitioners describe ethical dilemmas they face concerning formal, informal and perceived coercion. They provide a complex picture. They have to handle various ethical challenges, not seldom concerning questions of life and death. In every situation, the dignity of the patient is at stake when coercion is considered as morally right, as well as when coercion is not the preferred intervention. The work of the mental health professional is a complicated "moral enterprise". The ethical challenges deserve to be identified and handled in a systematic way. This is important for developing the quality of health care, and it is relevant to the current focus on reducing the use of coercion and increasing patient participation. Precise knowledge about ethical challenges is necessary for those who want to develop ethics support in mental health care. Better communication skills among health care professionals and improved therapeutic relationships seem to be vital. A systematic focus on ethical challenges when dealing with coercion is an important step forward in order to improve health care in the mental health field.

Fundamental Ethical Principles in Sports Medicine.

PubMed

Devitt, Brian M

2016-04-01

In sports medicine, the practice of ethics presents many unique challenges because of the unusual clinical environment of caring for players within the context of a team whose primary goal is to win. Ethical issues frequently arise because a doctor-patient-team triad often replaces the traditional doctor-patient relationship. Conflict may exist when the team's priority clashes with or even replaces the doctor's obligation to player well-being. Customary ethical norms that govern most forms of clinical practice, such as autonomy and confidentiality, are not easily translated to sports medicine. Ethical principles and examples of how they relate to sports medicine are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Ethics in nursing education: learning to reflect on care practices.

PubMed

Vanlaere, Linus; Gastmans, Chris

2007-11-01

Providing good care requires nurses to reflect critically on their nursing practices. Ethics education must provide nurses with tools to accomplish such critical reflection. It must also create a pedagogical context in which a caring attitude can be taught and cultivated. To achieve this twofold goal, we argue that the principles of a right-action approach, within which nurses conform to a number of minimum principles, must be integrated into a virtue ethics approach that cultivates a caring attitude. Ethics education that incorporates both the ;critical companionship' method and the use of codes of ethics contributes positively to cultivating critical reflection by nurses.

Innovative curriculum: Integrating the bio-behavioral and social science principles across the LifeStages in basic science years.

PubMed

Lele Mookerjee, Anuradha; Fischer, Bradford D; Cavanaugh, Susan; Rajput, Vijay

2018-05-20

Behavioral and social science integration in clinical practice improves health outcomes across the life stages. The medical school curriculum requires an integration of the behavioral and social science principles in early medical education. We developed and delivered a four-week course entitled "LifeStages" to the first year medical students. The learning objectives of the bio-behavioral and social science principles along with the cultural, economic, political, and ethical parameters were integrated across the lifespan in the curriculum matrix. We focused on the following major domains: Growth and Brain Development; Sexuality, Hormones and Gender; Sleep; Cognitive and Emotional Development; Mobility, Exercise, Injury and Safety; Nutrition, Diet and Lifestyle; Stress and coping skills, Domestic Violence; Substance Use Disorders; Pain, Illness and Suffering; End of Life, Ethics and Death along with Intergenerational issues and Family Dynamics. Collaboration from the clinical and biomedical science departments led to the dynamic delivery of the course learning objectives and content. The faculty developed and led a scholarly discussion, using the case of a multi-racial, multi-generational family during Active Learning Group (ALG) sessions. The assessment in the LifeStages course involved multiple assessment tools: including the holistic assessment by the faculty facilitator inside ALGs, a Team-Based Learning (TBL) exercise, multiple choice questions and Team Work Assessment during which the students had to create a clinical case on a LifeStages domain along with the facilitators guide and learning objectives.

Ethical theory, ethnography, and differences between doctors and nurses in approaches to patient care.

PubMed Central

Robertson, D W

1996-01-01

OBJECTIVES: To study empirically whether ethical theory (from the mainstream principles-based, virtue-based, and feminist schools) usefully describes the approaches doctors and nurses take in everyday patient care. DESIGN: Ethnographic methods: participant observation and interviews, the transcripts of which were analysed to identify themes in ethical approaches. SETTING: A British old-age psychiatry ward. PARTICIPANTS: The more than 20 doctors and nurses on the ward. RESULTS: Doctors and nurses on the ward differed in their conceptions of the principles of beneficence and respect for patient autonomy. Nurses shared with doctors a commitment to liberal and utilitarian conceptions of these principles, but also placed much greater weight on relationships and character virtues when expressing the same principles. Nurses also emphasised patient autonomy, while doctors were more likely to advocate beneficence, when the two principles conflicted. CONCLUSION: The study indicates that ethical theory can, contrary to the charges of certain critics, be relevant to everyday health care-if it (a) attends to social context and (b) is flexible enough to draw on various schools of theory. PMID:8910782

Keeping Up With the Drones: Is Just War Theory Obsolete

DTIC Science & Technology

2010-04-29

the laws of armed conflict. For centuries, just war principles have defined how responsible states have agreed to ethically wage war. The manner in...conflict. For centuries, just war principles have defined how responsible states have agreed to ethically wage war. The manner in which unmanned...3 will be morally and ethically waged. Failure to address the gaps this new technology exposes in traditional teachings will have profound

Philosophy of organ donation: Review of ethical facets.

PubMed

Dalal, Aparna R

2015-06-24

Transplantation ethics is a philosophy that incorporates systematizing, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviews several fundamental ethical principles, prevailing organ donation consent laws, incentives and policies related to the field of transplantation. The Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death outline criteria for death and organ retrieval. Presumed consent laws prevalent mostly in European countries maintain that the default choice of an individual would be to donate organs unless opted otherwise. Explicit consent laws require organ donation to be proactively affirmed with state registries. The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization's Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation have also been reviewed in detail.

Philosophy of organ donation: Review of ethical facets

PubMed Central

Dalal, Aparna R

2015-01-01

Transplantation ethics is a philosophy that incorporates systematizing, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviews several fundamental ethical principles, prevailing organ donation consent laws, incentives and policies related to the field of transplantation. The Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death outline criteria for death and organ retrieval. Presumed consent laws prevalent mostly in European countries maintain that the default choice of an individual would be to donate organs unless opted otherwise. Explicit consent laws require organ donation to be proactively affirmed with state registries. The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization’s Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation have also been reviewed in detail. PMID:26131406

Discussion of solutions to ethical issues in real-world study.

PubMed

Wang, Sicheng; Liu, Baoyan; Xiong, Ningning; Xie, Qi; Zhang, Runshun; Zhou, Xuezhong; Qiao, Jie

2014-09-01

In recent years, the paradigm of real-world study (RWS) has been at the forefront of clinical research worldwide, particularly in the field of traditional Chinese medicine. In this paper, basic features and nature of real-world clinical studies are discussed, and ethical issues in different stages of RWS are raised and reviewed. Moreover, some preliminary solutions to these issues, such as protecting subjects during the process of RWS and performing ethical review, are presented based on recent practices and basic ethical rules to improve the scientific validity and ethical level of RWS.

Ethical conflicts in caring for patients with cochlear implants.

PubMed

McCormick, Thomas R

2010-10-01

Although the use of cochlear implants as a treatment designed to help deaf individuals hear has a relatively brief history, the use of this therapy has given rise to a number of ethical conflicts. This article identifies ethical conflicts in cochlear implantation therapy and shows how ethical principles that are commonly accepted in health care ethics may guide decision making in resolving these issues. Furthermore, clinicians are often confronted with particular cases in which ethical conflicts arise. A useful paradigm for the clinical context, the 4-box method, is offered as a means of organizing the facts of a "case" so that the important facts are considered, and a principled approach to decision making can be used in working toward a resolution.

How medical ethical principles are applied in treatment with artificial insemination by donors (AID) in Hunan, China: effective practice at the Reproductive and Genetic Hospital of CITIC-Xiangya

PubMed Central

Li, L; Lu, G

2005-01-01

This paper investigates the efficiency of application of medical ethics principles in the practice of artificial insemination by donors (AID) in China, in a culture characterised by traditional ethical values and disapproval of AID. The paper presents the ethical approach to AID treatment as established by the Reproduction and Genetics Hospital of CITIC-Xiangya (CITIC Hunan-Yale Approach) in the central southern area of China against the social ethical background of China and describes its general features. The CITIC-Xiangya Approach facilitates the implementation of ethical relations between clinicians and patients participating in AID treatment procedures in Hunan-Yale. PMID:15923480

Psychiatric ethics in war and peace

PubMed Central

Raju, M. S. V. K.

2013-01-01

Practice of psychiatry is a complex activity because the psychiatrist generally practises his art in an emotionally charged environment with patients who may not be in a in a state of mind to exercise autonomy as a result of cognitive impairment and preoccupation with symptoms. No one principle of ethics will be suitable to guide right conduct in widely variable situations. Making ethical judgements in the military context can be difficult and may have potential for abuse as for an uniformed psychiatrist mission takes priority over man. However mission centered and medical text book centred ethics need not be compartamentalised. The present paper seeks to offer a brief overview of ethical principles and specific situations in which one may have to make ethical judgements. PMID:24459379

Ethics and Information Technology: Some Principles To Guide Students.

ERIC Educational Resources Information Center

Bodi, Sonia

1998-01-01

Discusses the ethical challenges of information technology, particularly electronic indexes and the Internet; considers principles to guide students; and discusses possible librarian responses. Topics include Kant's categorical imperative, ownership, right to privacy, social responsibility, self-respect, plagiarism and copyrights, and three…

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

PubMed

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

2016-11-10

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

[Nursing ethics and new challenges].

PubMed

Barrio, I M; Molina, A; Sánchez, C M; Ayudarte, M L

2006-01-01

The nursing profession has always placed great importance on the ethical requirements linked to its activities. However, the understanding and content to these activities has evolved over the course of history. Two approaches have been developed as the principal issues of nursing ethics: the ethics of virtue and the ethics of principles. The first approach enquires into the attitudes that must be held by a person in order to act as a good nurse. The second follows an inverse course and considers the actions and principles that must be respected in order to be a good professional. An approach that harmonises both perspectives must pose the following questions: What do we understand by nursing care? On what ethical principles is this form of understanding care based? What moral attitudes are related to caring correctly? In a modern professional model, the definition and exercise of care necessarily include consideration of team work. Similarly, carrying out a good caring function, that is to say quality nursing, requires apprenticeship on the one hand, and, on the other, the assimilation of the attitudes that are required in a person involved in caring. Both elements improve the capacity of the professionals to prevent and resolve ethical conflicts in the practice of care.

[Truth telling and advance care planning at the end of life].

PubMed

Hu, Wen-Yu; Yang, Chia-Ling

2009-02-01

One of the core values in terminal care the respect of patient 'autonomy'. This essay begins with a discussion of medical ethics principles and the Natural Death Act in Taiwan and then summarizes two medical ethical dilemmas, truth telling and advance care planning (ACP), faced in the development of hospice and palliative care in Taiwan. The terminal truth telling process incorporates the four basic principles of Assessment and preparation, Communication with family, Truth-telling process, and Support and follow up (the so-called "ACTs"). Many experts suggest practicing ACP by abiding by the following five steps: (1) presenting and illustrating topics; (2) facilitating a structured discussion; (3) completing documents with advanced directives (ADs); (4) reviewing and updating ADs; and (5) applying ADs in clinical circumstances. Finally, the myths and challenges in truth telling and ADs include the influence of healthcare system procedures and priorities, inadequate communication skills, and the psychological barriers of medical staffs. Good communication skills are critical to truth telling and ACP. Significant discussion about ACP should help engender mutual trust between patients and the medical staffs who take the time to establish such relationships. Promoting patient autonomy by providing the opportunity of a good death is an important goal of truth telling and ACP in which patients have opportunities to choose their terminal treatment.

Ethical dilemmas in personality assessment courses: using the classroom for in vivo training.

PubMed

Yalof, J; Brabender, V

2001-10-01

In this article, we argue that the student's first lessons in ethical decision making in personality assessment are in those assessment courses that have a practice component. In these courses, the student has an opportunity to experience in vivo how ethical problems are identified, addressed, and resolved. The faculty member's demonstration of a process wherein the ethical principles activated are highlighted and explored, will enable students to internalize a model for addressing future dilemmas. Four particular ethical situations are considered: (a) the students' procurement of personal experience with personality testing, (b) the identification of assessment participants, (c) the development of informed consent procedures for assessment participants, and (d) classroom presentations. This discussion does not provide concrete solutions to ethical problems but offers a consideration of the relevant ethical principles that any adequate solution must encompass.

Dismembering the ethical physician

PubMed Central

Genuis, S J

2006-01-01

Physicians may experience ethical distress when they are caught in difficult clinical situations that demand ethical decision making, particularly when their preferred action may contravene the expectations of patients and established authorities. When principled and competent doctors succumb to patient wishes or establishment guidelines and participate in actions they perceive to be ethically inappropriate, or agree to refrain from interventions they believe to be in the best interests of patients, individual professional integrity may be diminished, and ethical reliability is potentially compromised. In a climate of ever‐proliferating ethical quandaries, it is essential for the medical community, health institutions, and governing bodies to pursue a judicious tension between the indispensable regulation of physicians necessary to maintain professional standards and preserve public safety, and the support for “freedom of conscience” that principled physicians require to practise medicine in keeping with their personal ethical orientation. PMID:16597808

Too much information: visual research ethics in the age of wearable cameras.

PubMed

Mok, Tze Ming; Cornish, Flora; Tarr, Jen

2015-06-01

When everything you see is data, what ethical principles apply? This paper argues that first-person digital recording technologies challenge traditional institutional approaches to research ethics, but that this makes ethics governance more important, not less so. We review evolving ethical concerns across four fields: Visual ethics; ubiquitous computing; mobile health; and grey literature from applied or market research. Collectively, these bodies of literature identify new challenges to traditional notions of informed consent, anonymity, confidentiality, privacy, beneficence and maleficence. Challenges come from the ever-increasing power, breadth and multi-functional integration of recording technologies, and the ubiquity and normalization of their use by participants. Some authors argue that these evolving relationships mean that institutional ethics governance procedures are irrelevant or no longer apply. By contrast, we argue that the fundamental principles of research ethics frameworks have become even more important for the protection of research participants, and that institutional frameworks need to adapt to keep pace with the ever-increasing power of recording technologies and the consequent risks to privacy. We conclude with four recommendations for efforts to ensure that contemporary visual recording research is held appropriately accountable to ethical standards: (i) minimizing the detail, scope, integration and retention of captured data, and limiting its accessibility; (ii) formulating an approach to ethics that takes in both the 'common rule' approaches privileging anonymity and confidentiality together with principles of contextual judgement and consent as an ongoing process; (iii) developing stronger ethical regulation of research outside academia; (iv) engaging the public and research participants in the development of ethical guidelines.

Confronting ethical permissibility in animal research: rejecting a common assumption and extending a principle of justice.

PubMed

Choe Smith, Chong Un

2014-04-01

A common assumption in the selection of nonhuman animal subjects for research and the approval of research is that, if the risks of a procedure are too great for humans, and if there is a so-called scientific necessity, then it is permissible to use nonhuman animal subjects. I reject the common assumption as neglecting the central ethical issue of the permissibility of using nonhuman animal subjects and as being inconsistent with the principle of justice used in human subjects research ethics. This principle requires that certain classes of individuals not be subjected to a disproportionate share of the burdens or risks of research. I argue for an extension of this principle to nonhuman animal research and show that a prima facie violation of the principle occurs because nonhuman animals bear an overwhelmingly disproportionate share of the risks of research without sufficient justification or reciprocal benefit.

Ethics of clinical trials.

PubMed

Iyalomhe, G B S; Imomoh, P A

2007-01-01

Although clinical trials are conducted far more ethically and safer now than they were some decades ago, the elimination of gross abuses has tended to highlight more subtle ethical problems. Therefore, research in man, especially clinical drug trials, must now take into account ethical and legal requirements. This review examines the progress of clinical trial ethics, highlights the major ethical principles and challenges involved in the conduct of clinical trials, and suggests measures to ensure scientifically and ethically sound clinical trials. An internet search and a perusal of the literature on the history of clinical trials, medical ethics and good clinical practice, reveal that apart from laying a general principle, the Oath of Hippocrates did not provide a guide on the specific ethical problems involved in undertaking research, an important arm of advancement in medical knowledge. Hence, to avert continued ethical abuses of subjects during clinical research, the current reference guideliNe--the Helsinki Declaration of 1964 (revised in 1975), was adopted by the World Medical Assembly. It emphasized four major principles: autonomy, nonmaleficience, beneficence and justice. In applying these principles, the researcher must obtain a written free and well informed consent from patients who should be aware of their right to withdraw from trial at any moment. Where possible, a new drug should always first be compared to placebo in order to prove its superiority. He must ethically monitor and assess risks and benefits of the trial throughout its duration and use a fair procedure in selecting research subjects and must respect the concept of inviolability of the human person. Ethical challenges confronting clinical trials include the appropriateness of the proposed research, obtaining free informed consent, use of medications after completion of drug trials, drug toxicities and long-term side effects as well as the release and publication of research result. To improve protection for research subjects and have ethically sound clinical trials, there is need to adhere to global standards and legislations; establish, strengthen and empower regulatory bodies; develop partnership among stakeholders; intensify public enlightenment and train research personnel.

Principles of scarce medical resource allocation in natural disaster relief: a simulation approach.

PubMed

Cao, Hui; Huang, Simin

2012-01-01

A variety of triage principles have been proposed. The authors sought to evaluate their effects on how many lives can be saved in a hypothetical disaster. To determine an optimal scarce resource-rationing principle in the emergency response domain, considering the trade-off between lifesaving efficiency and ethical issues. A discrete event simulation model is developed to examine the efficiency of four resource-rationing principles: first come-first served, random, most serious first, and least serious first. Seven combinations of available resources are examined in the simulations to evaluate the performance of the principles under different levels of resource scarcity. The simulation results indicate that the performance of the medical resource allocation principles is related to the level of the resource scarcity. When the level of the scarcity is high, the performances of the four principles differ significantly. The least serious first principle performs best, followed by the random principle; the most serious first principle acts worst. However, when the scarcity is relieved, there are no significant differences among the random, first come-first served, and least serious first principles, yet the most serious first principle still performs worst. Although the least serious first principle exhibits the highest efficiency, it is not ethically flawless. Considering the trade off between the lifesaving efficiency and the ethical issues, random selection is a relatively fair and efficient principle for allocating scarce medical resources in natural disaster responses.

Some Basics about Ethics.

ERIC Educational Resources Information Center

Dean, Peter J.

1994-01-01

Discussion of ethics focuses on the role of human performance technology professionals in helping corporate ethicists. Highlights include definitions of ethics, morals, values, and business ethics; ethics in academia and in business; and application of the knowledge of ethics to decision-making. (Contains 18 references.) (LRW)

Principlism and communitarianism

PubMed Central

Callahan, D

2003-01-01

The decline in the interest in ethical theory is first outlined, as a background to the author's discussion of principlism. The author's own stance, that of a communitarian philosopher, is then described, before the subject of principlism itself is addressed. Two problems stand in the way of the author's embracing principlism: its individualistic bias and its capacity to block substantive ethical inquiry. The more serious problem the author finds to be its blocking function. Discussing the four scenarios the author finds that the utility of principlism is shown in the two scenarios about Jehovah's Witnesses but that when it comes to selling kidneys for transplantation and germline enhancement, principlism is of little help. PMID:14519838

Principlism and communitarianism.

PubMed

Callahan, D

2003-10-01

The decline in the interest in ethical theory is first outlined, as a background to the author's discussion of principlism. The author's own stance, that of a communitarian philosopher, is then described, before the subject of principlism itself is addressed. Two problems stand in the way of the author's embracing principlism: its individualistic bias and its capacity to block substantive ethical inquiry. The more serious problem the author finds to be its blocking function. Discussing the four scenarios the author finds that the utility of principlism is shown in the two scenarios about Jehovah's Witnesses but that when it comes to selling kidneys for transplantation and germline enhancement, principlism is of little help.

Open Science: a first step towards Science Communication

NASA Astrophysics Data System (ADS)

Grigorov, Ivo; Tuddenham, Peter

2015-04-01

As Earth Science communicators gear up to adopt the new tools and captivating approaches to engage citizen scientists, budding entrepreneurs, policy makers and the public in general, researchers have the responsibility, and opportunity, to fully adopt Open Science principles and capitalize on its full societal impact and engagement. Open Science is about removing all barriers to basic research, whatever its formats, so that it can be freely used, re-used and re-hashed, thus fueling discourse and accelerating generation of innovative ideas. The concept is central to EU's Responsible Research and Innovation philosophy, and removing barriers to basic research measurably contributes to engaging citizen scientists into the research process, it sets the scene for co-creation of solutions to societal challenges, and raises the general science literacy level of the public. Despite this potential, only 50% of today's basic research is freely available. Open Science can be the first passive step of communicating marine research outside academia. Full and unrestricted access to our knowledge including data, software code and scientific publications is not just an ethical obligation, but also gives solid credibility to a more sophisticated communication strategy on engaging society. The presentation will demonstrate how Open Science perfectly compliments a coherent communication strategy for placing Marine Research in societal context, and how it underpin an effective integration of Ocean & Earth Literacy principles in standard educational, as well mobilizing citizen marine scientists, thus making marine science Open Science.

Compliance of NHS dental practice websites in Wales before and after the introduction of the GDC document 'Principles of ethical advertising'.

PubMed

Budd, M L; Davies, M; Dewhurst, R; Atkin, P A

2016-06-10

Objectives To evaluate the compliance of NHS dental practice websites in Wales, UK, with the 2012 GDC document Principles of ethical advertising, before its introduction (2011) and again after its introduction (2014).Methods All practices in Wales with an NHS contract and dental practice website were identified. The content of the website was evaluated to determine if it complied with the principles outlined in the 2012 GDC document Principles of Ethical Advertising.Results Twenty-five percent of the 446 practices sampled in 2011 had a website, compared to 44% of the 436 practices sampled in 2014. The principles best complied with were; displaying the name, geographic address, and telephone number of the practice (100% for both years). None of the websites compared the qualifications or skills of its practitioners to others, therefore 100% complied with this principle. Displaying team members' professional qualification and the country from which this is obtained was fairly well represented; 92% and 61% respectively in 2014; an improvement from only 50% and 49% respectively in 2011. Principles worst complied with were displaying the GDC's address (3% 2011; 9% 2014) or link to the GDC website (11% 2011; 7% 2014) and details of the practice complaints procedure (1% 2011; 5% 2014). Overall, no practice complied with all of the compulsory principles.Conclusion In both 2011 and 2014 no practice website was compliant with all the principles outlined in the 2012 GDC document Principles of ethical advertising. Reflecting results from previous studies, this study showed that compliance is slowly improving, yet over 4 years after the introduction of the mandatory principles, it remains that no practice website is 100% compliant.

