Evoking vigilance: Would you (dis)trust a scientist who discusses ethical implications of research in a science blog?

PubMed

Hendriks, Friederike; Kienhues, Dorothe; Bromme, Rainer

2016-11-01

The experimental studies presented here investigated whether discussing ethical implications of preliminary scientific results in a science blog would impact blog readers' perception of the responsible scientist blogger's epistemic trustworthiness (on the dimensions expertise, integrity, and benevolence). They also investigated whether it made a difference in who had brought forward the ethics aspects: the responsible scientist blogger or another expert. Results indicate that by the mere introduction of ethics, people infer something about the blogger's communicative intentions: Introducing ethical aspects seems to raise vigilance about an expert's benevolence and integrity. Moreover, ratings of epistemic trustworthiness differed depending on who added ethical arguments: If ethics were introduced by the scientist blogger himself, his benevolence and integrity were rated higher than when ethics were introduced by another expert. These results are relevant for science bloggers, science communicators, and researchers who study laypeople's understanding of epistemic uncertainty within science. © The Author(s) 2016.

Teaching Business Ethics after the Financial Meltdown: Is It Time for Ethics with a Sermon?

ERIC Educational Resources Information Center

Cavaliere, Frank J.; Mulvaney, Toni P.; Swerdlow, Marleen R.

2010-01-01

Our country is faced with a financial crisis of mammoth proportions: a crisis rooted in ethics, or rather, the lack of ethics. Critics are increasingly complaining that business schools focus too much teaching effort on maximizing shareholder value, with only a limited understanding of ethical and social aspects of business leadership. Business…

The "Subject of Ethics" and Educational Research OR Ethics or Politics? Yes Please!

ERIC Educational Resources Information Center

Bazzul, Jesse

2017-01-01

This paper outlines a theoretical context for research into "the subject of ethics" in terms of how students come to see themselves as self-reflective actors. I maintain that the "subject of ethics," or ethical subjectivity, has been overlooked as a necessary aspect of creating politically transformative spaces in education. At…

In a Dimension of Height: Ethics in the Education of Others

ERIC Educational Resources Information Center

Tarc, Aparna Mishra

2006-01-01

Ethics penetrates every aspect of Western education. Many of its dominant narratives-- education as salvation, as progress, as panacea, and as liberation, for example--are infused with the ethical. Educators are compelled by ethical callings; in fact, education as the call of the ethical informs the singular and collective identities of educators.…

The Practical Aspects of Online Counseling: Ethics, Training, Technology, and Competency

ERIC Educational Resources Information Center

Mallen, Michael J.; Vogel, David L.; Rochlen, Aaron B.

2005-01-01

This article addresses the practical aspects of online counseling, including ethics, training, supervision, technology, and competency issues. The authors discuss online counseling's strengths and limitations and present guidelines for what types of clients and counseling psychologists may be appropriate for online counseling. To illustrate the…

Ethical aspects on rare diseases.

PubMed

Barrera, Luis A; Galindo, Gilberto Cely

2010-01-01

In this chapter we discuss several of the most relevant subjects related to ethics on Rare Diseases. Some general aspects are discussed such as the socio-psychological problems that confront the patients and their families that finally lead to marginalization and exclusion of patients affected by these diseases from the health programs, even in wealthy countries. Then we address problems related to diagnosis and some ethical aspects of newborn screening, prenatal, pre-implantation diagnosis and reference centers, as well as some conditions that should be met by the persons and institutions performing such tasks. Alternatives of solutions for the most critical situations are proposed. Subsequently the orphan drugs subject is discussed not only from the availability point of view, prizes, industrial practices, and purchasing power in developed and developing societies. The research related to rare disease in children and other especially vulnerable conditions, the need for informed consent, review boards or ethics comities, confidentiality of the information, biobanks and pharmacogenetics are discussed.

Ethical, legal, and societal issues and recommendations for controlled and uncontrolled DCD.

PubMed

Haase, Bernadette; Bos, Michael; Boffa, Catherine; Lewis, Penney; Rudge, Chris; Valero, Ricard; Wind, Tineke; Wright, Linda

2016-07-01

This report deals with organ retrieval procedures in both controlled and uncontrolled DCD, looking at the ethical, legal, and psychosocial aspects during the different phases of the process. A recently published report by the UK Donation Ethics Committee (UKDEC) has served as an important reference document to outline the steps in the controlled DCD patient-donor pathway (Academy of Medical Royal Colleges. UK Donation Ethics Committee. An ethical framework for controlled donation after circulatory death. December 2011). For uncontrolled DCD, the UKDEC pathway description was adapted. At the 6th International Conference in Organ Donation held in Paris in 2013, an established expert European Working Group reviewed the UKDEC reports, which were then considered along with the available published literature. Along this pathway, the crucial ethical, legal, and psychosocial aspects have been flagged, and relevant recommendations have been formulated based on a consensus of the working group. © 2015 Steunstichting ESOT.

Navigating the Legal and Ethical World of Overseas Contracts.

ERIC Educational Resources Information Center

Skinner, Karla Jo

1998-01-01

Referring to Iowa contract law, reviews ethical and legal aspects of overseas employment contracts signed by educators at recruitment fairs. Iowa Department of Education guidelines state the following aspects of a good contract: it is in writing; it states the salary, pay periods, benefits, and dates of employment; it lists special conditions and…

Crucial contextual attributes of nursing leadership towards a care ethics.

PubMed

Gustafsson, Lena-Karin; Stenberg, Maja

2017-06-01

It is of importance to understand and communicate caring ethics as a ground for qualitative caring environments. Research is needed on nursing attributes that are visible in nursing leadership since it may give bases for reflections related to the patterns of specific contexts. The aim of this study was to illuminate the meaning of crucial attributes in nursing leadership toward an ethical care of patients in psychiatric in-patient settings. The design of the study was descriptive and qualitative with a phenomenological hermeneutical approach. Participants and research context: The study comprised focus group interviews with nurses working in indoor psychiatric care who participated after giving informed consent. Ethical considerations: Since the topic and informants are not labeled as sensitive and subject to ethical approval, it is not covered by the ethics committee's aim and purpose according to Swedish law. However, careful procedures have been followed according to ethics expressed in the Declaration of Helsinki. When identifying the thematic structures, analysis resulted in three major themes: To supply, including the following aspects: to supply evidence, to supply common space, and to supply good structures; To support, including the following aspects: to be a role model, to show appreciation and care, and to harbor; To shield, including the following aspects: to advocate, to emit non-tolerance of unethical behavior, and to reprove. Leadership is challenging for nurses and plays an important role in ethical qualitative care. These findings should not be understood as a description about nurse manager's role, which probably has different attributes and more focus on an organizational level. Making the understanding about crucial attributes explicit, the nurse may receive confirmation and recognition of crucial attributes for ethical care in order to move toward an ethical care.

Court of Ethics: Teaching Ethics and Ageing by Means of Role-Playing

ERIC Educational Resources Information Center

Doron, Israel

2007-01-01

Technological and scientific developments, progress in the discipline of gerontology, and an ageing population mean that we now have to contend with previously unknown ethical problems. Therefore, the teaching of ethics is an essential element of a comprehensive education in gerontology. This article discusses the unique aspects of gerontology…

Ethical Ideology and Cultural Orientation: Understanding the Individualized Ethical Inclinations of Marketing Students

ERIC Educational Resources Information Center

Smith, Brent

2009-01-01

As today's marketing graduates formally enter the business profession, they are expected to demonstrate the fruits of their ethics-intensive education. Hence, their professors and future bosses may call upon these graduates to discern and deal with ethical situations that affect various aspects of company and consumer relations. However, students…

Ethical aspects of human biobanks: a systematic review

PubMed Central

Budimir, Danijela; Polašek, Ozren; Marušić, Ana; Kolčić, Ivana; Zemunik, Tatijana; Boraska, Vesna; Jerončić, Ana; Boban, Mladen; Campbell, Harry; Rudan, Igor

2011-01-01

Aim To systematically assess the existing literature on ethical aspects of human biobanks. Method We searched the Web of Science and PubMed databases to find studies addressing ethical problems in biobanks with no limits set (study design, study population, time period, or language of publication). All identified articles published until November 2010 were included. We analyzed the type of published articles, journals publishing them, involvement of countries/institutions, year of publication, and citations received, and qualitatively assessed every article in order to identify ethical issues addressed by the majority of published research on human biobanking. Results Hundred and fifty four studies satisfied our review criteria. The studies mainly came from highly developed countries and were all published in the last two decades, with over half of them published in 2009 or 2010. They most commonly discussed the informed consent, privacy and identifiability, return of results to participants, importance of public trust, involvement of children, commercialization, the role of ethics boards, international data exchange, ownership of samples, and benefit sharing. Conclusions The focus on ethical aspects is strongly present through the whole biobanking research field. Although there is a consensus on the old and most typical ethical issues, with further development of the field and increasingly complex structure of human biobanks, these issues will likely continue to arise and accumulate, hence requiring constant re-appraisal and continuing discussion. PMID:21674823

HIV vaccine trials: critical issues in informed consent.

PubMed

Lindegger, G; Richter, L M

2000-06-01

Informed consent (IC), a fundamental principle of ethics in medical research, is recognized as a vital component of HIV vaccine trials. There are different notions of IC, some legally based and others based on ethics. It is argued that, though legal indemnity is necessary, vaccine trials should be founded on fully ethical considerations. Various contentious aspects of IC are examined, especially the problem of social desirability and of adequate comprehension. The need for sensitivity to cultural norms in implementing IC procedures is critically reviewed, and some of the potential conflict between ethos and ethics is considered. The transmission of information is examined as a particular aspect of IC in HIV vaccine trials.

Ethical aspects of registry-based research in the Nordic countries.

PubMed

Ludvigsson, Jonas F; Håberg, Siri E; Knudsen, Gun Peggy; Lafolie, Pierre; Zoega, Helga; Sarkkola, Catharina; von Kraemer, Stephanie; Weiderpass, Elisabete; Nørgaard, Mette

2015-01-01

National health care registries in the Nordic countries share many attributes, but different legal and ethical frameworks represent a challenge to promoting effective joint research. Internationally, there is a lack of knowledge about how ethical matters are considered in Nordic registry-based research, and a lack of knowledge about how Nordic ethics committees operate and what is needed to obtain an approval. In this paper, we review ethical aspects of registry-based research, the legal framework, the role of ethics review boards in the Nordic countries, and the structure of the ethics application. We discuss the role of informed consent in registry-based research and how to safeguard the integrity of study participants, including vulnerable subjects and children. Our review also provides information on the different government agencies that contribute registry-based data, and a list of the major health registries in Denmark, Finland, Iceland, Norway, and Sweden. Both ethical values and conditions for registry-based research are similar in the Nordic countries. While Denmark, Finland, Iceland, Norway, and Sweden have chosen different legal frameworks, these differences can be resolved through mutual recognition of ethical applications and by harmonizing the different systems, likely leading to increased collaboration and enlarged studies.

Ethical aspects of registry-based research in the Nordic countries

PubMed Central

Ludvigsson, Jonas F; Håberg, Siri E; Knudsen, Gun Peggy; Lafolie, Pierre; Zoega, Helga; Sarkkola, Catharina; von Kraemer, Stephanie; Weiderpass, Elisabete; Nørgaard, Mette

2015-01-01

National health care registries in the Nordic countries share many attributes, but different legal and ethical frameworks represent a challenge to promoting effective joint research. Internationally, there is a lack of knowledge about how ethical matters are considered in Nordic registry-based research, and a lack of knowledge about how Nordic ethics committees operate and what is needed to obtain an approval. In this paper, we review ethical aspects of registry-based research, the legal framework, the role of ethics review boards in the Nordic countries, and the structure of the ethics application. We discuss the role of informed consent in registry-based research and how to safeguard the integrity of study participants, including vulnerable subjects and children. Our review also provides information on the different government agencies that contribute registry-based data, and a list of the major health registries in Denmark, Finland, Iceland, Norway, and Sweden. Both ethical values and conditions for registry-based research are similar in the Nordic countries. While Denmark, Finland, Iceland, Norway, and Sweden have chosen different legal frameworks, these differences can be resolved through mutual recognition of ethical applications and by harmonizing the different systems, likely leading to increased collaboration and enlarged studies. PMID:26648756

Music Piracy--Differences in the Ethical Perceptions of Business Majors and Music Business Majors

ERIC Educational Resources Information Center

Taylor, Susan Lee

2004-01-01

In this study, the author investigated the ethical perceptions of business majors and music business majors from a private university and observed whether the taking of a business ethics course affected students' perceptions regarding the ethical aspects of downloading, sharing, copying, and selling copyrighted music from Internet and non-Internet…

Students' Ethical Decision-Making in an Information Technology Context: A Theory of Planned Behavior Approach

ERIC Educational Resources Information Center

Riemenschneider, Cynthia K.; Leonard, Lori N. K.; Manly, Tracy S.

2011-01-01

Business educators have increased the focus on ethics in the classroom. In order for students to become ethical professionals, they must first be held to an ethical standard as students. As information technology continues to permeate every aspect of students' lives, it becomes increasingly important to understand student decision-making in this…

Teaching and assessing medical ethics: where are we now?

PubMed Central

Mattick, K; Bligh, J

2006-01-01

Objectives To characterise UK undergraduate medical ethics curricula and to identify opportunities and threats to teaching and learning. Design Postal questionnaire survey of UK medical schools enquiring about teaching and assessment, including future perspectives. Participants The lead for teaching and learning at each medical school was invited to complete a questionnaire. Results Completed responses were received from 22/28 schools (79%). Seventeen respondents deemed their aims for ethics teaching to be successful. Twenty felt ethics should be learnt throughout the course and 13 said ethics teaching and learning should be fully integrated horizontally. Twenty felt variety in assessment was important and three tools was the preferred number. A shortfall in ethics core competencies did not preclude graduation in 15 schools. The most successful aspects of courses were perceived to be their integrated nature and the small group teaching; weaknesses were described as a need for still greater integration and the heavily theoretical aspects of ethics. The major concerns about how ethics would be taught in the future related to staffing and staff development. Conclusions This study describes how ethics was taught and assessed in 2004. The findings show that, although ethics now has an accepted place in the curriculum, more can be done to ensure that the recommended content is taught and assessed optimally. PMID:16507668

Methodological and ethical aspects of randomized controlled clinical trials in minors with malignant diseases.

PubMed

Rothenberger, Lillian G; Henschel, Andreas Dirk; Schrey, Dominik; Becker, Andreas; Boos, Joachim

2011-10-01

Due to the new European regulations for pediatric medications, future clinical trials will include an increasing number of minors. It is therefore important to reconsider and evaluate recent methodological and ethical aspects of clinical trials in minors. The following questions were investigated: How are randomized controlled clinical trials (RCTs) performed in practice? Do investigators take into consideration biomedical ethical principles, explicated for example by Beauchamp and Childress, when planning and conducting a trial? The study was conducted in a descriptive manner. A systematic, algorithm-guided search focusing on RCTs in minors with malignant diseases was carried out in PubMed. One-thousand-nine-hundred-sixty-two publications from 2001 to 2005 were randomized in sequence. The first 1,000 publications were screened according to a priori defined inclusion criteria. One hundred seventy-five publications met the criteria and were reviewed using the SIGN methodological checklist (2004), the CONSORT Statement (2001, section Methods, items 3-12) and indicators for ethical aspects. Seventeen publications were checked by two raters. Information on randomization and blinding was often equivocal. The publications were mainly rated positive for the criteria of the SIGN checklist, and mostly rated negative for the additional items of the CONSORT Statement. Regarding the ethical principles, only few contributions were found in the publications. Inter-rater reliability was good. In the publications analyzed, we found only limited information concerning methods and reflections on ethical principles of the trials. Improvements are thus necessary and possible. We suggest how such trials and their respective publications can be optimized for these aspects. Copyright © 2011 Wiley-Liss, Inc.

Foundations Symposium: A Continued Dialogue on Critical Theory, Cultural Analysis, and Ethical Aspects of the Field.

ERIC Educational Resources Information Center

Anderson, Jane; And Others

Seven articles are presented from a symposium on critical theory, cultural analysis, and the ethical aspects of the use of educational technology. Two papers deal with the educational philosophy of two modern thinkers, and others focus on educational technology in the modern or postmodern era. The following papers are included: (1) "Foucault…

A note on ethical aspects of BCI.

PubMed

Haselager, Pim; Vlek, Rutger; Hill, Jeremy; Nijboer, Femke

2009-11-01

This paper focuses on ethical aspects of BCI, as a research and a clinical tool, that are challenging for practitioners currently working in the field. Specifically, the difficulties involved in acquiring informed consent from locked-in patients are investigated, in combination with an analysis of the shared moral responsibility in BCI teams, and the complications encountered in establishing effective communication with media.

[Acute care nurses’ ethical reasoning: a thematic analysis].

PubMed

Barandun Schäfer, Ursi; Ulrich, Anja; Meyer-Zehnder, Barbara; Frei, Irena Anna

2015-12-01

In the day-to-day course of nursing, ethical issues are being openly articulated to a growing extent. However, nurses only rarely systematically address these issues. This subject was explored in interviews with professionals who have a particular focus on ethics. Gain input for further developing the skills of nursing staff in ethical reasoning. In two focus groups and four individual interviews, we questioned 14 professionals, including nine nurses, who have a special interest in ethics. Nurses find it ethically problematic when the wishes of patients are not respected or something is forced on them, creating the impression that the care being given is exacerbating rather than alleviating the patient’s suffering. These problematic aspects are often overlooked because the consequences of the action in question are not immediately apparent. Ethical issues in nursing are often addressed in informal, non-systematic discussions among nursing staff. Nurses actively and confidently engage in discussions on treatment goals, and the teamwork with doctors is usually experienced as being based on mutual respect and partnership. The inherent hierarchical role differences between nursing and medical staff nevertheless manifest in ethical issues. Through the practical application of ethical reasoning in day-to-day nursing, structured discussions of the ethical aspects of cases and dedicated further education, nurses should learn to better recognise ethical issues in nursing and effectively analyse them and find solutions.

An Alternative Analysis of the Discourse by Descartes, Kant and Hegel in terms of the Ethical Structure of the Kanun.

PubMed

Yamamoto, Kazuhiko

2015-06-01

The ethical structure of the Albanian customary code, the Kanun, is deemed to represent the ethical value system of a society without state power. In spite of the appearance of civilizations and the resultant advent of an incipient state power, humans seemed to have known only the ethical value system of a society without state power until Gotama, Socrates, Plato and Jesus proposed new religious and philosophical doctrines. The basic trait of these religious and philosophical doctrines, which try to antagonize the ethical value system of a society without state power by eliminating the emotional aspect of humanity from the ethical value system, has been inherited by western philosophers such as Descartes, Kant and Hegel. The discourses by Descartes, Kant and Hegel were reviewed while paying attention to how they dealt with the sensuous and emotional aspects of humanity. The metaphysical implications of the ethical structure of the Kanun surfaced through the critical reviewing of their philosophy, and a hypothesis concerning its origin was presented.

The Return of Lombroso? Ethical Aspects of (Visions of) Preventive Forensic Screening.

PubMed

Munthe, Christian; Radovic, Susanna

2015-11-01

The vision of legendary criminologist Cesare Lombroso to use scientific theories of individual causes of crime as a basis for screening and prevention programmes targeting individuals at risk for future criminal behaviour has resurfaced, following advances in genetics, neuroscience and psychiatric epidemiology. This article analyses this idea and maps its ethical implications from a public health ethical standpoint. Twenty-seven variants of the new Lombrosian vision of forensic screening and prevention are distinguished, and some scientific and technical limitations are noted. Some lures, biases and structural factors, making the application of the Lombrosian idea likely in spite of weak evidence are pointed out and noted as a specific type of ethical aspect. Many classic and complex ethical challenges for health screening programmes are shown to apply to the identified variants and the choice between them, albeit with peculiar and often provoking variations. These variations are shown to actualize an underlying theoretical conundrum in need of further study, pertaining to the relationship between public health ethics and the ethics and values of criminal law policy.

The Return of Lombroso? Ethical Aspects of (Visions of) Preventive Forensic Screening

PubMed Central

Munthe, Christian; Radovic, Susanna

2015-01-01

The vision of legendary criminologist Cesare Lombroso to use scientific theories of individual causes of crime as a basis for screening and prevention programmes targeting individuals at risk for future criminal behaviour has resurfaced, following advances in genetics, neuroscience and psychiatric epidemiology. This article analyses this idea and maps its ethical implications from a public health ethical standpoint. Twenty-seven variants of the new Lombrosian vision of forensic screening and prevention are distinguished, and some scientific and technical limitations are noted. Some lures, biases and structural factors, making the application of the Lombrosian idea likely in spite of weak evidence are pointed out and noted as a specific type of ethical aspect. Many classic and complex ethical challenges for health screening programmes are shown to apply to the identified variants and the choice between them, albeit with peculiar and often provoking variations. These variations are shown to actualize an underlying theoretical conundrum in need of further study, pertaining to the relationship between public health ethics and the ethics and values of criminal law policy. PMID:26566397

The French model of psychoanalytic training: Ethical conflicts.

PubMed

François-Poncet, Claire-Marine

2009-12-01

Research on psychoanalytical education within the IPA may be clarified by reflecting on the ethic behind each of the three main models (Eitingonian, French and Uruguayan). In fact, the ethic underpinning psychoanalytical education, whatever the model, is confronted by irreducible conflicts between transmitting psychoanalysis by means of analytical experience or by means of academic teaching. Transmission by experience is essentially based on the ethic of psychoanalytic practice, which is difficult to regulate through institutional standards, whereas the academic aspect can be evaluated by objective and public criteria. The importance of both aspects and their relative weight in the training process depend on the conception of psychoanalysis underlying each model. This paper will look primarily at the French training model, the essentially analytical aspects of which favour the transmission of the very ethical foundations of psychoanalytic practice itself: the application of the method both as a working tool and as a tool of evaluation. It presupposes expanding the observation and analysis of transference beyond the framework of treatment to that of supervision. From this analysis, the paper will attempt to demonstrate how the French model proposes dealing with the inevitable conflicts between transmission by means of analysis and training by means of apprenticeship.

Business as Usual: Business Students' Conceptions of Ethics

ERIC Educational Resources Information Center

Reid, Anna; Taylor, Paul; Petocz, Peter

2011-01-01

There is continuing debate about how best to teach ethics to students in business, that is, how best to help them to develop the ethical aspects of their future profession. This debate has covered whether to teach ethics, what to teach and whether it has any effect on students' views or future behaviour. For the most part, the views of the…

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.

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.

Performance and Maqasid al-Shari'ah's Pentagon-Shaped Ethical Measurement.

PubMed

Bedoui, Houssem Eddine; Mansour, Walid

2015-06-01

Business performance is traditionally viewed from the one-dimensional financial angle. This paper develops a new approach that links performance to the ethical vision of Islam based on maqasid al-shari'ah (i.e., the objectives of Islamic law). The approach involves a Pentagon-shaped performance scheme structure via five pillars, namely wealth, posterity, intellect, faith, and human self. Such a scheme ensures that any firm or organization can ethically contribute to the promotion of human welfare, prevent corruption, and enhance social and economic stability and not merely maximize its own performance in terms of its financial return. A quantitative measure of ethical performance is developed. It surprisingly shows that a firm or organization following only the financial aspect at the expense of the others performs poorly. This paper discusses further the practical instances of the quantitative measurement of the ethical aspects of the system taken at an aggregate level.

Ethical aspects of transformational leadership.

PubMed

Cassidy, V R; Koroll, C J

1994-10-01

The requirements of leadership in the current environment of health care reform necessitate a clear distinction between leadership and management, an alteration in traditional leadership roles, and an evaluation of the knowledge and skills needed to address the ethical issues that arise from such reform. Transformational leadership is well suited to the current climate in health care because of the manner in which it actively embraces and encourages innovation and change. The article explores the elements of transformational leadership, describes the need for transformational leaders to be cognizant of the ethical aspects of their roles, and outlines the responsibilities of transformational leaders as moral agents.

Ethics for Industrial Technology

ERIC Educational Resources Information Center

Rosentrater, Kurt A.; Balamuralikrishna, Radha

2005-01-01

This paper takes aim at one specific, as well as basic, need in teamwork and interdisciplinary projects--ethics and its implications for professional practice. A preliminary study suggests that students majoring in industrial technology degree programs may not have adequate opportunity to formally study and engage in ethical aspects of technology…

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.

Teaching ethics using popular songs: feeling and thinking.

PubMed

O'Mathúna, Dónal P

2008-01-01

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

The Care Dialog: the "ethics of care" approach and its importance for clinical ethics consultation.

PubMed

Schuchter, Patrick; Heller, Andreas

2018-03-01

Ethics consultation in institutions of the healthcare system has been given a standard form based on three pillars: education, the development of guidelines and concrete ethics consultation in case conferences. The spread of ethics committees, which perform these tasks on an organizational level, is a remarkable historic achievement. At the same time it cannot be denied that modern ethics consultation neglects relevant aspects of care ethics approaches. In our essay we present an "ethics of care" approach as well as an empirical pilot project-"Ethics from the bottom up"-which organizes ethics consultation based on this focus. Findings and philosophy of the project will be discussed as far as relevant for ethics consultation in the healthcare system.

40 CFR 26.1603 - Operation of the Human Studies Review Board.

Code of Federal Regulations, 2012 CFR

2012-07-01

... appropriate for the scientific and ethical review of human research, including research ethics, biostatistics... scientific and ethical aspects of research proposals and reports of completed research with human subjects... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Operation of the Human Studies Review...

40 CFR 26.1603 - Operation of the Human Studies Review Board.

Code of Federal Regulations, 2010 CFR

2010-07-01

... appropriate for the scientific and ethical review of human research, including research ethics, biostatistics... scientific and ethical aspects of research proposals and reports of completed research with human subjects... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Operation of the Human Studies Review...

40 CFR 26.1605 - Operation of the Human Studies Review Board.

Code of Federal Regulations, 2014 CFR

2014-07-01

... appropriate for the scientific and ethical review of human research, including research ethics, biostatistics... scientific and ethical aspects of research proposals and reports of completed research with human subjects... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Operation of the Human Studies Review...

40 CFR 26.1605 - Operation of the Human Studies Review Board.

Code of Federal Regulations, 2013 CFR

2013-07-01

... appropriate for the scientific and ethical review of human research, including research ethics, biostatistics... scientific and ethical aspects of research proposals and reports of completed research with human subjects... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Operation of the Human Studies Review...

40 CFR 26.1603 - Operation of the Human Studies Review Board.

Code of Federal Regulations, 2011 CFR

2011-07-01

... appropriate for the scientific and ethical review of human research, including research ethics, biostatistics... scientific and ethical aspects of research proposals and reports of completed research with human subjects... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Operation of the Human Studies Review...

Finding The Right Way: Towards an Army Institutional Ethic

DTIC Science & Technology

2012-03-22

professionally and ethically," "demonstrate organisational values and codes of conduct," and "display high ethical and professional standards in all aspects of...government officials may find it necessary to violate that legal ban (official disobedience) in those instances.薍 Charitably , this is a tortured

Everyday Ethics in Dementia Day Care: Narratives of Crossing the Line.

ERIC Educational Resources Information Center

Hasselkus, Betty Risteen

1997-01-01

Examines the ethical aspects of the experience of providing day care to dementia patients. Results, based on telephone interviews (N=40), indicate that ethical challenges arise in everyday incidents when participants, staff, or family members "cross the line" of acceptable behavior. Staff responses ranged from benign manipulation to…

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,…

Teaching Medical Ethics in its Contexts: Penn State College of Medicine.

ERIC Educational Resources Information Center

Barnard, David; Clouser, K. Danner

1989-01-01

The medical school's ethics program evolved through cooperation with the humanities department. Key aspects of the program include the teaching of medical ethics in the context of other issues of value and meaning in medicine, and involvement of humanities faculty in the medical center. (Author/MSE)

Ethical and Legal Responsibilities of Counselors.

ERIC Educational Resources Information Center

Glennen, Robert E.

In the aftermath of the Watergate scandal, each profession is reviewing its ethical practices. This paper assists in this renewal by citing the code of ethical standards of APGA; reviewing the laws of the State of Nevada regarding privileged communications; and covering the legal aspects which relate to counseling situations. (Author)

How much are researchers aware of the ethical and social implications of their activities? The example of the European Project ENVRI Plus

NASA Astrophysics Data System (ADS)

Peppoloni, Silvia; Di Capua, Giuseppe; Haslinger, Florian

2017-04-01

Over the last years the attention to ethical and social aspects of scientific research has grown remarkably. Large scientific projects that refer to environment, resources, or natural hazards, assign great importance to the topics of big data and data management, environmental impact, science dissemination and education. These topics are also analyzed from an ethical and social perspective, recognizing the close relation to and evident repercussions on the life and activity of the human communities touched by those projects. ENVRIplus is a Horizon2020 project in which ethics applied to geosciences features as a fundamental issue, at the base of scientific activities. It brings together Environmental and Earth System Research Infrastructures (RIs), projects, and networks, with technical specialist partners to create a more coherent, interdisciplinary and interoperable cluster of Environmental Research Infrastructures across Europe (http://www.envriplus.eu/). In ENVRIplus, ethics applied to geosciences features as a fundamental issue at the base of scientific activities. Within the theme "Societal relevance and understanding", an entire work package aims at developing an ethical framework for RIs. Its objectives are: • increase the awareness of both the scientists and the public on the importance of ethical aspects in Earth and Environmental sciences; • establish a shared ethical reference framework, to be adopted by RIs governing bodies; • increase the awareness of RIs management and operational levels and of the individual involved scientists on their social role in conducting research activities and research work environment; • assess the ethical and social aspects related to the results achieved and deliverables released within the project. As one element of this work we created a questionnaire to investigate how each RI participating in ENVRI Plus faces ethical issues in relation to its activities, and so to understand the level of perception that researchers and technicians involved in the project have on the ethical implications of their scientific activities. Here we present and discuss the results of this survey, together with the next steps towards the formulation of an ethical reference framework.

Business ethics in ethics committees?

PubMed

Boyle, P

1990-01-01

The "Ethics committees" column in this issue of the Hastings Center Report features an introduction by Cynthia B. Cohen and four brief commentaries on the roles hospital ethics committees may play in the making of institutional and public health care policy in the 1990s. The pros and cons of a broader, more public role for ethics committees in reconciling the business and patient care aspects of health care delivery are debated by Cohen in "Ethics committees as corporate and public policy advocates," and by Philip Boyle in this article. Boyle is an associate for ethical studies at The Hastings Center.

Ethics in the classroom: a reflection on integrating ethical discussions in an introductory course in computer programming.

PubMed

Smolarski, D C; Whitehead, T

2000-04-01

In this paper, we describe our recent approaches to introducing students in a beginning computer science class to the study of ethical issues related to computer science and technology. This consists of three components: lectures on ethics and technology, in-class discussion of ethical scenarios, and a reflective paper on a topic related to ethics or the impact of technology on society. We give both student reactions to these aspects, and instructor perspective on the difficulties and benefits in exposing students to these ideas.

The current state of clinical ethics and healthcare ethics committees in Belgium

PubMed Central

Meulenbergs, T; Vermylen, J; Schotsmans, P

2005-01-01

Ethics committees are the most important practical instrument of clinical ethics in Belgium and fulfil three tasks: the ethical review of experimental protocols, advising on the ethical aspects of healthcare practice, and ethics consultation. In this article the authors examine the current situation of ethics committees in Belgium from the perspective of clinical ethics. Firstly, the most important steps which thus far have been taken in Belgium are examined. Secondly, recent opinion by the Belgian Advisory Committee on Bioethics with regard to ethics committees is presented and the activities of Belgian ethics committees are discussed. Finally, the option to bring research ethics and clinical ethics under the roof of just one committee is criticised using a pragmatic and a methodological argument. Concomitantly, the authors build an argument in favour of the further development of ethics consultation. PMID:15923477

Ethical competency of nurse leaders: A qualitative study.

PubMed

Barkhordari-Sharifabad, Maasoumeh; Ashktorab, Tahereh; Atashzadeh-Shoorideh, Foroozan

2018-02-01

Ethics play an important role in activating the manpower and achieving the organizational goals. The nurse leaders' ethical behavior can promote the care quality by affecting the nurses' performance and bringing up several positive consequences for the organization. The aim of this study was to identify and describe the ethical competency of nurse leaders in cultural domains and the working conditions of the Iranian healthcare setting to arrive at a more comprehensive and specific perspective. This was a qualitative conventional content analysis study conducted with the participation of 14 nurse leaders at various levels. The participants were selected using the purposive sampling method, and the required data were collected using deep interview and also semi-structured interview. A deductive method of content analysis was applied in data analysis. Ethical considerations: This study was conducted in accord with the principles of research ethics and national rules and regulations relating to informed consent and confidentiality. Data analysis resulted in 17 subcategories that were subsequently grouped into three major categories including empathetic interactions, ethical behavior, and exalted manners. Our findings are consistent with previous ones, yet presenting a more complete knowledge about aspects of ethical competency of nurse leaders. The nurse leaders can provide a proper behavioral model for the work environment through the use of new information. The nurse leaders introduced various aspects of ethical competency, so the leaders' ethical competency could be promoted via planning and managing some ethical development programs. More future research is needed regarding the experiences of the subordinates and other related parties.

Ethical considerations in biomedical research: a personal view.

PubMed

Dahlöf, Carl

2013-06-01

Ethical considerations are made when an experiment is planned and take a regulatory system of moral principles into account. Ethical considerations should first and foremost be made in order to protect the individual subject/animal from being exposed to any unethical and perhaps even illegal intervention and to ensure that the experimental conditions used are appropriate. The main role of research ethics committees is to assess the scientific and ethical aspects of submitted protocols and follow up the trial until its closure.

Implant ethics

PubMed Central

Hansson, S

2005-01-01

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

Holistic Assessment and Ethical Disputation on a New Trend in Solid Biofuels.

PubMed

Hašková, Simona

2017-04-01

A new trend in the production technology of solid biof uels has appeared. There is a wide consensus that most solid biofuels will be produced according to the new production methods within a few years. Numerous samples were manufactured from agro-residues according to conventional methods as well as new methods. Robust analyses that reviewed the hygienic, environmental, financial and ethical aspects were performed. The hygienic and environmental aspect was assessed by robust chemical and technical analyses. The financial aspect was assessed by energy cost breakdown. The ethical point of view was built on the above stated findings, the survey questionnaire and critical discussion with the literature. It is concluded that the new production methods are significantly favourable from both the hygienic and environmental points of view. Financial indicators do not allow the expressing of any preference. Regarding the ethical aspect, it is concluded that the new methods are beneficial in terms of environmental responsibility. However, it showed that most of the customers that took part in the survey are price oriented and therefore they tend to prefer the cheaper-conventional alternative. In the long term it can be assumed that expansion of the new technology and competition among manufacturers will reduce the costs.

Surgical innovation: the ethical agenda: A systematic review.

PubMed

Broekman, Marike L; Carrière, Michelle E; Bredenoord, Annelien L

2016-06-01

The aim of the present article was to systematically review the ethics of surgical innovation and introduce the components of the learning health care system to guide future research and debate on surgical innovation.Although the call for evidence-based practice in surgery is increasingly high on the agenda, most surgeons feel that the format of the randomized controlled trial is not suitable for surgery. Innovation in surgery has aspects of, but should be distinguished from both research and clinical care and raises its own ethical challenges.To answer the question "What are the main ethical aspects of surgical innovation?", we systematically searched PubMed and Embase. Papers expressing an opinion, point of view, or position were included, that is, normative ethical papers.We included 59 studies discussing ethical aspects of surgical innovation. These studies discussed 4 major themes: oversight, informed consent, learning curve, and vulnerable patient groups. Although all papers addressed the ethical challenges raised by surgical innovation, surgeons hold no uniform view of surgical innovation, and there is no agreement on the distinction between innovation and research. Even though most agree to some sort of oversight, they offer different alternatives ranging from the formation of new surgical innovation committees to establishing national registries. Most agree that informed consent is necessary for innovative procedures and that surgeons should be adequately trained to assure their competence to tackle the learning curve problem. All papers agree that in case of vulnerable patients, alternatives must be found for the informed consent procedure.We suggest that the concept of the learning health care system might provide guidance for thinking about surgical innovation. The underlying rationale of the learning health care system is to improve the quality of health care by embedding research within clinical care. Two aspects of a learning health care system might particularly enrich the necessary future discussion on surgical innovation: integration of research and practice and a moral emphasis on "learning activities." Future research should evaluate whether the learning health care system and its adjacent moral framework provides ethical guidance for evidence-based surgery.

A Comparison of the Financial Management Curriculum at the Naval Postgraduate School and Other Graduate Public Financial Management Curricula in the United States

DTIC Science & Technology

1992-06-01

Administration, Legal Principles, Ethics in Government or Public Administration courses in the NPS curriculum. These courses, however, are found in more...Other X Other: Legal Aspects X X X Ethics in Government X X X Public Administration X X 2 X Admin Theory/Policy X X X 2 X Degree Offered: 1)MPA 2 3 2 1 1...Other Other: Legal Aspects X X X Ethics in Government X X X Public Administration X X X X X X X X Admin Theory/Policy X X X X Degree Offered: 1)MPA 1 1

[The clinical history in surgical processes. Bioethical aspects and basic professional ethics].

PubMed

Collazo Chao, Eliseo

2008-11-01

Surgeons are increasingly facing multiple civil liability claims from their patients. Against this background and taking any eventual liability claims into account, surgeons must be increasingly aware of the importance of maintaining patient medical histories, which raises numerous questions on the length of time and form of keeping them. Ethical and legal obligations need to be taken into account in order to identify the controversial aspects related to patients and their environment, as well as shedding light on the most appropriate behaviour in each case. We must never forget the case history is a clinical document, subjected to the medical art and medical ethics which regulate it.

Counterfactual Thinking and Ethical Decision Making: A New Approach to an Old Problem for Marketing Education

ERIC Educational Resources Information Center

Celuch, Kevin; Saxby, Carl

2013-01-01

The present study extends understanding of the self-regulatory aspects of ethical decision making by integrating and exploring relationships among counterfactual thinking, attribution, anticipatory emotions, and ethical decision-making constructs and processes. Specifically, we examine the effects of a manipulation designed to stimulate a…

Ethics and Body Politics: Interdisciplinary Possibilities for Embodied Psychotherapeutic Practice and Research

ERIC Educational Resources Information Center

Allegranti, Beatrice

2011-01-01

Ethical approaches to practice and research in counselling and arts/psychotherapies demand an urgent attention to body politics. Bodies are not neutral; gender, sexuality, ethnicity and class are socio-political aspects that shape our mental, emotional and physical selves and inform our ethical values. Drawing from the author's embodied practice…

Ethical Issues for an Editorial Board: "Kairaranga"

ERIC Educational Resources Information Center

Clark, John

2008-01-01

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

77 FR 60116 - Human Studies Review Board; Notification of a Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-02

... advise the Agency on the EPA scientific and ethical reviews of research with human subjects. DATES: This... and ethics issues under discussion, it is not our intent to permit organizations to expand the time..., information, and recommendations to the EPA on issues related to scientific and ethical aspects of human...

76 FR 80938 - Human Studies Review Board; Notification of a Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... Agency on the EPA scientific and ethical reviews of research with human subjects. DATES: This public... of oral comments on the science and ethics issues under discussion, it is not our intent to permit... related to scientific and ethical aspects of human subjects research. The major objectives of the HSRB are...

Sensing as an Ethical Dimension of Teacher Professionality

ERIC Educational Resources Information Center

Edling, Silvia; Frelin, Anneli

2016-01-01

The purpose of this article is to theoretically discuss how teacher professionality, as an aspect of teacher professionalism, can be understood in relation to the notion of sensing within the "ethics of alterity" and the "ethics of dissensus," both of which express a desire to contest the various forms of violence in society.…

Faculty's Perceptions of Teaching Ethics and Leadership in Engineering Education

ERIC Educational Resources Information Center

AlSagheer, Abdullah; Al-Sagheer, Areej

2011-01-01

This paper addressed the faculty's perception of engineering ethics and leadership training. The study looks into the present state of and methodologies for teaching engineering ethics and leadership and aims to determine the faculty's perception of an identified gap in this aspect of engineering education. Engineering education has strong ethics…

Ethics of reproductive technology: AFS recommendations, dissent.

PubMed

McCormick, R A

1987-03-01

The Ethics Committee of the American Fertility Society recently released its report, "Ethical Considerations of the New Reproductive Technologies." The report examines general ethical, legal, and biological aspects of and makes ethical recommendations on procreative technologies, from standard in vitro fertilization, through all its possible variations and accompaniments, including donor gametes and preembryos, surrogate mothers, and cryopreservation. The judgment of ethical acceptability of third-party involvement in reproductive technology is the report's weakest aspect. The potential impact of such participation was not sufficiently weighed because of primacy given to a single value: the provision of a baby to an individual couple, or even an individual, who could not otherwise have one. A dissent to the report is based on two analyses: Third-party involvement itself violates the marriage covenant, independent of any potential damaging effects or benefits, and relaxation of marital exclusivity could harm the marriage (and marriage in general) and the prospective child. The committee also failed to resolve the problem of preembryo status. Instead, it recommended that local programs offering reproductive assistance draw up their own policies.

Ethics and Continuing Medical Education.

ERIC Educational Resources Information Center

Felch, William C.

1986-01-01

Aspects of ethics and continuing medical education (CME) are discussed in terms of CME consumers (physicians), providers, and others; vacation CME and "brownie points"; marketing and cosponsorship; financial support from industry; and entrepreneurialism. (CT)

[Ethic rounds in intensive care. Possible instrument for a clinical-ethical assessment in intensive care units].

PubMed

Scheffold, N; Paoli, A; Gross, J; Riemann, U; Hennersdorf, M

2012-10-01

Ethical problems, such as medical end-of-life decisions or withdrawing life-sustaining treatment are viewed as an essential task in intensive care units. This article presents the ethics rounds as an instrument for evaluation of ethical problems in intensive care medicine units. The benchmarks of ethical reflection during the ethics rounds are considerations of ethical theory of principle-oriented medical ethics. Besides organizational aspects and the institutional framework, the role of the ethicist is described. The essential evaluation steps, as a basis of the ethics rounds are presented. In contrast to the clinical ethics consultation, the ethicist in the ethics rounds model is integrated as a member of the ward round team. Therefore ethical problems may be identified and analyzed very early before the conflict escalates. This preventive strategy makes the ethics rounds a helpful instrument in intensive care units.

Ethical Presence in the Psychoanalytic Encounter and the Role of Apology.

PubMed

Weiss, Micha

2018-03-01

This paper discusses aspects of ethical presence in psychoanalysis, and the possible use of apology in the therapeutic process. The author roughly delineates two periods in the history of psychoanalysis regarding the ethical dimension-the early classical period which is influenced by Freud's ethics of honesty, which gradually evolves towards the more recent intersubjectively-influenced period, necessitating the assimilation of an ethics of relationships. It is suggested that explicit theorizing of the ethical dimension into psychoanalysis offers added value to its effectiveness, and a framework is presented for combining relational, intersubjectively informed ethical dialogue, with contributions of classical technique, enriching the therapeutic potential of psychoanalytic work.

The normative background of empirical-ethical research: first steps towards a transparent and reasoned approach in the selection of an ethical theory.

PubMed

Salloch, Sabine; Wäscher, Sebastian; Vollmann, Jochen; Schildmann, Jan

2015-04-04

Empirical-ethical research constitutes a relatively new field which integrates socio-empirical research and normative analysis. As direct inferences from descriptive data to normative conclusions are problematic, an ethical framework is needed to determine the relevance of the empirical data for normative argument. While issues of normative-empirical collaboration and questions of empirical methodology have been widely discussed in the literature, the normative methodology of empirical-ethical research has seldom been addressed. Based on our own research experience, we discuss one aspect of this normative methodology, namely the selection of an ethical theory serving as a background for empirical-ethical research. Whereas criteria for a good ethical theory in philosophical ethics are usually related to inherent aspects, such as the theory's clarity or coherence, additional points have to be considered in the field of empirical-ethical research. Three of these additional criteria will be discussed in the article: (a) the adequacy of the ethical theory for the issue at stake, (b) the theory's suitability for the purposes and design of the empirical-ethical research project, and (c) the interrelation between the ethical theory selected and the theoretical backgrounds of the socio-empirical research. Using the example of our own study on the development of interventions which support clinical decision-making in oncology, we will show how the selection of an ethical theory as a normative background for empirical-ethical research can proceed. We will also discuss the limitations of the procedures chosen in our project. The article stresses that a systematic and reasoned approach towards theory selection in empirical-ethical research should be given priority rather than an accidental or implicit way of choosing the normative framework for one's own research. It furthermore shows that the overall design of an empirical-ethical study is a multi-faceted endeavor which has to balance between theoretical and pragmatic considerations.

Toward a Responsibility-Catering Prioritarian Ethical Theory of Risk.

PubMed

Wikman-Svahn, Per; Lindblom, Lars

2018-03-05

Standard tools used in societal risk management such as probabilistic risk analysis or cost-benefit analysis typically define risks in terms of only probabilities and consequences and assume a utilitarian approach to ethics that aims to maximize expected utility. The philosopher Carl F. Cranor has argued against this view by devising a list of plausible aspects of the acceptability of risks that points towards a non-consequentialist ethical theory of societal risk management. This paper revisits Cranor's list to argue that the alternative ethical theory responsibility-catering prioritarianism can accommodate the aspects identified by Cranor and that the elements in the list can be used to inform the details of how to view risks within this theory. An approach towards operationalizing the theory is proposed based on a prioritarian social welfare function that operates on responsibility-adjusted utilities. A responsibility-catering prioritarian ethical approach towards managing risks is a promising alternative to standard tools such as cost-benefit analysis.

Introducing ethics to chemistry students in a "Research Experiences for Undergraduates" (REU) program.

PubMed

Hanson, Mark J

2015-01-01

A three-day ethics seminar introduced ethics to undergraduate environmental chemistry students in the Research Experiences for Undergraduates (REU) program. The seminar helped students become sensitive to and understand the ethical and values dimensions of their work as researchers. It utilized a variety of resources to supplement lectures and class discussion on a variety of issues. Students learned about the relevance of ethics to research, skills in moral reasoning, and the array of ethical issues facing various aspects of scientific research. © 2015 The International Union of Biochemistry and Molecular Biology.

Comparative Study On The Ethical Perceptions Of Contractors And Designers In The China Construction Industry

NASA Astrophysics Data System (ADS)

Kang, Byung Gyoo; Long, Kaiwen; Zhang, Cheng; Li Hao, Jian

2017-12-01

Ethics is becoming one of the most important requirements for successful business in the 21st century. The construction industry cannot be exceptional from this trend. However construction ethics management requires different approaches from other industries, as the products of the industry are construction projects which are completely different from mass production. Contractors and designers are two major participants in construction projects. The roles and responsibilities of these two project stakeholders decisively influence all aspects of construction project. Practically ethical perceptions of contractors and designers are one of main aspects to be considered for the effective and efficient management of ethics for the construction industry. This research has investigated the ethical perceptions of contractors and designers in the China construction industry. A questionnaire survey which contains 15 ethical issues and 6 demographic factors has been conducted. 170 construction professionals from construction companies and consulting companies have been participated in this survey. These 15 ethical issues are ranked in terms of seriousness, frequency and importance for both contractors and designers as a single group to understand the overall perceptions in the industry. The analysis has also been conducted for contractors and designers respectively to make comparisons between them. The top three serious ethical issues in the industry are ‘Bribery and corruption’, ‘Failure to practice whistle-blowing’ and ‘Improper bidding practices’. Contractors and designers showed similar outcomes for the top five important ethical issues. But for the middle ranged ethical issues, they showed some differences. Further researches are required to identify the causes of the similarity and differences.

78 FR 57383 - Human Studies Review Board; Notification of a Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-18

... advise the Agency on the EPA scientific and ethical reviews of research with human subjects. DATES: This... organization. While it is our intent to hear a full range of oral comments on the science and ethics issues..., information, and recommendations to the EPA on issues related to scientific and ethical aspects of human...

The Academic Ethic and the Transition to College

ERIC Educational Resources Information Center

Smith, William L.; Zhang, Pidi

2009-01-01

This paper investigates one aspect of the transition of students from high school to college. It assesses whether students who had an academic ethic in high school performed better in their first semester of college than students who did not possess an academic ethic in high school. Survey data were collected from students at a medium-sized state…

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

PubMed Central

Newton, M J

1986-01-01

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

Assessment vs. appraisal of ethical aspects of health technology assessment: can the distinction be upheld?

