What ethics for case managers? Literature review and discussion.
Corvol, Aline; Moutel, Grégoire; Somme, Dominique
2016-11-01
Little is known about case managers' ethical issues and professional values. This article presents an overview of ethical issues in case managers' current practice. Findings are examined in the light of nursing ethics, social work ethics and principle-based biomedical ethics. A systematic literature review was performed to identify and analyse empirical studies concerning ethical issues in case management programmes. It was completed by systematic content analysis of case managers' national codes of ethics. Only nine empirical studies were identified, eight of them from North America. The main dilemmas were how to balance system goals against the client's interest and client protection against autonomy. Professional codes of ethics shared important similarities, but offered different responses to these two dilemmas. We discuss the respective roles of professional and organizational ethics. Further lines of research are suggested. © The Author(s) 2015.
A Case Study of Engineering Ethics
NASA Astrophysics Data System (ADS)
Shimizu, Kazuo
In Engineering Ethics Class at Shizuoka University, the Code of Ethics and Cases for Electrical Engineers by IEEJ Ethics committee is used to promote for high education effect to correspond large number of students (140students). In this paper, a case study in the class, and survey results for ethics value of students are presented. In addition, some comments for role playing act on the case of virtual experiences by students are described.
Effectiveness of a Case-Based Computer Program on Students' Ethical Decision Making.
Park, Eun-Jun; Park, Mihyun
2015-11-01
The aim of this study was to test the effectiveness of a case-based computer program, using an integrative ethical decision-making model, on the ethical decision-making competency of nursing students in South Korea. This study used a pre- and posttest comparison design. Students in the intervention group used a computer program for case analysis assignments, whereas students in the standard group used a traditional paper assignment for case analysis. The findings showed that using the case-based computer program as a complementary tool for the ethics courses offered at the university enhanced students' ethical preparedness and satisfaction with the course. On the basis of the findings, it is recommended that nurse educators use a case-based computer program as a complementary self-study tool in ethics courses to supplement student learning without an increase in course hours, particularly in terms of analyzing ethics cases with dilemma scenarios and exercising ethical decision making. Copyright 2015, SLACK Incorporated.
Cautionary Tales: Ethics and Case Studies in Science
Herreid, Clyde Freeman
2014-01-01
Ethical concerns are normally avoided in science classrooms in spite of the fact that many of our discoveries impinge directly on personal and societal values. We should not leave the ethical problems for another day, but deal with them using realistic case studies that challenge students at their ethical core. In this article we illustrate how case studies can be used to teach STEM students principles of ethics. PMID:25574280
The Lavelle Affair: An Air Force Case Study in Ethics
2016-06-01
THE LAVELLE AFFAIR: AN AIR FORCE CASE STUDY IN ETHICS BY KRISTINA ELLIS A THESIS PRESENTED TO THE FACULTY OF THE SCHOOL OF... ethical transgressions. As such, the story of General Lavelle’s wartime command experiences became a case study in ethics and integrity within Air...1 1 THE LIFE AND CAREER OF GENERAL LAVELLE 8 1 VIETNAM 14 2 CIVIL-MILITARY RELATIONS 25 2 ETHICAL
CRIS Case Study Materials in Ethical Decision Making.
ERIC Educational Resources Information Center
Blanning, James R.
Designed for secondary-level classroom discussion, these materials contain nine, short case studies of ethical dilemmas. The cast studies focus mainly on incidents and issues relevant to high school students. Discussion questions for each case study require students to examine the case, discuss the issue, and make an ethical decision about how…
Ethics: A Bridge for Studying the Social Contexts of Professional Communication.
ERIC Educational Resources Information Center
Speck, Bruce W.
1989-01-01
Describes a method for helping students evaluate ethical issues in a systematic way, based on Lawrence Kohlberg's stages of moral development. Recommends the case-study approach for creating social constructs in which students face ethical dilemmas, and outlines a case-study ethics unit using Kohlberg's model. (MM)
O'Donnell, Lolita T
2007-01-01
The purpose of this study was to describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute care setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice of case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the organizations that employ them and the healthcare needs of the patients that they advocate for. 3. Aside from the importance of linking patient care outcomes with accountability, nurse case managers may need to advocate for policy change and system reform.
Clarifying perspectives: Ethics case reflection sessions in childhood cancer care.
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.
O'Donnell, Lolita T
2007-01-01
To describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute hospital setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice in case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the organizations that employ them and the healthcare needs of the patients that they advocate for. 3. Aside from the importance of linking patient care outcomes with accountability, nurse case managers may need to advocate for policy change and system reform.
Case Studies, Ethics, Philosophy, and Liberal Learning for the Management Profession
ERIC Educational Resources Information Center
Rendtorff, Jacob Dahl
2015-01-01
Case studies can be an important methodology for ethics and philosophy in humanistic management and liberal education as well as in the social sciences because they integrate a deeper, reflective, philosophical, and ethical understanding of the organization. A case study approach based on philosophy of management contributes to putting into…
The role of professional knowledge in case-based reasoning in practical ethics.
Pinkus, Rosa Lynn; Gloeckner, Claire; Fortunato, Angela
2015-06-01
The use of case-based reasoning in teaching professional ethics has come of age. The fields of medicine, engineering, and business all have incorporated ethics case studies into leading textbooks and journal articles, as well as undergraduate and graduate professional ethics courses. The most recent guidelines from the National Institutes of Health recognize case studies and face-to-face discussion as best practices to be included in training programs for the Responsible Conduct of Research. While there is a general consensus that case studies play a central role in the teaching of professional ethics, there is still much to be learned regarding how professionals learn ethics using case-based reasoning. Cases take many forms, and there are a variety of ways to write them and use them in teaching. This paper reports the results of a study designed to investigate one of the issues in teaching case-based ethics: the role of one's professional knowledge in learning methods of moral reasoning. Using a novel assessment instrument, we compared case studies written and analyzed by three groups of students whom we classified as: (1) Experts in a research domain in bioengineering. (2) Novices in a research domain in bioengineering. (3) The non-research group--students using an engineering domain in which they were interested but had no in-depth knowledge. This study demonstrates that a student's level of understanding of a professional knowledge domain plays a significant role in learning moral reasoning skills.
Bagdasarov, Zhanna; Thiel, Chase E; Johnson, James F; Connelly, Shane; Harkrider, Lauren N; Devenport, Lynn D; Mumford, Michael D
2013-09-01
Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sense making processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed.
Stewart, Kearsley A
2015-03-01
Over the past decade, global health has emerged as one of the fastest growing academic programs in the United States. Ethics training is cited widely as an essential feature of U.S. global health programs, but generally it is not deeply integrated into the global health teaching and training curricula. A discussion about the pedagogy of teaching global health ethics is long overdue; to date, only a few papers specifically engage with pedagogy rather than competencies or content. This paper explores the value of case study pedagogy for a full-semester graduate course in global health ethics at an American university. I address some of the pedagogical challenges of teaching global health ethics through my innovative use of case study methodology-the "prospective case study" (PSC).
ERIC Educational Resources Information Center
Reid, Kenneth J.
2012-01-01
Ethics is among the professional skills embedded in the first year engineering curriculum in many institutions. The general format of the study of ethics is similar to many other institutions: student teams review case studies and develop written and oral presentations on the ethical issues encountered. This report investigates whether the use of…
Coughlin, S S; Etheredge, G D; Metayer, C; Martin, S A
1996-01-01
The ethical problems that surrounded the Tuskegee Syphilis Study prompted widespread public criticism when they first surfaced in 1972; the Tuskegee Study remains an important case in bioethics. We recently examined public health student knowledge of the ethical significance of the Tuskegee Study as part of an ethics curriculum needs assessment at Tulane University. A brief questionnaire was administered to 236 graduate students currently enrolled in seven epidemiology courses. Basic demographic information was obtained along with information about degree program. A series of questions was then asked to assess student knowledge of bioethics including the ethical significance of the Tuskegee Study. Only 19% (46 of 236) of the students demonstrated knowledge of the ethical significance of the Tuskegee Study. Knowledge of the Tuskegee Study's ethical significance was higher among students who were from the United States and those who were enrolled in the epidemiology program (P < .05). The ethical problems that surrounded the Tuskegee Study have rarely been encountered in public health. However, this important case stands as an exemplar of the potential for ethical abuses in human subjects research. Such cases ought to be highlighted in public health curricula. Medical Subject Headings (MeSH): blacks, African Americans, educational curriculum, epidemiology, ethics, public health, racism.
Karwaki, Tanya E; Hazlet, Thomas K
2017-05-01
This study was designed to better understand pharmacy students' experiences and recognition of legal and ethical tensions existing in pharmacy practice as demonstrated in student-written law and ethics cases. A qualitative analysis of 132 student-written cases representing the team efforts of 1053 students over a 12-year time period was conducted. Student-written cases were coded and analyzed thematically. Our results demonstrate the types of ethical and legal issues our students have experienced in pharmacy practice during the first five quarters of their professional education. Our data highlight three themes: 1) ethical dilemmas presented when the law is misapplied; 2) ethical dilemmas presented when an institutional policy or law was viewed as insufficient; and 3) ethical dilemmas presented as provider distress. The third theme was further subdivided into five subthemes. The themes that emerged from this study represent some of the ethical dilemmas that second professional year students have encountered and how these dilemmas may intersect with legal boundaries. Educators can use cases demonstrating these themes to reinforce law and ethics education in the curriculum, thus helping prepare students for pharmacy practice. This article recommends how and when to use case examples. Copyright © 2017 Elsevier Inc. All rights reserved.
Teaching ethical analysis in occupational therapy.
Haddad, A M
1988-05-01
Ethical decision making is a cognitive skill requiring education in ethical principles and an understanding of specific ethical issues. It is also a psychodynamic process involving personalities, values, opinions, and perceptions. This article proposes the use of case studies and role-playing techniques in teaching ethics in occupational therapy to supplement conventional methods of presenting ethical theories and principles. These two approaches invite students to discuss and analyze crucial issues in occupational therapy from a variety of viewpoints. Methodology of developing case studies and role-playing exercises are discussed. The techniques are evaluated and their application to the teaching of ethics is examined.
Continuing education in ethical decision making using case studies from medical social work.
McCormick, Andrew J; Stowell-Weiss, Patti; Carson, Jennifer; Tebo, Gerald; Hanson, Inga; Quesada, Bianca
2014-01-01
Medical social workers have needs for training in ethics that is specific to dilemmas that arise while providing service to patients who are very ill, mentally compromised, or in a terminal condition. A social work department developed a continuing education training to educate social workers in bioethics related to determining decisional capacity and understanding standards of ethical decision making. Case studies are used to illustrate ethical conflicts and the role of social workers in resolving them. The benefits of case study training are discussed.
Education research: a case-based bioethics curriculum for neurology residents.
Tolchin, Benjamin; Willey, Joshua Z; Prager, Kenneth
2015-03-31
In 2012, the American Academy of Neurology (AAN) updated and expanded its ethics curriculum into Practical Ethics in Clinical Neurology, a case-based ethics curriculum for neurologists. We piloted a case-based bioethics curriculum for neurology residents using the framework and topics recommended by the AAN, matched to clinical cases drawn from Columbia's neurologic services. Our primary outcome was residents' ability to analyze and manage ethically complex cases as measured on precurriculum and postcurriculum multiple-choice quizzes. Secondary outcomes included precurriculum and postcurriculum self-assessed comfort in discussing and managing ethically complex cases, as well as attendance at ethics discussion sessions as compared to attendance at other didactic sessions. Resident performance on quizzes improved from 75.8% to 86.7% (p = 0.02). Comfort in discussing ethically complex cases improved from 6.4 to 7.4 on a 10-point scale (p = 0.03). Comfort in managing such cases trended toward improvement but did not reach statistical significance. Attendance was significantly better at ethics discussions (73.5%) than at other didactic sessions (61.7%, p = 0.04). Our formal case-based ethics curriculum for neurology residents, based on core topics drawn from the AAN's published curricula, was successfully piloted. Our study showed a statistically significant improvement in residents' ability to analyze and manage ethically complex cases as measured by multiple-choice tests and self-assessments. © 2015 American Academy of Neurology.
Ethics: A Course of Study for Educational Leaders.
ERIC Educational Resources Information Center
Kimbrough, Ralph B.
This monograph provides readings in ethical thought and professional ethics in educational administration, supplemented by case studies illustrating ethical problems administrators face. Comments on the field of ethics and the importance of administrative ethics introduce the booklet, along with background information about the booklet and…
ERIC Educational Resources Information Center
Gillis, Robert James
2017-01-01
The purpose of this qualitative single case study was to explore how department chairs described the influence of recent corporate ethics scandals on content and availability of ethics education in postsecondary business schools in Arizona. The following research questions guided this study: RQ1: How do department chairs describe the influence of…
Ethical Implications of Case-Based Payment in China: A Systematic Analysis.
Jin, Pingyue; Biller-Andorno, Nikola; Wild, Verina
2015-12-01
How health care providers are paid affects how medicine is practiced. It is thus important to assess provider payment models not only from the economic perspective but also from the ethical perspective. China recently started to reform the provider payment model in the health care system from fee-for-service to case-based payment. This paper aims to examine this transition from an ethical perspective. We collected empirical studies on the impact of case-based payment in the Chinese health care system and applied a systematic ethical matrix that integrates clinical ethics and public health ethics to analyze the empirical findings. We identified eleven prominent ethical issues related to case-based payment. Some ethical problems of case-based payment in China are comparable to ethical problems of managed care and diagnosis related groups in high-income countries. However, in this paper we discuss in greater detail four specific ethical issues in the Chinese context: professionalism, the patient-physician relationship, access to care and patient autonomy. Based on the analysis, we cautiously infer that case-based payment is currently more ethically acceptable than fee-for-service in the context of China, mainly because it seems to lower financial barriers to access care. Nonetheless, it will be difficult to justify the implementation of case-based payment if no additional measures are taken to monitor and minimize its existing negative ethical implications. © 2014 John Wiley & Sons Ltd.
Teaching Business Ethics: A Practical Guide and Case Studies. SBDC Professional Enrichment.
ERIC Educational Resources Information Center
Collins, Denis; Page, Laura V.
This teaching guide is for instructors who wish to include a discussion of ethical dilemmas in their regular business seminars and workshops. It discusses why it is essential to teach ethics and how to do so. It reviews the format of specially annotated ethics cases that are designed to help teach business ethics and shows how to use them. These…
A Survey of Hospital Ethics Structures in Ontario.
Breslin, Jonathan
2017-01-01
In response to the growing recognition of the prevalence of ethical issues in clinical care, hospitals in Canada began forming ethics committees in the 1980s. Studies showed significant growth in the prevalence of ethics committees over the ensuing decade. Although the limited studies available suggest that ethics committees have become very prevalent in Canadian hospitals, hospital ethics services have evolved in recent years to include a wider range of structures. In some cases, these structures may work in conjunction with an ethics committee, but in other cases they may replace ethics committees. They include on-staff ethicists, external ethics consultants, "hub-and-spokes" structures and regional ethics programs. What is not known, however, is how prevalent these other structures are and whether ethics committees continue to function as the main delivery mechanism for ethics services in Canadian hospitals. This paper reports on the results of a survey of hospitals in Ontario to answer those questions.
Antes, Alison L.; Thiel, Chase E.; Martin, Laura E.; Stenmark, Cheryl K.; Connelly, Shane; Devenport, Lynn D.; Mumford, Michael D.
2015-01-01
This study examined the role of reflection on personal cases for making ethical decisions with regard to new ethical problems. Participants assumed the position of a business manager in a hypothetical organization and solved ethical problems that might be encountered. Prior to making a decision for the business problems, participants reflected on a relevant ethical experience. The findings revealed that application of material garnered from reflection on a personal experience was associated with decisions of higher ethicality. However, whether the case was viewed as positive or negative, and whether the outcomes, process, or outcomes and processes embedded in the experience were examined, influenced the application of case material to the new problem. As expected, examining positive experiences and the processes involved in those positive experiences resulted in greater application of case material to new problems. Future directions and implications for understanding ethical decision-making are discussed. PMID:26257506
Ethical issues in engineering models: an operations researcher's reflections.
Kleijnen, J
2011-09-01
This article starts with an overview of the author's personal involvement--as an Operations Research consultant--in several engineering case-studies that may raise ethical questions; e.g., case-studies on nuclear waste, water management, sustainable ecology, military tactics, and animal welfare. All these case studies employ computer simulation models. In general, models are meant to solve practical problems, which may have ethical implications for the various stakeholders; namely, the modelers, the clients, and the public at large. The article further presents an overview of codes of ethics in a variety of disciples. It discusses the role of mathematical models, focusing on the validation of these models' assumptions. Documentation of these model assumptions needs special attention. Some ethical norms and values may be quantified through the model's multiple performance measures, which might be optimized. The uncertainty about the validity of the model leads to risk or uncertainty analysis and to a search for robust models. Ethical questions may be pressing in military models, including war games. However, computer games and the related experimental economics may also provide a special tool to study ethical issues. Finally, the article briefly discusses whistleblowing. Its many references to publications and websites enable further study of ethical issues in modeling.
Ethical Leadership and Moral Literacy: Incorporating Ethical Dilemmas in a Case-Based Pedagogy
ERIC Educational Resources Information Center
Jenlink, Patrick M.; Jenlink, Karen Embry
2015-01-01
In this paper the authors examine an ethical dilemma approach to case-based pedagogy for leadership preparation, which was used in a doctoral studies program. Specifically, the authors argue that preparing educational leaders for the ethical dilemmas and moral decision-making that define schools requires assessing current programs and pedagogical…
Mind the Gap: A Case Study of Values-Based Decision Making in a Nonprofit Organization
ERIC Educational Resources Information Center
Craft, Jana L.
2013-01-01
Using an exploratory case study approach, this research examined the consistency between espoused and enacted values within a large nonprofit organization known as an ethical leader in the human services industry. This research explored ethical business culture, ethical decision making, deontological and utilitarian moral paradigms and learning…
An Active Learning Activity for an IT Ethics Course
ERIC Educational Resources Information Center
Woods, David M.; Howard, Elizabeth V.
2014-01-01
Courses in Information Technology Ethics are often designed as discussion-intensive courses where case studies are introduced and evaluated using ethical theories. Although many of the case studies directly apply to our students' online lives, the stories can sometimes seem too far removed from their own experiences. While we read the news…
Professional ethics. A case study of infusion nurse consultants.
Adams, J
2000-01-01
As the healthcare system continues to reform, opportunities exist for infusion nurses to expand their practice into the business world. Traditionally, biomedical ethics have been used in nursing education as a framework for identifying and responding to ethical dilemmas. However, in the business world, professional ethics may be more subtle and insidious. A case study of ten infusion nurse consultants and their experiences with professional ethical issues is presented. Data were obtained using interviews, and content analysis revealed emergent themes of integrity and intuitive knowing with related categories.
Why Are There So Few Ethics Consults in Children's Hospitals?
Carter, Brian; Brockman, Manuel; Garrett, Jeremy; Knackstedt, Angie; Lantos, John
2018-06-01
In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children's hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are (1) ethics committee meetings, (2) Nursing Ethics Forum, (3) ethics Brown Bag workshops, (4) PICU ethics rounds, (5) Grand Rounds, (6) NICU Comprehensive Care Rounds, (7) Palliative Care Team (PaCT) case conferences, (8) multidisciplinary consults in Fetal Health Center, and (9) ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of "core competencies" than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple "moral spaces" in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set out to do than in the role of the typical hospital ethics consultant today.
ERIC Educational Resources Information Center
Grant, Thomas A.
2012-01-01
This quasi-experimental study at a Northwest university compared two methods of teaching media ethics, a class taught with the principle-based SBH Maieutic Method (n = 25) and a class taught with a traditional case study method (n = 27), with a control group (n = 21) that received no ethics training. Following a 16-week intervention, a one-way…
Bernheim, Ruth Gaare; Stefanak, Matthew; Brandenburg, Terry; Pannone, Aaron; Melnick, Alan
2013-01-01
As public health departments around the country undergo accreditation using the Public Health Accreditation Board standards, the process provides a new opportunity to integrate ethics metrics into day-to-day public health practice. While the accreditation standards do not explicitly address ethics, ethical tools and considerations can enrich the accreditation process by helping health departments and their communities understand what ethical principles underlie the accreditation standards and how to use metrics based on these ethical principles to support decision making in public health practice. We provide a crosswalk between a public health essential service, Public Health Accreditation Board community engagement domain standards, and the relevant ethical principles in the Public Health Code of Ethics (Code). A case study illustrates how the accreditation standards and the ethical principles in the Code together can enhance the practice of engaging the community in decision making in the local health department.