Government and Ethics: The Constitutional Foundation.

ERIC Educational Resources Information Center

Rossum, Ralph A.

1984-01-01

Government and ethics teachers should educate students in the "wholesale sanity" of American democracy. In particular they should (1) identify and defend the principles of the American constitutional order, (2) criticize government actions departing from these principles, and (3) seek means by which to correct for these departures. (RM)

Why There Is No Education Ethics without Principles

ERIC Educational Resources Information Center

Krek, Janez; Zabel, Blaž

2017-01-01

Moral education and ethical reflection are always dependent on the content of the internalized norms, principles and values of the individual. As we demonstrate, this also means that there is no instance of "feeling," "emotion," "spontaneity," or "care" that can be independent of norms, rules, and values…

Social Justice and Education as Discursive Initiation

ERIC Educational Resources Information Center

Stojanov, Krassimir

2016-01-01

In this essay Krassimir Stojanov attempts first to reconstruct the "heart" of Jürgen Habermas's discourse ethics, namely the so-called "principle of universalization" of ethical norms. This principle grounds Habermas's proceduralist account of social justice via equal access of all concerned to the practices of deliberative…

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. © The Royal Society of Medicine.

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

PubMed Central

2015-01-01

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

Public health nursing, ethics and human rights.

PubMed

Ivanov, Luba L; Oden, Tami L

2013-05-01

Public health nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of Public Health, and the Scope and Standards of Public Health Nursing. Human rights and Rights-based care in public health nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to public health practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Public health nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations. © 2013 Wiley Periodicals, Inc.

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

PubMed

Attia, Peter

2013-09-01

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

Beyond utilitarianism: a method for analyzing competing ethical principles in a decision analysis of liver transplantation.

PubMed

Volk, Michael L; Lok, Anna S F; Ubel, Peter A; Vijan, Sandeep

2008-01-01

The utilitarian foundation of decision analysis limits its usefulness for many social policy decisions. In this study, the authors examine a method to incorporate competing ethical principles in a decision analysis of liver transplantation for a patient with acute liver failure (ALF). A Markov model was constructed to compare the benefit of transplantation for a patient with ALF versus the harm caused to other patients on the waiting list and to determine the lowest acceptable 5-y posttransplant survival for the ALF patient. The weighting of the ALF patient and other patients was then adjusted using a multiattribute variable incorporating utilitarianism, urgency, and other principles such as fair chances. In the base-case analysis, the strategy of transplanting the ALF patient resulted in a 0.8% increase in the risk of death and a utility loss of 7.8 quality-adjusted days of life for each of the other patients on the waiting list. These harms cumulatively outweighed the benefit of transplantation for an ALF patient having a posttransplant survival of less than 48% at 5 y. However, the threshold for an acceptable posttransplant survival for the ALF patient ranged from 25% to 56% at 5 y, depending on the ethical principles involved. The results of the decision analysis vary depending on the ethical perspective. This study demonstrates how competing ethical principles can be numerically incorporated in a decision analysis.

Do Chinese Researchers Conduct Ethical Research and Use Ethics Committee Review in Clinical Trials of Anti-Dementia Drugs? An Analysis of Biomedical Publications Originating from China.

PubMed

Zeng, Lingfeng; Liang, Weixiong; Pan, Jianke; Cao, Ye; Liu, Jun; Wang, Qi; Wang, Lu; Zou, Yuanping; Wang, Kezhu; Kong, Lingshuo; Xie, Hui; Xu, Weihua; Li, Weirong; Zhao, Wei; Mi, Suiqing; Chen, Yunbo; Cheng, Shuyi; Li, Xiaoyan; Cao, Qian; Zeng, Xing; Wang, Ningsheng

2016-03-25

Medical research using human participants must conform to the basic ethical principles found in the Declaration of Helsinki (DoH) of the World Medical Association. The purpose of this review was to assess whether journals in China have improved in regard to the fulfillment of ethical disclosure procedures for clinical trials of anti-dementia drugs. Four medical databases were searched for articles reporting clinical trials of oral anti-dementia drugs published in China in 2003, 2009, and 2014. The frequencies of reporting of informed consent from participants (ICP), approval of a regional ethical committee (REC), reference to DoH, and study registration were estimated respectively. Statistical analyses were conducted with SPSS v21 software. Among those randomized controlled trials published in 2003, 2009, and 2014, disclosure of REC approval was present for 2.67%, 1.15%, and 6.84%; statements of ICP were included in 9.33%, 7.76%, and 17.34%; reference to DoH was found for 4.00%, 1.44%, and 7.45%; and study registration reporting was included in 2.67%, 2.59%, and 9.28%, respectively. Improvements to reporting rates between 2009 and 2014 were seen, with more than twice as many trials reporting REC approval, ICP, reference to DoH, and study registration compared with 2009. Compared with 2003 and 2009, reporting rates for REC approval, ICP, reference to DoH, and study registration for clinical trials of anti-dementia drugs were enhanced in 2014 in the major medical journals of China. However, biomedical publications without definite statements of ethical considerations remain common, and this continues to be seen in Chinese journals. It is imperative that measures are taken to reinforce the ethical protection in clinical trials in China.

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

ERIC Educational Resources Information Center

Knowlton, Steven; McKinley, J. Christopher

2016-01-01

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

Ethics Education: Using Inductive Reasoning to Develop Individual, Group, Organizational, and Global Perspectives

ERIC Educational Resources Information Center

Taft, Susan H.; White, Judith

2007-01-01

Ethics education that prepares students to address ethical challenges at work is a multifaceted and long-term endeavor. In this article, the authors propose an inductive ethics pedagogy that begins the process of ethics education by grounding students in their own individual ethical principles. The approach centers on developing students' ethical…

Using Gaming To Help Nursing Students Understand Ethics.

ERIC Educational Resources Information Center

Metcalf, Barbara L.; Yankou, Dawn

2003-01-01

An ethics game involves nursing students in defending actions in ethics-based scenarios. Benefits include increased confidence, ability to see multiple perspectives, values clarification, and exposure to decision-making models, professional responsibilities, ethical principles, social expectations, and legal requirements. Difficulties include…

JEA's Code of Ethics for Advisers; and Sites for Additional Ethics Information.

ERIC Educational Resources Information Center

Bowen, John

1997-01-01

Lists general principles that media advisers should follow, the 12 points agreed upon as the Journalism Education Association's (JEA) Code of Ethics for Advisers, and a list of Web sites that deal with journalism ethics. (PA)

[Ethical questions related to nutrition and hidration: basic aspects].

PubMed

Collazo Chao, E; Girela, E

2011-01-01

Conditions that pose ethical problems related to nutrition and hydration are very common nowdays, particularly within Hospitals among terminally ill patients and other patients who require nutrition and hydration. In this article we intend to analyze some circumstances, according to widely accepted ethical values, in order to outline a clear action model to help clinicians in making such difficult decisions. The problematic situations analyzed include: should hydration and nutrition be considered basic care or therapeutic measures?, and the ethical aspects of enteral versus parenteral nutrition.

Different views on ethics: how animal ethics is situated in a committee culture.

PubMed

Ideland, M

2009-04-01

Research that includes non-human animal experimentation is fundamentally a dilemmatic enterprise. Humans use other animals in research to improve life for their own species. Ethical principles are established to deal with this dilemma. But despite this ethical apparatus, people who in one way or another work with animal experimentation have to interpret and understand the principles from their individual points of view. In interviews with members of Swedish animal ethics committees, different views on what the term ethics really means were articulated. For one member, the difficult ethical dilemma of animal experimentation is the lack of enriched cages for mice. For another, the ethical problem lies in regulations restraining research. A third member talks about animals' right not to be used for human interests. These different views on "ethics" intersect once a month in the animal ethics committee meetings. There is no consensus on what constitutes the ethical problem that the members should be discussing. Therefore, personal views on what ethics means, and hierarchies among committee members, characterise the meetings. But committee traditions and priorities of interpretation as well are important to the decisions. The author discusses how "ethics" becomes situated and what implications this may have for committees' decisions.

Mixed motives, mixed outcomes when accused parents won't agree to withdraw care.

PubMed

Appel, J M

2009-10-01

One of the basic tenets of paediatric ethics is that competent parents may render healthcare decisions for children who are too young or too incapacitated to make meaningful medical choices for themselves. In the USA, many jurisdictions have expanded this principle to include the right to terminate a child's life support, including nutrition and hydration, when that child enters a persistent vegetative state. However, this approach to the withdrawal of care in the paediatric setting has been put to the test by an increasing number of cases in which one or both parents are themselves accused of causing the child's life-threatening injuries. In such "mixed-motive" situations, parents may express a desire to keep a child on life support for religious or moral reasons; at the same time, forestalling the child's death may also prevent a murder charge against the accused parent. Principles need to be established for handling such tragic cases.

Ethical Considerations in Tissue Engineering Research: Case Studies in Translation

PubMed Central

Baker, Hannah B.; McQuilling, John P.

2016-01-01

Tissue engineering research is a complex process that requires investigators to focus on the relationship between their research and anticipated gains in both knowledge and treatment improvements. The ethical considerations arising from tissue engineering research are similarly complex when addressing the translational progression from bench to bedside, and investigators in the field of tissue engineering act as moral agents at each step of their research along the translational pathway, from early benchwork and preclinical studies to clinical research. This review highlights the ethical considerations and challenges at each stage of research, by comparing issues surrounding two translational tissue engineering technologies: the bioartificial pancreas and a tissue engineered skeletal muscle construct. We present relevant ethical issues and questions to consider at each step along the translational pathway, from the basic science bench to preclinical research to first-in-human clinical trials. Topics at the bench level include maintaining data integrity, appropriate reporting and dissemination of results, and ensuring that studies are designed to yield results suitable for advancing research. Topics in preclinical research include the principle of “modest translational distance” and appropriate animal models. Topics in clinical research include key issues that arise in early-stage clinical trials, including selection of patient-subjects, disclosure of uncertainty, and defining success. The comparison of these two technologies and their ethical issues brings to light many challenges for translational tissue engineering research and provides guidance for investigators engaged in development of any tissue engineering technology. PMID:26282436

Ethical considerations in tissue engineering research: Case studies in translation.

PubMed

Baker, Hannah B; McQuilling, John P; King, Nancy M P

2016-04-15

Tissue engineering research is a complex process that requires investigators to focus on the relationship between their research and anticipated gains in both knowledge and treatment improvements. The ethical considerations arising from tissue engineering research are similarly complex when addressing the translational progression from bench to bedside, and investigators in the field of tissue engineering act as moral agents at each step of their research along the translational pathway, from early benchwork and preclinical studies to clinical research. This review highlights the ethical considerations and challenges at each stage of research, by comparing issues surrounding two translational tissue engineering technologies: the bioartificial pancreas and a tissue engineered skeletal muscle construct. We present relevant ethical issues and questions to consider at each step along the translational pathway, from the basic science bench to preclinical research to first-in-human clinical trials. Topics at the bench level include maintaining data integrity, appropriate reporting and dissemination of results, and ensuring that studies are designed to yield results suitable for advancing research. Topics in preclinical research include the principle of "modest translational distance" and appropriate animal models. Topics in clinical research include key issues that arise in early-stage clinical trials, including selection of patient-subjects, disclosure of uncertainty, and defining success. The comparison of these two technologies and their ethical issues brings to light many challenges for translational tissue engineering research and provides guidance for investigators engaged in development of any tissue engineering technology. Copyright © 2015 Elsevier Inc. All rights reserved.

The case of Samuel Golubchuk and the right to live.

PubMed

Jotkowitz, Alan; Glick, Shimon; Zivotofsky, Ari Z

2010-03-01

Samuel Golubchuk was unwittingly at the center of a medical controversy with important ethical ramifications. Mr. Golubchuk, an 84-year-old patient whose precise neurological level of function was open to debate, was being artificially ventilated and fed by a gastrostomy tube prior to his death. According to all reports he was neither brain dead nor in a vegetative state. The physicians directly responsible for his care had requested that they be allowed to remove the patient from life support against the wishes of the patient's family. Concurrently the Manitoba College of Physicians and Surgeons released a statement which states that the final decision to withdraw life support lies with the physician. In our opinion the statement is ethically problematic for a number of reasons. 1. It is an affront to the guiding principles of Western medical ethics: patient autonomy and human freedom. 2. The position of Samuel Golubchuk's physicians and the new statement lack cultural sensitivity towards other traditions. 3. In modern society there exists an erosion of a basic attitude towards the value of life. 4. The ability of physicians to predict life expectancy in terminally ill patients has been shown repeatedly to be quite limited.

Ethical concerns in nurse migration.

PubMed

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

2006-01-01

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

[Occupational medicine: practice and ethical requirements of the new law on health and safety in the workplace (legislative decree 81/2008)].

PubMed

Franco, Giuliano; Mora, Erika

2009-01-01

Decisions in occupational health may involve ethical conflicts arising from conflicts between stakeholders' interests. Codes of ethics can provide a practical guide to solve dilemmas. The new law on health and safety in the workplace in Italy (decree 81/2008) states that occupational health practice must comply with the code of ethics of the International Commission on Occupational Health. The universally acknowledged ethical principles of beneficience/nonmaleficience, autonomy and justice, which are the basis of the Charter of fundamental rights of the European Union, inspired this code. Although the code is not a systematic textbook of occupational health ethics and does not cover all possible aspects arising from the practice, making decisions based on it will assure their effectiveness and compliance with ethical principles, besides the formal respect of the law.

Using gaming to help nursing students understand ethics.

PubMed

Metcalf, Barbara L; Yankou, Dawn

2003-05-01

The authors developed an ethics game that uses specially designed ethical situations for students to consider. Two students argue a course of action based on the scenario and defend that action using content discussed in class. Substantive issues include decision-making models, values as they pertain to the situation, professional responsibilities, ethical principles, social expectations, and legal requirements. Points are awarded based on how compelling each argument is. All students have an opportunity to participate. The benefits of using the game are that students gain confidence in their ability to defend an ethical decision, are able to see ethical situations from more than one perspective, and have an opportunity to clarify values. In addition, ethical principles and decision-making models are brought to life in a fun way. Difficulties involved in using the game include class size and limited time between the students learning course content and using it in the game.

Forum Response: Ethics in Business and Teaching.

ERIC Educational Resources Information Center

Anderson, James A.

2003-01-01

Discusses the teaching of business ethics. Draws conclusions about teaching business ethics noting that such instruction must start with the principles of capitalism and the functions of a market economy. (SG)

[Health education: adjusting to parents' expectations. Results of a quantitative and qualitative survey in Morbihan].

PubMed

Bourhis, Cathy; Tual, Florence

2013-01-01

Health education among children and adolescents tends to be more effective if the objectives are shared, supported and promoted by parents. Professionals and policy-makers are therefore keen to promote the active involvement of parents. However, they face the same challenge: how to get parents involved. To address this issue, we need to examine parents' concerns and expectations directly. Professionals will need to adapt the proposed responses to the identified needs. This approach is a basic methodological and ethical principle in health education and requires the ability to change perceptions and practices while taking into account public expectations.

Curriculum Guidelines on Ethics and Professionalism in Dentistry.

ERIC Educational Resources Information Center

Journal of Dental Education, 1989

1989-01-01

Guidelines developed by the American Association of Dental Schools for curriculum development aids are presented. The dental ethics curriculum should provide opportunities for refining skills of ethical analysis so students are able to apply ethical principles to problems in the profession. (MLW)

Empirical ethics and its alleged meta-ethical fallacies.

PubMed

de Vries, Rob; Gordijn, Bert

2009-05-01

This paper analyses the concept of empirical ethics as well as three meta-ethical fallacies that empirical ethics is said to face: the is-ought problem, the naturalistic fallacy and violation of the fact-value distinction. Moreover, it answers the question of whether empirical ethics (necessarily) commits these three basic meta-ethical fallacies.

Deontological foundations for medical ethics?

PubMed

Gillon, R

1985-05-04

Gillon outlines the principles of the deontological, or duty-based, group of moral theories in one of a series of British Medical Journal articles on the philosophical foundations of medical ethics. He differentiates between monistic theories, such as Immanuel Kant's, which rely on a single moral principle, and pluralistic theories, such as that of W.D. Ross, which rely on several principles that potentially could conflict. He summarizes the contributions of Kant and Ross to the development of deontological thought, then concludes his essay with brief paragraphs on other deontological approaches to the resolution of conflicting moral principles.

How to design and write a clinical research protocol in Cosmetic Dermatology*

PubMed Central

Bagatin, Ediléia; Miot, Helio A.

2013-01-01

Cosmetic Dermatology is a growing subspecialty. High-quality basic science studies have been published; however, few double-blind, randomized controlled clinical trials, which are the major instrument for evidence-based medicine, have been conducted in this area. Clinical research is essential for the discovery of new knowledge, improvement of scientific basis, resolution of challenges, and good clinical practice. Some basic principles for a successful researcher include interest, availability, persistence, and honesty. It is essential to learn how to write a protocol research and to know the international and national regulatory rules. A complete clinical trial protocol should include question, background, objectives, methodology (design, variable description, sample size, randomization, inclusion and exclusion criteria, intervention, efficacy and safety measures, and statistical analysis), consent form, clinical research form, and references. Institutional ethical review board approval and financial support disclosure are necessary. Publication of positive or negative results should be an authors' commitment. PMID:23539006

How psychotherapists handle treatment errors – an ethical analysis

PubMed Central

2013-01-01

Background Dealing with errors in psychotherapy is challenging, both ethically and practically. There is almost no empirical research on this topic. We aimed (1) to explore psychotherapists’ self-reported ways of dealing with an error made by themselves or by colleagues, and (2) to reconstruct their reasoning according to the two principle-based ethical approaches that are dominant in the ethics discourse of psychotherapy, Beauchamp & Childress (B&C) and Lindsay et al. (L). Methods We conducted 30 semi-structured interviews with 30 psychotherapists (physicians and non-physicians) and analysed the transcripts using qualitative content analysis. Answers were deductively categorized according to the two principle-based ethical approaches. Results Most psychotherapists reported that they preferred to an disclose error to the patient. They justified this by spontaneous intuitions and common values in psychotherapy, rarely using explicit ethical reasoning. The answers were attributed to the following categories with descending frequency: 1. Respect for patient autonomy (B&C; L), 2. Non-maleficence (B&C) and Responsibility (L), 3. Integrity (L), 4. Competence (L) and Beneficence (B&C). Conclusions Psychotherapists need specific ethical and communication training to complement and articulate their moral intuitions as a support when disclosing their errors to the patients. Principle-based ethical approaches seem to be useful for clarifying the reasons for disclosure. Further research should help to identify the most effective and acceptable ways of error disclosure in psychotherapy. PMID:24321503

Modeling Medical Ethics through Intelligent Agents

NASA Astrophysics Data System (ADS)

Machado, José; Miranda, Miguel; Abelha, António; Neves, José; Neves, João

The amount of research using health information has increased dramatically over the last past years. Indeed, a significative number of healthcare institutions have extensive Electronic Health Records (EHR), collected over several years for clinical and teaching purposes, but are uncertain as to the proper circumstances in which to use them to improve the delivery of care to the ones in need. Research Ethics Boards in Portugal and elsewhere in the world are grappling with these issues, but lack clear guidance regarding their role in the creation of and access to EHRs. However, we feel we have an effective way to handle Medical Ethics if we look to the problem under a structured and more rational way. Indeed, we felt that physicians were not aware of the relevance of the subject in their pre-clinical years, but their interest increase when they were exposed to patients. On the other hand, once EHRs are stored in machines, we also felt that we had to find a way to ensure that the behavior of machines toward human users, and perhaps other machines as well, is ethically acceptable. Therefore, in this article we discuss the importance of machine ethics and the need for machines that represent ethical principles explicitly. It is also shown how a machine may abstract an ethical principle from a logical representation of ethical judgments and use that principle to guide its own behavior.

Dialectical principlism: an approach to finding the most ethical action.

PubMed

Weinstock, Robert

2015-03-01

Most forensic psychiatrists occasionally face complex situations in forensic work in which ethics dilemmas cause discomfort. They want to determine the most ethical action, but the best choice is unclear. Fostering justice is primary in forensic roles, but secondary duties such as traditional biomedical ethics and personal values like helping society, combating racism, and being sensitive to cultural issues can impinge on or even outweigh the presumptive primary duty in extreme cases. Similarly, in treatment the psychiatrists' primary duty is to patients, but that can be outweighed by secondary duties such as protecting children and the elderly or maintaining security. The implications of one's actions matter. In forensic work, if the psychiatrist determines that he should not assist the party who wants to hire him, despite evidence clearly supporting its side, the only ethical option becomes not to accept the case at all, because the evidence does not support the better side. Sometimes it can be ethical to accept cases only for one side. In ethics-related dilemmas, I call the method of prioritizing and balancing all types of conflicting principles, duties, and personal and societal values in a dialectic to resolve conflicts among them dialectical principlism. This approach is designed to help determine the most ethical action. It is aspirational and is not intended to get the psychiatrist into trouble. © 2015 American Academy of Psychiatry and the Law.

[RESPECT FOR AUTONOMY AND CONFIDENTIALITY, BETWEEN "ETHICAL NORMS' AND "LOCAL MORALITY". AN ANTHROPOLOGICAL ANALYSIS OF ETHICS OF CARE IN ST LUCIA].

PubMed

Meudec, Marie

2015-10-01

This article considers the difficulty of applying ethical norms as part of an anthropological research on moralities and ethics of healing practices in St. Lucia (Caribbean). This reflection is based on the moral evaluations related to obeah, locally conceived as a set of magical, religious and witchcraft practices that helps to manage disease and misfortune. Through the analysis of local conceptions surrounding the ethical notions of autonomy and confidentiality, I call attention to potential nuisance caused by the application of principles of beneficence and respect for the individual. Indeed, local idioms that are moral discretion and self-sufficiency, which can respectively refer to the concepts of autonomy and confidentiality, are, paradoxically, both valued and likely to be associated with dubious morality. I will demonstrate that the fact of applying these principles in all ethnographic relationship may harm interlocutors by increasing, in the case of St. Lucia, the risk of witchcraft accusations and derogatory moral attributions. The anthropological field experience presented here questions the principles of beneficence and respect for the individual as defined in the field of research ethics; it also imposes the need to think about their adaptation to suit local representations. This leads to recommend a pragmatic and emerging ethics of anthropological research/practice.