PubMed Central

Sandman, Lars; Heintz, Emelie

2014-01-01

An essential component of health technology assessment (HTA) is the assessment of ethical aspects. In some healthcare contexts, tasks are strictly relegated to different expert groups: the HTA-agencies are limited to assessment of the technology and other actors within the health care sector are responsible for appraisal and recommendations. Ethical aspects of health technologies are considered with reference to values or norms in such a way that may be prescriptive, or offer guidance as to how to act or relate to the issue in question. Given this internal prescriptivity, the distinction between assessment and appraisal seems difficult to uphold, unless the scrutiny stops short of a full ethical analysis of the technology. In the present article we analyse the distinction between assessment and appraisal, using as an example ethical aspects of implementation of GPS-bracelets for people with dementia. It is concluded that for HTA-agencies with a strictly delineated assessment role, the question of how to deal with the internal prescriptivity of ethics may be confusing. A full ethical analysis might result in a definite conclusion as to whether the technology in question is ethically acceptable or not, thereby limiting choices for decision-makers, who are required to uphold certain ethical values and norms. At the same time, depending on the exact nature of such a conclusion, different action strategies can be supported. A positive appraisal within HTA could result in a decision on mandatory implementation, or funding of the technology, thereby making it available to patients, or decisions to allow and even encourage the use of the technology (even if someone else will have to fund it). A neutral appraisal, giving no definite answer as to whether implementation is recommended or not, could result in a laissez-faire attitude towards the technology. A negative appraisal could result in a decision to discourage or even prohibit implementation. This paper presents an overview of the implications of different outcomes of the ethical analysis on appraisal of the technology. It is considered important to uphold the distinction between assessment and appraisal, primarily to avoid the influence of preconceived values and political interests on the assessment. Hence, as long as it is not based on the subjective value judgments of the HTA-agency (or its representative), such an appraising conclusion would not seem to conflict with the rationale for the separation of these tasks. Moreover, it should be noted that if HTA agencies abstain from including full ethical analyses because of the risk of issuing an appraisal, they may fail to provide the best possible basis for decision-makers. Hence, we argue that as long as the ethical analysis and its conclusions are presented transparently, disclosing how well-founded the conclusions are and/or whether there are alternative conclusions, the HTA-agencies should not avoid taking the ethical analysis as close as possible to a definite conclusion. PMID:25493102

Assessment vs. appraisal of ethical aspects of health technology assessment: can the distinction be upheld?

PubMed

Sandman, Lars; Heintz, Emelie

2014-01-01

An essential component of health technology assessment (HTA) is the assessment of ethical aspects. In some healthcare contexts, tasks are strictly relegated to different expert groups: the HTA-agencies are limited to assessment of the technology and other actors within the health care sector are responsible for appraisal and recommendations. Ethical aspects of health technologies are considered with reference to values or norms in such a way that may be prescriptive, or offer guidance as to how to act or relate to the issue in question. Given this internal prescriptivity, the distinction between assessment and appraisal seems difficult to uphold, unless the scrutiny stops short of a full ethical analysis of the technology. In the present article we analyse the distinction between assessment and appraisal, using as an example ethical aspects of implementation of GPS-bracelets for people with dementia. It is concluded that for HTA-agencies with a strictly delineated assessment role, the question of how to deal with the internal prescriptivity of ethics may be confusing. A full ethical analysis might result in a definite conclusion as to whether the technology in question is ethically acceptable or not, thereby limiting choices for decision-makers, who are required to uphold certain ethical values and norms. At the same time, depending on the exact nature of such a conclusion, different action strategies can be supported. A positive appraisal within HTA could result in a decision on mandatory implementation, or funding of the technology, thereby making it available to patients, or decisions to allow and even encourage the use of the technology (even if someone else will have to fund it). A neutral appraisal, giving no definite answer as to whether implementation is recommended or not, could result in a laissez-faire attitude towards the technology. A negative appraisal could result in a decision to discourage or even prohibit implementation. This paper presents an overview of the implications of different outcomes of the ethical analysis on appraisal of the technology. It is considered important to uphold the distinction between assessment and appraisal, primarily to avoid the influence of preconceived values and political interests on the assessment. Hence, as long as it is not based on the subjective value judgments of the HTA-agency (or its representative), such an appraising conclusion would not seem to conflict with the rationale for the separation of these tasks. Moreover, it should be noted that if HTA agencies abstain from including full ethical analyses because of the risk of issuing an appraisal, they may fail to provide the best possible basis for decision-makers. Hence, we argue that as long as the ethical analysis and its conclusions are presented transparently, disclosing how well-founded the conclusions are and/or whether there are alternative conclusions, the HTA-agencies should not avoid taking the ethical analysis as close as possible to a definite conclusion.

EHR in the perspective of security, integrity and ethics.

PubMed

Nordberg, Ragnar

2006-01-01

Success stories of modern applications in healthcare and welfare, like the electronic health record, are always linked to end user awareness, confidence, and acceptance. Reports and surveys have given proof of these dependencies. Knowing about existing and emerging concerns and weaknesses right in advance allows to taking actions on an ethical, social, and societal level. This paper gives a review of specific observations regarding security, privacy, authentication, integrity and ethical aspects when operating an electronic health record (EHR) system in a hospital, an open care department and in a wider community of the health care sector. A reference is given to existing and emerging international standards related to the aforementioned aspects.

Publication aspects of ethics in photogrammetry

USGS Publications Warehouse

Thompson, Morris M.

1991-01-01

According to the Code of Ethics of the American Society for Photogrammetry and Remote Sensing (ASPRS), the principles on which ethics are founded consist of honesty, justice, and courtesy, forming a moral philosophy associated with mutual interest among men. We will cover in particular the ethical problems of publication of photogrammetric material in the various media. There are many such problems, and we often face a dilemma in selecting a course which is the right thing to do.

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

PubMed

Frith, Lucy

2013-01-01

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

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

PubMed

Hawkins, Alice K; Ho, Anita

2012-06-01

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

[Ethics, science and utilitarianism].

PubMed

Ribeiro, T

1997-11-01

We begin this article with the distinction between Deontology, Moral and Ethics. We also review the concept and the relevance of Bioethics, as the "science of survival", and as part of Ethics, a section of Philosophy. We tried to answer two further questions considering the role of Science in orienting Ethics, or the possible place of utilitarianism in controlling Ethics. The author discusses some new aspects of the doctor/patient relationship, and their evolution in the last 100 years, as well as the relations between patients and Health care institutions. Some ethical problems were also raised related to the beginning and the end of life. Finally the author reflects on the difficulties of defining ethical concepts in the near future.

Methods and Tools for Ethical Usability

NASA Astrophysics Data System (ADS)

Kavathatzopoulos, Iordanis; Kostrzewa, Agata; Laaksoharju, Mikael

The objectives of the tutorial are to provide knowledge of basic ethical, psychological and organizational theories that are relevant to consider ethical aspects during design and use of IT systems; knowledge and skills about handling and solving ethical problems in connection with design and use of IT-systems; and skills in using questionnaires, surveys, interviews and the like in connection with software development and IT-use. It contains lectures, workshop and exercises; use of special tools to identify and consider IT ethical issues during planning, construction, installation and use of IT systems; and group exercises where the participants train their ethical skills on IT ethical conflicts and problems. Intended participants are system developers, purchasers, usability experts, academics, HCI teachers.

[Euthanasia/assisted suicide. Ethical and socio-religious aspects].

PubMed

Chiriţă, V; Chiriţă, Roxana; Duică, Lavinia; Talau, Gh

2009-01-01

Euthanasia/Assisted Suicide are viewed differently by moral and religious references. In a religious way, cardinal confessions (Christianity, Judaism, Islamism, Buddhism) condemn euthanasia/assisted suicide and, in the same time have a more relaxed attitude regarding passive euthanasia. Other aspects of euthanasia regard financial/economic and ethical-medical considerations. All these contradictory standpoints are expressed in some legal acts that make specifications on the concept of "euthanasia"--Oregon's Death with Dignity Act (1994) and Netherlands's Euthanasia Law (2001).

Teaching medical students to discern ethical problems in human clinical research studies.

PubMed

Roberts, Laura Weiss; Warner, Teddy D; Green Hammond, Katherine A; Brody, Janet L; Kaminsky, Alexis; Roberts, Brian B

2005-10-01

Investigators and institutional review boards are entrusted with ensuring the conduct of ethically sound human studies. Assessing ethical aspects of research protocols is a key skill in fulfilling this duty, yet no empirically validated method exists for preparing professionals to attain this skill. The authors performed a randomized controlled educational intervention, comparing a criteria-based learning method, a clinical-research- and experience-based learning method, and a control group. All 300 medical students enrolled at the University of New Mexico School of Medicine in 2001 were invited to participate. After a single half-hour educational session, a written posttest of ability to detect ethical problems in hypothetical protocol vignettes was administered. The authors analyzed responses to ten protocol vignettes that had been evaluated independently by experts. For each vignette, a global assessment of the perceived significance of ethical problems and the identification of specific ethical problems were evaluated. Eighty-three medical students (27%) volunteered: 50 (60%) were women and 55 (66%) were first- and second-year students. On global assessments, the criteria-focused group perceived ethical problems as more significant than did the other two groups (p < .02). Students in the criteria-focused group were better able than students in the control group (p < .03) to discern specific ethical problems, more closely resembling expert assessments. Unexpectedly, the group focused on clinical research participants identified fewer problems than did the control group (p < .05). The criteria-focused intervention produced enhanced ethical evaluation skills. This work supports the potential value of empirically derived methods for preparing professionals to discern ethical aspects of human studies.

Publication ethics in biomedical journals from countries in Central and Eastern Europe.

PubMed

Broga, Mindaugas; Mijaljica, Goran; Waligora, Marcin; Keis, Aime; Marusic, Ana

2014-03-01

Publication ethics is an important aspect of both the research and publication enterprises. It is particularly important in the field of biomedical science because published data may directly affect human health. In this article, we examine publication ethics policies in biomedical journals published in Central and Eastern Europe. We were interested in possible differences between East European countries that are members of the European Union (Eastern EU) and South-East European countries (South-East Europe) that are not members of the European Union. The most common ethical issues addressed by all journals in the region were redundant publication, peer review process, and copyright or licensing details. Image manipulation, editors' conflicts of interest and registration of clinical trials were the least common ethical policies. Three aspects were significantly more common in journals published outside the EU: statements on the endorsement of international editorial standards, contributorship policy, and image manipulation. On the other hand, copyright or licensing information were more prevalent in journals published in the Eastern EU. The existence of significant differences among biomedical journals' ethical policies calls for further research and active measures to harmonize policies across journals.

Saving lives in road traffic—ethical aspects

PubMed Central

2009-01-01

Aim This article aims at giving an overview of five ethical problem areas relating to traffic safety, thereby providing a general framework for analysing traffic safety from an ethical perspective and encouraging further discussion concerning problems, policies and technology in this area. Subjects and methods The problems presented in the article are criminalisation, paternalism, privacy, justice and responsibility, and the reasons for choosing these are the following. First, they are all important areas in moral philosophy. Second, they are fairly general and it should be possible to categorise more specific problems under these headings. Ethical aspects of road traffic have not received the philosophical attention they deserve. Every year, more than 1 million people die globally in traffic accidents, and 20 to 50 million people are injured. Ninety per cent of the road traffic fatalities occur in low- and middle-income countries, where it is a growing problem. Politics, economics, culture and technology affect the number of fatalities and injuries, and the measures used to combat deaths in traffic as well as the role of road traffic should be ethically scrutinised. The topics are analysed and discussed from a moral-philosophical perspective, and the discussion includes both theory and applications. Results and conclusion The author concludes with some thoughts on how the ethical discussion can be included in the public debate on how to save lives in road traffic. People in industrialised societies are so used to road traffic that it is almost seen as part of nature. Consequently, we do not acknowledge that we can introduce change and that we can affect the role we have given road traffic and cars. By acknowledging the ethical aspects of road traffic and illuminating the way the choices society makes are ethically charged, it becomes clear that there are alternative ways to design the road traffic system. The most important general conclusion is that discussion concerning these alternative ways of designing the system should be encouraged. PMID:21088693

Jewish ethics and xenotransplantation.

PubMed

Mathieu, Richard

2016-07-01

Although exclusively secular approaches to xenotransplantation are methodologically necessary to establish a fundamental verdict on its theoretical ethical acceptability, it is nevertheless pragmatically appropriate to take into account specifically religious positions, as religion is a factor relevant to societal acceptability. Apart from the aspect of societal acceptability, Jewish bioethics, like other religiously embedded ethics, may enrich the broader ethical discourse on xenotransplantation, as some of its principles-pikuach nefesh being the most prominent one-are plausible even in the framework of secular ethics. This paper first explores concepts of normativity in Jewish ethics before identifying specific ethical issues in Jewish bioethics and possible resolutions offered within the framework of Jewish ethics, and then finally examine the implications for the broader debate on xenotransplantation. Religions in general and Judaism in specific cannot and should not be systematically excluded from ethical debates, not only because they may provide helpful input, but also because religion, religiousness and the affiliation to a religion can be crucial factors regarding the societal acceptability of specific medical technologies and procedures as they may be important aspects of an individual's identity. The principles of Jewish bioethics may be compelling to those who do not necessarily share the specifically religious prerequisites on which Jewish ethics is established. Among these rather cogent concepts is the status of natural law and naturalness, which is far more open to medical technologies and procedures deemed as unnatural and thus morally wrong by other religious parties in public discourse. Jewish ethics has strong tendencies toward supporting xenotransplantation given a certain criteria is met. No categorical bans on xenotransplantation can be established on the grounds of Halacha. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Suffering, compassion and 'doing good medical ethics'.

PubMed

de Zulueta, Paquita C

2015-01-01

'Doing good medical ethics' involves attending to both the biomedical and existential aspects of illness. For this, we need to bring in a phenomenological perspective to the clinical encounter, adopt a virtue-based ethic and resolve to re-evaluate the goals of medicine, in particular the alleviation of suffering and the role of compassion in everyday ethics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

What Do Ethical Guidelines for Epidemiology Say About an Ethics Review? A Qualitative Systematic Review.

PubMed

Piasecki, Jan; Waligora, Marcin; Dranseika, Vilius

2017-06-01

Epidemiological research is subject to an ethics review. The aim of this qualitative review is to compare existing ethical guidelines in English for epidemiological research and public health practice in regard to the scope and matter of an ethics review. Authors systematically searched PubMed, Google Scholar and Google Search for ethical guidelines. Qualitative analysis (constant comparative method) was applied to categorize important aspects of the an ethics review process. Eight ethical guidelines in English for epidemiological research were retrieved. Five main categories that are relevant to the review of epidemiological research by Institutional Review Boards/Research Ethics Committees were distinguished. Within the scope of main categories, fifty-nine subcategories were analyzed. There are important differences between the guidelines in terms of the scope and matter of an ethics review. Not all guidelines encompass all identified ethically important issues, and some do not define precisely the scope and matter of an ethics review, leaving much to the ethics of the individual researchers and the discretion of IRBs/RECs.

[Ethical aspects of regenerative medicine, with special reference to embryonic stem cells and therapeutic cloning].

PubMed

Imura, Hiroo

2003-03-01

Regenerative medicine is expected to be new therapeutic means for treating incurable diseases but requires serious bioethical consideration. Embryonic stem(ES) cells, that are pleuripotent cells suitable to regenerative medicine, can be used in Japan for investigative use under a strict control by guide-lines. On the other hand, use of embryo produced by nuclear transfer has not been allowed in Japan and further serious consideration is required. Some other ethical aspects of regenerative medicine are also discussed.

Some ethical and psychiatric aspects of right-lobe liver transplantation in the United States and Japan.

PubMed

Surman, Owen S; Cosimi, A B; Fukunishi, Isao; Kawaii, Tatsuo; Findley, John; Kita, Yoshiaki; Makuuchi, Masatoshi

2002-01-01

Cadaver sources are insufficient for the increasing demand for liver transplantation. Right-lobe liver transplantation from living donors is fully developed in Japan and has been rapidly increasing in the United States during the past 2 years, although donor risk is greater than in other types of solid organ transplantation. The authors examine the psychiatric and ethical aspects of right-lobe liver transplantation in light of cultural differences between the United States and Japan.

Model for integrated management of quality, labor risks prevention, environment and ethical aspects, applied to R&D&I and production processes in an organization

NASA Astrophysics Data System (ADS)

González, M. R.; Torres, F.; Yoldi, V.; Arcega, F.; Plaza, I.

2012-04-01

It is proposed an integrated management model for an organization. This model is based on the continuous improvement Plan-Do-Check-Act cycle and it intends to integrate the environmental, risk prevention and ethical aspects as well as research, development and innovation projects management in the general quality management structure proposed by ISO 9001:2008. It aims to fulfill the standards ISO 9001, ISO 14001, OSHAS 18001, SGE 21 y 166002.

[Pneumothorax following dry needling treatment: legal and ethical aspects].

PubMed

Ronconi, Gianpaolo; De Giorgio, Fabio; Ricci, Eleonora; Maggi, Loredana; Spagnolo, Antonio G; Ferrara, Paola Emilia

2016-01-01

Trigger point "dry needling" is a technique used to treat myofascial pain. It involves using filiform needles which are inserted into muscles to give local pain relief. Few cases of serious adverse events following this treatment have been reported in the literature. In this paper we describe the case of a professional swimmer who developed pneumothorax after dry needling treatment and discuss the medicolegal and ethical aspects related to competencies and responsibilities of medical doctors and physiotherapists performing the procedure.

Abortion in Islamic Ethics, and How it is Perceived in Turkey: A Secular, Muslim Country

PubMed Central

Ekmekci, Perihan Elif

2016-01-01

Abortion is among the most widely discussed concepts of medical ethics. Since the well-known ethical theories have emerged from Western world, the position of Islamic ethics regarding main issues of medical ethics has been overlooked. Muslims constitute a considerable amount of world population. Turkish Republic is the only Muslim country ruled with secular democracy and one of the three Muslim countries where abortion is legalized. The first aim of this paper is to present discussions on abortion in Islamic ethics in the context of major ethical concepts; the legal status of the fetus, respect for life and the right not to be born. The second aim is to put forth Turkey’s present legislation about abortion in the context of Islamic ethical and religious aspects. PMID:27364347

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

Abortion in Islamic Ethics, and How it is Perceived in Turkey: A Secular, Muslim Country.

PubMed

Ekmekci, Perihan Elif

2017-06-01

Abortion is among the most widely discussed concepts of medical ethics. Since the well-known ethical theories have emerged from Western world, the position of Islamic ethics regarding main issues of medical ethics has been overlooked. Muslims constitute a considerable amount of world population. Turkish Republic is the only Muslim country ruled with secular democracy and one of the three Muslim countries where abortion is legalized. The first aim of this paper is to present discussions on abortion in Islamic ethics in the context of major ethical concepts; the legal status of the fetus, respect for life and the right not to be born. The second aim is to put forth Turkey's present legislation about abortion in the context of Islamic ethical and religious aspects.

The social transformation of some American ethics committees.

PubMed

Cohen, C B

1989-01-01

The relationship between ethics committees and the institutions in which they function is the topic of this edition of the Hastings Center Report's biannual "Ethics committees" column. Cohen introduces the column, commenting upon the trend toward institutional control of all aspects of health care delivered within their walls, including the activities of ethics committees. Contributions include Daniel Wikler's "Institutional agendas and ethics committees," Evelyn Van Allen, D. Gay Moldow, and Ronald Cranford's "Evaluating ethics committees," and the case study "Committee consultation to override family wishes," with a commentary by David Gary Smith. Two legal notes conclude the column: "New Jersey -- still the nation's proving ground?" by Paul W. Armstrong, and "The Philadelphia story," by Willard Green, on the results of the Delaware Valley Ethics Committee Network's survey of ethics committees' needs and policies.

Errant corporations, diffuse responsibilities, and the environment: ethical issues in the Orica case study.

PubMed

Grace, Damian

2009-04-01

The papers in this volume deal with various aspects of the HCB legacy at the Orica plant at Botany. Whether explicitly or implicitly, they are concerned with questions of ethics; with the just distribution of burdens and benefits; with just processes for disposing of dangerous industrial waste; and with a just custodianship of the Botany environment. These ethical issues illustrate the difficulty of securing corporate accountability, and the elusiveness of responsibility within organisations. This paper reflects on some of the issues for ethics raised by the Orica case and their significance for corporate ethics.

The ethical dimension of analytical psychology.

PubMed

Barreto, Marco Heleno

2018-04-01

The centrality of the ethical dimension in Carl Gustav Jung's analytical psychology is demonstrated through careful reference to fundamental moments in the Jungian text. Tracking Jung's statements about the primacy of the 'moral function' (or 'moral factor') in the cure of neurosis as well as in the process of individuation, the ethical nature of the psychotherapeutic praxis proposed by Jung is highlighted. This allows us to see the ethical aspect of psychological conflicts, and thus to understand better why individuation can be seen as a 'moral achievement'. Finally, the intelligible ethical structure of Jungian psychotherapeutic praxis is exposed. © 2018, The Society of Analytical Psychology.

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.

Ethical Dilemmas in Disaster Medicine

PubMed Central

Ozge Karadag, C; Kerim Hakan, A

2012-01-01

Background Disasters may lead to ethical challenges that are different from usual medical practices. In addition, disaster situations are related with public health ethics more than medical ethics, and accordingly may require stronger effort to achieve a balance between individual and collective rights. This paper aims to review some ethical dilemmas that arise in disasters and mainly focuses on health services. Disasters vary considerably with respect to their time, place and extent; therefore, ethical questions may not always have `one-size-fits-all` answers. On the other hand, embedding ethical values and principles in every aspect of health-care is of vital importance. Reviewing legal and organizational regulations, developing health-care related guidelines, and disaster recovery plans, establishing on-call ethics committees as well as adequate in-service training of health-care workers for ethical competence are among the most critical steps. It is only by making efforts before disasters, that ethical challenges can be minimized in disaster responses. PMID:23285411

The institutional turn in professional ethics.

PubMed

Thompson, Dennis F

1999-01-01

The traditional ideal in which professionals alone or in small groups serve their patients and clients in accord with a public-spirited goal is giving way to practice in which professionals serve in organizations that value mainly their expertise and expect them to act in accord with the organization's goals. The study of professional ethics has not kept pace with this trend and, as a result, has neglected the institutional aspects of ethical problems. I focus attention on these aspects by considering a case that raises 2 problems that are particularly relevant in the context in which professionals now practice: the problem of representation (whom does the professional act for) and the problem of authority (who has the right to make the policy for the institution).

[Bioethical analysis of the Brazilian Dentistry Code of Ethics].

PubMed

Pyrrho, Monique; do Prado, Mauro Machado; Cordón, Jorge; Garrafa, Volnei

2009-01-01

The Brazilian Dentistry Code of Ethics (DCE), Resolution CFO-71 from May 2006, is an instrument created to guide dentists' behavior in relation to the ethical aspects of professional practice. The purpose of the study is to analyze the above mentioned code comparing the deontological and bioethical focuses. In order to do so, an interpretative analysis of the code and of twelve selected texts was made. Six of the texts were about bioethics and six on deontology, and the analysis was made through the methodological classification of the context units, textual paragraphs and items from the code in the following categories: the referentials of bioethical principlism--autonomy, beneficence, nonmaleficence and justice -, technical aspects and moral virtues related to the profession. Together the four principles represented 22.9%, 39.8% and 54.2% of the content of the DCE, of the deontological texts and of the bioethical texts respectively. In the DCE, 42% of the items referred to virtues, 40.2% were associated to technical aspects and just 22.9% referred to principles. The virtues related to the professionals and the technical aspects together amounted to 70.1% of the code. Instead of focusing on the patient as the subject of the process of oral health care, the DCE focuses on the professional, and it is predominantly turned to legalistic and corporate aspects.

[Construction and validation of the "La Salle Instrument" to evaluate the ethical aspects in biomedical research on human beings].

PubMed

Valdivia-Gómez, Gilberto Guzmán; Velasco-Jiménez, María Teresa; Domínguez-González, Alejandro; Meneses-Ruíz, Dulce María; Padilla-García, Raúl Amauri

2017-01-01

Research projects must demonstrate not only a rigorous scientific methodology, but also the ethical aspects that require profound reflection of the reviewers. Current regulations establish criteria for research projects on human health, but many of these aspects are subjective. How can the evaluation of such projects be standardized? This is the main subject of the current project. This project comprises two phases. First, the design and construction of an instrument of evaluation based on the fundamental principles of bioethics, which are autonomy, beneficence, non-maleficence, and justice, and other aspects. The second phase consists of content validation through expert. During the phase of reviewing the instrument, it was necessary to make changes by adding, removing, or changing the concepts or criteria, which lead to the construction of the second version of the format. This new instrument was reviewed and analyzed by using the AGREE II instrument, and this version was validated by experts by greater than 95%. There are some recommendations to analyze the ethical aspects in research protocols involving human subjects, but they define the concepts and criteria to be evaluated. By presenting the criteria to be evaluated individually, the "La Salle instrument" allows the evaluation to be more objective and standardized.

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.

The Educational Efficacy of a Values-Based Online Tool in a Public Health Ethics Course

ERIC Educational Resources Information Center

Tripken, Jennifer L.

2016-01-01

Purpose: The purpose of this study was to assess the educational efficacy of an online software decision-making program, The Values Exchange. While ethics is a vital aspect of educating public health professionals, it is both difficult to teach and assess. There is a need to identify best practices in the pedagogy of public health ethics and in…

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

ERIC Educational Resources Information Center

Smith, Nick L.

2008-01-01

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

Ethical Mindfulness and Reflexivity: Managing a Research Relationship with Children and Young People in a 14-Year Qualitative Longitudinal Research (QLR) Study

ERIC Educational Resources Information Center

Warin, Jo

2011-01-01

This article draws on the articulation of a value for reflexivity that has accumulated within qualitative methods debates in the past decade. It demonstrates how reflexivity is interwoven with the concept of ethical mindfulness. The argument has developed from a consideration of the ethical dilemmas that were a salient aspect of an ongoing…

Aristotelian versus Virtue Ethical Character Education

ERIC Educational Resources Information Center

Curren, Randall

2016-01-01

This article examines some central aspects of Kristján Kristjánsson's book, "Aristotelian Character Education," beginning with the claim that contemporary virtue ethics provides methodological, ontological, epistemological, and moral foundations for Aristotelian character education. It considers three different formulations of what…

Integrating anticipated nutrigenomics bioscience applications with ethical aspects.

PubMed

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

2008-03-01

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

Who regulates ethics in the virtual world?

PubMed

Sharma, Seemu; Lomash, Hitashi; Bawa, Seema

2015-02-01

This paper attempts to give an insight into emerging ethical issues due to the increased usage of the Internet in our lives. We discuss three main theoretical approaches relating to the ethics involved in the information technology (IT) era: first, the use of IT as a tool; second, the use of social constructivist methods; and third, the approach of phenomenologists. Certain aspects of ethics and IT have been discussed based on a phenomenological approach and moral development. Further, ethical issues related to social networking sites are discussed. A plausible way to make the virtual world ethically responsive is collective responsibility which proposes that society has the power to influence but not control behavior in the virtual world.

The ethical framework for performing research with rare inherited neurometabolic disease patients.

PubMed

Giannuzzi, Viviana; Devlieger, Hugo; Margari, Lucia; Odlind, Viveca Lena; Ragab, Lamis; Bellettato, Cinzia Maria; D'Avanzo, Francesca; Lampe, Christina; Cassis, Linda; Cortès-Saladelafont, Elisenda; Cazorla, Ángels Garcia; Barić, Ivo; Cvitanović-Šojat, Ljerka; Fumić, Ksenija; Dali, Christine I; Bartoloni, Franco; Bonifazi, Fedele; Scarpa, Maurizio; Ceci, Adriana

2017-03-01

The need for performing clinical trials to develop well-studied and appropriate medicines for inherited neurometabolic disease patients faces ethical concerns mainly raising from four aspects: the diseases are rare; include young and very young patients; the neurological impairment may compromise the capability to provide 'consent'; and the genetic nature of the disease leads to further ethical implications. This work is intended to identify the ethical provisions applicable to clinical research involving these patients and to evaluate if these cover the ethical issues. Three searches have been performed on the European regulatory/legal framework, the literature and European Union-funded projects. The European legal framework offers a number of ethical provisions ruling the clinical research on paediatric, rare, inherited diseases with neurological symptoms. In the literature, relevant publications deal with informed consent, newborn genetic screenings, gene therapy and rights/interests of research participants. Additional information raised from European projects on sharing patients' data from different countries, the need to fill the gap of the regulatory framework and to improve information to stakeholders and patients/families. Several recommendations and guidelines on ethical aspects are applicable to the inherited neurometabolic disease research in Europe, even though they suffer from the lack of a common ethical approach. What is Known: • When planning and conducting clinical trials, sponsors and researchers know that clinical trials are to be performed according to well-established ethical rules, and patients should be aware about their rights. • In the cases of paediatric patients, vulnerable patients unable to provide consent, genetic diseases' further rules apply. What is New: • This work discusses which ethical rules apply to ensure protection of patient's rights if all the above-mentioned features coexist. • This work shows available data and information on how these rules have been applied.

A robotic shower system : Acceptance and ethical issues.

PubMed

Klein, Barbara; Schlömer, Inga

2018-01-01

Being able to maintain personal hygiene plays a crucial role for independent living in old age or when suffering from disabilities. Within the European project ICT Supported Bath Robots (I‑SUPPORT) an intelligent robotic shower system is being developed, which enables patients to shower independently at home or in institutionalized settings. The aim of this contribution is the identification of ethical issues in the development of a robotic shower system utilizing the model for the ethical evaluation of socio-technical arrangements (MEESTAR). In I‑SUPPORT a variety of concepts and methods are implemented in order to achieve technology acceptance such as user-centered requirements analysis, usability-tests and analysis of sociocultural and ethical aspects. This article reports the analysis of focus groups with 14 older adults and 9 professional caregivers utilizing MEESTAR as a heuristic approach for analyzing sociotechnical arrangements and identifying ethical problems. The MEESTAR procedure was adapted to the research question and client groups and implemented as a discursive method. This gave an insight into the meaning and background of ethical aspects and also a deeper insight into nursing processes as well as the requirements which the system should fulfil. Shortcomings are that the ethical dimensions are not everyday language and the time restrictions. In the next step a standardized assessment instrument will be developed and piloted.

Law and Ethics for Practitioners in Counseling and Guidance.

ERIC Educational Resources Information Center

Hummel, Dean L.

1985-01-01

Addresses pertinent aspects of law and ethics as they relate to practitioners in counseling and guidance. Identifies major areas and cites cases that involve civil liability litigation. Also discusses the rights of minors in cases dealing with child abuse and abortion. (ML)

ROBOTIC SURGERY: BIOETHICAL ASPECTS

PubMed Central

SIQUEIRA-BATISTA, Rodrigo; SOUZA, Camila Ribeiro; MAIA, Polyana Mendes; SIQUEIRA, Sávio Lana

2016-01-01

ABSTRACT Introduction: The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. Objective: To present review of the ethical aspects of robot use in surgery. Method: Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Results: Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains brief presentation on robotics, its inclusion in health and bioethical aspects, and the use of robots in surgery. Conclusion: Robotic surgery is a reality today in many hospitals, which makes essential bioethical reflection on the relationship between health professionals, automata and patients. PMID:28076489

Ethical aspects in placental perfusion studies: views of the researchers.

PubMed

Halkoaho, A; Pietilä, A-M; Vähäkangas, K

2011-07-01

Within the EU-project NewGeneris human placental perfusion has been used for predicting fetal exposure to food carcinogens. Within the work package of ethical aspects of the research, we studied opinions of the researchers (n = 23) who carried out perfusions of human placenta. Data were collected by focus group interviews (n = 12) and an open-ended questionnaire (n =19 of which 8 were also attending the group session) from scientists representing 9 different nationalities. Both types of data were analysed together thematically and with data triangulation. Studied researchers considered communication between all stakeholders extremely important. Good communication was considered a prerequisite for the recruitment of mothers to donate the placenta, as well as for the process of getting the informed consent. Voluntariness, confidentiality and societal meaning were mentioned as important by all studied researchers. Educating the hospital personnel was regarded as essential in order to provide the best possible information to the mothers. The researchers also pointed out that cultural aspects should be respected, and that in Western thinking placenta is mostly considered as waste. Some researchers suggested that current guidelines and processes for obtaining informed consent should be reviewed also from a cultural perspective. With the development of biobanks, the use of human tissues, including placenta will most probably increase in the future, and the awareness of ethical considerations both in legislation and in practice need support. Thus, continuous effort for better research ethics is essential and requires research on research ethics. Copyright © 2011 Elsevier Ltd. All rights reserved.

Ethics review in compassionate use.

PubMed

Borysowski, Jan; Ehni, Hans-Jörg; Górski, Andrzej

2017-07-24

Compassionate use is the use of unapproved drugs outside of clinical trials. So far, compassionate use regulations have been introduced in the US, Canada, many European countries, Australia and Brazil, and treatment on a compassionate use basis may be performed in Japan and China. However, there are important differences between relevant regulations in individual countries, particularly that approval by a research ethics committee (institutional review board) is a requirement for compassionate use in some countries (e.g. the US, Spain, and Italy), but not in others (e.g. Canada, the UK, France, and Germany). The main objective of this article is to present aspects of compassionate use that are important for the discussion of the role of research ethics committees in the review of compassionate use. These aspects include the nature of compassionate use, potential risks to patients associated with the use of drugs with unproven safety and efficacy, informed consent, physicians' qualifications, and patient selection criteria. Our analysis indicates that the arguments for mandatory review substantially outweigh the arguments to the contrary. Approval by a research ethics committee should be obligatory for compassionate use. The principal argument against mandatory ethical review of compassionate use is that it is primarily a kind of treatment rather than biomedical research. Nonetheless, compassionate use is different from standard clinical care and should be subject to review by research ethics committees. First, in practice, compassionate use often involves significant research aspects. Second, it is based on unapproved drugs with unproven safety and efficacy. Obtaining informed consent from patients seeking access to unapproved drugs on a compassionate use basis may also be difficult. Other important problems include the qualifications of the physician who is to perform treatment, and patient selection criteria.

Some methodological aspects of ethics committees' expertise: the Ukrainian example.

PubMed

Pustovit, Svitlana V

2006-01-01

Today local, national and international ethics committees have become an effective means of social regulation in many European countries. Science itself is an important precondition for the development of bioethical knowledge and ethics expertise. Cultural, social, historical and religious preconditions can facilitate different forms and methods of ethics expertise in each country. Ukrainian ethics expertise has some methodological problems connected with its socio-cultural, historical, science and philosophy development particularities. In this context, clarification of some common legitimacies or methodological approaches to ethics committee (EC) phenomena such as globalization, scientization and the prioritization of an ethics paradigm are very important. On the other hand, elaborate study and critical analysis of international experience by Ukraine and other Eastern European countries will provide the integration of their local and national ethics expertises into a world bioethics ethos.

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.

Nursing students' understanding of factors influencing ethical sensitivity: A qualitative study.

PubMed

Borhani, Fariba; Abbaszadeh, Abbas; Mohsenpour, Mohaddeseh

2013-07-01

Ethical sensitivity is considered as a component of professional competency of nurses. Its effects on improvement of nurses' ethical performance and the therapeutic relationship between nurses and patients have been reported. However, very limited studies have evaluated ethical sensitivity. Since no previous Iranian research has been conducted in this regard, the present study aimed to review nursing students' understanding of effective factors on ethical sensitivity. This qualitative study was performed in Kerman, Iran, during 2009. It used semi-structured individual interviews with eight MSc nursing students to assess their viewpoints. It also included two focus groups. Purposive sampling was continued until data saturation. Data were analyzed using manifest content analysis. The students' understanding of factors influencing ethical sensitivity were summarized in five main themes including individual and spiritual characteristics, education, mutual understanding, internal and external controls, and experience of an immoral act. The findings of this study create a unique framework for sensitization of nurses in professional performance. The application of these factors in human resource management is reinforcement of positive aspects and decrease in negative aspects, in education can use for educational objectives setting, and in research can designing studies based on this framework and making related tools. It is noteworthy that presented classification was influenced by students themselves and mentioned to a kind of learning activity by them.

Ethical international research on human subjects research in the absence of local institutional review boards.

PubMed

Bhat, S B; Hegde, T T

2006-09-01

International health-related research on human subjects entails unique ethical responsibilities and difficulties. Often, these difficulties are augmented by the lack of a local ethical review infrastructure. In a recent cross-national study conducted by us, three critical components of ethical regulation were identified--external oversight, local oversight and subject involvement--and integrated into the study design. These three concepts are outlined and established as an important aspect of ensuring ethical coherence in the local context, particularly when reviews by the local institutional review boards cannot practically be obtained. The three levels of ethical oversight identified are suggested to be the framework within which future field studies on human subjects are developed and a standard for maintaining ethical rigorousness in research on humans.

Methodological and ethical aspects of the sexual maturation assessment in adolescents

PubMed Central

de Faria, Eliane Rodrigues; Franceschini, Sylvia do Carmo C.; Peluzio, Maria do Carmo G.; Sant'Ana, Luciana Ferreira da R.; Priore, Silvia Eloiza

2013-01-01

OBJECTIVE To analyze methodological and ethical aspects in the sexual maturation assessment of adolescents. DATA SOURCES Books and theses, articles and legislations on the Medline, SciELO, Science Direct databases, besides institutional documents of the World Health Organization and the Pediatric Societies of Brazil and São Paulo, considering the period from 1962 to 2012. The following keywords were used in Portuguese and English: "sexual maturation", "self-assessment", "ethics", "OBJECTIVE assessment of sexual maturation", "puberty", "adolescent", and "adolescentdevelopment". DATA SYNTHESIS The sexual maturation assessment is used in populatinal studies and in clinical daily care. The direct evaluation is performed by a specialized physician, whereas the self-assessment is carried out by the adolescent. This evaluation should be carefully performed in the appropriate place, taking into account the ethical aspects. The patient should not be constrained and the physician must respect the privacy and the confidentiality. Before this evaluation and independently of the used method, the adolescent should receive information and explanation about the procedure and the tools that will be applied. Furthermore, the patient has the right to want or not an adult close to him. CONCLUSIONS Validation studies showed that self-assessment is inferior to clinical assessment and should, therefore, be performed only when the direct examination by physicians is not possible. PMID:24142325

5 CFR 2600.103 - Office of Government Ethics organization and functions.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) The Office of Administration and Information Management. (b) Office of the Director. The Director of... certain aspects of agency ethics programs. (f) Office of Administration and Information Management. The Office of Administration and Information Management provides support to all OGE operating programs...

5 CFR 2600.103 - Office of Government Ethics organization and functions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) The Office of Administration and Information Management. (b) Office of the Director. The Director of... certain aspects of agency ethics programs. (f) Office of Administration and Information Management. The Office of Administration and Information Management provides support to all OGE operating programs...

5 CFR 2600.103 - Office of Government Ethics organization and functions.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) The Office of Administration and Information Management. (b) Office of the Director. The Director of... certain aspects of agency ethics programs. (f) Office of Administration and Information Management. The Office of Administration and Information Management provides support to all OGE operating programs...

5 CFR 2600.103 - Office of Government Ethics organization and functions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) The Office of Administration and Information Management. (b) Office of the Director. The Director of... certain aspects of agency ethics programs. (f) Office of Administration and Information Management. The Office of Administration and Information Management provides support to all OGE operating programs...

PATIENT'S RIGHT TO INFORMED CONSENT IN REPUBLIC SRPSKA: LEGAL AND ETHICAL ASPECTS (WITH SPECIAL REFERENCE TO PHYSICAL REHABILITATION).

PubMed

Milinkovic, Igor; Majstorovic, Biljana

2014-12-01

The principle of informed consent, which requires a patient's fully-informed consent prior to the medical treatment, is closely connected with the value of human dignity. The realization and protection of a patient's dignity is not possible without his/her right to choose the character and scope of medical treatment. This goal cannot be adequately achieved within the traditional model of medical paternalism characterized by the physician's authoritative position. The first part of the article deals with the content and ethical significance of the informed consent doctrine. The legal framework of informed consent in Republic Srpska (RS), one of the two Bosnia and Herzegovina (BH)entities, is analyzed. Special reference is made to the relevance of the informed consent principle within the physical rehabilitation process. Although ethical aspects of physical rehabilitation are often overlooked, this medical field possesses a strong ethical dimension (including an appropriate realization of the patient's right to informed consent).

On the Brink of Shifting Paradigms, Molecular Systems Engineering Ethics Needs to Take a Proactive Approach.

PubMed

Heidari, Raheleh; Elger, Bernice S; Stutzki, Ralf

2016-01-01

Molecular Systems Engineering (MSE) is a paradigm shift in both engineering and life sciences. While the field is still in its infancy the perspectives of MSE in revolutionising technology is promising. MSE will offer a wide range of applications in clinical, biotechnological and engineering fields while simultaneously posing serious questions on the ethical and societal aspects of such technology. The moral and societal aspects of MSE need systematic investigation from scientific and social perspectives. In a democratic setting, the societal outcomes of MSE's cutting-edge technology need to be consulted and influenced by society itself. For this purpose MSE needs inclusive public engagement strategies that bring together the public, ethicists, scientists and policy makers for optimum flow of information that maximizes the impact of public engagement. In this report we present an MSE consortium and its ethics framework for establishing a proactive approach in the study of the ethics of MSE technology.

Facilitating awareness of philosophy of science, ethics and communication through manual skills training in undergraduate education.

PubMed

Kordahl, Hilde Lund; Fougner, Marit

2017-03-01

Professional health science education includes a common theoretical basis concerning the theory of science, ethics and communication. Former evaluations by first-year students of the bachelor physiotherapy program at Oslo and Akershus University College of Applied Sciences (HiOA) show that they find it hard to understand the relation between these particular topics and future professional practice. This challenge is the starting point for a pedagogical development project that aims to develop learning contexts that highlight the relevance of these theoretical concepts. The aim of the study is to explore and present findings on the value of using Sykegrep manual skills classes as an arena in which students can be encouraged to think about, reflect on and appreciate the role and value of the philosophical perspectives that inform their practice and contributes to practise knowledge. A qualitative study with data collection through focus groups was performed and analyzed using thematic content analysis. Eighteen first-year undergraduate students, who had completed the manual skills course, participated in the study. Analysis of the data yielded three categories of findings that can be associated with aspects of philosophy of science, ethics and communication. These are as follows: 1) preconceived understanding of physiotherapy; 2) body knowledge perspectives; and 3) relational aspects of interactions. Undergraduate students' understanding and experience of philosophy of science, ethics and communication may be facilitated by peer collaboration, reflection on intimacy and touch and the ethical aspects of interaction during manual skills training. Practical classes in Sykegrep provide a basis for students' discussions about the body as well as their experiences with the body in the collaborative learning context. The students' reflections on their expectations of manual skills in physiotherapy and experiences of touch and being touched can facilitate an awareness of philosophy of science, ethics and communication. Our study will be an incitement to further develop a manual skills teaching program that incorporates philosophy of science, ethics and communication in undergraduate education.

[Establishing and operating a human biobank. Ethical aspects].

PubMed

Jahns, Roland

2016-03-01

Particularly in the past decade which has been marked by efforts to foster individualized/personalized medicine the need for well-characterized high-quality collections of human biological material has significantly increased. When establishing and operating a human biobank the interests and the "freedom" of biomedical research must always be weighed against the interests and rights of patients and/or donors; in this process ethical aspects should be considered systematically. In addition, the importance of quality control and quality assurance has largely increased in human biobanking, both from a scientific and even more from an ethical point of view, because donated biological materials are potentially stored for decades and (on request) might serve for currently not foreseeable biomedical research purposes. In addition, the compatibility of national human biobanks with international biobank networks becomes increasingly important.

Ethical Sensitivity in Nursing Ethical Leadership: A Content Analysis of Iranian Nurses Experiences

PubMed Central

Esmaelzadeh, Fatemeh; Abbaszadeh, Abbas; Borhani, Fariba; Peyrovi, Hamid

2017-01-01

Background: Considering that many nursing actions affect other people’s health and life, sensitivity to ethics in nursing practice is highly important to ethical leaders as a role model. Objective: The study aims to explore ethical sensitivity in ethical nursing leaders in Iran. Method: This was a qualitative study based on the conventional content analysis in 2015. Data were collected using deep and semi-structured interviews with 20 Iranian nurses. The participants were chosen using purposive sampling. Data were analyzed using conventional content analysis. In order to increase the accuracy and integrity of the data, Lincoln and Guba's criteria were considered. Results: Fourteen sub-categories and five main categories emerged. Main categories consisted of sensitivity to care, sensitivity to errors, sensitivity to communication, sensitivity in decision making and sensitivity to ethical practice. Conclusion: Ethical sensitivity appears to be a valuable attribute for ethical nurse leaders, having an important effect on various aspects of professional practice and help the development of ethics in nursing practice. PMID:28584564

Teaching Ethical Issues in Science.

ERIC Educational Resources Information Center

Levinson, Ralph

This paper presents a study that investigates the teaching and learning aspects of controversial issues in science education. Teaching ethical issues is mandatory for science teachers in England; however, teachers may experience difficulties in exploring contemporary issues in science due to rapid and unpredictable changes. The study carries an…

Ethics of the Health Educator as Behavior Change Agent in Gerontological Health.

ERIC Educational Resources Information Center

Neutens, James J.; Jackson, Michael L.

1985-01-01

As health education becomes a focal point in the health care system, more attention will be given to the professional practice of health educators. Understanding ethical theory and other value judgments will be an important aspect of the health education profession. (DF)

The cultural specifity of research ethics—or why ethical debate in France is different

PubMed Central

Maio, G

2002-01-01

In the search for a globally binding ethical minimal consensus in dealing with research on human beings the awareness of the cultural specificity of such questions will be of central importance. France provides a good example of such cultural specificities. Three basic structures of French discussion on research ethics can be enumerated: first the particular weight placed on therapeutic benefit, second a particular accentuation on freedom and voluntarism, and third its lesser attention to the aspect of ability to give consent. The weak emphasis on the ability to give consent is rooted as much in the traditionally paternalistically imbued physician-patient relationship as in the French legal system, in which the doctrine of consent is not given the fundamental position of importance found in the Anglo-Saxon countries. As an important Roman country, a different accentuation in the ethical discussion on research on humans can be recognised, a discussion in which for a long time the right of self determination was less of a criterion for decision than the teleology of medical action. It is precisely this aspect of latent cultural influence in ethical convictions which is of decisive importance for future discussion on research on humans. PMID:12042397

Demographic factors associated with moral sensitivity among nursing students.

PubMed

Tuvesson, Hanna; Lützén, Kim

2017-11-01

Today's healthcare environment is often characterized by an ethically demanding work situation, and nursing students need to prepare to meet ethical challenges in their future role. Moral sensitivity is an important aspect of the ethical decision-making process, but little is known regarding nursing students' moral sensitivity and its possible development during nursing education. The aims of this study were to investigate moral sensitivity among nursing students, differences in moral sensitivity according to sample sub-group, and the relation between demographic characteristics of nursing students and moral sensitivity. A convenience sample of 299 nursing students from one university completed a questionnaire comprising questions about demographic information and the revised Moral Sensitivity Questionnaire. With the use of SPSS, non-parametric statistics, including logistic regression models, were used to investigate the relationship between demographic characteristics and moral sensitivity. Ethical considerations: The study followed the regulations according to the Swedish Ethical Review Act and was reviewed by the Ethics Committee of South-East Sweden. The findings showed that mean scores of nursing students' moral sensitivity were found in the middle to upper segment of the rating scale. Multivariate analysis showed that gender (odds ratio = 3.32), age (odds ratio = 2.09; 1.73), and parental status (odds ratio = 0.31) were of relevance to nursing students' moral sensitivity. Academic year was found to be unrelated to moral sensitivity. These demographic aspects should be considered when designing ethics education for nursing students. Future studies should continue to investigate moral sensitivity in nursing students, such as if and how various pedagogical strategies in ethics may contribute to moral sensitivity in nursing students.

Developing an Evaluation Tool for Assessing Clinical Ethics Consultation Skills in Simulation Based Education: The ACES Project.

PubMed

Wasson, Katherine; Parsi, Kayhan; McCarthy, Michael; Siddall, Viva Jo; Kuczewski, Mark

2016-06-01

The American Society for Bioethics and Humanities has created a quality attestation (QA) process for clinical ethics consultants; the pilot phase of reviewing portfolios has begun. One aspect of the QA process which is particularly challenging is assessing the interpersonal skills of individual clinical ethics consultants. We propose that using case simulation to evaluate clinical ethics consultants is an approach that can meet this need provided clear standards for assessment are identified. To this end, we developed the Assessing Clinical Ethics Skills (ACES) tool, which identifies and specifies specific behaviors that a clinical ethics consultant should demonstrate in an ethics case simulation. The aim is for the clinical ethics consultant or student to use a videotaped case simulation, along with the ACES tool scored by a trained rater, to demonstrate their competence as part of their QA portfolio. The development and piloting of the tool is described.

Exploration of pioneering as a major element of ethical leadership in nursing: A qualitative study

PubMed Central

Barkhordari-Sharifabad, Maasoumeh; Ashktorab, Tahereh; Atashzadeh-Shoorideh, Foroozan

2017-01-01

Background Commitment to ethical behavior is considered as an essential part of occupational responsibilities of nursing, and leaders’ pioneering in ethical growth and development has led to the emergence of the concept of ethical leadership. Objective The purpose of this study was to explain the nursing leaders’ perception and experiences of pioneering in the field of ethical leadership. Methods In this qualitative study, data were collected through semi-structured individual interviews. A total of 14 nursing leaders at different levels who were selected by purposeful sampling method participated in the study. Latent content analysis was used to analyze the data. Results Of 14 participants of the study, 8 were male and 6 were female aged 38 to 56 years old with a mean managerial experience of 12 years. In the analysis of interviews, 4 subcategories of “Role Modeling”, “Empowerment”, “Knowledge and Skill”, and “Recognition” were obtained which formed two main categories. These categories included “Leader as mentor” and “Professional insight”. Conclusion Pioneering leaders are an important part of ethical leadership, and nursing leaders should not only be moral people, but also go a step further and actively promote moral behavior with a role as a mentor and model as well as having professional insight. Nursing leaders with a better understanding of these aspects can develop their capacity of strong ethical leadership and consider the aspects in their activities. PMID:28894529

Private Ethics and Civic Virtue.

ERIC Educational Resources Information Center

McDonald, Lee C.