ERIC Educational Resources Information Center
McDermott, Brian J.
2010-01-01
The purpose of this study is to examine the influence of personal and professional ethics on the leadership of public school superintendents. A multi-case, qualitative research design was used to gather data from four practicing public school superintendents. Transformational leadership theory and the three pillars of ethics of leadership…
ERIC Educational Resources Information Center
Dow, Mirah J.; Boettcher, Carrie A.; Diego, Juana F.; Karch, Marziah E.; Todd-Diaz, Ashley; Woods, Kristine M.
2015-01-01
The purpose of this mixed methods study is to determine the effectiveness of case-based pedagogy in teaching basic principles of information ethics and ethical decision making. Study reports results of pre- and post-assessment completed by 49 library and information science (LIS) graduate students at a Midwestern university. Using Creswell's…
Marcus, Brian S; Carlson, Jestin N; Hegde, Gajanan G; Shang, Jennifer; Venkat, Arvind
2016-03-01
We sought to evaluate whether health care professionals' viewpoints differed on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas based on practice location. We conducted a survey study from December 21, 2013 to March 15, 2014 of health care professionals at six hospitals (one tertiary care academic medical center, three large community hospitals and two small community hospitals). The survey consisted of eight clinical ethics cases followed by statements on whether there was a role for the ethics committee or hospital in their resolution, what that role might be and case specific queries. Respondents used a 5-point Likert scale to express their degree of agreement with the premises posed. We used the ANOVA test to evaluate whether respondent views significantly varied based on practice location. 240 health care professionals (108-tertiary care center, 92-large community hospitals, 40-small community hospitals) completed the survey (response rate: 63.6 %). Only three individual queries of 32 showed any significant response variations across practice locations. Overall, viewpoints did not vary across practice locations within question categories on whether the ethics committee or hospital had a role in case resolution, what that role might be and case specific queries. In this multicenter survey study, the viewpoints of health care professionals on the role of ethics committees or hospitals in the resolution of clinical ethics cases varied little based on practice location.
Ethics--Business Educators Teach Students To Do the Right Thing!
ERIC Educational Resources Information Center
Keying In, 1997
1997-01-01
This issue focuses on teaching ethics in business education programs. Exploring the teaching of ethics in both high school and college, the newsletter first presents an overview of ethics and the study of ethics and makes a case for teaching ethics in business education courses. Following a short commentary on the difficulty of teaching ethics is…
Smith, Valerie J
2009-09-01
SCHOLARLY STUDIES OF REFUGEES and other vulnerable populations carry special ethical concerns. In this invited case study of Afghan refugees in Fremont, California, I provide illustrations and recommendations of ethical research methods with refugees. I also compare and contrast some ethical issues in the U.S. with issues in Thailand. The qualitative, ethnographic methods I report here demonstrate how to conduct culturally sensitive investigations by ethically approaching gatekeepers and other community members to preserve autonomy, ensure confidentiality, build trust, and improve the accuracy of interpretations and results. Six groups at risk for being marginalized in multiple ways within refugee populations are described. Ten best practices are recommended for ethically acquiring an in-depth understanding of the refugees, their community, and appropriate research methods.
Scientists' perception of ethical issues in nanomedicine: a case study.
Silva Costa, Helena; Sethe, Sebastian; Pêgo, Ana P; Olsson, I Anna S
2011-06-01
Research and development in nanomedicine has been accompanied by the consideration of ethical issues; however, little is known about how researchers working in this area perceive such issues. This case-study explores scientists' attitude towards and knowledge of ethical issues. Data were collected by semi-structured interviews with 22 nanomedicine practitioners and subject to content analysis. We found that scientists reflect with ambiguity on the reputed novelty of nanomedicine and what the ethical issues and risks are in their work. Respondents see no necessity for a paradigm shift in ethical considerations, but view ethical issues in nanomedicine as overlapping with those of other areas of biomedical research. Most respondents discuss ethical issues they faced in scientific work with their colleagues, but expect benefit from additional information and training on ethics. Our findings that scientists are motivated to reflect on ethical issues in their work, can contribute to the design of new strategies, including training programs, to engage scientists in ethical discussion and stimulate their responsibility as nanomedicine practitioners.
The Impact of Religious Beliefs on Professional Ethics: A Case Study of a New Teacher
ERIC Educational Resources Information Center
Barrett, Sarah Elizabeth
2015-01-01
This case study of a math and science teacher in a private religious school looks at the impact of a teacher's religious beliefs on her experience of engaging with ethical issues in her practice. A Freirean ethical framework is used to analyze her struggles with differences between her own personal religious convictions and those of the school in…
Ethics consultation on demand: concepts, practical experiences and a case study.
Reiter-Theil, S
2000-06-01
Despite the increasing interest in clinical ethics, ethics consultation as a professional service is still rare in Europe. In this paper I refer to examples in the United States. In Germany, university hospitals and medical faculties are still hesitant about establishing yet another "committee". One of the reasons for this hesitation lies in the ignorance that exists here about how to provide medical ethics services; another reason is that medical ethics itself is not yet institutionalised at many German universities. The most important obstacle, however, may be that medical ethics has not yet demonstrated its relevance to the needs of those caring for patients. The Centre for Ethics and Law, Freiburg, has therefore taken a different approach from that offered elsewhere: clinical ethics consultation is offered on demand, the consultation being available to clinician(s) in different forms. This paper describes our experiences with this approach; practical issues are illustrated by a case study.
Park, Dong Won; Moon, Jae Young; Ku, Eun Yong; Kim, Sun Jong; Koo, Young-Mo; Kim, Ock-Joo; Lee, Soon Haeng; Jo, Min-Woo; Lim, Chae-Man; Armstrong, John David; Koh, Younsuck
2015-04-01
This research aimed to investigate the changes in ethical issues in everyday clinical practice recognized by critical care nurses during two observation periods. We conducted a retrospective analysis of data obtained by prospective questionnaire surveys of nurses in the intensive care units (ICU) of a tertiary university-affiliated hospital in Seoul, Korea. Data were collected prospectively during two different periods, February 2002-January 2003 (Period 1) and August 2011-July 2012 (Period 2). Significantly fewer cases with ethical issues were reported in Period 2 than in Period 1 (89 cases [2.1%] of 4,291 ICU admissions vs. 51 [0.5%] of 9,302 ICU admissions, respectively; P < 0.001). The highest incidence of cases with identified ethical issues in both Periods occurred in MICU. The major source of ethical issues in Periods 1 and 2 was behavior-related. Among behaviorrelated issues, inappropriate healthcare professional behavior was predominant in both periods and mainly involved resident physicians. Ethical issue numbers regarding end-oflife (EOL) care significantly decreased in the proportion with respect to ethical issues during Period 2 (P = 0.044). In conclusion, the decreased incidence of cases with identified ethical issues in Period 2 might be associated with ethical enhancement related with EOL and improvements in the ICU care environment of the studied hospital. However, behaviorrelated issues involving resident physicians represent a considerable proportion of ethical issues encountered by critical care nurses. A systemic approach to solve behavior-related issues of resident physicians seems to be required to enhance an ethical environment in the studied ICU.
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.
Bollig, Georg; Schmidt, Gerda; Rosland, Jan Henrik; Heller, Andreas
2015-12-01
Many ethical problems exist in nursing homes. These include, for example, decision-making in end-of-life care, use of restraints and a lack of resources. The aim of the present study was to investigate nursing home staffs' opinions and experiences with ethical challenges and to find out which types of ethical challenges and dilemmas occur and are being discussed in nursing homes. The study used a two-tiered approach, using a questionnaire on ethical challenges and systematic ethics work, given to all employees of a Norwegian nursing home including nonmedical personnel, and a registration of systematic ethics discussions from an Austrian model of good clinical practice. Ninety-one per cent of the nursing home staff described ethical problems as a burden. Ninety per cent experienced ethical problems in their daily work. The top three ethical challenges reported by the nursing home staff were as follows: lack of resources (79%), end-of-life issues (39%) and coercion (33%). To improve systematic ethics work, most employees suggested ethics education (86%) and time for ethics discussion (82%). Of 33 documented ethics meetings from Austria during a 1-year period, 29 were prospective resident ethics meetings where decisions for a resident had to be made. Agreement about a solution was reached in all 29 cases, and this consensus was put into practice in all cases. Residents did not participate in the meetings, while relatives participated in a majority of case discussions. In many cases, the main topic was end-of-life care and life-prolonging treatment. Lack of resources, end-of-life issues and coercion were ethical challenges most often reported by nursing home staff. The staff would appreciate systematic ethics work to aid decision-making. Resident ethics meetings can help to reach consensus in decision-making for nursing home patients. In the future, residents' participation should be encouraged whenever possible. © 2015 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.
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Gholami, Khalil; Kuusisto, Elina; Tirri, Kirsi
2015-01-01
In this study, we investigated the culture-invariant and culture-dependent nature of teachers' ethical sensitivity in two countries. Our case study involves teachers from Finland (n = 864) representing Western culture, and from Iran (n = 556) representing Eastern culture. Culturally bound elements of ethical sensitivity were studied with the…
Reasons Preventing Teachers from Acting within the Framework of Ethical Principles
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Dag, Nilgün; Arslantas, Halis Adnan
2015-01-01
This study aims at putting forth the reasons preventing teachers from acting ethically, acting within the framework of ethical principles and having an ethical tendency. This study featuring a qualitative research model taking as a basis the case study approach followed a path of selecting people that can be a rich source of information for…
A Performative Approach to Teaching Care Ethics: A Case Study
ERIC Educational Resources Information Center
Hamington, Maurice
2012-01-01
This article describes a unique experiment in reconceptualizing the teaching of ethics as an embodied, performative activity rather than a purely intellectual, scholarly study. Although the inclusion of corporeal dimensions in the teaching of ethics makes intuitive sense, because morality is all about how one acts in the world, ethics education in…
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.
Being Ethically Minded: Practising the Scholarship of Teaching and Learning in an Ethical Manner
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Healey, Ruth L.; Bass, Tina; Caulfield, Jay; Hoffman, Adam; McGinn, Michelle K.; Miller-Young, Janice; Haigh, Martin
2013-01-01
The authors propose a working definition of ethical Scholarship of Teaching and Learning (SoTL), advance an ethical framework for SoTL inquiry, and present a case study that illustrates the complexity of ethical issues in SoTL. The Ethical SoTL Matrix is a flexible framework designed to support SoTL practitioners, particularly in the formative…
The Terri Schiavo case: legal, ethical, and medical perspectives.
Perry, Joshua E; Churchill, Larry R; Kirshner, Howard S
2005-11-15
Although tragic, the plight of Terri Schiavo provides a valuable case study. The conflicts and misunderstandings surrounding her situation offer important lessons in medicine, law, and ethics. Despite media saturation and intense public interest, widespread confusion lingers regarding the diagnosis of persistent vegetative state, the judicial processes involved, and the appropriateness of the ethical framework used by those entrusted with Terri Schiavo's care. First, the authors review the current medical understanding of persistent vegetative state, including the requirements for patient examination, the differential diagnosis, and the practice guidelines of the American Academy of Neurology regarding artificial nutrition and hydration for patients with this diagnosis. Second, they examine the legal history, including the 2000 trial, the 2002 evidentiary hearing, and the subsequent appeals. The authors argue that the law did not fail Terri Schiavo, but produced the highest-quality evidence and provided the most judicial review of any end-of-life guardianship case in U.S. history. Third, they review alternative ethical frameworks for understanding the Terri Schiavo case and contend that the principle of respect for autonomy is paramount in this case and in similar cases. Far from being unusual, the manner in which Terri Schiavo's case was reviewed and the basis for the decision reflect a broad medical, legal, and ethical consensus. Greater clarity regarding the persistent vegetative state, less apprehension of the presumed mysteries of legal proceedings, and greater appreciation of the ethical principles at work are the chief benefits obtained from studying this provocative case.
Lesson Plans To Advance Discussion of Ethical Issues.
ERIC Educational Resources Information Center
Swikle, Randy G.
2002-01-01
Presents lesson plans designed to enable high school students to recognize ethical issues involving the printed media and to give students practical experience in ethical decision-making using the newspaper as a learning tool. Includes 10 ethical issues and related case studies. (RS)
Case Complexity and Quality Attestation for Clinical Ethics Consultants.
Spielman, Bethany; Craig, Jana; Gorka, Christine; Miller, Keith
2015-01-01
A proposal by the American Society for Bioethics and Humanities (ASBH) to identify individuals who are qualified to perform ethics consultations neglects case complexity in candidates' portfolios. To protect patients and healthcare organizations, and to be fair to candidates, a minimum case complexity level must be clearly and publicly articulated. This proof-of-concept study supports the feasibility of assessing case complexity. Using text analytics, we developed a complexity scoring system, and retrospectively analyzed more than 500 ethics summaries of consults performed at an academic medical center during 2013. We demonstrate its use with seven case summaries that range in complexity from uncomplicated to very complicated. We encourage the ASBH to require a minimum level of case complexity, and recommend that attestation portfolios include several cases of moderate complexity and at least one very complex case. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.
Privacy and Ethics in the Age of the Smartphone: A Case Study
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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…
Pursuing an Ethic of Care: A Case Study of One Female Superintendent
ERIC Educational Resources Information Center
Rico, Rachelle G.
2009-01-01
This instrumental case study explores how the Ethic of Care is experienced within one Midwestern school system as an alternative approach to traditional school system hierarchical infrastructures. Through the qualitative tradition of portraiture (Lawrence-Lightfoot & Davis, 1997), this study documents the caring leadership actions, behaviors…
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Duke, Richard T. RT, IV
2017-01-01
This qualitative case study explored perspectives of alternative school leaders regarding professional ethics and standards. The study researched two components of alternative school leadership: effective alternative school characteristics based on professional standards and making decisions around the best interests of students. This study…
Ethic's Askew: A Case Study of Ethics in an Educational Environment
ERIC Educational Resources Information Center
Shurden, Susan; Santandreu, Juan; Shurden, Mike
2010-01-01
For a formal definition of ethics, Webster's New World Dictionary (1995) defines the term as "the study of standards of conduct and moral judgment". Ethics is important to individuals because we are concerned with what leaders do and who they are--their conduct and character. "Conduct" is a word that implies behavior. Behavior…
Everyday ethics in internal medicine resident clinic: an opportunity to teach.
Carrese, Joseph A; McDonald, Erin L; Moon, Margaret; Taylor, Holly A; Khaira, Kiran; Catherine Beach, Mary; Hughes, Mark T
2011-07-01
Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor-resident interactions. This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor-Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor-System Interaction (financial issues; doctor-system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their interactions with residents. Ethics education is important and residents may regard teaching about the ethics-related issues they actually encounter to be highly relevant. A better understanding of the barriers to teaching is needed in order to promote education about everyday ethics in the out-patient setting. © Blackwell Publishing Ltd 2011.
Everyday ethics in internal medicine resident clinic: an opportunity to teach
Carrese, Joseph A; McDonald, Erin L; Moon, Margaret; Taylor, Holly A; Khaira, Kiran; Beach, Mary Catherine; Hughes, Mark T
2011-01-01
OBJECTIVES Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor–resident interactions. METHODS This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. RESULTS Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor–Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor–System Interaction (financial issues; doctor–system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). CONCLUSIONS In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their interactions with residents. Ethics education is important and residents may regard teaching about the ethics-related issues they actually encounter to be highly relevant. A better understanding of the barriers to teaching is needed in order to promote education about everyday ethics in the out-patient setting. PMID:21649704
The Roles of Implicit Understanding of Engineering Ethics in Student Teams' Discussion.
Lee, Eun Ah; Grohman, Magdalena; Gans, Nicholas R; Tacca, Marco; Brown, Matthew J
2017-12-01
Following previous work that shows engineering students possess different levels of understanding of ethics-implicit and explicit-this study focuses on how students' implicit understanding of engineering ethics influences their team discussion process, in cases where there is significant divergence between their explicit and implicit understanding. We observed student teams during group discussions of the ethical issues involved in their engineering design projects. Through the micro-scale discourse analysis based on cognitive ethnography, we found two possible ways in which implicit understanding influenced the discussion. In one case, implicit understanding played the role of intuitive ethics-an intuitive judgment followed by reasoning. In the other case, implicit understanding played the role of ethical insight, emotionally guiding the direction of the discussion. In either case, however, implicit understanding did not have a strong influence, and the conclusion of the discussion reflected students' explicit understanding. Because students' implicit understanding represented broader social implication of engineering design in both cases, we suggest to take account of students' relevant implicit understanding in engineering education, to help students become more socially responsible engineers.
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.
Ethical issues confronted by medical students during clinical rotations.
Fard, Nazila Nikravan; Asghari, Fariba; Mirzazadeh, Azim
2010-07-01
This study aimed to examine the most common and important ethical issues confronting medical students during clinical rotations so that ethics-related topics can be prioritised according to students' needs and this information used to develop a curriculum for the ethics course. In a cross-sectional approach, we reviewed the medical ethics-related cases recorded in the logbooks of all medical students (n=241) at Tehran University of Medical Sciences who attended the medical ethics course during October 2006 to July 2007. As part of a graded assignment, each student was required to record three encounters with ethics-related issues in his or her logbook. A total of 713 cases were assessed. Information related to the ethical issues and the conditions in which ethical issues arose was extracted and recorded by two experts, whose analysis showed agreement of kappa 0.77. In cases of discrepancy, both experts reviewed and discussed the record until they achieved agreement. A total of 713 cases were analysed. The most common issues reported by students related to ethics in medical education (20.1%, n=143), professionalism (18.8%, n=134), confidentiality (7.6%, n=54), the doctor-patient relationship (7.3%, n=52), informed consent (7.0%, n=50) and the doctor-peer relationship (7.0%, n=50). After adjusting for length of rotation, the highest numbers of ethics-related incidents were reported from urology, general surgery, orthopaedics, internal medicine, neurology, and obstetrics and gynaecology wards. The results of this study indicate that professionalism and related elements represent one of the most important areas of concern that need to be addressed when planning courses for medical students. The other significant area of concern is that of ethics in medical education, which, although the subject is not considered essential for medical practitioners, should be taught and respected so that student sensitivity to medical ethics is maintained and even increased.
ERIC Educational Resources Information Center
Mc Danel de García, Mary Anne
2013-01-01
This article refers to an action research project involving pre-service teachers. The purpose of this study was to determine if specific learning outcomes could be successfully employed as objectives for an ethics course for preservice teacher preparation. Real life case histories were used by students to identify and reflect upon moral and…
ERIC Educational Resources Information Center
Egbufor, Dorothy Chukwudumebi
2017-01-01
The chief aim of this study was to develop a grounded theory of ethical leadership with school leaders in Southern Nigeria, utilizing a qualitative constructivist paradigm and multiple case study design. There is growing interest in public service of ethics (Barberis, 2001). The study of ethics has been a part of the [school] leadership erudition…
ERIC Educational Resources Information Center
Shapiro, Joan Poliner; Hassinger, Robert E.
2007-01-01
Purpose: The purpose of this paper is to focus on a case study, framed as an ethical dilemma. It serves as an illustration for the teaching of moral literacy, with a special emphasis on social justice. Design/methodology/approach: Initially, the paper provides a rationale for the inclusion of case studies, emphasizing moral problems in university…
ERIC Educational Resources Information Center
Amsale, Frew; Bekele, Mitiku; Tafesse, Mebratu
2016-01-01
The purpose of this study was to assess the extent to which educational leaders in the western cluster public universities of Ethiopia are ethical. Ethical leadership variables such as fairness, equity, multicultural competence, modeling ethical behaviors and altruism are considered in describing the ethical behaviors of the leaders. Descriptive…
Learning from Ethical Dilemmas.
ERIC Educational Resources Information Center
Havens, Mark D.
1987-01-01
Reports analysis of 60 case studies of ethical dilemmas faced by experiential educators. Identifies issues which enhance likelihood of moral dilemmas: funding, residential programming, and risk-taking. Exposes need for a professional "code of ethics." (NEC)
DuBois, James M
2004-01-01
Monshi and Zieglmayer's case study presents Sri Lankan participants as having views on the privacy of health information that differ radically from those commonly found in Western nations. This article explores 2 questions that their case study raises for the ethical review of research in international settings: First, are allegedly universal ethical principles--of the sort promulgated in the Belmont Report (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1978)--useful in international settings?, and second, how should research oversight bodies address the challenges that arise in international behavioral and social science research?