Introductory Course in Biomedical Ethics in the Obstetrics-Gynecology Residency.

ERIC Educational Resources Information Center

Elkins, Thomas E.

1988-01-01

Information used in a brief lecture that introduces a biomedical ethics curriculum in an obstetrics and gynecology residency is described. Major components include theories of philosophic ethics (formalist and consequentialist) and principles of biomedical ethics (honesty, contract-keeping, nonmaleficence, justice, autonomy, beneficence,…

Ethical problems in radiology: radiological consumerism.

PubMed

Magnavita, N; Bergamaschi, A

2009-10-01

One of the causes of the increasing request for radiological examinations occurring in all economically developed countries is the active role played by the patient-consumer. Consumerism places the radiologist in an ethical dilemma, between the principle of autonomy on the one hand and the ethical principles of beneficence, nonmaleficence and justice on the other. The choice made by radiologists in moral dilemmas is inspired by an adherence to moral principles, which in Italy and elsewhere refer to the Judaeo-Christian tradition or to neo-Darwinian relativism. Whatever the choice, the radiologist is bound to adhere to that choice and to provide the patient with all the relevant information regarding his or her state of health.

Respect for persons, respect for integrity: remarks for the conceptualization of integrity in social ethics.

PubMed

Fjellstrom, Roger

2005-01-01

Even though respect for integrity is hailed in several authoritative legal and ethical documents, and is typically presented as a complement to respect for autonomy, it is largely neglected in many leading works in ethics. Is such neglect warranted, or does it express a prejudice? This article argues that the latter is the case, and that this is due to misplaced conceptual concerns. It offers some proposals as regards the conceptualization of integrity in social ethics in general and in biomedical ethics in particular. Five main directions of interpretation of "integrity" are discerned and shown to be relevant for different areas of biomedical ethics. The defense of respect for integrity is served by a softening of principlism and by greater attention to context among the initial critics of this principle.

International variation in ethics committee requirements: comparisons across five Westernised nations

PubMed Central

Goodyear-Smith, Felicity; Lobb, Brenda; Davies, Graham; Nachson, Israel; Seelau, Sheila M

2002-01-01

Background Ethics committees typically apply the common principles of autonomy, nonmaleficence, beneficence and justice to research proposals but with variable weighting and interpretation. This paper reports a comparison of ethical requirements in an international cross-cultural study and discusses their implications. Discussion The study was run concurrently in New Zealand, UK, Israel, Canada and USA and involved testing hypotheses about believability of testimonies regarding alleged child sexual abuse. Ethics committee requirements to conduct this study ranged from nil in Israel to considerable amendments designed to minimise participant harm in New Zealand. Assessment of minimal risk is a complex and unreliable estimation further compounded by insufficient information on probabilities of particular individuals suffering harm. Estimating potential benefits/ risks ratio and protecting participants' autonomy similarly are not straightforward exercises. Summary Safeguarding moral/humane principles should be balanced with promotion of ethical research which does not impede research posing minimal risk to participants. In ensuring that ethical standards are met and research has scientific merit, ethics committees have obligations to participants (to meet their rights and protect them from harm); to society (to ensure good quality research is conducted); and to researchers (to treat their proposals with just consideration and respect). To facilitate meeting all these obligations, the preferable focus should be promotion of ethical research, rather than the prevention of unethical research, which inevitably results in the impediment of researchers from doing their work. How the ethical principles should be applied and balanced requires further consideration. PMID:11964190

Ethical issues identified by obstetrics and gynecology learners through a novel ethics curriculum.

PubMed

Mejia, Rachel B; Shinkunas, Laura A; Ryan, Ginny L

2015-12-01

Obstetrics and gynecology (ob/gyn) is fraught with bioethical issues, the professional significance of which may vary based on clinical experience. Our objective was to utilize our novel ethics curriculum to identify ethics and professionalism issues highlighted by ob/gyn learners and to compare responses between learner levels to further inform curricular development. We introduced an integrated and dynamic ob/gyn ethics and professionalism curriculum and mixed methods analysis of 181 resulting written reflections (case observation and assessments) from third-year medical students and from first- to fourth-year ob/gyn residents. Content was compared by learner level using basic thematic analysis and summary statistics. Within the 7 major ethics and professionalism domains, learners wrote most frequently about miscellaneous ob/gyn issues such as periviability and abortion (22% of students, 20% of residents) and problematic treatment decisions (20% of students, 19% of residents) rather than professional duty, communication, justice, student-/resident-specific issues, or quality of care. The most commonly discussed ob/gyn area by both learner groups was obstetrics rather than gynecology, gynecologic oncology, or reproductive endocrinology and infertility, although residents were more likely to discuss obstetrics-related concerns than students (65% vs 48%; P = .04) and students wrote about gynecologic oncology-related concerns more frequently than residents (25% vs 6%; P = .002). In their reflections, sources of ethical value (eg, the 4 classic ethics principles, professional guidelines, and consequentialism) were cited more frequently and in greater number by students than by residents (82% of students cited at least 1 source of ethical value vs 65% of residents; P = .01). Residents disagreed more frequently with the ethical propriety of clinical management than did students (67% vs 43%; P = .005). Our study introduces an innovative and dynamic approach to an ob/gyn ethics and professionalism curriculum that highlights important learner-identified ethics and professionalism issues both specific to ob/gyn and common to clinical medicine. Findings will help ob/gyn educators best utilize and refine this flexible curriculum such that it is appropriately focused on topics relevant to each learner level. Copyright © 2015 Elsevier Inc. All rights reserved.

Ancient Chinese medical ethics and the four principles of biomedical ethics.

PubMed Central

Tsai, D F

1999-01-01

The four principles approach to biomedical ethics (4PBE) has, since the 1970s, been increasingly developed as a universal bioethics method. Despite its wide acceptance and popularity, the 4PBE has received many challenges to its cross-cultural plausibility. This paper first specifies the principles and characteristics of ancient Chinese medical ethics (ACME), then makes a comparison between ACME and the 4PBE with a view to testing out the 4PBE's cross-cultural plausibility when applied to one particular but very extensive and prominent cultural context. The result shows that the concepts of respect for autonomy, non-maleficence, beneficence and justice are clearly identifiable in ACME. Yet, being influenced by certain socio-cultural factors, those applying the 4PBE in Chinese society may tend to adopt a "beneficence-oriented", rather than an "autonomy-oriented" approach, which, in general, is dissimilar to the practice of contemporary Western bioethics, where "autonomy often triumphs". PMID:10461594

Searching for solutions to alcohol and other drug abuse during pregnancy: ethics, values, and constitutional principles.

PubMed

Andrews, A B; Patterson, E G

1995-01-01

Recent efforts to develop legal mechanisms to detect prenatal substance abuse and force pregnant women into drug-free conditions have precipitated ethical struggles for social workers. This article reviews relevant social work values and ethical issues, particularly the need to balance obligations to promote client self-determination, privacy, and access to chosen services with professional values that support coercive intervention to aid vulnerable people and to protect life. The constitutional principles that most affect coercive interventions--due process and equal protection--are reviewed. Recommendations are offered to guide ethical and legal social work for case interventions and policy development.

Animal Models in Forensic Science Research: Justified Use or Ethical Exploitation?

PubMed

Mole, Calvin Gerald; Heyns, Marise

2018-05-01

A moral dilemma exists in biomedical research relating to the use of animal or human tissue when conducting scientific research. In human ethics, researchers need to justify why the use of humans is necessary should suitable models exist. Conversely, in animal ethics, a researcher must justify why research cannot be carried out on suitable alternatives. In the case of medical procedures or therapeutics testing, the use of animal models is often justified. However, in forensic research, the justification may be less evident, particularly when research involves the infliction of trauma on living animals. To determine how the forensic science community is dealing with this dilemma, a review of literature within major forensic science journals was conducted. The frequency and trends of the use of animals in forensic science research was investigated for the period 1 January 2012-31 December 2016. The review revealed 204 original articles utilizing 5050 animals in various forms as analogues for human tissue. The most common specimens utilized were various species of rats (35.3%), pigs (29.3%), mice (17.7%), and rabbits (8.2%) although different specimens were favored in different study themes. The majority of studies (58%) were conducted on post-mortem specimens. It is, however, evident that more needs to be done to uphold the basic ethical principles of reduction, refinement and replacement in the use of animals for research purposes.

Beyond Values Clarification: Addressing Client Values in Clinical Behavior Analysis

ERIC Educational Resources Information Center

Bonow, Jordan T.; Follette, William C.

2009-01-01

Ethical principles of psychology, as exemplified in the American Psychological Association (APA) Code of Ethics (2002), provide impractical advice for addressing client values during psychotherapy. These principles seem to argue that each client's values should be respected and protected at all times, except in cases in which this would result in…

The Ethical Principle of Regard for People: Using Dewey's Ideas in Schools

ERIC Educational Resources Information Center

Simpson, Douglas J.; Sacken, D. Mike

2015-01-01

In this study we analyze Dewey's writings and related literature in order to explain and utilize his ethical principle of regard for one's self, others and social groups. His reflections about consequences, the common good, accountability and responsibility undergo scrutiny too. Moreover, we probe his understanding of affections, interest and…

Engineering Codes of Ethics and the Duty to Set a Moral Precedent.

PubMed

Schlossberger, Eugene

2016-10-01

Each of the major engineering societies has its own code of ethics. Seven "common core" clauses and several code-specific clauses can be identified. The paper articulates objections to and rationales for two clauses that raise controversy: do engineers have a duty (a) to provide pro bono services and/or speak out on major issues, and (b) to associate only with reputable individuals and organizations? This latter "association clause" can be justified by the "proclamative principle," an alternative to Kant's universalizability requirement. At the heart of engineering codes of ethics, and implicit in what it is to be a moral agent, the "proclamative principle" asserts that one's life should proclaim one's moral stances (one's values, principles, perceptions, etc.). More specifically, it directs engineers to strive to insure that their actions, thoughts, and relationships be fit to offer to their communities as part of the body of moral precedents for how to be an engineer. Understanding codes of ethics as reflections of this principle casts light both on how to apply the codes and on the distinction between private and professional morality.

Informed consent in neurosurgery--translating ethical theory into action.

PubMed

Schmitz, Dagmar; Reinacher, Peter C

2006-09-01

Although a main principle of medical ethics and law since the 1970s, standards of informed consent are regarded with great scepticism by many clinicans. By reviewing the reactions to and adoption of this principle of medical ethics in neurosurgery, the characteristic conflicts that emerge between theory and everyday clinical experience are emphasised and a modified conception of informed consent is proposed. The adoption and debate of informed consent in neurosurgery took place in two steps. Firstly, respect for patient autonomy was included into the ethical codes of the professional organisations. Secondly, the legal demands of the principle were questioned by clinicians. Informed consent is mainly interpreted in terms of freedom from interference and absolute autonomy. It lacks a constructive notion of physician-patient interaction in its effort to promote the best interest of the patient, which, however, potentially emerges from a reconsideration of the principle of beneficence. To avoid insufficient legal interpretations, informed consent should be understood in terms of autonomy and beneficence. A continuous interaction between the patient and the given physician is considered as an essential prerequisite for the realisation of the standards of informed consent.

The risks and responsible roles for psychiatrists who interact with the media.

PubMed

Cooke, Brian K; Goddard, Emily R; Werner, Tonia L; Cooke, Erinn O; Griffith, Ezra E H

2014-01-01

Journalists often turn to psychiatrists for analysis of medical, social, political, and cultural events that involve human behavior and illness. Once journalists seek their expertise, psychiatrists often rush to be helpful, which can lead to ineffective performance and to statements that may run afoul of principles of professional ethics. In this article, we discuss the bases on which the professionalism of psychiatrists may be impugned when they commit errors in their media presentations. Found within the Principles of Medical Ethics with Special Annotations Especially Applicable to Psychiatry, the Goldwater Rule prohibits certain behaviors when psychiatrists share professional opinions with the public. We first discuss the Goldwater Rule, highlighting the events that led to its development and the professional response to its enactment. We then present a method to guide psychiatrists in their interaction with the media that will help them avoid violating ethics principles or the law. The method encourages knowledge of a framework of ethics principles that in turn guide the psychiatrist's behavior and thinking as he contemplates accepting invitations to interact with the media. The ethics-based roles include the Teacher, the Storyteller, the Celebrity Commentator, the Hollywood Consultant, the Clinician, and the Advertiser. © 2014 American Academy of Psychiatry and the Law.

Ethics for Fundraisers.

ERIC Educational Resources Information Center

Anderson, Albert

Intended for professionals and others in the field of philanthropy, this book applies ethics and ethical decision-making to fund raising. Its primary aim is to enhance the level of ethical fund raising throughout the nonprofit sector by equipping those involved with frameworks for understanding and taking principled actions and preventing…

Ethical Issues in the Mental Health Treatment of Gender Dysphoric Adolescents.

ERIC Educational Resources Information Center

Swann, Stephanie; Herbert, Sarah E.

1999-01-01

Examines ethical dilemmas arising when treating adolescents with gender dysphoria, discussing ethical and legal issues pertinent to treating any adolescent and highlighting gender dysphoric adolescents. Reviews legal decisions, existing data on adolescent decision making, and ethical principles for resolving complex situations. Illustrates ethical…

Teaching Ethics across the Public Relations Curriculum.

ERIC Educational Resources Information Center

Hutchison, Liese L.

2002-01-01

Suggests ways of incorporating ethics across the undergraduate public relations curriculum. Reviews current coverage of ethics in public relations principles, writing, cases, and textbooks. Suggests other methods that teachers can use to incorporate ethical pedagogical tools in all public relations courses in an effort to develop students' ethical…

Epistemological and Pedagogical Challenges of Teaching International Business Ethics Courses

ERIC Educational Resources Information Center

Dion, Michel

2015-01-01

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

Application of legal principles and medical ethics: multifetal pregnancy and fetal reduction

PubMed Central

Cheong, May Anne; Tay, Catherine Swee Kian

2014-01-01

In the management of complex medical cases such as a multifetal pregnancy, knowledge of the ethical and legal implications is important, alongside having competent medical skills. This article reviews these principles and applies them to scenarios of multifetal pregnancy and fetal reduction. Such a discussion is not solely theoretical, but is also relevant to clinical practice. The importance of topics such as bioethical principles and informed consent are also herein addressed. PMID:25017403

Applying Tactical Resources Against Strategic Challenges: The Ethical Pitfalls of MEDCAPs as an Instrument of National Policy

DTIC Science & Technology

2010-05-03

the principles of ownership, capacity building, and sustainability to enhance the host nation government’s ability to provide long-term health care to...utilized to select patients for care violate the ethical principle of justice, i.e., equal distribution of goods or services. Many people are... care is provided for the most ailing patients, upholding the principle of beneficence. Physicians participating in MEDCAP missions are unable to

Ethics, culture and nursing practice in Ghana.

PubMed

Donkor, N T; Andrews, L D

2011-03-01

This paper describes how nurses in Ghana approach ethical problems. The International Council of Nurses' (ICN) Code for Nurses (2006) that serves as the model for professional code of ethics worldwide also acknowledges respect for healthy cultural values. Using the ICN's Code and universal ethical principles as a benchmark, a survey was conducted in 2009 to ascertain how nurses in Ghana respond to ethical and cultural issues in their practice. The study was qualitative with 200 participant nurses. Data were obtained through anonymous self-administered questionnaires. Descriptive statistics were used to analyze the data. Nurses' approaches to ethical problems in Ghana do not always meet expectations of the ICN Code for Nurses. They are also informed by local ethical practices related to the institutional setting and cultural environment in the country. While some cultural values complemented the ICN's Code and universal ethical principles, others conflicted with them. These data can assist nurses to provide culturally competent solutions to ethical dilemmas in their practice. Dynamic communication between nurses and patients/clients, intentional study of local cultural beliefs, and the development of ethics education will improve the conformity between universal ethical standards and local cultural values. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Experienced speech-language pathologists' responses to ethical dilemmas: an integrated approach to ethical reasoning.

PubMed

Kenny, Belinda; Lincoln, Michelle; Balandin, Susan

2010-05-01

To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual narrative transcriptions were analyzed by using the participant's words to develop an ethical story that described and interpreted their responses to dilemmas. Key concepts from individual stories were then coded into group themes to reflect participants' reasoning processes. Five major themes reflected participants' approaches to ethical reasoning: (a) focusing on the well-being of the client, (b) fulfilling professional roles and responsibilities, (c) attending to professional relationships, (d) managing resources, and (e) integrating personal and professional values. SLPs demonstrated a range of ethical reasoning processes: applying bioethical principles, casuistry, and narrative reasoning when managing ethical dilemmas in the workplace. The results indicate that experienced SLPs adopted an integrated approach to ethical reasoning. They supported clients' rights to make health care choices. Bioethical principles, casuistry, and narrative reasoning provided useful frameworks for facilitating health professionals' application of codes of ethics to complex professional practice issues.

The Ethical Implications of the Five-Stage Skill-Acquisition Model

ERIC Educational Resources Information Center

Dreyfus, Hubert L.; Dreyfus, Stuart E.

2004-01-01

We assume that acting ethically is a skill. We then use a phenomenological description of five stages of skill acquisition to argue that an ethics based on principles corresponds to a beginner's reliance on rules and so is developmentally inferior to an ethics based on expert response that claims that, after long experience, the ethical expert…

The ethics of HIV research in developing nations.

PubMed

Resnik, David B

1998-10-01

This paper discusses a dispute concerning the ethics of research on preventing the perinatal transmission of HIV in developing nations. Critics of this research argue that it is unethical because it denies a proven treatment to placebo-control groups. Since studies conducted in developed nations would not deny this treatment to subjects, the critics maintain that these experiments manifest a double standard for ethical research and that a single standard of ethics should apply to all research on human subjects. Proponents of the research, however, argue that these charges fail to understand the ethical complexities of research in developing nations, and that study designs can vary according to the social, economic, and scientific conditions of research. This essay explores some of the ethical issues raised by this controversial case in order to shed some light on the deeper, meta-ethical questions. The paper argues that standards of ethical research on human subjects are universal but not absolute: there are some general ethical principles that apply to all cases of human subjects research but the application of these principles must take into account factors inherent in particular situations.

Forthcoming ethical issues in biological psychiatry.

PubMed

Helmchen, Hanfried

2005-01-01

Ethical issues in biological psychiatry are framed by (i) progress in the neurosciences, and (ii) a changing socio-cultural context. With regard to forthcoming neurotechniques to modify specifically defined brain functions by pharmacological substances with selective effects, by activating neuroplasticity including neurogenesis, or by implantation of neuronal tissues or computer-brain interfaces, etc., ethical problems will develop (i) at the border between therapy of diseases and enhancement of abilities in healthy people with regard to effects on society (e.g., social justice: equal access, loss of societal diversity) as well as on human value systems (e.g., personality, efforts, conditio humana), and (ii) at the border between the medical system and the wellness market with regard to financing what by whom? Ethical dilemmas in psychiatry develop (i) between the individual's best and the common good (demanded from outside medicine), (ii) among different ethical principles (inside medicine), iii) if solutions are influenced by personal reasons without observing ethical principles. Ethical guidelines are necessary for ethical orientation, but may protect against misconduct only (i) if psychiatrists are educated in ethics and (ii) if psychiatric acting is under continuous debate (by ethical review boards or the public). Thus, if we psychiatrists will become ethically sensitive by reflecting and perhaps solving our current ethical dilemmas we will be prepared to deal with forthcoming ethical issues in biological psychiatry.

Pragmatic ethical basis for radiation protection in diagnostic radiology.

PubMed

Malone, Jim; Zölzer, Friedo

2016-01-01

Medical ethics has a tried and tested literature and a global active research community. Even among health professionals, literate and fluent in medical ethics, there is low recognition of radiation protection principles such as justification and optimization. On the other hand, many in healthcare environments misunderstand dose limitation obligations and incorrectly believe patients are protected by norms including a dose limit. Implementation problems for radiation protection in medicine possibly flow from apparent inadequacies of the International Commission on Radiological Protection (ICRP) principles taken on their own, coupled with their failure to transfer successfully to the medical world. Medical ethics, on the other hand, is essentially global, is acceptable in most cultures, is intuitively understood in hospitals, and its expectations are monitored, even by managements. This article presents an approach to ethics in diagnostic imaging rooted in the medical tradition, and alert to contemporary social expectations. ICRP and the International Radiation Protection Association (IRPA), both alert to growing ethical concerns, organized a series of consultations on ethics for general radiation protection in the last few years. The literature on medical ethics and implicit ICRP ethical values were reviewed qualitatively, with a view to identifying a system that will help guide contemporary behaviour in radiation protection of patients. Application of the system is illustrated in six clinical scenarios. The proposed system is designed, as far as is possible, so as not to be in conflict with the conclusions emerging from the ICRP/IRPA consultations. A widely recognized and well-respected system of medical ethics was identified that has global reach and claims acceptance in all cultures. Three values based on this system are grouped with two additional values to provide an ethical framework for application in diagnostic imaging. This system has the potential to be robust and to reach conclusions that are in accord with contemporary medical, social and ethical thinking. The system is not intended to replace the ICRP principles. Rather, it is intended as a well-informed interim approach that will help judge and analyse situations that arouse ethical concerns in radiology. Six scenarios illustrate the practicality of the value system in alerting one to possible deficits in practice. Five widely recognized values and the basis for them are identified to support the contemporary practice of diagnostic radiology. These are essential to complement the widely used ICRP principles pending further development in the area.

The power of compassion: truth-telling among American doctors in the care of dying patients.