The paper delineates areas to investigate when seeking information about political ethics in western society. The main purpose of the paper is to call attention to the relationship of civic virtue to communal politics. Specifically, five questions are posed and answered which deal with various aspects of civic virtue and its relationship to…

The Internationalisation of Higher Education: Some Ethical Implications

ERIC Educational Resources Information Center

Hoey, Michael

2016-01-01

All the papers included in this volume implicitly adopt an ethical stance towards the aspect of internationalisation that they investigate or discuss, but necessarily these stances only occasionally become explicit. In this paper, therefore, I look at the impact of internationalisation on universities and at their impact in turn on the…

17 CFR 200.735-11 - Statement of employment and financial interests.

Code of Federal Regulations, 2010 CFR

2010-04-01

... EXCHANGE COMMISSION ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS Regulation Concerning... the Ethics in Government Act of 1978, Pub. L. 95-521. Members and such employees need not also file... Fellowship Programs. (iii) All employees engaged in any aspect of Government contracting or procurement...

Ethical Dilemmas in Qualitative Research Methodology: Researcher's Reflections

ERIC Educational Resources Information Center

Ngozwana, Nomazulu

2018-01-01

This article examines the ethical dilemmas that are specific to qualitative research methodology. These dilemmas concern the issues of withdrawal from the study, anonymity and confidentiality, which are discussed. Each aspect examines how it was dealt with using the researcher's reflections. The research was positioned within an interpretive…

The Ethics of Screening for Early Intervention in HIV Disease.

ERIC Educational Resources Information Center

Levine, Carol; Bayer, Ronald

1989-01-01

Discusses the ethical aspects of screening and testing for clinical detection of individuals infected with asymptomatic human immunodeficiency virus (HIV). Careful consideration must be given to individuals' rights, respect for their privacy, and society's obligations to provide needed clinical and social services in translating cautious medical…

Exploring the Ethical Implications of MOOCs

ERIC Educational Resources Information Center

Marshall, Stephen

2014-01-01

Massive open online courses (MOOCs) represent a potentially exciting opportunity to use technology to realise many of the long-promised benefits of universal higher education. While there are many positive aspects to the MOOCs on offer and in development, there are also significant ethical concerns arising from various initiatives. These include…

Improving Ethics and Morality in the Public Service: Looking to Mexican-American Administrators.

ERIC Educational Resources Information Center

Franc, Max B.

Administrative differences between the broad ethical and moral aspects of the mainstream majoritarian culture and one specific subculture--the Mexican American--are discussed. The main thesis is majoritarian inconsistency ("hyprocrisy") and the demand by the minority culture for consistency ("nonhyprocrisy"). The entire society…

An Approach to Ethics Utilizing the Experience of Women.

ERIC Educational Resources Information Center

Ferguson, Marianne

1996-01-01

Delineates a generalized difference between men and women in approaches to ethics. Reiterates Carol Gilligan's theory that men generally believe in a morality of rights whereas women subscribe to a morality of relationships. Discusses other aspects of this dichotomy including ideas of good, evil, and sin. (MJP)

The ethical aspects of gain sharing with physicians.

PubMed

Thompson, Richard E

2004-01-01

Gain sharing arrangements involving physicians can be a model combination of ethical business practices and maximizing profits. Or, gain sharing can be as unethical as fee-splitting was at the turn of the century, and as corrupt as any conflict of interest. The devil is--or is not--in the details.

Ethics of Caring Conversation and Dialectic of Love and Justice.

PubMed

Singsuriya, Pagorn

2018-06-01

Through the framework of Ricoeur's philosophy, Fredriksson and Eriksson develop an influential ethics of the caring conversation, which instructs nurses to have caritas, self-esteem, and autonomy on one hand and to engage respectfully and responsibly in caring conversations on the other. This article brings the ethics of the caring conversation into dialogue with Ricoeur's philosophy again. While Fredriksson and Eriksson draw upon Ricoeur's little ethics, this article relies on Ricoeur's dialectic of love and justice. The dialogue throws light on other aspects of caritas, which is vital in Fredriksson and Eriksson's ethics. It shows a need for nurses to strike a balance between love and justice and, also, to cultivate love.

Normativity unbound: liminality in palliative care ethics.

PubMed

Braude, Hillel

2012-04-01

This article applies the anthropological concept of liminality to reconceptualize palliative care ethics. Liminality possesses both spatial and temporal dimensions. Both these aspects are analyzed to provide insight into the intersubjective relationship between patient and caregiver in the context of palliative care. Aristotelian practical wisdom, or phronesis, is considered to be the appropriate model for palliative care ethics, provided it is able to account for liminality. Moreover, this article argues for the importance of liminality for providing an ethical structure that grounds the doctrine of double effect and overcomes the impasse of phronesis in the treatment of the terminally ill.

A survey of students` ethical attitudes using computer-related scenarios

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

Hanchey, C.M.; Kingsbury, J.

Many studies exist that examine ethical beliefs and attitudes of university students ascending medium or large institutions. There are also many studies which examine ethical attitudes and beliefs of computer science and computer information systems majors. None, however, examines ethical attitudes of university students (regardless of undergraduate major) at a small, Christian, liberal arts institution regarding computer-related situations. This paper will present data accumulated by an on-going study in which students are presented seven scenarios--all of which involve some aspect of computing technology. These students were randomly selected from a small, Christian, liberal-arts university.

Analyzing reflective narratives to assess the ethical reasoning of pediatric residents.

PubMed

Moon, Margaret; Taylor, Holly A; McDonald, Erin L; Hughes, Mark T; Beach, Mary Catherine; Carrese, Joseph A

2013-01-01

A limiting factor in ethics education in medical training has been difficulty in assessing competence in ethics. This study was conducted to test the concept that content analysis of pediatric residents' personal reflections about ethics experiences can identify changes in ethical sensitivity and reasoning over time. Analysis of written narratives focused on two of our ethics curriculum's goals: 1) To raise sensitivity to ethical issues in everyday clinical practice and 2) to enhance critical reflection on personal and professional values as they affect patient care. Content analysis of written reflections was guided by a tool developed to identify and assess the level of ethical reasoning in eight domains determined to be important aspects of ethical competence. Based on the assessment of narratives written at two times (12 to 16 months/apart) during their training, residents showed significant progress in two specific domains: use of professional values, and use of personal values. Residents did not show decline in ethical reasoning in any domain. This study demonstrates that content analysis of personal narratives may provide a useful method for assessment of developing ethical sensitivity and reasoning.

Consensus statements on occupational therapy ethics related to driving.

PubMed

Slater, Deborah Yarett

2014-04-01

As part of an expert panel convened to examine evidence and practice related to diverse aspects of driving evaluation and rehabilitation, consensus statements were developed on ethics. This paper provides context for the ethical obligation of practitioners to assess and make recommendations about the ability of clients to safely perform the activity of driving. It highlights key articles from the literature as well as principles from the Occupational Therapy Code of Ethics and Ethics Standards (2010). The statements support the importance of identifying impairments affecting driving, which could result in harm to the client as well as to the public. The ethical and professional obligation of practitioners to evaluate, make recommendations, and possibly report and/or refer to a driver rehabilitation specialist for further services is reinforced.

[A framework for evaluating ethical issues of public health initiatives: practical aspects and theoretical implications].

PubMed

Petrini, Carlo

2015-01-01

The "Framework for the Ethical Conduct of Public Health Initiatives", developed by Public Health Ontario, is a practical guide for assessing the ethical implications of evidence-generating public health initiatives, whether research or non-research activities, involving people, their biological materials or their personal information. The Framework is useful not only to those responsible for determining the ethical acceptability of an initiative, but also to investigators planning new public health initiatives. It is informed by a theoretical approach that draws on widely shared bioethical principles. Two considerations emerge from both the theoretical framework and its practical application: the line between practice and research is often blurred; public health ethics and biomedical research ethics are based on the same common heritage of values.

Ethical aspects of sexual medicine. Internet, vibrators, and other sex aids: toys or therapeutic instruments?

PubMed

Jannini, Emmanuele A; Limoncin, Erika; Ciocca, Giacomo; Buehler, Stephanie; Krychman, Michael

2012-12-01

Sexual health is the result of a complex interplay between social, relational, intrapsychic, and medical aspects. Sexual health care professionals (SHCP) may face several ethical issues. Some SHCP prescribe Internet pornography for both diagnosis and therapy and some others directly sell vibrators and sex aids in their offices. Five scientists, with different perspectives, debate the ethical aspects in the clinical practice of the SHCP. To give to the Journal of Sexual Medicine's reader enough data to form her/his own opinion on an important ethical topic. Expert #1, who is Controversy's Section Editor, together with two coworkers, expert psycho-sexologists, reviews data from literature regarding the use of the Internet in the SHCP. Expert #2 argues that licensed professionals, who treat sexual problems, should not sell sexual aids such as vibrators, lubricants, erotica, and instructional DVDs to their clients. On the other hand, Expert #3 is in favor of the possibility, for the patient, to directly purchase sexual aids from the SHCP in order to avoid embarrassment, confusion, and non-adherence to treatment. Evidence and intelligence would suggest that both the Internet (in selected subjects) and the vibrators (in the correct clinical setting), with the due efforts in counseling the patients and tailoring their therapy, are not-harmful, excellent tools in promoting sexual health. © 2012 International Society for Sexual Medicine.

Legal and ethical aspects of proprietary rights to federally funded media programs.

PubMed

Flint, C

1977-11-01

This article attempts to place in proper perspective the legal and ethical aspects of proprietary rights as they apply to federally funded media programs. Brief reference is made to the recently enacted revision of the Copyright Law, Title 17 of the U.S. Code. Distinction is made between the common law and statutary copyright protection afforded to the creator of an original work. The 'Fair Use' doctrine and the 'Rights in Data' clauses of the general provisions of the Federal Procurement Regulations are discussed in detail; so is the use of Talent Consent and Waivers and Easements of Copyright.

Societal and ethical aspects of the Fukushima accident.

PubMed

Oughton, Deborah

2016-10-01

The Fukushima Nuclear Power Station accident in Japan in 2011 was a poignant reminder that radioactive contamination of the environment has consequences that encompass far more than health risks from exposure to radiation. Both the accident and remediation measures have resulted in serious societal impacts and raise questions about the ethical aspects of risk management. This article presents a brief review of some of these issues and compares similarities and differences with the lessons learned from the 1986 Chernobyl Nuclear Power Plant accident in Ukraine. Integr Environ Assess Manag 2016;12:651-653. © 2016 SETAC. © 2016 SETAC.

Balancing theory and practicality: engaging non-ethicists in ethical decision making related to radiological protection.

PubMed

Martinez, Nicole; Wueste, Daniel

2016-12-01

This paper discusses an approach for engaging radiation protection professionals in the ethical aspects of decision-making, with discussion on how this approach fits in with the existing system of radiological protection. It explores finding common ground between ethical and scientific theory, how to present relevant moral theory in accessible language, and provides a practical framework for dealing with real-world problems. Although establishing the ethical theory behind the system of radiological protection is an important ongoing endeavour within the community, it is equally important to communicate this information in a way that is useful to non-ethicists. Discussion of both ethical theory and a useful strategy for applying the theory makes ethics more accessible to those working in the field by providing them with the knowledge and confidence to apply ethical principles in decisions and practice.

[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.

A study of an ethics education topic for undergraduate nursing students.

PubMed

Kalaitzidis, Evdokia; Schmitz, Karl

2012-01-01

The study aims to explore nursing students' perceptions of the relative value of various aspects of the ethical component of the undergraduate topic, 'Ethics and Law applied to Nursing' (topic NURS2104). To enable time for reflection on ethics in nursing, sampling occurred 1 year after successful completion of the above-mentioned topic and after successful completion of all but the final clinical experience components of the Bachelor of Nursing (BN) degree. A significant proportion of respondents perceived ethics education as relevant to professional practices. It is also noteworthy that the ethical decision-making strategies that had been incorporated into the topic (NURS2104) became transformed by the clinical experience of each particular student. While results of this study are not conclusive, they nevertheless provide important information for future nursing students on the evolutionary development of ethics education. Copyright © 2011 Elsevier Ltd. All rights reserved.

The ethics of donor human milk banking.

PubMed

Arnold, Lois D W

2006-01-01

This case study of donor human milk banking and the ethics that govern interested parties is the first time the ethics of donor milk banking has been explored. Two different models of ethics and their direct impact on donor milk banking are examined: biomedical ethics and public health ethics. How these models and principles affect different aspects of donor human milk banking and the parties involved in the delivery of this service are elucidated. Interactions of parties with each other and how the quality and type of interaction affects the ethical delivery of donor milk banking services are described. Crystallization is at the heart of the qualitative methodology used. Writing as a method of inquiry, an integrative research review, and personal experience are the three methods involved in the crystallization process. Suggestions are made for improving access and knowledge of banked donor human milk, a valuable public health resource.

Cross-Cultural Considerations in U.S. Research Ethics Education

PubMed Central

Heitman, Elizabeth

2014-01-01

Demand among graduate and postdoctoral trainees for international research experience brings together students and investigators from increasingly diverse cultural backgrounds around the world. Educators in research ethics and scientific integrity need to address the cultural aspects of both science and ethics to help all trainees learn ethical practices for effective collaboration with a diverse array of partners. NIH and NSF’s mandates for instruction in the responsible conduct of research do not specifically address the needs of international trainees or U.S. trainees who undertake research projects abroad. Nonetheless, research ethics educators’ typical focus on policy and professional standards can offer trainees and faculty investigators helpful insights into differing ethical values and priorities in research. Examination of linguistic differences can also reveal important conceptual frameworks that shape ethical practice. New resources for teaching research integrity in cross-cultural settings can be a valuable addition to the development of shared understanding of the goals of scientific research. PMID:25574262

Ethical issues associated with in-hospital emergency from the Medical Emergency Team's perspective: a national survey.

PubMed

Cabrini, Luca; Giannini, Alberto; Pintaudi, Margherita; Semeraro, Federico; Radeschi, Giulio; Borga, Sara; Landoni, Giovanni; Troiano, Herbert; Luchetti, Marco; Pellis, Thomas; Ristagno, Giuseppe; Minoja, Giulio; Mazzon, Davide; Alampi, Daniela

2016-01-01

Medical Emergency Teams (METs) are frequently involved in ethical issues associated to in-hospital emergencies, like decisions about end-of-life care and intensive care unit (ICU) admission. MET involvement offers both advantages and disadvantages, especially when an immediate decision must be made. We performed a survey among Italian intensivists/anesthesiologists evaluating MET's perspective on the most relevant ethical aspects faced in daily practice. A questionnaire was developed on behalf of the Italian scientific society of anesthesia and intensive care (SIAARTI) and administered to its members. Decision making criteria applied by respondents when dealing with ethical aspects, the estimated incidence of conflicts due to ethical issues and the impact on the respondents' emotional and moral distress were explored. The questionnaire was completed by 327 intensivists/anesthesiologists. Patient life-expectancy, wishes, and the quality of life were the factors most considered for decisions. Conflicts with ward physicians were reported by most respondents; disagreement on appropriateness of ICU admission and family unpreparedness to the imminent patient death were the most frequent reasons. Half of respondents considered that in case of conflicts the final decision should be made by the MET. Conflicts were generally recognized as causing increased and moral distress within the MET members. Few respondents reported that dedicated protocols or training were locally available. Italian intensivists/anesthesiologists reported that ethical issues associated with in-hospital emergencies are occurring commonly and are having a significant negative impact on MET well-being. Conflicts with ward physicians happen frequently. They also conveyed that hospitals don't offer ethics training and have no protocols in place to address ethical issues.

Current state of ethics literature synthesis: a systematic review of reviews.

PubMed

Mertz, Marcel; Kahrass, Hannes; Strech, Daniel

2016-10-03

Modern standards for evidence-based decision making in clinical care and public health still rely solely on eminence-based input when it comes to normative ethical considerations. Manuals for clinical guideline development or health technology assessment (HTA) do not explain how to search, analyze, and synthesize relevant normative information in a systematic and transparent manner. In the scientific literature, however, systematic or semi-systematic reviews of ethics literature already exist, and scholarly debate on their opportunities and limitations has recently bloomed. A systematic review was performed of all existing systematic or semi-systematic reviews for normative ethics literature on medical topics. The study further assessed how these reviews report on their methods for search, selection, analysis, and synthesis of ethics literature. We identified 84 reviews published between 1997 and 2015 in 65 different journals and demonstrated an increasing publication rate for this type of review. While most reviews reported on different aspects of search and selection methods, reporting was much less explicit for aspects of analysis and synthesis methods: 31 % did not fulfill any criteria related to the reporting of analysis methods; for example, only 25 % of the reviews reported the ethical approach needed to analyze and synthesize normative information. While reviews of ethics literature are increasingly published, their reporting quality for analysis and synthesis of normative information should be improved. Guiding questions are: What was the applied ethical approach and technical procedure for identifying and extracting the relevant normative information units? What method and procedure was employed for synthesizing normative information? Experts and stakeholders from bioethics, HTA, guideline development, health care professionals, and patient organizations should work together to further develop this area of evidence-based health care.

ENVRI PLUS project: Developing an ethical framework for Environmental and Earth System Research Infrastructures

NASA Astrophysics Data System (ADS)

Peppoloni, Silvia; Di Capua, Giuseppe; Haslinger, Florian

2016-04-01

ENVRI PLUS is a Horizon 2020 project bringing together Environmental and Earth System Research Infrastructures (RIs), projects and networks with technical specialist partners to create a more coherent, interdisciplinary and interoperable cluster of Environmental Research Infrastructures across Europe (http://www.envriplus.eu/). One theme of the project deals with the societal relevance and understanding, and within that theme an entire work-package (WP) aims at developing an ethical framework for RIs. Objectives of this WP are: • increase the awareness of both the scientists and the public on the importance of ethical aspects in Earth sciences; • establish a shared ethical framework of reference, to be adopted by RIs governing bodies; • increase the awareness of RIs management and operational levels and of the individual involved scientists on their social role in conducting research activities and research work environment; • assess the ethical and social aspects related to the results achieved and deliverables released within the project. The ongoing activities include: • reviewing the state of art on ethical issues useful for the goals of the project (collection and analysis of materials already existing within scientific organizations, institutions all over the world); • the creation of a questionnaire, through which to investigate how each RI participating in ENVRI PLUS faces ethical issues in relation to its activities, and so to understand the level of perception that researchers and technicians involved in the project have on the ethical implications of their scientific activities; • the definition of ethics guidelines to be used by partners for building their policies and their own codes of conduct; • the elaboration of an ethical label template to characterize each product of the project, that partners will be able to use in order to give essential information about the ethical and social implications of their products; • the dissemination of all the results of the previous activities on websites and social networks, so that they are suitable for the public. ENVRI PLUS is the first European project in which ethics applied to geosciences find space as a fundamental issue, at the base of scientific activities.

Research on ethics in two large Human Biomonitoring projects ECNIS and NewGeneris: a bottom up approach.

PubMed

Dumez, Birgit; Van Damme, Karel; Casteleyn, Ludwine

2008-06-05

Assessment of ethical aspects and authorization by ethics committees have become a major constraint for health research including human subjects. Ethical reference values often are extrapolated from clinical settings, where emphasis lies on decisional autonomy and protection of individual's privacy. The question rises if this set of values used in clinical research can be considered as relevant references for HBM research, which is at the basis of public health surveillance. Current and future research activities using human biomarkers are facing new challenges and expectancies on sensitive socio-ethical issues. Reflection is needed on the necessity to balance individual rights against public interest. In addition, many HBM research programs require international collaboration. Domestic legislation is not always easily applicable in international projects. Also, there seem to be considerable inconsistencies in ethical assessments of similar research activities between different countries and even within one country. All this is causing delay and putting the researcher in situations in which it is unclear how to act in accordance with necessary legal requirements. Therefore, analysis of ethical practices and their consequences for HBM research is needed.This analysis will be performed by a bottom-up approach, based on a methodology for comparative analysis of determinants in ethical reasoning, allowing taking into account different social, cultural, political and historical traditions, in view of safeguarding common EU values. Based on information collected in real life complexity, paradigm cases and virtual case scenarios will be developed and discussed with relevant stakeholders to openly discuss possible obstacles and to identify options for improvement in regulation. The material collected will allow developing an ethical framework which may constitute the basis for a more harmonized and consistent socio-ethical and legal approach. This will not only increase the possibilities for comparison between data generated but may also allow for more equality in the protection of the rights of European citizens and establish trustful relationships between science and society, based on firmly rooted ethical values within the EU legislative framework.These considerations outline part of the research on legal, socio-ethical and communication aspects of HBM within the scope of ECNIS (NoE) and NewGeneris (IP).

Research on ethics in two large Human Biomonitoring projects ECNIS and NewGeneris: a bottom up approach

PubMed Central

Dumez, Birgit; Van Damme, Karel; Casteleyn, Ludwine

2008-01-01

Assessment of ethical aspects and authorization by ethics committees have become a major constraint for health research including human subjects. Ethical reference values often are extrapolated from clinical settings, where emphasis lies on decisional autonomy and protection of individual's privacy. The question rises if this set of values used in clinical research can be considered as relevant references for HBM research, which is at the basis of public health surveillance. Current and future research activities using human biomarkers are facing new challenges and expectancies on sensitive socio-ethical issues. Reflection is needed on the necessity to balance individual rights against public interest. In addition, many HBM research programs require international collaboration. Domestic legislation is not always easily applicable in international projects. Also, there seem to be considerable inconsistencies in ethical assessments of similar research activities between different countries and even within one country. All this is causing delay and putting the researcher in situations in which it is unclear how to act in accordance with necessary legal requirements. Therefore, analysis of ethical practices and their consequences for HBM research is needed. This analysis will be performed by a bottom-up approach, based on a methodology for comparative analysis of determinants in ethical reasoning, allowing taking into account different social, cultural, political and historical traditions, in view of safeguarding common EU values. Based on information collected in real life complexity, paradigm cases and virtual case scenarios will be developed and discussed with relevant stakeholders to openly discuss possible obstacles and to identify options for improvement in regulation. The material collected will allow developing an ethical framework which may constitute the basis for a more harmonized and consistent socio-ethical and legal approach. This will not only increase the possibilities for comparison between data generated but may also allow for more equality in the protection of the rights of European citizens and establish trustful relationships between science and society, based on firmly rooted ethical values within the EU legislative framework. These considerations outline part of the research on legal, socio-ethical and communication aspects of HBM within the scope of ECNIS (NoE) and NewGeneris (IP). PMID:18541073

Ethical Issues in Pedagogical Documentation: Representations of Children through Digital Technology

ERIC Educational Resources Information Center

Lindgren, Anne-Li

2012-01-01

Documentation for pedagogical purposes is an increasingly important practice in Sweden, in Europe, and in the United States. This article focuses on the ethical aspects that need to be addressed in documentation practices in preschool. The empirical material is drawn from the blogs of Swedish preschool teachers who recorded their thoughts on…

"Parents as Partners" in Research and Evaluation: Methodological and Ethical Issues and Solutions.

ERIC Educational Resources Information Center

Wolfendale, Sheila

1999-01-01

This article investigates parents' status within educational research and examines some research paradigms that have been used. A number of inherent methodological and ethical issues are identified and several fundamental aspects are explored. It is argued that researchers should adopt a partnership model for cooperative research on parental…

Ethical and Privacy Principles for Learning Analytics

ERIC Educational Resources Information Center

Pardo, Abelardo; Siemens, George

2014-01-01

The massive adoption of technology in learning processes comes with an equally large capacity to track learners. Learning analytics aims at using the collected information to understand and improve the quality of a learning experience. The privacy and ethical issues that emerge in this context are tightly interconnected with other aspects such as…

Team-Based Simulations: Learning Ethical Conduct in Teacher Trainee Programs

ERIC Educational Resources Information Center

Shapira-Lishchinsky, Orly

2013-01-01

This study aimed to identify the learning aspects of team-based simulations (TBS) through the analysis of ethical incidents experienced by 50 teacher trainees. A four-dimensional model emerged: learning to make decisions in a "supportive-forgiving" environment; learning to develop standards of care; learning to reduce misconduct; and learning to…

Rethinking Aristotle's "Poetics": The Pragmatic Aspect of Art and Knowledge

ERIC Educational Resources Information Center

Gupta, Anoop

2010-01-01

I attempted to argue that, for Aristotle, art can be understood to have instrumental consequences directed toward external ends affecting ethical praxis. First, I considered the philosophical case that art, for Aristotle, affects ethical practice. Second, the non-philosophical literature related to some of the possible usages of art is sampled.…

Moral Attention: A Comparative Philosophical Study

ERIC Educational Resources Information Center

Gendron, Claude

2016-01-01

The notion of moral attention allows the recognition of fundamental aspects of ethical life ignored or neglected by mainstream ethical theories. It is central to the theories of several notable female ethicists and many of them identify the French philosopher Simone Weil as the source of the contemporary use of this concept which invites…

Post-Structuralism and Ethical Practical Action: Issues of Identity and Power

ERIC Educational Resources Information Center

Walshaw, Margaret

2013-01-01

In an era when familiar categories of identity are breaking down, an argument is made for using post-structuralist vocabulary to talk about ethical practical action in mathematics education. Using aspects of Foucault's post-structuralism, an explanation is offered of how mathematical identifications are tied to the social organization of power. An…

School Psychology: How Universal Are Ethical Principles Approved by International Associations?

ERIC Educational Resources Information Center

Pettifor, Jean L.

2004-01-01

Globalization is a dominant issue in all aspects of business and professional activities in the 21st Century. The International School Psychology Association and the International Test Commission have adopted ethics and competency guidelines to raise the standards of practice for their members. Other international organizations are doing likewise.…

Modernity, Ethics and Religious Education in Contemporary Britain

ERIC Educational Resources Information Center

Earl, Mary M.

2010-01-01

This article seeks to engage with the contention that, given the dilemmas of the self purportedly raised by these aspects of modernity, teachers of religious education need, ethically as well as professionally, to urgently revise their often traditionalist view of society, of children and of appropriate pedagogy for their subject. The aim of such…

Libraries and the Ethics of Censorship

ERIC Educational Resources Information Center

Duthie, Fiona

2010-01-01

This paper reviews a selection of literature pertaining to the subject of censorship in modern libraries. It interrogates the literature in terms of the ethical debates informing much of the contemporary academic writing on this subject. A multi-pronged approach to the subject is adopted. The review includes evaluations of the relevant aspects of…

The Fundamental Commitments of Educators

ERIC Educational Resources Information Center

Aloni, Nimrod

2008-01-01

This article seeks to examine central aspects of the relationship between ethics and education in the beginning of the twenty-first century. Since both ethics and education are practical disciplines that are bound to deal with and are challenged by human predicaments, cultural ills and social evils, it seems that in examining the relations between…

Science, human nature, and a new paradigm for ethics education.

PubMed

Lampe, Marc

2012-09-01

For centuries, religion and philosophy have been the primary basis for efforts to guide humans to be more ethical. However, training in ethics and religion and imparting positive values and morality tests such as those emanating from the categorical imperative and the Golden Rule have not been enough to protect humankind from its bad behaviors. To improve ethics education educators must better understand aspects of human nature such as those that lead to "self-deception" and "personal bias." Through rationalizations, faulty reasoning and hidden bias, individuals trick themselves into believing there is little wrong with their own unethical behavior. The application of science to human nature offers the possibility of improving ethics education through better self-knowledge. The author recommends a new paradigm for ethics education in contemporary modern society. This includes the creation of a new field called "applied evolutionary neuro-ethics" which integrates science and social sciences to improve ethics education. The paradigm can merge traditional thinking about ethics from religious and philosophical perspectives with new ideas from applied evolutionary neuro-ethics.

Legal, ethical and professional aspects of duty of care for nurses.

PubMed

Dowie, Iwan

2017-12-13

Duty of care is a fundamental aspect of nursing, and many nurses consider this to be an important part of their professional duties as a nurse. However, the legal underpinnings of duty of care are often overlooked, and, as such, nurses may be unsure about when to act if they encounter emergency situations or serious incidents, especially when they are off duty. This article examines the legal, ethical and professional aspects of duty of care, what these mean for nurses in practice, and how duty of care is intrinsically linked with standards of care and negligence. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

COMPREHENSIVE ASSESSMENT OF COMPLEX TECHNOLOGIES: INTEGRATING VARIOUS ASPECTS IN HEALTH TECHNOLOGY ASSESSMENT.

PubMed

Lysdahl, Kristin Bakke; Mozygemba, Kati; Burns, Jacob; Brönneke, Jan Benedikt; Chilcott, James B; Ward, Sue; Hofmann, Bjørn

2017-01-01

Despite recent development of health technology assessment (HTA) methods, there are still methodological gaps for the assessment of complex health technologies. The INTEGRATE-HTA guidance for effectiveness, economic, ethical, socio-cultural, and legal aspects, deals with challenges when assessing complex technologies, such as heterogeneous study designs, multiple stakeholder perspectives, and unpredictable outcomes. The objective of this article is to outline this guidance and describe the added value of integrating these assessment aspects. Different methods were used to develop the various parts of the guidance, but all draw on existing, published knowledge and were supported by stakeholder involvement. The guidance was modified after application in a case study and in response to feedback from internal and external reviewers. The guidance consists of five parts, addressing five core aspects of HTA, all presenting stepwise approaches based on the assessment of complexity, context, and stakeholder involvement. The guidance on effectiveness, health economics and ethics aspects focus on helping users choose appropriate, or further develop, existing methods. The recommendations are based on existing methods' applicability for dealing with problems arising with complex interventions. The guidance offers new frameworks to identify socio-cultural and legal issues, along with overviews of relevant methods and sources. The INTEGRATE-HTA guidance outlines a wide range of methods and facilitates appropriate choices among them. The guidance enables understanding of how complexity matters for HTA and brings together assessments from disciplines, such as epidemiology, economics, ethics, law, and social theory. This indicates relevance for a broad range of technologies.

WOC practice in cyberspace: legal and ethical issues.

PubMed

Hoyman, K

2001-07-01

WOC nurses have the opportunity to extend their practice geographically by using electronic media, also called telehealth or "practicing in cyberspace." Currently, laws and regulations affecting this aspect of practice are in rapid flux. In addition, practicing electronically makes the ethical issues of choice, privacy, and confidentiality more acute. This article describes the current status of relevant legislation, discusses relevant ethical issues, and provides guidelines for WOC nurses who are considering the use of e-mail and video conferencing within their practice.

Ethical Aspects of the Hippocratic Corpus text De arte.

PubMed

Konstantinidou, Meropi K

2016-12-01

The practice of medicine is a complex situation from an ethical point of view in the modern Western societies. But some very simple principles could help the immediate and effective response, at least to a percentage of the problems encountered. Such assistance can be derived from the writings of the Hippocratic Corpus, not only from the so-called ethical or theoretical texts. In this direction, the book titled De arte contains remarks about the right way of practicing medicine and the skills needed by the doctor.

Ethical aspects of surrogacy.

PubMed

Walters, W A

1989-08-01

Ethical issues related to surrogacy are explored and an argument made for its ethical approval in circumstances where the particularities of the case warrant this approach to reproduction. Despite recent and impending legislation to prohibit commercial surrogacy in some States of Australia, although data are difficult to obtain, unofficial and anecdotal reports from medical practitioners specializing in the management of infertility throughout the country indicate an increasing number of requests for surrogacy and increasing referral of infertile couples to the USA for commercial surrogacy arrangements.

Advancing an Ethic of Embodied Relational Sexuality to Guide Decision-Making in Dementia Care.

PubMed

Grigorovich, Alisa; Kontos, Pia

2018-03-19

Sexuality and intimacy are universal needs that transcend age, cognitive decline, and disability; sexuality is a fundamental aspect of the human experience. However, supporting sexuality in long-term residential care presents ethical challenges as this setting is both a home environment for residents and a workplace for health practitioners. This is particularly complex in the case of residents with dementia given the need to balance protection from harm and freedom of self-determination. Despite such complexity, this challenge has received limited critical theoretical attention. The dominant approach advocated to guide ethical reasoning is the bioethical four principles approach. However, the application of this approach in the context of dementia and long-term care may set the bar for practitioners' interference excessively high, restricting assentual (i.e., voluntary) sexual expression. Furthermore, it privileges cognitive and impartial decision-making, while disregarding performative, embodied, and relational aspects of ethical reasoning. With an interest in addressing these limitations, we explicate an alternative ethic of embodied relational sexuality that is grounded in a model of citizenship that recognizes relationality and the agential status of embodied self-expression. This alternative ethic broadens ethical reasoning from the exclusive duty to protect individuals from harm associated with sexual expression, to the duty to also uphold and support their rights to experience the benefits of sexual expression (e.g., pleasure, intimacy). As such it has the potential to inform the development of policies, organizational guidelines, and professional curricula to support the sexuality of persons with dementia, and thereby ensure more humane practices in long-term residential care settings.

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.

Ethical concerns in early 21st century organ transplantation

PubMed Central

Waness, Abdelkarim

2011-01-01

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

Ethics in American health 1: ethical approaches to health policy.

PubMed

Ruger, Jennifer Prah

2008-10-01

I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy.

Secret ethics business?

PubMed

Gillam, Lynn

2003-01-01

In this paper, I question the common assumption that the workings of Human Research Ethics Committees should be treated as confidential. This is actually quite a complex issue, since there are many stages in the ethics approval process, and a number of different stakeholders who might wish to claim access, or restrict access, to different sorts of information. Here I consider just one aspect--whether ethics committee members should be free to reveal in public the details of what occurs in their meetings. My approach is two-fold: first a negative argument that confidentiality does not apply to ethics committee deliberations, and then a positive argument that there is an important public good, namely accountability, to be served by making these deliberations open to the public.

Ethical aspects of personality disorders.

PubMed

Bendelow, Gillian

2010-11-01

To review recent literature around the controversial diagnosis of personality disorder, and to assess the ethical aspects of its status as a medical disorder. The diagnostic currency of personality disorder as a psychiatric/medical disorder has a longstanding history of ethical and social challenges through critiques of the medicalization of deviance. More recently controversies by reflexive physicians around the inclusion of the category in the forthcoming revisions of International Classification of Diseases and Diagnostic and Statistical Manual of Mental Disorders classifications reflect the problems of value-laden criteria, with the diagnostic category being severely challenged from within psychiatry as well as from without. The clinical diagnostic criteria for extremely value-laden psychiatric conditions such as personality disorder need to be analyzed through the lens of values-based medicine, as well as through clinical evidence, as the propensity for political and sociolegal appropriation of the categories can render their clinical and diagnostic value meaningless.

Ethics, jurisprudence, and economics in the medical school curriculum.

PubMed Central

O'Neill, L. C.; Davidson, R. C.; Tupper, C. J.; Scherger, J. E.; Walsh, D. A.

1990-01-01

Medical ethics, medical jurisprudence, and medical economics are recognized as important components of a medical school curriculum. These subjects were introduced through a course given at the University of California, Davis, School of Medicine. Four aspects of the format and content of the course were instrumental to its success. Teaching principles of medical ethics within the context of jurisprudence and economics permitted the students to gain an understanding of the institutions and processes that act as positive and negative constraints on physicians' clinical and professional behavior. The course was offered during the fourth year following required clinical rotations so that all aspects of the course could be based on the clinical experiences of the students. It was presented in a continuing medical education format away from the normal teaching environment of first- and second-year classrooms and third-year clerkships. Finally, the course was designed by a multidisciplinary, multidepartmental planning group that included students. PMID:2260303

Ethics and skeptics: what lies behind ethical codes in occupational health.

PubMed

Guidotti, Tee L

2005-02-01

Ethical codes, or systems, are conditioned and their enforcement is permitted by social processes and attitudes. In occupational health, our efforts to adhere to our own ethical frameworks often are undermined by forces and interests outside the field. Failure to acknowledge the profoundly social nature of ethical codes impedes our ability to anticipate consequences, to legitimate decisions based on utility and benefit, and to find social structures that support, rather than invalidate, our view of ethical behavior. We examine three sets of social philosophies. Jane Jacobs, the visionary urban planner, has written Systems of Survival: A Dialogue on the Moral Foundations of Commerce and Politics, which is a restatement in modern terms of a critical passage in Plato's most important dialogue, the Republic. She (and Plato) postulate two major ethical systems, renamed here the "guardian system," which is characterized by loyalty, cohesiveness, and confidentiality, and the "marketplace system," which is characterized by trade, decentralization, and shared information. Occupational health, in this formulation, often runs afoul of the guardian mentality and also may be subject to inappropriate negotiation and compromise in the marketplace system. George Lakoff, a semiotician, has written Moral Politics: What Conservatives Know That Liberals Don't, which argues that there are two fundamental social paradigms based on concepts of the family. One, which he calls the Strict Father, emphasizes discipline, the positive aspects of taking risks, and the need to individuals to be self-sufficient. The other, which he calls the Nurturing Parent, emphasizes empowerment, the positive aspects of security, and the need for community and relationships. Occupational health practice violates aspects of both and therefore is supported by neither. Classical Chinese thought involved many schools of thought, including Confucianism and Legalism. It has been suggested that Confucianism provides little support for government regulation or occupational health, however this is questioned. Occupational health may improve its standing as a social priority by recognizing and maneuvering within social frameworks that accomodate it, rejecting social frameworks that invalidate it, and reinforcing positive cultural trends within society that support it.

[Responsibilities of ethics committees].

PubMed

von Bergmann, K

1999-01-15

Increasing numbers of clinical research projects are submitted to ethical committees (institutional review boards) for approval. New therapeutic developments have to be evaluated by these committees to protect patients/volunteers. Thus, the responsibility of ethical committees is increasing. The "Nürnberger Kodex" and the "Declaration of Helsinki" are the background for these evaluations. According to the German drug law the physician is obligated by law to submit the protocol to such a committee. In addition, local state physician authorities require such a procedure. Important considerations during the review process besides ethical aspects are the informed consent, which should be written in an understandable form, and the obligations of the insurance.

[Responsibilities of ethics committees].

PubMed

von Bergmann, K

2000-05-01

Increasing numbers of clinical research projects are submitted to ethical committees (institutional review boards) for approval. New therapeutic developments have to be evaluated by these committees to protect patients/volunteers. Thus, the responsibility of ethical committees is increasing. The "Nürnberger Kodex" and the "Declaration of Helsinki" are the background for these evaluations. According to the German drug law the physician is obligated by law to submit the protocol to such a committee. In addition, local state physician authorities require such a procedure. Important considerations during the review process besides ethical aspects are the informed consent, which should be written in an understandable form, and the obligations of the insurance.

Ethics and prevention of overweight and obesity: an inventory.

PubMed

ten Have, M; de Beaufort, I D; Teixeira, P J; Mackenbach, J P; van der Heide, A

2011-09-01

Efforts to counter the rise in overweight and obesity, such as taxes on certain foods and beverages, limits to commercial advertising, a ban on chocolate drink at schools or compulsory physical exercise for obese employees, sometimes raise questions about what is considered ethically acceptable. There are obvious ethical incentives to these initiatives, such as improving individual and public health, enabling informed choice and diminishing societal costs. Whereas we consider these positive arguments to put considerable effort in the prevention of overweight indisputable, we focus on potential ethical objections against such an effort. Our intention is to structure the ethical issues that may occur in programmes to prevent overweight and/or obesity in order to encourage further debate. We selected 60 recently reported interventions or policy proposals targeting overweight or obesity and systematically evaluated their ethically relevant aspects. Our evaluation was completed by discussing them in two expert meetings. We found that currently proposed interventions or policies to prevent overweight or obesity may (next to the benefits they strive for) include the following potentially problematic aspects: effects on physical health are uncertain or unfavourable; there are negative psychosocial consequences including uncertainty, fears and concerns, blaming and stigmatization and unjust discrimination; inequalities are aggravated; inadequate information is distributed; the social and cultural value of eating is disregarded; people's privacy is disrespected; the complexity of responsibilities regarding overweight is disregarded; and interventions infringe upon personal freedom regarding lifestyle choices and raising children, regarding freedom of private enterprise or regarding policy choices by schools and other organizations. The obvious ethical incentives to combat the overweight epidemic do not necessarily override the potential ethical constraints, and further debate is needed. An ethical framework to support decision makers in balancing potential ethical problems against the need to do something would be helpful. Developing programmes that are sound from an ethical point of view is not only valuable from a moral perspective, but may also contribute to preventing overweight and obesity, as societal objections to a programme may hamper its effectiveness. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

'Faced' with responsibility: Levinasian ethics and the challenges of responsibility in Norwegian public health nursing.

PubMed

Clancy, Anne; Svensson, Tommy

2007-07-01

This paper is concerned with aspects of responsibility in Norwegian public health nursing. Public health nursing is an expansive profession with diffuse boundaries. The Norwegian public health nurse does not perform 'hands on' nursing, but focuses on the prevention of illness, injury, or disability, and the promotion of health. What is the essence of ethical responsibility in public health nursing? The aim of this article is to explore the phenomenon based on the ethics of responsibility as reflected upon by the philosopher Emanuel Levinas (1906-1995). From an ethical point of view, responsibility is about our duty towards the Other, a duty we have not always chosen, are prepared for, or can fully explain; but it is nevertheless a demand we have to live with. Interviews with five experienced Norwegian nurses provide the empirical base for reflection and interpretation. The nurses share stories from their practice. In interpreting the nurses' stories, the following themes emerge: personal responsibility; boundaries; temporality; worry, fear, and uncertainty; and a sense of satisfaction. As the themes are developed further, it becomes apparent that, despite their diversity, they are all interrelated aspects of ethical responsibility. Responsibility for the Other cannot be avoided, ignored, or transferred. The nurses' responsibility is personal and infinite. Levinasian ethics can help nurses understand the importance of accepting that being a responsive carer can involve not only contentment in the predictable, but also the fear, worry, and uncertainty of the unpredictable.

Towards a richer debate on tissue engineering: a consideration on the basis of NEST-ethics.

PubMed

Oerlemans, A J M; van Hoek, M E C; van Leeuwen, E; van der Burg, S; Dekkers, W J M

2013-09-01

In their 2007 paper, Swierstra and Rip identify characteristic tropes and patterns of moral argumentation in the debate about the ethics of new and emerging science and technologies (or "NEST-ethics"). Taking their NEST-ethics structure as a starting point, we considered the debate about tissue engineering (TE), and argue what aspects we think ought to be a part of a rich and high-quality debate of TE. The debate surrounding TE seems to be predominantly a debate among experts. When considering the NEST-ethics arguments that deal directly with technology, we can generally conclude that consequentialist arguments are by far the most prominently featured in discussions of TE. In addition, many papers discuss principles, rights and duties relevant to aspects of TE, both in a positive and in a critical sense. Justice arguments are only sporadically made, some "good life" arguments are used, others less so (such as the explicit articulation of perceived limits, or the technology as a technological fix for a social problem). Missing topics in the discussion, at least from the perspective of NEST-ethics, are second "level" arguments-those referring to techno-moral change connected to tissue engineering. Currently, the discussion about tissue engineering mostly focuses on its so-called "hard impacts"-quantifiable risks and benefits of the technology. Its "soft impacts"-effects that cannot easily be quantified, such as changes to experience, habits and perceptions, should receive more attention.

On Wittgenstein's Extension of the Domain of Aesthetic Education: Intransitive Knowledge and Ethics

ERIC Educational Resources Information Center

Escalera, Carla Carmona

2012-01-01

Ludwig Wittgenstein gave priority to aesthetics over other disciplines due to its invaluable capacities for revealing certain aspects of the nature of human understanding and for guiding our actions toward an ethical life. Although Wittgenstein did not focus on these issues in a systematic way, these worries were present in his philosophy during…

A Diffractive Reading of Dialogical Feedback through the Political Ethics of Care

ERIC Educational Resources Information Center

Bozalek, Vivienne; Mitchell, Veronica; Dison, Arona; Alperstein, Melanie

2016-01-01

With regard to improving higher education feedback practices, there is an increasing interest in using the efficacy of dialogue rather than the more traditional unidirectional approaches. We build on this impetus by considering how the ethics of care can be used to analyse the dialogical aspects of feedback. By diffractively reading insights of…

Ethics and Morality in Software Development: A Developer's Perspective

ERIC Educational Resources Information Center

Stephenson, James H.

2010-01-01

Computers and other digital devices have become ubiquitous in our lives. Almost all aspects of our lives are in part or wholly impacted by computers and the software that runs on them. Unknowingly, we are placing our livelihoods and even our lives in the hands unknown software developers. Ethical and moral decisions made during software…

Selling the Work Ethic: From Puritan Pulpit to Corporate PR.

ERIC Educational Resources Information Center

Beder, Sharon

This book provides an account and critique of the work ethic, a central aspect of modern capitalist society. Chapter 1 is an introduction. Chapter 2 considers social changes in Europe in the 16th-17th centuries, maintaining that work was imbued with moral qualities and wealth seeking acquired social legitimacy through religious sanction. Chapter 3…

Organizational Ethics Education and Training: A Review of Best Practices and Their Application

ERIC Educational Resources Information Center

Sekerka, Leslie E.

2009-01-01

Insuring that ethical action remains a vibrant aspect of an organization's climate and culture is an ongoing challenge for those responsible for training and development. To better understand what best practices are being utilized today, eight organizations in the Silicon Valley region of the United States were studied. Findings suggest that…

Room with a View: Ethical Encounters in Room 13

ERIC Educational Resources Information Center

Grube, Vicky

2012-01-01

In this article, the author describes ethical encounters in Room 13, a schoolroom where children made what they wanted, posed their own questions, and ran an art room like a small business. In Room 13 children had the responsibility to maintain all aspects of the art studio. Specific decisions fell to an annually elected management team, a small…

Research and the Ambiguity of Reflexivity and Ethical Practice

ERIC Educational Resources Information Center

Hastings, Wendy

2010-01-01

This paper examines the methodological dilemmas associated with analytical framing as an aspect of the research process. Doing qualitative research potentially changes a researcher--changes their sense of self, who they think they are, who they want to become. The paper examines the ethical dilemma of what that change might mean--for the project,…

Privacy and Ethics in the Age of the Smartphone: A Case Study

ERIC Educational Resources Information Center

Lawrence, Cameron; Firth, David; Balyeat, Jake

2013-01-01

Smartphones are fundamentally transforming almost all aspects of modern life. This case study examines moral and ethical issues surrounding the use of powerful smartphones that can be used to discreetly capture the activities of unsuspecting people. This case shows how a standard iPhone, coupled with widely available apps, can be used in a…

Moral Judgments of Chief Academic Officers at Institutions of Higher Education

ERIC Educational Resources Information Center

Weaver, Megan D.

2012-01-01

Chief Academic Officers (CAO) are leaders in institutions of higher education and have wide decision-making scope. Previous research has clearly demonstrated the need for leaders to engage in ethical decision-making. Moral judgments are an aspect of ethical decision-making, so it is important for CAOs to make moral judgments. This study examined…

Obesity: a problem of darwinian proportions?

PubMed

Watnick, Suzanne

2006-10-01

Obesity has been described as an abnormality arising from the evolution of man, who becomes fat during the time of perpetual plenty. From the perspective of "Darwinian Medicine," if famine is avoided, obesity will prevail. Problems regarding obesity arise within many disciplines, including socioeconomic environments, the educational system, science, law, and government. This article will discuss various ethical aspects of several disciplines regarding obesity, with a focus on scientific inquiry. We will discuss this within the categories: (1) chronic kidney disease predialysis, (2) dialysis, and (3) renal transplantation. This article aims to help nephrologists and their patients navigate through the ethical aspects of obesity and chronic kidney disease.

Surrogacy: ethical, legal, and social aspects.

PubMed

Bromham, D R

1995-09-01

In considering the interrelated ethical, legal and social aspects of surrogacy we acknowledge that society has long accepted the delegation of various parenteral functions and explore the role of a surrogate in relationship to this as well as alluding to commoner comparisons with prostitution and adultery. In particular, the "birth mother" rule, the public antipathy to "commercial" surrogacy and restrictive legislation are explored and found to be inappropriate. It is concluded that the regulation, surveillance and assessment needed to ensure the best outcome for all concerned would perhaps be easiest achieved in programmes that are formally licensed under permissive legislation and adequately funded by "commercial" means.

Ethical and legal aspects in medically assisted human reproduction in Romania.

PubMed

Ioan, Beatrice; Astarastoae, Vasile

2008-01-01

Up to the present, there have not been any specific norms regarding medically assisted human reproduction in Romanian legislation. Due to this situation the general legislation regarding medical assistance (law no. 95/2006, regarding the Reform in Health Care System), the Penal and Civil law and the provisions of the Code of Deontology of the Romanian College of Physicians are applied to the field of medically assisted human reproduction. By analysing the ethical and legal conflicts regarding medically assisted human reproduction in Romania, some characteristics cannot be set apart because they derive from religious, cultural and socio-economic aspects. In this article the authors identify the development stages of medically assisted human reproduction in Romania, beginning from these characteristics and insisting upon the failure of the legal system in this specific field. The authors consider that the law regarding medically assisted human reproduction cannot be effective because it did not take into account the ethical and cultural aspects that might appear. Furthermore, in this framework of the legal process, no public debate involving the representatives of civil society was undertaken although the Council of Europe Oviedo Convention approved by our country according to law no. 17/2001 stipulated exactly this working method.

Information, consent and treatment of patients with Morgellons disease: an ethical perspective.

PubMed

Söderfeldt, Ylva; Groß, Dominik

2014-04-01

Morgellons is a medically contested diagnosis with foremost dermatological symptoms. Patients experience fibers emerging from the skin, together with a range of other somatic, psychiatric, and neurological complaints. Within the medical community, it is generally held to be a variation of delusional parasitosis/delusional infestation, which is usually treated with antipsychotics. Little attention has been paid in the literature to the ethical aspects of treating patients with Morgellons disease. The communicative strategies suggested in the literature display significant ethical issues, primarily the use of therapeutic privilege, i.e. withholding information from the patient. Since this limits patient autonomy, that approach is ethically problematic. Instead, the physician has an ethical obligation to respect the patient's autonomy, provide full information, and seek consent before initiating a psychiatric referral.