Denier, Yvonne; Gastmans, Chris
2013-09-01
In our globalizing world, health care professionals and organizations increasingly experience cross-cultural challenges in care relationships, which give rise to ethical questions regarding "the right thing to do" in such situations. For the time being, the international literature lacks examples of elaborated ethical guidelines for cross-cultural healthcare on the organizational level. As such, the ethical responsibility of healthcare organizations in realizing cross-cultural care remains underexposed. This paper aims to fill this gap by offering a case-study that illustrates the bioethical practice on a large-scale organizational level by presenting the ethical guideline developed in the period 2007-2011 by the Ethics Committee of Zorgnet Vlaanderen, a Christian-inspired umbrella organization for over 500 social profit healthcare organizations in Flanders, Belgium. The guideline offers an ethical framework within which fundamental ethical values are being analyzed within the context of cross-cultural care. The case study concludes with implications for healthcare practice on four different levels: (1) the level of the healthcare organization, (2) staff, (3) care receivers, and (4) the level of care supply. The study combines content-based ethics with process-based benchmarks. Copyright © 2013. Published by Elsevier Ltd.
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Melvin, Sean P.
2012-01-01
A Harvard Business School-style teaching case can be a powerful pedagogical tool to teach law and ethics to business students because instructors can combine a traditional business case study with Socratic-style dialogue and legal analysis from a managerial perspective. This teaching note includes suggestions for several methods of using the case,…
The ethics of HIV research in developing nations.
Resnik, David B
1998-10-01
This paper discusses a dispute concerning the ethics of research on preventing the perinatal transmission of HIV in developing nations. Critics of this research argue that it is unethical because it denies a proven treatment to placebo-control groups. Since studies conducted in developed nations would not deny this treatment to subjects, the critics maintain that these experiments manifest a double standard for ethical research and that a single standard of ethics should apply to all research on human subjects. Proponents of the research, however, argue that these charges fail to understand the ethical complexities of research in developing nations, and that study designs can vary according to the social, economic, and scientific conditions of research. This essay explores some of the ethical issues raised by this controversial case in order to shed some light on the deeper, meta-ethical questions. The paper argues that standards of ethical research on human subjects are universal but not absolute: there are some general ethical principles that apply to all cases of human subjects research but the application of these principles must take into account factors inherent in particular situations.
Institutional Ethical Review and Ethnographic Research Involving Injection Drug Users: A Case Study
Small, Will; Maher, Lisa; Kerr, Thomas
2014-01-01
Ethnographic research among people who inject drugs (PWID) involves complex ethical issues. While ethical review frameworks have been critiqued by social scientists, there is a lack of social science research examining institutional ethical review processes, particularly in relation to ethnographic work. This case study describes the institutional ethical review of an ethnographic research project using observational fieldwork and in-depth interviews to examine injection drug use. The review process and the salient concerns of the review committee are recounted, and the investigators’ responses to the committee’s concerns and requests are described to illustrate how key issues were resolved. The review committee expressed concerns regarding researcher safety when conducting fieldwork and the investigators were asked to liaise with the police regarding the proposed research. An ongoing dialogue with the institutional review committee regarding researcher safety and autonomy from police involvement, as well as formal consultation with a local drug user group and solicitation of opinions from external experts, helped to resolve these issues. This case study suggests that ethical review processes can be particularly challenging for ethnographic projects focused on illegal behaviours, and that while some challenges could be mediated by modifying existing ethical review procedures, there is a need for legislation that provides legal protection of research data and participant confidentiality. PMID:24581074
The importance of meta-ethics in engineering education.
Haws, David R
2004-04-01
Our shared moral framework is negotiated as part of the social contract. Some elements of that framework are established (tell the truth under oath), but other elements lack an overlapping consensus (just when can an individual lie to protect his or her privacy?). The tidy bits of our accepted moral framework have been codified, becoming the subject of legal rather than ethical consideration. Those elements remaining in the realm of ethics seem fragmented and inconsistent. Yet, our engineering students will need to navigate the broken ground of this complex moral landscape. A minimalist approach would leave our students with formulated dogma--principles of right and wrong such as the National Society for Professional Engineers (NSPE) Code of Ethics for Engineers--but without any insight into the genesis of these principles. A slightly deeper, micro-ethics approach would teach our students to solve ethical problems by applying heuristics--giving our students a rational process to manipulate ethical dilemmas using the same principles simply referenced a priori by dogma. A macro-ethics approach--helping students to inductively construct a posteriori principles from case studies--goes beyond the simple statement or manipulation of principles, but falls short of linking personal moral principles to the larger, social context. Ultimately, it is this social context that requires both the application of ethical principles, and the negotiation of moral values--from an understanding of meta-ethics. The approaches to engineering ethics instruction (dogma, heuristics, case studies, and meta-ethics) can be associated with stages of moral development. If we leave our students with only a dogmatic reaction to ethical dilemmas, they will be dependent on the ethical decisions of others (a denial of their fundamental potential for moral autonomy). Heuristics offers a tool to deal independently with moral questions, but a tool that too frequently reduces to casuistry when rigidly applied to "simplified" dilemmas. Case studies, while providing a context for engineering ethics, can encourage the premature analysis of specific moral conduct rather than the development of broad moral principles--stifling our students' facility with meta-ethics. Clearly, if a moral sense is developmental, ethics instruction should lead our students from lower to higher stages of moral development.
Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review.
Rasoal, Dara; Skovdahl, Kirsti; Gifford, Mervyn; Kihlgren, Annica
2017-12-01
This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different countries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a "bottom-up" perspective might give healthcare personnel opportunities to think and reflect more than a "top-down" perspective. A "bottom-up" approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a "top-down" approach risks removing such moral responsibility.
Personal Values and Mission Statement: A Reflective Activity to Aid Moral Development
ERIC Educational Resources Information Center
Laird-Magee, Tyler; Gayle, Barbra Mae; Preiss, Raymond
2015-01-01
Personal values guide ethical decision-making behaviors. Business professors have traditionally addressed undergraduate ethics-based learning through a learn ethics approach using case studies, simulations, presentations, and other activities. Few offer a live ethics orientation requiring completion of a personal values self-assessment and…
Research ethics and case studies in psychology: a commentary on Taus v. Loftus.
Cheit, Ross E
2014-12-01
Loftus and Guyer have been criticized for the methods they employed in investigating an anonymous case study published by Corwin and Olafson. This article examines the ethical dimensions of their investigation. Loftus and Guyer have offered three defenses for their actions. All three of those defenses lack merit. Their investigation did not constitute oral history because it failed to comport with the basic requirements of that practice. Their investigation did not constitute ethical journalism because of the unjustified use of anonymous sources and the clear violation of basic fairness. Their investigation did not constitute justified medical research because of a failure to analyze or weigh the harms against the benefits. Their methods also violated ethical principles for psychologists, including the rule against activities that could reasonably be expected to impair the psychologist's objectivity. This case demonstrates that there is no ethical way to investigate a clinical case, without the patient's approval, that is both comprehensive enough to provide strong scholarship and yet respectful enough of privacy and medical confidentiality to honor important professional norms. © The Author(s) 2014.
Intrinsic ethics regarding integrated assessment models for climate management.
Schienke, Erich W; Baum, Seth D; Tuana, Nancy; Davis, Kenneth J; Keller, Klaus
2011-09-01
In this essay we develop and argue for the adoption of a more comprehensive model of research ethics than is included within current conceptions of responsible conduct of research (RCR). We argue that our model, which we label the ethical dimensions of scientific research (EDSR), is a more comprehensive approach to encouraging ethically responsible scientific research compared to the currently typically adopted approach in RCR training. This essay focuses on developing a pedagogical approach that enables scientists to better understand and appreciate one important component of this model, what we call intrinsic ethics. Intrinsic ethical issues arise when values and ethical assumptions are embedded within scientific findings and analytical methods. Through a close examination of a case study and its application in teaching, namely, evaluation of climate change integrated assessment models, this paper develops a method and case for including intrinsic ethics within research ethics training to provide scientists with a comprehensive understanding and appreciation of the critical role of values and ethical choices in the production of research outcomes.
Moral deliberation and nursing ethics cases: elements of a methodological proposal.
Schneider, Dulcinéia Ghizoni; Ramos, Flávia Regina Souza
2012-11-01
A qualitative study with an exploratory, descriptive and documentary design that was conducted with the objective of identifying the elements to constitute a method for the analysis of accusations of and proceedings for professional ethics infringements. The method is based on underlying elements identified inductively during analysis of professional ethics hearings judged by and filed in the archives of the Regional Nursing Board of Santa Catarina, Brazil, between 1999 and 2007. The strategies developed were based on the results of an analysis of the findings of fact (occurrences/infractions, causes and outcomes) contained in the records of 128 professional ethics hearings and on the structural elements (statements, rules and practices) identified in five example professional ethics cases. The strategies suggested for evaluating accusations of ethics infringements and the procedures involved in deliberating on ethics hearings constitute a generic proposal that will require adaptation to the context of specific professional ethics accusations.
Continuous Evaluation in Ethics Education: A Case Study.
McIntosh, Tristan; Higgs, Cory; Mumford, Michael; Connelly, Shane; DuBois, James
2018-04-01
A great need for systematic evaluation of ethics training programs exists. Those tasked with developing an ethics training program may be quick to dismiss the value of training evaluation in continuous process improvement. In the present effort, we use a case study approach to delineate how to leverage formative and summative evaluation measures to create a high-quality ethics education program. With regard to formative evaluation, information bearing on trainee reactions, qualitative data from the comments of trainees, in addition to empirical findings, can ensure that the training program operates smoothly. Regarding summative evaluation, measures examining trainee cognition, behavior, and organization-level results provide information about how much trainees have changed as a result of taking the ethics training. The implications of effective training program evaluation are discussed.
Virtuous acts as practical medical ethics: an empirical study.
Little, Miles; Gordon, Jill; Markham, Pippa; Rychetnik, Lucie; Kerridge, Ian
2011-10-01
To examine the nature, scope and significance of virtues in the biographies of medical practitioners and to determine what kind of virtues are at play in their ethical behaviour and reflection. A case study involving 19 medical practitioners associated with the Sydney Medical School, using semi-structured narrative interviews. Narrative data were analysed using dialectical empiricism, constant comparison and iterative reformulation of research questions. Participants represented virtuous acts as centrally important in their moral assessments of both themselves and others. Acts appeared to be contextually virtuous, rather than expressions of stable character traits, and virtue was linked to acts that served to protect or enhance fundamental values attached to ontological security and human flourishing. Virtue ethics, in this sense, was the single most important ethical system for each of the participants. Virtue ethics, construed as the appraisal of acts in contexts of risk, danger or threat to foundational values, emerged as the 'natural' ethical approach for medical practitioners in this case study. Teaching medical ethics to students and graduates alike needs to accommodate the priority attached to virtuous acts. © 2011 Blackwell Publishing Ltd.
A Case Study Approach to Study One Teacher's Moral Reflection.
ERIC Educational Resources Information Center
Husu, Jukka; Tirri, Kirsi
2003-01-01
Assessed one Finnish secondary school teacher's moral reflection, examining the ethic of purpose, ethic of rules and principles, and ethic of probability, together with their philosophical perspectives. Data included a narrative of a moral dilemma the teacher experienced regarding smoking at school. Results uncovered the background beliefs guiding…
Examining the Decisional Ethic of Textbook Adoption in Christian Schools: A Collective Case Study
ERIC Educational Resources Information Center
Phillips, Cecil John
2016-01-01
The purpose of this collective case study is to examine the decisional ethic Christian school administrators employ when evaluating textbooks for adoption in Christian schools. The study affirms the truism that Christian schools ought to be decidedly Christian and focuses upon textbook adoption practices in Christian schools. A multisite,…
Cases in Bioethics from the Hastings Center Report.
ERIC Educational Resources Information Center
Levine, Carol, Ed.; Veatch, Robert M.
Case studies of ethical issues based on real events are followed by comments illustrating how people from various ethical traditions and frameworks and from different academic and professional disciplines analyze the issues and work toward a resolution of the conflict posed. The cases are intended to help the public and professional persons pursue…
Austin, Melissa A
2002-04-01
Recent completion of the draft sequence of the human genome has been greeted with both excitement and skepticism, and the potential of this accomplishment for advancing public health has been tempered by ethical concerns about the protection of human subjects. This commentary explores ethical issues arising in human genome epidemiology by using a case study approach based on the ongoing Japanese American Family Study at the University of Washington in Seattle (1994-2003). Ethical issues encountered in designing the study, collecting the data, and reporting the study results are considered. When developing studies, investigators must consider whether to restrict the study to specific racial or ethnic groups and whether community involvement is appropriate. Once the study design is in place, further ethical issues emerge, including obtaining informed consent for DNA banking and protecting the privacy and confidentiality of family members. Finally, investigators must carefully consider whether to report genotype results to study participants and whether pedigrees illustrating the results of the study will be published. Overall, the promise of genomics for improving public health must be pursued based on the fundamental ethical principles of respect for persons, beneficence, and justice.
The Importance of Teaching Ethics of Sustainability
ERIC Educational Resources Information Center
Biedenweg, Kelly; Monroe, Martha C.; Oxarart, Annie
2013-01-01
Purpose: The purpose of this paper is to describe the importance of a focus on ethics in sustainability education and present results from a pilot graduate-level course titled the Ethics of Sustainability. Design/methodology/approach: This is a case study presenting a qualitative evaluation from a pilot 14-week Ethics of Sustainability course.…
The Ethics and Politics of Ethics Approval
ERIC Educational Resources Information Center
Battin, Tim; Riley, Dan; Avery, Alan
2014-01-01
The regulatory scope of Human Research Ethics Committees can be problematic for a variety of reasons. Some scholars have argued the ethics approval process, for example, is antithetical to certain disciplines in the humanities and social sciences, while others are willing to give it qualified support. This article uses a case study to cast the…
Ethics teaching in European veterinary schools: a qualitative case study.
Magalhães-Sant'Ana, M
2014-12-13
Veterinary ethics is recognised as a relevant topic in the undergraduate veterinary curriculum. However, there appears to be no widely agreed view on which contents are best suited for veterinary ethics teaching and there is limited information on the teaching approaches adopted by veterinary schools. This paper provides an inside perspective on the diversity of veterinary ethics teaching topics, based on an in-depth analysis of three European veterinary schools: Copenhagen, Lisbon and Nottingham. The case study approach integrated information from the analysis of syllabi contents and interviews with educators (curricular year 2010-2011). These results show that the curriculum of veterinary ethics is multidimensional and can combine a wide range of scientific, regulatory, professional and philosophical subjects, some of which may not be explicitly set out in the course descriptors. A conceptual model for veterinary ethics teaching is proposed comprising prominent topics included within four overarching concepts: animal welfare science, laws/regulations, professionalism, and theories/concepts. It is intended that this work should inform future curriculum development of veterinary ethics in European schools and assist ethical deliberation in veterinary practice. British Veterinary Association.
Ethics Training: Can We Really Teach People Right from Wrong?
ERIC Educational Resources Information Center
Zemke, Ron
1977-01-01
A discussion of the issue of ethics training in business and whether or not ethics is a problem appropriately addressed by training. Includes two case studies taken from a multimedia program by an educational media corporation. (LAS)
A Case Study Approach to Ethics in Career Development, Second Edition. Monograph Series
ERIC Educational Resources Information Center
Makela, Julia Panke; Perlus, Jessamyn G.
2017-01-01
This second edition tackles some of the most vexing questions that career development professionals encounter today. Using a case study design, it offers a hands-on experience with ethical terminology, resources, and issues. Each dilemma presented includes detailed, guided discussion of key issues and recommendations, with direct connections to…
Institutional ethical review and ethnographic research involving injection drug users: a case study.
Small, Will; Maher, Lisa; Kerr, Thomas
2014-03-01
Ethnographic research among people who inject drugs (PWID) involves complex ethical issues. While ethical review frameworks have been critiqued by social scientists, there is a lack of social science research examining institutional ethical review processes, particularly in relation to ethnographic work. This case study describes the institutional ethical review of an ethnographic research project using observational fieldwork and in-depth interviews to examine injection drug use. The review process and the salient concerns of the review committee are recounted, and the investigators' responses to the committee's concerns and requests are described to illustrate how key issues were resolved. The review committee expressed concerns regarding researcher safety when conducting fieldwork, and the investigators were asked to liaise with the police regarding the proposed research. An ongoing dialogue with the institutional review committee regarding researcher safety and autonomy from police involvement, as well as formal consultation with a local drug user group and solicitation of opinions from external experts, helped to resolve these issues. This case study suggests that ethical review processes can be particularly challenging for ethnographic projects focused on illegal behaviours, and that while some challenges could be mediated by modifying existing ethical review procedures, there is a need for legislation that provides legal protection of research data and participant confidentiality. Copyright © 2013 Elsevier Ltd. All rights reserved.
Beyond Compliance Checking: A Situated Approach to Visual Research Ethics.
Lenette, Caroline; Botfield, Jessica R; Boydell, Katherine; Haire, Bridget; Newman, Christy E; Zwi, Anthony B
2018-03-19
Visual research methods like photography and digital storytelling are increasingly used in health and social sciences research as participatory approaches that benefit participants, researchers, and audiences. Visual methods involve a number of additional ethical considerations such as using identifiable content and ownership of creative outputs. As such, ethics committees should use different assessment frameworks to consider research protocols with visual methods. Here, we outline the limitations of ethics committees in assessing projects with a visual focus and highlight the sparse knowledge on how researchers respond when they encounter ethical challenges in the practice of visual research. We propose a situated approach in relation to visual methodologies that encompasses a negotiated, flexible approach, given that ethical issues usually emerge in relation to the specific contexts of individual research projects. Drawing on available literature and two case studies, we identify and reflect on nuanced ethical implications in visual research, like tensions between aesthetics and research validity. The case studies highlight strategies developed in-situ to address the challenges two researchers encountered when using visual research methods, illustrating that some practice implications are not necessarily addressed using established ethical clearance procedures. A situated approach can ensure that visual research remains ethical, engaging, and rigorous.
ERIC Educational Resources Information Center
Salopek, Michelle M.
2013-01-01
This comparative case study examines the influence of ethics education on moral reasoning among pre-service teacher preparation and social work students. This study specifically investigates the ethical values of students enrolled in a teacher preparation and social work education program by their fourth year of study; the degree of ethical…
Rahim, Anika; Knights Née Jones, Felicity; Fyfe, Molly; Alagarajah, Janagan; Baraitser, Paula
2016-09-01
International health electives pose specific ethical challenges for students travelling from to low and middle income countries. We undertook a systematic review of the literature on interventions to prepare students to identify ethical issues addressed, educational approaches and to collate evidence on the effectiveness of different strategies. We searched nine electronic databases of peer-reviewed literature and identified grey literature through key word searches; supplemented through citation mapping and expert consultation. Articles that described ethical training conducted by universities or professional bodies were included for review. We reviewed forty-four full text articles. Ten sources of published literature and seven sources of grey literature met our inclusion criteria. We identified thirteen ethical situations that students should be prepared to manage and eight generic skills to support this process. Most interventions were delivered before the elective, used case studies or guidelines. Some suggested ethical principles or a framework for analysis of ethical issues. Only two papers evaluated the intervention described. Our paper collates a small but growing body of work on education to prepare students to manage ethical issues. Ethical training should have elements that are delivered before, during and after the elective. Interventions should include case studies covering thirteen ethical issues identified here, linked to ethical principles and a process for responding to ethical issues. We suggest that evaluations of interventions are an important area for future research.
Medical ethics education in China: Lessons from three schools.
Sherer, Renslow; Dong, Hongmei; Cong, Yali; Wan, Jing; Chen, Hua; Wang, Yanxia; Ma, Zhiying; Cooper, Brian; Jiang, Ivy; Roth, Hannah; Siegler, Mark
2017-01-01
Ethics teaching is a relatively new area of medical education in China, with ethics curricula at different levels of development. This study examined ethics education at three medical schools in China to understand their curricular content, teaching and learning methods, forms of assessments, changes over time, and what changes are needed for further improvement. We used student and faculty surveys to obtain information about the ethics courses' content, teaching methods, and revisions over time. The surveys also included five realistic cases and asked participants whether each would be appropriate to use for discussion in ethics courses. Students rated the cases on a scale and gave written comments. Finally, participants were asked to indicate how much they would agree with the statement that medical professionalism is about putting the interests of patients and society above one's own. There were both similarities and differences among these schools with regard to course topics, teaching and assessment methods, and course faculty compositions, suggesting their courses are at different levels of development. Areas of improvement for the schools' courses were identified based on this study's findings and available literature. A model of the evolution of medical ethics education in China was proposed to guide reform in medical ethics instruction in China. Analysis identified characteristics of appropriate cases and participants' attitudes toward the ideal of professionalism. We conclude that the development of medical ethics education in China is promising while much improvement is needed. In addition, ethics education is not confined to the walls of medical schools; the society at large can have significant influence on the formation of students' professional values.