PubMed

Miyaji, N T

1993-02-01

The perceptions of American doctors about their practice regarding truth-telling in the care of dying patients were examined based on semi-structured interviews with 32 physicians in a teaching hospital. The doctors inform patients of their disease using three basic styles; 'telling what patients want to know', 'telling what patients need to know' and 'translating information into terms that patients can take'. These styles are supported by five basic normative principles; 'respect the truth', 'patients rights', 'doctors' duty to inform', 'preserve hope' and 'individual contract between patients and doctors'. These styles and principles suggest that physicians adhere to the recent trends of American medical ethics based on informed consent doctrine, and give the impression that patients have control over obtaining information. But close analysis of their accounts shows that physicians still hold power to control information through their management of the information-giving process. The styles and principles are flexibly interpreted and selectively used in the process so that they facilitate a discourse which justifies, rather than eliminates, the information control. Clinical contexts of information control are analyzed by examining dissimilar manners of providing information about treatment as opposed to prognosis. Physicians give less, and vaguer information about prognosis, citing its uncertainty and lesser relevance to future actions as reasons. Information about treatment is more readily shared in order to counterbalance the negative impact of the news on patients. The analysis reveals that the way doctors control information is closely related to the way they handle aspects of the reality of clinical practice, such as physicians' own emotional coping, institutional and legal constraints, and power relationships among patients, doctors and other care-givers. Situating the findings in the historical context of normative discourse in American medicine, discussion focuses on the issues of trust and power of doctors. The humanistic role of the doctor, although suppressed in the currently dominant, contractual ethical framework, is still powerful in doctors' narratives. It expresses doctors' commitment to patients while preserving their authority. Implications of the individualistic approach to the doctor-patient relationship are also discussed.

'Relief of oppression': an organizing principle for researchers' obligations to participants in observational studies in the developing world.

PubMed

Lavery, James V; Bandewar, Sunita V S; Kimani, Joshua; Upshur, Ross E G; Plummer, Frances A; Singer, Peter A

2010-06-30

A central question in the debate about exploitation in international research is whether investigators and sponsors from high-income countries (HIC) have obligations to address background conditions of injustice in the communities in which they conduct their research, beyond the healthcare and other research-related needs of participants, to aspects of their basic life circumstances. In this paper, we describe the Majengo sexually transmitted disease (STD) Cohort study, a long-term prospective, observational cohort of sex workers in Nairobi, Kenya. Despite important scientific contributions and a wide range of benefits to the women of the cohort, most of the women have remained in the sex trade during their long-standing participation in the cohort, prompting allegations of exploitation. The Majengo STD cohort case extends the debate about justice in international research ethics beyond clinical trials into long-term observational research. We sketch the basic features of a new approach to understanding and operationalizing obligations of observational researchers, which we call 'relief of oppression'. 'Relief of oppression' is an organizing principle, analogous to the principle of harm reduction that is now widely applied in public health practice. Relief of oppression aims to help observational researchers working in conditions of injustice and deprivation to clarify their ethical obligations to participants. It aims to bridge the gap between a narrow, transaction-oriented account of avoiding exploitation and a broad account emphasizing obligations of reparation for historic injustices. We propose that relief of oppression might focus researchers' consideration of benefits on those that have some relevance to background conditions of injustice, and so elevate the priority of these benefits, in relation to others that might be considered and negotiated with participants, according to the degree to which the participating communities are constrained in their realization of fundamental freedoms. The over-arching aim of relief of oppression is that, within the range of benefits negotiated over time with the local communities and organizations, an increasing proportion reflects a shared interest in improving participants' fundamental freedoms. We describe how harm reduction serves as a useful analogy for how we envision relief of oppression functioning in international research.

'Relief of oppression': An organizing principle for researchers' obligations to participants in observational studies in the developing world

PubMed Central

2010-01-01

Background A central question in the debate about exploitation in international research is whether investigators and sponsors from high-income countries (HIC) have obligations to address background conditions of injustice in the communities in which they conduct their research, beyond the healthcare and other research-related needs of participants, to aspects of their basic life circumstances. Discussion In this paper, we describe the Majengo sexually transmitted disease (STD) Cohort study, a long-term prospective, observational cohort of sex workers in Nairobi, Kenya. Despite important scientific contributions and a wide range of benefits to the women of the cohort, most of the women have remained in the sex trade during their long-standing participation in the cohort, prompting allegations of exploitation. The Majengo STD cohort case extends the debate about justice in international research ethics beyond clinical trials into long-term observational research. We sketch the basic features of a new approach to understanding and operationalizing obligations of observational researchers, which we call 'relief of oppression'. 'Relief of oppression' is an organizing principle, analogous to the principle of harm reduction that is now widely applied in public health practice. Relief of oppression aims to help observational researchers working in conditions of injustice and deprivation to clarify their ethical obligations to participants. It aims to bridge the gap between a narrow, transaction-oriented account of avoiding exploitation and a broad account emphasizing obligations of reparation for historic injustices. We propose that relief of oppression might focus researchers' consideration of benefits on those that have some relevance to background conditions of injustice, and so elevate the priority of these benefits, in relation to others that might be considered and negotiated with participants, according to the degree to which the participating communities are constrained in their realization of fundamental freedoms. Summary The over-arching aim of relief of oppression is that, within the range of benefits negotiated over time with the local communities and organizations, an increasing proportion reflects a shared interest in improving participants' fundamental freedoms. We describe how harm reduction serves as a useful analogy for how we envision relief of oppression functioning in international research. PMID:20591194

Focus on Ethics and Public Relations Practice in a University Classroom

ERIC Educational Resources Information Center

Smudde, Peter M.

2011-01-01

Public relations action relies on sound decision making about how to inspire cooperation between an organization and its publics. Such thinking must uphold principles for ethical communication. Effectively combining ethics with public relations practice for students is key. A pedagogical approach to public relations ethics, hinging on selected…

Reflections on Ethics in Practice

ERIC Educational Resources Information Center

Adams, Helen R.

2009-01-01

Each profession has its own code of ethics. The Merriam-Webster Online Dictionary (2008) defines professional ethics as "the principles of conduct governing an individual or a group." The Code of Ethics of the American Library Association (ALA Council 2008) has served librarians for seventy years and reflects the ideals toward which all librarians…

There Is More to Ethics than Principles.

ERIC Educational Resources Information Center

Kitchener, Karen Strohm

1996-01-01

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

Ethics for Professionals in Education: Perspectives for Preparation and Practice.

ERIC Educational Resources Information Center

Strike, Kenneth A., Ed.; Ternasky, P. Lance, Ed.

This book examines ethical principles governing the conduct of teachers, administrators, and other education professionals. The collection of articles, some with conflicting views, provides an overview of the many issues that define the place of ethics in professional preparation and practice. Following the introduction, "Ethics in Educational…

An Environmental Ethic for Parks and Recreation.

ERIC Educational Resources Information Center

McAvoy, Leo

1990-01-01

Suggests an environmental ethic for parks and recreation professionals who are often on the wrong side of the environmental controversy because they lack a professional ethic. This article provides a guide for implementing an environmental ethic, noting that philosophy of service must be grounded in ecological principles, not merchant values. (SM)

School Counselors and Ethical Decision Making

ERIC Educational Resources Information Center

West, Dana R.

2016-01-01

Students and their parents/guardians rely on school counselors to provide counseling services based on ethically sound principles. However, there is a lack of empirical evidence about what influences a school counselor's ethical decision making. Ethical decision making for this study was defined as the degree to which decisions pertaining to…

The 'four principles of bioethics' as found in 13th century Muslim scholar Mawlana's teachings

PubMed Central

Aksoy, Sahin; Tenik, Ali

2002-01-01

Background There have been different ethical approaches to the issues in the history of philosophy. Two American philosophers Beachump and Childress formulated some ethical principles namely 'respect to autonomy', 'justice', 'beneficence' and 'non-maleficence'. These 'Four Principles' were presented by the authors as universal and applicable to any culture and society. Mawlana, a great figure in Sufi tradition, had written many books which not only guide people how to worship God to be close to Him, but also advise people how to lead a good life to enrich their personality, as well as to create a harmonious society and a peaceful world. Methods In this study we examined the major works of Mawlana to find out which of these 'Four Principles of Bioethics' exist in Mawlana's ethical understanding. Results We have found in our study that all these principles exist in Mawlana's writings and philosophy in one form or another. Conclusions We have concluded that, further to Beachump and Childress' claim that these principles are universal and applicable to any culture and society, these principles have always existed in different moral traditions in different ways, of which Mawlana's teaching might be presented as a good example. PMID:12370082

Ethical codes for attorneys: a brief introduction.

PubMed

Zarkowski, P

1997-01-01

Ethical standards for lawyers are contained in the Model Rules of Professional Conduct (which lays out both "shall/shall not" rules and "may" suggestions in nine broad areas) and the Model Code of Professional Responsibility (which covers essentially the same topic areas but offers more detailed commentary). Topics included in the Rules are the client-lawyer relationship, the attorney's role as an advocate and counselor, law firms and associations, public service, transactions with individuals other than clients and information about legal services including advertising, firm names, and letterhead. The American Dental Association's Principles of Ethics and Code of Professional Conduct is organized around the five ethical principles of patient autonomy, nonmaleficence, beneficence, justice, and veracity. There are substantial similarities in intent between the ethical standards of dentists and lawyers; there are also differences.

Not just autonomy--the principles of American biomedical ethics.

PubMed Central

Holm, S

1995-01-01

The Principles of Biomedical Ethics by Tom L Beauchamp and James F Childress which is now in its fourth edition has had a great influence on the development of bioethics through its exposition of a theory based on the four principles: respect for autonomy; non-maleficence; beneficence, and justice (1). The theory is developed as a common-morality theory, and the present paper attempts to show how this approach, starting from American common-morality, leads to an underdevelopment of beneficence and justice, and that the methods offered for specification and balancing of principles are inadequate. PMID:8778456

The ethical use of paradoxical interventions in psychotherapy.

PubMed Central

Foreman, D M

1990-01-01

The purpose of this paper is to establish ethical guidelines for the use of paradoxical interventions in psychotherapy. These are defined as interventions which are counterintuitive, coercive, and which require non-observance by the client. Arguments are developed to show that such interventions are associated with a psychology that understands individuals solely in terms of their relationship: a 'strong interactionist' position. Ethical principles consistent with such a position are considered, and from these it is derived that: paradox is an ethical technique with resistive patients; it requires consent; its content should be consistent with general ethical principles, especially those of beneficence and non-maleficence; non-paradoxical techniques should be preferred when possible; and it should not be used as an assessment procedure. It is concluded that research is needed to explore the effect of such ethical guidelines of effectiveness, though preliminary impressions are encouraging. PMID:2287016

Ethical challenges embedded in qualitative research interviews with close relatives.

PubMed

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

2014-02-01

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

A Reply on Behalf of the Relativist to Mark Mason's Justification of Universal Ethical Principles

ERIC Educational Resources Information Center

MacKenzie, Jim

2007-01-01

Mark Mason, in his "A Justification, After the Postmodern Turn, of Universal Ethical Principles and Educational Ideals" Educational Philosophy and Theory, 37 (2005), attempts to justify transcultural multiculturalism. In this paper I argue that he fails to refute moral relativism, and that multiculturalism as he interprets it is not morally…

Fair shares: a preliminary framework and case analyzing the ethics of offshoring.

PubMed

Gordon, Cameron; Zimmerman, Alan

2010-06-01

Much has been written about the offshoring phenomenon from an economic efficiency perspective. Most authors have attempted to measure the net economic effects of the strategy and many purport to show that "in the long run" that benefits will outweigh the costs. There is also a relatively large literature on implementation which describes the best way to manage the offshoring process. But what is the morality of offshoring? What is its "rightness" or "wrongness?" Little analysis of the ethics of offshoring has been completed thus far. This paper develops a preliminary framework for analyzing the ethics of offshoring and then applies this framework to basic case study of offshoring in the U.S. The paper following discusses the definition of offshoring; shifts to the basic philosophical grounding of the ethical concepts; develops a template for conducting an ethics analysis of offshoring; applies this template using basic data for offshoring in the United States; and conducts a preliminary ethical analysis of the phenomenon in that country, using a form of utilitarianism as an analytical baseline. The paper concludes with suggestions for further research.

Reflections on Ethics and Humanity in Pediatric Neurology: the Value of Recognizing Ethical Issues in Common Clinical Practice.

PubMed

Ronen, Gabriel M; Rosenbaum, Peter L

2017-05-01

Our goals in this reflection are to (i) identify the ethical dimensions inherent in any clinical encounter and (ii) bring to the forefront of our pediatric neurology practice the myriad of opportunities to explore and learn from these ethical questions. We highlight specifically Beauchamp and Childress's principles of biomedical ethics. We use the terms ethics in common clinical practice and an ethical lens to remind people of the ubiquity of ethical situations and the usefulness of using existing ethical principles to analyze and resolve difficult situations in clinical practice. We start with a few common situations with which many of us tend to struggle. We describe what we understand as ethics and how and why developments in technology, novel potential interventions, policies, and societal perspectives challenge us to think about and debate ethical issues. Individual patients are not a singular population; each patient has their own unique life situations, culture, goals, and expectations that need to be considered with a good dose of humanity and humility. We believe that using an ethical lens-by which we mean making an explicit effort to identify and consider these issues openly-will help us to achieve this goal in practice, education, and research.

[Research ethics committees: a necessary good].

PubMed

Riera, Alejandra V

2013-12-01

The Nuremberg Code, issued as the result of the deliberations of the Nuremberg Trials, which judged the atrocities carried out during Nazi Germany (1933-1945), was the first universal document that defined research ethics principles for human experimentation. This code served as the basis for the subsequent ethical codes and principles used today by the Research Ethics Committees. The Research Ethics Committee is a multidisciplinary body whose primary role is to protect the rights and welfare of research subjects through the review of research protocols, ensuring compliance with internationally and locally accepted ethical guidelines. Worldwide, there have been important improvements in order to promote and regulate bioethics in medical research. In Venezuela, several national organizations have been constituted with the aim of promoting the establishment of ethics committees; however, there has not been a significant progress in the quantity or quality of the functioning of Research Ethics Committees in the country. It is imperative for each research institution to establish and work to improve their ethics committee to ensure the quality of the clinical research conducted, making it adherent to ethical codes, and safeguarding the integrity and credibility of the investigators and the research institutions, and more importantly, the patient's rights.

Building workforce capacity for ethical reflection in health promotion: a practitioner's experience.

PubMed

Axford, Annabel; Carter, Drew

2015-12-01

Health promotion does not have a code of ethics, although attempts have been made to assist practitioners in their understanding and application of ethical concepts. This article describes and analyses one such attempt, sustained from 2006 to 2014 in rural South Australia. The attempt comprised capacity-building activities that were informed by principles of organisational change management, especially the principle of creating champions. The article also presents a framework (largely comprising ethical questions) that may help practitioners as a prompt and guide to ethical reflection. The framework was developed to be as accessible as possible in light of the diverse educational backgrounds found in rural settings. Finally, the article highlights some philosophical dimensions to the framework and defends its role, proposing that ethical reflection is integral to good practice and never simply the province of theorists. The article does all this with a view to stimulating discussion on how to increase the frequency and quality of ethical reflection undertaken by health promotion practitioners.

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

PubMed

Lundy, Courtnee

2006-01-01

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

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

PubMed Central

Soskolne, C L

1997-01-01

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

Should people with unhealthy lifestyles pay higher health insurance premiums?

PubMed

Buchanan, David R

2011-02-01

This commentary sets the article by Dubois on the ethical justification for charging higher insurance premiums for people with unhealthy lifestyles in the context of US health care reform. It reviews the relevance and strength of normative concerns identified by Dubois about the acceptability of such differentiated "means-tested" plans. It identifies key issues involving whether certain health behaviors matter ethically, and if so, the grounds that would justify an obligation for people to take action. The article frames the answer in terms of the need to achieve an ethically acceptable balance between the principle of equality and principle of merit and concludes with four ethical standards to focus the terms of the debate.

The call of the sirens: ethically navigating the sea of nonvalidated therapies.

PubMed

Grimmett, M R; Sulmasy, D P

1998-01-01

Medical research and innovation are vital to the advancement of medicine and, ultimately, benefit society and individual patients. However, the ethical principles of beneficence, respect for persons, and justice must guide the development and implementation of new practices. Ethical codes governing clinical practice and research already warn practitioners to avoid the use of nonvalidated practices outside of controlled clinical trials. Nonetheless, lack of compliance with these codes places many patients at risk for harm. Ophthalmologists, as well as all physicians, must recommit themselves to these ethical principles and codes and establish more vigorous peer-review methods to protect patients from nonvalidated practices that are implemented without a scientific basis.

Outcome of a research ethics training workshop among clinicians and scientists in a Nigerian university.

PubMed

Ajuwon, Ademola J; Kass, Nancy

2008-01-24

In Nigeria, as in other developing countries, access to training in research ethics is limited, due to weak social, economic, and health infrastructure. The project described in this article was designed to develop the capacity of academic staff of the College of Medicine, University of Ibadan, Nigeria to conduct ethically acceptable research involving human participants. Three in-depth interviews and one focus group discussion were conducted to assess the training needs of participants. A research ethics training workshop was then conducted with College of Medicine faculty. A 23-item questionnaire that assessed knowledge of research ethics, application of principles of ethics, operations of the Institutional Review Board (IRB) and ethics reasoning was developed to be a pre-post test evaluation of the training workshop. Ninety-seven workshop participants completed the questionnaire before and after the workshop; 59 of them completed a second post-test questionnaire one month after the workshop. The trainees came from a multi-disciplinary background including medicine, nursing, pharmacy, social science and laboratory science. The mean scores for knowledge of the principles of research ethics rose from 0.67 out of 3 points at pre-test to 2.25 at post-test (p < 0.05). Also, 42% correctly mentioned one international guideline or regulation at pretest, with most of those knowing of the Declaration of Helsinki. Trainees' knowledge of the operations of an IRB increased from 6.05 at pre-test to 6.29 at post test out of 7 points. Overall, participants retained much of the knowledge acquired from the workshop one month after its completion. The training improved participants' knowledge of principles of research ethics, international guidelines and regulations and operations of IRBs. It thus provided an opportunity for research ethics capacity development among academic staff in a developing country institution.

Evolution of Ethics in Clinical Research and Ethics Committee

PubMed Central

Das, Nilay Kanti; Sil, Amrita

2017-01-01

Ethics are the moral values of human behavior and the principles which govern these values. The situation becomes challenging for a doctor when he assumes the role of researcher. The doctor-researcher has to serve both the roles and at times the zeal of an investigator has the potential to cloud the morality of the physician inside. It is very important to realize that exploiting the faith of patients is an offence that tantamount to a crime. Medical science is one discipline where the advancement of knowledge is hugely guided by research and mankind has benefitted from many experiments. However benefit and risk are the two faces of the same coin. Various unethical human experiments made us realize that the whims of researchers need to be reined and led to the evolution of the first guidelines for researcher, the Nuremberg code. Thereafter the Good Clinical Practice guidelines serve as the guiding doctrine of clinical research. The principles of ethics rest on the four pillars of autonomy, beneficence, justice, non-maleficence and recently two more pillars are added which includes, confidentiality and honesty. Ethics committees serve as a guardian of these principles. The multidisciplinary Ethics Committee ensures a competent review of the ethical aspects of the project proposal submitted and does it free from any bias or external influence. Ethical review of clinical trial applications follows a decentralized process in India, and requires Ethics Committee approval for each trial site. All Ethics committees have to be registered with Drug Controller General of India (DCGI) without which they cannot approve any clinical trial protocol and has come into effect from 25th February 2013. PMID:28794547

Evolution of Ethics in Clinical Research and Ethics Committee.

PubMed

Das, Nilay Kanti; Sil, Amrita

2017-01-01

Ethics are the moral values of human behavior and the principles which govern these values. The situation becomes challenging for a doctor when he assumes the role of researcher. The doctor-researcher has to serve both the roles and at times the zeal of an investigator has the potential to cloud the morality of the physician inside. It is very important to realize that exploiting the faith of patients is an offence that tantamount to a crime. Medical science is one discipline where the advancement of knowledge is hugely guided by research and mankind has benefitted from many experiments. However benefit and risk are the two faces of the same coin. Various unethical human experiments made us realize that the whims of researchers need to be reined and led to the evolution of the first guidelines for researcher, the Nuremberg code. Thereafter the Good Clinical Practice guidelines serve as the guiding doctrine of clinical research. The principles of ethics rest on the four pillars of autonomy, beneficence, justice, non-maleficence and recently two more pillars are added which includes, confidentiality and honesty. Ethics committees serve as a guardian of these principles. The multidisciplinary Ethics Committee ensures a competent review of the ethical aspects of the project proposal submitted and does it free from any bias or external influence. Ethical review of clinical trial applications follows a decentralized process in India, and requires Ethics Committee approval for each trial site. All Ethics committees have to be registered with Drug Controller General of India (DCGI) without which they cannot approve any clinical trial protocol and has come into effect from 25th February 2013.

Ethics and Childbirth Educators: Do Your Values Cause You Ethical Distress?

PubMed Central

Ondeck, Michele

2009-01-01

The Code of Ethics for Lamaze Certified Childbirth Educators outlines the ethical principles and standards that are derived from childbirth education's core values to assure quality and ethical practice. This article presents a summary of the history of ethics and medical ethics that informs a value-oriented decision-making process in childbirth education. The role of evidence in ethics is explored from the childbirth educator's viewpoint, and scenarios are used to reflect on situations that are examples of ethical distress. The conclusion is that the practice of ethics and ethical decision making includes regular reflection. PMID:19436591

Ethics and childbirth educators: do your values cause you ethical distress?

PubMed

Ondeck, Michele

2009-01-01

The Code of Ethics for Lamaze Certified Childbirth Educators outlines the ethical principles and standards that are derived from childbirth education's core values to assure quality and ethical practice. This article presents a summary of the history of ethics and medical ethics that informs a value-oriented decision-making process in childbirth education. The role of evidence in ethics is explored from the childbirth educator's viewpoint, and scenarios are used to reflect on situations that are examples of ethical distress. The conclusion is that the practice of ethics and ethical decision making includes regular reflection.

Ethical Grand Rounds: Teaching Ethics at the Point of Care.

PubMed

Airth-Kindree, Norah M M; Kirkhorn, Lee-Ellen C

2016-01-01

We offer an educational innovation called Ethical Grand Rounds (EGR) as a teaching strategy to enhance ethical decision-making. Nursing students participate in EGR-flexible ethical laboratories, where they take stands on ethical dilemmas, arguing for--or against--an ethical principle. This process provides the opportunity to move past normative ethics, that is, an ideal ethical stance in accord with ethical conduct codes, to applied ethics, what professional nurses would do in actual clinical practice, given the constraints that exist in contemporary care settings. EGR serves as a vehicle to translate "what ought to be" into "what is."