Ethics in American Health 1: Ethical Approaches to Health Policy

PubMed Central

2008-01-01

I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy. PMID:18703449

[Ethics and epidemiology].

PubMed

Barata, Rita Barradas

2005-01-01

Human actions take place at the confluence of circumstances that require us to discern the proper way to act. Ethics falls within the terrain of practical knowledge, of knowledge about what is contingent. It belongs to the domain of moral judgments or value judgments. The counterpart of disenchantment with our contemporary world lies in an effort to re-establish an interest in ethics. There are basically three orders of relations between public health and human rights: the quest for balance between the collective good and individual rights; methods and techniques for identifying human rights violations and assessing their negative impact; and the tie between protecting individual rights and promoting health. The relationship between ethics and epidemiology goes beyond the ethical aspects involving research on human beings to encompass political commitments, practices within health services, and the production of knowledge.

Ethical issues in nanomedicine: Tempest in a teapot?

PubMed

Allon, Irit; Ben-Yehudah, Ahmi; Dekel, Raz; Solbakk, Jan-Helge; Weltring, Klaus-Michael; Siegal, Gil

2017-03-01

Nanomedicine offers remarkable options for new therapeutic avenues. As methods in nanomedicine advance, ethical questions conjunctly arise. Nanomedicine is an exceptional niche in several aspects as it reflects risks and uncertainties not encountered in other areas of medical research or practice. Nanomedicine partially overlaps, partially interlocks and partially exceeds other medical disciplines. Some interpreters agree that advances in nanotechnology may pose varied ethical challenges, whilst others argue that these challenges are not new and that nanotechnology basically echoes recurrent bioethical dilemmas. The purpose of this article is to discuss some of the ethical issues related to nanomedicine and to reflect on the question whether nanomedicine generates ethical challenges of new and unique nature. Such a determination should have implications on regulatory processes and professional conducts and protocols in the future.

The ethically trained physician: myth or reality?

PubMed Central

Balkos, G. K.

1983-01-01

Through a questionnaire distributed to 300 physicians in the Toronto area, three aspects of their ethical awareness were examined: the formal codes, the need for consultation in making decisions and the need for training in medical ethics. Most of the physicians (81%) felt that they were facing ethical problems in their daily practice. A majority of these would try to solve the problems either themselves (30%) or through discussion with a colleague (43%). When they turned outside the profession it was sometimes to a lawyer (12%), which suggests concern with the legalities of some situations. Only a small proportion of the respondents were found to be familiar with two of the established codes of ethics, yet 13% would still turn to the code of the Canadian Medical Association for guidance. Finally, there was widespread recognition of the need for proper training in medical ethics and for the establishment of a specialty in this field. PMID:6825034

Improving our application of the health education code of ethics.

PubMed

Marks, Ray; Shive, Steven E

2006-01-01

The Health Education Code of Ethics was designed to provide a framework of shared values within which health education might be practiced. However, an informal survey conducted on a limited sample in November 2004 indicated that ethics and how to apply the code are topics not readily taught formally within all health education programs. There is, however, an expressed interest among health educators in understanding the code and its application. Because of the immense import of ethics, affecting responsible professional conduct at all levels, this article is designed to introduce the topic to health education practitioners who have had little formal exposure to ethics curricula, as well as to faculty who would like to teach this subject. The authors specifically review several resources that might be especially helpful in fostering a better understanding of this essential but often underestimated aspect of health education practice and research, namely, its ethical application.

Using Social Media as a Research Recruitment Tool: Ethical Issues and Recommendations

PubMed Central

Gelinas, Luke; Pierce, Robin; Winkler, Sabune; Cohen, I. Glenn; Lynch, Holly Fernandez; Bierer, Barbara E.

2017-01-01

The use of social media as a recruitment tool for research with humans is increasing, and likely to continue to grow. Despite this, to date there has been no specific regulatory guidance and little in the bioethics literature to guide investigators and IRBs faced with navigating the ethical issues it raises. We begin to fill this gap by first defending a non-exceptionalist methodology for assessing social media recruitment; second, examining respect for privacy and investigator transparency as key norms governing social media recruitment; and, finally, analyzing three relatively novel aspects of social media recruitment: (i) the ethical significance of compliance with website ‘terms of use’; (ii) the ethics of recruiting from the online networks of research participants; and (iii) the ethical implications of online communication from and between participants. Two checklists aimed at guiding investigators and IRBs through the ethical issues are included as Appendices. PMID:28207365

Ethics of clinical trials in Nigeria.

PubMed

Okonta, Patrick I

2014-05-01

The conduct of clinical trials for the development and licensing of drugs is a very important aspect of healthcare. Drug research, development and promotion have grown to a multi-billion dollar global business. Like all areas of human endeavour involving generation and control of huge financial resources, it could be subject to deviant behaviour, sharp business practices and unethical practices. The main objective of this review is to highlight potential ethical challenges in the conduct of clinical trials in Nigeria and outline ways in which these can be avoided. Current international and national regulatory and ethical guidelines are reviewed to illustrate the requirements for ethical conduct of clinical trials. Past experiences of unethical conduct of clinical trials especially in developing countries along with the increasing globalisation of research makes it imperative that all players should be aware of the ethical challenges in clinical trials and the benchmarks for ethical conduct of clinical research in Nigeria.

Ethics of clinical trials in Nigeria

PubMed Central

Okonta, Patrick I.

2014-01-01

The conduct of clinical trials for the development and licensing of drugs is a very important aspect of healthcare. Drug research, development and promotion have grown to a multi-billion dollar global business. Like all areas of human endeavour involving generation and control of huge financial resources, it could be subject to deviant behaviour, sharp business practices and unethical practices. The main objective of this review is to highlight potential ethical challenges in the conduct of clinical trials in Nigeria and outline ways in which these can be avoided. Current international and national regulatory and ethical guidelines are reviewed to illustrate the requirements for ethical conduct of clinical trials. Past experiences of unethical conduct of clinical trials especially in developing countries along with the increasing globalisation of research makes it imperative that all players should be aware of the ethical challenges in clinical trials and the benchmarks for ethical conduct of clinical research in Nigeria. PMID:25013247

Using Social Media as a Research Recruitment Tool: Ethical Issues and Recommendations.

PubMed

Gelinas, Luke; Pierce, Robin; Winkler, Sabune; Cohen, I Glenn; Lynch, Holly Fernandez; Bierer, Barbara E

2017-03-01

The use of social media as a recruitment tool for research with humans is increasing, and likely to continue to grow. Despite this, to date there has been no specific regulatory guidance and there has been little in the bioethics literature to guide investigators and institutional review boards (IRBs) faced with navigating the ethical issues such use raises. We begin to fill this gap by first defending a nonexceptionalist methodology for assessing social media recruitment; second, examining respect for privacy and investigator transparency as key norms governing social media recruitment; and, finally, analyzing three relatively novel aspects of social media recruitment: (i) the ethical significance of compliance with website "terms of use"; (ii) the ethics of recruiting from the online networks of research participants; and (iii) the ethical implications of online communication from and between participants. Two checklists aimed at guiding investigators and IRBs through the ethical issues are included as appendices.

Legal and ethical issues in research.

PubMed

Yip, Camille; Han, Nian-Lin Reena; Sng, Ban Leong

2016-09-01

Legal and ethical issues form an important component of modern research, related to the subject and researcher. This article seeks to briefly review the various international guidelines and regulations that exist on issues related to informed consent, confidentiality, providing incentives and various forms of research misconduct. Relevant original publications (The Declaration of Helsinki, Belmont Report, Council for International Organisations of Medical Sciences/World Health Organisation International Guidelines for Biomedical Research Involving Human Subjects, World Association of Medical Editors Recommendations on Publication Ethics Policies, International Committee of Medical Journal Editors, CoSE White Paper, International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use-Good Clinical Practice) form the literature that are relevant to the ethical and legal aspects of conducting research that researchers should abide by when conducting translational and clinical research. Researchers should note the major international guidelines and regional differences in legislation. Hence, specific ethical advice should be sought at local Ethics Review Committees.

Supporting ethical competence of nurses during recruitment and performance reviews - the role of the nurse leader.

PubMed

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

2014-09-01

The aim of this study was to analyse how nurse leaders support the ethical competence of nurses during recruitment and performance reviews. Ethical competence of nurses refers to ethical behaviour and action requiring ethical knowledge and reflection. Nurse leaders have a key role in supporting the ethical competence of nurses, but little is known about just how this should be done. The data were collected using a structured questionnaire and analysed statistically. The target sample consisted of nurse leaders (n = 198) from two university hospitals in two healthcare districts in Finland. Nurse leaders support the ethical competence of nurses more often during performance reviews than during recruitment. During recruitment, nurse leaders ensure the ethical behaviour and knowledge of nurses to varying degrees. During performance reviews, nurse leaders ensure that nurses meet the requirements for collegiality and comply with ethical guidelines and that they do so according to nursing values and principles. There seems to be a need to examine and improve support for the ethical competence of nurses, both during recruitment and performance reviews. Future priorities should include a focus on supporting the ethical knowledge, reflection and behaviour of nurses. An important aspect in terms of supporting the ethical competence of nurses has to do with the ethical knowledge and education of nurse leaders and organisational policies or recommendations for ethical support. © 2013 John Wiley & Sons Ltd.

The commerce of professional psychology and the new ethics code.

PubMed

Koocher, G P

1994-11-01

The 1992 version of the American Psychological Association's Ethical Principles of Psychologists and Code of Conduct brings some changes in requirements and new specificity to the practice of psychology. The impact of the new code on therapeutic contracts, informed consent to psychological services, advertising, financial aspects of psychological practice, and other topics related to the commerce of professional psychology are discussed. The genesis of many new thrusts in the code is reviewed from the perspective of psychological service provider. Specific recommendations for improved attention to ethical matters in professional practice are made.

Ethics in biomedical engineering.

PubMed

Morsy, Ahmed; Flexman, Jennifer

2008-01-01

This session focuses on a number of aspects of the subject of Ethics in Biomedical Engineering. The session starts by providing a case study of a company that manufactures artificial heart valves where the valves were failing at an unexpected rate. The case study focuses on Biomedical Engineers working at the company and how their education and training did not prepare them to deal properly with such situation. The second part of the session highlights the need to learn about various ethics rules and policies regulating research involving human or animal subjects.

Ethical aspects of sexual medicine.

PubMed

Wagner, Gorm; Bondil, Pierre; Dabees, Khalid; Dean, John; Fourcroy, Jean; Gingell, Clive; Kingsberg, Sheryl; Kothari, Prakash; Rubio-Aurioles, Eusebio; Ugarte, Fernando; Navarrete, R Vela

2005-03-01

Ethics describe the ways in which moral life is understood. Morality comprises norms for human conduct, and addresses what is right and what is wrong. To provide a consensus-based summary of the ethical aspects of sexual medicine. Over 200 multidisciplinary specialists from 60 countries were divided into 17 consultation committees as part of a process organized by an international consultation on sexual medicine held in Paris, June 28-July 1, 2003 in close alliance with several sexual medicine organizations. Embarking on a study on ethics in sexual medicine, 10 experts from eight countries assembled over a two-year period to develop this consensus-based summary. Although ethics are recognized as subjective, expert opinion was based on grading of evidence-based medical literature, in addition to cultural and ethical considerations. The process also involved extensive internal committee discussion, public presentation, and debate. Contemporary medical practitioners provide health care for patients from many different cultures from all around the world. Thus, it is recommended that all health professionals working in sexual medicine should above all be able to demonstrate respect, understanding, and tolerance toward the differing moral worldviews of their patients and colleagues, and the societies they represent. In sexual medicine, health professionals have an obligation to respect the autonomy of any individual that they treat, regardless of that individual's religious or socio-cultural tradition, race, gender, or sexual orientation. Sexual rights are a necessary condition for sexual health. Sexual health requires a positive and respectful approach to sexuality and sexual relationships as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected, and fulfilled. Additional discussion and research on ethics in sexual medicine is needed.

Code of Ethics in a Multicultural Company and its Legal Context

NASA Astrophysics Data System (ADS)

Odlerová, Eva; Ďurišová, Jaroslava; Šramel, Bystrík

2012-12-01

The entry of foreign investors and simultaneous expansion of different national cultures, religions, rules, moral and ethical standards is bringing up problems of cooperation and coexistence of different nationalities, ethnicities and cultures. Working in an international environment therefore requires adaptation to a variety of economic, political, legal, technical, social, cultural and historical conditions. One possible solution is to define a code of ethics, guidelines which find enough common moral principles, which can become the basis for the adoption of general ethical standards, while respecting national, cultural differences and practices. In this article, the authors pay attention not only to the analysis of the common ethical rules in a multicultural company, but also to the legal aspects of codes of ethics. Each code of ethics is a set of standards, which, like the legal norms, regulate the behaviour of individuals. These standards, however, must simultaneously meet certain statutory criteria that define the boundaries of regulation of employee’s behaviour.

Professional Ethics for Astronomers

NASA Astrophysics Data System (ADS)

Marvel, K. B.

2005-05-01

There is a growing recognition that professional ethics is an important topic for all professional scientists, especially physical scientists. Situations at the National Laboratories have dramatically proven this point. Professional ethics is usually only considered important for the health sciences and the legal and medical professions. However, certain aspects of the day to day work of professional astronomers can be impacted by ethical issues. Examples include refereeing scientific papers, serving on grant panels or telescope allocation committees, submitting grant proposals, providing proper references in publications, proposals or talks and even writing recommendation letters for job candidates or serving on search committees. This session will feature several speakers on a variety of topics and provide time for questions and answers from the audience. Confirmed speakers include: Kate Kirby, Director Institute for Theoretical Atomic and Molecular Physics - Professional Ethics in the Physical Sciences: An Overview Rob Kennicutt, Astrophysical Journal Editor - Ethical Issues for Publishing Astronomers Peggy Fischer, Office of the NSF Inspector General - Professional Ethics from the NSF Inspector General's Point of View

Everyday ethical problems in dementia care: a teleological model.

PubMed

Bolmsjö, Ingrid Agren; Edberg, Anna-Karin; Sandman, Lars

2006-07-01

In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and nurses' ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses' everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care.

Ethical Dilemmas in Office Practice: Physician Response and Rationale

PubMed Central

Secundy, Marian Gray

1985-01-01

A survey of black and white family physicians in the District of Columbia is described. The survey provides insight into decision-making processes and the ability to recognize ethical dilemmas in medical practice. Comments were elicited to hypothetical case vignettes typical of ethical conflict in office practice. Findings note physician ability to recognize ethical dilemmas in day-to-day aspects of medical practice. Methods of decision making and rationale for decisions made, however, appear to be inconsistent, nonuniversal, and individualistic without evidence of specific models or criteria. No significant differences were noted between black and white physicians. The need in physician training for clarification and development of criteria is evident. PMID:4078929

[Mental health film festival and ethics].

PubMed

Simonnet, Daniel

2010-01-01

The mental health film festival is based on the respect of the patient as a subject and is a place where psychic suffering can be expressed. As a film is destined to be shown, there is a dilemma between the aesthetic and the therapeutic aspects and, it's in this link that the ethical dimension concerned by this kind of activity takes place.

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

ERIC Educational Resources Information Center

Mitchell, Jennifer M.; Yordy, Eric D.

2010-01-01

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

To Know or Not to Know? Integrating Ethical Aspects of Genomic Healthcare in the Education of Health Professionals

ERIC Educational Resources Information Center

Eriksen, Kathrine Krageskov

2015-01-01

Novel possibilities for employing genetic testing as part of the diagnostic process for a wide variety of diseases and conditions are emerging almost every day. This development brings prospects of more efficient treatment and prevention of serious and often lethal conditions. However, it also raises ethical questions concerning the issue of…

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

PubMed

Schwartz, Michael B

2009-10-01

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

Ethical Leadership Development as Care of the Self: A Foucauldian Perspective

ERIC Educational Resources Information Center

Pignatelli, Frank

2015-01-01

This essay addresses the care of the self as an important aspect in the development of educational leaders. It draws upon Michel Foucault's analysis of power and its relationship to his understanding of ethics as a practice one cultivates and takes on in the interests of leadership development. Foucault's work in these areas is timely for graduate…

Character virtues in psychiatric practice.

PubMed

Radden, Jennifer; Sadler, John Z

2008-01-01

The character-focused approach known as virtue ethics is especially well suited to understanding and promoting ethical psychiatric practice. Virtues are stable dispositions and responses attributed to character, and a virtue-based ethics is one in which people's selves or characters are at the center of moral assessment. In this discussion by a clinician and a philosopher, clinical scenarios using exchanges and inner monologue illustrate key aspects of virtues. Virtues are acquired through habituation; they are habits of mind as much as behavior; they are as a group heterogeneous, and individually composite; they involve affective responses; they are not impartial; they are compatible with the "role morality" required of professionals; they are responses to particular temptations and weaknesses; and they include, in the capacity for practical judgment known as phronesis, a way of resolving many of the conflicts and dilemmas that arise in practice. The virtue approach to ethics will likely be most useful in the educational setting where practitioners are learning clinical skills and socialized into the broad ethos of professional practice. Aspects of this educational effort are briefly reviewed, including whether it ought to be undertaken at all, whether the effort to teach virtues is possible, and, if so, how it can be achieved.

[Bioethical analysis of the use of newly dead patients in medical learning].

PubMed

Gomes, Andréia Patrícia; Rego, Sergio; Palácios, Marisa; Siqueira-Batista, Rodrigo

2010-01-01

The purpose of this article is to carry out, a discussion on the subject of bioethics and cadavers based upon a critic review of literature. A review of literature, was made with a survey of articles between 1977 and 2007 in the sites 'Biblioteca Virtual de Saúde', PubMed and SciElo, utilizing the keywords: newly deceased patients, newly dead patients, simulators,. This was complemented by a critical evaluation of books published in the area of ethics and bioethics. The possibility to develop learning without orientation by a supervisor is doubtful.. The utilization of newly dead for learning invasive procedures is very frequent and seldom admitted. These procedures, are usually, carried out secretly, without the knowledge and consent of the family. The ethical aspects of these practices are not discussed in the practical medical education. It essential that the ethics of use of recent deceased become a necessary content of graduate education. Performance of these procedures by students should always be authorized by family members. The simulators meet the requirements of training. Discussions about the ethical and bioethical aspects cannot be separated from practical considerations during the students learning time.

Xenotransplantation from the perspective of moral theology.

PubMed

Sautermeister, Jochen

2015-01-01

Current medical research in the area of xenotransplantation is driven by the aim to save human lives and to improve the quality of life of those suffering from organ insufficiencies. This study reflects the therapeutic intent of xenotransplantation from a theological-ethical perspective. Regarding statements of Christian communities, the analysis focuses mainly on catholic documents. This study takes into account the document on Prospects for Xenotransplantation by the Pontifical Academy for Life as well as a position paper on xenotransplantation released as a collaboration between the German Bishops Conference (Catholic) and the Evangelical Church in Germany (Protestant). Documents of other Christian denominations will be discussed in a separate paper. Aspects concerning the areas of medicine, social ethics and animal ethics are considered as well as biographical, psychosocial, culture-bound and ideological preconditions of acceptability. These aspects also include consequences for the construction of personal identity. With regard to an anthropocentrism that is based theologically and relationally, xenotransplantation--in general--can be viewed as a permissible form of therapy, given that the principles of biomedical ethics will be observed and that animals are treated with respect. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Application of Ethics for Providing Telemedicine Services and Information Technology.

PubMed

Langarizadeh, Mostafa; Moghbeli, Fatemeh; Aliabadi, Ali

2017-10-01

Advanced technology has increased the use of telemedicine and Information Technology (IT) in treating or rehabilitating diseases. An increased use of technology increases the importance of the ethical issues involved. The need for keeping patients' information confidential and secure, controlling a number of therapists' inefficiency as well as raising the quality of healthcare services necessitates adequate heed to ethical issues in telemedicine provision. The goal of this review is gathering all articles that are published through 5 years until now (2012-2017) for detecting ethical issues for providing telemedicine services and Information technology. The reason of this time is improvement of telemedicine and technology through these years. This article is important for clinical practice and also to world, because of knowing ethical issues in telemedicine and technology are always important factors for physician and health providers. the required data in this research were derived from published electronic sources and credible academic articles published in such databases as PubMed, Scopus and Science Direct. The following key words were searched for in separation and combination: tele-health, telemedicine, ethical issues in telemedicine. A total of 503 articles were found. After excluding the duplicates (n= 93), the titles and abstracts of 410 articles were skimmed according to the inclusion criteria. Finally, 64 articles remained. They were reviewed in full text and 36 articles were excluded. At the end, 28 articles were chosen which met our eligibility criteria and were included in this study. Ethics has been of a great significance in IT and telemedicine especially the Internet since there are more chances provided for accessing information. It is, however, accompanied by a threat to patients' personal information. Therefore, suggestions are made to investigate ethics in technology, to offer standards and guidelines to therapists. Due to the advancement in technology, access to information has become simpler than the past. This has prompted hackers to seize the opportunity. This research shows that the ethical issues in telemedicine can be investigated from several aspects like technology, doctor-patient relationship, data confidentiality and security, informed consent, patient's and family's satisfaction with telemedicine services. Following ethical issues in telemedicine is a primary aspect of high quality services. In other words, if therapists abide by ethical rules, they can provide better services for patients. Attention to ethical issues in telemedicine guarantees a safer use of the services.

Known unknowns: building an ethics of uncertainty into genomic medicine.

PubMed

Newson, Ainsley J; Leonard, Samantha J; Hall, Alison; Gaff, Clara L

2016-09-01

Genomic testing has reached the point where, technically at least, it can be cheaper to undertake panel-, exome- or whole genome testing than it is to sequence a single gene. An attribute of these approaches is that information gleaned will often have uncertain significance. In addition to the challenges this presents for pre-test counseling and informed consent, a further consideration emerges over how - ethically - we should conceive of and respond to this uncertainty. To date, the ethical aspects of uncertainty in genomics have remained under-explored. In this paper, we draft a conceptual and ethical response to the question of how to conceive of and respond to uncertainty in genomic medicine. After introducing the problem, we articulate a concept of 'genomic uncertainty'. Drawing on this, together with exemplar clinical cases and related empirical literature, we then critique the presumption that uncertainty is always problematic and something to be avoided, or eradicated. We conclude by outlining an 'ethics of genomic uncertainty'; describing how we might handle uncertainty in genomic medicine. This involves fostering resilience, welfare, autonomy and solidarity. Uncertainty will be an inherent aspect of clinical practice in genomics for some time to come. Genomic testing should not be offered with the explicit aim to reduce uncertainty. Rather, uncertainty should be appraised, adapted to and communicated about as part of the process of offering and providing genomic information.

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

NASA Astrophysics Data System (ADS)

Berne, Birgitta

2014-11-01

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

Oocyte cryopreservation beyond cancer: tools for ethical reflection.

PubMed

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

2015-08-01

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

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.

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

PubMed

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

2017-03-01

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

Quality of life and ethics.

PubMed

Fumincelli, Laís; Mazzo, Alessandra; Martins, José Carlos Amado; Mendes, Isabel Amélia Costa

2017-01-01

In health, ethics is an essential aspect of practice and care and guarantees a better quality of life for patients and their caregivers. To outline a conceptual analysis of quality of life and ethics, identifying attributes, contexts and magnitudes for health. A qualitative design about quality of life and ethics in health, considering the evolutionary approach in order to analyse the concept. To collect the data, a search was done using the keywords ethic*, quality of life and health. After, in total, 152 studies were found, finalizing seven relevant studies for the proposed concept analysis. Of seven studies analysed, their main results were shown by means of antecedents, consequences and attributes of the concepts. The three final attributes that synthesize the concept of quality of life and ethics in health were highlighted: Ethics dilemmas and quality of life; Human ethics and quality of life; and Ethics of care and quality of life. In fact, the attributes and context clearly reveal that ethics and quality of life influence the ability to solve ethical dilemmas, guarantee human ethics in healthcare and impact ethics in healthcare for the production of effective health policies and care that encompasses professional quality of life as well. The magnitude of ethical knowledge in each professional discipline permits cultivating a solidary attitude and developing the willingness to improve healthcare. The right to access, dignity and respect in care delivery are rooted in behaviours and are spontaneously applied in practice to the extent that they play an ethical role.

Engaging Elementary School Pre-Service Teachers in Modeling a Socioscientific Issue as a Way to Help Them Appreciate the Social Aspects of Science

ERIC Educational Resources Information Center

Evagorou, Maria; Mauriz, Blanca Puig

2017-01-01

Socioscientific issues are ill-structured problems that involve moral, ethical, and financial aspects, and lack clear-cut solutions. Teaching socioscientific issues necessarily puts a demand on teachers to draw on knowledge stemming from other domains, and to also appreciate, and present to the students the societal aspects of science. For new…

The teaching of medical ethics to medical students.

PubMed Central

Glick, S M

1994-01-01

Teaching medical ethics to medical students in a pluralistic society is a challenging task. Teachers of ethics have obligations not just to teach the subject matter but to help create an academic environment in which well motivated students have reinforcement of their inherent good qualities. Emphasis should be placed on the ethical aspects of daily medical practice and not just on the dramatic dilemmas raised by modern technology. Interdisciplinary teaching should be encouraged and teaching should span the entire duration of medical studies. Attention should be paid particularly to ethical problems faced by the students themselves, preferably at the time when the problems are most on the students' minds. A high level of academic demands, including critical examination of students' progress is recommended. Finally, personal humility on the part of teachers can help set a good example for students to follow. PMID:7861430

Technological innovations in forensic genetics: social, legal and ethical aspects.

PubMed

Wienroth, Matthias; Morling, Niels; Williams, Robin

2014-01-01

This paper discusses the nature of four waves of technological innovations in forensic genetics alongside the social, legal and ethical aspect of these innovations. It emphasises the way in which technological advances and their socio-legal frameworks are co-produced, shaping technology expectations, social identities, and legal institutions. It also considers how imagined and actual uses of forensic genetic technologies are entangled with assertions about social order, affirmations of common values and civil rights, and promises about security and justice. Our comments seek to encourage the participation of scientific actors in the development of anticipatory governance deliberations concerning the widening application of forensic genetics in an increasing number of criminal and civil jurisdictions.

Body measures: phenomenological considerations of corporeal ethics.

PubMed

Fielding, H A

1998-08-01

The development of bioethics primarily at the cognitive level further perpetuates the tendency to construe all aspects of our lives, including our bodies, as technical systems. For example, if we consider the moral issue of organ sales without taking our embodiment into account there appear to be no sound arguments for opposing such sales. However, it is important to consider the aspects of the phenomenal body that challenge rational deliberation by exploring an embodied approach to the ethical dilemma produced by a proposed kidney exchange as presented in one of Krzysztof Kieślowski's Dekalog films. What is sought is a description of a body-measure that would serve as a critique of strictly cognitive bioethical deliberations.

Written institutional ethics policies on euthanasia: an empirical-based organizational-ethical framework.

PubMed

Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Schotsmans, Paul; Gastmans, Chris

2014-05-01

As euthanasia has become a widely debated issue in many Western countries, hospitals and nursing homes especially are increasingly being confronted with this ethically sensitive societal issue. The focus of this paper is how healthcare institutions can deal with euthanasia requests on an organizational level by means of a written institutional ethics policy. The general aim is to make a critical analysis whether these policies can be considered as organizational-ethical instruments that support healthcare institutions to take their institutional responsibility for dealing with euthanasia requests. By means of an interpretative analysis, we conducted a process of reinterpretation of results of former Belgian empirical studies on written institutional ethics policies on euthanasia in dialogue with the existing international literature. The study findings revealed that legal regulations, ethical and care-oriented aspects strongly affected the development, the content, and the impact of written institutional ethics policies on euthanasia. Hence, these three cornerstones-law, care and ethics-constituted the basis for the empirical-based organizational-ethical framework for written institutional ethics policies on euthanasia that is presented in this paper. However, having a euthanasia policy does not automatically lead to more legal transparency, or to a more professional and ethical care practice. The study findings suggest that the development and implementation of an ethics policy on euthanasia as an organizational-ethical instrument should be considered as a dynamic process. Administrators and ethics committees must take responsibility to actively create an ethical climate supporting care providers who have to deal with ethical dilemmas in their practice.

How do nursing home doctors involve patients and next of kin in end-of-life decisions? A qualitative study from Norway.

PubMed

Romøren, Maria; Pedersen, Reidar; Førde, Reidun

2016-01-14

Ethically challenging critical events and decisions are common in nursing homes. This paper presents nursing home doctors' descriptions of how they include the patient and next of kin in end-of-life decisions. We performed ten focus groups with 30 nursing home doctors. Advance care planning; aspects of decisions on life-prolonging treatment, and conflict with next of kin were subject to in-depth analysis and condensation. The doctors described large variations in attitudes and practices in all aspects of end-of-life decisions. In conflict situations, many doctors were more concerned about the opinion of next of kin than ensuring the patient's best interest. Many end-of-life decisions appear arbitrary or influenced by factors independent of the individual patient's values and interests and are not based on systematic ethical reflections. To protect patient autonomy in nursing homes, stronger emphasis on legal and ethical knowledge among nursing home doctors is needed.

Ethical aspects of directly observed treatment for tuberculosis: a cross-cultural comparison

PubMed Central

2013-01-01

Background Tuberculosis is a major global public health challenge, and a majority of countries have adopted a version of the global strategy to fight Tuberculosis, Directly Observed Treatment, Short Course (DOTS). Drawing on results from research in Ethiopia and Norway, the aim of this paper is to highlight and discuss ethical aspects of the practice of Directly Observed Treatment (DOT) in a cross-cultural perspective. Discussion Research from Ethiopia and Norway demonstrates that the rigid enforcement of directly observed treatment conflicts with patient autonomy, dignity and integrity. The treatment practices, especially when imposed in its strictest forms, expose those who have Tuberculosis to extra burdens and costs. Socially disadvantaged groups, such as the homeless, those employed as day labourers and those lacking rights as employees, face the highest burdens. Summary From an ethical standpoint, we argue that a rigid practice of directly observed treatment is difficult to justify, and that responsiveness to social determinants of Tuberculosis should become an integral part of the management of Tuberculosis. PMID:23819555

* Ethical Issues in the Use of Animal Models for Tissue Engineering: Reflections on Legal Aspects, Moral Theory, Three Rs Strategies, and Harm-Benefit Analysis.

PubMed

Liguori, Gabriel R; Jeronimus, Bertus F; de Aquinas Liguori, Tácia T; Moreira, Luiz Felipe P; Harmsen, Martin C

2017-12-01

Animal experimentation requires a solid and rational moral foundation. Objective and emphatic decision-making and protocol evaluation by researchers and ethics committees remain a difficult and sensitive matter. This article presents three perspectives that facilitate a consideration of the minimally acceptable standard for animal experiments, in particular, in tissue engineering (TE) and regenerative medicine. First, we review the boundaries provided by law and public opinion in America and Europe. Second, we review contemporary moral theory to introduce the Neo-Rawlsian contractarian theory to objectively evaluate the ethics of animal experiments. Third, we introduce the importance of available reduction, replacement, and refinement strategies, which should be accounted for in moral decision-making and protocol evaluation of animal experiments. The three perspectives are integrated into an algorithmic and graphic harm-benefit analysis tool based on the most relevant aspects of animal models in TE. We conclude with a consideration of future avenues to improve animal experiments.

Soldiers as subjects of medical research: Comments on Hassidim et al. on ethical standards of the Israel Defense Force.

PubMed

Kasher, Asa

2017-01-01

In 2008 a group of former soldiers of the Israel Defense Force (IDF) sued the Ministry of Defense and others, claiming they had suffered from medical problems that resulted from an IDF medical experiment in which they had participated in the 1970s. There was no compelling medical evidence with respect to causal relationships between their participation in the experiment and their later medical problems. The President of the District Court, Justice Hila Gerstl, appointed me, with the consent of the parties, to write a deposition with respect to the ethical aspects of the case. My comments in the sequel rest on my deposition, applying not only to the case that had been under discussion but also to each and every case of experimentation. My arguments, strictly confined to the ethical aspects of the case, as opposed to the legal aspects and the debated facts, were not in favor of either party. As a result the state and the former soldiers reached an agreement approved by the court. One of the major points made in that deposition is that the Nuremberg and Helsinki principles follow from those of medical ethics in general, except for the requirement to have an Institutional Review Board (IRB). A second major point is that under very strict conditions, more than what is usually required, soldiers may participate in medical experiments administered by their military force. However, new conscripts during their first months of their service should not take part in medical experimentation within their military force.

Fetal therapy for Down syndrome: an ethical exploration.

PubMed

de Wert, Guido; Dondorp, Wybo; Bianchi, Diana W

2017-03-01

Parallel to recent advances in prenatal screening for Down syndrome (DS), therapies for different aspects of the condition have become available. As intellectual disability is a key aspect, this is an active area for research. Several groups have hypothesized that prenatal interventions will give better chances at improving cognitive functioning in persons with DS than postnatal treatment. Clinical trials are being developed. We first discuss the ethical pros and cons of trying to improve cognitive functioning in persons with DS to see if there are categorical objections to the general idea, and then move on to explore ethically relevant aspects of the prospect of developing fetal therapy for DS (FTDS). Only on the basis of a one-dimensional emphasis on the social model of disability would (fetal) therapy aimed at cognitive improvement be inherently problematic. Inviting pregnant women to participate in FTDS-research should be based on adequate pre-clinical trials, as well as information aimed at avoiding the so-called 'therapeutic misconception'. Should FTDS be proven to be effective and safe, women carrying a fetus with trisomy 21 who have decided to continue the pregnancy may have a moral obligation to make use of this option. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

[Man's place and anthropology in bioethics].

PubMed

Tomar Romero, Francisca

2013-01-01

From the analysis of its epistemological status, the article focuses on the philosophical fundament of bioethics, stressing the need for an authentic anthropology as a reference or starting point. Being an applied ethics, the first fundament of bioethics is in ethics. It shows how only personalistic ethics, which takes as reference the nature or essence of man, can offer objective and universal criteria. Philosophical anthropology studies man as a whole, in an integral manner, from the perspective of its nature or fundamental aspects of his being. It analyzes the distinction and relationship between the philosophical anthropology and the positive anthropologies, as well as with the physical, human and social sciences. Finally, it reflects on the current anthropological crisis and its ethical consequences.

[Hunger striking in prisons: ethics and the ethical and legal aspects].

PubMed

García-Guerrero, J

2013-01-01

Hunger strike is a common form of protest in prisons and is a potential cause of many types of problems, both for the prison administration and the doctors who care for prisoners who participate in one. Issues of conflict of rights and obligations involved, and how to treat people who are subject to the Administration, which in this case takes the position of guarantor, have created major controversies over doctrine. Conscientious objection and the conflict of dual loyalty of doctors working in prisons are also issues closely linked to a prison hunger strike. In this paper we review the solution given to the problem of treatment of a prison hunger strike from three perspectives: ethics, ethical and legal.

Ethics and the UN Sustainable Development Goals: The Case for Comprehensive Engineering : Commentary on "Using Student Engagement to Relocate Ethics to the Core of the Engineering Curriculum".

PubMed

van den Hoven, Jeroen

2016-12-27

In the twenty-first century, the urgent problems the world is facing (the UN Sustainable Development Goals) are increasingly related to vast and intricate 'systems of systems', which comprise both socio-technical and eco-systems. In order for engineers to adequately and responsibly respond to these problems, they cannot focus on only one technical or any other aspect in isolation, but must adopt a wider and multidisciplinary perspective of these systems, including an ethical and social perspective. Engineering curricula should therefore focus on what we call 'comprehensive engineering'. Comprehensive engineering implies ethical coherence, consilience of scientific disciplines, and cooperation between parties.

Ethical issues in research with children and young people.

PubMed

Matutina, Robin E

2009-10-01

This article, which concentrates largely on literature from the United States, discusses the ethical aspects of research with children, beginning with the historical ill-treatment of children and extending to the present-day protections. Researchers struggle to find the balance that would most benefit this vulnerable population. Children must be protected but society deserves the knowledge that can only be gained through child-specific research. Ethical questions arise through the presentation of historical and current cases of children involved in or excluded from research. Examples of ethical dilemmas are presented in an effort to allow the reader to learn from the past while seeking to provide research-based care today. Strategies are included to help safeguard the autonomy of the child who participates in research.

[The environment and health. Of the difficulty of reconciling environmental and health standards in cultural nature].

PubMed

Mittelstrass, J

1989-09-15

Scientific cultures, i.e. modern industrial societies, create their own environment. The expression denoting such a creation is a Kultur-Natur ('cultural nature') determined by environmental and health standards. These standards are neither natural laws nor can they be derived from nature. They are instead a part of human rationality. They also have an ethical dimension. The argument focuses on the following aspects: (scientific and technological) rationality as problem solver and problem producer, exploration of the concept of the Kultur-Natur, the status of environmental and health standards, presenting the case for the concept of rational ethics (Vernunftethik) against the concept of ecological ethics and the supplementation of a research imperative by an ethical imperative.

Resolving ethical issues in stem cell clinical trials: the example of Parkinson disease.

PubMed

Lo, Bernard; Parham, Lindsay

2010-01-01

Clinical trials of stem cell transplantation raise ethical issues that are intertwined with scientific and design issues, including choice of control group and intervention, background interventions, endpoints, and selection of subjects. We recommend that the review and IRB oversight of stem cell clinical trials should be strengthened. Scientific and ethics review should be integrated in order to better assess risks and potential benefits. Informed consent should be enhanced by assuring that participants comprehend key aspects of the trial. For the trial to yield generalizable knowledge, negative findings and serious adverse events must be reported.

Social and ethical issues in environmental risk management.

PubMed

Oughton, Deborah H

2011-07-01

The recognition of the social and ethical aspects of radiation risk management has been an important part of international projects following the Chernobyl accident of 1986. This study comments on the science and policy issues in environmental risk assessment, including the social and ethical dimensions of emergency preparedness and remediation experiences gained from the Chernobyl accident. While the unique situation of Fukushima, combined with an earthquake and tsunami, raises its own social and political challenges, it is hoped that some of the lessons learnt from Chernobyl will be relevant to long-term management of the Fukushima site. Copyright © 2011 SETAC.

[Ethics of research in psychiatry. Comparison of France and the United States].

PubMed

Lemoine, P; Pacault-Legendre, V

1983-01-01

This article presents a comparison of research ethics in psychopharmacology in France and the United States. The authors present some elements of definition, etymology and of history. In addition, they study how this very specific research is actually done. Many questions are discussed, including the right of the patient, and the problem of normal volunteers. Other aspects are more technical i.e. remuneration, protocol, and the product. Finally the role of the ethics committees is investigated. These committees comprise the third component of the trial that consists of the research and the subject.

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.

Knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses from a resource poor setting, Nepal.

PubMed

Adhikari, Samaj; Paudel, Kumar; Aro, Arja R; Adhikari, Tara Ballav; Adhikari, Bipin; Mishra, Shiva Raj

2016-11-08

Healthcare ethics is neglected in clinical practice in LMICs (Low and Middle Income Countries) such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal. This was a cross sectional study conducted among resident doctors (n = 118) and ward nurses (n = 86) in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire. A Cramer's V value was assessed to ascertain the strength of the differences in the variables between doctors and nurses. Association of variables were determined by Chi square and statistical significance was considered if p value was less than 0.05. Our study demonstrated that a significant proportion of the doctors and nurses were unaware of major documents of healthcare ethics: Hippocratic Oath (33 % of doctors and 51 % of nurses were unaware), Nuremberg code (90 % of both groups were unaware) and Helsinki Declaration (85 % of doctors and 88 % of nurses were unaware). A high percentage of respondents said that their major source of information on healthcare ethics were lectures (67.5 % doctors versus 56.6 % nurses), books (62.4 % doctors versus 89.2 % nurses), and journals (59 % doctors versus 89.2 % nurses). Attitude of doctors and nurses were significantly different (p < 0.05) in 9 out of 22 questions pertaining to different aspects of healthcare ethics. More nurses had agreement than doctors on the tested statements pertaining to different aspects of healthcare ethics except for need of integration of medical ethics in ungraduate curricula (97.4 % doctors versus 81.3 % nurses),paternalistic attitude of doctor was disagreed more by doctors (20.3 % doctors versus 9.3 % nurses). Notably, only few (9.3 % doctors versus 14.0 % nurses) doctors stood in support of physician-assisted dying. Significant proportion of doctors and nurses were unaware of three major documents on healthcare ethics which are the core principles in clinical practice. Provided that a high percentage of respondents had motivation for learning medical ethics and asked for inclusion of medical ethics in the curriculum, it is imperative to avail information on medical ethics through subscription of journals and books on ethics in medical libraries in addition to lectures and training at workplace on medical ethics which can significantly improve the current paucity of knowledge on medical ethics.

European Union. Ethical considerations for clinical trials on medicinal products conducted with the paediatric population.

PubMed

2008-07-01

This document has been developed by the ad hoc group for the development of implementing guidelines for Directive 2001/20/EC relating to good clinical practice in the conduct of clinical trials on medicinal products for human use, chaired by the European Commission. The document provides recommendations on various ethical aspects of clinical trials performed in children from birth up to the legal age of adulthood. This will contribute to the protection of all children who are the subject of clinical trials. As the approval of clinical trials, including ethical approval, is performed by the Member States, any recommendations on ethical aspects of clinical trials in children will also facilitate a harmonised approach to the application of the clinical trials directive across the EU, thereby facilitating the conduct of clinical trials in the EU and in whichever country the paediatric trial occurs. The protection against the risks of research in such a vulnerable population is paramount whilst this should not lead to denying them the benefits of research. Children are not small adults and there is a need to carry out specific trials that cannot be performed in adults. In general, children (minors) are unable to consent (in the legal sense) but their assent should be sought using age appropriate information. Ethics Committees need paediatric expertise to balance the benefits and risks of research in children. The lack of legal ability to consent has implications on the design, analysis and the choice of comparators used in trials, which should only be performed by trained investigators with paediatric experience. Pain, fear, distress and parental separation should be prevented and minimised when unavoidable. The neonate represents the most vulnerable of all paediatric age groups and requires even more careful review. Finally, various other aspects relating to the performance of trials in children are discussed.

Emotions, narratives, and ethical mindfulness.

PubMed

Guillemin, Marilys; Gillam, Lynn

2015-06-01

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

Obstacles and problems of ethical leadership from the perspective of nursing leaders: a qualitative content analysis.

PubMed

Barkhordari-Sharifabad, Maasoumeh; Ashktorab, Tahereh; Atashzadeh-Shoorideh, Foroozan

2017-01-01

In the nursing profession, leadership plays a significant role in creating motivation and thus enabling nurses to provide high quality care. Ethics is an essential component of leadership qualifications and the ethical leader can help create an ethical atmosphere, offer ethical guidance, and ensure the occupational satisfaction of personnel through prioritizing moralities. However, some issues prevent the implementation of this type of leadership by nursing leaders. The aim of this study was to identify and describe some problems and obstacles in ethical leadership faced by nursing leaders, and to help them achieve more accurate information and broader perspective in this field. The present study was conducted using a qualitative approach and content analysis. A total of 14 nursing managers and educators were selected purposefully, and deep and semi-structured interviews were conducted with them. Content analysis was performed using an inductive approach. Three main categories were obtained after data analysis: ethical, cultural and managerial problems. "Ethical problems" pertain to doubt in ethical actions, ethical conflicts and ethical distress; "cultural problems" include organizational and social culture; and "managerial problems" are connected to organizational and staff-related issues. Nursing leaders put forth various aspects of the problems associated with ethical leadership in the clinical setting. This style of leadership could be promoted by developing suitable programs and providing clear-cut strategies for removing the current obstacles and correcting the organizational structure. This can lead to ethical improvement in nursing leaders and subsequently the nurses.

Obstacles and problems of ethical leadership from the perspective of nursing leaders: a qualitative content analysis

PubMed Central

Barkhordari-Sharifabad, Maasoumeh; Ashktorab, Tahereh; Atashzadeh-Shoorideh, Foroozan

2017-01-01

In the nursing profession, leadership plays a significant role in creating motivation and thus enabling nurses to provide high quality care. Ethics is an essential component of leadership qualifications and the ethical leader can help create an ethical atmosphere, offer ethical guidance, and ensure the occupational satisfaction of personnel through prioritizing moralities. However, some issues prevent the implementation of this type of leadership by nursing leaders. The aim of this study was to identify and describe some problems and obstacles in ethical leadership faced by nursing leaders, and to help them achieve more accurate information and broader perspective in this field. The present study was conducted using a qualitative approach and content analysis. A total of 14 nursing managers and educators were selected purposefully, and deep and semi-structured interviews were conducted with them. Content analysis was performed using an inductive approach. Three main categories were obtained after data analysis: ethical, cultural and managerial problems. “Ethical problems” pertain to doubt in ethical actions, ethical conflicts and ethical distress; “cultural problems” include organizational and social culture; and “managerial problems” are connected to organizational and staff-related issues. Nursing leaders put forth various aspects of the problems associated with ethical leadership in the clinical setting. This style of leadership could be promoted by developing suitable programs and providing clear-cut strategies for removing the current obstacles and correcting the organizational structure. This can lead to ethical improvement in nursing leaders and subsequently the nurses. PMID:28523116

Ethical aspects of clinical research with minors.

PubMed

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

2013-07-01

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

Legal and ethical issues in research

PubMed Central

Yip, Camille; Han, Nian-Lin Reena; Sng, Ban Leong

2016-01-01

Legal and ethical issues form an important component of modern research, related to the subject and researcher. This article seeks to briefly review the various international guidelines and regulations that exist on issues related to informed consent, confidentiality, providing incentives and various forms of research misconduct. Relevant original publications (The Declaration of Helsinki, Belmont Report, Council for International Organisations of Medical Sciences/World Health Organisation International Guidelines for Biomedical Research Involving Human Subjects, World Association of Medical Editors Recommendations on Publication Ethics Policies, International Committee of Medical Journal Editors, CoSE White Paper, International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use-Good Clinical Practice) form the literature that are relevant to the ethical and legal aspects of conducting research that researchers should abide by when conducting translational and clinical research. Researchers should note the major international guidelines and regional differences in legislation. Hence, specific ethical advice should be sought at local Ethics Review Committees. PMID:27729698

Animal experimentation.

PubMed

Kolar, Roman

2006-01-01

Millions of animals are used every year in often times extremely painful and distressing scientific procedures. Legislation of animal experimentation in modern societies is based on the supposition that this is ethically acceptable when certain more or less defined formal (e.g. logistical, technical) demands and ethical principles are met. The main parameters in this context correspond to the "3Rs" concept as defined by Russel and Burch in 1959, i.e. that all efforts to replace, reduce and refine experiments must be undertaken. The licensing of animal experiments normally requires an ethical evaluation process, often times undertaken by ethics committees. The serious problems in putting this idea into practice include inter alia unclear conditions and standards for ethical decisions, insufficient management of experiments undertaken for specific (e.g. regulatory) purposes, and conflicts of interest of ethics committees' members. There is an ongoing societal debate about ethical issues of animal use in science. Existing EU legislation on animal experimentation for cosmetics testing is an example of both the public will for setting clear limits to animal experiments and the need to further critically examine other fields and aspects of animal experimentation.

[Ethics in clinical practice and in health care].

PubMed

Pintor, S; Mennuni, G; Fontana, M; Nocchi, S; Giarrusso, P; Serio, A; Fraioli, A

2015-01-01

The clinical ethics is the identification, analysis and solution of moral problems that can arise during the care of a patient. Given that when dealing with ethical issues in health care some risks will be encountered (talking about ethics in general, or as a problem overlapped with others in this area, or by delegation to legislative determinations) in the text certain important aspects of the topic are examined. First of all ethics as human quality of the relationship between people for the common good, especially in health services where there are serious problems like the life and the health. It is also necessary a "humanizing relationship" between those who work in these services in order to achieve quality and efficiency in this business. It is important a proper training of health professionals, especially doctors, so that they can identify the real needs and means of intervention. It is also important that scientific research must respect fundamental ethical assumptions. In conclusion, ethics in health care is not a simple matter of "cookbook" rules, but involves the responsibility and consciousness of individual operators.

Ethics Across the Curriculum: Prospects for Broader (and Deeper) Teaching and Learning in Research and Engineering Ethics.

PubMed

Mitcham, Carl; Englehardt, Elaine E

2016-08-22

The movements to teach the responsible conduct of research (RCR) and engineering ethics at technological universities are often unacknowledged aspects of the ethics across the curriculum (EAC) movement and could benefit from explicit alliances with it. Remarkably, however, not nearly as much scholarly attention has been devoted to EAC as to RCR or to engineering ethics, and RCR and engineering ethics educational efforts are not always presented as facets of EAC. The emergence of EAC efforts at two different institutions-the Illinois Institute of Technology and Utah Valley University (UVU)-provide counter examples. The remarkably successful UVU initiative gave birth to EAC as a scholarly movement and to the associated Society for Ethics Across the Curriculum. EAC initiatives at the Colorado School of Mines, however, point up continuing institutional resistances to EAC. Finally, comparative reflection on successes and failures can draw some lessons for the future. One suggestion is that increasing demands for accountability and pedagogical research into what works in teaching and learning offers special opportunities.

Towards a specific approach to education in dental ethics: a proposal for organising the topics of biomedical ethics for dental education.