ERIC Educational Resources Information Center
Vesper, Joan F.; And Others
1995-01-01
Presents a case study for a business communication class to help instructors in stimulating class discussions dealing with ethical issues in an international environment, particularly the paying of bribes. (SR)
Ethics Reporting in Biospecimen and Genetic Research: Current Practice and Suggestions for Changes
Chin, William Wei Lim; Wieschowski, Susanne; Prokein, Jana; Illig, Thomas
2016-01-01
Modern approaches for research with human biospecimens employ a variety of substantially different types of ethics approval and informed consent. In most cases, standard ethics reporting such as “consent and approval was obtained” is no longer meaningful. A structured analysis of 120 biospecimen studies recently published in top journals revealed that more than 85% reported on consent and approval, but in more than 90% of cases, this reporting was insufficient and thus potentially misleading. Editorial policies, reporting guidelines, and material transfer agreements should include recommendations for meaningful ethics reporting in biospecimen research. Meaningful ethics reporting is possible without higher word counts and could support public trust as well as networked research. PMID:27483445
Ethics in biomedical engineering.
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.
Using Significant Geologic Hazards and Disasters to Focus Geoethics Case Studies
NASA Astrophysics Data System (ADS)
Cronin, V. S.
2015-12-01
Ethics education since classical times has involved the consideration of stories, parables, myths, fables, allegories and histories. These are the ancient equivalents of case studies. Modern case studies are used in applied-ethics courses in law, engineering, business, and science. When used in a geoscience course, geoethical case studies can enrich a student's understanding of the relationships between issues of geoscience, engineering, sociology, business, public policy and law - all with an ethical dimension. Perhaps more importantly, real cases affected real people. Students develop a strong empathetic connection to the people involved, enhancing students' drive to understand the interconnected layers of the cases. Students might begin to appreciate that geoscientists can help to avoid or alleviate human suffering -- that their careers can have meaning and purpose beyond simply earning a paycheck. Geologic disasters in which losses could have been predicted, avoided or minimized are quite effective as cases. Coupling a "disaster" case with a comparable "hazard" case is particularly effective. For example, there are many places along the San Andreas Fault in California where [1] significant coseismic displacement has occurred during historical times, [2] structures that are still inhabited were built along or across active traces prior to the Alquist-Priolo Earthquake Fault Zoning Act in 1971, and [3] inhabited structures have been built legally since 1971 within a few tens of feet of active traces. The question students confront is whether society ought to allow habitable structures to be built very near to a major active fault. This topic allows students to work with issues of law, history, seismology, seismic site response, crustal deformation adjacent to active faults, building codes and, ultimately, ethics. Similar progressions can be developed for other major geologic hazards, both natural and man-made, such as floods, landslides, erosion along rivers and coastlines, subsidence caused by fluid/gas withdrawal, induced seismicity, and pollution due to extractive industries. Case study sources are available via http://CroninProjects.org/Vince/GeoEthics/ and SERC has a growing collection of useful case studies (e.g., http://serc.carleton.edu/geoethics/case_studies.html).
Can ethnography save the life of medical ethics?
Hoffmaster, B
1992-12-01
Since its inception contemporary medical ethics has been regarded by many of its practitioners as 'applied ethics', that is, the application of philosophical theories to the moral problems that arise in health care. This 'applied ethics' model of medical ethics is, however, beset with internal and external difficulties. The internal difficulties point out that the model is intrinsically flawed. The external difficulties arise because the model does not fit work in the field. Indeed, the strengths of that work are its highly nuanced, particularized analyses of cases and issues and its appreciation of the circumstances and contexts that generate and structure these cases and issues. A shift away from a theory-driven 'applied ethics' to a more situational, contextual approach to medical ethics opens the way for ethnographic studies of moral problems in health care as well as a conception of moral theory that is more responsive to the empirical dimensions of those problems.
ERIC Educational Resources Information Center
Myers, Edward L.
2013-01-01
This qualitative single-site case study examined the philosophy, decisions, and behaviors of a particular male school principal who subscribed to a form of care-based leadership practice. A Pennsylvania high school principal with a distinct leadership philosophy centered on the ethic of care was chosen to participate in this study. The purpose of…
Successes and Failures Teaching Visual Ethics: A Class Study
ERIC Educational Resources Information Center
Roundtree, Aimee Kendall
2010-01-01
This article discusses and evaluates the inclusion of ethics learning modules in a graduate- level visual design theory course. Modules were designed as a part of an NEH grant. Students grappled with case studies that probed the ethics of visuals at the crux of the BP oil refinery accident, NASA space shuttle disasters, the Enron collapse, and…
Ethics in the Classroom: Bridging the Gap between Theory and Practice
ERIC Educational Resources Information Center
Mahoney, Dan
2008-01-01
Examining ourselves, why we do what we do, is the essence of human psychology and of ethics. The purpose of this book is to show how educators might choose among ethical approaches to decision-making as they face the choices they make each day. Features include the theory-based ethics and case studies of real and significant issues that teachers…
ERIC Educational Resources Information Center
Zheng, Lou; Hui, Song
2005-01-01
The standard of professional ethics among teachers directly determines the educational standards of a school; they are an essential component of education. In order to clarify the current situation with regard to the professional ethics of teachers in institutions of higher education, this article analyzes how society evaluates those ethics and…
ERIC Educational Resources Information Center
Kim, Mijung; Roth, Wolff-Michael
2008-01-01
In this paper we argue that scientific literacy ought to be rethought in that it involves ethics as its core element. Considering the fact that science education has addressed ethical dilemmas of Science, Technology, Society and Environment (STSE) issues, it is worthwhile to question what the ethics of scientific knowledge mean in terms of their…
Overcoming Bias toward Same-Sex Couples: A Case Study from inside an MFT Ethics Classroom
ERIC Educational Resources Information Center
Charles, Laurie L.; Thomas, Dina; Thornton, Matthew L.
2005-01-01
This article illustrates a teaching case in which a marriage and family therapy (MFT) trainee learned to develop cultural sensitivity toward same-sex couples despite religious beliefs that put her at risk of discriminating against that population. The case took place during a marriage and family therapy ethics course in the spring of 2003. From…
A blended-learning programme regarding professional ethics in physiotherapy students.
Aguilar-Rodríguez, Marta; Marques-Sule, Elena; Serra-Añó, Pilar; Espí-López, Gemma Victoria; Dueñas-Moscardó, Lirios; Pérez-Alenda, Sofía
2018-01-01
In the university context, assessing students' attitude, knowledge and opinions when applying an innovative methodological approach to teach professional ethics becomes fundamental to know if the used approach is enough motivating for students. To assess the effect of a blended-learning model, based on professional ethics and related to clinical practices, on physiotherapy students' attitude, knowledge and opinions towards learning professional ethics. Research design and participants: A simple-blind clinical trial was performed (NLM identifier NCT03241693) (control group, n = 64; experimental group, n = 65). Both groups followed clinical practices for 8 months. Control group performed a public exposition of a clinical case about professional ethics. By contrast, an 8-month blended-learning programme regarding professional ethics was worked out for experimental group. An online syllabus and online activities were elaborated, while face-to-face active participation techniques were performed to discuss ethical issues. Students' attitudes, knowledge and opinions towards learning professional ethics were assessed. Ethical considerations: The study was approved by the University Ethic Committee of Human Research and followed the ethical principles according to the Declaration of Helsinki. After the programme, attitudes and knowledge towards learning professional ethics of experimental group students significantly improved, while no differences were observed in control group. Moreover, opinions reported an adequate extension of themes and temporization, importance of clinical practices and interest of topics. Case study method and role playing were considered as the most helpful techniques. The blended-learning programme proposed, based on professional ethics and related to clinical practices, improves physiotherapy students' attitudes, knowledge and opinions towards learning professional ethics.
Sortedahl, Charlotte; Mottern, Nina; Campagna, Vivian
The purpose of this article is to examine how case managers are routinely confronted by ethical dilemmas within a fragmented health care system and given the reality of financial pressures that influence life-changing decisions. The Code of Professional Conduct for Case Managers (Code), published by the Commission for Case Manager Certification, acknowledges "case managers may often confront ethical dilemmas" (Code 1996, Rev. 2015). The Code and expectations that professional case managers, particularly those who are board certified, will uphold ethical and legal practice apply to case managers in every practice setting across the full continuum of health care. This discussion acknowledges the ethical dilemmas that case managers routinely confront, which empowers them to seek support, guidance, and resources to support ethical practice. In addition, the article seeks to raise awareness of the effects of burnout and moral distress on case managers and others with whom they work closely on interdisciplinary teams.
Ethical Dilemmas in Retail Merchandising: Student Perceptions
ERIC Educational Resources Information Center
Paulins, V. Ann; Lombardy, Lisa
2005-01-01
Ethical dilemmas observed by students in retailing internships were the basis for a survey in which students indicated their perceptions as to whether case situations involved unethical behavior. Expanded case situations were offered to students for further exploration. The specific questions posed in this study included the following: (1) In what…
School Counseling Principles: Ethics and Law
ERIC Educational Resources Information Center
Stone, Carolyn
2006-01-01
This practical guide will sensitize the professional school counselor to legal and ethical issues involved in working with minors in school settings. Using a case study approach and more than 100 cases representing school counselors daily dilemmas, chapters help the reader connect the reality of school counseling to critical federal and state…
ERIC Educational Resources Information Center
Karayama, Saffet
2018-01-01
The aim of the study was to determine what ethical dilemmas are faced by school administrators working in different institutions, what they are doing to solve the dilemmas/according to the motives. The research is a patterned qualitative case study and multiple case design is used. 50 school administrators participated by easy-to-reach state…
Ethics and the Computerization of Pharmacy.
ERIC Educational Resources Information Center
McCarthy, Robert L.; Perrolle, Judith A.
1991-01-01
The current and potential impact of computerization on pharmacy practice is discussed, focusing on ethical dilemmas in the pharmacist-patient relationship, confidentiality of records, and the role of artificial intelligence in decision making about drug therapy. Case studies for use by teachers of pharmaceutical ethics are provided. (Author/MSE)
A Worksheet for Ethics Instruction and Exercises in Reason.
ERIC Educational Resources Information Center
Bivins, Thomas H.
1993-01-01
Argues that teaching applied mass media ethics requires two vital components: a grounding in the relevant ethical theories, and a structured approach to analyzing the issues in case-study format. Presents a worksheet model that provides such an approach over a wide range of issues. (SR)
An Approach to Ethical Practice in Management and Trainer Training.
ERIC Educational Resources Information Center
Johnston, Rita
1992-01-01
Concern with ethics has given rise to two educational approaches, one derived from philosophical principles of social ethics, the other based on case studies of practical issues. A combination of these is necessary to ensure situational applicability and to avoid moral relativism and expediency. (SK)
Peacock, Juandre; Harkrider, Lauren N; Bagdasarov, Zhanna; Connelly, Shane; Johnson, James F; Thiel, Chase E; Macdougall, Alexandra E; Mumford, Michael D; Devenport, Lynn D
2013-09-01
Case-based instruction has been regarded by many as a viable alternative to traditional lecture-based education and training. However, little is known about how case-based training techniques impact training effectiveness. This study examined the effects of two such techniques: (a) presentation of alternative outcome scenarios to a case, and (b) conducting a structured outcome evaluation. Consistent with the hypotheses, results indicate that presentation of alternative outcome scenarios reduced knowledge acquisition, reduced sensemaking and ethical decision-making strategy use, and reduced decision ethicality. Conducting a structured outcome evaluation had no impact on these outcomes. Results indicate that those who use case-based instruction should take care to use clear, less complex cases with only a singular outcome if they are seeking these types of outcomes.
Nagao, Noriko; Aulisio, Mark P; Nukaga, Yoshio; Fujita, Misao; Kosugi, Shinji; Youngner, Stuart; Akabayashi, Akira
2008-01-01
Background Few comparative studies of clinical ethics consultation practices have been reported. The objective of this study was to explore how American and Japanese experts analyze an Alzheimer's case regarding ethics consultation. Methods We presented the case to physicians and ethicists from the US and Japan (one expert from each field from both countries; total = 4) and obtained their responses through a questionnaire and in-depth interviews. Results Establishing a consensus was a common goal among American and Japanese participants. In attempting to achieve consensus, the most significant similarity between Japanese and American ethics consultants was that they both appeared to adopt an "ethics facilitation" approach. Differences were found in recommendation and assessment between the American and Japanese participants. In selecting a surrogate, the American participants chose to contact the grandson before designating the daughter-in-law as the surrogate decision-maker. Conversely the Japanese experts assumed that the daughter-in-law was the surrogate. Conclusion Our findings suggest that consensus building through an "ethics facilitation" approach may be a commonality to the practice of ethics consultation in the US and Japan, while differences emerged in terms of recommendations, surrogate assessment, and assessing treatments. Further research is needed to appreciate differences not only among different nations including, but not limited to, countries in Europe, Asia and the Americas, but also within each country. PMID:18226273
Implementing a Course in Business Environment and Public Policy: A Case Study.
ERIC Educational Resources Information Center
Wooten, Bob E.; Snider, Walter D.
1982-01-01
Describes a course of study dealing with business values, ethics, and environment. The course focuses on issues concerning ethical and moral considerations that may be encountered in the marketplace. (JOW)
Compassionate use programs in Italy: ethical guidelines.
De Panfilis, Ludovica; Satolli, Roberto; Costantini, Massimo
2018-03-09
This article proposes a retrospective analysis of a compassionate use (CU), using a case study of request for Avelumab for a patient suffering from Merkel Cell Carcinoma. The study is the result of a discussion within a Provincial Ethics Committee (EC) following the finding of a high number of requests for CU program. The primary objective of the study is to illustrate the specific ethical and clinical profiles that emerge from the compassionate use program (CUP) issue. The secondary goals are: a) to promote a moral reflection among physicians who require approval for the CUP and b) provide the basis for recommendations on how to request CUP. The instruments for carrying out the analysis of the case study and the discussion are as follows: Analysis of the audio-recording of the EC meeting regarding the selected Case study. In-depth discussion of topics that emerged during the meeting by means of administration of 5 semi-structured interviews with 2 doctors involved in the case (proposing physician and palliative physician) and with 3 components of the EC who played a major role in the EC internal discussion. In an exploration of emerging clinical and ethical issues, four primary themes arise: 1. efficacy, safety of the treatment and patient's quality of life; 2. clear, realistic, adequate communication; 3. right to hope; 4. simultaneous Palliative Care approach. The results of ethical analysis carried out concern two areas: 1) ethical profiles relating to the use of CUP; 2) the role of the EC concerning the compassionate use of drugs and the need to provide recommendations on how to request CUP. With the aim of implementing these conclusions, the provincial EC of Reggio Emilia chose to steer the request for drugs for compassionate use through recommendations for good clinical and ethical practice based on the following assumptions: 1) the "simultaneous care" approach must be preferred. Secondly, 2) the EC's assessment must be part of the decision-making process that the care team conducts before proposing compassionate use to the patient.
Elms, Heather; Berman, Shawn; Wicks, Andrew C
2002-10-01
This paper utilizes a qualitative case study of the health care industry and a recent legal case to demonstrate that stakeholder theory's focus on ethics, without recognition of the effects of incentives, severely limits the theory's ability to provide managerial direction and explain managerial behavior. While ethics provide a basis for stakeholder prioritization, incentives influence whether managerial action is consistent with that prioritization. Our health care examples highlight this and other limitations of stakeholder theory and demonstrate the explanatory and directive power added by the inclusion of the interactive effects of ethics and incentives in stakeholder ordering.
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.
ERIC Educational Resources Information Center
Hozien, Wafa Ismail
2012-01-01
The purpose of this study is to explore and describe individual Pennsylvania rural elementary principals' experiences of ethical decision-making in a complex era. Ethical dilemma, in this case, is the term used to depict an incident which calls for a decision to be made when moral values or ethical principles were in conflict. Also, to learn how…
ERIC Educational Resources Information Center
Lijia, Wang; Lai, Manhong; Lo, Leslie N. K.
2016-01-01
This paper highlights Chinese teachers' ethical concerns in their relationships with students, colleagues, and students' parents. Through a qualitative study of 26 teachers, it was found that the teachers were often trapped in a dilemma between teaching to students' real development and teaching to the test. The ethics of professional…
Ethical Issues in Addressing Inequity in/through ESL Research
ERIC Educational Resources Information Center
Lee, Ena
2011-01-01
This article outlines a researcher's struggles with conducting "ethical" research when her case study reveals racializations faced by a minority teacher in a Canadian ESL program. How might becoming privy to research participants' experiences of inequity in ESL education complicate the notion of research ethics when "doing the right…
Ethics in an operations management course.
Rudnicka, Ewa A
2005-10-01
Graduates of the management major at the University of Pittsburgh at Greensburg find employment in a variety of organizations. As future managers with employees from different professions, students expressed an interest in discussing ethics cases in the operations management class. The semester starts with students familiarizing themselves with various professional and corporate codes of ethics. Throughout the semester a number of short ethics' cases in operations' areas such as inventory management, scheduling, facility location, and product design are introduced to illustrate ethical issues that a manager and his/her employees might face. Students prepare individual responses before the in-class discussions. The semester ends with a long group ethics case discussion and formal case presentations. In the end-of-semester survey, students responded very favorably to an ethics component in the operations management class.
Ethical challenges embedded in qualitative research interviews with close relatives.
Haahr, Anita; Norlyk, Annelise; Hall, Elisabeth Oc
2014-02-01
Nurse researchers engaged in qualitative interviews with patients and spouses in healthcare may often experience being in unforeseen ethical dilemmas. Researchers are guided by the bioethical principles of justice, beneficence, non-maleficence, respect for human rights and respect for autonomy through the entire research process. However, these principles are not sufficient to prepare researchers for unanticipated ethical dilemmas related to qualitative research interviews. We describe and discuss ethically challenging and difficult moments embedded in two cases from our own phenomenological interview studies. We argue that qualitative interviews involve navigation between being guided by bioethics as a researcher, being a therapist/nurse and being a fellow human being or even a friend. The researchers' premises to react to unexpected situations and act in a sound ethical manner must be enhanced, and there is a need for an increased focus on the researchers' ethical preparation and to continually address and discuss cases from their own interviews.
Quigley, Dianne
2006-04-01
This article presents a review of 14 case studies and articles of research ethics issues in the conduct of environmental and public health research with Native American and other indigenous populations. The purpose of this review is to highlight new practices in the ethical conduct of research with native community populations. The findings from this review can promote more dialogue and policy development on the issue of community protections in research. Formal guidelines exist in ethical codes for individual rights as human subjects, but there is a lack of development on community rights in the ethics of research. This review illustrates how community-based participatory research practices can provide working guidelines that can overcome past research harms. More important, the compilations of guidelines offer tested field methods for improving the ethical conduct of research with native community populations.
Leaders on the Front Line--Managing Emotion for Ethical Decision Making
ERIC Educational Resources Information Center
Tenuto, Penny L.; Gardiner, Mary E.; Yamamoto, Julie K.
2016-01-01
To build capacity for students in educational leadership programs, we developed a teaching case study focused on managing emotion for ethical decision making in supervision of personnel. The case offers troubling encounters between a secondary assistant principal and a novice teacher, a veteran teacher, and a veteran administrator. Scenarios…
Evaluating Research Ethics Training in the Maryland Sea Grant REU Program
NASA Astrophysics Data System (ADS)
Allen, M. R.; Kumi, G. A.; Kumi, B. C.; Moser, F. C.