Resolving Ethical Issues when Conducting Sexuality Education

ERIC Educational Resources Information Center

Bruess, Clint E.; Greenberg, Jerrold S.

2008-01-01

Ethical issues about conducting sexuality education often arise. This paper describes one system of ethics and how the sexuality educator can use that system to determine whether an action is moral or immoral and, therefore, the appropriate action to take for that sexuality educator to be consistent with his or her values. Ethical principles are…

Ethical Issues in the Assessment and Treatment of a Rational Suicidal Client.

ERIC Educational Resources Information Center

Snipe, Rosetta M.

1988-01-01

Notes that rational client's decision to commit suicide may present complex ethical issues for therapist. Presents and discusses three-month account of therapy with client, from perspective of ethical values and principles upon which assessment and treatment decisions were made, and complex ethical dilemmas encountered as therapist juxtaposed…

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

ERIC Educational Resources Information Center

Vasquez, Melba J. T.

1996-01-01

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

76 FR 71343 - Ethics, Independence, Arm's-Length Role, Ex Parte Communications and Open Government

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-17

... FARM CREDIT ADMINISTRATION [FCA-PS-81; NV 11-25] Ethics, Independence, Arm's-Length Role, Ex Parte...) and the public. The FCA Board also is committed to the ethics principles and laws governing all Executive Branch employees and to the Agency's strong ethics program. DATES: Effective Date: November 7...

A Feminine and Poststructural Extension of Cosmopolitan Ethics in Music Education

ERIC Educational Resources Information Center

Richerme, Lauren Kapalka

2017-01-01

The interconnected nature of 21st-century life demands that music educators and students consider those beyond their immediate communities in their ethical deliberations. While Appiah's cosmopolitan ethical principles of universal concern and respect for legitimate difference may serve as a starting point for global ethical considerations in music…

Documenting moral agency: a qualitative analysis of abortion decision making for fetal indications.

PubMed

Gawron, Lori M; Watson, Katie

2017-02-01

We explored whether the decision-making process of women aborting a pregnancy for a fetal indication fit common medical ethical frameworks. We applied three ethical frameworks (principlism, care ethics, and narrative ethics) in a secondary analysis of 30 qualitative interviews from women choosing 2nd trimester abortion for fetal indications. All 30 women offered reasoning consistent with one or more ethical frameworks. Principlism themes included avoidance of personal suffering (autonomy), and sparing a child a poor quality of life and painful medical interventions (beneficence/non-maleficence). Care ethics reasoning included relational considerations of family needs and resources, and narrative ethics reasoning contextualized this experience into the patient's life story. This population's universal application of commonly accepted medical ethical frameworks supports the position that patients choosing fetal indication abortions should be treated as moral decision-makers and given the same respect as patients making decisions about other medical procedures. These findings suggest recent political efforts blocking abortion access should be reframed as attempts to undermine the moral decision-making of women. Published by Elsevier Inc.

The role of food ethics in food policy.

PubMed

Mepham, T B

2000-11-01

Certain developments in the agricultural and food sciences have far-reaching implications for society and the environment, which suggest the need to examine their ethical acceptability as a standard component of technology assessment. Such considerations have led to the emergence of a new academic discipline, food ethics. The present paper describes how ethical theory may be applied to the analysis of the impacts of prospective food biotechnologies to assess potential effects on four 'interest groups', i.e. consumers, producers, treated organisms and the biota (fauna and flora). The principles which structure the framework used, i.e. the ethical matrix, are adapted to the field of agriculture and food from those applied in medical ethics. Use of the ethical matrix is illustrated by applying it to the specific case of bovine somatotrophin, the genetically-engineered protein hormone which is injected into lactating cattle to increase their milk yields. Ethical analysis is seen to depend on a number of critical requirements, i.e. scientific data, non-scientific evidence and predictions, suitably-qualified assessors ('competent moral judges'), the 'world-views' of the assessors and application of the precautionary principle to cope with 'uncertainty'.

A comparative analysis of moral principles and behavioral norms in eight ethical codes relevant to health sciences librarianship, medical informatics, and the health professions.

PubMed

Byrd, Gary D; Winkelstein, Peter

2014-10-01

Based on the authors' shared interest in the interprofessional challenges surrounding health information management, this study explores the degree to which librarians, informatics professionals, and core health professionals in medicine, nursing, and public health share common ethical behavior norms grounded in moral principles. Using the "Principlism" framework from a widely cited textbook of biomedical ethics, the authors analyze the statements in the ethical codes for associations of librarians (Medical Library Association [MLA], American Library Association, and Special Libraries Association), informatics professionals (American Medical Informatics Association [AMIA] and American Health Information Management Association), and core health professionals (American Medical Association, American Nurses Association, and American Public Health Association). This analysis focuses on whether and how the statements in these eight codes specify core moral norms (Autonomy, Beneficence, Non-Maleficence, and Justice), core behavioral norms (Veracity, Privacy, Confidentiality, and Fidelity), and other norms that are empirically derived from the code statements. These eight ethical codes share a large number of common behavioral norms based most frequently on the principle of Beneficence, then on Autonomy and Justice, but rarely on Non-Maleficence. The MLA and AMIA codes share the largest number of common behavioral norms, and these two associations also share many norms with the other six associations. The shared core of behavioral norms among these professions, all grounded in core moral principles, point to many opportunities for building effective interprofessional communication and collaboration regarding the development, management, and use of health information resources and technologies.

Ethical principles and the rationing of health care: a qualitative study in general practice

PubMed Central

Berney, Lee; Kelly, Moira; Doyal, Len; Feder, Gene; Griffiths, Chris; Jones, Ian Rees

2005-01-01

Background Researching sensitive topics, such as the rationing of treatments and denial of care, raises a number of ethical and methodological problems. Aim To describe the methods and findings from a number of focus group discussions that examined how GPs apply ethical principles when allocating scarce resources. Design of study A small-scale qualitative study involving purposive sampling, semi-structured interviews and focus groups. Setting Twenty-four GPs from two contrasting areas of London: one relatively affluent and one relatively deprived. Method Initial interviews asked GPs to identify key resource allocation issues. The interviews were transcribed and themes were identified. A number of case studies, each illustrative of an ethical issue related to rationing, were written up in the form of vignettes. In focus group discussions, GPs were given a number of these vignettes to debate. Results With respect to the ethical basis for decision making, the findings from this part of the study emphasised the role of social and psychological factors, the influence of the quality of the relationship between GPs and patients and confusion among GPs about their role in decision making. Conclusion The use of vignettes developed from prior interviews with GPs creates a non-threatening environment to discuss sensitive or controversial issues. The acceptance by GPs of general moral principles does not entail clarity of coherence of the application of these principles in practice. PMID:16105371

Resource allocation on the frontlines of public health preparedness and response: report of a summit on legal and ethical issues.

PubMed

Barnett, Daniel J; Taylor, Holly A; Hodge, James G; Links, Jonathan M

2009-01-01

In the face of all-hazards preparedness challenges, local and state health department personnel have to date lacked a discrete set of legally and ethically informed public health principles to guide the distribution of scarce resources in crisis settings. To help address this gap, we convened a Summit of academic and practice experts to develop a set of principles for legally and ethically sound public health resource triage decision-making in emergencies. The invitation-only Summit, held in Washington, D.C., on June 29, 2006, assembled 20 experts from a combination of academic institutions and nonacademic leadership, policy, and practice settings. The Summit featured a tabletop exercise designed to highlight resource scarcity challenges in a public health infectious disease emergency. This exercise served as a springboard for Summit participants' subsequent identification of 10 public health emergency resource allocation principles through an iterative process. The final product of the Summit was a set of 10 principles to guide allocation decisions involving scarce resources in public health emergencies. The principles are grouped into three categories: obligations to community; balancing personal autonomy and community well-being/benefit; and good preparedness practice. The 10 Summit-derived principles represent an attempt to link law, ethics, and real-world public health emergency resource allocation practices, and can serve as a useful starting framework to guide further systematic approaches and future research on addressing public health resource scarcity in an all-hazards context.

From Theory to Practice: Facing Ethical Challenges as a Clinical Intern

ERIC Educational Resources Information Center

Hambrick, James P.; Pimentel, Sandra; Albano, Anne Marie

2009-01-01

Although formal ethics classes provide a basic foundation in managing ethical dilemmas, professionals often point to their experiences on internship as an important training ground for consolidation of their ethical development. Clinical interns face many personal and professional transitions that can lead to a number of ethical dilemmas.…

A Chaplain’s Guide to Privileged Communications

DTIC Science & Technology

2001-04-01

the privilege.82 [This case presents an interesting dilemma . In our day of paranoia concerning accusations of sexual impropriety, some clergy, when...legal, and professional) an ethical principle is developed, which is then applied to specific situation involving privileged communication. This...legal, and professional) an ethical principle is developed, which is then applied to specific situation involving privileged communication. This work

Oral History Research Ethics: Should Anonymity and Confidentially Issues Be Dealt with on Their Own Merit?

ERIC Educational Resources Information Center

Le Roux, C.

2015-01-01

A primary principle of ethical codes in research involving people is that of informed consent which ensures participants' right to privacy, confidentiality and anonymity. A blanket application of the principle of anonymity to Oral History (OH) research could well be counterproductive to the purported aims of OH research. The research comprised a…

Ethics in oncology: principles and responsibilities declared in the Italian Ragusa statement.

PubMed

Gori, Stefania; Pinto, Carmine; Caminiti, Caterina; Aprile, Giuseppe; Marchetti, Paolo; Perrone, Francesco; Di Maio, Massimo; Omodeo Salè, Emanuela; Mancuso, Annamaria; De Cicco, Maurizio; Di Costanzo, Francesco; Crispino, Sergio; Passalacqua, Rodolfo; Merlano, Marco; Zagonel, Vittorina; Fioretto, Luisa; Micallo, Giovanni; Labianca, Roberto; Bordonaro, Roberto; Comandone, Alessandro; Spinsanti, Sandro; Iacono, Carmelo; Nicolis, Fabrizio

2016-12-01

Cancer care involves many ethical issues. The need for more patient-centered healthcare together with the improved empowerment of every person diagnosed with cancer have been transposed by the Italian Association of Medical Oncology (AIOM) and eventually translated in the Ragusa statement. This position paper describes the philosophy that lies beneath this document and its fundamental principles.

Ethical standards for mental health and psychosocial support research in emergencies: review of literature and current debates.

PubMed

Chiumento, Anna; Rahman, Atif; Frith, Lucy; Snider, Leslie; Tol, Wietse A

2017-02-08

Research in emergencies is needed to understand the prevalence of mental health and psychosocial problems and strengthen the evidence base for interventions. All research - including operational needs assessments, programme monitoring and evaluation, and formal academic research - must be conducted ethically. While there is broad consensus on fundamental principles codified in research ethics guidelines, these do not address the ethical specificities of conducting mental health and psychosocial support (MHPSS) research with adults in emergencies. To address this gap, this paper presents a review of multidisciplinary literature to identify specific ethical principles applicable to MHPSS research in emergencies. Fifty-nine sources meeting the literature review inclusion criteria were analysed following a thematic synthesis approach. There was consensus on the relevance of universal ethical research principles to MHPSS research in emergencies, including norms of participant informed consent and protection; ensuring benefit arises from research participation; researcher neutrality, accountability, and safety; and the duty to ensure research is well designed and accounts for contextual factors in emergency settings. We go onto discuss unresolved issues by highlighting six current debates relating to the application of ethics in emergency settings: (1) what constitutes fair benefits?; (2) how should informed consent be operationalised?; (3) is there a role for decision making capacity assessments?; (4) how do risk management approaches impact upon the construction of ethical research?; (5) how can ethical reflection best be achieved?, and (6) are ethical review boards sufficiently representative and equipped to judge the ethical and scientific merit of emergency MHPSS research? Underlying these debates is a systemic tension between procedural ethics and ethics in practice. In summary, underpinning the literature is a desire to ensure the protection of participants exposed to emergencies and in need of evidence-based MHPSS. However, there is a lack of agreement on how to contextualise guidelines and procedures to effectively maximise the perspectives of researchers, participants and ethical review boards. This is a tension that the field must address to strengthen ethical MHPSS research in emergencies.

Clinical ethics and values: how do norms evolve from practice?

PubMed

Spranzi, Marta

2013-02-01

Bioethics laws in France have just undergone a revision process. The bioethics debate is often cast in terms of ethical principles and norms resisting emerging social and technological practices. This leads to the expression of confrontational attitudes based on widely differing interpretations of the same principles and values, and ultimately results in a deadlock. In this paper I would like to argue that focusing on values, as opposed to norms and principles, provides an interesting perspective on the evolution of norms. As Joseph Raz has convincingly argued, "life-building" values and practices are closely intertwined. Precisely because values have a more indeterminate meaning than norms, they can be cited as reasons for action by concerned stakeholders, and thus can help us understand how controversial practices, e.g. surrogate motherhood, can be justified. Finally, norms evolve when the interpretations of the relevant values shift and cause a change in the presumptions implicit in the norms. Thus, norms are not a prerequisite of the ethical solution of practical dilemmas, but rather the outcome of the decision-making process itself. Struggling to reach the right decision in controversial clinical ethics situations indirectly causes social and moral values to change and principles to be understood differently.

Conscientious objection or fear of social stigma and unawareness of ethical obligations.

PubMed

Faúndes, Anibal; Duarte, Graciana Alves; Osis, Maria José Duarte

2013-12-01

Conscientious objection is a legitimate right of physicians to reject the practice of actions that violate their ethical or moral principles. The application of that principle is being used in many countries as a justification to deny safe abortion care to women who have the legal right to have access to safe termination of pregnancy. The problem is that, often, this concept is abused by physicians who camouflage under the guise of conscientious objection their fear of experiencing discrimination and social stigma if they perform legal abortions. These colleagues seem to ignore the ethical principle that the primary conscientious duty of OB/GYNs is-at all times-to treat, or provide benefit and prevent harm to, the patients for whose care they are responsible. Any conscientious objection to treating a patient is secondary to this primary duty. One of the jobs of the FIGO Working Group for the Prevention of Unsafe Abortion is to change this paradigm and make our colleagues proud of providing legal abortion services that protect women's life and health, and concerned about disrespecting the human rights of women and professional ethical principles. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Informed consent in neurosurgery—translating ethical theory into action

PubMed Central

Schmitz, Dagmar; Reinacher, Peter C

2006-01-01

Objective Although a main principle of medical ethics and law since the 1970s, standards of informed consent are regarded with great scepticism by many clinicans. Methods By reviewing the reactions to and adoption of this principle of medical ethics in neurosurgery, the characteristic conflicts that emerge between theory and everyday clinical experience are emphasised and a modified conception of informed consent is proposed. Results The adoption and debate of informed consent in neurosurgery took place in two steps. Firstly, respect for patient autonomy was included into the ethical codes of the professional organisations. Secondly, the legal demands of the principle were questioned by clinicians. Informed consent is mainly interpreted in terms of freedom from interference and absolute autonomy. It lacks a constructive notion of physician–patient interaction in its effort to promote the best interest of the patient, which, however, potentially emerges from a reconsideration of the principle of beneficence. Conclusion To avoid insufficient legal interpretations, informed consent should be understood in terms of autonomy and beneficence. A continuous interaction between the patient and the given physician is considered as an essential prerequisite for the realisation of the standards of informed consent. PMID:16943326

[Science and ethics].

PubMed

Harrer, Friedrich

2002-01-01

In current ethics debates, the protection of animals and the environment are central themes. In this context, reference is made to "ethics of responsibility". In the reality of scientific life and the conduct of science, "ethics of responsibility" have only had a modest impact. Reflection based on the history of thought may explain this finding. Upon abolishing God, man has redirected an initially religious love and devotion toward himself. The postulate of unfettered dominion over the Earth has become the supreme principle. "Theoria" in the sense of its original meaning, that is a celebratory admiration for sacred Nature, is incomprehensible to modern man. Nature has been stripped of its sanctity and transformed into something to be exploited for its human utility. Consequently, today the credo applies that to interpret the freedom of science according to ethical principles is utterly untenable. The author pleads for reconsideration.

Relevance and limits of the principle of "equivalence of care" in prison medicine.

PubMed

Niveau, Gérard

2007-10-01

The principle of "equivalence of care" in prison medicine is a principle by which prison health services are obliged to provide prisoners with care of a quality equivalent to that provided for the general public in the same country. It is cited in numerous national and international directives and recommendations. The principle of equivalence is extremely relevant from the point of view of normative ethics but requires adaptation from the point of view of applied ethics. From a clinical point of view, the principle of equivalence is often insufficient to take account of the adaptations necessary for the organization of care in a correctional setting. The principle of equivalence is cost-effective in general, but has to be overstepped to ensure the humane management of certain special cases.

Fallibility: a new perspective on the ethics of clinical trial enrollment.

PubMed

Shamy, Michel C F; Stahnisch, Frank W; Hill, Michael D

2015-01-01

The ethical principle of 'equipoise', introduced in 1974, represents the most widely influential justification for the enrollment of patients into randomized clinical trials. However, definitions of equipoise vary, and its terms are not universally accepted. In this paper, we suggest a new way of approaching the ethics of clinical trial enrollment, which we call fallibility. The principle of fallibility argues that all physician opinions are sufficiently uncertain to warrant investigation, and that the ethical justification for any trial becomes a question of its epistemic validity, by which we mean the strength of its hypotheses and methods. The principle of fallibility can be translated into practice through the virtues of humility, skepticism and caring. While we cite recent examples from stroke medicine to demonstrate the limitations of equipoise, we propose that fallibility may offer a more general means of addressing the controversies that arise surrounding randomized controlled trials in many disciplines of medicine. © 2014 World Stroke Organization.

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

PubMed

Riley, Donna

2013-03-01

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

Framing ethical acceptability: a problem with nuclear waste in Canada.

PubMed

Wilding, Ethan T

2012-06-01

Ethical frameworks are often used in professional fields as a means of providing explicit ethical guidance for individuals and institutions when confronted with ethically important decisions. The notion of an ethical framework has received little critical attention, however, and the concept subsequently lends itself easily to misuse and ambiguous application. This is the case with the 'ethical framework' offered by Canada's Nuclear Waste Management Organization (NWMO), the crown-corporation which owns and is responsible for the long-term management of Canada's high-level nuclear fuel waste. It makes a very specific claim, namely that it is managing Canada's long-lived radioactive nuclear fuel waste in an ethically responsible manner. According to this organization, what it means to behave in an ethically responsible manner is to act and develop policy in accordance with its ethical framework. What, then, is its ethical framework, and can it be satisfied? In this paper I will show that the NWMO's ethical and social framework is deeply flawed in two respects: (a) it fails to meet the minimum requirements of a code of ethic or ethical framework by offering only questions, and no principles or rules of conduct; and (b) if posed as principles or rules of conduct, some of its questions are unsatisfiable. In particular, I will show that one of its claims, namely that it seek informed consent from individuals exposed to risk of harm from nuclear waste, cannot be satisfied as formulated. The result is that the NWMO's ethical framework is not, at present, ethically acceptable.

Ethical principles for novel therapies in veterinary practice.

PubMed

Yeates, J W

2016-02-01

To present insights to aid decision-making about novel veterinary treatments from regulations concerning animal experimentation and human clinical medical trials. EU Directive 2010/63/EU on the protection of animals used for scientific purposes and EU Regulation 536/2014 on clinical trials on medicinal products for human use were analysed, evaluated and "translated" into relevant principles for veterinary surgeons. A number of principles are relevant, relating to treatment expectations, thresholds and objectives; client consent; minimising harms; personnel; review committees; assessment and publication. These principles should assist veterinary surgeons to make good ethical decisions about novel treatments. © 2015 British Small Animal Veterinary Association.

The bioethical principles and Confucius' moral philosophy.

PubMed

Tsai, D F-C

2005-03-01

This paper examines whether the modern bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice proposed by Beauchamp and Childress are existent in, compatible with, or acceptable to the leading Chinese moral philosophy-the ethics of Confucius. The author concludes that the moral values which the four prima facie principles uphold are expressly identifiable in Confucius' teachings. However, Confucius' emphasis on the filial piety, family values, the "love of gradation", altruism of people, and the "role specified relation oriented ethics" will inevitably influence the "specification" and application of these bioethical principles and hence tend to grant "beneficence" a favourable position that diminishes the respect for individual rights and autonomy. In contrast, the centrality of respect for autonomy and its stance of "first among equals" are more and more stressed in Western liberal viewpoints. Nevertheless, if the Confucian "doctrine of Mean" (chung-yung) and a balanced "two dimensional personhood" approach are properly employed, this will require both theorists and clinicians, who are facing medical ethical dilemmas, of searching to attain due mean out of competing moral principles thus preventing "giving beneficence a priority" or "asserting autonomy must triumph".

Ethical Challenges

ERIC Educational Resources Information Center

Morris, Michael

2004-01-01

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

Integrating Ethics into the Social Studies Curriculum.

ERIC Educational Resources Information Center

Howe, Kenneth R.

1991-01-01

Urges incorporation of ethics into social studies curriculum. Provides an overview of ethical theory including principle-based theories of utilitarianism and deontology and virtue-based theories. Discusses philosophies of social science including positivism, interpretivism, and critical social science. Suggests teaching methods and curriculum…

Hippocratic, religious, and secular ethics: the points of conflict.

PubMed

Veatch, Robert M

2012-02-01

The origins of professional ethical codes and oaths are explored. Their legitimacy and usefulness within the profession are questioned and an alternative ethical source is suggested. This source relies on a commonly shared, naturally knowable set of principles known as common morality.

AIDS: Balancing Confidentiality and the Duty to Protect.

ERIC Educational Resources Information Center

Lynch, Sherry K.

1993-01-01

Explores legal and ethical responsibilities of counselors working with human immunodeficiency virus-infected students and reviews guidelines for making critical decisions involving these students. Court decisions, Kitchner's (1985) five ethical principles, and ethical standards of several professional associations are considered. (Author/NB)

Ethical issues in healthcare financing.