PubMed

Gorkey, Sefik; Guven, Tolga; Sert, Gurkan

2012-01-01

Understanding dental ethics as a field separate from its much better known counterpart, medical ethics, is a relatively new, but necessary approach in bioethics. This need is particularly felt in dental education and establishing a curriculum specifically for dental ethics is a challenging task. Although certain topics such as informed consent and patient rights can be considered to be of equal importance in both fields, a number of ethical issues in dental practice are only remotely-if at all-relevant for medical practice. Therefore, any sound approach to education in dental ethics has to recognise the unique aspects of dental practice in order to meet the needs of dental students and prepare them for the ethical challenges they may face during their professional practice. With this goal in mind, this paper examines the approach of the authors to dental ethics education and proposes a system to organise the topics of biomedical ethics for dental education. While the authors' perspective is based on their experience in Turkey, the proposed system of classification is not a rigid one; it is open to interpretation in other contexts with different social, cultural and professional expectations. Therefore, the paper also aims to inspire discussion on the development of an ideal dental ethics curriculum at an international level.

Philosophocal and legislation aspects of surrogacy.

PubMed

Zakariadze, A

2011-06-01

Among current bioethical issues one of the most dilemmatic is an issue of surrogacy. It causes great moral, ethical and legal debate. The article aims to show philosophical and legislation aspects of surrogacy. The meaning of "motherhood", "kinship", "liberty" in connection with surrogacy is analyzed. The article provides an overview of Georgian Orthodox Church on surrogate motherhood.

The nuclear dilemma and the just war tradition

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

O'Brien, W.V.; Langan, J.

This book presents papers on the ethical aspects of nuclear weapons. Topics considered include the concept of a ''just'' war, national defense, political aspects, religion and politics, the failure of deterrence, conventional warfare, nuclear deterrence and democratic politics, the future of the nuclear debate, non-proliferation policy, arms control, national security, and government policies.

Is Judgement of Biotechnological Ethical Aspects Related to High School Students' Knowledge?

ERIC Educational Resources Information Center

Crne-Hladnik, Helena; Hladnik, Ales; Javornik, Branka; Kosmelj, Katarina; Peklaj, Cirila

2012-01-01

Quantitative and qualitative studies of various aspects of the perception of biotechnology were conducted among 469 Slovenian high school students of average age 17 years. Our research aimed to explore relationships among students' pre-knowledge of molecular and human genetics, and their attitudes to four specific biotechnological applications.…

AIDS-MEDICOLEGAL ASPECTS.

PubMed

Kotabagi, R B; Pathak, P R; Apte, V V

1999-04-01

AIDS/HIV Positivity has been the most widely debated disease of this century. Reasons for this are manifold, viz-the non-availability of cure and consequent 100% mortality of a full blown case; its mode of transmission-homosexual and heterosexual activities; widespread occurrence amongst 'main liners'; and patients receiving blood and blood products etc. These aspects have created a dreaded halo around AIDS as well as social stigma. Even the medical community is not exempt from these problems. Unfortunately, legislatures around the world, more so in India, have lagged behind in clarifying many legal issues involved by not enacting specific laws pertaining to AIDS. Consequently many legal & ethical doubts arise in the minds of doctors when confronted with a case of AIDS either in a live patient or in a dead body. In addition, the disease being incurable & 100% fatal, makes it essential to adopt effective preventive measures which in turn need thorough knowledge of social aspects of the epidemic. Certain medicolegal, and ethical aspects of the problem of AIDS are recapitulated in this article for the benefit of the medical community.

Ethical issues in paleopathological and anthropological research experiences.

PubMed

Licata, Marta; Monza, Francesca

2017-10-23

In recent years, archaeologists and anthropologists involved in the study of human remains have had to take into consideration ethical issues, which have come to the fore. The aim of this study is to illustrate the ethical and religious issues involved in relation to the positions of researchers. Ethical issues involve the different study phases of human remains: archaeological excavation, anthropological analysis and, finally, museum display. Osteoarchaeological remains may find a place in museums. However, in recent years, even the display of human remains museum has had to face new important ethical issue involving previously ignored or neglected aspect. The adoption of Native American Grave Protection Act in 1990 in the United States and the Human Tissue Act in 2004 in England, has created new scenarios relating to the storage of human remains in museum. All this caused a series of changes in the study of human remains, but many issues remain open to debate.

Social and ethical aspects of forensic genetics: A critical review.

PubMed

Williams, R; Wienroth, M

2017-07-01

This review describes the social and ethical responses to the history of innovations in forensic genetics and their application to criminal investigations. Following an outline of the three recurrent social perspectives that have informed these responses (crime management, due process, and genetic surveillance), it goes on to introduce the repertoire of ethical considerations by describing a series of key reports that have shaped subsequent commentaries on forensic DNA profiling and databasing. Four major ethical concerns form the focus of the remainder of the paper (dignity, privacy, justice, and social solidarity), and key features of forensic genetic practice are examined in the light of these concerns. The paper concludes with a discussion of the concept of "proportionality" as a resource for balancing the social and ethical risks and benefits of the use of forensic genetics in support of criminal justice. Copyright © 2017 Central Police University.

Occupational health practice and exposure to nanoparticles: reconciling scientific evidence, ethical aspects, and legal requirements.

PubMed

Franco, Giuliano

2011-01-01

The paper aims at focusing the relationship between scientific evidence and ethical values' issues of occupational health practice according to the new Italian law 81/2008 stating that the occupational health physician (OHP) is required to act according to the Code of Ethics of the International Commission on Occupational Health. The code itself emphasizes that (i) the practice should be relevant, knowledge-based, sound, and appropriate to the occupational risks and (ii) the objectives and methods of health surveillance must be clearly defined. Because exposure to nanoparticles involves several uncertainties about health effects and may limit the effectiveness of workers' health surveillance, OHPs face a several ethical dilemmas, involving different stakeholders. The dilemmas arising from the practice should be dealt with according to the ethical principles of beneficence, autonomy, and justice in order to take a decision.

Ethics in psychiatry and psychoanalysis.

PubMed

Lothane, Z

1999-01-01

Ethics plays a dual role in psychiatry. The extrinsic role is in defining the rules of ethical conduct for the psychiatrist as a professional dealing with patients, peers and society at large. The intrinsic role is in defining ethical or moral conflict as a determining component in the construction of symptoms of mental disorder. Ethical considerations play a role in the truthful description of the disorder, diagnosis, dynamic formulation and the doctor-patient relationship in treatment. In treatment, there is a need to acknowledge 2 dimensions of psychological conflict: (1) an appraisal of the actual realistic moral conflicts due to symptomatic unethical conduct that goes against one's normative conscience, and (2) resolution of past conflicts arising from unconscious or repressed aspects of the neurotic conscience or superego, i.e. a holdover of unreflected obedience to parental authority. The resolution of past and ongoing conflicts promotes growth toward autonomy of moral judgment, free choice and moral responsibility.

Mitochondrial Replacement: Ethics and Identity

PubMed Central

Wilkinson, Stephen; Appleby, John B.

2015-01-01

Abstract Mitochondrial replacement techniques (MRTs) have the potential to allow prospective parents who are at risk of passing on debilitating or even life‐threatening mitochondrial disorders to have healthy children to whom they are genetically related. Ethical concerns have however been raised about these techniques. This article focuses on one aspect of the ethical debate, the question of whether there is any moral difference between the two types of MRT proposed: Pronuclear Transfer (PNT) and Maternal Spindle Transfer (MST). It examines how questions of identity impact on the ethical evaluation of each technique and argues that there is an important difference between the two. PNT, it is argued, is a form of therapy based on embryo modification while MST is, instead, an instance of selective reproduction. The article's main ethical conclusion is that, in some circumstances, there is a stronger obligation to use PNT than MST. PMID:26481204

[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.

Ethics and subsequent use of electronic health record data.

PubMed

Lee, Lisa M

2017-07-01

The digital health landscape in the United States is evolving and electronic health record data hold great promise for improving health and health equity. Like many scientific and technological advances in health and medicine, there exists an exciting narrative about what we can do with the new technology, as well as reflection about what we should do with it based on what we value. Ethical reflections about the use of EHR data for research and quality improvement have considered the important issues of privacy and informed consent for subsequent use of data. Additional ethical aspects are important in the conversation, including data validity, patient obligation to participate in the learning health system, and ethics integration into training for all personnel who interact with personal health data. Attention to these ethical issues is paramount to our realizing the benefits of electronic health data. Published by Elsevier Inc.

[Ethical aspects of human embryonic stem cell use and commercial umbilical cord blood stem cell banking. Ethical reflections on the occasion of the regulation of the European Council and Parliament on advanced therapy medicinal products].

PubMed

Virt, G

2010-01-01

The regulation of the European Council and Parliament on advanced therapy medicinal products also includes therapies with human embryonic stem cells. The use of these stem cells is controversially and heavily discussed. Contrary to the use of adult stem cells, medical and ethical problems concerning the use of human embryonic stem cells persists, because this use is based on the destruction of human life at the very beginning. The regulation foresees, therefore, subsidiarity within the European Member States. Although there are no ethical problems in principle with the use of stem cells from the umbilical cord blood, there are social ethical doubts with the banking of these stem cells for autologous use without any currently foreseeable medical advantage by commercial blood banks. Also in this case subsidiarity is valid.

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.

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

PubMed

Mullen, Caroline

2008-12-01

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

Conflicts Between Parents and Health Professionals About a Child's Medical Treatment: Using Clinical Ethics Records to Find Gaps in the Bioethics Literature.

PubMed

McDougall, Rosalind; Notini, Lauren; Phillips, Jessica

2015-09-01

Clinical ethics records offer bioethics researchers a rich source of cases that clinicians have identified as ethically complex. In this paper, we suggest that clinical ethics records can be used to point to types of cases that lack attention in the current bioethics literature, identifying new areas in need of more detailed bioethical work. We conducted an analysis of the clinical ethics records of one paediatric hospital in Australia, focusing specifically on conflicts between parents and health professionals about a child's medical treatment. We identified, analysed, and compared cases of this type from the clinical ethics records with cases of this type discussed in bioethics journals. While the cases from journals tended to describe situations involving imminent risk to the child's life, a significant proportion of the clinical ethics records cases involved different stakes for the child involved. These included distress, poorer functional outcome, poorer psychosocial outcome, or increased risk of surgical complications. Our analysis suggests that one type of case that warrants more detailed ethics research is parental refusal of recommended treatment, where the refusal does not endanger the child's life but rather some other aspect of the child's well-being.

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

Comparison of Nigerian high school male athletes and nonathletes on self-concept.

PubMed

Salokun, S O

1990-06-01

Nigerian high school athletes (112 high and 90 low in performance) and 108 nonathletes were administered the Tennessee Self-concept Scale. Athletes scored significantly higher on all self-concept subscales except behavior, moral-ethical and family. Better athletes scored significantly higher on all aspects of self-concept: social, moral-ethical, family and behavior, as is consistent with findings from the USA and other countries.

Ethicted (evaluation process model to improve personalised ICT services for independent living and active ageing)--future scenario.

PubMed

Kärki, Anne; Sävel, Jaana; Sallinen, Merja; Kuusinen, Jere

2013-01-01

ICT innovations are constantly developed, and there is no lack of elderly customers, as the number of the elderly is dramatically increasing. Elderly are willing to use ICT to increase their own safety and social activity, but they need trust on the reliability, accessibility and other ethical aspects of ICT including the maintenance of privacy and self-determination. Ethical standards for ICT are usually not considered. "Ethicted" characterizes an ICT service or product as ethically evaluated. As a standardized procedure, it will not only increase the acceptability of ICT, but also provide services for ICT developers. In the future scenario, ICT under development should be evaluated by using a process model that is specifically built to find the lacks in ethical aspects. The model would then be tested by end-users, the formal and informal care givers, to receive direct feedback for redeveloping solutions. As final outcomes, there should be standards for ICT in elderly care and a service for ICT developers to utilize the evaluation model. This future scenario work included partners from 6 EU member countries. The combination of academic research and industrial/commercial interest of ICT developers should and can bring new value to assistive ICT for elderly care.

Same same but different: why we should care about the distinction between professionalism and ethics.

PubMed

Salloch, Sabine

2016-07-22

Medical professionalism forms a belief system which is used to defend physicians' ethos against counterforces which might threaten the integrity of medical practice. The current debates on professionalism, however, are characterized by the lack of a clear distinction between professional and ethical aspects of physicians' conduct. This article argues that a differentiation between professionalism and ethics is not of mere academic interest. Instead, it is of great practical importance with regard to morally contentious issues in medicine.A short analysis of the discussions in history and social sciences reveals that professionalism is more than a catchphrase of modern medical debates but has a complex theoretical background which is still not conclusively understood. Whereas professionalism is clearly linked to the honorable aims of providing services to the individual and the society, it potentially entails problematic aspects, such as elitism, monopoly or the maintaining of power and privileges. With regard to morally contentious topics, the professional ethos of physicians must be differentiated from the perspective of ethics which can take a universal standpoint and has the potential to critically assess context-specific moral norms. The example of the current regulation on suicide assistance in German professional law is taken as an example to demonstrate how professional bodies tend to overstep the limits of their expertise and regulatory power with regard to issues which need an ethical evaluation.The article concludes that the narrowing of ethics and professionalism in public discussions and in medical education should be seen as problematic and that morally contentious topics in modern societies should be open to a participatory and inclusive discussion and democratic decision procedures.

Application of Ethics for Providing Telemedicine Services and Information Technology

PubMed Central

Langarizadeh, Mostafa; Moghbeli, Fatemeh; Aliabadi, Ali

2017-01-01

Introduction: Advanced technology has increased the use of telemedicine and Information Technology (IT) in treating or rehabilitating diseases. An increased use of technology increases the importance of the ethical issues involved. The need for keeping patients’ information confidential and secure, controlling a number of therapists’ inefficiency as well as raising the quality of healthcare services necessitates adequate heed to ethical issues in telemedicine provision. Aim: The goal of this review is gathering all articles that are published through 5 years until now (2012-2017) for detecting ethical issues for providing telemedicine services and Information technology. The reason of this time is improvement of telemedicine and technology through these years. This article is important for clinical practice and also to world, because of knowing ethical issues in telemedicine and technology are always important factors for physician and health providers. Material and methods: the required data in this research were derived from published electronic sources and credible academic articles published in such databases as PubMed, Scopus and Science Direct. The following key words were searched for in separation and combination: tele-health, telemedicine, ethical issues in telemedicine. A total of 503 articles were found. After excluding the duplicates (n= 93), the titles and abstracts of 410 articles were skimmed according to the inclusion criteria. Finally, 64 articles remained. They were reviewed in full text and 36 articles were excluded. At the end, 28 articles were chosen which met our eligibility criteria and were included in this study. Results: Ethics has been of a great significance in IT and telemedicine especially the Internet since there are more chances provided for accessing information. It is, however, accompanied by a threat to patients’ personal information. Therefore, suggestions are made to investigate ethics in technology, to offer standards and guidelines to therapists. Due to the advancement in technology, access to information has become simpler than the past. This has prompted hackers to seize the opportunity. Discussion: This research shows that the ethical issues in telemedicine can be investigated from several aspects like technology, doctor-patient relationship, data confidentiality and security, informed consent, patient’s and family’s satisfaction with telemedicine services. Following ethical issues in telemedicine is a primary aspect of high quality services. In other words, if therapists abide by ethical rules, they can provide better services for patients. Attention to ethical issues in telemedicine guarantees a safer use of the services. PMID:29284905

Getting comfortable with "comfort feeding": An exploration of legal and ethical aspects of the Australian speech-language pathologist's role in palliative dysphagia care.

PubMed

Kelly, Katherine; Cumming, Steven; Kenny, Belinda; Smith-Merry, Jennifer; Bogaardt, Hans

2018-06-01

With an ageing population, speech-language pathologists (SLPs) can expect to encounter legal and ethical challenges associated with palliative and end-of-life care more frequently. An awareness of the medico-legal and ethical framework for palliative dysphagia management will better equip SLPs to work effectively in this area. This narrative review examines a range of legislation, legal, ethical and SLP literature that is currently available to orient SLPs to legal and ethical palliative dysphagia management in the Australian context. Relevant legal and ethical considerations in palliative and end-of-life care are described. SLPs have a role in palliative dysphagia management, however, this can involve unique legal and ethical challenges. The legal position on provision and cessation of nutrition and hydration differs between Australian States and Territories. Decisions by the courts have established a body of relevant case law. This article introduces SLPs to some of the important considerations for legal and ethical palliative care, but is not intended to be directive. SLPs are encouraged to explore their local options for ethical and medico-legal guidance. It is hoped that increasing SLPs awareness of many of the concepts discussed in this article enhances the provision of high-quality patient-centred care.

Ethical practice in internet research involving vulnerable people: lessons from a self-harm discussion forum study (SharpTalk).

PubMed

Sharkey, Siobhan; Jones, Ray; Smithson, Janet; Hewis, Elaine; Emmens, Tobit; Ford, Tamsin; Owens, Christabel

2011-12-01

The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about the vulnerability of potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a 'report' button for participants, links to online support, and a discussion room for forum moderators. This experience with SharpTalk suggests that an approach to ethics, which recognises the relational aspects of research with vulnerable people, is particularly useful for internet-based health research. The solutions presented here can act as guidance for researchers developing proposals and for ethics committees reviewing them.

Ethical aspects of malaria control and research.

PubMed

Jamrozik, Euzebiusz; de la Fuente-Núñez, Vânia; Reis, Andreas; Ringwald, Pascal; Selgelid, Michael J

2015-12-22

Malaria currently causes more harm to human beings than any other parasitic disease, and disproportionally affects low-income populations. The ethical issues raised by efforts to control or eliminate malaria have received little explicit analysis, in comparison with other major diseases of poverty. While some ethical issues associated with malaria are similar to those that have been the subject of debate in the context of other infectious diseases, malaria also raises distinct ethical issues in virtue of its unique history, epidemiology, and biology. This paper provides preliminary ethical analyses of the especially salient issues of: (i) global health justice, (ii) universal access to malaria control initiatives, (iii) multidrug resistance, including artemisinin-based combination therapy (ACT) resistance, (iv) mandatory screening, (v) mass drug administration, (vi) benefits and risks of primaquine, and (vii) malaria in the context of blood donation and transfusion. Several ethical issues are also raised by past, present and future malaria research initiatives, in particular: (i) controlled infection studies, (ii) human landing catches, (iii) transmission-blocking vaccines, and (iv) genetically-modified mosquitoes. This article maps the terrain of these major ethical issues surrounding malaria control and elimination. Its objective is to motivate further research and discussion of ethical issues associated with malaria--and to assist health workers, researchers, and policy makers in pursuit of ethically sound malaria control practice and policy.

Doing what's right: A grounded theory of ethical decision-making in occupational therapy.

PubMed

VanderKaay, Sandra; Letts, Lori; Jung, Bonny; Moll, Sandra E

2018-04-20

Ethical decision-making is an important aspect of reasoning in occupational therapy practice. However, the process of ethical decision-making within the broader context of reasoning is yet to be clearly explicated. The purpose of this study was to advance a theoretical understanding of the process by which occupational therapists make ethical decisions in day-to-day practice. A constructivist grounded theory approach was adopted, incorporating in-depth semi-structured interviews with 18 occupational therapists from a range of practice settings and years of experience. Initially, participants nominated as key informants who were able to reflect on their decision-making processes were recruited. Theoretical sampling informed subsequent stages of data collection. Participants were asked to describe their process of ethical decision-making using scenarios from clinical practice. Interview transcripts were analyzed using a systematic process of initial then focused coding, and theoretical categorization to construct a theory regarding the process of ethical decision-making. An ethical decision-making prism was developed to capture three main processes: Considering the Fundamental Checklist, Consulting Others, and Doing What's Right. Ethical decision-making appeared to be an inductive and dialectical process with the occupational therapist at its core. Study findings advance our understanding of ethical decision-making in day-to-day clinical practice.

Ethics Literacy and "Ethics University": Two Intertwined Models for Public Involvement and Empowerment in Bioethics.

PubMed

Strech, Daniel; Hirschberg, Irene; Meyer, Antje; Baum, Annika; Hainz, Tobias; Neitzke, Gerald; Seidel, Gabriele; Dierks, Marie-Luise

2015-01-01

Informing lay citizens about complex health-related issues and their related ethical, legal, and social aspects (ELSA) is one important component of democratic health care/research governance. Public information activities may be especially valuable when they are used in multi-staged processes that also include elements of information and deliberation. This paper presents a new model for a public involvement activity on ELSA (Ethics University) and evaluation data for a pilot event. The Ethics University is structurally based on the "patient university," an already established institution in some German medical schools, and the newly developed concept of "ethics literacy." The concept of "ethics literacy" consists of three levels: information, interaction, and reflection. The pilot project consisted of two series of events (lasting 4 days each). The thematic focus of the Ethics University pilot was ELSA of regenerative medicine. In this pilot, the concept of "ethics literacy" could be validated as its components were clearly visible in discussions with participants at the end of the event. The participants reacted favorably to the Ethics University by stating that they felt more educated with regard to the ELSA of regenerative medicine and with regard to their own abilities in normative reasoning on this topic. The Ethics University is an innovative model for public involvement and empowerment activities on ELSA theoretically underpinned by a concept for "ethics literacy." This model deserves further refinement, testing in other ELSA topics and evaluation in outcome research.

A Nationwide Population-Based Approach to Study Health-Related and Psychosocial Aspects of Neurofibromatosis Type 1

DTIC Science & Technology

2015-07-01

Neurofibromatosis Type 1 PRINCIPAL INVESTIGATOR: Dr. Jeanette Falck Winther CONTRACTING ORGANIZATION: Danish Cancer Society Research Center Copenhagen, Denmark...Study Health-Related and Psychosocial Aspects of Neurofibromatosis Type 1 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...Clinics in Denmark and a clinical geneticist with expertise in ethical aspects. 15. SUBJECT TERMS Neurofibromatosis type 1, population-based, nation

[Global aspects of medical ethics: conditions and possibilities].

PubMed

Neitzke, G

2001-01-01

A global or universal code of medical ethics seems paradoxical in the era of pluralism and postmodernism. A different conception of globalisation will be developed in terms of a "procedural universality". According to this philosophical concept, a code of medical ethics does not oblige physicians to accept certain specific, preset, universal values and rules. It rather obliges every culture and society to start a culture-sensitive, continuous, and active discourse on specific issues, mentioned in the codex. This procedure might result in regional, intra-cultural consensus, which should be presented to an inter-cultural dialogue. To exemplify this procedure, current topics of medical ethics (spiritual foundations of medicine, autonomy, definitions concerning life and death, physicians' duties, conduct within therapeutic teams) will be discussed from the point of view of western medicine.

[Review of ethical aspects in biomedical research. The experience of the Ethics Committee of the Center for Toxic Oil Syndrome and Rare Diseases [CISATER

PubMed

Martín-Arribas, M C; Posada, M; Terracini, B; Carballo, F; Abaitua, I

2003-01-01

This Field Note aims to make known the decisions taken by the Ethics Committee of the Instituto de Salud Carlos III for Toxic Oil Syndrome regarding the secondary use of research specimens in biological research when informed consent is lacking. This is a common concern in the field of biomedical research. After debating the ethical suitability of the secondary use of these samples, our main conclusion is that researchers conducting prospective studies should expressly solicit written informed consent from participants in the study about i) whether there will or could be any secondary use of the samples and, if so, ii) whether such secondary use would be conditional on the type of research.

Neuroethics: a modern context for ethics in neuroscience

PubMed Central

Illes, Judy; Bird, Stephanie J.

2006-01-01

Neuroethics, a recently modernized field at the intersection of bioethics and neuroscience, is founded on centuries of discussion of the ethical issues associated with mind and behavior. Broadly defined, neuroethics is concerned with ethical, legal and social policy implications of neuroscience, and with aspects of neuroscience research itself. Advances in neuroscience increasingly challenge long-held views of the self and the individual's relationship to society. Neuroscience also has led to innovations in clinical medicine that have not only therapeutic but also non-therapeutic dimensions that extend well beyond previously charted boundaries. The exponential increase in cross-disciplinary research, the commercialization of cognitive neuroscience, the impetus for training in ethics, and the increased attention being paid to public understanding of science all illuminate the important role of neuroethics in neuroscience. PMID:16859760

Derivation and Implementation of a Protocol in Israel for Organ Donation after Cardio-Circulatory Death.

PubMed

Cohen, Jonathan; Rahamimov, Ruth; Hoffman, Aaron; Katvan, Eyal; Grozovski, Kyril; Ashkenazi, Tamar

2017-09-01

Strategies aimed at expanding the organ donor pool have been sought, which has resulted in renewed interest in donation after cardio-circulatory death (DCCD), also known as non-heart beating donors (NHBDs). To describe the derivation and implementation of a protocol for DCCD in Israel and report on the results with the first six cases. After receiving approval from an extraordinary ethics committee, Ministry of Health, the steering committee of the National Transplant Center defined and reached consensus on the unique challenges presented by a DCCD program. These protocol included medical aspects (construction of a clinical pathway), social and ethical aspects (presentation of the protocol at a public gathering(, legal/ethical aspects (consent for organ preservation procedures being either implied if the donor had signed an organ donor card or received directly from a surrogate decision maker), and logistical aspects (pilot study confined to kidney retrieval and to four medical centers). Data regarding organ donors and recipients were recorded. The protocol was implemented at four medical centers. Consent for organ donation was received from four of the six potential donors meeting criteria for inclusion, in all cases, from a surrogate decision maker. Of the eight kidneys retrieved, only four were suitable for transplantation, which was carried out successfully for four recipients. Graft function remained normal in all cases in 6-12 months follow-up. The DCCD program was successfully implemented and initial results are encouraging, suggesting that expansion of the program might further aid in decreasing the gap between needs and availability of organs.

Pandemic influenza preparedness: an ethical framework to guide decision-making.

PubMed

Thompson, Alison K; Faith, Karen; Gibson, Jennifer L; Upshur, Ross E G

2006-12-04

Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on values because science alone cannot tell us how to prepare for a public health crisis. In this paper, we present an ethical framework for pandemic influenza planning. The ethical framework was developed with expertise from clinical, organisational and public health ethics and validated through a stakeholder engagement process. The ethical framework includes both substantive and procedural elements for ethical pandemic influenza planning. The incorporation of ethics into pandemic planning can be helped by senior hospital administrators sponsoring its use, by having stakeholders vet the framework, and by designing or identifying decision review processes. We discuss the merits and limits of an applied ethical framework for hospital decision-making, as well as the robustness of the framework. The need for reflection on the ethical issues raised by the spectre of a pandemic influenza outbreak is great. Our efforts to address the normative aspects of pandemic planning in hospitals have generated interest from other hospitals and from the governmental sector. The framework will require re-evaluation and refinement and we hope that this paper will generate feedback on how to make it even more robust.

The Budapest Meeting 2005 intensified networking on ethics of science: the case of reproductive cloning, germline gene therapy and human dignity.

PubMed

Van Steendam, Guido; Dinnyés, András; Mallet, Jacques; Meloni, Rolando; Casabona, Carlos Romeo; González, Jorge Guerra; Kure, Josef; Szathmáry, Eörs; Vorstenbosch, Jan; Molnár, Péter; Edbrooke, David; Sándor, Judit; Oberfrank, Ferenc; Cole-Turner, Ron; Hargittai, István; Littig, Beate; Ladikas, Miltos; Mordini, Emilio; Roosendaal, Hans E; Salvi, Maurizio; Gulyás, Balázs; Malpede, Diana

2006-10-01

This paper reports on the meeting of the Sounding Board of the EU Reprogenetics Project that was held in Budapest, Hungary, 6-9 November 2005. The Reprogenetics Project runs from 2004 until 2007 and has a brief to study the ethical aspects of human reproductive cloning and germline gene therapy. Discussions during The Budapest Meeting are reported in depth in this paper as well as the initiatives to involve the participating groups and others in ongoing collaborations with the goal of forming an integrated network of European resources in the fields of ethics of science.

The Exploration Ethic: Its Historical-Intellectual Basis. Outlook for Space (1980 - 2000)

NASA Technical Reports Server (NTRS)

Priscoli, J. D.; Marney, M.

1975-01-01

Principle components of the exploration ethic are discussed. Attempts were made to justify both the historical and intellectual aspects of the concept. It was noted that intellectual justification is strongly grounded on: (1) the complementarity of objective and normative inquiry as to method, and (2) interdisciplinary alliance of ethics of adaptive systems with contemporary decision sciences, as a theoretical basis. Historical exploration justification was associated with: (1) periods of civilization transition, (2) changes in the process of exploration which cause change in types of rationals used, sponsors involved, and explorers interest, and (3) the incorrectness of proven prior cost/benefit calculations.

Facial transplants: current situation and ethical issues.

PubMed

Petrini, C

2015-01-01

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

The Education of People of the "Third Age"

ERIC Educational Resources Information Center

Gergokova, Zh. Kh.

2009-01-01

It was acknowledged by the Second United Nations World Assembly on Aging that this process is a global social and demographic reality that has had its impact on the entire world in all aspects of its existence--the traditional national, financial economic, political, and moral-ethical aspects. At the present time every state is confronted by the…

Ideals of Freedom and the Ethics of Thought--Meaning and Mystique

ERIC Educational Resources Information Center

Yun, Suninn

2016-01-01

This paper considers prominent forms of discourse in educational research, the nature of their appeal and the force of the idea of freedom within that appeal. For this, two different aspects of research are juxtaposed, aspects in which the value of freedom is articulated in contrasting ways. First, evidence-based education (EBE) is considered as a…

Incorporating Knowledge of Legal and Ethical Aspects into Computing Curricula of South African Universities

ERIC Educational Resources Information Center

Wayman, Ian; Kyobe, Michael

2012-01-01

As students in computing disciplines are introduced to modern information technologies, numerous unethical practices also escalate. With the increase in stringent legislations on use of IT, users of technology could easily be held liable for violation of this legislation. There is however lack of understanding of social aspects of computing, and…

[The ethics of dental records].

PubMed

Prinsloo, P M

2000-01-01

This article highlights five aspects of necessary record-keeping in practices: ethicolegal requirements, confidentiality and disclosure, risk management and consent, accounts and practice management, and forensic functions. Patient records therefore have ethical, moral, legal and management implications. Unfortunately, they are often underestimated or ignored by practitioners. In the light of increasing litigation and disciplinary hearings, it is necessary to remind practitioners that every clinical action also contains an administrative component which has to fulfill many requirements.

The cyber-aspects of virtual communities: free downloader ethics, cognition, and perceived service quality.

PubMed

Lin, Chin-Feng

2008-02-01

This study examined the downloader cognitive structures toward Web service quality and the downloader ethical attitudes across various levels of participation in a virtual community. Using four types of free downloads as the research subjects, the researcher found that the users in different participation degrees have different perception preferences. Owners of the free downloading Web sites can use the findings of this study to develop effective Web marketing strategies.

Is The Late Mandibular Fracture From Third Molar Extraction a Risk Towards Malpractice? Case Report with the Analysis of Ethical and Legal Aspects.

PubMed

Dos Santos Silva, Weuler; Silveira, Rubens Jorge; de Araujo Andrade, Michelle Gouveia Benicio; Franco, Ademir; Silva, Rhonan Ferreira

2017-01-01

The present study reports a case of late mandibular fracture due to third molar extraction and highlights the inherent clinical, ethical and legal aspects related to this surgical complication. A female patient underwent surgical procedure for the extraction of the mandibular right third molar. Two days after the surgery the patient reported pain and altered occlusion in the right side of the mandible. After clinical and radiographic re-examination, the diagnosis of late mandibular fracture was established. A second surgery, under general anaesthesia, was performed for the fixation of the mandibular bone. The fractured parts were reduced and fixed with locking plate systems and 2 mm screws following load-sharing principles. The masticatory function showed optimal performance within 7 and 21 days after the surgery. Complete bone healing was observed within 1 year of follow-up. For satisfactory surgical outcomes, adequate surgical planning and techniques must be performed. Signed informed consents explaining the risks and benefits of the treatment must be used to avoid ethical and legal disputes in dentistry.

Personalized Medicine in a New Genomic Era: Ethical and Legal Aspects.

PubMed

Shoaib, Maria; Rameez, Mansoor Ali Merchant; Hussain, Syed Ather; Madadin, Mohammed; Menezes, Ritesh G

2017-08-01

The genome of two completely unrelated individuals is quite similar apart from minor variations called single nucleotide polymorphisms which contribute to the uniqueness of each and every person. These single nucleotide polymorphisms are of great interest clinically as they are useful in figuring out the susceptibility of certain individuals to particular diseases and for recognizing varied responses to pharmacological interventions. This gives rise to the idea of 'personalized medicine' as an exciting new therapeutic science in this genomic era. Personalized medicine suggests a unique treatment strategy based on an individual's genetic make-up. Its key principles revolve around applied pharmaco-genomics, pharmaco-kinetics and pharmaco-proteomics. Herein, the ethical and legal aspects of personalized medicine in a new genomic era are briefly addressed. The ultimate goal is to comprehensively recognize all relevant forms of genetic variation in each individual and be able to interpret this information in a clinically meaningful manner within the ambit of ethical and legal considerations. The authors of this article firmly believe that personalized medicine has the potential to revolutionize the current landscape of medicine as it makes its way into clinical practice.

Doctor-patient communication in radiology: a great opportunity for future radiology.

PubMed

Bazzocchi, M

2012-04-01

This text discusses several aspects of doctor-patient communication in radiology, including the origins, advantages, and ethical and legal aspects. Over the last 10 years, radiologists have assumed increasing responsibilities towards patients and society. Patients, who are becoming better informed and more aware about medical issues, have a right to be given a timely diagnosis and want to receive as much information as possible from the radiologist. This has implications for several levels of everyday radiological practice, including the organisation of work, legal and ethical aspects and radiologist training. Better interaction with the patient helps to build a closer, more trusting, relationship with the result that the radiologist will be more motivated in his or her work. Until now, radiologists were not adequately trained to communicate the diagnosis directly and verbally to patients, especially when the diagnosis was unfavourable. It is important to emphasise the need for more specific and practical training in this respect, which is indispensable for future developments of the discipline.

Deception in advertising and marketing: ethical applications in rehabilitation.

PubMed

Banja, J D

1994-09-01

A much discussed issue in contemporary discussions of health care reform is the considerable competition that is anticipated to occur among providers. An inevitable aspect of this competition will be the ways health care services are presented in the marketplace through advertising and other forms of promotional literature. Considerable concern has already emerged among certain rehabilitation professionals, however, that advertising and marketing practices in rehabilitation must cohere with ethical standards. This article will discuss certain aspects of those standards, particularly as they have evolved from the Federal Trade Commission's definition of and rulings on deceptive practices in advertising. Salient aspects of the Commission's 1983 definition of deception will be related to rehabilitation by way of examining instances of rehabilitation advertising and marketing that might satisfy the Commission's definition of deception. The article will conclude with certain recommendations, principally drawn from various Federal Trade Commission rulings, that might be useful to individuals or corporate entities who advertise or market rehabilitation services.

Undergraduate healthcare ethics education, moral resilience, and the role of ethical theories.

PubMed

Monteverde, Settimio

2014-06-01

This article combines foundational and empirical aspects of healthcare education and develops a framework for teaching ethical theories inspired by pragmatist learning theory and recent work on the concept of moral resilience. It describes an exemplary implementation and presents data from student evaluation. After a pilot implementation in a regular ethics module, the feasibility and acceptance of the novel framework by students were evaluated. In addition to the regular online module evaluation, specific questions referring to the teaching of ethical theories were added using simple (yes/no) and Likert rating answer formats. At the Bern University of Applied Sciences, a total of 93 students from 2 parallel sub-cohorts of the bachelor's program in nursing science were sent the online survey link after having been exposed to the same modular contents. A total of 62% of all students participated in the survey. The survey was voluntary and anonymous. Students were free to write their name and additional comments. Students consider ethical theories-as taught within the proposed framework-as practically applicable, useful, and transferable into practice. Teaching ethical theories within the proposed framework overcomes the shortcomings described by current research. Students do not consider the mutually exclusive character of ethical theories as an insurmountable problem. The proposed framework is likely to promote the effectiveness of healthcare ethics education. Inspired by pragmatist learning theory, it enables students to consider ethical theories as educative playgrounds that help them to "frame" and "name" the ethical issues they encounter in daily practice, which is seen as an expression of moral resilience. Since it does not advocate a single ethical theory, but is open to the diversity of traditions that shape ethical thinking, it promotes a culturally sensitive, ethically reflected healthcare practice. © The Author(s) 2013.

The ethics of in vivo calibrations in oral health surveys.

PubMed

Andrade, Flávia Reis de; Narvai, Paulo Capel; Montagner, Miguel Ângelo

2016-01-01

To analyze the ethics of in vivo calibration, using the discourse of the administrators of the National Oral Health Survey (SBBrasil 2010) as a starting point. This is a qualitative research involving semi-structured individual interviews with 12 members of the Steering Group and Technical Advisory Committee of the Ministry of Health, and two coordinators, one State and the other Municipal. The discourse of the collective subject technique was used for data analysis. When asked about the experiences of SBBrasil 2010, which included ethical aspects, respondents identified the forms of standardization and training of teams who collected field data. For them, there is little scientific evidence to ethically support the way the training stage, including calibration, is carried out in oral health epidemiological surveys, as a certain unease can be predicted in participants of these studies. The ethics of a research also derives from its methodological rigor; the training process; and calibration in particular, is a fundamental technical and ethical requirement in surveys such as the SBBrasil 2010. The unease of the volunteers in face of test repetition does not ethically invalidate the in vivo calibration, but mechanisms to minimize it must be developed.

[Spinal muscular atrophy and respiratory failure. How do primary care pediatricians act in a simulated scenario?].

PubMed

Agra Tuñas, M C; Sánchez Santos, L; Busto Cuiñas, M; Rodríguez Núñez, A

2015-11-01

Spinal muscular atrophy type 1 (SMA-1) tends to be fatal in the first year of life if there is no ventilatory support. The decision whether to start such support is an ethical conflict for healthcare professionals. A scenario of acute respiratory failure in an infant with SMA-1 has been included in a training program using advanced simulation for Primary Care pediatricians (PCP). The performances of 34 groups of 4 pediatricians, who participated in 17 courses, were systematically analyzed. Clinical, ethical and communication aspects with parents were evaluated. The initial technical assistance (Administration of oxygen and immediate ventilatory support) was correctly performed by 94% of the teams. However, the PCP had problems in dealing with the ethical aspects of the case. Of the 85% of the teams that raised the ethical conflict with parents, 29% did so on their own initiative, 23% actively excluded them, and only 6% involved them and took their opinion into account in making decisions. Only 11.7% asked about the quality of life of children and 12% for their knowledge of the prognosis of the disease. None explained treatment alternatives, nor tried to contact the pediatrician responsible for the child. When faced with a simulated SMA-1 infant with respiratory failure, PCP have difficulties in interacting with the family, and to involve it in the decision making process. Practical training of all pediatricians should include case scenarios with an ethical clinical problem. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

[A pilot study of the professional ethical thinking of Quebec hospital pharmacists and pharmacy students].

PubMed

Guérin, A; Bussières, J-F

2017-01-01

The main objective was to assess the position of Quebec pharmaceutical community about pharmaceutical ethics statements. The second objective was to compare the level of agreement of pharmacy students and hospitals pharmacists. Survey conducted one day given in 2012 and 2013 for students in 2013 and from 29/08/2014 to 02/09/2014 for pharmacists. A questionnaire of eight themes and 43 statements was developed: training and education (5 questions), clinical research (7) advertising and marketing (5) evaluation (5) dispensing medication (4), pharmaceutical care (9) economic aspect (6) and code of ethics (2). A Likert scale with four choices was used to measure the level of agreement. The primary outcome was the difference between the level of agreement of pharmacy students and hospital pharmacists. The Chi 2  test was used. A total of 347 students and 398 pharmacists responded to the survey. There was a statistically significant difference regarding the level of agreement with 28 statements on 43. The differences focused on eight themes of the questionnaire, or training and education (3/5 significantly different questions), clinical research (2/7), advertising and marketing (2/5), Evaluation (4/5) dispensing medication (4/4), pharmaceutical care (5/9), economic aspect (6/6) and ethics (2/2). This study shows that there is a difference between pharmacists and pharmacy students about pharmaceutical ethics statements. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Ethical issues for otolaryngology and surgery in the elderly.

PubMed

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

1999-06-01

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

[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.

The role of ethics in data governance of large neuro-ICT projects.

PubMed

Stahl, Bernd Carsten; Rainey, Stephen; Harris, Emma; Fothergill, B Tyr

2018-05-14

We describe current practices of ethics-related data governance in large neuro-ICT projects, identify gaps in current practice, and put forward recommendations on how to collaborate ethically in complex regulatory and normative contexts. We undertake a survey of published principles of data governance of large neuro-ICT projects. This grounds an approach to a normative analysis of current data governance approaches. Several ethical issues are well covered in the data governance policies of neuro-ICT projects, notably data protection and attribution of work. Projects use a set of similar policies to ensure users behave appropriately. However, many ethical issues are not covered at all. Implementation and enforcement of policies remain vague. The data governance policies we investigated indicate that the neuro-ICT research community is currently close-knit and that shared assumptions are reflected in infrastructural aspects. This explains why many ethical issues are not explicitly included in data governance policies at present. With neuro-ICT research growing in scale, scope, and international involvement, these shared assumptions should be made explicit and reflected in data governance.

Ethical challenges in designing and conducting medicine quality surveys.

PubMed

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

2016-06-01

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

When ethics constrains clinical research: trial design of control arms in "greater than minimal risk" pediatric trials.

PubMed

de Melo-Martín, Inmaculada; Sondhi, Dolan; Crystal, Ronald G

2011-09-01

For more than three decades clinical research in the United States has been explicitly guided by the idea that ethical considerations must be central to research design and practice. In spite of the centrality of this idea, attempting to balance the sometimes conflicting values of advancing scientific knowledge and protecting human subjects continues to pose challenges. Possible conflicts between the standards of scientific research and those of ethics are particularly salient in relation to trial design. Specifically, the choice of a control arm is an aspect of trial design in which ethical and scientific issues are deeply entwined. Although ethical quandaries related to the choice of control arms may arise when conducting any type of clinical trials, they are conspicuous in early phase gene transfer trials that involve highly novel approaches and surgical procedures and have children as the research subjects. Because of children's and their parents' vulnerabilities, in trials that investigate therapies for fatal, rare diseases affecting minors, the scientific and ethical concerns related to choosing appropriate controls are particularly significant. In this paper we use direct gene transfer to the central nervous system to treat late infantile neuronal ceroid lipofuscinosis to illustrate some of these ethical issues and explore possible solutions to real and apparent conflicts between scientific and ethical considerations.

Supplementing research ethics training in psychiatry residents: A five-tier approach.

PubMed

Viswanath, Biju; Jayarajan, Rajan Nishanth; Chandra, Prabha S; Chaturvedi, Santosh K

2018-04-01

Ethics training is a key step in the research supervision of psychiatry trainees and there is need for a structured educational module. We developed a new research ethics training module for psychiatry residents - The Five-Tier Approach. Twenty-five first year psychiatry residents of an academic psychiatric training centre in India participated in this multi-session workshop. Module 1 included the completion of NIH online certification course for research ethics training. Module 2 was a one-hour interactive group discussion on ethical principles in research. Module 3 was a two-hour session consisting of case-based group discussion of nine selected research vignettes. Module 4 involved preparation of an informed consent form. Module 5 was a mock ethics committee role-played by seven students while the larger group observed using a Fish Bowl technique and provided feedback. Assessments were done during the third and final modules. During the third module, understanding regarding certain areas - autonomy, benefits and justice was found to be inadequate. In the final step, all ethical aspects were covered by the students. This five-tier approach seems like a superior tool for research ethics training in academic institutions, especially in Southeast Asia, where the student-teacher ratios are generally very high. Copyright © 2018 Elsevier B.V. All rights reserved.

2002 CNA Code of Ethics: some recommendations.

PubMed

Kikuchi, June F

2004-07-01

The Canadian Nurses Association (CNA) recently revised its 1997 Code of Ethics for Registered Nurses to reflect the context within which nurses practise today. Given the unprecedented changes that have taken place within the profession, healthcare and society, it was timely for the CNA to review and revise its Code. But the revisions were relatively minor; important problematic, substantive aspects of the Code were essentially left untouched and persist in the updated 2002 Code. In this paper, three of those aspects are examined and discussed: the 2002 Code's (a) definition of health and well-being, (b) notion of respect and (c) conception of justice. Recommendations are made. It is hoped that these comments will encourage nurse leaders in Canada to initiate discussion of the Code now, in preparation for its next planned revision in 2007.

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.

[Economy in intensive care medicine--a contradiction?].

PubMed

Janssens, U

2015-05-01

Medical progress and demographic changes will lead to increasing budgetary constraints in the health care system in the coming years. With respect to economic, medical, and ethical aspects, intensive care medicine has a particular role within the health system. Nonetheless, financial restriction will be inevitable in the near future. A literature review was performed. In an era of economic decline accompanied by widespread recognition that healthcare costs are on a consistent upward spiral, rationalization and rationing are unavoidable. Priorization models will play a pivotal role in allocation of resources. Individual ethics (respect for autonomy, nonmaleficence, beneficence) as well as justice are essential in daily practice. Economic thinking and acting as well as being ethically responsible are not mutually exclusive. On the contrary, acting in an ethically responsible manner will be of considerable significance given the pressure of increasing costs in intensive care medicine.

Organ Donation After Circulatory Death: Ethical Issues and International Practices.

PubMed

Jericho, Barbara G

2018-05-21

Donation after circulatory death (DCD) is an increasingly utilized practice that can contribute to reducing the difference between the supply of organs and the demand for organs for transplantation. As the number of transplanted organs from DCD donors continues to increase, there is an essential need to address the ethical aspects of DCD in institutional DCD protocols and clinical practice. Ethical issues of respecting the end-of-life wishes of a potential donor, respecting a recipient's wishes, and addressing potential conflicts of interest are important considerations in developing policies and procedures for DCD programs. Although there may be diversity among DCD programs in Europe, Australia, Israel, China, the United States, and Canada, addressing ethical considerations in these DCD programs is essential to respect donors and recipients during the altruistic and generous act of organ donation.

A Qualitative Evaluation of Ethics Educational Program in Health Science.

PubMed

Ekmekci, Perihan Elif; Oral, Murat; Yurdakul, Eray Serdar

2015-06-01

This paper originates from a panel discussion on the evaluation of "Ethics Educational Program in Health Sciences" held during the IAEE Conference 2014 Ankara, Turkey. The participants of the panel had consultations to solidify the concepts about the topic. The qualitative data out of these antecedent discussions became mature with the contributions in the panel. The outcome of this qualitative study mainly focuses on the examples of two current curricula; one from PhD on History of Medicine and Medical Ethics, the other one from an elective course on medical ethics as a part of a PhD program on Pharmacy Management and History, followed by the major challenges the trainees face during their education, their expectations and whether the program was satisfactory, the aspects of the programs which are prone to improvement and their overall evaluations of the programs.

In-home monitoring of persons with dementia: ethical guidelines for technology research and development.

PubMed

Mahoney, Diane F; Purtilo, Ruth B; Webbe, Frank M; Alwan, Majd; Bharucha, Ashok J; Adlam, Tim D; Jimison, Holly B; Turner, Beverly; Becker, S Ann

2007-07-01

Innovative technologies are rapidly emerging that offer caregivers the support and means to assist older adults with cognitive impairment to continue living "at home." Technology research and development efforts applied to older adults with dementia invoke special grant review and institutional review board concerns, to ensure not only safe but also ethically appropriate interventions. Evidence is emerging, however, that tensions are growing between innovators and reviewers. Reviewers with antitechnology biases are in a position to stifle needed innovation. Technology developers who fail to understand the clinical and caregiving aspects of dementia may design applications that are not in alignment with users' capabilities. To bridge this divide, we offer an analysis of the ethical issues surrounding home monitoring, a model framework, and ethical guidelines for technology research and development for persons with Alzheimer's disease and their caregivers.

Ethical issues experienced by intensive care unit nurses in everyday practice.

PubMed

Fernandes, Maria I D; Moreira, Isabel M P B

2013-02-01

This research aims to identify the ethical issues perceived by intensive care nurses in their everyday practice. It also aims to understand why these situations were considered an ethical issue and what interventions/strategies have been or are expected to be developed so as to minimize them. Data were collected using a semi-structured interview with 15 nurses working at polyvalent intensive care units in 4 Portuguese hospitals, who were selected by the homogenization of multiple samples. The qualitative content analysis identified end-of-life decisions, privacy, interaction, team work, and health-care access as emerging ethical issues. Personal, team, and institutional aspects emerge as reasons behind the experience of these issues. Personal and team resources are used in and for solving these issues. Moral development and training are the most significant strategies.

Trust Repair between a Military Organization and a Local Population: A Pilot Study

DTIC Science & Technology

2011-02-01

l’aspect « public » du paradigme IIMP, une approche relativement nouvelle pour un grand nombre de militaires et le plus grand des défis pour les...questionnaires were reviewed and approved by the DRDC Human Research Ethics Committee (HREC) and all participants received remuneration according to DRDC...Form. The Human Research Ethics Committee (HREC) of Defence Research and Development Canada (DRDC) has approved this study (L-701A). If you have

The walkshop approach to science and technology ethics.