2016-02-01
The NSF's Research Experiences for Undergraduates (REU) program is an opportunity to cultivate responsible research practices in researchers at an early stage in their career. However, teaching responsible research conduct and science ethics in this program has been challenging because of a lack of consensus regarding which instructional methods are most effective for educating students about ethical concepts and establishing the process of ethical decision-making. Over the last 15 years, Maryland Sea Grant's REU ethics program has evolved by exploring different teaching models and looking for ways to effectively engage upper level undergraduates throughout their summer experience in ethical responsibility training. Since 2007, we have adopted a concerted experiential learning approach that includes an ethics seminar, role playing, case studies, and reflection. Currently, our summer long ethics training includes: 1) an interactive seminar; 2) a workshop with role playing and case studies; 3) 1-2 readings; and 4) a roundtable discussion with faculty mentors and their mentees to discuss researchers' real-world experiences with ethical dilemmas. Within the last 3 years, we have expanded our student learning outcomes assessments by administering pre- and post-program surveys to assess ethical skills students acquire through the program. Reevaluations administered three and six years after the REU experience will measure long term effectiveness of the training. Results from the first group of students reveal a greater awareness of ethical issues following our summer program. Students show a high level of competence about "black and white" issues (falsification, fabrication, plagiarism), but are more challenged by ethical "gray areas" such as data ownership and authorship. Results suggest many undergraduates come to research programs with basic ethics training, but benefit from our additional focus on complex ethical dilemmas.
Can instruction in engineering ethics change students' feelings about professional responsibility?
Hashemian, Golnaz; Loui, Michael C
2010-03-01
How can a course on engineering ethics affect an undergraduate student's feelings of responsibility about moral problems? In this study, three groups of students were interviewed: six students who had completed a specific course on engineering ethics, six who had registered for the course but had not yet started it, and six who had not taken or registered for the course. Students were asked what they would do as the central character, an engineer, in each of two short cases that posed moral problems. For each case, the role of the engineer was successively changed and the student was asked how each change altered his or her decisions about the case. Students who had completed the ethics course considered more options before making a decision, and they responded consistently despite changes in the cases. For both cases, even when they were not directly involved, they were more likely to feel responsible and take corrective action. Students who were less successful in the ethics course gave answers similar to students who had not taken the course. This latter group of students seemed to have weaker feelings of responsibility: they would say that a problem was "not my business." It appears that instruction in ethics can increase awareness of responsibility, knowledge about how to handle a difficult situation, and confidence in taking action.
Ethical principles in federal regulations: the case of children and research risks.
Williams, P C
1996-04-01
Ethical principles play an important part not only in the promulgation of regulations but also in their application, i.e., enforcement and adjudication. while traditional ethical principles--promotion of welfare, freedom, and fairness--play an important role in both elements of regulation, some other kinds of ethical principles are significant as well. Principles governing the structure of decision processes should shape the structure and actions of agencies; principles of wise application should govern the work of those whose responsibility it is to apply regulatory language to particular situations. These points are demonstrated by investigating a case study: federal regulations designed to protect children involved in scientific research applied to a placebo study of the effects of recombinant human growth hormone on children of extremely short stature.
Rodriguez, Maria-Virginia
2012-03-01
This article contains an analysis of a research ethics committee's (REC) concerns about a study protocol involving genetic screening for antisocial personality disorder. The study was proposed by US university researchers and to be conducted with Mesoamerican populations in the United States and in their countries of origin. The analysis explains why the study was not considered ethical by the REC, pointing to issues with the choice of study population, informed consent, confidentiality, and posttrial obligations. Some recommendations are provided for ways in which the study could have been redesigned.
Fritschi, Lin; Kelsall, Helen L; Loff, Bebe; Slegers, Claudia; Zion, Deborah; Glass, Deborah C
2015-07-01
Study explanatory forms often state that an ethics committee has approved a research project. To determine whether the lay community understand the roles of ethics committees in research, we took a cross-sectional national sample from three sampling frames: the general population (n=1532); cohort study participants (n=397); and case-control study participants (n=151). About half (51.3%) of the participants had heard of ethics committees. Those who had were more likely to be those who had participated in previous surveys, older participants, those born in Australia and those with higher education. Almost all participants agreed that the roles of an ethics committee were to protect participants' privacy and ensure no harm came to study participants and most agreed that the committee's role was to ensure that the research was capable of providing answers. Case-control and cohort participants were more likely than the general population to consider that the role of an ethics committee was to design the research and obtain research funding. Overall, we found that about half of the population are aware of ethics committees and that most could correctly identify that ethics committees are there to protect the welfare and rights of research participants, although a substantial minority had some incorrect beliefs about the committees' roles. Increased education, particularly for migrants and older people, might improve understanding of the role of ethics committees in research. 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.
Perception of and attitude toward ethical issues among Korean occupational physicians.
Choi, Junghye; Suh, Chunhui; Lee, Jong-Tae; Lee, Segyeong; Lee, Chae-Kwan; Lee, Gyeong-Jin; Kim, Taekjoong; Son, Byung-Chul; Kim, Jeong-Ho; Kim, Kunhyung; Kim, Dae Hwan; Ryu, Ji Young
2017-01-01
Occupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs. An email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents. The questionnaire was also distributed to 52 specialists and 46 residents who attended the annual meeting of the Korean Association of Occupational and Environmental Clinics in October 2015, and to 240 specialists by uploading the questionnaire to the online community 'oem-doctors' in February 2016. The responses to each question (perception of general ethical conflicts, recognition of various ethical codes for OPs, core professional values in ethics of occupational medicine, and a mock case study) were compared between specialists and residents by the chi-squared test and Fisher's exact test. Responses were received from 80 specialists and 71 residents. Most participants had experienced ethical conflicts at work and felt the need for systematic education and training. OPs suffered the most ethical conflicts in decisions regarding occupational health examination and evaluation for work relatedness. Over 60% of total participants were unaware of the ethical codes of other countries. Participants thought 'consideration of worker's health and safety' (26.0%) and 'neutrality' (24.7%) as the prominent ethical values in professionality ofoccupational medicine. In mock cases, participants chose beneficence and justice for fitness for work and confidential information acquired while on duty, and beneficence and respect for autonomy in pre-placement examinations. This study evaluated the current perception of and attitude toward ethical issues among the Korean OPs. These findings will facilitate the development of a code of ethics and the ethical decision-making program forthe Korean OPs.
Ethics in Engineering: Student Perceptions and Their Professional Identity Development
ERIC Educational Resources Information Center
Stappenbelt, Brad
2013-01-01
Professional ethics instruction in engineering is commonly conducted by examining case studies in light of the code of conduct of a suitable professional body. Although graphical presentations of spectacular failures, sobering stories of the repercussions and the solid framework provided by the tenets of a code of ethics may leave a lasting…
ERIC Educational Resources Information Center
Zakaria, Noor Syamilah
2013-01-01
Counseling ethics competency is an important part of counselor identity development as required by the counseling profession training standards, and counseling ethics education is one major component of knowledge acquisition in counseling profession. Counselor educators and counselor education training programs have a core responsibility to…
A Basic Unit on Ethics for Technical Communicators.
ERIC Educational Resources Information Center
Markel, Mike
1991-01-01
Describes a basic unit on ethics for technical communicators and offers suggestions on how to go about teaching the unit. Includes a brief definition of ethics, an explanation of the employee's three basic obligations, ways to analyze common dilemmas in technical communication, the role of the code of conduct, and a case study. (SR)
Ethical Issues of Ethnography Method: A Comparative Approach to Subaltern, Self, and the Others
ERIC Educational Resources Information Center
Odeyemi, Christo
2013-01-01
Using urban and rural community settings, this review article focuses on ethical issues associated with ethnographer-participant interaction and draws from the ethnographic accounts of Bronislaw Malinowski and Susan Krieger. As such, the following sections intend to illuminate the issue of ethics in ethnography research. As case studies, the…
Bad Men "Speaking" Well: A Case Study of Political Campaign Ethics.
ERIC Educational Resources Information Center
Kelley, Colleen E.
This essay examines some of the campaign communication behavior during the 1988 presidential race in terms of ethical criteria for a participatory democracy. Overall, this campaign violated several standards for ethical behavior through strategies such as over-reliance on emotional appeals, ridicule, failure to focus on relevant issues, and…
Ethical Values in the Classroom: How College Students Responded
ERIC Educational Resources Information Center
Humbarger, Michele; DeVaney, Sharon A.
2005-01-01
It is important to understand the ethical values of college students because they will be the leaders of the future. As part of an undergraduate honors project, a survey was developed that consisted of eight cases depicting ethical dilemmas in the classroom. Each case included a choice of four actions ranging from most ethical to least ethical.…
McDougall, Rosalind J; Notini, Lauren
2016-09-01
Clinical ethics has been developing in paediatric healthcare for several decades. However, information about how paediatricians use clinical ethics case consultation services is extremely limited. In this project, we analysed a large set of case records from the clinical ethics service of one paediatric hospital in Australia. We applied a paediatric-specific typology to the case referrals, based on the triadic doctor-patient-parent relationship. We reviewed the 184 cases referred to the service in the period 2005-2014, noting features including the type of case, the referring department(s) and the patient's age at referral. The two most common types of referral involved clinician uncertainty about the appropriate care pathway for the child (26% of total referrals) and situations where the child's parents disagreed with the doctors' recommendations for the child's care (22% of total referrals). Referrals came from 28 different departments. Cancer, cardiology/cardiac surgery and general medicine referred the highest numbers of cases. The most common patient age groups were children under 1, and 14-15 years old. For three controversial areas of paediatric healthcare, clinicians had initiated processes of routine review of cases by the clinical ethics service. These insights into the way in which one very active paediatric clinical ethics service is used further our understanding of the work of paediatric clinical ethics, particularly the kinds of ethically challenging cases that paediatricians view as appropriate to refer for clinical ethics support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Comparison of ethical judgments exhibited by clients and ethics consultants in Japan.
Nagao, Noriko; Kadooka, Yasuhiro; Asai, Atsushi
2014-03-04
Healthcare professionals must make decisions for patients based on ethical considerations. However, they rely on clinical ethics consultations (CEC) to review ethical justifications of their decisions. CEC consultants support the cases reviewed and guide medical care. When both healthcare professionals and CEC consultants face ethical problems in medical care, how is their judgment derived? How do medical judgments differ from the ethical considerations of CECs? This study examines CECs in Japan to identify differences in the ethical judgment of clients and CEC consultants. The CEC request and response documents of all 60 cases reviewed across Japan between October 2006 and the end of October 2011 were classified in terms of the presence of decisional capacity in the patient. We conducted a qualitative content analysis of the differences in reasoning between client and CEC consultants. Reasoned judgments were verified in individual cases to classify the similarities or differences of opinion between CEC clients and teams. As the result of classification of the decisional capacity and the difference of opinion regarding medical care, the most frequent category was 25 cases (41.7%) of "uncertain decisional capacity," and 23 cases (38.3%) of "withholding of decision-making." A chi-square analysis was performed on presence of decisional capacity and agreement in decision-making, yielding a statistically significant difference (p < 0.05). The CEC consultants' reasoning was based on "patient's preference was ambiguous," "validity of family as a surrogate," "estimation of patient preference," and "patient's best interest," whereas the CEC client's reasoning was based on "consistent family preference was shown/not shown" and "appropriate therapeutic methods to manage patient safety." Differences in opinions were found in cases classified according to decisional capacity. Furthermore, the reasoning behind judgments differed between CEC clients and CEC consultants. The reasoning of CEC consultants was critical and reflective, while for clients it was situational and pragmatic.
The Effect of Teaching Medical Ethics on Medical Students' Moral Reasoning.
ERIC Educational Resources Information Center
Self, Donnie J; And Others
1989-01-01
A study of the effect of incorporating medical ethics into the medical curriculum and comparing two teaching methods (lecture and case studies) found higher moral reasoning after instruction, but neither method was significantly more effective. (Author/MSE)
NASA Astrophysics Data System (ADS)
Bruton, Samuel V.
2003-05-01
While the usefulness of the case study method in teaching research ethics is frequently emphasized, less often noted is the educational value of professional codes of ethics. Much can be gained by having students examine codes and reflect on their significance. This paper argues that codes such as the American Chemical Society‘s The Chemist‘s Code of Conduct are an important supplement to the use of cases and describes one way in which they can be integrated profitably into a class discussion of research ethics.
[Limitation of medical treatment and ethics in chronic recurrent Clivus chordoma].
Egger, Alexandra; Müller-Busch, H Christof
2008-01-01
In this paper ethical questions concerning the limitation and termination of medical treatment of comatose patients will be discussed on the basis of a case study. The team is confronted with extremely high communicative and ethical demands, since every person engaged in the treatment and care of the patient should take part in this decision making process. The final responsibility regarding the medical decisions, however, lies with the doctor in charge. In such cases advance directives or living wills are important and should be taken into consideration.
Moral Injury and the Ethics of Educational Injustice
ERIC Educational Resources Information Center
Levinson, Meira
2015-01-01
In this article, Meira Levinson presents a case study of school personnel who must decide whether to expel a fourteen-year-old student for bringing marijuana onto campus. She uses the case to explore a class of ethical dilemmas in which educators are obligated to take action that fulfills the demands of justice but under conditions in which no…
Ethics of Inquiry: Issues in the Scholarship of Teaching and Learning.
ERIC Educational Resources Information Center
Hutchings, Pat, Ed.
This collection contains seven case studies about ethical issues faced by scholars of teaching and learning, each with commentary from individuals who bring different perspectives to bear on the issues. This case-plus-commentaries format enacts a central theme of the volume, which is that there is no single right way to resolve the ethical…
ERIC Educational Resources Information Center
Lundeberg, Mary A.; Bergland, Mark; Klyczek, Karen; Mogen, Kim; Johnson, Doug; Harmes, Nina
Software designed to promote the use of open-ended investigations in science education was evaluated in a study of whether using case-based simulation enhances students' understanding of ethical issues and data interpretation in science. The software was a DNA gel electrophoresis simulation that enabled students to conduct simulated genetic tests.…
Caring for one and all - Exploring ethical challenges in an ICU.
Jones, Jennifer; Mitchell, Marion; Milligan, Eleanor
2016-08-01
This discussion paper explores some of the complex ethical and moral issues confronting contemporary critical care nurses. In contemporary healthcare discussions, there is an increased appreciation of the complexity of ethical challenges, the multiplicity of stakeholders and that a broad range of possible and practical outcomes exist. Furthermore, many scholars also acknowledge the limitations of principle based ethical frameworks. In seeking to build critical care nurses' capacity to negotiate the complex - and often conflicting - ethical challenges, the authors have adopted a person-centred, values-based approach in this case study. Furthermore, by exploring these complex issues, this paper supports and builds upon critical care nurses' decision making capacities in the clinical area. This case study has been purposefully left open-ended with the aim of inviting the reader to consider the questions posed in a collegial, collaborative manner within the particular context in which she/he is embedded. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.
Pope, Anne
2012-03-01
This case study describes research into interventions to enhance stroke patients' ability to communicate. Because patients' cognitive abilities are compromised, it is argued that they may lack the capacity to consent and that surrogate consent should be required. In South Africa, this would make conducting the research difficult because only court-appointed curators are "legally appropriate" substitutes for research enrolment. Here, the research ethics committee must balance legal requirements and ethical concerns. It must also balance protection and respect for autonomy, even for cognitively compromised participants. First, incapacity should not simply be assumed but should be individually assessed. However, stroke patients present a further complication for capacity assessment because they may retain the capacity to reason but have lost the ability to communicate effectively. Second, the research ethics committee must decide whether recruitment should be restricted or whether incapacitated participants may be enrolled. Given the low risk of harm, incapacitated persons could be enrolled by proxies.
Foo, Jong Yong Abdiel; Wilson, Stephen James
2012-12-01
The growing emphasis on the importance of publishing scientific findings in the academic world has led to increasing prevalence of potentially significant publications in which scientific and ethical rigour may be questioned. This has not only hindered research progress, but also eroded public trust in all scientific advances. In view of the increasing concern and the complexity of research misconduct, the Committee on Publication Ethics (COPE) was established in 1997 to manage cases with ethical implications. In order to review the outcomes of cases investigated by COPE, a total of 408 cases that had been managed by COPE were successfully extracted and analysed with respect to 7 distinct criteria. The results obtained indicate that the number of ethical implications per case has not changed significantly (p > 0.01) since the year COPE was instigated. Interestingly, the number of ethical cases, and to some extent, research misconduct, is not diminishing. Therefore, journal editors and publishers need to work closely together with COPE to inculcate adoption of appropriate research ethics and values in younger researchers while discouraging others from lowering standards. It is hoped that with a more concerted effort from the academic community and better public awareness, there will be fewer incidences of ethically and scientifically challenged publications. The ultimate aim being to enhance the quality of published works with concomittant public trust in the results.
Ethical issues in caring for patients with dementia.
Hughes, Julian; Common, Jill
2015-08-05
This article discusses issues that might count as 'ethical' in the care of people with dementia and some of the dilemmas that occur. Ethical theories, such as virtue ethics, deontology and consequentialism are discussed, and ethical approaches that can be useful are outlined. Thinking about matters case-by-case is another approach, one that forms the first component of the Nuffield Council's ethical framework for dementia care, which is described. Case examples are provided, raising issues of autonomy, diagnosis, restraint and withholding treatment. The notion of personhood and the need to understand the person with dementia as broadly as possible are emphasised. Recommendations for nursing practice are included.
Keefer, Matthew W; Wilson, Sara E; Dankowicz, Harry; Loui, Michael C
2014-03-01
Recent research in ethics education shows a potentially problematic variation in content, curricular materials, and instruction. While ethics instruction is now widespread, studies have identified significant variation in both the goals and methods of ethics education, leaving researchers to conclude that many approaches may be inappropriately paired with goals that are unachievable. This paper speaks to these concerns by demonstrating the importance of aligning classroom-based assessments to clear ethical learning objectives in order to help students and instructors track their progress toward meeting those objectives. Two studies at two different universities demonstrate the usefulness of classroom-based, formative assessments for improving the quality of students' case responses in computational modeling and research ethics.
SciEthics Interactive: Science and Ethics Learning in a Virtual Environment
ERIC Educational Resources Information Center
Nadolny, Larysa; Woolfrey, Joan; Pierlott, Matthew; Kahn, Seth
2013-01-01
Learning in immersive 3D environments allows students to collaborate, build, and interact with difficult course concepts. This case study examines the design and development of the TransGen Island within the SciEthics Interactive project, a National Science Foundation-funded, 3D virtual world emphasizing learning science content in the context of…
Revisiting Principles of Ethical Practice Using a Case Study Framework
ERIC Educational Resources Information Center
Combes, Bertina H.; Peak, Pamela W.; Barrio, Brenda L.; Lindo, Endia J.; Hovey, Katrina A.; Lim, Okyoung; Peterson-Ahmad, Maria; Dorel, Theresa G.; Goran, Lisa
2016-01-01
A code of ethics serves as a compass, guiding professionals as they perform the roles associated with their profession. These codes are evidence to the public that professionals are concerned about the services they provide and the individuals to whom they are provided. Codes of ethics should be living documents, changing focus as the fields they…
Restructuring University Degree Programmes: A New Opportunity for Ethics Education?
ERIC Educational Resources Information Center
Escamez, Juan; Lopez, Rafaela Garcia; Jover, Gonzalo
2008-01-01
This article explores the possibilities of reinforcing ethics education at the university level within the context of new internationalisation processes. The situation in Spain is used as a case study. The article begins with a review of the rationale behind this issue and goes on to analyse the place of the ethical dimension in education in the…
Ethics of Research into Learning and Teaching with Web 2.0: Reflections on Eight Case Studies
ERIC Educational Resources Information Center
Chang, Rosemary L.; Gray, Kathleen
2013-01-01
The unique features and educational affordances of Web 2.0 technologies pose new challenges for conducting learning and teaching research in ways that adequately address ethical issues of informed consent, beneficence, respect, justice, research merit and integrity. This paper reviews these conceptual bases of human research ethics and gives…
[Moral case deliberation: time for ethical reflection in the daily practice of mental health care].
Vellinga, A; van Melle-Baaijens, E A H
2016-01-01
Nowadays, reflecting on ethics, which we choose to call moral case deliberation, is occurring more and more frequently in psychiatric institutions. We have personal experience of organising and supervising moral case deliberation in a large psychiatric institute and we can confirm the positive effects of moral case deliberation which have been reported in the literature. To describe a structured method for moral case deliberation which enables care-givers in health care and/or addiction care to reflect on moral dilemmas. We refer to the main findings in relevant literature and describe how we developed a structured method for implementing moral case deliberation. Our studies of the literature indicate that systematic reflection about ethical dilemmas can improve the quality of care and make care-givers more satisfied with their work. This is why we have developed our own method which is applicable particularly to psychiatric and/or addition care and which can be used systematically in discussions of moral dilemmas. Our method for discussing ethical issues works well in clinical practice, particularly when it is embedded in a multidisciplinary context. Of course, to ensure the continuity of the system, deliberation about moral and ethical issues needs to be financially safeguarded and embedded in the organisation. Discussion of moral issues improves the quality of care and increases care-givers' satisfaction with their work.