PubMed

Maharaj, S R; Paul, T J

2011-07-01

The four goals of good healthcare are to relieve symptoms, cure disease, prolong life and improve quality of life. Access to healthcare has been a perpetual challenge to healthcare providers who must take into account important factors such as equity, efficiency and effectiveness in designing healthcare systems to meet the four goals of good healthcare. The underlying philosophy may designate health as being a basic human right, an investment, a commodity to be bought and sold, a political demand or an expenditure. The design, policies and operational arrangements will usually reflect which of the above philosophies underpin the healthcare system, and consequently, access. Mechanisms for funding include fee-for-service, cost sharing (insurance, either private or government sponsored) free-of-fee at point of delivery (payments being made through general taxes, health levies, etc) or cost-recovery. For each of these methods of financial access to healthcare services, there are ethical issues which can compromise the four principles of ethical practices in healthcare, viz beneficence, non-maleficence, autonomy and justice. In times of economic recession, providing adequate healthcare will require governments, with support from external agencies, to focus on poverty reduction strategies through provision of preventive services such as immunization and nutrition, delivered at primary care facilities. To maximize the effect of such policies, it will be necessary to integrate policies to fashion an intersectoral approach.

Teaching Business Ethics: The Effectiveness of Common Pedagogical Practices in Developing Students' Moral Judgment Competence

ERIC Educational Resources Information Center

Bosco, Susan M.; Melchar, David E.; Beauvais, Laura L.; Desplaces, David E.

2010-01-01

This study investigates the effectiveness of pedagogical practices used to teach business ethics. The business community has greatly increased its demands for better ethics education in business programs. Educators have generally agreed that the ethical principles of business people have declined. It is important, then, to examine how common…

One Chairperson's Experience of Ethical Review: Balancing Principle, Convention, Relationship and Risk in Educational Research

ERIC Educational Resources Information Center

O'Neill, John

2010-01-01

The author's experience of ethical review over six years as an academic member and chairperson of a university human ethics committee has been largely positive and educative. The account brings together archival records and personal experience to create a "transactive" account of the practical experience of doing ethical review in one…

Playing with a "Full DECK": A Creative Application of the Integrative Decision-Making Framework of Ethical Behavior

ERIC Educational Resources Information Center

Case, Jan C.; Plaisance, Pamela M.; Renfrow, Jennifer J.; Olivier, Brandi N.

2008-01-01

Rehabilitation practitioners are faced with a variety of complex ethical decisions in a dynamic, changing world. Attention to principle ethics, virtue ethics, critical thinking, and creativity are essential for best practice. This article presents one tool (DECK--Decision-Making that Enhances Counselor Know-How) to facilitate such ethical…

Broadening Student Perspectives on Marketing Research Ethics: Development and Applications of a Teaching Module

ERIC Educational Resources Information Center

Handlin, Amy

2012-01-01

This paper describes an ethics module developed by the author to engage marketing research students during the fall semester, when they are bombarded by political polls. The module matches ethically questionable polling practices to similarly troubling practices in marketing research. The goals are to show that ethical principles are not topic- or…

A Constructivist Approach to Business Ethics: Developing a Student Code of Professional Conduct

ERIC Educational Resources Information Center

Willey, Lorrie; Burke, Debra D.

2011-01-01

Business ethics may be defined as "the principles, values and standards that guide behavior in the world of business." The importance of ethical awareness in business transactions and education is widely recognized, and evidence shows that ethics education can influence decision making in the workplace. As a result, colleges of business often…

Experiential Ethics as a Foundation for Dialogue between Health Communication and Health-Care Ethics.

ERIC Educational Resources Information Center

Reich, Warren Thomas

1988-01-01

Advocates that health-care ethics should start with a knowledge of moral reality based on experience, with patterns of moral behavior expressed not in principles, but in models, images, stories, myths, and paradigms. Notes that this approach offers a rich potential for exchange and collaboration between ethical and communication theories. (SR)

Toward a Democratic Ethic of Curricular Decision-Making: A Guide for Educational Practitioners

ERIC Educational Resources Information Center

Simpson, Douglas J.; Jackson, Michael J. B.; Bunuan, Rommel L.; Chan, Yoke-Meng; Collins, B. Renee; King, Erica L.; Mosley, Linder K.

2004-01-01

In this article, the authors present a philosophical exploration of the import of a democratic ethic in making decisions concerning curricula. Specifically, the authors offer a guide for ethical decision making that is concerned with promoting fairness and acting on social justice principles. The ethical responsibilities of educators are explored,…

Pragmatic ethical basis for radiation protection in diagnostic radiology

PubMed Central

Zölzer, Friedo

2016-01-01

Objective: Medical ethics has a tried and tested literature and a global active research community. Even among health professionals, literate and fluent in medical ethics, there is low recognition of radiation protection principles such as justification and optimization. On the other hand, many in healthcare environments misunderstand dose limitation obligations and incorrectly believe patients are protected by norms including a dose limit. Implementation problems for radiation protection in medicine possibly flow from apparent inadequacies of the International Commission on Radiological Protection (ICRP) principles taken on their own, coupled with their failure to transfer successfully to the medical world. Medical ethics, on the other hand, is essentially global, is acceptable in most cultures, is intuitively understood in hospitals, and its expectations are monitored, even by managements. This article presents an approach to ethics in diagnostic imaging rooted in the medical tradition, and alert to contemporary social expectations. ICRP and the International Radiation Protection Association (IRPA), both alert to growing ethical concerns, organized a series of consultations on ethics for general radiation protection in the last few years. Methods: The literature on medical ethics and implicit ICRP ethical values were reviewed qualitatively, with a view to identifying a system that will help guide contemporary behaviour in radiation protection of patients. Application of the system is illustrated in six clinical scenarios. The proposed system is designed, as far as is possible, so as not to be in conflict with the conclusions emerging from the ICRP/IRPA consultations. Results and conclusion: A widely recognized and well-respected system of medical ethics was identified that has global reach and claims acceptance in all cultures. Three values based on this system are grouped with two additional values to provide an ethical framework for application in diagnostic imaging. This system has the potential to be robust and to reach conclusions that are in accord with contemporary medical, social and ethical thinking. The system is not intended to replace the ICRP principles. Rather, it is intended as a well-informed interim approach that will help judge and analyse situations that arouse ethical concerns in radiology. Six scenarios illustrate the practicality of the value system in alerting one to possible deficits in practice. Advances in knowledge: Five widely recognized values and the basis for them are identified to support the contemporary practice of diagnostic radiology. These are essential to complement the widely used ICRP principles pending further development in the area. PMID:26796852

The development and psychometric validation of the Ethical Awareness Scale.

PubMed

Milliken, Aimee; Ludlow, Larry; DeSanto-Madeya, Susan; Grace, Pamela

2018-04-19

To develop and psychometrically assess the Ethical Awareness Scale using Rasch measurement principles and a Rasch item response theory model. Critical care nurses must be equipped to provide good (ethical) patient care. This requires ethical awareness, which involves recognizing the ethical implications of all nursing actions. Ethical awareness is imperative in successfully addressing patient needs. Evidence suggests that the ethical import of everyday issues may often go unnoticed by nurses in practice. Assessing nurses' ethical awareness is a necessary first step in preparing nurses to identify and manage ethical issues in the highly dynamic critical care environment. A cross-sectional design was used in two phases of instrument development. Using Rasch principles, an item bank representing nursing actions was developed (33 items). Content validity testing was performed. Eighteen items were selected for face validity testing. Two rounds of operational testing were performed with critical care nurses in Boston between February-April 2017. A Rasch analysis suggests sufficient item invariance across samples and sufficient construct validity. The analysis further demonstrates a progression of items uniformly along a hierarchical continuum; items that match respondent ability levels; response categories that are sufficiently used; and adequate internal consistency. Mean ethical awareness scores were in the low/moderate range. The results suggest the Ethical Awareness Scale is a psychometrically sound, reliable and valid measure of ethical awareness in critical care nurses. © 2018 John Wiley & Sons Ltd.

Preparing students for the ethical challenges on international health electives: A systematic review of the literature on educational interventions.

PubMed

Rahim, Anika; Knights Née Jones, Felicity; Fyfe, Molly; Alagarajah, Janagan; Baraitser, Paula

2016-09-01

International health electives pose specific ethical challenges for students travelling from to low and middle income countries. We undertook a systematic review of the literature on interventions to prepare students to identify ethical issues addressed, educational approaches and to collate evidence on the effectiveness of different strategies. We searched nine electronic databases of peer-reviewed literature and identified grey literature through key word searches; supplemented through citation mapping and expert consultation. Articles that described ethical training conducted by universities or professional bodies were included for review. We reviewed forty-four full text articles. Ten sources of published literature and seven sources of grey literature met our inclusion criteria. We identified thirteen ethical situations that students should be prepared to manage and eight generic skills to support this process. Most interventions were delivered before the elective, used case studies or guidelines. Some suggested ethical principles or a framework for analysis of ethical issues. Only two papers evaluated the intervention described. Our paper collates a small but growing body of work on education to prepare students to manage ethical issues. Ethical training should have elements that are delivered before, during and after the elective. Interventions should include case studies covering thirteen ethical issues identified here, linked to ethical principles and a process for responding to ethical issues. We suggest that evaluations of interventions are an important area for future research.

Nursing ethics in the seventh-day adventist religious tradition.

PubMed

Taylor, Elizabeth Johnston; Carr, Mark F

2009-11-01

Nurses' religious beliefs influence their motivations and perspectives, including their practice of ethics in nursing care. When the impact of these beliefs is not recognized, great potential for unethical nursing care exists. Thus, this article examines how the theology of one religious tradition, Seventh-day Adventism (SDA), could affect nurses. An overview of SDA history and beliefs is presented, which explains why 'medical missionary' work is central to SDAs. Theological foundations that would permeate an SDA nurse's view of the nursing metaparadigm concepts of person, health, environment (i.e. community), and nursing (i.e. service) are presented. The ethical principles guiding SDA nurses (i.e. principled, case-based, and care ethics) and the implications of these theological foundations for nurses are noted in a case study.

Living donation and cosmetic surgery: a double standard in medical ethics?

PubMed

Testa, Giuliano; Carlisle, Erica; Simmerling, Mary; Angelos, Peter

2012-01-01

The commitment of transplant physicians to protect the physical and psychological health of potential donors is fundamental to the process of living donor organ transplantation. It is appropriate that strict regulations to govern an individual's decision to donate have been developed. Some may argue that adherence to such regulations creates a doctor-patient relationship that is rooted in paternalism, which is in drastic contrast with a doctor-patient relationship that is rooted in patients' autonomy, characteristic of most other operative interventions. In this article we analyze the similarities between cosmetic plastic surgery and living donor surgery as examples of surgeries governed by different ethical principles. It is interesting that, while the prevailing ethical approach in living donor surgery is based on paternalism, the ethical principle guiding cosmetic surgery is respect for patients' autonomy. The purpose of this article is not to criticize either practice, but to suggest that, given the similarities between the two procedures, both operative interventions should be guided by the same ethical principle: a respect for patients' autonomy. We further suggest that if living organ donation valued donors' autonomy as much as cosmetic plastic surgery does, we might witness a wider acceptance of and increase in living organ donation.

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 duties of commission? The task of examining ethical dilemmas is a relatively recent issue in the 3K years old philosophy and, off course, just a "baby" in geosciences. But the time has arrived to better examine and rethink the challenge of answering and how to approach geoethical dilemmas.

Ethical religion in primary care

PubMed Central

Torry, Malcolm

2017-01-01

Religion is increasingly significant in UK society, and is highly significant for many patients and primary care practitioners. An important task for the practitioner is to ensure that the place of religion in the patient/practitioner relationship is treated with the same ethical seriousness as every other aspect of that relationship. The article finds the ‘four principles of biomedical ethics’ to be applicable, and recent GMC guidelines to be consistent with the four principles. The article applies the four principles to the particular case of practitioners wearing religious symbolism. PMID:28811838

Seeking better health care outcomes: the ethics of using the "nudge".

PubMed

Blumenthal-Barby, J S; Burroughs, Hadley

2012-01-01

Policymakers, employers, insurance companies, researchers, and health care providers have developed an increasing interest in using principles from behavioral economics and psychology to persuade people to change their health-related behaviors, lifestyles, and habits. In this article, we examine how principles from behavioral economics and psychology are being used to nudge people (the public, patients, or health care providers) toward particular decisions or behaviors related to health or health care, and we identify the ethically relevant dimensions that should be considered for the utilization of each principle.

[Ethical considerations about research with women in situations of violence].

PubMed

Rafael, Ricardo de Mattos Russo; Soares de Moura, Anna Tereza Miranda

2013-01-01

This essay aims at reflecting on the ethical and methodological principles involved in research with women in situation of violence. The text raises the discussion of the application of the principles of beneficence and non-maleficence during researches involving this issue, pointing to recommendations towards privacy, autonomy and immediate contributions for volunteers. Then, taking as theoretical reference the principles of justice and equity, the authors propose a debate on methodological aspects involved in protection of respondents, with a view at improving the quality of the data obtained and possible social contributions.

Ethics: A Theory of Medical Ethics.

PubMed

Brody, Howard

This book review characterizes Robert Veatch's A Theory of Medical Ethics as a "third-generation" treatise that looks beyond case- and issue-oriented analysis to develop the theoretical bases of a "true system of medical ethics." Veatch proposes a "draft medical ethical covenant" based on a "triple contract" model, in which the moral principles of contract keeping, autonomy, honesty, avoiding killing, and justice govern the physician's relationship to both individual patients and society.

Cautionary Tales: Ethics and Case Studies in Science

PubMed Central

Herreid, Clyde Freeman

2014-01-01

Ethical concerns are normally avoided in science classrooms in spite of the fact that many of our discoveries impinge directly on personal and societal values. We should not leave the ethical problems for another day, but deal with them using realistic case studies that challenge students at their ethical core. In this article we illustrate how case studies can be used to teach STEM students principles of ethics. PMID:25574280

The evolution of ethics for community practice.

PubMed

Racher, Frances E

2007-01-01

Defining the community as client or partner requires a different ethical approach, an approach focused on the aggregate, community, or societal level. A discussion of rule ethics, virtue ethics, and feminist ethics transports the community practitioner beyond traditional ethical principles to consider a more contemporary ethical foundation for public health and community practice. Inclusion, diversity, participation, empowerment, social justice, advocacy, and interdependence create an evolving ethical foundation to support community practice. Collaboration among health care professionals and members of the organizations, communities, and societies in which they practice will facilitate the further development of moral thought and ethical theory to underpin community practice.

Against the principle that the individual shall have priority over science.

PubMed

Helgesson, G; Eriksson, S

2008-01-01

This paper highlights a feature common to many ethical guidelines--namely, the idea that the interests of the individual shall always prevail over the interests of science and society. The paper presents how some major ethical guidelines treat the balancing of research interests against those of research subjects and spells out the difficulties in interpreting the principle of the primacy of the individual in a way that can be action-guiding. It suggests various alternative interpretations of the primacy of the individual and argues that they do not hold. Finally, the implications of this analysis for ethical guidelines are discussed.

What are the Ethical Problems Raised by the Increase of Cognitive Capabilities in the Defence Structure: The French Legal Structure, the Ethical Position of the French Military Health Service

DTIC Science & Technology

2009-10-01

principles for conducting research on humans as animals has been defined in 1988 and confirmed in the bioethical law in 1994 [3]. Some modifications...ethical principles for conducting research on humans as animals has been defined in 1988 and confirmed in the bioethical law in 1994 [3]. Some...partly, to the doctors and it had become necessary to think of the power of man outside of medicine. According to the German Hans Jonas “ bioethics

[Ethics in anorexia nervosa: autonomy, beneficence or responsibility?].

PubMed

Figueroa, Gustavo

2008-05-01

In patients with anorexia nervosa, ethical dilemmas will appear in case of difficult and serious medical situations. Although the principle of beneficence could be used to argue for the use of coercive medical therapies, the respect for autonomy must take precedence. The latter is a central principle of bioethics. However, the interactions between autonomy, beneficence, non-maleficence, and justice become quite complex when these patients need to be treated. Difficulties must be overcome and a balance between these considerations must be reached. This paper gives an account of ethical values relevant to moral assessment in anorexia nervosa: conviction, responsibility and care.

Health care needs assessment among adolescents in correctional institutions in Zambia: an ethical analysis.

PubMed

Kumwenda, Maureen; Nzala, Selestine; Zulu, Joseph M

2017-08-22

While health care needs assessments have been conducted among juveniles or adolescents by researchers in developed countries, assessments using an ethics framework particularly in developing countries are lacking. We analysed the health care needs among adolescents at the Nakambala Correctional Institution in Zambia, using the Beauchamp and Childress ethics framework. The ethics approach facilitated analysis of moral injustices or dilemmas triggered by health care needs at the individual (adolescent) level. The research team utilized 35 in-depth interviews with juveniles, 6 key informant interviews and 2 focus group discussions to collect data. We analysed the data using thematic analysis. The use of three sources of data facilitated triangulation of data. Common health problems included HIV/AIDS, STIs, flu, diarrhoea, rashes, and malaria. Although there are some health promotion strategies at the Nakambala Approved School, the respondents classified the health care system as inadequate. The unfavourable social context which included clouded rooms and lack of adolescent health friendly services unfairly exposed adolescents to several health risks and behaviours thus undermining the ethics principle of social justice. In addition, the limited prioritisation of adolescent centres by the stakeholders and erratic funding also worsened injustices by weakening the health care system. Whereas the inadequate medical and drug supplies, shortage of health workers in the nearby health facilities and weak referral systems excluded the juveniles from enjoying maximum health benefits thus undermining adolescents' wellbeing or beneficence. Inadequate medical and drug supplies as well as non-availability of adolescent friendly health services at the nearest health facility did not only affect social justice and beneficence ethics principles but also threatened juveniles' privacy, liberty and confidentiality as well as autonomy with regard to health service utilisation. Adequately addressing the health needs in correctional institutions may require adopting an ethics framework in conducting health needs assessment. An ethics approach is important because it facilitates understanding of moral dilemmas that arise due to health needs. Furthermore, strategies for addressing health needs related to one ethics principle may have a positive ripple effect over other health needs as the principles are intertwined thus facilitating a comprehensive response to health needs.

Psychiatric Residents' Needs for Education about Informed Consent, Principles of Ethics and Professionalism, and Caring for Vulnerable Populations: Results of a Multisite Survey

ERIC Educational Resources Information Center

Jain, Shaili; Lapid, Maria I.; Dunn, Laura B.; Roberts, Laura Weiss

2011-01-01

Objective: The authors examined psychiatric residents' perceived needs for education in informed consent, principles of ethics and professionalism, and treating vulnerable populations. Method: A written survey was distributed to psychiatric residents (N = 249) at seven U.S. residency programs in 2005. The survey contained 149 questions in 10…

Equipoise, design bias, and randomized controlled trials: the elusive ethics of new drug development.

PubMed

Fries, James F; Krishnan, Eswar

2004-01-01

The concept of 'equipoise', or the 'uncertainty principle', has been represented as a central ethical principle, and holds that a subject may be enrolled in a randomized controlled trial (RCT) only if there is true uncertainty about which of the trial arms is most likely to benefit the patient. We sought to estimate the frequency with which equipoise conditions were met in industry-sponsored RCTs in rheumatology, to explore the reasons for any deviations from equipoise, to examine the concept of 'design bias', and to consider alternative ethical formulations that might improve subject safety and autonomy. We studied abstracts accepted for the 2001 American College of Rheumatology meetings that reported RCTs, acknowledged industry sponsorship, and had clinical end-points (n = 45), and examined the proportion of studies that favored the registration or marketing of the sponsor's drug. In every trial (45/45) results were favorable to the sponsor, indicating that results could have been predicted in advance solely by knowledge of sponsorship (P < 0.0001). Equipoise clearly was being systematically violated. Publication bias appeared to be an incomplete explanation for this dramatic result; this bias occurs after a study is completed. Rather, we hypothesize that 'design bias', in which extensive preliminary data are used to design studies with a high likelihood of being positive, is the major cause of the asymmetric results. Design 'bias' occurs before the trial is begun and is inconsistent with the equipoise principle. However, design bias increases scientific efficiency, decreases drug development costs, and limits the number of subjects required, probably reducing aggregate risks to participants. Conceptual and ethical issues were found with the equipoise principle, which encourages performance of negative studies; ignores patient values, patient autonomy, and social benefits; is applied at a conceptually inappropriate decision point (after randomization rather than before); and is in conflict with the Belmont, Nuremberg, and other sets of ethical principles, as well as with US Food and Drug Administration procedures. We propose a principle of 'positive expected outcomes', which informs the assessment that a trial is ethical, together with a restatement of the priority of personal autonomy.

Sexuality in institutionalized elderly persons: a systematic review of argument-based ethics literature.

PubMed

Mahieu, Lieslot; Gastmans, Chris

2012-03-01

Admission to a nursing home might challenge the way in which individuals experience their own sexuality, but it does not automatically diminish their need and desire for sexual fulfillment. Despite the fact that sexuality proves to be an intrinsic part of human existence, the sexual expression of geriatric residents remains a sensitive subject for many caregivers and family members. It evokes a variety of ethical issues and concerns, especially when dementia patients are involved. The overall objective of this review was to examine the ethical arguments and concepts about the debate on sexuality within a nursing home environment. We conducted a systematic search for argument-based ethics literature focusing on sexuality in institutionalized elderly people. Twenty-five appropriate studies were identified. A thematic analysis of the included literature led us to distinguish two major groups of ethical arguments: (i) principles and (ii) care. Ethics arguments on sexuality in institutionalized elderly are particularly guided by the principle of respect for autonomy and the concomitant notion of informed consent. Arguments related to care were also apparent within the research literature although they received considerably less attention than the arguments related to the principles of respect for autonomy, beneficence, nonmaleficence and justice. The lack of clarity in the conceptualization of the arguments referred to in the research literature indicates that there is a pressing need for a better defined, more fundamental philosophical-ethical analysis of the values at stake.

Distinguishing genetics and eugenics on the basis of fairness.

PubMed Central

Ledley, F D

1994-01-01

There is concern that human applications of modern genetic technologies may lead inexorably to eugenic abuse. To prevent such abuse, it is essential to have clear, formal principles as well as algorithms for distinguishing genetics from eugenics. This work identifies essential distinctions between eugenics and genetics in the implied nature of the social contract and the importance ascribed to individual welfare relative to society. Rawls's construction of 'justice as fairness' is used as a model for how a formal systems of ethics can be used to proscribe eugenic practices. Rawls's synthesis can be applied to this problem if it is assumed that in the original condition all individuals are ignorant of their genetic constitution and unwilling to consent to social structures which may constrain their own potential. The principles of fairness applied to genetics requires that genetic interventions be directed at extending individual liberties and be applied to the greatest benefit of individuals with the least advantages. These principles are incompatible with negative eugenics which would further penalize those with genetic disadvantage. These principles limit positive eugenics to those practices which are designed to provide absolute benefit to those individuals with least advantage, are acceptable to its subjects, and further a system of basic equal liberties. This analysis also illustrates how simple deviations from first principles in Rawls's formulation could countenance eugenic applications of genetic technologies. PMID:7996561

Bringing back Aristotle.