PubMed

Wickson, Fern; Strand, Roger; Kjølberg, Kamilla Lein

2015-02-01

In research and teaching on ethical aspects of emerging sciences and technologies, the structure of working environments, spaces and relationships play a significant role. Many of the routines and standard practices of academic life, however, do little to actively explore and experiment with these elements. They do even less to address the importance of contextual and embodied dimensions of thinking. To engage these dimensions, we have benefitted significantly from practices that take us out of seminar rooms, offices and laboratories as well as beyond traditional ways of working and interacting. We have called one such practice the 'walkshop'. Through walkshops, we have spent several days walking together with our colleagues and students in open outdoor spaces, keeping a sustained intellectual discussion on ethical aspects of science, technology and innovation while moving through these landscapes. For us, this has generated useful opportunities to escape established hierarchies, roles and patterns of thought and to rethink conceptual and philosophical issues from new perspectives, under new attitudes and with renewed energy. In this paper we wish to highlight the potential benefits of the walkshop approach by sharing some of our experiences and describing how we have prepared for and carried out these events. We share this information in the hope that we may encourage others to both experiment with the walkshop approach and exchange information on their own innovative processes for research and teaching in science and engineering ethics.

The ethical landscape: identifying the right way to think about the ethical and societal aspects of synthetic biology research and products

PubMed Central

Yearley, Steven

2009-01-01

Synthetic biology promises to be highly innovative in its contribution to scientific understanding. But it offers other sorts of innovation too: in the variety of applications that could result and in the wide range of practitioners who could become involved. But directly corresponding to each of these is a kind of regulatory concern. If the entry barriers are low for a form of scientific practice with dramatic implications then the need for regulatory control over access is great since no one wants unlicensed operators releasing experimental organisms. If there are likely to be extensive opportunities for application within the human body and in the open environment (for energy production or novel forms of bioremediation) then the release and safety-testing implications are potentially enormous. Proponents of synthetic biology have been quick to realise that these challenges call for reviews of the societal and ethical aspects of synthetic biology. This paper shows that the template commonly adopted for such reviews draws on bioethics. It goes on to show that this template is far from ideal, both because of limitations in the way that bioethics has been institutionalized and because of key differences between the regulatory demands on synthetic biology and on bioethics. The paper concludes that broader models of societal and ethical review of synthetic biology are urgently required. PMID:19447816

[Outsourcing of nursing human resources from ethical to management: a survey in a Lazio Region Hospital].

PubMed

d'Amore, Maurizia; Peroni, Antonia

2008-01-01

In 2006, 279 nurses of a Lazio Region Hospital were assessed to verify whether certain Human Resources decisions, such as outsourcing, can negatively influence their working motivation and sense of belonging to a health organization and whether any dissatisfaction can be attributed to poor ethical information within the health service. The research method had a descriptive basis and for data collection a questionnaire with 35 questions was issued. Results showed that nurses felt strongly involved in the study and interesting aspects for management of human resources emerged, depicting an organization lacking in motivation : this confirmed one of the aspects of the study : poor levels of motivation and sense of belonging can be correlated to insufficient ethical information in local health organizations. The main working needs that emerged among the nurses of this hospital regarded economical retribution (90%), security and success (88%) , belonging (86%) and self-satisfaction (77%): the need for power was relatively low (40%). The strong points of the study were : the strong involvement of nurses, the value of the information gathered regarding working motivation, sense of belong to a nursing organization , working needs , ethical information in health environments, organization according to targets. The limits of the study were: limited number of nurses in outsourcing at the time of the study (12%), impossibility of comparing the results with data prior to the outsourcing choices made by the hospital in question.

Consciousness in the Study of Human Life and Experience: "Higher Aspects" and Their Nature

ERIC Educational Resources Information Center

Witz, Klaus G.; Lee, Hyunju; Huang, Wanju

2010-01-01

This article deals with the consciousness in a person when one tries to understand her more deeply and as a whole, as is done in studies using the "Participant as Ally-Essentialist Portraiture" approach, and focuses on "higher aspects" or moral-ethical, metaphysical, social and religious ideals, values, commitments, or inspiration in a person. The…

End-of-life decisions in Malaysia: Adequacies of ethical codes and developing legal standards.

PubMed

Kassim, Puteri Nemie Jahn; Alias, Fadhlina

2015-06-01

End-of-life decision-making is an area of medical practice in which ethical dilemmas and legal interventions have become increasingly prevalent. Decisions are no longer confined to clinical assessments; rather, they involve wider considerations such as a patient's religious and cultural beliefs, financial constraints, and the wishes and needs of family members. These decisions affect everyone concerned, including members of the community as a whole. Therefore it is imperative that clear ethical codes and legal standards are developed to help guide the medical profession on the best possible course of action for patients. This article considers the relevant ethical, codes and legal provisions in Malaysia governing certain aspects of end-of-life decision-making. It highlights the lack of judicial decisions in this area as well as the limitations with the Malaysian regulatory system. The article recommends the development of comprehensive ethical codes and legal standards to guide end-of-life decision-making in Malaysia.

Invisibility, moral knowledge and nursing work in the writings of Joan Liaschenko and Patricia Rodney.

PubMed

Bjorklund, Pamela

2004-03-01

The ethical 'eye' of nursing, that is, the particular moral vision and values inherent in nursing work, is constrained by the preoccupations and practices of the superordinate biomedical structure in which nursing as a practice discipline is embedded. The intimate, situated knowledge of particular persons who construct and attach meaning to their health experience in the presence of and with the active participation of the nurse, is the knowledge that provides the evidence for nurses' ethical decision making. It is largely invisible to all but other nurses. Two nurse researchers, Joan Liaschenko of the University of Minnesota and Patricia Rodney of the University of Victoria, have investigated the ethical concerns of practising nurses and noted in their separate enquiries the invisible nature of critical aspects of nursing work. Noting the similarities in their respective observations, and with the feminist ethics of Margaret Urban Walker as a theoretical framework, this article examines the concept of 'invisibility' as it relates to nursing work and nursing ethics.

Ethics in the minutiae: examining the role of the physical laboratory environment in ethical discourse.

PubMed

Bezuidenhout, Louise

2015-02-01

Responsibility within life science research is a highly scrutinised field. Increasingly, scientists are presented with a range of duties and expectations regarding their conduct within the research setting. In many cases, these duties are presented deontologically, forgoing extensive discussion on how these are practically implemented into the minutiae of daily research practices. This de-contextualized duty has proven problematic when it comes to practical issues of compliance, however it is not often considered as a fundamental aspect of building ethics discourse. This paper examines this issue in detail, particularly focusing on how differences in the contrasts between the ideal and real physical research environments cause conceptual problems for scientists and retard ethical engagement. Such issues are particularly pertinent in low- and middle-income countries. This paper combines theoretical and empirical analyses using the concept of "dual-use" as a focalizing topic. The data show that the research environment acts as an intimate component in the interpretation and implementation of ethical actions.

Evaluating the Effects that Existing Instruction on Responsible Conduct of Research Has on Ethical Decision Making

PubMed Central

Antes, Alison L.; Wang, Xiaoqian; Mumford, Michael D.; Brown, Ryan P.; Connelly, Shane; Devenport, Lynn D.

2015-01-01

Purpose To examine the effects that existing courses on the responsible conduct of research (RCR) have on ethical decision making by assessing the ethicality of decisions made in response to ethical problems and the underlying processes involved in ethical decision making. These processes included how an individual thinks through ethical problems (i.e., meta-cognitive reasoning strategies) and the emphasis placed on social dimensions of ethical problems (i.e., social–behavioral responses). Method In 2005–2007, recruitment announcements were made, stating that a nationwide, online study was being conducted to examine the impact of RCR instruction on the ethical decision making of scientists. Recruitment yielded contacts with over 200 RCR faculty at 21 research universities and medical schools; 40 (20%) RCR instructors enrolled their courses in the current study. From those courses, 173 participants completed an ethical decision-making measure. Results A mixed pattern of effects emerged. The ethicality of decisions did not improve as a result of RCR instruction and even decreased for decisions pertaining to business aspects of research, such as contract bidding. Course participants improved on some meta-cognitive reasoning strategies, such as awareness of the situation and consideration of personal motivations, but declined for seeking help and considering others’ perspectives. Participants also increased in their endorsement of detrimental social–behavioral responses, such as deception, retaliation, and avoidance of personal responsibility. Conclusions These findings indicated that RCR instruction may not be as effective as intended, and in fact, may even be harmful. Harmful effects might result if instruction leads students to overstress avoidance of ethical problems, be overconfident in their ability to handle ethical problems, or overemphasize their ethical nature. Future research must examine these and other possible obstacles to effective RCR instruction. PMID:20182131

Evaluating the effects that existing instruction on responsible conduct of research has on ethical decision making.

PubMed

Antes, Alison L; Wang, Xiaoqian; Mumford, Michael D; Brown, Ryan P; Connelly, Shane; Devenport, Lynn D

2010-03-01

To examine the effects that existing courses on the responsible conduct of research (RCR) have on ethical decision making by assessing the ethicality of decisions made in response to ethical problems and the underlying processes involved in ethical decision making. These processes included how an individual thinks through ethical problems (i.e., meta-cognitive reasoning strategies) and the emphasis placed on social dimensions of ethical problems (i.e., social-behavioral responses). In 2005-2007, recruitment announcements were made, stating that a nationwide, online study was being conducted to examine the impact of RCR instruction on the ethical decision making of scientists. Recruitment yielded contacts with over 200 RCR faculty at 21 research universities and medical schools; 40 (20%) RCR instructors enrolled their courses in the current study. From those courses, 173 participants completed an ethical decision-making measure. A mixed pattern of effects emerged. The ethicality of decisions did not improve as a result of RCR instruction and even decreased for decisions pertaining to business aspects of research, such as contract bidding. Course participants improved on some meta-cognitive reasoning strategies, such as awareness of the situation and consideration of personal motivations, but declined for seeking help and considering others' perspectives. Participants also increased their endorsement of detrimental social-behavioral responses, such as deception, retaliation, and avoidance of personal responsibility. These findings indicated that RCR instruction may not be as effective as intended and, in fact, may even be harmful. Harmful effects might result if instruction leads students to overstress avoidance of ethical problems, be overconfident in their ability to handle ethical problems, or overemphasize their ethical nature. Future research must examine these and other possible obstacles to effective RCR instruction.

Ethical issues in physiotherapy--reflected from the perspective of physiotherapists in private practice.

PubMed

Praestegaard, Jeanette; Gard, Gunvor

2013-02-01

An important aspect of physiotherapy professional autonomy is the ethical code of the profession, both collectively and for the individual member of the profession. The aim of this study is to explore and add additional insight into the nature and scope of ethical issues as they are understood and experienced by Danish physiotherapists in outpatient, private practice. A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analyzed, using a phenomenological hermeneutic framework. One main theme emerged: The ideal of being beneficent toward the patient. Here, the ethical issues uncovered in the interviews were embedded in three code-groups: 1) ethical issues related to equality; 2) feeling obligated to do one's best; and 3) transgression of boundaries. In an ethical perspective, physiotherapy in private practice is on a trajectory toward increased professionalism. Physiotherapists in private practice have many reflections on ethics and these reflections are primarily based on individual common sense arguments and on deontological understandings. As physiotherapy by condition is characterized by asymmetrical power encounters where the parties are in close physical and emotional contact, practiced physiotherapy has many ethical issues embedded. Some physiotherapists meet these issues in a professional manner, but others meet them in unconscious or unprofessional ways. An explicit ethical consciousness among Danish physiotherapists in private practice seems to be needed. A debate of how to understand and respect the individual physiotherapist's moral versus the ethics of the profession needs to be addressed.

Pandemic influenza preparedness: an ethical framework to guide decision-making

PubMed Central

Thompson, Alison K; Faith, Karen; Gibson, Jennifer L; Upshur, Ross EG

2006-01-01

Background Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on values because science alone cannot tell us how to prepare for a public health crisis. Discussion In this paper, we present an ethical framework for pandemic influenza planning. The ethical framework was developed with expertise from clinical, organisational and public health ethics and validated through a stakeholder engagement process. The ethical framework includes both substantive and procedural elements for ethical pandemic influenza planning. The incorporation of ethics into pandemic planning can be helped by senior hospital administrators sponsoring its use, by having stakeholders vet the framework, and by designing or identifying decision review processes. We discuss the merits and limits of an applied ethical framework for hospital decision-making, as well as the robustness of the framework. Summary The need for reflection on the ethical issues raised by the spectre of a pandemic influenza outbreak is great. Our efforts to address the normative aspects of pandemic planning in hospitals have generated interest from other hospitals and from the governmental sector. The framework will require re-evaluation and refinement and we hope that this paper will generate feedback on how to make it even more robust. PMID:17144926

Ethical sensitivity in obsessive-compulsive disorder and generalized anxiety disorder: the role of reversal learning.

PubMed

Szabó, Csilla; Németh, Attila; Kéri, Szabolcs

2013-12-01

In obsessive-compulsive disorder (OCD), amplified moral sensitivity may be related to the orbitofrontal-striatal circuit, which is also critical in reversal learning. This study examined three questions: (1) What aspects of ethical sensitivity is altered in OCD?; (2) What is the relationship between ethical sensitivity and reversal learning?; (3) Are potential alterations in ethical sensitivity and reversal learning present in generalized anxiety disorder (GAD)? Participants were 28 outpatients with OCD, 21 individuals with GAD, and 30 matched healthy controls. Participants received the ethical sensitivity scale questionnaire (ESSQ), rating scales for clinical symptoms, a reversal learning task, and the Wisconsin Card Sorting Test (WCST). We found higher ethical sensitivity scores in OCD compared with healthy controls in the case of generating interpretations and options and identifying the consequences of actions. Individuals with OCD displayed prolonged reaction times on probabilistic errors without shift and final reversal errors. Participants with GAD did not differ from healthy controls on the ESSQ, but they were slower on reversal learning relative to nonpatients. In OCD, reaction time on final reversal errors mediated the relationship between ethical sensitivity and compulsions. WCST performance was intact in OCD and GAD. Small sample size, limited neuropsychological assessment, self-rating scale for ethical sensitivity. Prolonged reaction time at switching reinforcement contingencies is related to increased ethical sensitivity in OCD. Slow affective switching may link ethical sensitivity and compulsions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Practical aspects of telehealth: financial considerations.

PubMed

Loh, P K; Sabesan, S; Allen, D; Caldwell, P; Mozer, R; Komesaroff, P A; Talman, P; Williams, M; Shaheen, N; Grabinski, O; Withnall, D

2013-07-01

The second in a series of articles about the practical aspects of telehealth, this paper includes information and a case history on the cost-benefits for patients and practitioners using telehealth. The case history demonstrates that telehealth can save travel time for patients, carers and specialists, and can reduce out-of-pocket expenses. The practical aspects of telehealth article series considers the contextual, clinical, technical and ethical components of online video consultations. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

Navigating rough waters: an overview of psychological aspects of surrogacy.

PubMed

Ciccarelli, Janice C; Beckman, Linda J

2005-03-01

This article provides an overview of the social and psychological aspects surrounding the surrogacy process including attitudes about surrogacy, perceptions and problems of surrogate mothers and intended/social parents, and questions concerning children resulting from contractual parenting. Review of the literature on contractual parenting reveals a wealth of discussion about the ethical, moral, legal, and psychological implications, but limited empirical data on the psychological and social aspects. Future research can provide empirical evidence as a foundation for counseling at all phases of the surrogacy process.

Improving ethical knowledge and sensemaking from cases through elaborative interrogation and outcome valence.

PubMed

Johnson, James F; Bagdasarov, Zhanna; MacDougall, Alexandra E; Steele, Logan; Connelly, Shane; Devenport, Lynn D; Mumford, Michael D

2014-01-01

The case-based approach to learning is popular among many applied fields. However, results of case-based education vary widely on case content and case presentation. This study examined two aspects of case-based education-outcome valence and case elaboration methods-in a two-day case-based Responsible Conduct of Research (RCR) ethics education program. Results suggest that outcome information is an integral part of a quality case. Furthermore, valence consistent outcomes may have certain advantages over mixed valence outcome information. Finally, students enjoy and excel working with case material, and the use of elaborative interrogation techniques can significantly improve internally-focused ethical sensemaking strategies associated with personal biases, constraints, and emotions.

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.

[Etiology and nosology of "rage" and "mania" in the texts of Paracelsus].

PubMed

Korschunow, N

2001-01-01

In this paper etiological and nosological concepts of the Renaissance medico, alchemist, philosopher, and theologist Theophrast von Hohenheim ("Paracelsus" (1493/94-1541)), concerning the "taubsucht [rage, fury]", the "mania", and contextual aspects, are shown. Paradigmatic oscillations between concepts of the present time and the views of Hohenheim are analyzed. Four kinds of "taubsucht" are presented by Hohenheim in his earliest psychopathologically orientated treatise "Von der Taubsucht". Their relations towards later texts are described. He introduces many disorders in later texts, e.g. "mania", "lunatici", "ebricata", "phantasmata", "vihisch vernunft", that resemble aspects of the four kinds of "taubsucht". Three main principles of etiology are documented and characterized as "theological-ethical", "elemental-sidereal", and "alchemistical". Contrary to today's preferred "descriptive" approach the main principle of Paracelsian classification is seen as "etiological-dimensional". Seven etiologic dimensions are described. Hierarchical correspondences between these dimensions are investigated. The seven dimensions are characterized as: a) Elemental influences (incorporation of psychotropic substances) b) Firmamental-sidereal influences (astrological and astronomical emanations) c) Spiritual influences (spirits deranging man's mind) d) Alchemistical ("chemical") influences e) Secondary diseases (caused by some pre-existing disorder) f) Intrinsic ethical and moral dispositions as the final cause of disorders (theological-ethical view) g) Heredity. By evaluating the paradigmatic aspects of Hohenheims nosological approach, differences with today's mainstream-views of psychiatry are seen in the field of "invisible" (spiritual and transcendental), "etiological-dimensional" explanations for the derangement of the mind (see b, c, f). Potential similarities are considered in the field of "visible" (materialistic), dimensions (see a, d, e, g). It is concluded that Hohenheim strives towards an integration of spiritual and materialistic aspects in the application of etiological and nosological tools. Hohenheims concepts are summarized as a 16th century "integrative" psychopathological approach.

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

PubMed

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

2016-06-01

Childhood cancer care involves many ethical concerns. Deciding on treatment levels and providing care that infringes on the child's growing autonomy are known ethical concerns that involve the whole professional team around the child's care. The purpose of this study was to explore healthcare professionals' experiences of participating in ethics case reflection sessions in childhood cancer care. Data collection by observations, individual interviews, and individual encounters. Data analysis were conducted following grounded theory methodology. Healthcare professionals working at a publicly funded children's hospital in Sweden participated in ethics case reflection sessions in which ethical issues concerning clinical cases were reflected on. The children's and their parents' integrity was preserved through measures taken to protect patient identity during ethics case reflection sessions. The study was approved by a regional ethical review board. Consolidating care by clarifying perspectives emerged. Consolidating care entails striving for common care goals and creating a shared view of care and the ethical concern in the specific case. The inter-professional perspectives on the ethical aspects of care are clarified by the participants' articulated views on the case. Different approaches for deliberating ethics are used during the sessions including raising values and making sense, leading to unifying interactions. The findings indicate that ethical concerns could be eased by implementing ethics case reflection sessions. Conflicting perspectives can be turned into unifying interactions in the healthcare professional team with the common aim to achieve good pediatric care. Ethics case reflection sessions is valuable as it permits the discussion of values in healthcare-related issues in childhood cancer care. Clarifying perspectives, on the ethical concerns, enables healthcare professionals to reflect on the most reasonable and ethically defensible care for the child. A consolidated care approach would be valuable for both the child and the healthcare professionals because of the common care goals. © The Author(s) 2015.

Steps toward improving ethical evaluation in health technology assessment: a proposed framework.

PubMed

Assasi, Nazila; Tarride, Jean-Eric; O'Reilly, Daria; Schwartz, Lisa

2016-06-06

While evaluation of ethical aspects in health technology assessment (HTA) has gained much attention during the past years, the integration of ethics in HTA practice still presents many challenges. In response to the increasing demand for expansion of health technology assessment (HTA) methodology to include ethical issues more systematically, this article reports on a multi-stage study that aimed at construction of a framework for improving the integration of ethics in HTA. The framework was developed through the following phases: 1) a systematic review and content analysis of guidance documents for ethics in HTA; 2) identification of factors influencing the integration of ethical considerations in HTA; 3) preparation of an action-oriented framework based on the key elements of the existing guidance documents and identified barriers to and facilitators of their implementation; and 4) expert consultation and revision of the framework. The proposed framework consists of three main components: an algorithmic flowchart, which exhibits the different steps of an ethical inquiry throughout the HTA process, including: defining the objectives and scope of the evaluation, stakeholder analysis, assessing organizational capacity, framing ethical evaluation questions, ethical analysis, deliberation, and knowledge translation; a stepwise guide, which focuses on the task objectives and potential questions that are required to be addressed at each step; and a list of some commonly recommended or used tools to help facilitate the evaluation process. The proposed framework can be used to support and promote good practice in integration of ethics into HTA. However, further validation of the framework through case studies and expert consultation is required to establish its utility for HTA practice.

The active engagement model of applied ethics as a structure for ethical reflection in the context of course-based service learning.

PubMed

Nesbit, Kathryn C; Jensen, Gail M; Delany, Clare

2018-01-01

The purpose of this case report is to explore the active engagement model as a tool to illuminate the ethical reflections of student physical therapists in the context of service learning in a developing country. The study participants were a convenience sample of six students. The study design is a case report using a phenomenological perspective. Data were collected from students' narrative writing and semi-structured interviews. The steps of the active engagement model provided the structural framework for student responses. The analysis process included open coding, selective coding, and member checking. Results showed the emergence of two main themes: 1) gathering rich detail and 2) developing independent moral identity. Students' descriptions of their relationships were detailed and included explanations about the complexities of the sociocultural context. Independent and deliberate agency was evident by the students' preparedness to be collaborative, to raise ethical questions, to identify ethically important aspects of their practice and to describe their professional roles. The students noted that the use of the model increased their engagement in the ethical decision-making process and their recognition of ethical questions. This case report illustrates attributes of the active engagement model which have implications for teaching ethical reflection: scaffolding for ethical reflection, use of narrative for reflection, reflection in action, and illumination of relevant themes. Each of these attributes leads to the development of meaningful ethical reflection. The attributes of this model shown by this case report have potential applications to teaching ethical reflection.

Barriers and facilitators influencing ethical evaluation in health technology assessment.

PubMed

Assasi, Nazila; Schwartz, Lisa; Tarride, Jean-Eric; O'Reilly, Daria; Goeree, Ron

2015-01-01

The objective of this study was to explore barriers and facilitators influencing the integration of ethical considerations in health technology assessment (HTA). The study consisted of two complementary approaches: (a) a systematic review of the literature; and (b) an eighteen-item online survey that was distributed to fifty-six HTA agencies affiliated with the International Network of Agencies for Health Technology Assessment. The review identified twenty-six relevant articles. The most often cited barriers in the literature were: scarcity, heterogeneity and complexity of ethical analysis methods; challenges in translating ethical analysis results into knowledge that is useful for decision makers; and lack of organizational support in terms of required expertise, time and financial resources. The most frequently cited facilitators included: usage of value-based appraisal methods, stakeholder and public engagement, enhancement of practice guidelines, ethical expertise, and educational interventions. Representatives of twenty-six (46.5 percent) agencies from nineteen countries completed the survey. A median of 10 percent (interquartile range, 5 percent to 50 percent) of the HTA products produced by the agencies was reported to include an assessment of ethical aspects. The most commonly perceived barriers were: limited ethical knowledge and expertise, insufficient time and resources, and difficulties in finding ethical evidence or using ethical guidelines. Educational interventions, demand by policy makers, and involvement of ethicists in HTA were the most commonly perceived facilitators. Our results emphasize the importance of simplification of ethics methodology and development of good practice guidelines in HTA, as well as capacity building for engaging HTA practitioners in ethical analyses.

Female genital mutilation: when a cultural practice generates clinical and ethical dilemmas.

PubMed

Gibeau, A M

1998-01-01

Female genital mutilation (FGM) is of growing concern to health care providers in the United States and Canada as more women from countries where the procedure is practiced emigrate to North America. An introduction to the demographics of FGM, including prevalence rates, is a necessary antecedent for understanding the cultural rationales for this widespread practice. Considering the health consequences of this practice promotes questions about legal and ethical aspects of care as North Americans approach FGM from their own individual cultural frameworks.

Human radiation, experimentation, ethics, and gene therapy. Hearing before the Subcommittee on Energy of the Committee on Science, Space, and Technology, U.S. House of Representatives, One Hundred Third Congress, Second Session, February 10, 1994

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

NONE

1994-12-31

The hearing addressed the human radiation experimentation of the Department of Energy (DOE) and the ethics of such treatment and gene therapy. Historical aspects of these subjects and their contributions to advancing current medical treatments are presented. Statements of officials from government, industry and educational institutions are provided along with documents submitted for the record.

An African ethic for nursing?

PubMed

Haegert, S

2000-11-01

This article derives from a doctoral thesis in which a particular discourse was used as a 'paradigm case'. From this discourse an ethic set within a South African culture arose. Using many cultural 'voices' to aid the understanding of this narrative, the ethic shows that one can build on both a 'justice' and a 'care' ethic. With further development based on African culture one can take the ethic of care deeper and reveal 'layers of understanding'. Care, together with compassion, forms the foundation of morality. Nursing ethics has followed particular western moral philosophers. Often nursing ethics has been taught along the lines of Kohlberg's theory of morality, with its emphasis on rules, rights, duties and general obligations. These principles were universalistic, masculine and noncontextual. However, there is a new ethical movement among Thomist philosophers along the lines to be expounded in this article. Nurses such as Benner, Bevis, Dunlop, Fry and Gadow--to name but a few--have welcomed the concept of an 'ethic of care'. Gilligan's work gave a feminist view and situated ethics in the everyday aspects of responsiveness, responsibility, context and concern. Shutte's search for a 'philosophy for Africa' has resulted in finding similarities in Setiloane and in Senghor with those of Thomist philosophers. Using this African philosophy and a research participant's narrative, an African ethic evolves out of the African proverb: 'A person is a person through other persons', or its alternative rendering: 'I am because we are: we are because I am.' This hermeneutic narrative reveals 'the way affect imbues activity with ethical meaning' within the context of a black nursing sister in a rural South African hospital. It expands upon the above proverb and incorporates the South African constitutional idea of 'Ubuntu' (compassion and justice or humanness).

Scientific Productivity on Research in Ethical Issues over the Past Half Century: A JoinPoint Regression Analysis.

PubMed

Long, Nguyen Phuoc; Huy, Nguyen Tien; Trang, Nguyen Thi Huyen; Luan, Nguyen Thien; Anh, Nguyen Hoang; Nghi, Tran Diem; Hieu, Mai Van; Hirayama, Kenji; Karbwang, Juntra

2014-09-01

Ethics is one of the main pillars in the development of science. We performed a JoinPoint regression analysis to analyze the trends of ethical issue research over the past half century. The question is whether ethical issues are neglected despite their importance in modern research. PubMed electronic library was used to retrieve publications of all fields and ethical issues. JoinPoint regression analysis was used to identify the significant time trends of publications of all fields and ethical issues, as well as the proportion of publications on ethical issues to all fields over the past half century. Annual percent changes (APC) were computed with their 95% confidence intervals, and a p-value < 0.05 was considered statistically significant. We found that publications of ethical issues increased during the period of 1965-1996 but slightly fell in recent years (from 1996 to 2013). When comparing the absolute number of ethics related articles (APEI) to all publications of all fields (APAF) on PubMed, the results showed that the proportion of APEI to APAF statistically increased during the periods of 1965-1974, 1974-1986, and 1986-1993, with APCs of 11.0, 2.1, and 8.8, respectively. However, the trend has gradually dropped since 1993 and shown a marked decrease from 2002 to 2013 with an annual percent change of -7.4%. Scientific productivity in ethical issues research on over the past half century rapidly increased during the first 30-year period but has recently been in decline. Since ethics is an important aspect of scientific research, we suggest that greater attention is needed in order to emphasize the role of ethics in modern research.

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.

Academic espionage: dysfunctional aspects of the publish or perish ethic.

PubMed

Mensah, L L

1982-11-01

There are many dysfunctional manifestations relative to the tenure and promotion process. These are disruptive to academic life. Much of this is encouraged by the university because of their publish or perish ethic. Excellence in classroom teaching and success in the field of clinical and human endeavours are not highly valued in deliberations to grant tenure and advancement in academic rank. Research and publications are the major yardsticks upon which a faculty member is judged. This prevailing perspective poses a dilemma for many nursing faculty who have high clinical workloads and have not been socialized for academic survival. The pressures to publish and research can be achieved in a realistic and non-stressful way. Three aspects seem to be particularly relevant to facilitate this achievement; these are: anticipatory planning, balancing the workload, and understanding the interpersonal dimensions of collegiality.

Why and how is compassion necessary to provide good quality healthcare?

PubMed Central

Fotaki, Marianna

2015-01-01

Recent disclosures of failures of care in the National Health Service (NHS) in England have led to debates about compassion deficits disallowing health professionals to provide high quality responsive care. While the link between high quality care and compassion is often taken for granted, it is less obvious how compassion – often originating in the individual’s emotional response – can become a moral sentiment and lead to developing a system of norms and values underpinning ethics of care. In this editorial, I argue why and how compassion might become a foundation of ethics guiding health professionals and a basis for ethics of care in health service organisations. I conclude by discussing a recent case of prominent healthcare failure in the NHS to highlight the relationship between compassion as an aspect of professional ethics on the one hand, and values and norms that institutions and specific policies promote on the other hand. PMID:25844380

Symbiotic empirical ethics: a practical methodology.

PubMed

Frith, Lucy

2012-05-01

Like any discipline, bioethics is a developing field of academic inquiry; and recent trends in scholarship have been towards more engagement with empirical research. This 'empirical turn' has provoked extensive debate over how such 'descriptive' research carried out in the social sciences contributes to the distinctively normative aspect of bioethics. This paper will address this issue by developing a practical research methodology for the inclusion of data from social science studies into ethical deliberation. This methodology will be based on a naturalistic conception of ethical theory that sees practice as informing theory just as theory informs practice - the two are symbiotically related. From this engagement with practice, the ways that such theories need to be extended and developed can be determined. This is a practical methodology for integrating theory and practice that can be used in empirical studies, one that uses ethical theory both to explore the data and to draw normative conclusions. © 2010 Blackwell Publishing Ltd.

The ethics of organizational change in healthcare.

PubMed

Ferrari, Antonio; Manotti, Pietro; Balestrino, Antonio; Fabi, Massimo

2018-03-27

The article addresses the increasingly important issue of organizational ethics in healthcare. Assuming that the governance of organizational change consists of a seriousness of continuous choices and of objectives to be determined and achieved, a possible definition of this new discipline is then deepened, and its fields of application are identified. In the discussion therefore emerge the close link between ethical choice in organization and legality, passing through transparency and prevention of corruptive phenomena. After a focus on the strategic role played by the Medical Doctor of the healthcare management team, in conclusion, the need arises to support a strengthened supervisory and evaluation system and a culture of the ethical organizational choice of health managers, a rooting of the sense of identity and belonging to the healthcare organization and its mission by Professionals. Also governing this last aspect is the new challenge for the management of public healthcare enterprises.

[Single or double moral standards? Professional ethics of psychiatrists regarding self-determination, rights of third parties and involuntary treatment].

PubMed

Pollmächer, T

2015-09-01

The current intensive discussion on the legal and moral aspects of involuntary treatment of psychiatric patients raises a number of ethical issues. Physicians are unambiguously obligated to protect patient welfare and autonomy; however, in psychiatric patients disease-related restrictions in the capacity of self-determination and behaviors endangering the rights of third parties can seriously challenge this unambiguity. Therefore, psychiatry is assumed to have a double function and is also obligated to third parties and to society in general. Acceptance of such a kind of double obligation carries the risk of double moral standards, placing the psychiatrist ethically outside the community of physicians and questioning the unrestricted obligation towards the patient. The present article formulates a moral position, which places the psychiatrist, like all other physicians, exclusively on the side of the patient in terms of professional ethics and discusses the practical problems arising from this moral position.

[Presumptive organ donations for transplants agreement of the Ethics Committee of the University of Chile Medical School].

PubMed

Roa, A; Rosselot, E

1995-04-01

The ethics committee of the Faculty of Medicine, University of Chile was consulted about the ethical aspects of presumptive organ donation for transplantation. After analyzing the problem, the committee concluded that every human being has the right to make use of his organs freely, voluntarily and according to his own discernment. The society has no right to make obligatory this donation, even after death. The foundations of this agreement were laid in a series of reasons. In fact, the corpse is not a juridical but a ethical asset and deserves respect for whom it was. It cannot be commercialized and is the only non-religious object susceptible of profanation. It is also object of popular affective and religious manifestations. Beliefs and affects must be respected. Organ donation is an act of charity and cannot be compulsory. The organ donation consent must be explicit, voluntary and solemn.

The ethics of deactivating a pacemaker in a pacing-dependent patient: reflections on a case study.

PubMed

Malpas, Phillipa J; Cooper, Lisa

2012-11-01

The decision to deactivate a pacemaker in a pacing-dependent patient is troubling for some health professionals who may regard such interventions as hastening death and therefore ethically impermissible. This may be especially concerning in situations where a patient is unable to clearly state what their preferences may be and the decision--were it to be made--will almost certainly result in the patient's immediate death. In this discussion, we reflect on some of the ethical aspects that arise when JP, a 75-year-old woman who is pacing dependent, suffers a significant brain injury, and the family request that her pacemaker be deactivated. Taking into account the clinical reality of her situation, the united wishes and loving concern of her husband and family, and their substituted judgment regarding her likely preferences, we claim that the decision to deactivate her pacemaker was ethically sound.

[The scope of forensic psychiatry: ethical responsibilities and conflicts of values].

PubMed

Arboleda-Flórez, Julio; Weisstub, David N

2006-01-01

To write about ethics in specialties that straddle the lines of multiple systems cannot be done without discussing values and decisional rules that underlie each one of those systems. By virtue of its multiple associations, forensic psychiatry is an archetype of such specialties ; it works within a set of values that might be viewed as antithetical, even irreconcilable, with other aspects of psychiatry. The extensive scope of action of forensic psychiatry compels its practitioners to hold alternate world views and to apply decisional rules that may clash with the classical values and ethical considerations of medicine (Weisstub, 1980). In this article, following an historical précis, the authors review the scope of action of forensic psychiatry as the basis for the definition of this subspecialty. The concepts, themes and controversies pertaining to the ethical practice of this specialty will be reflected upon in the light of issues encountered in actual practice.

Deep and continuous palliative sedation (terminal sedation): clinical-ethical and philosophical aspects.

PubMed

Materstvedt, Lars Johan; Bosshard, Georg

2009-06-01

Terminal sedation continues to fuel debate. When confronted with a patient for whom terminal sedation is considered a possible treatment option, decision making can be difficult. In this paper we focus on the clinical-ethical issues, with an aim to provide clinicians with ways of framing the issue from an ethical point of view. In addition to the clinical-ethical issues, terminal sedation touches upon interesting and complex questions of an essentially philosophical nature. What it means to be a "person" is one such question, and is a topic that is relevant to clinical, daily practice. Accordingly, in the latter part of this paper we draw briefly on selected philosophical positions to elucidate this question. A doctor's belief of what it means to be a "person" might well affect their actions. For example, if a doctor believes terminal sedation involves the destruction of the person, they might not be willing to proceed with it.

The Role of the Relationship with Parents with Respect to Work Orientation and Work Ethic.

PubMed

Leenders, Monique V E; Buunk, Abraham P; Henkens, Kène

2017-01-01

We examined the extent to which individual relationships with mother and father, social support from partner, and quality of the relationship with the partner, are related to work orientation and work ethic. Survey data were obtained from 3841 respondents from the Netherlands Kinship Panel Study (wave 2). The results showed that, overall, people with a more positive relationship with their parents had a more positive work orientation and a stronger work ethic. A positive relationship with the father had a greater influence on these work aspects than a positive relationship with the mother, particularly for men. Partner support and the quality of the partner relationship partially mediated the association between the relationship with one's parents and work orientation only for women. There were no significant relationships between partner support or the quality of the partner relationship, and work ethic. Research on the relationship with parents and work-related variables is discussed.

Clinical supervision of psychotherapy: essential ethics issues for supervisors and supervisees.

PubMed

Barnett, Jeffrey E; Molzon, Corey H

2014-11-01

Clinical supervision is an essential aspect of every mental health professional's training. The importance of ensuring that supervision is provided competently, ethically, and legally is explained. The elements of the ethical practice of supervision are described and explained. Specific issues addressed include informed consent and the supervision contract, supervisor and supervisee competence, attention to issues of diversity and multicultural competence, boundaries and multiple relationships in the supervision relationship, documentation and record keeping by both supervisor and supervisee, evaluation and feedback, self-care and the ongoing promotion of wellness, emergency coverage, and the ending of the supervision relationship. Additionally, the role of clinical supervisor as mentor, professional role model, and gatekeeper for the profession are discussed. Specific recommendations are provided for ethically and effectively conducting the supervision relationship and for addressing commonly arising dilemmas that supervisors and supervisees may confront. © 2014 Wiley Periodicals, Inc.

Teaching Ethics to Engineers: A Socratic Experience.

PubMed

Génova, Gonzalo; González, M Rosario

2016-04-01

In this paper we present the authors' experience of teaching a course in Ethics for Engineers, which has been delivered four times in three different universities in Spain and Chile. We begin by presenting the material context of the course (its place within the university program, the number of students attending, its duration, etc.), and especially the intellectual background of the participating students, in terms of their previous understanding of philosophy in general, and of ethics in particular. Next we set out the objectives of the course and the main topics addressed, as well as the methodology and teaching resources employed to have students achieve a genuine philosophical reflection on the ethical aspects of the profession, starting from their own mindset as engineers. Finally we offer some results based on opinion surveys of the students, as well as a more personal assessment by the authors, recapitulating the most significant achievements of the course and indicating its underlying Socratic structure.

Ethical perspectives of the Australian live export trade.

PubMed

Phillips, C J C

2005-09-01

To examine the ethical perspectives of the Australian live export trade. The perspectives of farmers and other industry personnel, overseas consumers, the Australian public, veterinarians and the assumed interests of transported animals are compared in relation to the ethical consequences. Animal welfare, societal, personal and professional ethics are identified and the ratification of different perspectives considered. There are positive and negative aspects of the trade for each stakeholder group, and the overall position adopted by any individual reflects their perspective of the balance of these components. The debate as to whether Australia should continue with the trade will be best served by consideration of the interests of all parties in the trade, including the consumers and animals, which are among the most affected by the trade. There is a need for further research to address the major welfare problems for the animals, an openness to inspection on the part of the trade and balance in media reporting.

A Qualitative Evaluation of Ethics Educational Program in Health Science1

PubMed Central

Ekmekci, Perihan Elif; Oral, Murat; Yurdakul, Eray Serdar

2015-01-01

This paper originates from a panel discussion on the evaluation of “Ethics Educational Program in Health Sciences” held during the IAEE Conference 2014 Ankara, Turkey. The participants of the panel had consultations to solidify the concepts about the topic. The qualitative data out of these antecedent discussions became mature with the contributions in the panel. The outcome of this qualitative study mainly focuses on the examples of two current curricula; one from PhD on History of Medicine and Medical Ethics, the other one from an elective course on medical ethics as a part of a PhD program on Pharmacy Management and History, followed by the major challenges the trainees face during their education, their expectations and whether the program was satisfactory, the aspects of the programs which are prone to improvement and their overall evaluations of the programs. PMID:26664129

Ethical budgets: a critical success factor in implementing new public management accountability in health care.

PubMed

Bosa, Iris M

2010-05-01

New public management accountability is increasingly being introduced into health-care systems throughout the world - albeit with mixed success. This paper examines the successful introduction of new management accounting systems among general practitioners (GPs) as an aspect of reform in the Italian health-care system. In particular, the study examines the critical role played by the novel concept of an 'ethical budget' in engaging the willing cooperation of the medical profession in implementing change. Utilizing a qualitative research design, with in-depth interviews with GPs, hospital doctors and managers, along with archival analysis, the present study finds that management accounting can be successfully implemented among medical professionals provided there is alignment between the management imperative and the ethical framework in which doctors practise their profession. The concept of an 'ethical budget' has been shown to be an innovative and effective tool in achieving this alignment.

Science, ethics and war: a pacifist's perspective.

PubMed

Kovac, Jeffrey

2013-06-01

This article considers the ethical aspects of the question: should a scientist engage in war-related research, particularly use-inspired or applied research directed at the development of the means for the better waging of war? Because scientists are simultaneously professionals, citizens of a particular country, and human beings, they are subject to conflicting moral and practical demands. There are three major philosophical views concerning the morality of war that are relevant to this discussion: realism, just war theory and pacifism. In addition, the requirements of professional codes of ethics and common morality contribute to an ethical analysis of the involvement of scientists and engineers in war-related research and technology. Because modern total warfare, which is facilitated by the work of scientists and engineers, results in the inevitable killing of innocents, it follows that most, if not all, war-related research should be considered at least as morally suspect and probably as morally prohibited.

[Care between ethics, work and political].

PubMed

Svandra, Philippe

2015-09-01

Down to the roots, the ethics of care have stood up a "different voice". Building on Carol Gilligan's works, the concept was developed widely in opposition with the rational and universalist aspect of Kant's moral philosophy. However, it also appears that this vision of care runs counter sets the three other main dominant moral theories, ie, utilitarism, John Rawls' procedural ethics and the Aristotelian virtue ethics. We may assert that the care theory presents itself as a contextualized moral theory aiming at taking into account others' vulnerability, in a practical way. Hence, the general term of "care" may encompass the notions of "help", "support" and "healing process", which, in France, for have often been opposed for varied reasons--historical, economical, psychological, professional etc... Switching from a moral position to a professional and practical activity, the concept of care has now undeniably taken on now a social and political dimension.

Biobanks for non-clinical purposes and the new law on forensic biobanks: does the Italian context protect the rights of minors?

PubMed

Tozzo, Pamela; Pegoraro, Renzo; Caenazzo, Luciana

2010-12-01

Biobanks are an important resource for medical research. Genetic research on biological material from minors can yield valuable information that can improve our understanding of genetic-environmental interactions and the genesis and development of early onset genetic disorders. The major ethical concerns relating to biobanks concern consent, privacy, confidentiality, commercialisation, and the right to know or not to know. However, research on paediatric data raises specific governance and ethical questions with regard to consent and privacy. We have considered the Italian normative context focusing on what is mentioned in each document on the ethical and legal requirements that guarantee the rights of minors. We found out that there is no systematic reflection on the ethical and policy issues arising from the participation of minors in biobank research. Moreover, we have focused on the same aspects for the new Italian Law on the National Forensic Biobank.

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.

[Project for the Creation of a Medical or Hospital Ethical Committee at a Local Level in the San Miguel Arcangel Hospital, District of San Miguelito, Province of Panama. Year 2013].

PubMed

Díaz Rivera, Yashiro A

2015-01-01

The next project was based on the design on the creation of a medical ethical Committee at a hospital. It was developed at the San Miguel Arcangel Hospital, District of San Miguelito, Province of Panama, in 2013. Insomuch as the creation of social projects requires unified international parameters, format is taken from the Unesco's guides for the establishing and working of bioethics committees; adapted to the socio-economic, political and cultural context of the San Miguelito District, Panama Province. Furthermore to adapting to socio-ecological aspect where the research project is carried out, the theoretical aspect includes from the ontological personalistic bioethics, where the cornerstone is the dignity of the human person. A study of perceptions of medical staff and nursing was developed on the management of the most common ethical dilemmas in the Hospital San Miguel Arcángel. The instrument used was a previously validated perception survey through a pilot test. Reliability was measured using Cronbach's alpha coefficient, and validity was obtained from the content. Satisfactory statistical results, that verify the working hypotheses on the recognition of the importance of autonomy, confidentiality, protection of vulnerable population, occupational health staff welfare and integration of bioethics at the institutional agenda, were obtained. However, there were particular aspects that indicate some doubt as to the management of some realities that are presented in the context of health care.

The International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of porcine islet products in type 1 diabetes--chapter 1: Key ethical requirements and progress toward the definition of an international regulatory framework.

PubMed

Cozzi, Emanuele; Tallacchini, Mariachiara; Flanagan, Enda B; Pierson, Richard N; Sykes, Megan; Vanderpool, Harold Y

2009-01-01

The outstanding results recently obtained in islet xenotransplantation suggest that porcine islet clinical trials may soon be scientifically appropriate. Before the initiation of such clinical studies, however, it is essential that a series of key ethical and regulatory conditions are satisfied. As far as ethics is concerned, the fundamental requirements have been previously reported in a position paper of the Ethics Committee of the International Xenotransplantation Association. These include aspects related to the selection of adequately informed, appropriate recipients; animal breeding and welfare; safety issues and the need for a favorable risk/benefit assessment based on strong efficacy data in relevant xenotransplantation studies in the primate. As most diabetic patients are not at risk of short-term mortality without islet transplantation, only a small subset of patients could currently be considered for any type of islet transplant. However, there are potential advantages to xenotransplantation that could result in a favorable benefit-over-harm determination for islet xenotransplantation in this subpopulation and ultimately in a broader population of diabetic patients. With regard to regulatory aspects, the key concepts underlying the development of the regulatory models in existence in the United States, Europe and New Zealand are discussed. Each of these models provides an example of a well-defined regulatory approach to ensure the initiation of well-regulated and ethically acceptable clinical islet xenotransplantation trials. At this stage, it becomes apparent that only a well-coordinated international effort such as that initiated by the World Health Organization, aimed at harmonizing xenotransplantation procedures according to the highest ethical and regulatory standards on a global scale, will enable the initiation of clinical xenotransplantation trials under the best auspices for its success and minimize any risk of failure.

When Ethics Constrains Clinical Research: Trial Design of Control Arms in “Greater Than Minimal Risk” Pediatric Trials

PubMed Central

de Melo-Martín, Inmaculada; Sondhi, Dolan

2011-01-01

Abstract For more than three decades clinical research in the United States has been explicitly guided by the idea that ethical considerations must be central to research design and practice. In spite of the centrality of this idea, attempting to balance the sometimes conflicting values of advancing scientific knowledge and protecting human subjects continues to pose challenges. Possible conflicts between the standards of scientific research and those of ethics are particularly salient in relation to trial design. Specifically, the choice of a control arm is an aspect of trial design in which ethical and scientific issues are deeply entwined. Although ethical quandaries related to the choice of control arms may arise when conducting any type of clinical trials, they are conspicuous in early phase gene transfer trials that involve highly novel approaches and surgical procedures and have children as the research subjects. Because of children's and their parents' vulnerabilities, in trials that investigate therapies for fatal, rare diseases affecting minors, the scientific and ethical concerns related to choosing appropriate controls are particularly significant. In this paper we use direct gene transfer to the central nervous system to treat late infantile neuronal ceroid lipofuscinosis to illustrate some of these ethical issues and explore possible solutions to real and apparent conflicts between scientific and ethical considerations. PMID:21446781

Public titles of clinical trials should have ethics review.

PubMed

Saenz, Carla; Reveiz, Ludovic; Tisdale, John F

2015-09-01

A key aspect to guarantee that research with human subjects is ethical is being overlooked. Ethics review committees invest great effort examining the informed consent documents of research protocols to ensure that potential participants can provide consent validly and are not deluded into thinking that the experimental intervention they may sign up for is already known to be therapeutic. However, these efforts to avoid what is called the "therapeutic misconception" might be in vain if the title with which the studies are being introduced to the potential participants escapes ethics review. Research participants might be deceived by clinical trials entitled "novel therapy" when the point of the trial is precisely to find out whether the intervention at stake is therapeutic or not. Providing potential research participants with such misleading information hampers their ability to make informed decisions. The well-established scrutiny that ethics review committees exercise with regard to consent forms is limited if the registration of clinical trials, for which a public title is chosen, constitutes a process that is independent from the ethics review. In this article, we examine this problem, assess recent measures to integrate clinical trial registration with ethics review processes, and provide specific recommendations to solve the problem and ultimately enhance the accountability, transparency, and ethics of research with human subjects. Copyright © 2015 Pan American Health Organization. Published by Elsevier Inc. All rights reserved.

Complementary and alternative medicine: the challenges of ethical justification. A philosophical analysis and evaluation of ethical reasons for the offer, use and promotion of complementary and alternative medicine.

PubMed

Mertz, Marcel

2007-09-01

With the prevalence of complementary and alternative medicine (CAM) increasing in western societies, questions of the ethical justification of these alternative health care approaches and practices have to be addressed. In order to evaluate philosophical reasoning on this subject, it is of paramount importance to identify and analyse possible arguments for the ethical justification of CAM considering contemporary biomedical ethics as well as more fundamental philosophical aspects. Moreover, it is vital to provide adequate analytical instruments for this task, such as separating 'CAM as belief system' and 'CAM as practice'. Findings show that beneficence and non-maleficence are central issues for an ethical justification of CAM as practice, while freedom of thought and religion are central to CAM as belief system. Many justification strategies have limitations and qualifications that have to be taken into account. Singularly descriptive premises in an argument often prove to be more problematic than universal ethical principles. Thus, non-ethical issues related to a general philosophical underpinning--e.g. epistemology, semantics, and ontology--are highly relevant for determining a justification strategy, especially when strong metaphysical assumptions are involved. Even if some values are shared with traditional biomedicine, axiological differences have to be considered as well. Further research should be done about specific CAM positions. These could be combined with applied qualitative social research methods.