Anderson, James G
2004-03-18
The purpose of this paper is to propose a case-based approach to instruction regarding ethical issues raised by the use of information technology (IT) in healthcare. These issues are rarely addressed in graduate degree and continuing professional education programs in health informatics. There are important reasons why ethical issues need to be addressed in informatics training. Ethical issues raised by the introduction of information technology affect practice and are ubiquitous. These issues are frequently among the most challenging to young practitioners who are ill prepared to deal with them in practice. First, the paper provides an overview of methods of moral reasoning that can be used to identify and analyze ethical problems in health informatics. Second, we provide a framework for defining cases that involve ethical issues and outline major issues raised by the use of information technology. Specific cases are used as examples of new dilemmas that are posed by the introduction of information technology in healthcare. These cases are used to illustrate how ethics can be integrated with the other elements of informatics training. The cases discussed here reflect day-to-day situations that arise in health settings that require decisions. Third, an approach that can be used to teach ethics in health informatics programs is outlined and illustrated.
Pires Marques, Tiago
2017-09-01
In the last few decades, the definition of deontological ethics, a well-identified ethical territory in psychiatry, has been the object of increasing concerns. This has been the case in France, where claims of a specific ethical tradition in psychiatry have accompanied the institutionalization of psychiatric ethics and the perceived globalization of an Anglo-American model of mental health care. This study traces the history of the 'French ethical tradition in psychiatry' and its relationship with establishing institutional spaces for ethical decision-making. The 'ethical tradition' thus conceived proves to be functional in terms of preserving the threatened identity of French psychiatry. Nevertheless, this movement also pinpoints impasses that transcend the French context and may provide valuable resources for ethical reflections on mental health on a global scale.
It Is a Small World after All: Teaching Business Ethics in a Global Environment
ERIC Educational Resources Information Center
Budden, Connie B.; Budden, Michael C.
2011-01-01
Increasingly, managers and employees are facing ethical issues when conducting business in the global marketplace. Business educators attempting to teach appropriate ethical behavior and develop skills for dealing with complex ethical situations need to incorporate realistic case scenarios to challenge students. Such cases should appropriately…
Evaluating institutional capacity for research ethics in Africa: a case study from Botswana.
Hyder, Adnan A; Zafar, Waleed; Ali, Joseph; Ssekubugu, Robert; Ndebele, Paul; Kass, Nancy
2013-07-30
The increase in the volume of research conducted in Low and Middle Income Countries (LMIC), has brought a renewed international focus on processes for ethical conduct of research. Several programs have been initiated to strengthen the capacity for research ethics in LMIC. However, most such programs focus on individual training or development of ethics review committees. The objective of this paper is to present an approach to institutional capacity assessment in research ethics and application of this approach in the form of a case study from an institution in Africa. We adapted the Octagon model originally used by the Swedish International Development Cooperation Agency to assess an organization along eight domains in research ethics: basic values and identity; structure and organization; ability to carry out activities; relevance of activities to stated goals; capacity of staff and management; administrative, financing and accounting systems; its relations with target groups; and the national context. We used a mixed methods approach to collect empirical data at the University of Botswana from March to December 2010. The overall shape of the external evaluation Octagon suggests that strengths of the University of Botswana are in the areas of structure, relevance, production and identity; while the university still needs more work in the areas of systems of finance, target groups, and environment. The Octagons also show the similarities and discrepancies between the 'external' and 'internal' evaluations and provide an opportunity for exploration of these different assessments. For example, the discrepant score for 'identity' between internal and external evaluations allows for an exploration of what constitutes a strong identity for research ethics at the University of Botswana and how it can be strengthened. There is a general lack of frameworks for evaluating research ethics capacity in LMICs. We presented an approach that stresses evaluation from both internal and external perspectives. This case study highlights the university's rapid progress in developing research ethics capacity and points to some notable areas for improvement. We believe that such an empirically-driven and participatory assessment allows a more holistic measurement and promotion of institutional capacity strengthening for research ethics in LMICs.
Evaluating institutional capacity for research ethics in Africa: a case study from Botswana
2013-01-01
Background The increase in the volume of research conducted in Low and Middle Income Countries (LMIC), has brought a renewed international focus on processes for ethical conduct of research. Several programs have been initiated to strengthen the capacity for research ethics in LMIC. However, most such programs focus on individual training or development of ethics review committees. The objective of this paper is to present an approach to institutional capacity assessment in research ethics and application of this approach in the form of a case study from an institution in Africa. Methods We adapted the Octagon model originally used by the Swedish International Development Cooperation Agency to assess an organization along eight domains in research ethics: basic values and identity; structure and organization; ability to carry out activities; relevance of activities to stated goals; capacity of staff and management; administrative, financing and accounting systems; its relations with target groups; and the national context. We used a mixed methods approach to collect empirical data at the University of Botswana from March to December 2010. Results The overall shape of the external evaluation Octagon suggests that strengths of the University of Botswana are in the areas of structure, relevance, production and identity; while the university still needs more work in the areas of systems of finance, target groups, and environment. The Octagons also show the similarities and discrepancies between the 'external' and 'internal' evaluations and provide an opportunity for exploration of these different assessments. For example, the discrepant score for 'identity' between internal and external evaluations allows for an exploration of what constitutes a strong identity for research ethics at the University of Botswana and how it can be strengthened. Conclusions There is a general lack of frameworks for evaluating research ethics capacity in LMICs. We presented an approach that stresses evaluation from both internal and external perspectives. This case study highlights the university's rapid progress in developing research ethics capacity and points to some notable areas for improvement. We believe that such an empirically-driven and participatory assessment allows a more holistic measurement and promotion of institutional capacity strengthening for research ethics in LMICs. PMID:23899301
Linking biomedical engineering ethics case study approach and policy.
Dibrell, William; Dobie, Elizabeth Ann
2007-01-01
In this paper we link bioengineering case study methods to the development of policy. The case study approach to ethics is an excellent way to show the complex nature of practical/moral reasoning. This approach can, however, lead to a kind of overwhelming complexity. The individual nature of each case makes it difficult to identify the most important information and difficult to see what moral considerations are most relevant. In order to make the overwhelming complexity less debilitating, we present a framework for moral decision making derived from suggestions made by W.D. Ross and Virginia Held. Ross articulates the multiple sources of morality and Held deepens the discussion by reminding us of the foundational importance of care and sympathy to our moral natures. We show how to use the notion of prima facie duty and discuss moral conflict. In doing this, we show how the framework, applied to cases, can be of assistance in helping us develop policies and codes of ethics with sufficient plasticity to be useful in the complex world of the bioengineer.
Norlyk, Annelise; Haahr, Anita; Hall, Elisabeth
2016-04-01
To discuss ethical and methodological challenges related to in-depth interviews with patients and partners when interviewed together or separately. Increased interest in exploring illness phenomena from both patients' and partners' perspectives has emerged. The decision about how to collect data is challenging. Patients and partners can be interviewed separately or together; in both scenarios researchers face complex questions of methodology and ethics. This paper contributes to the ongoing debate on individual or joint interviewing and the effect of absence/presence of the partner on data collection. Discussion paper that draws on data from three phenomenological studies. Referring to three cases from our phenomenological studies, we discuss the different types of ethical and methodological dilemmas faced when undertaking joint and separate interviews with couples. Furthermore, we discuss how the unexpected presence of the partner potentially influences the data gathered from the patient. The cases demonstrate the interrelatedness of ethics and methodology in studies based on in-depth interviews with couples. Nurse researchers may be caught up in a dilemma between ethical concerns and methodological considerations. We argue that the presence of the partner during an interview session might influence the data and favour expressions of shared rather than individual experiences of the phenomenon studied. Furthermore, we argue that ethical concerns must be given higher priority than methodology when interviewing couples. An increased awareness of the tension between ethical and methodological challenges in joint or individual interviewing with patients and partners is necessary, as this issue is underexposed. © 2015 John Wiley & Sons Ltd.
Nursing ethics in the seventh-day adventist religious tradition.
Taylor, Elizabeth Johnston; Carr, Mark F
2009-11-01
Nurses' religious beliefs influence their motivations and perspectives, including their practice of ethics in nursing care. When the impact of these beliefs is not recognized, great potential for unethical nursing care exists. Thus, this article examines how the theology of one religious tradition, Seventh-day Adventism (SDA), could affect nurses. An overview of SDA history and beliefs is presented, which explains why 'medical missionary' work is central to SDAs. Theological foundations that would permeate an SDA nurse's view of the nursing metaparadigm concepts of person, health, environment (i.e. community), and nursing (i.e. service) are presented. The ethical principles guiding SDA nurses (i.e. principled, case-based, and care ethics) and the implications of these theological foundations for nurses are noted in a case study.
Teaching ethics to paediatrics residents: the centrality of the therapeutic alliance.
Taylor, Holly A; McDonald, Erin L; Moon, Margaret; Hughes, Mark T; Carrese, Joseph A
2009-10-01
Previous research on ethical issues encountered by medical professionals in training and practice have presented the thematic content of the cases they encounter rather than the activities in which clinicians engage and in which they most often encounter ethical issues. We conducted a direct observation study of paediatrics residents and their preceptors seeing patients in an out-patient general paediatrics clinic. Our objectives were to describe the everyday ethics-related issues paediatrics residents encounter as they interact with patients. Our ultimate goal is to use this knowledge to enhance current efforts to teach ethics to paediatrics residents. The study team directly observed paediatrics residents discussing patients with their faculty preceptors (19 half-day sessions, 76 hours) in an out-patient general paediatrics clinic located in an urban academic medical centre. Each interaction between resident and preceptor about a single patient was considered a case for further analysis. A total of 247 cases were recorded. Forty-one of the cases were coded as having ethics-related content. A constant comparative method of qualitative data analysis revealed that residents were most likely to encounter ethical issues when engaged in the following activities: (i) maintaining a therapeutic alliance with the caregiver (e.g. the parent); (ii) prioritising patient or family needs; (iii) adjusting to the power embodied by the role of doctors, and (iv) distinguishing suboptimal care from abuse or neglect. In addition, our findings indicate that it is through their efforts to maintain the therapeutic alliance with the caregivers of their patients that residents engage in and integrate three processes: developing their medical knowledge; adhering to professional norms, and balancing the power inherent in the doctor's role with their responsibility to serve the patient's interests. Medical faculty tasked with teaching ethics to paediatrics residents can utilise the results of this project to better target and enhance their ethics education efforts directed at residents in the out-patient setting. Future research could further examine and test these findings in other clinical settings (e.g. adult general medicine).
Teaching ethics in the clinic. The theory and practice of moral case deliberation.
Molewijk, A C; Abma, T; Stolper, M; Widdershoven, G
2008-02-01
A traditional approach to teaching medical ethics aims to provide knowledge about ethics. This is in line with an epistemological view on ethics in which moral expertise is assumed to be located in theoretical knowledge and not in the moral experience of healthcare professionals. The aim of this paper is to present an alternative, contextual approach to teaching ethics, which is grounded in a pragmatic-hermeneutical and dialogical ethics. This approach is called moral case deliberation. Within moral case deliberation, healthcare professionals bring in their actual moral questions during a structured dialogue. The ethicist facilitates the learning process by using various conversation methods in order to find answers to the case and to develop moral competencies. The case deliberations are not unique events, but are a structural part of the professional training on the work floor within healthcare institutions. This article presents the underlying theory on (teaching) ethics and illustrates this approach with an example of a moral case deliberation project in a Dutch psychiatric hospital. The project was evaluated using the method of responsive evaluation. This method provided us with rich information about the implementation process and effects the research process itself also lent support to the process of implementation.
Teaching ethical aptitude to graduate student researchers.
Weyrich, Laura S; Harvill, Eric T
2013-01-01
Limited time dedicated to each training areas, irrelevant case-studies, and ethics "checklists" have resulted in bare-bones Responsible Conduct of Research (RCR) training for present biomedical graduate student researchers. Here, we argue that science graduate students be taught classical ethical theory, such as virtue ethics, consequentialist theory, and deontological theory, to provide a basic framework to guide researchers through ethically complex situations and examine the applicability, implications, and societal ramifications of their research. Using a relevant biomedical research example to illustrate this point, we argue that proper ethics training for graduate student researchers not only will enhance current RCR training, but train more creative, responsible scientists.
Troubling STEM: Making a Case for an Ethics/STEM Partnership
NASA Astrophysics Data System (ADS)
Steele, Astrid
2016-06-01
Set against the backdrop of a STEM-based (science, technology, engineering and mathematics) activity in a teacher education science methods class, the author examines the need for ethics education to be partnered with STEM education. To make the case, the origin of the STEM initiative, undertaken and strongly supported by both US government and corporate sources, is briefly recounted. The STSE initiative (science, technology, society and environment) is posited as a counterpoint to STEM. Also considered are: (a) an historical perspective of science and technology as these impact difficult individual and social decision making; (b) STEM knowledge generation considered through the lens of Habermas' threefold knowledge typology; and (c) the experiences of the teacher candidates working through the STEM activity when an ethical challenge is posed. The author demonstrates the need for a moral component for science education and makes the case for a partnership between STEM and ethics education. Further, such a partnership has been shown to increase student enjoyment and motivation for their science studies. Three possible ethical frameworks are examined for their theoretical and practical utility in a science classroom.
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.
Hyder, Adnan A; Merritt, Maria; Ali, Joseph; Tran, Nhan T; Subramaniam, Kulanthayan; Akhtar, Tasleem
2008-08-01
Scientific progress is a significant basis for change in public-health policy and practice, but the field also invests in value-laden concepts and responds daily to sociopolitical, cultural and evaluative concerns. The concepts that drive much of public-health practice are shaped by the collective and individual mores that define social systems. This paper seeks to describe the ethics processes in play when public-health mechanisms are established in low- and middle-income countries, by focusing on two cases where ethics played a crucial role in producing positive institutional change in public-health policy. First, we introduce an overview of the relationship between ethics and public health; second, we provide a conceptual framework for the ethical analysis of health system events, noting how this approach might enhance the power of existing frameworks; and third, we demonstrate the interplay of these frameworks through the analysis of a programme to enhance road safety in Malaysia and an initiative to establish a national ethics committee in Pakistan. We conclude that, while ethics are gradually being integrated into public-health policy decisions in many developing health systems, ethical analysis is often implicit and undervalued. This paper highlights the need to analyse public-health decision-making from an ethical perspective.
ERIC Educational Resources Information Center
Chang, Dave; Bai, Heesoon
2016-01-01
Many teacher candidates get their first taste of life as a full-time teacher in their practicums, during which they confront a host of challenges, pedagogical and ethical. Because ethics is fundamental to the connection between teachers and students, teacher candidates are often required to negotiate dilemmas in ways that keep with the ethical…
ERIC Educational Resources Information Center
Lourenço, Fernando; Sappleton, Natalie; Cheng, Ranis
2015-01-01
The authors examined the following questions: Does gender influence the ethicality of enterprise students to a greater extent than it does nascent entrepreneurs? If this is the case, then is it due to factors associated with adulthood such as age, work experience, marital status, and parental status? Sex-role socialization theory and moral…
ERIC Educational Resources Information Center
Löfström, Erika; Pyhältö, Kirsi
2017-01-01
This study explored the perceptions of ethical issues in supervision among doctoral students and supervisors. The nature of ethical issues identified by doctoral students (n = 28) and their supervisors (n = 14) is explored and the degree of fit and misfit between their perceptions in two cases representing the natural and behavioural sciences is…
Exploration of Critical Self-Reflection in the Teaching of Ethics: The Case of Physical Therapy.
ERIC Educational Resources Information Center
Jensen, Gail M.
The effect of clinical simulations on student learning in the teaching of ethics in a physical therapy curriculum was examined in a study of the experiences of 54 physical therapy students enrolled in a course in ethics in physical therapy practice. During the three-semester-hour course, the students participated in two clinical simulations that…
[Medical ethics and human rights training in Europe].
Claudot, F; Van Baaren-Baudin, A J; Chastonay, P
2006-03-01
In 1999 the World Medical Association (WMA) issued a declaration recommending that there be the teaching of medical ethics and human rights included in the basic medical school curricula across Europe. The study aims to investigate the level of medical ethics and human rights training provided and to take an inventory of the existing programmes in the European Union's medical schools. The study was carried out using a self-administered questionnaire which was disseminated in the year 2002 to 219 schools of medicine in 14 of the 15 European Union member states (Luxembourg did not yet have a school of medicine). One-fourth of the medical schools solicited sent back a reply. Medical ethics are taught in 93% of medical schools; its teaching is of a multi-disciplinary and cross-cutting nature in 80% of the schools. Courses on ethics are compulsory in 75% of the cases. Human rights are taught in 63% of the European medical schools, and it is most often the case that the teaching of human rights is incorporated into the ethics courses. Even if the WMA's recommendation is not always fully implemented according to the guidelines of their declaration, this study demonstrates and reveals nonetheless the increasing of awareness and realization by European medical schools of the significance of including such a track in their programme.
The social transformation of some American ethics committees.
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.
Voss, Georgina
2013-09-01
This paper examines how young peoples' lived experiences with personal technologies can be used to teach engineering ethics in a way which facilitates greater engagement with the subject. Engineering ethics can be challenging to teach: as a form of practical ethics, it is framed around future workplace experience in a professional setting which students are assumed to have no prior experience of. Yet the current generations of engineering students, who have been described as 'digital natives', do however have immersive personal experience with digital technologies; and experiential learning theory describes how students learn ethics more successfully when they can draw on personal experience which give context and meaning to abstract theories. This paper reviews current teaching practices in engineering ethics; and examines young people's engagement with technologies including cell phones, social networking sites, digital music and computer games to identify social and ethical elements of these practices which have relevance for the engineering ethics curricula. From this analysis three case studies are developed to illustrate how facets of the use of these technologies can be drawn on to teach topics including group work and communication; risk and safety; and engineering as social experimentation. Means for bridging personal experience and professional ethics when teaching these cases are discussed. The paper contributes to research and curriculum development in engineering ethics education, and to wider education research about methods of teaching 'the net generation'.
Clinical governance and research ethics as barriers to UK low-risk population-based health research?
van Teijlingen, Edwin R; Douglas, Flora; Torrance, Nicola
2008-01-01
Background Since the Helsinki Declaration was introduced in 1964 as a code of practice for clinical research, it has generally been agreed that research governance is also needed in the field of public health and health promotion research. Recently, a range of factors led to the development of more stringent bureaucratic procedures, governing the conduct of low-risk population-based health research in the United Kingdom. Methods Our paper highlights a case study of the application process to medical research ethics committees in the United Kingdom for a study of the promotion of physical activity by health care providers. The case study presented here is an illustration of the challenges in conducting low-risk population-based health research. Results Our mixed-methods approach involved a questionnaire survey of and semi-structured interviews with health professionals (who were all healthy volunteers). Since our study does not involve the participation of either patients or the general population, one would expect the application to the relevant research ethics committees to be a formality. This proved not to be the case! Conclusion Research ethics committees could be counter-productive, rather than protecting the vulnerable in the research process, they can stifle low-risk population-based health research. Research ethics in health services research is first and foremost the responsibility of the researcher(s), and we need to learn to trust health service researchers again. The burden of current research governance regulation to address the perceived ethical problems is neither appropriate nor adequate. Senior researchers/academics need to educate and train students and junior researchers in the area of research ethics, whilst at the same time reducing pressures on them that lead to unethical research, such as commercial funding, inappropriate government interference and the pressure to publish. We propose that non-invasive low-risk population-based health studies such as face-to-face interviews with health and social care professionals or postal questionnaire studies with patients on non-sensitive topics are given a waiver or a light touch review. We suggest that this can be achieved through a two-staged ethics application process. The first stage starts with a one or two-page outline application which ethics committees can use as the basis to grant a waiver or request a full application. PMID:19040750
Making Our Judgments Right: Ethics of Corporal Punishment in Indian Schools
ERIC Educational Resources Information Center
Tiwari, Ashwini
2015-01-01
The case "Ayub Khan v. Municipal Corporation of Delhi Schools" is one of the landmark cases for promoting a conversation on ethics of corporal punishment in Indian society. Based on literature synthesis and the critical examination of the Court case using ethical frameworks (Stefkovich, 2006; Stefkovich & Shapiro, 2010) this paper…
When Ethics and Policy Collide
ERIC Educational Resources Information Center
Hightower, Bynum Blake; Klinker, JoAnn Franklin
2012-01-01
This case study explores an ethical dilemma faced by a new junior high school principal. It is appropriate for use in all preparation course work, including the internship. Studies show that novice principal decision making differs from that of experienced principals in moral dilemmas, including following policy versus best interests of the…
Ethical Considerations in Filing Personal Bankruptcy: A Hypothetical Case Study
ERIC Educational Resources Information Center
Landry, Robert J., III
2012-01-01
A great deal of research by legal studies scholars pertains to employment law, international law, and corporate governance, as well as other fields including ethics and international law. The fields typically addressed are very important and rightfully receive considerable attention in the scholarship and textbooks. However, bankruptcy as a…
Evaluation of moral case deliberation at the Dutch Health Care Inspectorate: a pilot study.