PubMed

Saunders, John

2011-01-01

Ethical analysis in medicine has been dominated by an approach derived from "the four principles" which focus on actions. By contrast, consideration of the virtues emphasises the importance of the moral agent. A renewed emphasis on virtue ethics, not as a rival, but integrated into deontological ethics is proposed.

Ethics in humanitarian services: report on the earthquake in Nepal.

PubMed

Aacharya, Ramesh P; Tiwari, Sanjeeb; Shrestha, Tirtha M

2017-01-01

The Nepal earthquake was one of the biggest natural calamities of the year 2015. This paper attempts to explore the ethical issues involved in the humanitarian services rendered during the crisis and thereafter. The four principles of biomedical ethics - autonomy, beneficence, non-maleficence, and justice - are discussed in relation to the relief activities immediately following the disaster and the subsequent long-term activities, such as rehabilitation, wherever applicable. The discussion touches upon public health components such as vulnerable populations, environmental ethics and justice for the future. Incorporating ethical principles into the response to disasters is of vital importance to ensure that healthcare complies with professional norms and ethical standards, and is in tune with the medical needs of the local culture. Beneficence is prioritised, while non-maleficence and autonomy tend to be ignored. Justice, particularly distributive justice, deserves due attention in the context of limited resources, not only during the emergency phase but also during the phases of rehabilitation and planning for the future.

Imaginative ethics--bringing ethical praxis into sharper relief.

PubMed

Hansson, Mats G

2002-01-01

The empirical basis for this article is three years of experience with ethical rounds at Uppsala University Hospital. Three standard approaches of ethical reasoning are examined as potential explanations of what actually occurs during the ethical rounds. For reasons given, these are not found to be satisfying explanations. An approach called "imaginative ethics", is suggested as a more satisfactory account of this kind of ethical reasoning. The participants in the ethical rounds seem to draw on a kind of moral competence based on personal life experience and professional competence and experience. By listening to other perspectives and other experiences related to one particular patient story, the participants imagine alternative horizons of moral experience and explore a multitude of values related to clinical practice that might be at stake. In his systematic treatment of aesthetics in the Critique of Judgement, Kant made use of an operation of thought that, if applied to ethics, will enable us to be more sensitive to the particulars of each moral situation. Based on this reading of Kant, an account of imaginative ethics is developed in order to bring the ethical praxis of doctors and nurses into sharper relief. The Hebraic and the Hellenic traditions of imagination are used in order to illuminate some of the experiences of ethical rounds. In conclusion, it is argued that imaginative ethics and principle-based ethics should be seen as complementary in order to endow a moral discourse with ethical authority. Kantian ethics will do the job if it is remembered that Kant suggested only a modest, negative role of principle-based deliberation.

Income-related health transfers principles and orderings of joint distributions of income and health.

PubMed

Khaled, Mohamad A; Makdissi, Paul; Yazbeck, Myra

2018-01-01

The objective of this article is to provide the analyst with the necessary tools that allow for a robust ordering of joint distributions of health and income. We contribute to the literature on the measurement and inference of socioeconomic health inequality in three distinct but complementary ways. First, we provide a formalization of the socioeconomic health inequality-specific ethical principle introduced by Erreygers et al. (2012) . Second, we propose new graphical tools and dominance tests for the identification of robust orderings of joint distributions of income and health associated with this new ethical principle. Finally, based on both pro-poor and pro-extreme ranks ethical principles we address a very important aspect of dominance literature: the inference. To illustrate the empirical relevance of the proposed approach, we compare joint distributions of income and a health-related behavior in the United States in 1997 and 2014. Copyright © 2017 Elsevier B.V. All rights reserved.

[Ethical principles of clinical trials in minors].

PubMed

Koch, H J; Raschka, C

2002-12-05

Clinical trials in volunteers and patients are essential to ensure rational treatment of patients. As a rule, drugs are routinely developed for adults, but children are excluded. A major reason for this restriction are ethical justifications, in particular the lack of autonomy on the part of children. The principle of fairness, however, requires that everyone should benefit from progress. Industry, science and society are therefore called upon to find ways of making available safe and adequate treatment for children as quickly as possible, by defining the required conditions for pediatric clinical trials. Important principles are minimal risk, minimal invasivity, rapid decision-making, and careful documentation of trial results. Dynamic ethical principles, such as autonomy and competence in adolescents must be considered on equal footing with existing international GCP guidelines. Aspects of child psychology indicate that the autonomy of adolescents should be respected. Where economic incentives for such trials are absent, for example, in the case of non-pharmacological problems, pediatric trials must be considered a task for society as a whole.

Ethnographic research with adolescent students: situated fieldwork ethics and ethical principles governing human research.

PubMed

Hemmings, Annette

2009-12-01

This paper explores ethical dilemmas in situated fieldwork ethics concerning ethnographic studies of adolescent students. While consequentialist and deontological ethics form the basis of the ethical stances shared by ethnographers and research ethics committees, the interpretation of those principles may diverge in school-based ethnography with adolescent students because of the particular role of the adult ethnographer vis-à-vis developmentally immature adolescents not held legally responsible for many of their actions. School ethnographers attempt to build trust with adolescent participants in order to learn about their hidden cultural worlds, which may involve activities that are very harmful to the youths involved. They face many difficult and sometimes unexpected choices, including whether to intervene and how to represent events and adolescents in published findings. Scenarios with examples drawn from research conducted in public high schools are used to illustrate and explicate dilemmas in formal research and latent insider/outsider roles and relations involving harmful adolescent behaviors, advocacy, and psychological trauma. Also examined are analytical procedures used to construct interpretations leading to representations of research participants in the resulting publication.

Ethics and methods for biological rhythm research on animals and human beings.

PubMed

Portaluppi, Francesco; Smolensky, Michael H; Touitou, Yvan

2010-10-01

This article updates the ethical standards and methods for the conduct of high-quality animal and human biological rhythm research, which should be especially useful for new investigators of the rhythms of life. The editors of Chronobiology International adhere to and endorse the Code of Conduct and Best Practice Guidelines of the Committee On Publication Ethics (COPE), which encourages communication of such updates at regular intervals in the journal. The journal accepts papers representing original work, no part of which was previously submitted for publication elsewhere, except as brief abstracts, as well as in-depth reviews. The majority of research papers published in Chronobiology International entails animal and human investigations. The editors and readers of the journal expect authors of submitted manuscripts to have made an important contribution to the research of biological rhythms and related phenomena using ethical methods/procedures and unbiased, accurate, and honest reporting of findings. Authors of scientific papers are required to declare all potential conflicts of interest. The journal and its editors endorse compliance of investigators to the Guide for the Care and Use of Laboratory Animals of the Institute for Laboratory Animal Research of the National Research Council, relating to the conduct of ethical research on laboratory and other animals, and the principles of the Declaration of Helsinki of the World Medical Association, relating to the conduct of ethical research on human beings. The peer review of manuscripts by Chronobiology International thus includes judgment as to whether or not the protocols and methods conform to ethical standards. Authors are expected to show mastery of the basic methods and procedures of biological rhythm research and proper statistical assessment of data, including the appropriate application of time series data analyses, as briefly reviewed in this article. The journal editors strive to consistently achieve high standards for the research of original and review papers reported in Chronobiology International, and current examples of expectations are presented herein.

Guidelines for Teaching Cross-Cultural Clinical Ethics: Critiquing Ideology and Confronting Power in the Service of a Principles-Based Pedagogy.

PubMed

Brunger, Fern

2016-03-01

This paper presents a pedagogical framework for teaching cross-cultural clinical ethics. The approach, offered at the intersection of anthropology and bioethics, is innovative in that it takes on the "social sciences versus bioethics" debate that has been ongoing in North America for three decades. The argument is made that this debate is flawed on both sides and, moreover, that the application of cross-cultural thinking to clinical ethics requires using the tools of the social sciences (such as the critique of the universality of the Euro-American construct of "autonomy") within (rather than in opposition to) a principles-based framework for clinical ethics. This paper introduces the curriculum and provides guidelines for how to teach cross-cultural clinical ethics. The learning points that are introduced emphasize culture in its relation to power and underscore the importance of viewing both biomedicine and bioethics as culturally constructed.

[Public health, genetics and ethics].

PubMed

Kottow, Miguel H

2002-10-01

Genetics research has shown enormous developments in recent decades, although as yet with only limited clinical application. Bioethical analysis has been unable to deal with the vast problems of genetics because emphasis has been put on the principlism applied to both clinical and research bioethics. Genetics nevertheless poses its most complex moral dilemmas at the public level, where a social brand of ethics ought to supersede the essentially interpersonal perspective of principlism. A more social understanding of ethics in genetics is required to unravel issues such as research and clinical explorations, ownership and patents, genetic manipulation, and allocation of resources. All these issues require reflection based on the requirements of citizenry, consideration of common assets, and definition of public policies in regulating genetic endeavors and protecting the society as a whole Bioethics has privileged the approach to individual ethical issues derived from genetic intervention, thereby neglecting the more salient aspects of genetics and social ethics.

Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices.

PubMed

Yönt, Gülendam Hakverdioğlu; Korhan, Esra Akin; Dizer, Berna; Gümüş, Fatma; Koyuncu, Rukiye

2014-01-01

Nurses are more likely to face the dilemma of whether to resort to physical restraints or not and have a hard time making that decision. This is a descriptive study. A total of 55 nurses participated in the research. For data collection, a question form developed by researchers to determine perceptions of ethical dilemmas by nurses in the application of physical restraint was used. A descriptive analysis was made by calculating the mean, standard deviation, and maximum and minimum values. The nurses expressed (36.4%) having difficulty in deciding to use physical restraint. Nurses reported that they experience ethical dilemmas mainly in relation to the ethic principles of nonmaleficence, beneficence, and convenience. We have concluded that majority of nurses working in critical care units apply physical restraint to patients, although they are facing ethical dilemmas concerning harm and benefit principles during the application.

A history of ethics and law in the intensive care unit.

PubMed

Luce, John M; White, Douglas B

2009-01-01

Because they provide potential benefit at great personal and public cost, the intensive care unit (ICU) and the interventions rendered therein have become symbols of both the promise and the limitations of medical technology. At the same time, the ICU has served as an arena in which many of the ethical and legal dilemmas created by that technology have been defined and debated. This article outlines major events in the history of ethics and law in the ICU, covering the evolution of ICUs, ethical principles, informed consent and the law, medical decision-making, cardiopulmonary resuscitation, withholding and withdrawing life-sustaining therapy, legal cases involving life support, advance directives, prognostication, and futility and the allocation of medical resources. Advancement of the ethical principle of respect for patient autonomy in ICUs increasingly is in conflict with physicians' concern about their own prerogatives and with the just distribution of medical resources.

Ethics fundamentals.

PubMed

Chambers, David W

2011-01-01

Ethics is about studying the right and the good; morality is about acting as one should. Although there are differences among what is legal, charitable, professional, ethical, and moral, these desirable characteristics tend to cluster and are treasured in dentistry. The traditional approach to professionalism in dentistry is based on a theory of biomedical ethics advanced 30 years ago. Known as the principles approach, general ideals such as respect for autonomy, nonmaleficence, beneficence, justice, and veracity, are offered as guides. Growth in professionalism consists in learning to interpret the application of these principles as one's peers do. Moral behavior is conceived as a continuous cycle of sensitivity to situations requiring moral response, moral reasoning, the moral courage to take action when necessary, and integration of habits of moral behavior into one's character. This essay is the first of two papers that provide the backbone for the IDEA Project of the College--an online, multiformat, interactive "textbook" of ethics for the profession.

Ethics in Evaluating a Sociotechnical Intervention With Socially Isolated Older Adults.

PubMed

Waycott, Jenny; Morgans, Amee; Pedell, Sonja; Ozanne, Elizabeth; Vetere, Frank; Kulik, Lars; Davis, Hilary

2015-11-01

The purpose of this article is to consider how ethical principles can inform the effective design and implementation of technology-based interventions that aim to promote the well-being of socially isolated older adults. We evaluated a new iPad application with small groups of older adults. In this article, we reflect on the ethical issues encountered at each stage of the research process. Drawing on the ethical principles of beneficence, research merit and integrity, justice, and respect, we identify key issues to consider in the future design and implementation of social isolation interventions that use new technologies. Key issues include (a) providing sufficient support to facilitate ongoing social interactions, (b) managing older adults' expectations, (c) providing encouragement without coercion, and (d) responding to individual needs. We conclude that it is important to report on ethical challenges incurred when evaluating social isolation interventions to inform future research in this important area. © The Author(s) 2015.

Ethics and forensic psychiatry: translating principles into practice.

PubMed

Appelbaum, Paul S

2008-01-01

Twenty-five years ago, Alan Stone expressed his skepticism that forensic psychiatry could be practiced ethically. His remarks have proven a useful goad to the field, focusing attention on the importance of an ethics framework for forensic practice. But Stone remains dubious that any system of ethics--including the "Standard Position" on which he focuses his critique--could be of much value in practice. In contrast, I suggest that Stone's pessimism is not well founded. Immanent in forensic practice itself is a reasonable set of ethics principles, based on truth-telling and respect for persons. Psychiatrists can offer reliable and valid testimony, while resisting seduction into an advocacy role. Indeed, with new structured approaches to assessment, the potential utility of forensic testimony is probably greater than ever. Though problematic behavior still exists, forensic psychiatry offers the factual background and interpretive context to allow legal decision-makers to make better choices than they otherwise would.

Nursing and euthanasia: a review of argument-based ethics literature.

PubMed

Quaghebeur, Toon; Dierckx de Casterlé, Bernadette; Gastmans, Chris

2009-07-01

This article gives an overview of the nursing ethics arguments on euthanasia in general, and on nurses' involvement in euthanasia in particular, through an argument-based literature review. An in-depth study of these arguments in this literature will enable nurses to engage in the euthanasia debate. We critically appraised 41 publications published between January 1987 and June 2007. Nursing ethics arguments on (nurses' involvement in) euthanasia are guided primarily by the principles of respect for autonomy, nonmaleficence, beneficence and justice. Ethical arguments related to the nursing profession are described. From a care perspective, we discuss arguments that evaluate to what degree euthanasia can be considered positively or negatively as a form of good nursing care. Most arguments in the principle-, profession- and care-orientated approaches to nursing ethics are used both pro and contra euthanasia in general, and nurses' involvement in euthanasia in particular.

The place of care in ethical theory.

PubMed

Veatch, R M

1998-04-01

The concept of care and a related ethical theory of care have emerged as increasingly important in biomedical ethics. This essay outlines a series of questions about the conceptualization of care and its place in ethical theory. First, it considers the possibility that care should be conceptualized as an alternative principle of right action; then as a virtue, a cluster of virtues, or as a synonym for virtue theory. The implications for various interpretations of the debate of the relation of care and justice are then explored, suggesting three possible meanings for that contrast. Next, the possibility that care theorists are taking up the debate over the relation between principles and cases is considered. Finally, it is suggested that care theorists may be pressing for consideration of an entirely new question in moral theory: the assessment of the normative appropriateness of relationships. Issues needing to be addressed in an ethic of relationships are suggested.

Ethical Statistics and Statistical Ethics: Making an Interdisciplinary Module

ERIC Educational Resources Information Center

Lesser, Lawrence M.; Nordenhaug, Erik

2004-01-01

This article describes an innovative curriculum module the first author created on the two-way exchange between statistics and applied ethics. The module, having no particular mathematical prerequisites beyond high school algebra, is part of an undergraduate interdisciplinary ethics course which begins with a 3-week introduction to basic applied…

A quick guide to ethical theory in healthcare: solving ethical dilemmas in nutrition support situations.

PubMed

Ferrie, Suzie

2006-04-01

Ethical dilemmas can be challenging for the nutrition support clinician who is accustomed to evidence-based practice. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle's virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, nonmaleficence, and justice). Adopting a step-by-step approach can simplify the process of resolving ethical problems.

Ethical models in bioethics: theory and application in organ allocation policies.

PubMed

Petrini, C

2010-12-01

Policies for allocating organs to people awaiting a transplant constitute a major ethical challenge. First and foremost, they demand balance between the principles of beneficence and justice, but many other ethically relevant principles are also involved: autonomy, responsibility, equity, efficiency, utility, therapeutic outcome, medical urgency, and so forth. Various organ allocation models can be developed based on the hierarchical importance assigned to a given principle over the others, but none of the principles should be completely disregarded. An ethically acceptable organ allocation policy must therefore be in conformity, to a certain extent, with the requirements of all the principles. Many models for organ allocation can be derived. The utilitarian model aims to maximize benefits, which can be of various types on a social or individual level, such as the number of lives saved, prognosis, and so forth. The prioritarian model favours the neediest or those who suffer most. The egalitarian model privileges equity and justice, suggesting that all people should have an equal opportunity (casual allocation) or priority should be given to those who have been waiting longer. The personalist model focuses on each individual patient, attempting to mesh together all the various aspects affecting the person: therapeutic needs (urgency), fairness, clinical outcomes, respect for persons. In the individualistic model the main element is free choice and the system of opting-in is privileged. Contrary to the individualistic model, the communitarian model identities in the community the fundamental elements for the legitimacy of choices: therefore, the system of opting-out is privileged. This article does not aim at suggesting practical solutions. Rather, it furnishes to decision makers an overview on the possible ethical approach to this matter.

Relevance and limits of the principle of “equivalence of care” in prison medicine

PubMed Central

Niveau, Gérard

2007-01-01

The principle of “equivalence of care” in prison medicine is a principle by which prison health services are obliged to provide prisoners with care of a quality equivalent to that provided for the general public in the same country. It is cited in numerous national and international directives and recommendations. The principle of equivalence is extremely relevant from the point of view of normative ethics but requires adaptation from the point of view of applied ethics. From a clinical point of view, the principle of equivalence is often insufficient to take account of the adaptations necessary for the organization of care in a correctional setting. The principle of equivalence is cost‐effective in general, but has to be overstepped to ensure the humane management of certain special cases. PMID:17906061

Applied Ethics and eHealth: Principles, Identity, and RFID

NASA Astrophysics Data System (ADS)

Whitehouse, Diane; Duquenoy, Penny

The social and ethical implications of contemporary technologies are becoming an issue of steadily growing importance. This paper offers an overview in terms of identity and the field of ethics, and explores how these apply to eHealth in both theory and practice. The paper selects a specific circumstance in which these ethical issues can be explored. It focuses particularly on radio-frequency identifiers (RFID). It ends by discussing ethical issues more generally, and the practice of ethical consideration.

Ethical evaluation of decision-making for distribution of health resources in China.

PubMed

Guo-Ping, Wang

2007-06-01

Since distribution of health resources involves various aspects of ethics, the evaluation of ethical problems should be emphasised in health decisions using criteria of fairness and fundamental principles of ethics correctly understood and chosen in order to solve the real conflicts evident in the distribution of health resources and to enable fair and reasonable distribution of health resources.

Serving the Once and Future King: Using the TV Series "Merlin" to Teach Servant-Leadership and Leadership Ethics in Schools

ERIC Educational Resources Information Center

Oliver, Laura M.; Reynolds, Kae

2010-01-01

The recent financial crisis has brought business ethics issues to the forefront. While most colleges have formal training in business ethics, a person's ethical standards have often developed before college age. This application brief proposes using digital popular media to teach servant-leadership principles to public school adolescents. The…

Towards an ethics safe harbor for global biomedical research

PubMed Central

Dove, Edward S.; Knoppers, Bartha M.; Zawati, Ma'n H.

2014-01-01

Although increasingly global, data-driven genomics and other ‘omics’-focused research hold great promise for health discoveries, current research ethics review systems around the world challenge potential improvements in human health from such research. To overcome this challenge, we propose a ‘Safe Harbor Framework for International Ethics Equivalency’ that facilitates the harmonization of ethics review of specific types of data-driven international research projects while respecting globally transposable research ethics norms and principles. The Safe Harbor would consist in part of an agency supporting an International Federation for Ethics Review (IFER), formed by a voluntary compact among countries, granting agencies, philanthropies, institutions, and healthcare, patient advocacy, and research organizations. IFER would be both a central ethics review body, and also a forum for review and follow-up of policies concerning ethics norms for international research projects. It would be built on five principle elements: (1) registration, (2) compliance review, (3) recognition, (4) monitoring and enforcement, and (5) public participation. The Safe Harbor would create many benefits for researchers, countries, and the general public, and may eventually have application beyond (gen)omics to other areas of biomedical research that increasingly engage in secondary use of data and present only negligible risks. PMID:27774154

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

PubMed

Ypinazar, Valmae A; Margolis, Stephen A

2004-07-30

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

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

PubMed Central

Ypinazar, Valmae A; Margolis, Stephen A

2004-01-01

Background Little is known about teaching medical ethics across cultural and linguistic boundaries. This study examined two successive cohorts of first year medical students in a six year undergraduate MBBS program. Methods The objective was to investigate whether Arabic speaking students studying medicine in an Arabic country would be able to correctly identify some of the principles of Western medical ethical reasoning. This cohort study was conducted on first year students in a six-year undergraduate program studying medicine in English, their second language at a medical school in the Arabian Gulf. The ethics teaching was based on the four-principle approach (autonomy, beneficence, non-malfeasance and justice) and delivered by a non-Muslim native English speaker with no knowledge of the Arabic language. Although the course was respectful of Arabic culture and tradition, the content excluded an analysis of Islamic medical ethics and focused on Western ethical reasoning. Following two 45-minute interactive seminars, students in groups of 3 or 4 visited a primary health care centre for one morning, sitting in with an attending physician seeing his or her patients in Arabic. Each student submitted a personal report for summative assessment detailing the ethical issues they had observed. Results All 62 students enrolled in these courses participated. Each student acting independently was able to correctly identify a median number of 4 different medical ethical issues (range 2–9) and correctly identify and label accurately a median of 2 different medical ethical issues (range 2–7) There were no significant correlations between their English language skills or general academic ability and the number or accuracy of ethical issues identified. Conclusions This study has demonstrated that these students could identify medical ethical issues based on Western constructs, despite learning in English, their second language, being in the third week of their medical school experience and with minimal instruction. This result was independent of their academic and English language skills suggesting that ethical principles as espoused in the four principal approach may be common to the students' Islamic religious beliefs, allowing them to access complex medical ethical reasoning skills at an early stage in the medical curriculum. PMID:15283868

An Approach to Ethical Practice in Management and Trainer Training.