Clinical group supervision for integrating ethical reasoning: Views from students and supervisors.

PubMed

Blomberg, Karin; Bisholt, Birgitta

2016-11-01

Clinical group supervision has existed for over 20 years in nursing. However, there is a lack of studies about the role of supervision in nursing students' education and especially the focus on ethical reasoning. The aim of this study was to explore and describe nursing students' ethical reasoning and their supervisors' experiences related to participation in clinical group supervision. The study is a qualitative interview study with interpretative description as an analysis approach. A total of 17 interviews were conducted with nursing students (n = 12) who had participated in clinical group supervision in their first year of nursing education, and with their supervisors (n = 5). The study was based on the ethical principles outlined in the Declaration of Helsinki, and permission was obtained from the Regional Ethical Review Board in Sweden. The analysis revealed that both the form and content of clinical group supervision stimulated reflection and discussion of handling of situations with ethical aspects. Unethical situations were identified, and the process uncovered underlying caring actions. Clinical group supervision is a model that can be used in nursing education to train ethical reflection and to develop an ethical competence among nursing students. Outcomes from the model could also improve nursing education itself, as well as healthcare organizations, in terms of reducing moral blindness and unethical nursing practice. © The Author(s) 2015.

Burden of Disease Study and Priority Setting in Korea: an Ethical Perspective

PubMed Central

2016-01-01

When thinking about priority setting in access to healthcare resources, decision-making requires that cost-effectiveness is balanced against medical ethics. The burden of disease has emerged as an important approach to the assessment of health needs for political decision-making. However, the disability adjusted life years approach hides conceptual and methodological issues regarding the claims and value of disabled people. In this article, we discuss ethical issues that are raised as a consequence of the introduction of evidence-based health policy, such as economic evidence, in establishing resource allocation priorities. In terms of ethical values in health priority setting in Korea, there is no reliable rationale for the judgment used in decision-making as well as for setting separate and distinct priorities for different government bodies. An important question, therefore, is which ethical values guiding the practice of decision-making should be reconciled with the economic evidence found in Korean healthcare. The health technology assessment core model from the European network for Health Technology Assessment (EUnetHTA) project is a good example of incorporating ethical values into decision-making. We suggest that a fair distribution of scarce healthcare resources in South Korea can be achieved by considering the ethical aspects of healthcare. PMID:27775247

Barriers to Considering Ethical and Societal Implications of Research: Perceptions of Life Scientists.

PubMed

McCormick, Jennifer Blair; Boyce, Angie M; Ladd, Jennifer M; Cho, Mildred

2012-01-01

BACKGROUND: As part of an empirical study investigating how life scientists think about ethical and societal implications of their work, and about life science research in general, we sought to elucidate barriers that scientists might face in considering such implications. METHOD: Between 2005 and 2007, we conducted a study consisting of phone interviews, focus groups, and a national survey of life scientists at biomedical research institutions. The study population included graduate students, postdoctoral fellows, faculty, clinical instructors, and research staff. We analyzed data through qualitative and quantitative methods. RESULTS: In analyzing the data, we found that life scientists do, in fact, face barriers to considering ethical and societal implications of research. We categorized these barriers as falling into four broad domains: (1) lack of awareness of ethical and societal implications; (2) lack of relevance of such concerns to their specific research; (3) self-confidence in their ability to resolve such concerns; and (4) aspects of the daily practice of science itself. CONCLUSIONS: Life science researchers experience elements inherent in their training and in the conduct of science as barriers to thinking about ethical and societal implications related to their work. These findings suggest areas in which research ethics educators, bioethicists, and the scientific community can focus their efforts to improve social and ethical accountability in research.

The ethics of neuromodulation for anorexia nervosa: a focus on rTMS

PubMed Central

2014-01-01

Objective Recently there has been emerging clinical and research interest in the application of deep brain stimulation (DBS) and repetitive transcranial magnetic stimulation (rTMS) to the treatment of anorexia nervosa (AN). To our knowledge, few studies have discussed ethical aspects associated with the increased use of neuromodulation in AN, some of which are quite specific to AN, despite the rapid development and dissemination of these new technologies. Method We provide a brief overview of three published rTMS studies for AN and discuss ethical issues involved in the use of neuromodulation for AN. Results In contrast to neurosurgery or DBS, rTMS is a less invasive technique, with less associated risk, and thus has greater potential to become a more widespread augmentation or add-on therapy for AN. New therapeutic procedures are promising, yet they raise ethical questions regarding informed consent and patient selection. Illness-specific issues surrounding authenticity and autonomy are important to consider, ensuring an ethical approach to treatment for patients with AN. Discussion We argue that ethical investigations for neuromodulation techniques are timely and important, and discussions should go beyond the immediate goals of patient safety, consent, and risk and benefit, to consider broader ethical concepts such as authenticity and autonomy. PMID:24690315

Collaborative partnership and the social value of clinical research: a qualitative secondary analysis.

PubMed

Nurmi, Sanna-Maria; Halkoaho, Arja; Kangasniemi, Mari; Pietilä, Anna-Maija

2017-10-25

Protecting human subjects from being exploited is one of the main ethical challenges for clinical research. However, there is also a responsibility to protect and respect the communities who are hosting the research. Recently, attention has focused on the most efficient way of carrying out clinical research, so that it benefits society by providing valuable research while simultaneously protecting and respecting the human subjects and the communities where the research is conducted. Collaboration between partners plays an important role and that is why we carried out a study to describe how collaborative partnership and social value are emerging in clinical research. A supra-analysis design for qualitative descriptive secondary analysis was employed to consider a novel research question that pertained to nurse leaders' perceptions of ethical recruitment in clinical research and the ethics-related aspects of clinical research from the perspective of administrative staff. The data consisted of two separate pre-existing datasets, comprising 451 pages from 41 interviews, and we considered the research question by using deductive-inductive content analysis with NVivo software. A deductive analysis matrix was generated on the basis of two requirements, namely collaborative partnership and social value, as presented in An Ethical Framework for Biomedical Research by Emanuel et al. The findings showed that collaborative partnership was a cornerstone for ethical clinical research and ways to foster inter-partner collaboration were indicated, such as supporting mutual respect and equality, shared goals and clearly defined roles and responsibilities. In addition, the social value of clinical research was an important precondition for ethical clinical research and its realisation required the research partners to demonstrate collaboration and shared responsibility during the research process. However, concerns emerged that the multidimensional meaning of clinical research for society was not fully recognised. Achieving greater social value for clinical research required greater transparency, setting research priorities, shared responsibility for the dissemination and use of the findings and stronger community awareness of the ethics-related aspects of clinical research. Collaborative partnership and social values are essential for protecting the human subjects and communities involved in clinical research.

Genetically Modified (GM) Foods and Ethical Eating.

PubMed

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

2016-02-01

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

[Ethical aspects of human lactation and breastfeeding].

PubMed

Parrilla Rodríguez, A M; Gorrín Peralta, J J

2000-06-01

Breastfeeding has experienced a surge in Puerto Rico thanks to the efforts of many women, as well as governmental, non-governmental and private organizations. Among the aspects which can affect the initiation, establishment and maintenance of successful breastfeeding one finds potential ethical conflicts among health professionals as well as the financial interests of the companies which produce and market artificial milks. These companies dedicate great marketing efforts and enormous sums of money in the sale of their products, in detriment of breastfeeding. The profit motive of these companies is in open contradiction to public health and to breastfeeding promotion. The international community has carried out efforts for more than two decades in the creation of structures which protect the rights of women and their children to ideal nutrition practices, free from commercial pressures, through breastfeeding. Possible ethical conflicts related to the new industry of breastfeeding paraphernalia are discussed, especially when these are marketed exclusively for profit. Recommendations are presented for health professionals in order for them to be able to face and respond to the unethical strategies practiced by the manufacturers of artificial milks in utilizing these professionals for legitimating and marketing their products.

Analysis and critical review of the development of bioethics in Belarus.

PubMed

Vishneuskaya, Yuliya A

2012-11-01

The main trends of the bioethics development in Belarus have been analyzed on the basis of the materials collected by the Ethics Documentation Center (ISEU, Minsk, Belarus). A critical review of the most important publications in the field since 2000 suggests that development of bioethics in Belarus has occurred in two parallel directions distantly connected to each other: a theoretical direction and a practical one. Despite there are objective and subjective reasons for introducing bioethics in Belarus as an institutionally-organized system based on liberal values such as individual rights and freedom, a range of essential problems could be identified. Non-equivalent regulation of ethical issues in health care and other fields of biomedical research has been emphasized, as well as the problem of unclear hierarchical relationships among institutions dealing with various aspects of bioethics in the country and low ethical and educational level of the social and professional groups involved in further expansion of bioethical knowledge. The contextual aspects of the development of bioethics in the country such as the consequences of the Chernobyl disaster, the prevalence of the authoritarian social morality and traditionally paternalistic nature of the relations between physicians and their patients are discussed.

Video laboratories for the teaching and learning of professional ethics in exercise physiology curricula.

PubMed

Senchina, David S

2011-09-01

Student researchers in physiology courses often interact with human subjects in classroom research but may be unfamiliar with the professional ethics of experimenter-subject interactions. This communication describes experiences related to an interactive video used in exercise science and general biology courses to help students become aware of, sensitive to, and comfortable with implementing professional ethics into their own thinking and behavior as researchers before entering the laboratory. The activity consisted of a filmed exercise physiology experiment complemented with interactive question sheets followed by small- and large-group discussion and culminating with individual student reflections. Student written responses from multiple courses indicated that students were able to 1) identify and consider the ethics of experimenter-subject interactions from the movie, 2) generalize broader ideas of professional ethics from those observations, and 3) consider their observations in terms of future experiments they would be conducting personally and how they should interact with human subjects. A majority of students indicated a positive reaction to the video and identified specific aspects they appreciated. It is hoped that this report will encourage other instructors to consider the use of interactive videos in the teaching and learning of professional ethics related to their courses.

The Ethical, Legal, and Social Issues Impacted by Modern Assisted Reproductive Technologies

PubMed Central

Brezina, Paul R.; Zhao, Yulian

2012-01-01

Background. While assisted reproductive technology (ART), including in vitro fertilization has given hope to millions of couples suffering from infertility, it has also introduced countless ethical, legal, and social challenges. The objective of this paper is to identify the aspects of ART that are most relevant to present-day society and discuss the multiple ethical, legal, and social challenges inherent to this technology. Scope of Review. This paper evaluates some of the most visible and challenging topics in the field of ART and outlines the ethical, legal, and social challenges they introduce. Major Conclusions. ART has resulted in a tectonic shift in the way physicians and the general population perceive infertility and ethics. In the coming years, advancing technology is likely to exacerbate ethical, legal, and social concerns associated with ART. ART is directly challenging society to reevaluate the way in which human life, social justice and equality, and claims to genetic offspring are viewed. Furthermore, these issues will force legal systems to modify existing laws to accommodate the unique challenges created by ART. Society has a responsibility to ensure that the advances achieved through ART are implemented in a socially responsible manner. PMID:22272208

Social and ethical analysis in health technology assessment.

PubMed

Tantivess, Sripen

2014-05-01

This paper presents a review of the domestic and international literature on the assessment of the social and ethical implications of health technologies. It gives an overview of the key concepts, principles, and approaches that should be taken into account when conducting a social and ethical analysis within health technology assessment (HTA). Although there is growing consensus among healthcare experts that the social and ethical ramifications of a given technology should be examined before its adoption, the demand for this kind of analysis among policy-makers around the world, including in Thailand, has so far been lacking. Currently decision-makers mainly base technology adoption decisions using evidence on clinical effectiveness, value for money, and budget impact, while social and ethical aspects have been neglected. Despite the recognized importance of considering equity, justice, and social issues when making decisions regarding health resource allocation, the absence of internationally-accepted principles and methodologies, among other factors, hinders research in these areas. Given that developing internationally agreed standards takes time, it has been recommended that priority be given to defining processes that are justifiable, transparent, and contestable. A discussion of the current situation in Thailand concerning social and ethical analysis of health technologies is also presented.

Could the ethics of institutionalized health care be anything but Kantian? Collecting building blocks for a unifying metaethics.

PubMed

Kaldis, Byron

2005-01-01

Is a Health Care Ethics possible? Against sceptical and relativist doubts Kantian deontology may advance a challenging alternative affirming the possibility of such an ethics on the condition that deontology be adopted as a total programme or complete vision. Kantian deontology is enlisted to move us from an ethics of two-person informal care to one of institutions. It justifies this affirmative answer by occupying a commanding meta-ethical stand. Such a total programme comprises, on the one hand, a dual-aspect strategy incorporating the macro- (institutional) and micro- (person-to-person) levels while, on the other, it integrates consistently within moral epistemology a meta-ethics with lower-ground moral theories. The article describes the issues to be dealt with and the problems which have to be solved on the way to a unifying theory of that kind (Sections I-III) and indicates elements of Kantian moral philosophy which may serve as building blocks (Section IV). Among these are not only Kant's ideas concerning the moral acting of persons and his ideas concerning civil society and state but also his ideas concerning morality, schematism and religion.

What Next? Translating AGI's 2015 Guidelines for Ethical Professional Conduct into Practice

NASA Astrophysics Data System (ADS)

Boland, M. A.; Keane, C.

2016-12-01

In 2015, the American Geosciences Institute (AGI) published a revised version of the 1999 Guidelines for Ethical Professional Conduct, an aspirational document outlining ethical principles that should inform the professional behavior of all geoscientists. The revised Guidelines reflect a consensus of opinion among AGI's 51 member societies and show an evolution in thinking about geoscience ethics. The Guidelines also represent a foundational document to support the expansion of ethical guidelines by individual societies and organizations. Publishing the Guidelines was a significant milestone but aspirations need to be matched by action. We examine several developments that implement aspects of the Guidelines, including the development of a consensus statement regarding access and inclusion of individuals living with disabilities in the geosciences, a Joint AGI/Geological Society of America Societies meeting on professional conduct, geoethics training initiatives, and efforts to foster international cooperation in recognizing and implementing ethical practice in the geosciences. In addition, we examine the level of success in using these Guidelines as philosophical cornerstones for a number of international projects, such as Resourcing Future Generations and the International Raw Materials Observatory, that bring geoscience directly into contact with large societal issues.

Recommendations for the ethical use and design of artificial intelligent care providers.

PubMed

Luxton, David D

2014-09-01

This paper identifies and reviews ethical issues associated with artificial intelligent care providers (AICPs) in mental health care and other helping professions. Specific recommendations are made for the development of ethical codes, guidelines, and the design of AICPs. Current developments in the application of AICPs and associated technologies are reviewed and a foundational overview of applicable ethical principles in mental health care is provided. Emerging ethical issues regarding the use of AICPs are then reviewed in detail. Recommendations for ethical codes and guidelines as well as for the development of semi-autonomous and autonomous AICP systems are described. The benefits of AICPs and implications for the helping professions are discussed in order to weigh the pros and cons of their use. Existing ethics codes and practice guidelines do not presently consider the current or the future use of interactive artificial intelligent agents to assist and to potentially replace mental health care professionals. AICPs present new ethical issues that will have significant ramifications for the mental health care and other helping professions. Primary issues involve the therapeutic relationship, competence, liability, trust, privacy, and patient safety. Many of the same ethical and philosophical considerations are applicable to use and design of AICPs in medicine, nursing, social work, education, and ministry. The ethical and moral aspects regarding the use of AICP systems must be well thought-out today as this will help to guide the use and development of these systems in the future. Topics presented are relevant to end users, AI developers, and researchers, as well as policy makers and regulatory boards. Published by Elsevier B.V.

Evaluation of Ethical Attitude Approaches in Midwives and their Relationship with their Demographic Features

PubMed Central

Afhami, Narges; Nekuei, Nafisehsadat; Bahadoran, Parvin; Taleghani-Esfahani, HamidReza

2018-01-01

Background: Ethical approach is one of the paramount aspects of life. The position of this approach in medical occupations has always been noticed. This study was carried out to analyze the types of ethical approaches in midwives and their relationship with their demographic features. Materials and Methods: The current descriptive-correlation and cross-sectional study was conducted from October to December 2014 using quota random sampling technique. The participants consisted of 189 midwives employed in Isfahan, Iran. The data collection tool was a researcher-made questionnaire. The midwives' attitudes were examined in the four fields of virtue ethics, deontologism, utilitarianism, and religious ethics. Data were analyzed using descriptive and inferential statistics in SPSS software (p < 0.050). Results: The highest score belonged to religious ethics with the mean value of 64.36 out of 100. A positive significant relationship was found between deontologism and education level (F = 8.74; p = 0.004), and total ethical approach and workplace (F = 2.60; p = 0.053). There was a reverse significant relationship between age and work experience and virtue ethics (r = −0.15; p = 0.035 and r = −0.20; p = 0.005, respectively). Conclusions: The existing high percentage of religious ethics shows the religious tendency of the participants. The determination of ethical approach among midwives as one of the important medical groups and creation and improvement of the most appropriate attitude among them based on the present regulations and requirements in society are principles that we should attempt to achieve. PMID:29861757

Validation of the Hospital Ethical Climate Survey for older people care.

PubMed

Suhonen, Riitta; Stolt, Minna; Katajisto, Jouko; Charalambous, Andreas; Olson, Linda L

2015-08-01

The exploration of the ethical climate in the care settings for older people is highlighted in the literature, and it has been associated with various aspects of clinical practice and nurses' jobs. However, ethical climate is seldom studied in the older people care context. Valid, reliable, feasible measures are needed for the measurement of ethical climate. This study aimed to test the reliability, validity, and sensitivity of the Hospital Ethical Climate Survey in healthcare settings for older people. A non-experimental cross-sectional study design was employed, and a survey using questionnaires, including the Hospital Ethical Climate Survey was used for data collection. Data were analyzed using descriptive statistics, inferential statistics, and multivariable methods. Survey data were collected from a sample of nurses working in the care settings for older people in Finland (N = 1513, n = 874, response rate = 58%) in 2011. This study was conducted according to good scientific inquiry guidelines, and ethical approval was obtained from the university ethics committee. The mean score for the Hospital Ethical Climate Survey total was 3.85 (standard deviation = 0.56). Cronbach's alpha was 0.92. Principal component analysis provided evidence for factorial validity. LISREL provided evidence for construct validity based on goodness-of-fit statistics. Pearson's correlations of 0.68-0.90 were found between the sub-scales and the Hospital Ethical Climate Survey. The Hospital Ethical Climate Survey was found able to reveal discrimination across care settings and proved to be a valid and reliable tool for measuring ethical climate in care settings for older people and sensitive enough to reveal variations across various clinical settings. The Finnish version of the Hospital Ethical Climate Survey, used mainly in the hospital settings previously, proved to be a valid instrument to be used in the care settings for older people. Further studies are due to analyze the factor structure and some items of the Hospital Ethical Climate Survey. © The Author(s) 2014.

Ethical Dilemmas for Oocyte Donations: Slippery Slope for Conflicts of Interest.

PubMed

Tulay, Pinar

2016-01-01

Oocyte donations have increased with improvements in oocyte cryopreservation procedures in recent years. Women with medical conditions that require chemotherapy or radiotherapy have begun to opt for oocyte cryo¬preservation prior to their treatment or to enroll in an oocyte donation program. Alternatively, some women apply for "third-party" oocyte donation programs for nonmedical reasons such as delayed childbearing. Although society seems to accept oocyte donations for medical reasons, it appears that there are still some moral issues surrounding nonmedical oocyte donations. In this review, the ethical aspects of oocyte donations and donors' perspectives are discussed. With developing technologies, the genetic screening of donors has expanded to include diseases. This review explores the ethical issues involved in genetic screening of gamete donors.

Medical experimentation concerning chemical and biological weapons for mass destruction.

PubMed

Deutsch, Erwin

2003-04-01

This article is the text of a speech originally presented at the Second World Conference on Medical Ethics at Gijon, Spain, on 2 October 2002 under the title "Medical Experimentation Concerning Chemical and Biological Weapons for Mass Destruction: Clinical Design for New Smallpox Vaccines: Ethical and Legal Aspects." Experimentation on vaccines such as smallpox is subject to the usual ethical rules such as the need for informed consent. However, the participants will not often be at risk of catching the disease but expose themselves by taking part in the experimentation. Professor Deutsch explores the implications of this, including the position of vulnerable groups such as children, those with mental handicaps, and those acting under orders such as the miliary, the policy and fire officers.

The virtues in the moral education of nurses: Florence Nightingale revisited.

PubMed

Sellman, D

1997-01-01

The virtues have been a neglected aspect of morality; only recently has reference been made to their place in professional ethics. Unfashionable as Florence Nightingale is, it is nonetheless worth noting that she was instrumental in continuing the Aristotelian tradition of being concerned with the moral character of persons. Nurses who came under Nightingale's sphere of influence were expected to develop certain exemplary habits of behaviour. A corollary can be drawn with the current UK professional body: nurses are expected to behave in certain ways and to display particular kinds of disposition. The difference lies in the fact that, while Nightingale was clear about the need for moral education, current emphasis is placed on ethical theory and ethical decision-making.

Ethics, government and sexual health: insights from Foucault.

PubMed

Winch, Sarah

2005-03-01

The work of Michel Foucault, the French philosopher who was interested in power relationships, has resonated with many nurses who seek a radically analytical view of nursing practice. The purpose of this article is to explore 'ethics' through a Foucauldian lens, in a conceptual and methodological sense. The intention is to provide a useful framework that will help researchers critically to explore aspects of nursing practice that relate to the construction of the self, morality and identity, be that nurse or patient related. The fundamentals of the research method of genealogy and the methods of ethics are reviewed. Using an example taken from the sexual health practice area, advice is given on how to structure data collection, incorporate interview data, avoid discourse determinism and measure resistance.

Social and ethical issues in environmental remediation projects.

PubMed

Oughton, D H

2013-05-01

The contamination of environments with radionuclides can give rise to consequences that encompass far more than health risks from exposure to radiation. As experience from Chernobyl demonstrated, both the accident and remediation measures can have serious social and economic consequences. This paper presents a review of some of these issues, including their ethical relevance, and presents a check-list of socio-ethical aspects of remediation measures. The paper concludes with an overview of social remediation measures, encompassing actions that are directed towards benefits other than dose reduction (e.g., local food monitoring stations or medical check-up), or measures that require social rather than technical implementation (e.g. information centres, stakeholder dialogue). Copyright © 2011 Elsevier Ltd. All rights reserved.

Ethical analysis in HTA of complex health interventions.

PubMed

Lysdahl, Kristin Bakke; Oortwijn, Wija; van der Wilt, Gert Jan; Refolo, Pietro; Sacchini, Dario; Mozygemba, Kati; Gerhardus, Ansgar; Brereton, Louise; Hofmann, Bjørn

2016-03-22

In the field of health technology assessment (HTA), there are several approaches that can be used for ethical analysis. However, there is a scarcity of literature that critically evaluates and compares the strength and weaknesses of these approaches when they are applied in practice. In this paper, we analyse the applicability of some selected approaches for addressing ethical issues in HTA in the field of complex health interventions. Complex health interventions have been the focus of methodological attention in HTA. However, the potential methodological challenges for ethical analysis are as yet unknown. Six of the most frequently described and applied ethical approaches in HTA were critically assessed against a set of five characteristics of complex health interventions: multiple and changing perspectives, indeterminate phenomena, uncertain causality, unpredictable outcomes, and ethical complexity. The assessments are based on literature and the authors' experiences of developing, applying and assessing the approaches. The Interactive, participatory HTA approach is by its nature and flexibility, applicable across most complexity characteristics. Wide Reflective Equilibrium is also flexible and its openness to different perspectives makes it better suited for complex health interventions than more rigid conventional approaches, such as Principlism and Casuistry. Approaches developed for HTA purposes are fairly applicable for complex health interventions, which one could expect because they include various ethical perspectives, such as the HTA Core Model® and the Socratic approach. This study shows how the applicability for addressing ethical issues in HTA of complex health interventions differs between the selected ethical approaches. Knowledge about these differences may be helpful when choosing and applying an approach for ethical analyses in HTA. We believe that the study contributes to increasing awareness and interest of the ethical aspects of complex health interventions in general.

Ethics by opinion poll? The functions of attitudes research for normative deliberations in medical ethics.

PubMed

Salloch, Sabine; Vollmann, Jochen; Schildmann, Jan

2014-09-01

Empirical studies on people's moral attitudes regarding ethically challenging topics contribute greatly to research in medical ethics. However, it is not always clear in which ways this research adds to medical ethics as a normative discipline. In this article, we aim to provide a systematic account of the different ways in which attitudinal research can be used for normative reflection. In the first part, we discuss whether ethical judgements can be based on empirical work alone and we develop a sceptical position regarding this point, taking into account theoretical, methodological and pragmatic considerations. As empirical data should not be taken as a direct source for normative justification, we then delineate different ways in which attitudes research can be combined with theoretical accounts of normative justification in the second part of the article. Firstly, the combination of attitudes research with normative-ethical theories is analysed with respect to three different aspects: (a) The extent of empirical data which is needed, (b) the question of which kind of data is required and (c) the ways in which the empirical data are processed within the framework of an ethical theory. Secondly, two further functions of attitudes research are displayed which lie outside the traditional focus of ethical theories: the exploratory function of detecting and characterising new ethical problems, and the field of 'moral pragmatics'. The article concludes with a methodological outlook and suggestions for the concrete practice of attitudinal research in medical ethics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Technology and its ethics in nursing and caring journals: An integrative literature review.

PubMed

Korhonen, Eila-Sisko; Nordman, Tina; Eriksson, Katie

2015-08-01

Over the past 20 years, the impact of technology has increased significantly in health care. The diversity of technology is growing and its knowledge scattered. The concept of technology is ambiguous in caring and nursing sciences and its ethics remains unidentified. To find evidence on how the concept of technology and its ethics are defined in caring and nursing sciences and practice. The purpose of this study is to describe and summarize the concept of technology and its ethics in the past nursing and caring literature. The integrative literature review of the past nursing and caring literature. The data were collected from caring and nursing journal articles from 2000 to 2013 focusing on technology and its ethics.The results were summarized and themed. Technology as a concept has three implications. First, technology is devices and products, including ICT and advanced, simple and assistive technology. Second, technology refers to a process consisting of methods for helping people. Third, technology as a service indicates the production of care by technology. The ethics of technology has not been established as a guiding principle. Some studies excluded ethical reflection completely. Many studies discussed the ethics of technology as benefits such as improved communication and symptoms management, and the simple use of e-health services whilst others remained critical presenting ethical problems such as unwillingness and the inability to use technology, or conflicts with human aspects or questions of inequality. In conclusion, this study indicates that technology as a concept is described diversely. The relation between technology and ethics is not a truism. Despite some evidence, more is needed to promote ethical care when using technology. © The Author(s) 2014.

Empirical research in medical ethics: how conceptual accounts on normative-empirical collaboration may improve research practice.

PubMed

Salloch, Sabine; Schildmann, Jan; Vollmann, Jochen

2012-04-13

The methodology of medical ethics during the last few decades has shifted from a predominant use of normative-philosophical analyses to an increasing involvement of empirical methods. The articles which have been published in the course of this so-called 'empirical turn' can be divided into conceptual accounts of empirical-normative collaboration and studies which use socio-empirical methods to investigate ethically relevant issues in concrete social contexts. A considered reference to normative research questions can be expected from good quality empirical research in medical ethics. However, a significant proportion of empirical studies currently published in medical ethics lacks such linkage between the empirical research and the normative analysis. In the first part of this paper, we will outline two typical shortcomings of empirical studies in medical ethics with regard to a link between normative questions and empirical data: (1) The complete lack of normative analysis, and (2) cryptonormativity and a missing account with regard to the relationship between 'is' and 'ought' statements. Subsequently, two selected concepts of empirical-normative collaboration will be presented and how these concepts may contribute to improve the linkage between normative and empirical aspects of empirical research in medical ethics will be demonstrated. Based on our analysis, as well as our own practical experience with empirical research in medical ethics, we conclude with a sketch of concrete suggestions for the conduct of empirical research in medical ethics. High quality empirical research in medical ethics is in need of a considered reference to normative analysis. In this paper, we demonstrate how conceptual approaches of empirical-normative collaboration can enhance empirical research in medical ethics with regard to the link between empirical research and normative analysis.

Empirical research in medical ethics: How conceptual accounts on normative-empirical collaboration may improve research practice

PubMed Central

2012-01-01

Background The methodology of medical ethics during the last few decades has shifted from a predominant use of normative-philosophical analyses to an increasing involvement of empirical methods. The articles which have been published in the course of this so-called 'empirical turn' can be divided into conceptual accounts of empirical-normative collaboration and studies which use socio-empirical methods to investigate ethically relevant issues in concrete social contexts. Discussion A considered reference to normative research questions can be expected from good quality empirical research in medical ethics. However, a significant proportion of empirical studies currently published in medical ethics lacks such linkage between the empirical research and the normative analysis. In the first part of this paper, we will outline two typical shortcomings of empirical studies in medical ethics with regard to a link between normative questions and empirical data: (1) The complete lack of normative analysis, and (2) cryptonormativity and a missing account with regard to the relationship between 'is' and 'ought' statements. Subsequently, two selected concepts of empirical-normative collaboration will be presented and how these concepts may contribute to improve the linkage between normative and empirical aspects of empirical research in medical ethics will be demonstrated. Based on our analysis, as well as our own practical experience with empirical research in medical ethics, we conclude with a sketch of concrete suggestions for the conduct of empirical research in medical ethics. Summary High quality empirical research in medical ethics is in need of a considered reference to normative analysis. In this paper, we demonstrate how conceptual approaches of empirical-normative collaboration can enhance empirical research in medical ethics with regard to the link between empirical research and normative analysis. PMID:22500496

Umbilical cord blood banks. Ethical aspects. Public versus private banks.

PubMed

Aznar Lucea, Justo

2012-01-01

The creation of umbilical cord blood (UCB) banks raises interesting medical, social, economic and ethical issues. This paper reviews the ethical problems specifically. In this respect, it evaluates: a) whether there are advantages to the use of UCB compared to bone marrow, b) whether or not it is ethical to create UCB banks, c) whether their creation is ethically acceptable in terms of their clinical usefulness or d) the use made of them for therapeutic purposes, and finally e) whether their creation is ethically justified from a cost/profitability point of view. We focus primarily on evaluating the ethical controversy between public and private banks, particularly on whether it is ethical to bank autologous blood in private UCB banks, on the basis of its limited possibilities for use by the cord blood donor. We can conclude that, from an ethical point of view, autologous blood banks have limited acceptance among specialised researchers, scientific societies and other public institutions. Therefore, we believe that it is ethically more acceptable to support the creation of public UCB banks for medical and social reasons and, above all, based on the principle of justice and human solidarity. Nevertheless, there is no definitive ethical argument why a couple, according to their autonomy and freedom, cannot bank their child's UCB in a private bank. An equally acceptable solution could be the creation of mixed banks, such as that proposed by the Virgin Health Bank or like the Spanish system where autologous samples can be stored in public banks but with the proviso that if at any time the stored sample is required by any person other than the donor, it would have to be given to them.

[Ethical aspects of prenatal screening for Down's syndrome].

PubMed

Tóth, A; Szabó, J

2000-10-15

Trisomy 21, the chromosomal base of Down's syndrome, results in severe mental and physical handicap. Owing to the development of medical genetics reliable screening and diagnostic procedures for the detection of the disorder are available in Hungary. To achieve the goals of prenatal screening it is important to address the main ethical issues arising through the application of technical-professional skills. The core objective of prenatal screening for Down's syndrome is to give information about the genetic condition of the fetus in order to enhance the autonomy of the parents in family planning. Screening programs should respect the ethical requirements of the principles of "do no harm", beneficence and autonomy of the patients, which are the most important ethical norms of doctor-patient relationship. Regarding the social aspects of screening it is essential to claim that voluntary participation and nondirective genetic counselling can exclude eugenic purposes. Though introduction of prenatal tests does not imply the discrimination of the disabled, anxiety of handicapped people deserves more attention. Abortion of affected fetuses isn't among the objectives of prenatal genetic screening but patient's autonomy is supported in decisions concerning the future of the pregnancy. Social justice can be taken into consideration by providing the test to all women without respect to their social position, educational level or their age. An open debate about the issues of prenatal screening for Down's syndrome could promote the formation of a consensus between professionals and the public.

Vaccine hesitancy and trust. Ethical aspects of risk communication.

PubMed

Nihlén Fahlquist, Jessica

2018-03-01

This paper analyses vaccination policy from an ethical perspective, against the background of the growing hesitancy towards e.g. the measles vaccine. The paper is normative and analyses ethical aspects of risk communication in the context of vaccination. It is argued that ethical analysis of risk communication should be done at the level of the message, the procedure and the effects. The paper takes examples from the Swedish context, linking the current lack of trust in experts to the 2009 vaccination policy and communication promoting the H1N1 vaccine Pandemrix. During the Swedish H1N1 vaccination policy in 2009, the message was that the vaccine is safe. However, a group of adolescents developed narcolepsy as a side effect of the vaccine. Taking this into account, it becomes clear that the government should communicate risks and benefits responsibly and take responsibility for individuals affected negatively by populational health interventions. To communicate respectfully entails not treating vaccine sceptics as ill-informed or less educated, but instead taking the concerns of the vaccine hesitant, who potentially could change their minds, as a starting-point of a respectful discussion. There will inevitably be individuals who suffer from side effects of justifiable population-based health promotion activities. However, the public should be able to trust the message and count on the government to take responsibility for individuals affected by side effects. This is important for normative reasons, but is additionally likely to contribute to restored and maintained trust.

A Framework for Ethical Decision Making in the Rehabilitation of Patients with Anosognosia.

PubMed

Egbert, Anna Rita

2017-01-01

Currently, the number of patients diagnosed with impaired self-awareness of their own deficits after brain injury-anosognosia-is increasing. One reason is a growing understanding of this multifaceted phenomenon. Another is the development and accessibility of alternative measurements that allow more detailed diagnoses. Anosognosia can adversely affect successful rehabilitation, as often patients lack confidence in the need for treatment. Planning such treatment can become a complex process full of ethical dilemmas. To date, there is no systematic way to deal with different aspects of anosognosia rehabilitation planning. This is the first article to present a framework for ethical decision making in establishing rehabilitation plans that are focused on increasing patients' self-awareness of their own deficits after brain injury. It concentrates especially on addressing the ethical dilemmas that may arise, and describes stepwise procedures that can be applied to distinct theoretical approaches, as well as diagnostic and rehabilitation methods. To show the flexibility of the use of this framework, alternative approaches are discussed. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Perception of Ethical Misconduct by Neuropsychology Professionals in Latin America.

PubMed

Panyavin, Ivan S; Goldberg-Looney, Lisa D; Rivera, Diego; Perrin, Paul B; Arango-Lasprilla, Juan Carlos

2015-08-01

To date, extremely limited research has focused on the ethical aspects of clinical neuropsychology practice in Latin America. The current study aimed to identify the frequency of perceived ethical misconduct in a sample of 465 self-identified neuropsychology professionals from Latin America in order to better guide policies for training and begin to establish standards for practitioners in the region. Frequencies of neuropsychologists who knew another professional engaging in ethical misconduct ranged from 1.1% to 60.4% in the areas of research, clinical care, training, and professional relationships. The most frequently reported perceived misconduct was in the domain of professional training and expertise, with nearly two thirds of participants knowing other professionals who do not possess adequate training to be working as neuropsychologists. The least frequently reported perceived misconduct was in the domain of professional relationships. Nearly one third of participants indicated that they had never received formal training in professional ethics. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Ethical problems in clinical psychopharmacology.

PubMed

Müller-Oerlinghausen, B

1978-10-01

The present article originates from some intriguing problems which the author, working as a clinical pharmacologist and psychiatrist, was faced with during clinical investigations. Practical difficulties appearing at first glance as of a rather methodological nature often reveal themselves as ethical questions. Investigation of psychotropic drugs in normal volunteers as well as in psychiatric patients is taken as a model to exemplify certain fundamental ethical aspects of medical research. It is emphasized that the "solution" of ethical problems cannot be achieved by referring to a given code of norms which themselves depend on certain historical circumstances, but rather by recognizing and reasoning the conflicts which result from various moral maxims. Clinical psychopharmacology should not only be conscious of its methodological shortcomings and future goals but also accept the justification of discussions about the ethical and legal questions involved in its dealings and take an active part in these debates. With regard to the relationship between patient and investigator, "solidarity" [23] instead of ongoing paternalism or legal formalism, appears to be a realistic goal. This is also true in the area of psychopharmacological research.

History of evolution of the concept of medical ethics.

PubMed

Majumdar, Sisir K

2003-01-01

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

[Ethical Evaluation of Non-Therapeutic Male Circumcision].

PubMed

İzgi, M Cumhur

2015-01-01

Elective circumcision for nonmedical reasons is a surgical approach which is historically long standing and accepted as the most performed procedure. The necessity of the procedure is usually for religious and traditional reasons alongside some medical ground related benefits to enable its social acceptability. The discussion of the subject from the aspect of ethics becomes necessary as there is no consensus about the benefits or harmfulness of nonmedical circumcision. Fundamental ethical discussions about circumcision, which contradicts legal acceptance criteria of any medical application, are related to the basic concepts of the existence of an individual such as sovereignty, the loss of bodily integrity, and privacy. The recent legal processes and the fact that the European Council and the American Academy of Pediatrics have put the issue on their agenda have increased the necessity of these ethical evaluations. The responsibility of consideration and evaluation of ethical permission of every circumcision procedure, besides discussing the necessity of circumcision for improvement and protection of health rests on the shoulders of the physicians because the dignity and intellectual identity of the profession require so.

The ethics of intellectual property rights in an era of globalization.

PubMed

Shah, Aakash Kaushik; Warsh, Jonathan; Kesselheim, Aaron S

2013-01-01

Since the 1980s, developed countries, led by the United States and the countries of the European Union, have sought to incorporate intellectual property rights provisions into global trade agreements. These countries successfully negotiated the World Trade Organization's 1994 Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), which required developing countries to adopt intellectual property provisions comparable to developed countries. In this manuscript, we review the policy controversy surrounding TRIPS and examine the two main ethical arguments articulated in its support--a theory of natural rights and a utilitarian argument. We contend that these theories provide insufficient bases for an intellectual property rights regime that compromises access to essential medicines in the developing world. While the policy community has engaged in active debate around the policy effects of TRIPS, scholars have not thoroughly considered the full ethical underpinnings of those policy arguments. We believe that a more robust understanding of the ethical implications of the agreement should inform policy discussions in the future. © 2013 American Society of Law, Medicine & Ethics, Inc.

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.

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

Ethics, Nanobiosensors and Elite Sport: The Need for a New Governance Framework.

PubMed

Evans, Robert; McNamee, Michael; Guy, Owen

2017-12-01

Individual athletes, coaches and sports teams seek continuously for ways to improve performance and accomplishment in elite competition. New techniques of performance analysis are a crucial part of the drive for athletic perfection. This paper discusses the ethical importance of one aspect of the future potential of performance analysis in sport, combining the field of biomedicine, sports engineering and nanotechnology in the form of 'Nanobiosensors'. This innovative technology has the potential to revolutionise sport, enabling real time biological data to be collected from athletes that can be electronically distributed. Enabling precise real time performance analysis is not without ethical problems. Arguments concerning (1) data ownership and privacy; (2) data confidentiality; and (3) athlete welfare are presented alongside a discussion of the use of the Precautionary Principle in making ethical evaluations. We conclude, that although the future potential use of Nanobiosensors in sports analysis offers many potential benefits, there is also a fear that it could be abused at a sporting system level. Hence, it is essential for sporting bodies to consider the development of a robust ethically informed governance framework in advance of their proliferated use.

A second chance for authors of hijacked journals to publish in legitimate journals.

PubMed

Jalalian, Mehrdad

2015-01-01

This article proposes the republication of articles that have previously been published in counterfeit websites of hijacked journals. The paper also discusses the technical and ethical aspects of republishing such articles.

[Surrogate maternity--literature review and practice].

PubMed

Pilka, L; Rumpík, D; Pilka, R; Koudelka, M; Prudil, L

2009-04-01

This review summarizes opinions on surrogacy including internatinal and governmental organizations attitudes, as well as some religious concerns. Literature review. Reprofit International, Brno, Reproductive medicine and gynecology centre, Zlin, Department of obstetrics and gynecology, Palacky University, Olomouc. The developments in the field of assissted reproduction during the last twenty years have attracted unexpected public interest in some of its ethical and moral aspects. It is very difficult to find a uniform attitude to ethical concerns of assisted conception in plural society. Surrogate mother is defined as a woman who bears and relinquishes a child for another person. The european congress on human reproduction in Barcelona 2008 adopted following résumé on surrogacy: Public opinion has shifted to a position where surrogacy is recognized as an appropriate response to infertility in some circumstances and it is to be expected that this approach will be further strenghtened with stress on positive aspects of familiar life.

[ETHICS, MORALS AND SOCIETY IN PERSONALIZED MEDICINE].

PubMed

Flugelman, Anath

2015-09-01

Following the completion of the human genome project, genomic medicine including personalized medicine, widely based on pharmacogenetics and pharmacogenomics, is rapidly developing. This breakthrough should benefit humankind thanks to tailoring the most appropriate prevention, interventions and therapies to each individual, minimizing adverse side effects, based on inter-personal genetic variety and polymorphism. Yet wide spectrum ethical, legal and social issues carry significant implications regarding individuals, families, society and public health. The main issues concern genomic information and autonomy, justice and equity, resources allocation and solidarity, challenging the traditional role of medicine and dealing with unlimited boundaries of knowledge. Those issues are not new nor exceptional to genomic medicine, yet their wide unlimited scope and implications on many aspects of life renders them crucial. These aspects will be discussed in light of Beauchamp and Childress' four principles: non-maleficence, beneficence, autonomy and justice, and main moral philosophies, Kant's autonomy, Utilitarianism which promotes the common good, and Rawls' Theory of Justice.

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

Utilitarianism.

PubMed

Gillon, R

1985-05-11

In one of a series of British Medical Journal articles on the philosophical foundations of medical ethics, Gillon outlines the pros and cons of utilitarian theories of ethics, which determine the morality of actions by whether or not they increase happiness or decrease suffering. He counters utilitarian claims to have overcome the disadvantages of deontological theories by pointing out flaws in the coherence, justification, and results of utilitarian arguments, as these arguments are exemplified in the writings of Bentham, Mill, and Hare. He observes that many modern utilitarians have overcome problems with their basic theories by accommodating aspects of deontological thinking.

[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.

Commercial filming of prehospital patient care

PubMed Central

Godfrey, P D; Henning, J D

2007-01-01

Commercial filming of patients in the hospital and now the prehospital environment is becoming increasingly common. Television programmes that focus on medical emergencies with real footage of events remain highly successful and can make compelling viewing for both medical professionals and the general public alike. Recently several commentators have questioned the ethical aspects of filming in hospital emergency departments, and noted the lack of available evidence. This article reviews commercial filming and its impact in the prehospital environment and examines the ethical implications and current guidance in this unique setting. PMID:18029523

Commercial filming of prehospital patient care.

PubMed

Godfrey, P D; Henning, J D

2007-12-01

Commercial filming of patients in the hospital and now the prehospital environment is becoming increasingly common. Television programmes that focus on medical emergencies with real footage of events remain highly successful and can make compelling viewing for both medical professionals and the general public alike. Recently several commentators have questioned the ethical aspects of filming in hospital emergency departments, and noted the lack of available evidence. This article reviews commercial filming and its impact in the prehospital environment and examines the ethical implications and current guidance in this unique setting.

Ethical aspects of genome diversity research: genome research into cultural diversity or cultural diversity in genome research?

PubMed

Ilkilic, Ilhan; Paul, Norbert W

2009-03-01

The goal of the Human Genome Diversity Project (HGDP) was to reconstruct the history of human evolution and the historical and geographical distribution of populations with the help of scientific research. Through this kind of research, the entire spectrum of genetic diversity to be found in the human species was to be explored with the hope of generating a better understanding of the history of humankind. An important part of this genome diversity research consists in taking blood and tissue samples from indigenous populations. For various reasons, it has not been possible to execute this project in the planned scope and form to date. Nevertheless, genomic diversity research addresses complex issues which prove to be highly relevant from the perspective of research ethics, transcultural medical ethics, and cultural philosophy. In the article at hand, we discuss these ethical issues as illustrated by the HGDP. This investigation focuses on the confrontation of culturally diverse images of humans and their cosmologies within the framework of genome diversity research and the ethical questions it raises. We argue that in addition to complex questions pertaining to research ethics such as informed consent and autonomy of probands, genome diversity research also has a cultural-philosophical, meta-ethical, and phenomenological dimension which must be taken into account in ethical discourses. Acknowledging this fact, we attempt to show the limits of current guidelines used in international genome diversity studies, following this up by a formulation of theses designed to facilitate an appropriate inquiry and ethical evaluation of intercultural dimensions of genome research.

Institutional ethics policies on medical end-of-life decisions: a literature review.

PubMed

Lemiengre, Joke; de Casterlé, Bernadette Dierckx; Van Craen, Katleen; Schotsmans, Paul; Gastmans, Chris

2007-10-01

The responsibility of healthcare administrators for handling ethically sensitive medical practices, such as medical end-of-life decisions (MELDs), within an institutional setting has been receiving more attention. The overall aim of this paper is to thoroughly examine the prevalence, content, communication, and implementation of written institutional ethics policies on MELDs by means of a literature review. Major databases (Pubmed, Cinahl, PsycINFO, Cochrane Library, FRANCIS, and Philosopher's Index) and reference lists were systematically searched for all relevant papers. Inclusion criteria for relevance were that the study was empirically based and that it focused on the prevalence, content, communication, or implementation of written institutional ethics policies concerning MELDs. Our search yielded 19 studies of American, Canadian, Dutch and Belgian origin. The majority of studies dealt with do-not-resuscitate (DNR) policies (prevalence: 10-89%). Only Dutch and Belgian studies dealt with policies on pain and symptom control (prevalence: 15-19%) and policies on euthanasia (prevalence: 30-79%). Procedural and technical aspects were a prime focus, while the defining of the specific roles of involved parties was unclear. Little attention was given to exploring ethical principles that question the ethical function of policies. In ethics policies on euthanasia, significant consideration was given to procedures that dealt with conscientious objections of physicians and nurses. Empirical studies about the implementation of ethics policies are scarce. With regard to providing support for physicians and nurses, DNR and euthanasia policies expressed support by primarily providing technical and procedural guidelines. Further research is needed whether and in which way written institutional ethics policies on MELDs could contribute to better end-of-life care.

Ethical aspects of soft tissue engineering for congenital birth defects in children--what do experts in the field say?

PubMed

Oerlemans, Anke J M; Rodrigues, Catarina H C M L; Verkerk, Marian A; van den Berg, Paul P; Dekkers, Wim J M

2010-08-01

This article is part of the EuroSTEC project, which aims at developing tissue engineering-based treatments for structural disorders present at birth. EuroSTEC is positioned at the intersection of three areas with their own ethical issues: (1) regenerative medicine, (2) research with pregnant women and fetuses, and (3) research with neonates. Because of the overlap of these three areas in this project, we can expect to be confronted with new ethical challenges. To be able to respond adequately and timely to current and possible future ethical issues, a prospective and anticipatory ethical analysis is essential. To obtain a first survey of ethical issues that might arise during the different phases of the project, the Delphi method was used. The professionals directly involved in the EuroSTEC project were questioned about their views on possible ethical issues. The first round yielded 27 ethical issues, which the respondents were asked to prioritize in the second round. For the fundamental research phase, issues deemed most important were privacy and informed consent of the tissue donor. For the animal experimentation phase, three issues were mentioned (in order of decreasing priority): the suffering of animals, the use of animals as means to an end, and the limited adequacy of the animal models. Issues that were deemed most important during the clinical (trial) phase pertained to the problem of weighing risks and benefits for the fetus/child and the pregnant woman.

Ethical challenges in neonatal intensive care nursing.

PubMed

Strandås, Maria; Fredriksen, Sven-Tore D

2015-12-01

Neonatal nurses report a great deal of ethical challenges in their everyday work. Seemingly trivial everyday choices nurses make are no more value-neutral than life-and-death choices. Everyday ethical challenges should also be recognized as ethical dilemmas in clinical practice. The purpose of this study is to investigate which types of ethical challenges neonatal nurses experience in their day-to-day care for critically ill newborns. Data were collected through semi-structured qualitative in-depth interviews. Phenomenological-hermeneutic analysis was applied to interpret the data. Six nurses from neonatal intensive care units at two Norwegian hospitals were interviewed on-site. The study is designed to comply with Ethical Guidelines for Nursing Research in the Nordic Countries and the Helsinki declaration. Findings suggest that nurses experience a diverse range of everyday ethical challenges related to challenging interactions with parents and colleagues, emotional strain, protecting the vulnerable infant, finding the balance between sensitivity and authority, ensuring continuity of treatment, and miscommunication and professional disagreement. A major finding in this study is how different agents involved in caring for the newborn experience their realities differently. When these realities collide, ethical challenges arise. Findings suggest that acting in the best interests of the child becomes more difficult in situations involving many agents with different perceptions of reality. The study presents new aspects which increases knowledge and understanding of the reality of nursing in a neonatal intensive care unit, while also demanding increased research in this field of care. © The Author(s) 2014.

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.

Ethical dimensions of paediatric nursing: A rapid evidence assessment.