Seekles, Wike; Widdershoven, Guy; Robben, Paul; van Dalfsen, Gonny; Molewijk, Bert
2016-05-21
Moral case deliberation (MCD) as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics support on the level of health care regulation, employees of regulatory bodies are regularly confronted with moral challenges. This pilot study describes and evaluates the use of MCD at the Dutch Health Care Inspectorate (IGZ). The objective of this pilot study is to investigate: 1) the current way of dealing with moral issues at the IGZ; 2) experience with and evaluation of MCD as clinical ethics support, and 3) future preferences and (perceived) needs regarding clinical ethics support for dealing with moral questions at the IGZ. We performed an explorative pilot study. The research questions were assessed by means of: 1) interviews with MCD participants during four focus groups; and 2) interviews with six key stakeholders at the IGZ. De qualitative data is illustrated by data from questionnaires on MCD outcomes, perspective taking and MCD evaluation. Professionals do not always recognize moral issues. Employees report a need for regular and structured moral support in health care regulation. The MCD meetings are evaluated positively. The most important outcomes of MCD are feeling secure and learning from others. Additional support is needed to successfully implement MCD at the Inspectorate. We conclude that the respondents perceive moral case deliberation as a useful form of clinical ethics support for dealing with moral questions and issues in health care regulation.
Comparison of ethical judgments exhibited by clients and ethics consultants in Japan
2014-01-01
Background Healthcare professionals must make decisions for patients based on ethical considerations. However, they rely on clinical ethics consultations (CEC) to review ethical justifications of their decisions. CEC consultants support the cases reviewed and guide medical care. When both healthcare professionals and CEC consultants face ethical problems in medical care, how is their judgment derived? How do medical judgments differ from the ethical considerations of CECs? This study examines CECs in Japan to identify differences in the ethical judgment of clients and CEC consultants. Methods The CEC request and response documents of all 60 cases reviewed across Japan between October 2006 and the end of October 2011 were classified in terms of the presence of decisional capacity in the patient. We conducted a qualitative content analysis of the differences in reasoning between client and CEC consultants. Reasoned judgments were verified in individual cases to classify the similarities or differences of opinion between CEC clients and teams. Results As the result of classification of the decisional capacity and the difference of opinion regarding medical care, the most frequent category was 25 cases (41.7%) of “uncertain decisional capacity,” and 23 cases (38.3%) of “withholding of decision-making.” A chi-square analysis was performed on presence of decisional capacity and agreement in decision-making, yielding a statistically significant difference (p < 0.05). The CEC consultants’ reasoning was based on “patient’s preference was ambiguous,” “validity of family as a surrogate,” “estimation of patient preference,” and “patient’s best interest,” whereas the CEC client’s reasoning was based on “consistent family preference was shown/not shown” and “appropriate therapeutic methods to manage patient safety.” Conclusion Differences in opinions were found in cases classified according to decisional capacity. Furthermore, the reasoning behind judgments differed between CEC clients and CEC consultants. The reasoning of CEC consultants was critical and reflective, while for clients it was situational and pragmatic. PMID:24592932
Case studies in medical futility.
Mains, Douglas A; Coustasse, Alberto; Lurie, Sue G
2007-01-01
Technology has provided means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient. This study presents two case histories, compiled from historical patient charts, staff notes and observations, that illustrate the variety of ethical issues involved and the role culture plays in the decision making process related to possible futile medical treatment. Ethical and cultural issues related to the cases are discussed and processes are presented that can help hospitals to avoid, or decrease the level of, medically futile care, and improve the cultural appropriateness of medical care and relationships with patients.
ERIC Educational Resources Information Center
Faddis, Toni Osborn
2017-01-01
The purpose of this phenomenological study was to explore and describe the individual experiences of elementary principals' in Southern San Diego County when making ethical decisions that are unique to schools near the United States/Mexico border. Ethical decision-making, in this case, is the term used to depict an incident that calls for a…
Challenges in the Ethical Review of Peer Support Interventions
Simmons, David; Bunn, Christopher; Nakwagala, Fred; Safford, Monika M.; Ayala, Guadalupe X.; Riddell, Michaela; Graffy, Jonathan; Fisher, Edwin B.
2015-01-01
PURPOSE Ethical review processes have become increasingly complex. We have examined how 8 collaborating diabetes peer-support clinical trials were assessed by ethics committees. METHODS The ethical reviews from the 8 peer-support studies were collated and subjected to a thematic analysis. We mapped the recommendations of local Institutional Review Boards and ethics committees onto the “4+1 ethical framework” (autonomy, beneficence, non-maleficence, and justice, along with concern for their scope of application). RESULTS Ethics committees did not consistently focus on tasks within the 4+1 framework: many conducted reviews of scientific, organizational, and administrative activities. Of the 20 themes identified across the ethical reviews, only 4 fell within the scope of the 4+1 framework. Variation in processes and requirements for ethics committees were particularly evident between study countries. Some of the consent processes mandated by ethical review boards were disproportionate for peer support, increased participant burden, and reduced the practicality of testing an ethical intervention. Across the 8 studies, ethics committees’ reviews included the required elements to ensure participant safety; however, they created a range of hurdles that in some cases delayed the research and required consent processes that could hinder the spontaneity and/or empathy of peer support. CONCLUSION Ethics committees should avoid repeating the work of other trusted agencies and consider the ethical validity of “light touch” consent procedures for peer-support interventions. The investigators propose an ethical framework for research on peer support. PMID:26304976
Hildebrand, J; Maycock, B; Comfort, J; Burns, S; Adams, E; Howat, P
2015-12-01
Mature minor consent only became available in Australia in 2007. There is neither an explicitly defined protocol, nor a clear definition evident in the literature relating to use of the mature minor concept in health research. Due to difficulties in defining fixed age ranges to varying levels of maturity and vulnerability, there is a lack of clarity surrounding when it might be reasonable and ethical to apply for or grant a waiver for parental consent. This paper describes the challenges faced and solutions created when gaining approval for use of mature minor consent in a respondent-driven sampling (RDS) study to explore the social norms and alcohol consumption among 14-17-year-old adolescents (n = 1012) in the community. The University's Human Research Ethics Committee granted mature minor consent for this study, and the techniques applied enabled recruitment of adolescents from community-based settings through use of RDS to achieve the required sample. This paper has relevance for research that requires a waiver for parental consent; it presents a case study for assessing mature minors and makes recommendations on how ethical guidelines can be improved to assist human research ethics application processes.
The right to die--ethical dilemmas in persons with spinal cord injury.
Rundquist, Jeanine M
2002-01-01
The right to die can be a controversial topic, and health care workers in the rehabilitation setting may find themselves in the center of this heated debate. This article presents a case study of a patient with tetraplegia, Daniel, and his choices regarding life and death. The case study will be examined through the use of ethical principles as well as from a legal standpoint. Social, cultural, and economic issues are also discussed. Guidelines for possible resolution to the conflict are offered.
Using rhetorical theory in medical ethics cases.
Heifferon, B
2000-01-01
In this paper I argue that rhetorical theory is a valuable tool in medical ethics cases. The case I use as an example is one in which traditional, philosophy-based medical ethics are applied. In this case the traditional ethical approach is not adequate to the task. Key issues and problems are not addressed, resulting in a problem that seems to be solved on the surface, but, when rhetorically analyzed, it's obvious that none of the issues have been resolved in any satisfactory way. By using rhetorical theory, such as that Michel Foucault uses in Power/Knowledge, we discover that the reason this case has not been solved is that the power issues have not been addressed. Using Foucault's concepts of "subjugated knowledge", "local knowledge", "situated knowledge", and "docile bodies", we can tease out the real issues that surface in this ethics case and solve them. Foucault also recommends we use theory as a "toolkit". I propose a model that is a further iteration of this idea. My model uses numerous rhetorical and literary theories, depending on the issues that need to be addressed in each individual medical ethics case. I briefly describe the various theories and include a handout of what the new model of using rhetorical theory in such cases would look like.
The Virtue of Principle Ethics.
ERIC Educational Resources Information Center
Bersoff, Donald N.
1996-01-01
Presents arguments against adopting virtue ethics as a guiding concept in developing counseling guidelines: (1) virtue ethics is irrelevant in the resolution of most ethics cases; (2) virtue and principle ethics overlap; (3) principle ethics are more suited to acting and deciding; (4) the emphasis on virtue ethics increases the possibility of…
Engineering Ethics Education on the Basis of Continuous Education to Improve Communication Ability
NASA Astrophysics Data System (ADS)
Takahara, Kenji; Kajiwara, Toshinori
The paper proposes the engineering ethics education method for students on the basis of continuous education to improve communication ability. First, through a debate, the students acquire the fundamental skills required to marshal their arguments, to construct the rebuttals and to summarize the debates. Secondly, the students study the fundamental techniques to make a presentation on technical subjects related to electrical engineering. Following these classes, in the lecture of engineering ethics, the students probe the cause of each accident and consider the better means for avoiding such an accident, each other. In most cases, the students can express right and commonsensical opinions from an ethical standpoint. However, they can hardly make judgments when the situations such as the human relations in the above accidents are set concretely. During the engineering ethics class, the students come to know that human relations behind the case make the ethical matters more complicated. Furthermore, they come to understand that facilitating daily communications with co-workers and/or bosses is very important in order to avoid the accidents. The recognition of the students is just the results of the continuous education through three years. It can be said that the engineering ethics education thus constructed makes the students raise such spontaneous awareness and their ethical qualities as engineers.
Teaching Ethics to Pediatric Residents: A Literature Analysis and Synthesis.
Martakis, K; Czabanowska, K; Schröder-Bäck, P
2016-09-01
Ethics education rarely exists in pediatric resident curricula, although ethical conflicts are common in the clinical practice. Ethics education can prepare residents to successfully handle these conflicts. We searched for methods in teaching ethics to clinical and especially pediatric residents, and identified recurring barriers to ethics teaching and solutions to overcome them. Literature from 4 electronic databases with peer-reviewed articles was screened in 3 phases and analyzed. The literature included papers referring to applied methods or recommendations to teaching ethics to clinical residents, and on a second level focusing especially on pediatrics. An analysis and critical appraisal was conducted. 3 231 articles were identified. 96 papers were included. The applied learning theory, the reported teaching approaches, the barriers to teaching ethics and the provided solutions were studied and analyzed. We recommend case-based ethics education, including lectures, discussion, individual study; regular teaching sessions in groups, under supervision; affiliation to an ethics department, institutional and departmental support; ethics rounds and consultations not as core teaching activity; recurring problems to teaching ethics, primarily deriving from the complexity of residential duties to be addressed in advance; teaching ethics preferably in the first years of residency. We may be cautious generalizing the implementation of results on populations with different cultural backgrounds. © Georg Thieme Verlag KG Stuttgart · New York.
The Right Not To Hear: The Ethics of Parental Refusal of Hearing Rehabilitation
Byrd, Serena; Shuman, Andrew G.; Kileny, Sharon; Kileny, Paul R.
2015-01-01
Objective To explore the ethics of parental refusal of auditory-oral hearing rehabilitation. Study Design Case study with medical ethical discussion and review. Methods Two young brothers present with severe-to-profound congenital sensorineural hearing loss. The parents, both of whom have normal hearing and work as sign language interpreters, have decided to raise their children with American Sign Language as their only form of communication. They have chosen not to pursue cochlear implantation nor support the use of hearing aids. Discussion This case raises significant questions concerning whether hearing rehabilitation should be mandated, and if there are circumstances in which parental preferences should be questioned or overridden with regard to this issue. In addition, legal concerns may be raised regarding the possible need to file a report with child protective services. Although similar cases involving the Deaf community have historically favored parental rights to forego hearing rehabilitation with either cochlear implantation or hearing aids, we explore whether conclusions should be different because the parents in this case are not hearing impaired. Conclusions The ethics of parental rights to refuse hearing augmentation are complex and strikingly context-dependent. A comprehensive appreciation of the medical, practical and legal issues is crucial prior to intervening in such challenging situations. PMID:21792972
Causal Relation Analysis Tool of the Case Study in the Engineer Ethics Education
NASA Astrophysics Data System (ADS)
Suzuki, Yoshio; Morita, Keisuke; Yasui, Mitsukuni; Tanada, Ichirou; Fujiki, Hiroyuki; Aoyagi, Manabu
In engineering ethics education, the virtual experiencing of dilemmas is essential. Learning through the case study method is a particularly effective means. Many case studies are, however, difficult to deal with because they often include many complex causal relationships and social factors. It would thus be convenient if there were a tool that could analyze the factors of a case example and organize them into a hierarchical structure to get a better understanding of the whole picture. The tool that was developed applies a cause-and-effect matrix and simple graph theory. It analyzes the causal relationship between facts in a hierarchical structure and organizes complex phenomena. The effectiveness of this tool is shown by presenting an actual example.
Confidentiality in participatory research: Challenges from one study.
Petrova, Elmira; Dewing, Jan; Camilleri, Michelle
2016-06-01
This article presents key ethical challenges that were encountered when conducting a participatory qualitative research project with a very specific, small group of nurses, in this case with practice development nurses in Malta. With the small number of nurses employed in practice development roles in Malta, there are numerous difficulties of maintaining confidentiality. Poorly constructed interventions by the researcher could have resulted in detrimental effects to research participants and the overall trustworthiness of the research. Generally, ethical guidelines for research exist to reinforce validity of research; however, there is not an established consensus on how these strategies can be utilised in some types of qualitative field work. The researcher used an exploratory case study methodology. The sample consisted of 10 participants who were interviewed twice using face-to-face interviews, over a period of 2 months. The study was ethically reviewed by the University Research Ethics Committee and the Faculty Research Ethics Committee, University of Malta. The participants referred to in this article have been given adequate information about the study and their consent has been obtained. Numerous strategies for ensuring confidentiality during recruitment of the participants, during data collection, during transcription and data analysis and during dissemination of research results assisted the researcher in responding to potential and actual ethical issues. This article emphasises the main strategies that can be used to respond to ethical challenges when researching with a small easily identifiable group. The learning discussed here may be relevant to or even transferable to other similar research studies or research contexts. These methods fostered a greater credibility throughout the research process and predisposed the participants to greater trust, and thus, they disclosed their experiences and speak more freely, thus enhancing the quality of the study. © The Author(s) 2014.
A case report of embryo donation: ethical and clinical implications for psychologists.
Rizk, Marianne; Pawlak, Stacey
2016-10-01
Third-party reproduction is a growing field, and an increasing body of literature considers the ethics of embryo donation. Due to the psychosocial complexities that generally accompany the donation and/or use of donor embryos, psychologists can play a pivotal role in these specialised fertility cases. While laws in the USA are in place to regulate the medical procedures involved in embryo donation, only unenforceable guidelines exist for psychologists specialising in fertility cases. The presentation of this case study aims to: (1) clarify the ethical concerns that fertility psychologists should consider in similar situations by assessing whether American Society of Reproductive Medicine (ASRM) and the American Psychological Association (APA) guidelines compete or complement one another within this case of embryo donation and (2) consider the interests, obligations and rights of all parties involved. Several principles, standards and guidelines that must be considered are described. Overall, the APA Ethics Code and the ASRM Guidelines appear to complement one another for most aspects of this case. Fertility psychologists should consider the clinical implications of the interests, rights and duties of all involved parties, including themselves. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Fair shares: a preliminary framework and case analyzing the ethics of offshoring.
Gordon, Cameron; Zimmerman, Alan
2010-06-01
Much has been written about the offshoring phenomenon from an economic efficiency perspective. Most authors have attempted to measure the net economic effects of the strategy and many purport to show that "in the long run" that benefits will outweigh the costs. There is also a relatively large literature on implementation which describes the best way to manage the offshoring process. But what is the morality of offshoring? What is its "rightness" or "wrongness?" Little analysis of the ethics of offshoring has been completed thus far. This paper develops a preliminary framework for analyzing the ethics of offshoring and then applies this framework to basic case study of offshoring in the U.S. The paper following discusses the definition of offshoring; shifts to the basic philosophical grounding of the ethical concepts; develops a template for conducting an ethics analysis of offshoring; applies this template using basic data for offshoring in the United States; and conducts a preliminary ethical analysis of the phenomenon in that country, using a form of utilitarianism as an analytical baseline. The paper concludes with suggestions for further research.
Bahus, Marianne K; Førde, Reidun
2016-09-01
With disagreement, doubts, or ambiguous grounds in end-of-life decisions, doctors are advised to involve a clinical ethics committee (CEC). However, little has been published on doctors' experiences with discussing an end-of-life decision in a CEC. As part of the quality assurance of this work, we wanted to find out if clinicians have benefited from discussing end-of-life decisions in CECs and why. We will disseminate some Norwegian doctors' experiences when discussing end-of-life decisions in CECs, based on semi-structured interviews with fifteen Norwegian physicians who had brought an end-of-life decision case to a CEC. Almost half of the cases involved conflicts with the patients' relatives. In a majority of the cases, there was uncertainty about what would be the ethically preferable solution. Reasons for referring the case to the CEC were to get broader illumination of the case, to get perspective from people outside the team, to get advice, or to get moral backing on a decision already made. A great majority of the clinicians reported an overall positive experience with the CECs' discussions. In cases where there was conflict, the clinicians reported less satisfaction with the CECs' discussions. The study shows that most doctors who have used a CEC in an end-of-life decision find it useful to have ethical and/or legal aspects illuminated, and to have the dilemma scrutinized from a new perspective. A systematic discussion seems to be significant to the clinicians.
Case Studies in Science Ethics
NASA Astrophysics Data System (ADS)
Williams, Karen
2010-03-01
Everyone in science should have ethics education training. I have seen graduate students taken advantage of by their mentors. Many of us have seen misconduct...but what should we do about it? Young scientists are often unaware of the rules in science and make mistakes because of their ignorance of the rules in that particular field of study. Then there are an increasing number of cases in the news of overt cases of misrepresentation in science. All are welcome to attend this discussion of case studies. A case study on topics such as: how to treat data properly, how our values in science affect our work, who gets authorship on scientific papers, who is first author on a paper, what you should do if you uncover misconduct or plagiarism in your university, and we will discuss the scientist's role in society. This will be a painless, non-confrontational small group, then large group discussion of each case
Truth-telling, decision-making, and ethics among cancer patients in nursing practice in China.
Ling, Dong-Lan; Yu, Hong-Jing; Guo, Hui-Ling
2017-01-01
Truth-telling toward terminally ill patients is a challenging ethical issue in healthcare practice. However, there are no existing ethical guidelines or frameworks provided for Chinese nurses in relation to decision-making on truth-telling of terminal illness and the role of nurses thus is not explicit when encountering this issue. The intention of this paper is to provide ethical guidelines or strategies with regards to decision-making on truth-telling of terminal illness for Chinese nurses. This paper initially present a case scenario and then critically discuss the ethical issue in association with ethical principles and philosophical theories. Instead of focusing on attitudes toward truth disclosure, it aims to provide strategies regarding this issue for nurses. It highlights and discusses some of the relevant ethical assumptions around the perceived role of nurses in healthcare settings by focusing on nursing ethical virtues, nursing codes of ethics, and philosophical perspectives. And Confucian culture is discussed to explicate that deontology does not consider family-oriented care in China. Treating each family individually to explore the family's beliefs and values on this issue is essential in healthcare practice and nurses should tailor their own approach to individual needs regarding truth-telling in different situations. Moreover, the Chinese Code of Ethics should be modified to be more specific and applicable. Finally, a narrative ethics approach should be applied and teamwork between nurses, physicians and families should be established to support cancer patients and to ensure their autonomy and hope. Ethical considerations: This paper was approved by the Ethics Committee of The Second Affiliated Hospital of Guangzhou Medical University. The authors have obtained consent to use the case study and it has been anonymised to preserve the patient's confidentiality.