ERIC Educational Resources Information Center

Johnston, Rita

1992-01-01

Concern with ethics has given rise to two educational approaches, one derived from philosophical principles of social ethics, the other based on case studies of practical issues. A combination of these is necessary to ensure situational applicability and to avoid moral relativism and expediency. (SK)

The Ethics of Digital Writing Research: A Rhetorical Approach

ERIC Educational Resources Information Center

McKee, Heidi; Porter, James E.

2008-01-01

The study of writers and writing in digital environments raises distinct and complex ethical issues for researchers. Rhetoric theory and casuistic ethics, working in tandem, provide a theoretical framework for addressing such issues. A casuistic heuristic grounded in rhetorical principles can help digital writing researchers critically…

Ethics Simulations as Preparation for Public Discourse

ERIC Educational Resources Information Center

Hamilton, James P.; Mueller, Alfred G.

2010-01-01

Courses: Fundamentals of public speaking, basic hybrid course, introduction to communication, introduction to journalism, introduction to advertising, and any other course that includes components of communication ethics. Objective: Students will understand the fundamental elements of communication ethics.

"Enhanced" interrogation of detainees: do psychologists and psychiatrists participate?

PubMed Central

Halpern, Abraham L; Halpern, John H; Doherty, Sean B

2008-01-01

After revelations of participation by psychiatrists and psychologists in interrogation of prisoners at Guantánamo Bay and Central Intelligence Agency secret detention centers, the American Psychiatric Association and the American Psychological Association adopted Position Statements absolutely prohibiting their members from participating in torture under any and all circumstances, and, to a limited degree, forbidding involvement in interrogations. Some interrogations utilize very aggressive techniques determined to be torture by many nations and organizations throughout the world. This paper explains why psychiatrists and psychologists involved in coercive interrogations violate the Geneva Conventions and the laws of the United States. Whether done with ignorance of professional ethical obligations or not, these psychiatrists and psychologists have crossed an ethical barrier that may best be averted from re-occurring by teaching medical students and residents in all medical specialties about the ethics principles stemming from the 1946–1947 Nuremberg trials and the Geneva Conventions, together with the Ethics Codes of the World Medical Association and the American Medical Association; and, with regard to psychiatric residents and psychological trainees, by the teaching about The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry and the Ethical Principles of Psychologists and Code of Conduct, respectively. In this way, all physicians and psychologists will clearly understand that they have an absolute moral obligation to "First, do no harm" to the human beings they professionally encounter. PMID:18817568

Ethical issues and best practice in clinically based genomic research: Exeter Stakeholders Meeting Report.

PubMed

Carrieri, D; Bewshea, C; Walker, G; Ahmad, T; Bowen, W; Hall, A; Kelly, S

2016-09-27

Current guidelines on consenting individuals to participate in genomic research are diverse. This creates problems for participants and also for researchers, particularly for clinicians who provide both clinical care and research to their patients. A group of 14 stakeholders met on 7 October 2015 in Exeter to discuss the ethical issues and the best practice arising in clinically based genomic research, with particular emphasis on the issue of returning results to study participants/patients in light of research findings affecting research and clinical practices. The group was deliberately multidisciplinary to ensure that a diversity of views was represented. This report outlines the main ethical issues, areas of best practice and principles underlying ethical clinically based genomic research discussed during the meeting. The main point emerging from the discussion is that ethical principles, rather than being formulaic, should guide researchers/clinicians to identify who the main stakeholders are to consult with for a specific project and to incorporate their voices/views strategically throughout the lifecycle of each project. We believe that the mix of principles and practical guidelines outlined in this report can contribute to current debates on how to conduct ethical clinically based genomic research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Ethical perspectives in neuroscience nursing practice.

PubMed

Murphy, W J; Olsen, B J

1999-09-01

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

32 CFR 776.19 - Principles.

Code of Federal Regulations, 2011 CFR

2011-07-01

... applicable ethics rules. (3) Protect the legal rights and interests of clients, organizational and individual... the performance of legal services. (6) Maintain the integrity of the legal profession. (b) Ethical...

An overview of the major changes in the 2002 APA Ethics Code.

PubMed

Knapp, Samuel; VandeCreek, Leon

2003-06-01

This article summarizes the major changes that were made to the 2002 Ethical Principles and Code of Conduct of the American Psychological Association. The 2002 Ethics Code retains the general format of the 1992 Ethics Code and does not radically alter the obligations of psychologists. One goal of the Ethics Committee Task Force was to reduce the potential of the Ethics Code to be used to unnecessarily punish psychologists. In addition, the revised Ethics Code expresses greater sensitivity to the needs of cultural and linguistic minorities and students. Shortcomings of the 2002 Ethics Code are discussed.

China Report, Red Flag No. 16 August 1982

DTIC Science & Technology

1982-10-12

illegal activities. Such phenomena 19 are clear illustrations of the egoism of the capitalist classes which has developed in the hearts of some...and educate the people on the ideas arid ethics of communism. Article 20 in the "General Principles" stipulates in principle the develop- ment of...one important aspect of socialist spiritual civilization—political consciousness and ideas and ethics . This article embraces three contents: One is

Ethical, legal, and social aspects of farm animal cloning in the 6th Framework Programme for Research.

PubMed

Claxton, John; Sachez, Elena; Matthiessen-Guyader, Line

2004-01-01

Cloned livestock have potential importance in the provision of improved medicine as well as in the development of livestock production. The public is, however, increasingly concerned about the social and ethical consequences of these advances in knowledge and techniques. There is unevenness throughout Europe in different Member States' attitudes to research into livestock cloning. Although there is EU legislation controlling the use of animals for research purposes, there is no legislation specifically governing cloning in livestock production. The main EU reference is the 9th Opinion of the European Group on Ethics, which states "Cloning of farm animals may prove to be of medical and agricultural as well as economic benefit. It is acceptable only when the aims and methods are ethically justified and when carried out under ethical conditions." The ethical justification includes the avoidance of suffering, the use of the 3Rs principle and a lack of better alternatives. The Commission addresses these issues in the 6th Framework Programme by promoting the integration of ethical, legal and social aspects in all proposals where they are relevant, by fostering ethical awareness and foresight in the proposals, by encouraging public dialogue, and by supporting specific actions to promote the debate. Research must respect fundamental ethical principles, including animal welfare requirements.

The ethics of educational methods to teach geoethics.

NASA Astrophysics Data System (ADS)

Promduangsri, Pimnutcha; Crookall, David

2017-04-01

Our planet is in dire need of geoethical behaviour by all its citizens. That can only be achieved through education, on an intergenerational basis. Geoethics education needs to tackle real issues, not with a philosopher's stone, but using ethical practice. Geoethics happens essentially, not in what we say, but in what we do. Here the doing is twofold. First is deciding on educational content; in our case geoethical dilemmas related to pollution, sustainability, climate change, deforestation, acidification, limits to growth (planetary boundaries), and a myriad other life-threatening problems. Second are the educational methods that we select and use to help people learn that content. Achieving both is an uphill battle. It will continue to be uphill a wide range of concerns related to our ideas of what constitutes learning, of what is appropriate to learn, of the value placed on education, of how to teach, of societal power relations, and so on. The steepness of the hill depends also on the ethics we use to make content decisions and to facilitate learning episodes (usually called classes). My contention is that geoethics needs to be taught in all courses, at all levels and in all subjects worldwide; that is a long-term content objective. The shorter-term objective is the methods that we use to teach the geoethics. A variety of methods are used to teach geoethical issues, some appearing more successful than others. Methods that have made some considerable impact in various parts of the globe include simulation/gaming, role-play and other experiential learning approaches. These rely on creating a situation or event that the learner experiences first hand (rather than contemplating, as in a lecture). One might call such events geoethical simulations because their content focuses on some ethical dilemma related to the earth. For example, a conflict among stakeholders over management of water along a river, or competition among fishers for limited fish stocks (tragedy of the commons). This kind of learning method itself raises ethical issues. One set of ethical issues revolves round the content (as exemplified above); a second set concerns the manner in which the simulation is conducted and the effect it has on participants. Simulations of geoethical problems often generate strong emotions, just like their real-world counterparts. However, asking young people to participate in an emotion-generating event requires it to be done according to ethical principles. In many cases, many such simulations do more harm than good simply because they are not conducted properly. The simple fact of inviting people to participate in an emotionally challenging situation itself raises ethical issues, and this in turn has ethical implications for the way in which we conduct these kinds of geoethical simulations. In this presentation, we will briefly outline the basic principles of conducting geoethical simulation in an ethical manner. We will then illustrate the ethics involved in the practice; we will give examples of the steps, the materials and the precautions needed. We hope that this will inspire others to use such methods.

Cross-cultural perspectives of scientific misconduct.

PubMed

Momen, Hooman; Gollogly, Laragh

2007-09-01

The increasing globalization of scientific research lends urgency to the need for international agreement on the concepts of scientific misconduct. Universal spiritual and moral principles on which ethical standards are generally based indicate that it is possible to reach international agreement on the ethical principles underlying good scientific practice. Concordance on an operational definition of scientific misconduct that would allow independent observers to agree which behaviour constitutes misconduct is more problematic. Defining scientific misconduct to be universally recognized and universally sanctioned means addressing the broader question of ensuring that research is not only well-designed - and addresses a real need for better evidence - but that it is ethically conducted in different cultures. An instrument is needed to ensure that uneven ethical standards do not create unnecessary obstacles to research, particularly in developing countries.

Enhancing John Rawls's Theory of Justice to Cover Health and Social Determinants of Health1

PubMed Central

Ekmekci, Perihan Elif; Arda, Berna

2015-01-01

The vast improvements in medical technology reviled the crucial role of social determinants of health for the etiology, prevalence and prognosis of diseases. This changed the content of the right to health concept from a demand of health services, to a claim of having access to all social determinants of health. Thus, the just allocation of scarce resources of health and social determinants of health became an issue of ethical theories. John Rawls developed a theory of justice. His theory suggests that the principles of justice should be determined by individuals in a hypothetic initial position. In the initial position, individuals agree on principles of justice. Rawls puts forth that the institutions of the society should be structured in compliance with these principles to reach a fair social system. Although Rawls did not justify right to health in his theory, the efforts to enlarge the theory to cover right to health flourished quite fast. In this paper first the basic components of Rawls theory is explained. Then the most outstanding approaches to enlarge his theory to cover right to health is introduced and discussed within the discourse of Rawls theory of justice. PMID:27340331

Enhancing John Rawls's Theory of Justice to Cover Health and Social Determinants of Health.

PubMed

Ekmekci, Perihan Elif; Arda, Berna

2015-11-01

The vast improvements in medical technology reviled the crucial role of social determinants of health for the etiology, prevalence and prognosis of diseases. This changed the content of the right to health concept from a demand of health services, to a claim of having access to all social determinants of health. Thus, the just allocation of scarce resources of health and social determinants of health became an issue of ethical theories. John Rawls developed a theory of justice. His theory suggests that the principles of justice should be determined by individuals in a hypothetic initial position. In the initial position, individuals agree on principles of justice. Rawls puts forth that the institutions of the society should be structured in compliance with these principles to reach a fair social system. Although Rawls did not justify right to health in his theory, the efforts to enlarge the theory to cover right to health flourished quite fast. In this paper first the basic components of Rawls theory is explained. Then the most outstanding approaches to enlarge his theory to cover right to health is introduced and discussed within the discourse of Rawls theory of justice.

Ethical Issues of Scientific Inquiry in Health Science Education.

ERIC Educational Resources Information Center

Pigg, R. Morgan, Jr., Ed.

1994-01-01

This monograph contains 13 papers on the ethics of planning, conducting, and reporting research in health sciences education. It includes four background papers and nine perspective papers. The titles are: (1) "The Imperative for Ethical Conduct in Scientific Inquiry" (Steve M. Dorman); (2) "Fundamental Principles of Ethical…

Uncommon Commonalities: Cosmopolitan Ethics as a Framework for Music Education Policy Analysis

ERIC Educational Resources Information Center

Richerme, Lauren Kapalka

2016-01-01

Contemporary American education policy rhetoric is problematic because its authors' assertions, particularly those about the goals of education, frequently conflict with their implied moral and/or ethical commitments. This philosophical policy analysis uses Appiah's cosmopolitan principles to examine the ethical implications of current education…

A Case Study Approach to Study One Teacher's Moral Reflection.

ERIC Educational Resources Information Center

Husu, Jukka; Tirri, Kirsi

2003-01-01

Assessed one Finnish secondary school teacher's moral reflection, examining the ethic of purpose, ethic of rules and principles, and ethic of probability, together with their philosophical perspectives. Data included a narrative of a moral dilemma the teacher experienced regarding smoking at school. Results uncovered the background beliefs guiding…

Ethical Challenges Scenario: Youth Involvement in Evaluation

ERIC Educational Resources Information Center

Cooksy, Leslie J.

2007-01-01

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

Human Subjects Protection: A Source for Ethical Service-Learning Practice

ERIC Educational Resources Information Center

Wendler, Rachael

2012-01-01

Human subjects research ethics were developed to ensure responsible conduct when university researchers learn by interacting with community members. As service-learning students also learn by interacting with community members, a similar set of principles may strengthen the ethical practice of service-learning. This article identifies ethical…

Deontological vs. Teleological Ethics--Some Remarks on the Impact of Ethics on Educational Practice.

ERIC Educational Resources Information Center

Ahrens, Jurgen

1989-01-01

Maintains that pedagogical practice must take into account the principles of moral philosophy. Claims that current pedagogical research on ethics is determined by the teleological and deontological paradigms associated with Aristotle and Kant respectively. Discusses these two paradigms and their relationship to educational practice. (RW)

Ethical Realism: A Guide to Action?

ERIC Educational Resources Information Center

Matkin, Gary

2008-01-01

This article presents the author's response to Gary Miller's essay entitled "Ethical Realism and Continuing Education." In his essay, Dr. Miller has provided a valuable opportunity to reflect on the practice of continuing education (CE) leadership. Dr. Miller reviews six principles that are encapsulated in the concept of ethical realism, but are…

Waiver Culture: The Unintended Consequence of Ethics Compliance

ERIC Educational Resources Information Center

Genova, Gina L.

2008-01-01

The passage of the U.S. Sarbanes-Oxley Act (2002) spawned a series of compliance and ethics programs --the revised Principles of Federal Prosecution of Business Organizations known as the Thompson Memo (Thompson, 2003), the revised Federal Sentencing Guidelines that included the Effective Compliance and Ethics Program and the corporate…

Ethical Considerations in Human Movement Research.

ERIC Educational Resources Information Center

Olivier, Steve

1995-01-01

Highlights ethical issues for human subject research, identifying principles that form the construct of a code of research ethics and evaluating against this construct past human experimentation and current research in human movement studies. The efficacy of legislation and self-regulation is examined. Particular attention is given to the context…

Distance Supervision in Rehabilitation Counseling: Ethical and Clinical Considerations

ERIC Educational Resources Information Center

Lund, Emily M.; Schultz, Jared C.

2015-01-01

Background: The use of technology-mediated distance supervision is a rapidly growing area in rehabilitation counseling and other fields. Distance supervision has both tremendous potential and notable challenges to address, including questions of ethics and evidence. Purpose: This article examines both the ethical and nonethical principles that…

Professional Decision Making and Personal Ethics.

ERIC Educational Resources Information Center

Black, Jay; Steele, Robert

1991-01-01

Discusses ethics regarding the journalism and mass communications professoriate. Suggests a schema or audit to positively address such issues as accountability and loyalty, values, and principles. Offers eight questions for a personal ethics audit which attempt to join good intentions with good decisions, and shift the enterprise to a positive…

School District Superintendents' Response to Ethical Dilemmas: A Grounded Theory

ERIC Educational Resources Information Center

Sprouse, Fay Simpson

2009-01-01

Ethical dilemmas, situations involving a conflict between values or principles, often arise when employees of school districts violate laws or professional codes of behavior. Ethical dilemmas also occur when there are inequities in educational programming, resulting in missed opportunities for students. This qualitative study, conducted with the…

'He is now like a brother, I can even give him some blood'--relational ethics and material exchanges in a malaria vaccine 'trial community' in The Gambia.

PubMed

Geissler, P Wenzel; Kelly, Ann; Imoukhuede, Babatunde; Pool, Robert

2008-09-01

This paper explores social relations within the 'trial community' (staff and volunteers) of a Malaria Vaccine Trial (MVT), implemented by the Medical Research Council (MRC) in The Gambia between 2001 and 2004. It situates ethical concerns with medical research within the everyday life of scientific fieldwork. Based upon discussions with volunteers and staff, we explore processes of mediation between scientific project and study population, and between formal ethics, local ethical debates and everyday practice. We observe that material contact and substantial transactions, notably of blood and medicine, are central to the construction of the MVT. These transactions are guided by a concrete and relational form of ethics, which contrasts with the abstract and vertical formal ethical principles underwriting the scientific study protocol. The success of the MVT owed much to these kinship-like ethics. One possible conclusion from these observations is that research ethics should be understood, not just as a quasi-legal frame but also as an open, searching movement, much in the same way that kinship is not merely a juridical institution and a prescriptive frame of rules, but a network made through relational work. However, this conclusion raises new problems: by contrasting formal, abstract principles to intimate, immediate relations, and economic justice to personal morality, we accept that the order of medical research is moved further out of the public and political, and into the domains of either quasi-legal claims or of private morality. Irrespective of the undeniable importance of clear-cut rules and of good face-to-face relations, a third essential foundation of medical research ethics is the democratically constituted public sphere, including equitable health services, and transparent institutions to facilitate open debate and regulate particular interests. Ultimately, the ethics of global science can rely neither on principles nor trust but requires citizenship and democratic government.

Development of a moral judgment measure for veterinary education.

PubMed

Verrinder, Joy M; Phillips, Clive J C

2014-01-01

Veterinarians increasingly face animal ethics issues, conflicts, and dilemmas, both in practice and in policy, such as the tension between clients' and animals' interests. Little has been done to measure the capacity of veterinarians to make ethical judgments to prevent and address these issues or to identify the effectiveness of strategies to build this capacity. The objectives of this study were, first, to develop a test to identify the capacity of veterinarians to make ethical decisions in relation to animal ethics issues and, second, to assess students' perceptions of the usefulness of three methods for the development of ethical decision making. The Veterinary Defining Issues Test (VetDIT) was piloted with 88 first-year veterinary students at an Australian university. The veterinary students were at a variety of reasoning stages in their use of the Personal Interest (PI), Maintaining Norms (MN), and Universal Principles (UP) reasoning methods in relation to both human ethics and animal ethics issues and operated at a higher level of reasoning for animal than human ethics. Thirty-eight students assessed three methods for developing ethical decision-making skills and identified these as being helpful in clarifying their positions, clarifying others' positions, increasing awareness of the complexity of making ethical decisions, using ethical frameworks and principles, and improving moral reasoning skills, with two methods identified as most helpful. These methods and the VetDIT have the potential to be used as tools for development and assessment of moral judgment in veterinary education to address animal ethics issues.

Applied ethics: Have we lost a crucial opportunity?

PubMed

Kerkhoff, Thomas R; Hanson, Stephanie L

2015-11-01

Comments on the article, "Guidelines for competency development and measurement in rehabilitation psychology postdoctoral training," by Stiers et al. (see record 2014-55195-001). A review of the recent publication of Stiers et al., a well-organized distillation of the functional competencies required of practitioners of Rehabilitation Psychology that evolved from the Baltimore Consensus Conference (Stiers et al., 2012), revealed a potentially important omission in the section labeled Structured Observations of Competencies in Assessment and Intervention (Table 4, p. 117). Throughout the subsections regarding Knowledge, Skills/Abilities, and Attitudes/ Values, indirect reference to the American Psychological Association (APA) Ethical Principles of Psychologists and Code of Conduct (APA, 2010) is evident without formal citation of the Code. The concepts operationalized in the APA ethical principles suffuse the content of this section of the competencies, but without direct reference to those principles. The remainder of the tables (5-7, pp. 188 -120) include explicit inclusion of knowledge of ethics in the contexts of demonstrating competencies in consultation, research and evaluation, teaching and supervision, and management and administration. (c) 2015 APA, all rights reserved).

Developing an Ethical Framework in Decision Making of Rural Elementary School Principals in Pennsylvania

ERIC Educational Resources Information Center

Hozien, Wafa Ismail

2012-01-01

The purpose of this study is to explore and describe individual Pennsylvania rural elementary principals' experiences of ethical decision-making in a complex era. Ethical dilemma, in this case, is the term used to depict an incident which calls for a decision to be made when moral values or ethical principles were in conflict. Also, to learn how…

Universal ethical principles in a diverse universe: a commentary on Monshi and Zieglmayer's case study.

PubMed

DuBois, James M

2004-01-01

Monshi and Zieglmayer's case study presents Sri Lankan participants as having views on the privacy of health information that differ radically from those commonly found in Western nations. This article explores 2 questions that their case study raises for the ethical review of research in international settings: First, are allegedly universal ethical principles--of the sort promulgated in the Belmont Report (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1978)--useful in international settings?, and second, how should research oversight bodies address the challenges that arise in international behavioral and social science research?

Confidentiality in Sports Medicine.

PubMed

Malcolm, Dominic

2016-04-01

This article synthesizes existing literature to provide a summary of the ethical issues concerning patient confidentiality in sport. It outlines the medical principle of confidentiality and identifies cross-cultural ethicolegal variations that shape its implementation. Clinicians' multiple obligations, physical environments, and practice and policy contexts are discussed, and research detailing experiences of maintaining patient confidentiality in sport is reviewed. Policy recommendations for enhancing compliance with this ethical principle are summarized. It is argued that the context of sport exacerbates pressures on clinicians to break patient confidentiality, breaches occur regularly, and interventions are required to enhance ethical compliance in sports medicine. Copyright © 2016 Elsevier Inc. All rights reserved.