PubMed

Bagnasco, Annamaria; Cadorin, Lucia; Barisone, Michela; Bressan, Valentina; Iemmi, Marina; Prandi, Marzia; Timmins, Fiona; Watson, Roger; Sasso, Loredana

2018-02-01

Paediatric nurses often face complex situations requiring decisions that sometimes clash with their own values and beliefs, or with the needs of the children they care for and their families. Paediatric nurses often use new technology that changes the way they provide care, but also reduces their direct interaction with the child. This may generate ethical issues, which nurses should be able to address in the full respect of the child. Research question and objectives: The purpose of this review is to describe the main ethical dimensions of paediatric nursing. Our research question was, 'What are the most common ethical dimensions and competences related to paediatric nursing?' A rapid evidence assessment. According to the principles of the rapid evidence assessment, we searched the PubMed, SCOPUS and CINAHL databases for papers published between January 2001 and March 2015. These papers were then independently read by two researchers and analysed according to the inclusion criteria. Ethical considerations: Since this was a rapid evidence assessment, no approval from the ethics committee was required. Ten papers met our inclusion criteria. Ethical issues in paediatric nursing were grouped into three areas: (a) ethical issues in paediatric care, (b) social responsibility and (c) decision-making process. Few studies investigate the ethical dimensions and aspects of paediatric nursing, and they are mainly qualitative studies conducted in critical care settings based on nurses' perceptions and experiences. Paediatric nurses require specific educational interventions to help them resolve ethical issues, contribute to the decision-making process and fulfil their role as advocates of a vulnerable population (i.e. sick children and their families). Further research is needed to investigate how paediatric nurses can improve the involvement of children and their families in decision-making processes related to their care plan.

Ethics and gender issues in palliative care in nursing homes: an Austrian participatory research project.

PubMed

Reitinger, Elisabeth; Heimerl, Katharina

2014-06-01

The development of palliative care in nursing homes in German-speaking countries has gained in importance within the past 15-20 years. Ethical and gender issues are core aspects of a palliative care culture and should therefore be better understood. The aim of this study was to highlight insights regarding ethical and gender issues, based on the experiences of professionals in nursing homes. A 2-year participatory action research study was performed in collaboration with three nursing homes in Austria. The article focusses on 10 group discussions with interdisciplinary professional teams that were conducted to generate ethical narratives. Thematic and narrative analysis was undertaken both individually and within the interdisciplinary research team. Findings and interpretations were validated with practitioners and researchers. A total of 36 narratives were collected and summarised within eight themes concerning the theoretical journey of a nursing home resident with relatives from entry into the house until death. The most burdensome ethical dilemmas are not the ones around death and dying but rather those relating to small-scale everyday work/life issues. Sharing experiences and feelings in ethical discussions provides relief. Emotions are important facilitators of insight into ethical dilemmas. Gender issues can be observed in care situations as well as in the organisational structure of nursing homes. Opportunities to share experiences and perspectives around ethical questions in interdisciplinary group discussions help professionals to better understand difficult issues and find appropriate ways of managing them. There is a need for communication structures such as facilitated ethical discussions that enable nursing home staff to reflect their everyday decisions. Expression of emotions should be encouraged in ethical decision-making processes in nursing homes. Gender-sensitive reflection supports the development of palliative care as organisational culture. © 2014 John Wiley & Sons Ltd.

Challenges in the research ethics review of cluster randomized trials: international survey of investigators.

PubMed

Chaudhry, Shazia H; Brehaut, Jamie C; Grimshaw, Jeremy M; Weijer, Charles; Boruch, Robert; Donner, Allan; Eccles, Martin P; McRae, Andrew D; Saginur, Raphael; Skea, Zoë C; Zwarenstein, Merrick; Taljaard, Monica

2013-04-01

Cluster randomized trials (CRTs) complicate the interpretation of standard research ethics guidelines for several reasons. For one, the units of allocation, intervention, and observation often may differ within a single trial. In the absence of tailored and internationally accepted ethics guidelines for CRTs, researchers and research ethics committees have no common standard by which to judge ethically appropriate practices in CRTs. Moreover, lack of familiarity with and consideration of the unique features of the CRT design by research ethics committees may cause difficulties in the research ethics review process, and amplify problems such as variability in the requirements and decisions reached by different research ethics committees. We aimed to characterize research ethics review of CRTs, examine investigator experiences with the ethics review process, and assess the need for ethics guidelines for CRTs. An electronic search strategy implemented in MEDLINE was used to identify and randomly sample 300 CRTs published in English language journals from 2000 to 2008. A web-based survey with closed- and open-ended questions was administered to corresponding authors in a series of six contacts. The survey response rate was 64%. Among 182 of 285 eligible respondents, 91% indicated that they had sought research ethics approval for the identified CRT, although only 70% respondents reported research ethics approval in the published article. Nearly one-third (31%) indicated that they have had to meet with ethics committees to explain aspects of their trials, nearly half (46%) experienced variability in the ethics review process in multijurisdictional trials, and 38% experienced negative impacts of the ethics review process on their trials, including delays in trial initiation (28%), increased costs (10%), compromised ability to recruit participants (16%), and compromised methodological quality (9%). Most respondents (74%; 95% confidence interval (CI): 67%-80%) agreed or strongly agreed that there is a need to develop ethics guidelines for CRTs, and (70%; 95% CI: 63%-77%) that ethics committees could be better informed about distinct ethical issues surrounding CRTs. Thirty-six percent of authors did not respond to the survey. Due to the absence of comparable results from a representative sample of authors of individually randomized trials, it is unclear to what extent the reported challenges result from the CRT design. CRT investigators are experiencing challenges in the research ethics review of their trials, including excessive delays, variability in process and outcome, and imposed requirements that can have negative consequences for study conduct. Investigators identified a clear need for ethics guidelines for CRTs and education of research ethics committees about distinct ethical issues in CRTs.

Bridging the Gap between Social Acceptance and Ethical Acceptability.

PubMed

Taebi, Behnam

2017-10-01

New technology brings great benefits, but it can also create new and significant risks. When evaluating those risks in policymaking, there is a tendency to focus on social acceptance. By solely focusing on social acceptance, we could, however, overlook important ethical aspects of technological risk, particularly when we evaluate technologies with transnational and intergenerational risks. I argue that good governance of risky technology requires analyzing both social acceptance and ethical acceptability. Conceptually, these two notions are mostly complementary. Social acceptance studies are not capable of sufficiently capturing all the morally relevant features of risky technologies; ethical analyses do not typically include stakeholders' opinions, and they therefore lack the relevant empirical input for a thorough ethical evaluation. Only when carried out in conjunction are these two types of analysis relevant to national and international governance of risky technology. I discuss the Rawlsian wide reflective equilibrium as a method for marrying social acceptance and ethical acceptability. Although the rationale of my argument is broadly applicable, I will examine the case of multinational nuclear waste repositories in particular. This example will show how ethical issues may be overlooked if we focus only on social acceptance, and will provide a test case for demonstrating how the wide reflective equilibrium can help to bridge the proverbial acceptance-acceptability gap. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

View Points of an Ecologist on Practical Environmental Ethic: Socioecology, Common-Pool Resources and Conservation.

PubMed

Castilla, Juan Carlos

2016-01-01

The paper centers on environmental practical ethic point of views according to a professional ecologist. Ecology and the science of Socio-ecology are defined. The framework of the Millennium Ecosystem Assessment initiative (MA 2003), including the use of ecosystems as the environmental unit of analysis, ecosystem services and human well-being as the center for assessment are discussed. Common-pool resources (CPR) and the allegory of the tragedy of the commons are used to illustrate main scientific and ethical environmental approaches, and above all to highlight the case of climate change, considering ″air-atmosphere″ as a CPR. The need to adopt practical personal environmental ethical positions is highlighted. Furthermore, on climate change, a discussion on the need to develop environmental and socio-ecological polycentric approaches: top-down and bottom-up, is included. An updated discussion on the concept of conservation, including main scientific and ethic points of view, is presented. Pope Francis's Encyclical, Laudato Si', is used to highlight environmental, socio-ecological and ethical aspects behind the comprehensive concept of Integral Ecology. The paper ends with a short synthesis on Earth modern unseen and astonishing environmental and socio-ecological rates of changes, and identifying the main barriers for personal environmental engagement. A call is done regarding the urgent need for socio-environmental ethic personal engagement and collective actions.

Counseling Older Japanese American Clients: An Overview and Observations.

ERIC Educational Resources Information Center

Itai, Goro; McRae, Cynthia

1994-01-01

Discusses important aspects of providing counseling to older Japanese American clients, including ethical issues based on cultural differences and nontraditional approaches to counseling. Examines unique historical and cultural characteristics of these clients. Includes 26 citations. (Author/CRR)

[Foetal therapy for Down syndrome: a pro-active ethical reflection].

PubMed

de Wert, G M W R; Dondorp, W J

2016-01-01

Prenatal screening for Down syndrome has to date focused on facilitating the informed choice to continue or not with a pregnancy. The non-invasive prenatal test (NIPT) for Down syndrome does potentially offer the option to apply foetal neurocognitive therapy for Down syndrome (FTDS). Current research in animal models looks promising and therefore a proactive ethical reflection in relation to clinical trials is urgently needed. This discussion includes an exploration of the ethical aspects of FTDS. There seem to be no convincing a priori objections on the basis of the social model of disability. Arguments in terms of (respect for) autonomy, wellbeing and justice seem to in principle support such therapy. Still, both the conditions for sound clinical trials and the implications of possible effective therapy for current prenatal screening need further scrutiny.

[Ethics and legal aspects of use of animals in experimental studies].

PubMed

Vaculín, S

2000-02-01

Animals have been used in research since ancient times already. Originally they were used for anatomical and physiological demonstrations. Later they started to be used by another fields--microbiology, toxicology and pharmacology, surgery. Animal use is frequently implicated in relation to ethical problems. Actual view is based on biocentric opinion, which part is formed by "three R's" concept--reduction, replacement, refinement in animal use. Laws applied to animal use in Czech Republic are anchored in Law on Animal Protection and Decree of Ministry of Agriculture on Experimental Animal Use and Breeding. Owing to militant behaviour of organisations involved in animal rights movement there is no adequate propagation of experiments, which are ethically and juridically clear and which particularly help mankind in a struggle against diseases.

Ethical, legal and clinical aspects of live surgery in urology – contemporary issues and a glimpse of the future

PubMed Central

Ferician, Ovidiu Catalin; Latcu, Silviu Constantin; Pricop, Catalin; Bardan, Razvan Tiberiu

2017-01-01

Beside dry and wet lab training, simulators, video tapes, fellowships and clinical visits, live surgery has gained popularity during the last years, being an attraction point at large scientific meetings and at postgraduate courses as well. This type of surgical training raises both ethical and legal issues. Thus, there are professional societies that have banned such meetings, mainly due to safety reasons for the patient. The current article aims to identify and to discuss ethical and legal issues related to the topic, advantages, disadvantages and weak points of this emerging challenge for modern medicine, trying to analyze the issues from all relevant points of view: those of the patient, the surgeon and the session attendant. PMID:28446925

[Ethical issues raised by 2 kinds of protocols for organ donation after cardiac death: aspects particular to France, Spain and the United States].

PubMed

Tortosa, Jean-Christophe; Rodríguez-Arias Vailhen, David; Moutel, Grégoire

2010-02-01

France, Spain and US are three leader countries in activity of organ procurement and transplantation. Donation after cardiac death is one of the strategies they have been implemented in order to face organ shortage. Donation after cardiac death is internationally considered to be an encouraging source of organs for transplantation both because of its capacity to significantly increase the donor pool and because of the quality of the organs obtained from non-heart-beating organ donors. These protocols give rise to important ethical issues that have been widely discussed in the international literature. The aim of this paper is to identify and discuss the ethical issues that these protocols raise in these three countries.

Ethical aspects of using medical social media in healthcare applications.

PubMed

Denecke, Kerstin

2014-01-01

The advances in internet and mobile technologies and their increased use in healthcare led to the development of a new research field: health web science. Many research questions are addressed in that field, starting from analysing social-media data, to recruiting participants for clinical studies and monitoring the public health status. The information provided through this channel is unique in a sense that there is no other written source of experiences from patients and health carers. The increased usage and analysis of health web data poses questions on privacy, and ethics. Through a literature review, the current awareness on ethical issues in the context of public health monitoring and research using medical social media data is determined. Further, considerations on the topic were collected from members of the IMIA Social Media Working group.

Ethics and the pharmaceutical industry.

PubMed

Green, Stephen

2008-06-01

Relationships between the pharmaceutical industry and the medical profession enhance the potential for physicians to become involved in conflicts of interest. Whether or not these rise to a level that violates standards of medical ethics depends on the degree to which they detract from the quality of health care and its cost, the objectivity of research, and the profession's integrity. This paper explores those issues from two perspectives--the micro-level of the medical profession and the macro-level of society. Practices and policies that affect varied aspects of the interaction between the pharmaceutical industry and the medical profession--such as education, research and marketing--are discussed. The reader is asked to reflect on the ethics of issues raised; the author offers suggestions for mitigating conflicts of interest and, in turn, the potential for unethical medical care.

A Case-Study of the Resources and Functioning of Two Research Ethics Committees in Western India.

PubMed

Chenneville, Tiffany; Menezes, Lynette; Kosambiya, Jayendrakumar; Baxi, Rajendra

2016-12-01

Assessing the resources and functioning of research ethics committees (RECs) in low-resource settings poses many challenges. We conducted a case study of two medical college RECs (A and B) in Western India utilizing the Research Ethics Committee Quality Assurance Self-Assessment Tool (RECQASAT) as well as in-depth interviews with representative members to evaluate REC effectiveness. REC A and B obtained 62% and 67% of allowable points on the RECQASAT. These scores together with findings from the in-depth interviews suggest the need for significant improvement in REC effectiveness particularly in the areas of membership and educational training, organizational aspects, recording minutes, communicating decisions, and REC resources. Developing evidence-based best practices and strengthening infrastructure are essential to enhancing REC efficacy in low-resource countries.

Coordinating ‘Ethical’ Clinical Trials: The Role of Research Coordinators in the Contract Research Industry

PubMed Central

Fisher, Jill A.

2010-01-01

Change in the way new drugs are developed, including the privatization of clinical trials, has altered the arrangement and roles of health care professions. In this article I examine one aspect of this change: the role of research coordinators in the conduct of contract research in the United States. My focus on coordinators highlights the ethical conflicts embedded in clinical trials. I describe the ways in which coordinators experience and contend with the conflict between research and care and show how their construction of ethics is distinct from institutional conceptions formally associated with human subjects research. My analysis demonstrates how the coordinators' focus on ethics is a response to their role conflict and an attempt to reinsert individualized care into the context of research. PMID:17184412

Trends in nursing ethics research: Mapping the literature production.

PubMed

Blažun Vošner, Helena; Železnik, Danica; Kokol, Peter; Vošner, Janez; Završnik, Jernej

2017-12-01

There have been a number of debates in the field of nursing ethics. Researchers have focused on various aspects of nursing ethics, such as professional ethics, professional, nursing and ethical values. Within this research, a variety of literature reviews have been conducted, but to the best of our knowledge, bibliometric mapping has not yet been used. This article aims to analyse the production of literature within nursing ethics research. In order to examine publishing patterns, we focused on publishing dynamics, prolific research entities and the most-cited articles. We additionally visualised the content of the literature using a novel mixed-method approach, combining bibliometric analysis and mapping with thematic analysis. Ethical considerations: In our study, ethical review was not required. A total of 1416 information sources were found in the Scopus database. Overall, literature production has increased; however, in recent years, the quantity of published material has begun to decrease. The most prolific countries are the United States, the United Kingdom and Canada, and the most prolific source titles are Nursing Ethics, Journal of Advanced Nursing and Nursing Times. Lately, research in the field of nursing ethics has been focused more on life care (providing for the basic needs of older residents), moral distress and community nursing. The dynamics of research literature production showed an exponential rise in the number of published information sources - a rise which started in the period between 1974 and 1998. Since that period, the trend has stabilised, which might indicate that nursing ethics research is starting a transition to a mature phase. The innovative use of bibliometric analysis and mapping, together with thematic analysis, is a useful tool for analysis of research production in the field of nursing ethics. The results presented can be an excellent starting point for literature reviews and more exhaustive data, information and knowledge seeking.

Ethical and Sociocultural Aspects of Sexual Function and Dysfunction in Both Sexes.

PubMed

Atallah, Sandrine; Johnson-Agbakwu, Crista; Rosenbaum, Talli; Abdo, Carmita; Byers, E Sandra; Graham, Cynthia; Nobre, Pedro; Wylie, Kevan; Brotto, Lori

2016-04-01

This study aimed to highlight the salient sociocultural factors contributing to sexual health and dysfunction and to offer recommendations for culturally sensitive clinical management and research as well for an ethically sound sexual health care, counseling and medical decision-making. There are limited data on the impact of sociocultural factors on male and female sexual function as well as on ethical principles to follow when clinical care falls outside of traditional realms of medically indicated interventions. This study reviewed the current literature on sociocultural and ethical considerations with regard to male and female sexual dysfunction as well as cultural and cosmetic female and male genital modification procedures. It is recommended that clinicians evaluate their patients and their partners in the context of culture and assess distressing sexual symptoms regardless of whether they are a recognized dysfunction. Both clinicians and researchers should develop culturally sensitive assessment skills and instruments. There are a number of practices with complex ethical issues (eg, female genital cutting, female and male cosmetic genital surgery). Future International Committee of Sexual Medicine meetings should seek to develop guidelines and associated recommendations for a separate, broader chapter on ethics. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The religious and social principles of patients' rights in holy books (Avesta, Torah, Bible, and Quran) and in traditional medicine.

PubMed

Hatami, Hossein; Hatami, Maryam; Hatami, Neda

2013-03-01

Health protection and promotion in healthy people and restoring patients' health have been the most important themes in medicine and health throughout our history. Therefore, discussion of different aspects of patients' rights includes implementation of these objectives by the medical community, including physicians, nurses, pharmacists, etc., and the people in charge of health affairs. The principal objective of our research is the study of medical ideology and the approaches of our ancestors in relation to different aspects of patients' rights. To study the different ideologies of traditional medicine in relation to patients' rights, appropriate data were extracted from the original resources of traditional medicine and from religious books. By means of library research we studied these resources in addition to electronic versions of the Alhavi book (by Rhazes), the Kamel-al-Sanaah (by Ahvazi), the Canon of Medicine (by Avicenna), the Zakhireye Khawrazmshahi (by Jorjani), the Avesta, the Torah, the Bible, the Quran, and many other resources, and, finally, after searching, gathering, and encoding the findings, analyzed them qualitatively for thematic content. The holy Avesta book clearly insists on the competence of physicians and setting the appointment fee in accordance with peoples' income. The Old Testament (holy Torah) warned government officials who did not observe patients' rights. In the four gospels (holy Bible) the importance of treatment and taking care of the patient is stressed. After the emergence of Islam, medical students, before beginning the principal courses, had to study Islamic jurisprudence, ethics, logic sciences, natural sciences, geometry, astrology, calculus, and similar courses so that after purifying their soul they could enter the saintly profession of physicians. The holy Quran refers to saving the life of a human irrespective of social class, race, and religion, and insists on exemption of patients from physical activity, including the physical aspects of prayer. In these resources, some warnings are offered in relation to fake drugs, the lack of awareness of some physicians, the need for complete preparedness of medical society, and the need to manufacture appropriate drugs and offer a suitable medical service. This information is to familiarize medical and health authorities and persons receiving health services. According to the evidence available about traditional medicine, there was no specific difference between public and professional ethics, public and professional rights, or rights and ethics-ethics were no different from rights nor rights from ethics. So ethics are similar to the soul in the body of rights, and rights are similar to the litter of ethics, and they have developed in parallel with each other. Traditional medicine is community-based and preservation of the health of healthy people is given priority over the treatment of patients; there is insistence that "health rights" has wider scope than "patients' rights". It can be stated that health rights in Iran both before and after the emergence of Islam have been based on guidance from divine religions, observation of humanist ethics, passing suitable courses in the basic sciences, and an introduction to the practical piety of our ancestors, in addition to the syllabus of medical and health education.

Ethics and Regulatory Challenges and Opportunities in Patient-Centered Comparative Effectiveness Research.

PubMed

Sugarman, Jeremy

2016-04-01

The Affordable Care Act includes provisions for the conduct of large-scale, patient-centered comparative effectiveness research. Such efforts aim toward the laudable moral goal of having evidence to improve health care decision making. Nevertheless, these pragmatic clinical research efforts that typically pose minimal incremental risk and are enmeshed in routine care settings perhaps surprisingly encounter an array of ethics and regulatory challenges and opportunities for academic health centers. An emphasis on patient-centeredness forces an examination of the appropriateness of traditional methods used to protect the rights, interests, and welfare of participants. At the same time, meaningful collaboration with patients throughout the research process also necessitates ensuring that novel approaches to research (including recruitment and consent) entail necessary protections regarding such issues as privacy. As the scientific and logistical aspects of this research are being developed, substantial attention is being focused on the accompanying ethics and regulatory issues that have emerged, which should help to facilitate ethically appropriate research in a variety of contexts.

Practical Divinity and Medical Ethics: Lawful versus Unlawful Medicine in the Writings of William Perkins (1558–1602)

PubMed Central

Gevitz, Norman

2013-01-01

This article examines for the first time the theologically based medical ethics of the late sixteenth-century English Calvinist minister William Perkins. Although Perkins did not write a single focused book on the subject of medical ethics, he addressed a variety of moral issues in medicine in his numerous treatises on how laypeople should conduct themselves in their vocations and in all aspects of their daily lives. Perkins wrote on familiar issues such as the qualities of a good physician, the conduct of sick persons, the role of the minister in healing, and obligations in time of pestilence. His most significant contribution was his distinction between “lawful” and “unlawful” medicine, the latter category including both medical astrology and magic. Perkins's works reached a far greater audience in England and especially New England than did the treatises of contemporary secular medical ethics authors and his writings were influential in guiding the moral thinking of many pious medical practitioners and laypersons. PMID:22235029

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

PubMed

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

2003-01-01

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

Practical divinity and medical ethics: lawful versus unlawful medicine in the writings of William Perkins (1558-1602).

PubMed

Gevitz, Norman

2013-04-01

This article examines for the first time the theologically based medical ethics of the late sixteenth-century English Calvinist minister William Perkins. Although Perkins did not write a single focused book on the subject of medical ethics, he addressed a variety of moral issues in medicine in his numerous treatises on how laypeople should conduct themselves in their vocations and in all aspects of their daily lives. Perkins wrote on familiar issues such as the qualities of a good physician, the conduct of sick persons, the role of the minister in healing, and obligations in time of pestilence. His most significant contribution was his distinction between "lawful" and "unlawful" medicine, the latter category including both medical astrology and magic. Perkins's works reached a far greater audience in England and especially New England than did the treatises of contemporary secular medical ethics authors and his writings were influential in guiding the moral thinking of many pious medical practitioners and laypersons.

School-based smoking prevention programmes: ethical aspects.

PubMed

Lotrean, Lucia Maria; Trofor, Antigona; Mihălţan, Florin; Santillan, Edna Arillo

2011-01-01

School-based health education has the potential to inform and educate young people, in order to promote healthy behaviours among them, which will help to prevent diseases and social problems. The present study gives an overview of several ethical issues which must be considered in different phases of school-based smoking prevention programs. This will help health educators, public health professionals and researchers in their activity of health education in schools. The ethical issues must be taken into consideration during all the activities and refer to the involvement of officials, schools, parents, young people who participate into the program, authors and persons/institutions responsible with the implementation, evaluation or funding of the programs. The application into practice of these ethical principles, influence the quality of the health education, its acceptability BY the target group and the correctness of results. Also, it prevents possible problems and misunderstandings between persons and institutions involved in the health education and smoking prevention process, which could seriously affect and even destroy implementation of such health education activities.

[Medical ethical aspects of culture in social interactions with Muslim patients].

PubMed

Ilkilic, I

2007-07-30

In today's world, the plurality of values is considered to be a constitutive feature of modern societies. In these societies, transcultural patient-physician relationships are a part of daily medical practice. Culturally determined value systems can be crucial for understanding the perception of notions such as "health" and "illness", leading to fundamental differences in assessing medical interventions and therapeutic objectives. Therefore, transcultural conflicts of interest are presenting medical ethical decision-making with new challenges. Time and again, medical practice demonstrates that cultural differences between physician and patient are correlated with the complexity of medical ethical conflicts, as can be seen in the relationship between Muslim patients and non-Muslim physicians in the German health care system. This paper discusses some of the central issues in these relationships like communication, sense of shame, religious duties, and medical end-of-life decisions, analyzing some concrete cases. Subsequently, a number of medical ethical theses relevant for multicultural societies will be discussed.

Managing ethically questionable parental requests: growth suppression and manipulation of puberty.

PubMed

Isaacs, David; Tobin, Bernadette; Hamblin, Julie; Slaytor, Emma; Donaghue, Kim C; Munns, Craig; Kilham, Henry A

2011-09-01

Doctors sometimes struggle with ethically challenging requests for treatment from children's parents. For instance, we have recently had two requests by parents of children, a girl and a boy, each with a severe developmental disability, for hormonal therapy to suppress growth and puberty: the girl's parents requested, in addition, hysterectomy and mastectomy. We propose a reliable approach to assessing the ethical and legal aspects of these and other requests for 'non-therapeutic' treatment of a minor who lacks the capacity to give informed consent. We argue that a doctor should first assess whether the request is one that he or she can, in conscience, accede to, and then, if it is, seek the authorisation of a court. We outline considerations relevant to the doctor's assessment of both the ethical issues and to the need for court authorisation. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Research governance: new hope for ethics committees?

PubMed

Frew, Deborah; Martlew, Ainsley

2007-01-01

For many years there has been discussion regarding the problems confronting our current ethics review system. Commentators have identified numerous issues that threaten the sustainability of Australia's voluntary HREC system. Various ad hoc solutions to these problems have been posed, but have not resulted in any significant advances. However, in recent years, discourse regarding research governance has become prominent in the Australian research environment. The application of research governance principles is gaining momentum amongst the regulators of research, including research institutions and their governing bureaucracies. We argue that this is potentially the most significant development in several years towards creating a sustainable HREC system in Australia. The recognition by research institutions and their governing bureaucracies that the responsibility for overall research governance lies with them, rather than solely with their HRECs, is leading to a range of initiatives which should significantly lessen the burden on Australian ethics committees, and improve their ability to undertake their core task of reviewing the ethical aspects of research proposals.

Personalized Medicine: Ethical Aspects.

PubMed

Sharrer, G Terry

2017-01-01

In our time of genome-based personalized medicine, clinical research and clinical medicine are accelerating at a quick pace. Faster and cheaper DNA sequencing and protein profiling, microfluidic devices for capturing blood biomarkers, nanoparticles for precise drug delivery and enhanced imaging, rapid computational analysis of massive data inputs, and other technological wonders coalesce to create a kind of Moore's Law for medicine. Needs are obvious, knowledge grows, capital becomes available, but these factors are not entirely sufficient to make health more achievable. Personalized medicine also requires social acceptability, not only for accuracy and efficacy but also because medicine is a moral domain. This chapter deals with medical ethics that determine the choices a society makes regarding healthcare; and it has not always been a steady, morally correct course of progress. Indeed, medical ethics has largely derived from socio-scientific calamities in the past. Personalized medicine, with its enhanced capacity to access the individuality of illness, must have a continuously evolving feedback mechanism-the most important element being the physician-patient relationship-which is its ethical footing.

[Consent and confidentiality in occupational health practice: balance between legal requirements and ethical values].

PubMed

Mora, Erika; Franco, G

2010-01-01

The recently introduced Italian law on the protection of workers' health states that the occupational health physician (competent physician) is required to act according to the Code of Ethics of the International Commission on Occupational Health (ICOH). This paper aims at examining the articles of legislative decree 81/2008 dealing with informed consent and confidentiality compared with the corresponding points of the ICOH Ethics Code. Analysis of the relationship between articles 25 and 39 (informed consent) and 18, 20 and 39 (confidentiality) of the decree shows that there are some points of disagreement between the legal requirements and the Code of Ethics, in particular concerning prescribed health surveillance, consent based on appropriate information (points 8, 10 and 12 of the Code) and some aspects of confidentiality (points 10, 20, 21, 22 and 23 of the Code). Although the competent physician is required to act according to the law, the decisional process could lead to a violation of workers' autonomy.

Organ donation after cardiac death in the Middle East.

PubMed

Faraj, W; Fakih, H; Mukherji, D; Khalife, M

2010-04-01

The shortage of organ donors along with the increased number of waiting recipients have created the need for new strategies to expand the organ pool: living donors, split livers, domino livers, and organs from donations after cardiac death (DCD). The purpose of this article was to focus upon aspects of DCD application in the religious, traditional, ethical, and legal aspects of the Arab world. DCD can increase the donor pool by 15%-25%. Several ethical, legal, and social concerns need to be addressed to make DCD more widely accepted by the general population in Western countries as well as in the Middle East. Organs from DCD donors have been transplanted since the 1960s. As soon as brain death criteria were published in 1968, organ retrieval from cadaveric heart-beating donors predominated. Donation after brain death (DBD) almost completely replaced DCD. In the 1990s, the organ shortage led to DCD in many countries, but not in the Arab world. DCD is still not accepted by most in the Arab world due to religious, ethical, social, and legal issues. DCD in the Arab world is more complicated than in Western countries. It should be re-evaluated and thoroughly reviewed with the new criteria for DCD and its implementation in our region. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Decisions by Finnish Medical Research Ethics Committees: A Nationwide Study of Process and Outcomes.

PubMed

Hemminki, Elina; Virtanen, Jorma I; Regushevskaya, Elena

2015-10-01

Review by research ethics committees (RECs) is the key in medical research regulation. Data from meeting notes and project summaries were abstracted from all projects submitted in 2002 (n = 1,004) and 2007 (n = 1,045) to the official medical RECs in Finland. Data from consecutive submissions were combined per project. When comparing RECs, logistic regression was used to adjust for application characteristics. The number of projects handled varied notably by REC. In the first handling, 85% of applications in 2002 and 77% in 2007 were approved, while 13% and 20% were tabled. For 61% of the projects, the review time was <30 days, 16% had >89 days, and 6% had 6 months or longer. The variation by REC in approval rates, number of handlings, or long review times was not explained by project characteristics. In the last handling, 94% of the projects in both years were approved or concluded not to need a statement from that REC. The most common reason for tabling or not approving an application was patient autonomy, usually centered on the patient leaflet. The next most common reasons were requests for further information and dissatisfaction with the scientific aspects of the project. The reasons classified as "ethics" in the narrow sense were rare. The REC focus was to assure that researchers follow the various rules on medical research and to improve the quality of research and project documents. REC considerations could be divided into decisions based on ethics and recommendations covering other aspects. © The Author(s) 2015.

Countering Brutality to Wildlife, Relationism and Ethics: Conservation, Welfare and the 'Ecoversity'.

PubMed

Garlick, Steve; Matthews, Julie; Carter, Jennifer

2011-01-27

Wildlife objectification and cruelty are everyday aspects of Australian society that eschew values of human kindness, empathy, and an understanding of the uniqueness and importance of non-human life in the natural world. Fostered by institutional failure, greed and selfishness, and the worst aspects of human disregard, the objectification of animals has its roots in longstanding Western anthropocentric philosophical perspectives, post colonialism, and a global uptake of neoliberal capitalism. Conservation, animal rights and welfare movements have been unable to stem the ever-growing abuse of wildlife, while 'greenwash' language such as 'resource use', 'management', 'pests', 'over-abundance', 'conservation hunting' and 'ecology' coat this violence with a respectable public veneer. We propose an engaged learning approach to address the burgeoning culture of wildlife cruelty and objectification that comprises three elements: a relational ethic based on intrinsic understanding of the way wildlife and humans might view each other [1-3]; geography of place and space [4], where there are implications for how we ascribe contextual meaning and practice in human-animal relations; and, following [5], engaged learning designed around our ethical relations with others, beyond the biophysical and novel and towards the reflective metaphysical. We propose the 'ecoversity' [6], as a scholarly and practical tool for focusing on the intersection of these three elements as an ethical place-based learning approach to wildlife relationism. We believe it provides a mechanism to help bridge the gap between human and non-human animals, conservation and welfare, science and understanding, and between objectification and relationism as a means of addressing entrenched cruelty to wildlife.

ESPEN guideline on ethical aspects of artificial nutrition and hydration.

PubMed

Druml, Christiane; Ballmer, Peter E; Druml, Wilfred; Oehmichen, Frank; Shenkin, Alan; Singer, Pierre; Soeters, Peter; Weimann, Arved; Bischoff, Stephan C

2016-06-01

The worldwide debate over the use of artificial nutrition and hydration remains controversial although the scientific and medical facts are unequivocal. Artificial nutrition and hydration are a medical intervention, requiring an indication, a therapeutic goal and the will (consent) of the competent patient. The guideline was developed by an international multidisciplinary working group based on the main aspects of the Guideline on "Ethical and Legal Aspects of Artificial Nutrition" published 2013 by the German Society for Nutritional Medicine (DGEM) after conducting a review of specific current literature. The text was extended and introduced a broader view in particular on the impact of culture and religion. The results were discussed at the ESPEN Congress in Lisbon 2015 and accepted in an online survey among ESPEN members. The ESPEN Guideline on Ethical Aspects of Artificial Nutrition and Hydration is focused on the adult patient and provides a critical summary for physicians and caregivers. Special consideration is given to end of life issues and palliative medicine; to dementia and to specific situations like nursing care or the intensive care unit. The respect for autonomy is an important focus of the guideline as well as the careful wording to be used in the communication with patients and families. The other principles of Bioethics like beneficence, non-maleficence and justice are presented in the context of artificial nutrition and hydration. In this respect the withholding and withdrawing of artificial nutrition and/or hydration is discussed. Due to increasingly multicultural societies and the need for awareness of different values and beliefs an elaborated chapter is dedicated to cultural and religious issues and nutrition. Last but not least topics like voluntary refusal of nutrition and fluids, and forced feeding of competent persons (persons on hunger strike) is included in the guideline. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Conservation: Toward firmer ground

NASA Technical Reports Server (NTRS)

1975-01-01

The following aspects of energy conservation were reviewed in order to place the problems in proper perspective: history and goals, conservation accounting-criteria, and a method to overcome obstacles. The effect of changing prices and available supplies of energy sources and their causes on consumption levels during the last few decades were described. Some examples of attainable conservation goals were listed and justified. A number of specific criteria applicable to conservation accounting were given. Finally, a discussion was presented to relate together the following aspects of energy conservation: widespread impact, involvement of government, industry, politics, moral and ethical aspects, urgency and time element.

Digital Ethics: Computers, Photographs, and the Manipulation of Pixels.

ERIC Educational Resources Information Center

Mercedes, Dawn

1996-01-01

Summarizes negative aspects of computer technology and problems inherent in the field of digital imaging. Considers the postmodernist response that borrowing and alteration are essential characteristics of the technology. Discusses the implications of this for education and research. (MJP)

The perceptions of danish physiotherapists on the ethical issues related to the physiotherapist-patient relationship during the first session: a phenomenological approach

PubMed Central

2011-01-01

Background In the course of the last four decades, the profession of physiotherapy has progressively expanded its scope of responsibility and its focus on professional autonomy and evidence-based clinical practice. To preserve professional autonomy, it is crucial for the physiotherapy profession to meet society's expectations and demands of professional competence as well as ethical competence. Since it is becoming increasingly popular to choose a carrier in private practice in Denmark this context constitutes the frame of this study. Physiotherapy in private practice involves mainly a meeting between two partners: the physiotherapist and the patient. In the meeting, power asymmetry between the two partners is a condition that the physiotherapist has to handle. The aim of this study was to explore whether ethical issues rise during the first physiotherapy session discussed from the perspective of the physiotherapists in private practice. Methods A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analysed by using a phenomenological framework. Results Four descriptive themes emerged: general reflections on ethics in physiotherapy; the importance of the first physiotherapy session; the influence of the clinical environment on the first session and; reflections and actions upon beneficence towards the patient within the first session. The results show that the first session and the clinical context in private practice are essential from an ethical perspective. Conclusions Ethical issues do occur within the first session, the consciousness about ethical issues differs in Danish physiotherapy private practice, and reflections and acts are to a lesser extent based on awareness of ethical theories, principles and ethical guidelines. Beneficence towards the patient is a fundamental aspect of the physiotherapists' understanding of the first session. However, if the physiotherapist lacks a deeper ethical awareness, the physiotherapist may reason and/or act ethically to a varying extent: only an ethically conscious physiotherapist will know when he or she reflects and acts ethically. Further exploration of ethical issues in private practice is recommendable, and as management policy is deeply embedded within the Danish public sector there are reasons to explore public contexts of physiotherapy as well. PMID:21992627

The perceptions of Danish physiotherapists on the ethical issues related to the physiotherapist-patient relationship during the first session: a phenomenological approach.

PubMed

Praestegaard, Jeanette; Gard, Gunvor

2011-10-12

In the course of the last four decades, the profession of physiotherapy has progressively expanded its scope of responsibility and its focus on professional autonomy and evidence-based clinical practice. To preserve professional autonomy, it is crucial for the physiotherapy profession to meet society's expectations and demands of professional competence as well as ethical competence. Since it is becoming increasingly popular to choose a carrier in private practice in Denmark this context constitutes the frame of this study. Physiotherapy in private practice involves mainly a meeting between two partners: the physiotherapist and the patient. In the meeting, power asymmetry between the two partners is a condition that the physiotherapist has to handle. The aim of this study was to explore whether ethical issues rise during the first physiotherapy session discussed from the perspective of the physiotherapists in private practice. A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analysed by using a phenomenological framework. Four descriptive themes emerged: general reflections on ethics in physiotherapy; the importance of the first physiotherapy session; the influence of the clinical environment on the first session and; reflections and actions upon beneficence towards the patient within the first session. The results show that the first session and the clinical context in private practice are essential from an ethical perspective. Ethical issues do occur within the first session, the consciousness about ethical issues differs in Danish physiotherapy private practice, and reflections and acts are to a lesser extent based on awareness of ethical theories, principles and ethical guidelines. Beneficence towards the patient is a fundamental aspect of the physiotherapists' understanding of the first session. However, if the physiotherapist lacks a deeper ethical awareness, the physiotherapist may reason and/or act ethically to a varying extent: only an ethically conscious physiotherapist will know when he or she reflects and acts ethically. Further exploration of ethical issues in private practice is recommendable, and as management policy is deeply embedded within the Danish public sector there are reasons to explore public contexts of physiotherapy as well.

Countering Brutality to Wildlife, Relationism and Ethics: Conservation, Welfare and the ‘Ecoversity’

PubMed Central

Garlick, Steve; Matthews, Julie; Carter, Jennifer

2011-01-01

Simple Summary Wildlife cruelty is commonplace in society. We argue for a new engagement with wildlife through three elements: a relational ethic based on intrinsic understanding of the way wildlife and humans might view each other; a geography of place and space, where there are implications for how we ascribe contextual meaning and practice in human-animal relations; and, engaged learning designed around our ethical relations with others, beyond the biophysical and novel, and towards the reflective metaphysical. We propose the ‘ecoversity’, as a scholarly and practical tool for focusing on the intersection of these three elements as an ethical place-based learning approach. Abstract Wildlife objectification and cruelty are everyday aspects of Australian society that eschew values of human kindness, empathy, and an understanding of the uniqueness and importance of non-human life in the natural world. Fostered by institutional failure, greed and selfishness, and the worst aspects of human disregard, the objectification of animals has its roots in longstanding Western anthropocentric philosophical perspectives, post colonialism, and a global uptake of neoliberal capitalism. Conservation, animal rights and welfare movements have been unable to stem the ever-growing abuse of wildlife, while ‘greenwash’ language such as ‘resource use’, ‘management’, ‘pests’, ‘over-abundance’, ‘conservation hunting’ and ‘ecology’ coat this violence with a respectable public veneer. We propose an engaged learning approach to address the burgeoning culture of wildlife cruelty and objectification that comprises three elements: a relational ethic based on intrinsic understanding of the way wildlife and humans might view each other [1,2,3]; geography of place and space [4], where there are implications for how we ascribe contextual meaning and practice in human-animal relations; and, following [5], engaged learning designed around our ethical relations with others, beyond the biophysical and novel and towards the reflective metaphysical. We propose the ‘ecoversity’ [6], as a scholarly and practical tool for focusing on the intersection of these three elements as an ethical place-based learning approach to wildlife relationism. We believe it provides a mechanism to help bridge the gap between human and non-human animals, conservation and welfare, science and understanding, and between objectification and relationism as a means of addressing entrenched cruelty to wildlife. PMID:26486221

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

A Moral (Normative) Framework for the Judgment of Actions and Decisions in the Construction Industry and Engineering: Part II.

PubMed

Alkhatib, Omar J

2017-12-01

The construction industry is typically characterized as a fragmented, multi-organizational setting in which members from different technical backgrounds and moral values join together to develop a particular business or project. The most challenging obstacle in the construction process is to achieve a successful practice and to identify and apply an ethical framework to manage the behavior of involved specialists and contractors and to ensure the quality of all completed construction activities. The framework should reflect a common moral ground for myriad people involved in this process to survive and compete ethically in today's turbulent construction market. This study establishes a framework for moral judgment of behavior and actions conducted in the construction process. The moral framework provides the basis of judging actions as "moral" or "immoral" based on three levels of moral accountability: personal, professional, and social. The social aspect of the proposed framework is developed primarily from the essential attributes of normative business decision-making models identified in the literature review and subsequently incorporates additional attributes related to professional and personal moral values. The normative decision-making models reviewed are based primarily on social attributes as related to moral theories (e.g., utilitarianism, duty, rights, virtue, etc.). The professional and moral attributes are established by identifying a set of common moral values recognized by professionals in the construction industry and required to prevent common construction breaches. The moral framework presented here is the complementary part of the ethical framework developed in Part I of this article and is based primarily on the personal behavior or the moral aspect of professional responsibility. The framework can be implemented as a form of preventive personal ethics, which would help avoid ethical dilemmas and moral implications in the first place. Furthermore, the moral framework can be considered as a decision-making model to guide actions and improve the moral reasoning process, which would help individuals think through possible implications and the consequences of ethical and moral issues in the construction industry.

A Writing Intensive Course in "Natural Disasters: Geoethics and the Layman"

NASA Astrophysics Data System (ADS)

Fryer, P.

2011-12-01

One course with a contemporary ethics focus is a graduation requirement under the University of Hawaii at Manoa's General Education rules. The goal of the University of Hawaii General Education Committee is to encourage faculty to design ethics-focus courses for each field of undergraduate concentration. Undergraduate students are also required to take 5 writing intensive courses. It is permitted to combine the ethics and writing intensive foci in a given course, as long as one third of the course is devoted to each focus. The course I designed uses current disasters as the subject matter, thus course content varies from year to year. The prerequisite for enrollment is one introductory course in geoscience, to ensure students are familiar with basic geologic processes. I bring in geo-professionals, active in the fields we study, to discuss with students the realities of dealing with civil authorities, elected officials, the media, and the public during a natural disaster. This is one of the aspects of the course the students most enjoy. Such a course could be designed for any locality. Learning outcomes by which the students' work is assessed are as follows. The best student: (1) clearly identifies the inherent ethical choices and implications involved in the professional geoscientist's role during contemporary natural hazard situations; (2) gives evidence of understanding the effects of perspective, context, personal views as pertains to natural hazards; (3) specifies the decision-makers and stakeholders involved in hazard situations; (4) integrates clear descriptions of relevant ethical ambiguities/dilemmas into the overall analysis of a given hazard situation; (5) draws upon frameworks, principles of ethics to develop pertinent arguments and/or positions; (6) develops and presents alternate arguments/positions; (7) discusses and/or debates ethical issues with sensitivity to others' perspectives and the context, while also defending own position with logic and fact; (8) makes a reasoned judgment that takes into account an array of arguments and perspectives; (9) shows evidence of a logical, systematic decision-making process. Weekly writing assignments and term papers that assess the ethical aspects of actions taken by stakeholders in various disaster situations are required and feedback from both classmates and instructor offer the student an opportunity to revise drafts and thus improve both writing skills and grade. Grades are based on class participation and attendance (50%), writing assignments (30%), term paper (10%), and a final exam (10%). Student assessments of the course have been very positive over the past 3 years (average score of 4.7 out of 5).

Yesterday’s Doctors: The Human Aspects of Medical Education in Britain, 1957–93

PubMed Central

Bates, Victoria

2017-01-01

In the wake of the Second World War there was a movement to counterbalance the apparently increasingly technical nature of medical education. These reforms sought a more holistic model of care and to put people – rather than diseases – back at the centre of medical practice and medical education. This article shows that students often drove the early stages of education reform. Their innovations focused on relationships between doctors and their communities, and often took the form of informal discussions about medical ethics and the social dimensions of primary care. Medical schools began to pursue ‘humanistic’ education more formally from the 1980s onwards, particularly within the context of general practice curricula and with a focus on individual doctor–patient relationships. Overall from the 1950s to the 1990s there was a broad shift in discussions of the human aspects of medical education: from interest in patient communities to individuals; from social concerns to personal characteristics; and from the relatively abstract to the measurable and instrumental. There was no clear shift from ‘less’ to ‘more’ humanistic education, but rather a shift in the perceived goals of integrating human aspects of medical education. The human aspects of medicine show the importance of student activism in driving forward community and ethical medicine, and provide an important backdrop to the rise of competencies within general undergraduate education. PMID:27998331

Nurse's Awareness on Ethico-legal Aspects of Nursing Profession.

PubMed

Paudel Subedi, Krishna Kumari; Timalsina, Kalpana; Bhele, Raja Laxmi

2018-03-13

Nursing practice amicably includes practical efficacy and ethics. Now a days legal and ethical problems associated with client care are arising day by day. Therefore, nurses should have adequate understanding of basic legal concepts and issues relevant to nursing profession in order to protect the rights of the clients and the nurses. A cross sectional descriptive design was adopted for the study. 142 nurses were included by using purposive sampling technique. Data was collected with self-administered structured questionnaire. Descriptive statistics was used to reveal demographic information. Kruskal Wallis and Mann Whitney test were used to find out association of selected demographic variables and ethico legal aspects of nursing. Majority of participants were belonging to 20-29 years of age. More than half nurses had complete bachelor's degree and had less than 10 year's experiences. Majority of participants reported that they did not encounter any legal issues in their professional life till date. Similarly, majority of participants had average level knowledge and equate level of practice. Years of experiences and education level did not affect in knowledge level and existing practice related to ethico legal aspect of nursing. There was no significant relationship between level of knowledge and existing practice. Nurses have average knowledge and practice on ethico legal aspects. There is positive relationship between knowledge and practice though it is not statistically significant.

Ethical issues in palliative care for nursing homes: Development and testing of a survey instrument.

PubMed

Preshaw, Deborah Hl; McLaughlin, Dorry; Brazil, Kevin

2018-02-01

To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes. Registered nurses and healthcare assistants have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers. Cross-sectional survey of Registered nurses and healthcare assistants in nursing homes in one region of the UK. A survey instrument, "Ethical issues in Palliative Care for Nursing homes", was developed through the findings of qualitative interviews with Registered nurses and healthcare assistants in nursing homes and a literature review. It was reviewed by an expert panel and piloted prior to implementation in a survey in 2015 with a convenience sample of 596 Registered nurses and healthcare assistants. Descriptive and exploratory factor analyses were used to assess the underlying structure of the Frequency and Distress Scales within the instrument. Analysis of 201 responses (response rate = 33.7%) revealed four factors for the Frequency Scale and five factors for the Distress Scale that comprise the Ethical issues in Palliative Care for Nursing homes. Factors common to both scales included "Processes of care," "Resident autonomy" and "Burdensome treatment." Additionally, the Frequency Scale included "Competency," and the Distress Scale included "Quality of care" and "Communication." The Ethical issues in Palliative Care for Nursing homes instrument has added to the palliative care knowledge base by considering the ethical issues experienced specifically by Registered nurses and healthcare assistants within the nursing home. This research offers preliminary evidence of the psychometric properties of the Ethical issues in Palliative Care for Nursing homes survey instrument. The two largest factors highlight the need to address the organisational aspects of caring and provide training in negotiating conflicting ethical principles. © 2017 John Wiley & Sons Ltd.

[Man and his fellow-creatures under ethical aspects].

PubMed

Teutsch, Gotthart M

2004-01-01

The repeated attempts to tighten up the literary report are finally showing effects. This not only as a result of shorter reports but also because of the fact that less is being written and published regarding our topic. The discussion seems exhausted which, for years, dealt with the controversial moral status of animals and the--finally--constitutionally sanctioned status of animal protection in Germany. The problem of animals in ethics is becoming a rarity. Correspondingly, bio-ethics is oriented towards human problems and related borderline cases in a rather one-sided manner. This radically altered situation corresponds to an equally profound shift in the direction of our thinking. In the 1970's it was the shock in reaction to brutality towards T.V.-reports. But soon questions asking about the guilty were being posed. To direct the question from a guilt-related "who" to the "what" of the underlying reasons was a more difficult task. Just like social ethics developed out of social criticism, modern animal ethics developed out of the criticism of cruelty to animals. And, to the degree that this criticism became a common public concern, it lost its importance in comparison to the ethical questions now moving into the centre of the interest. In view of book-production this means that animal protection-related literature appears in three major groups: Husbandry, Use and Abuse, Animal Protection Law, Animal (Protection) Ethics. To collect these three groups simultaneously is becoming increasingly difficult. The concentration on, and supposedly a limitation to the sectors morals and ethics of the man-animal relationship cannot be avoided in the literary report. Morals is stressed here in particular in order to limit the excessive dominance of theoretical ethics and to preserve the priority of action-guiding morals.