Ethical and Moral Education: A National Case Study of Poland.
ERIC Educational Resources Information Center
Janowski, Andrzej
This study explores the Polish experience in values education. Between the years 1944 and 1989 Polish education was often state controlled with the sole purpose of subjugating education to Marxist-Leninist ideology. Over the years the communist party's dictates varied in intensity. Despite the party's efforts to prescribe ethics, certain values…
Vynckier, Tine; Gastmans, Chris; Cannaerts, Nancy; de Casterlé, Bernadette Dierckx
2015-05-01
The effectiveness of ethics education continues to be disputed. No studies exist on how nursing students perceive the effectiveness of nursing ethics education in Flanders, Belgium. To develop a valid and reliable instrument, named the 'Students' Perceived Effectiveness of Ethics Education Scale' (SPEEES), to measure students' perceptions of the effectiveness of ethics education, and to conduct a pilot study in Flemish nursing students to investigate the perceived efficacy of nursing ethics education in Flanders. Content validity, comprehensibility and usability of the SPEEES were assessed. Reliability was assessed by means of a quantitative descriptive non-experimental pilot study. 86 third-year baccalaureate nursing students of two purposefully selected university colleges answered the SPEEES. Formal approval was given by the ethics committee. Informed consent was obtained and anonymity was ensured for both colleges and their participating students. The scale content validity index/Ave scores for the subscales were 1.00, 1.00 and 0.86. The comprehensibility and user-friendliness were favourable. Cronbach's alpha was 0.94 for general effectiveness, 0.89 for teaching methods and 0.85 for ethical content. Students perceived 'case study', 'lecture' and 'instructional dialogue' to be effective teaching methods and 'general ethical concepts' to contain effective content. 'Reflecting critically on their own values' was mentioned as the only ethical competence that, was promoted by the ethics courses. The study revealed rather large differences between both schools in students' perceptions of the contribution of ethics education to other ethical competences. The study revealed that according to the students, ethics courses failed to meet some basic objectives of ethics education. Although the SPEEES proved to be a valid and reliable measure, the pilot study suggests that there is still space for improvement and a need for larger scale research. Additional insights will enable educators to improve current nursing ethics education. © The Author(s) 2014.
Ethics education for clinician–researchers in genetics: The combined approach
Zawati, Ma'n; Cohen, Eliza; Parry, David; Avard, Denise; Syncox, David
2014-01-01
Advancements in genomic technology and genetic research have uncovered new and unforeseen ethical and legal issues that must now be faced by clinician–researchers. However, lack of adequate ethical training places clinician–researchers in a position where they might be unable to effectively assess and resolve the issues presented to them. The literature demonstrates that ethics education is relevant and engaging where it is targeted to the level and context of the learners, and it includes real-world based cases approached in innovative ways. In order to test the feasibility of a combined approach to ethics education, a conference was held in 2012 to raise awareness and familiarize participants with the ethical and legal issues surrounding medical technology in genetics and then to have them apply this to reality-based case studies. The conference included participants from a variety of backgrounds and was divided into three sections: (i) informative presentations by experts in the field; (ii) mock REB deliberations; and (iii) a second mock-REB, conducted by a panel of experts. Feedback from participants was positive and indicated that they felt the learning objectives had been met and that the material was presented in a clear and organized fashion. Although only an example of the combined approach in a particular setting, the success of this conference suggests that combining small group learning, practical cases, role-play and interdisciplinary learning provides a positive experience and is an effective approach to ethics education. PMID:26937344
McIntosh, Scott; Sierra, Essie; Dozier, Ann; Diaz, Sergio; Quiñones, Zahira; Primack, Aron; Chadwick, Gary; Ossip-Klein, Deborah J
2008-09-01
The current ethical structure for collaborative international health research stems largely from developed countries' standards of proper ethical practices. The result is that ethical committees in developing countries are required to adhere to standards that might impose practices that conflict with local culture and unintended interpretations of ethics, treatments, and research. This paper presents a case example of a joint international research project that successfully established inclusive ethical review processes as well as other groundwork and components necessary for the conduct of human behavior research and research capacity building in the host country.
An Exploration of Ethical Issues in Research in Children’s Health and the Environment
Paulson, Jerome A.
2006-01-01
The consideration of ethical issues relating to pediatric environmental health is a recent phenomenon. Discussions of biomedical ethics, research on children, and environmental health research have a longer history. In the late 1990s, researchers at the Kennedy Krieger Institute in Baltimore, Maryland, undertook a study to compare the effectiveness of several methods of reducing lead risk in housing. In a preliminary finding in the case of Grimes v. Kennedy Krieger Institute, Inc., a Maryland court questioned the ethics of performing research on children when there is no prospect of direct benefit to those children and whether parents can consent to such research. This case dramatically raised the profile of ethical issues among the pediatric environmental health research community. To broaden the discussion of these issues and in response to the Kennedy-Krieger case, the Children’s Environmental Health Network held a working meeting on 5 and 6 March 2004 to explore this topic. The articles in this mini-monograph were prepared by the authors as a result of the workshop and represent their opinions. This article is an introduction to the workshop and a summary of the articles to follow. PMID:17035150
Langer, Thorsten; Jazmati, Danny; Jung, Ole; Schulz, Christian; Schnell, Martin W
2016-01-01
Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students' perspectives on their development in ethical judgment has received less attention. Better insights in the learners' experiences can help to improve educational interventions in medical ethics. Methods: A vignette featuring a challenging case with opposing views between a patient's parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5). The questionnaire included closed and open-ended questions addressing the participant's preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28%) over the study period. Participants' responses changed overtime. Accepting parents' autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%). On the contrary, not readily following the parents' decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%). Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor). Conclusions: Over the course of their medical training, the participants seemed to increasingly frame the presented vignette as a medical problem. To optimize the development of ethical judgment teaching of ethics should be more integrated in clinical teaching. In addition to the analysis of rare and extreme cases, teaching ethics should also expand on challenges students and junior doctors commonly encounter themselves to promote ethical sensitivity and confidence in students.
Langer, Thorsten; Jazmati, Danny; Jung, Ole; Schulz, Christian; Schnell, Martin W.
2016-01-01
Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students’ perspectives on their development in ethical judgment has received less attention. Better insights in the learners’ experiences can help to improve educational interventions in medical ethics. Methods: A vignette featuring a challenging case with opposing views between a patient’s parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5). The questionnaire included closed and open-ended questions addressing the participant’s preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28%) over the study period. Participants’ responses changed overtime. Accepting parents’ autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%). On the contrary, not readily following the parents’ decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%). Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor). Conclusions: Over the course of their medical training, the participants seemed to increasingly frame the presented vignette as a medical problem. To optimize the development of ethical judgment teaching of ethics should be more integrated in clinical teaching. In addition to the analysis of rare and extreme cases, teaching ethics should also expand on challenges students and junior doctors commonly encounter themselves to promote ethical sensitivity and confidence in students. PMID:27990470
Ramos, Flávia Regina Souza; de Pires, Denise Elvira Pires; Brehmer, Laura Cavalcanti de Farias; Gelbcke, Francine Lima; Schmoeller, Soraia Dornelles; Lorenzetti, Jorge
2013-10-01
From a scenario of political and technological changes in work and health education, the purpose of this study was to understand the ethics discourse in nurses' education process in Brazilian nursing schools. A research was performed with a qualitative approach, characterized as a case study, involving six schools of a region in the south of Brazil. The data were collected by focal groups involving 50 teachers. The results were organized in three categories: (1) experience and motivation to teach ethics and bioethics, (2) indicators of change identified in global and local contexts and (3) challenges in the education of ethics, values and related themes. The teachers have highlighted complex elements related to scientific, educational and professional contexts, and pointed out the need for a critical perspective on the professional scenario and on their own situations as nurses and educators. The analyzed discourse brings to light the topic of ethics, seen as peculiar to the present day and in intimate connection with the daily routine of clinical, pedagogical and political professional practices. The findings suggest that the reflections on nurses' ethics education should not be limited to discussing content and pedagogical strategies but should be extended to include a commitment to the adoption of values in professional practice and to the process of the construction of a professional identity. Copyright © 2012 Elsevier Ltd. All rights reserved.
Ethics consultants and ethics committees.
La Puma, J; Toulmin, S E
1989-05-01
To address moral questions in patient care, hospitals and health care systems have enlisted the help of hospital ethicists, ethics committees, and ethics consultation services. Most physicians have not been trained in the concepts, skills, or language of clinical ethics, and few ethicists have been trained in clinical medicine, so neither group can fully identify, analyze, and resolve clinical ethical problems. Some ethics committees have undertaken clinical consultations themselves, but liability concerns and variable standards for membership hinder their efforts. An ethics consultation service comprising both physician-ethicists and nonphysician-ethicists brings complementary viewpoints to the management of particular cases. If they are to be effective consultants, however, nonphysician-ethicists need to be "clinicians": professionals who understand an individual patient's medical condition and personal situation well enough to help in managing the case. Ethics consultants and ethics committees may work together, but they have separate identities and distinct objectives: ethics consultants are responsible for patient care, while ethics committees are administrative bodies whose primary task is to advise in creating institutional policy.
Using Video-Based Instruction to Integrate Ethics into the Curriculum
ERIC Educational Resources Information Center
Sedaghat, Ali M.; Mintz, Steven M.; Wright, George M.
2011-01-01
This paper describes a video case discussion project based on the IMA's Statement of Ethical Professional Practice that was administered in a cost accounting class to assess the extent to which students were able to identify and discuss ethical issues raised by the facts of a case scenario. The case was developed by the IMA to advance the…
Overcoming bias toward same-sex couples: a case study from inside an MFT ethics classroom.
Charlés, Laurie L; Thomas, Dina; Thornton, Matthew L
2005-07-01
This article illustrates a teaching case in which a marriage and family therapy (MFT) trainee learned to develop cultural sensitivity toward same-sex couples despite religious beliefs that put her at risk of discriminating against that population. The case took place during a marriage and family therapy ethics course in the spring of 2003. From two first-person perspectives, the authors illustrate the processes that facilitated the student's change, addressing the class activities, discussions, and pivotal moments of teaching and learning that promoted the student's cultural competency and helped her to resolve this personal and ethical dilemma. A set of classroom techniques (creating a safe environment, using a stance of curiosity, finding alternative learning formats, extrapolating ideas from multiple sources, and capitalizing on students' experiences outside of class) used in the case are detailed throughout the article.
Brian Roy Lockhart; Ralph D. Nyland
2004-01-01
Professional ethics involve statements by a professional organization to guide the behavior of its members, and to help them determine acceptable and unacceptable behavior in a given situation. Most, if not all, natural resource organizations have Code of Ethics. How to incorporate them across the curriculum and in individual courses of a natural resources program is a...
Introducing Summer High School Student-Researchers to Ethics in Scientific Research
ERIC Educational Resources Information Center
Mabrouk, Patricia Ann
2007-01-01
A case based workshop on science ethics for high school students participating in summer research apprenticeships is developed and tested. It is found that this case-based approach is useful in facilitating faculty-student discussions of research ethics with their proteges.
Ethical issues in action-oriented research in Indonesia.
Rachmawaty, Rini
2017-09-01
Action-oriented research is one of the most frequent research types implemented to transform community health in Indonesia. Three researchers and 11 graduate students from a developed country in East Asia conducted a fieldwork program in a remote area in South Sulawesi Province. Although the project was completed, whether or not the international standards for human subject research were applied into that study remains unclear. This study aimed to examine ethical issues raised from that case, analyze constraints to the problems, and recommend alternatives to protect vulnerable populations from being exploited by local/international researchers. A problem-solving approach was used in this study. It began with problem identification, evaluation of the action-oriented research goal, investigation of the constraints to the problem, and recommendation of some relevant alternatives to address the central issue. Ethical Consideration: The approval for conducting the action-oriented research that being investigated in this work was only obtained from the Head of local district. Some ethical issues were found in this case. No special protection for this population, no informed consent was obtained from the participants, exposure to social and economic risks, no future benefits for the subjects, and conflict of interests. Lack of control from the local research ethics committee and lack of competence of local researchers on human subject research were considered as the constraints to the problems. Creating an independent research ethics committee, providing research ethics training to the local researchers, obtaining written/video consents from underserved populations, and meeting local health needs were recommended alternatives to solve these problems. Indonesian government bodies should reform their international collaborative system on research involving human subjects. Exploitation may not occur if all participants as well as all local and national governing bodies understand the research ethics on human subjects and apply it into their practice.
Gain-of-Function Research: Ethical Analysis.
Selgelid, Michael J
2016-08-01
Gain-of-function (GOF) research involves experimentation that aims or is expected to (and/or, perhaps, actually does) increase the transmissibility and/or virulence of pathogens. Such research, when conducted by responsible scientists, usually aims to improve understanding of disease causing agents, their interaction with human hosts, and/or their potential to cause pandemics. The ultimate objective of such research is to better inform public health and preparedness efforts and/or development of medical countermeasures. Despite these important potential benefits, GOF research (GOFR) can pose risks regarding biosecurity and biosafety. In 2014 the administration of US President Barack Obama called for a "pause" on funding (and relevant research with existing US Government funding) of GOF experiments involving influenza, SARS, and MERS viruses in particular. With announcement of this pause, the US Government launched a "deliberative process" regarding risks and benefits of GOFR to inform future funding decisions-and the US National Science Advisory Board for Biosecurity (NSABB) was tasked with making recommendations to the US Government on this matter. As part of this deliberative process the National Institutes of Health commissioned this Ethical Analysis White Paper, requesting that it provide (1) review and summary of ethical literature on GOFR, (2) identification and analysis of existing ethical and decision-making frameworks relevant to (i) the evaluation of risks and benefits of GOFR, (ii) decision-making about the conduct of GOF studies, and (iii) the development of US policy regarding GOFR (especially with respect to funding of GOFR), and (3) development of an ethical and decision-making framework that may be considered by NSABB when analyzing information provided by GOFR risk-benefit assessment, and when crafting its final recommendations (especially regarding policy decisions about funding of GOFR in particular). The ethical and decision-making framework ultimately developed is based on the idea that there are numerous ethically relevant dimensions upon which any given case of GOFR can fare better or worse (as opposed to there being necessary conditions that are either satisfied or not satisfied, where all must be satisfied in order for a given case of GOFR to be considered ethically acceptable): research imperative, proportionality, minimization of risks, manageability of risks, justice, good governance (i.e., democracy), evidence, and international outlook and engagement. Rather than drawing a sharp bright line between GOFR studies that are ethically acceptable and those that are ethically unacceptable, this framework is designed to indicate where any given study would fall on an ethical spectrum-where imaginable cases of GOFR might range from those that are most ethically acceptable (perhaps even ethically praiseworthy or ethically obligatory), at one end of the spectrum, to those that are most ethically problematic or unacceptable (and thus should not be funded, or conducted), at the other. The aim should be that any GOFR pursued (and/or funded) should be as far as possible towards the former end of the spectrum.
Yanar, Zeynep M; Fazli, Mehria; Rahman, Jahanara; Farthing, Rys
2016-04-01
Participatory action research (PAR) is a methodological approach that seeks to maximize the participation of people whose lives it researches. It is underpinned by an ethical concern to research "with" people, rather than "on" people. However, this ethical approach to research is often, paradoxically, problematized by universities' research ethics committees (RECs). This article explores one site of tension between PAR and RECs-the requirement for anonymity for below 18-year-olds. It explores this tension by exploring a case study of a peer-to-peer research project undertaken by young women in East London, and using our own experiences and perspectives, it argues that anonymity can be unjust, disempowering, and unnecessary, and can reduce "pride." Without wanting to develop specific recommendations, given the limited scope of our case study, this article uses firsthand experiences to add weight to the broader discussions calling for a critical rethink of REC guidelines. © The Author(s) 2016.
Ethical implications of excessive cluster sizes in cluster randomised trials.
Hemming, Karla; Taljaard, Monica; Forbes, Gordon; Eldridge, Sandra M; Weijer, Charles
2018-02-20
The cluster randomised trial (CRT) is commonly used in healthcare research. It is the gold-standard study design for evaluating healthcare policy interventions. A key characteristic of this design is that as more participants are included, in a fixed number of clusters, the increase in achievable power will level off. CRTs with cluster sizes that exceed the point of levelling-off will have excessive numbers of participants, even if they do not achieve nominal levels of power. Excessively large cluster sizes may have ethical implications due to exposing trial participants unnecessarily to the burdens of both participating in the trial and the potential risks of harm associated with the intervention. We explore these issues through the use of two case studies. Where data are routinely collected, available at minimum cost and the intervention poses low risk, the ethical implications of excessively large cluster sizes are likely to be low (case study 1). However, to maximise the social benefit of the study, identification of excessive cluster sizes can allow for prespecified and fully powered secondary analyses. In the second case study, while there is no burden through trial participation (because the outcome data are routinely collected and non-identifiable), the intervention might be considered to pose some indirect risk to patients and risks to the healthcare workers. In this case study it is therefore important that the inclusion of excessively large cluster sizes is justifiable on other grounds (perhaps to show sustainability). In any randomised controlled trial, including evaluations of health policy interventions, it is important to minimise the burdens and risks to participants. Funders, researchers and research ethics committees should be aware of the ethical issues of excessively large cluster sizes in cluster trials. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Qualitative research ethics on the spot: Not only on the desktop.
Øye, Christine; Sørensen, Nelli Øvre; Glasdam, Stinne
2016-06-01
The increase in medical ethical regulations and bureaucracy handled by institutional review boards and healthcare institutions puts the researchers using qualitative methods in a challenging position. Based on three different cases from three different research studies, the article explores and discusses research ethical dilemmas. First, and especially, the article addresses the challenges for gatekeepers who influence the informant's decisions to participate in research. Second, the article addresses the challenges in following research ethical guidelines related to informed consent and doing no harm. Third, the article argues for the importance of having research ethical guidelines and review boards to question and discuss the possible ethical dilemmas that occur in qualitative research. Research ethics must be understood in qualitative research as relational, situational, and emerging. That is, that focus on ethical issues and dilemmas has to be paid attention on the spot and not only at the desktop. © The Author(s) 2015.
NASA Astrophysics Data System (ADS)
Chang, Pei-Fen; Wang, Dau-Chung
2011-08-01
In May 2008, the worst earthquake in more than three decades struck southwest China, killing more than 80,000 people. The complexity of this earthquake makes it an ideal case study to clarify the intertwined issues of ethics in engineering and to help cultivate critical thinking skills. This paper first explores the need to encourage engineering ethics within a cross-cultural context. Next, it presents a systematic model for designing an engineering ethics curriculum based on moral development theory and ethic dilemma analysis. Quantitative and qualitative data from students' oral and written work were collected and analysed to determine directions for improvement. The paper also presents results of an assessment of this interdisciplinary engineering ethics course. This investigation of a disaster is limited strictly to engineering ethics education; it is not intended to assign blame, but rather to spark debate about ethical issues.
Romain, Frederic; Courtwright, Andrew
2016-09-01
Distrust in the American healthcare system is common among Afro-Caribbeans but the role of this distrust in conflict over life-sustaining treatment is not well described. To identify the ways that distrust manifests in ethics committee consultation for conflict over life-sustaining treatment among Afro-Caribbean patients. This was a retrospective cohort study at a large academic hospital of all ethics committee consultations for life-sustaining treatment among Afro-Caribbean patients and their surrogates. We reviewed medical records and identified cases in which ethics consultants described distrust as playing a role in the conflict over life-sustaining treatment. Of the 169 ethics committee consultation cases for conflict over life-sustaining treatment, 11 (6.5%) involved patients who self-identified as Afro-Caribbean. Distrust played a role in several of these cases, with surrogates of three patients, in particular, illustrating the way that perceived heath disparities, past labelling and concerns about continued maltreatment generated distrust leading to conflict over life-sustaining treatment. Exploring issues of distrust may help ethics consultants identify the source of conflict over life-sustaining treatment among Afro-Caribbean patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
A Case-Study of the Resources and Functioning of Two Research Ethics Committees in Western India.
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.
Finding boundaries inside prison walls: case study of a terminally ill inmate.
O'Connor, Mary-Frances
2004-01-01
The number of terminally ill prison inmates rises each year. Mental health professionals are uniquely prepared to provide therapy during the end-of-life process with their assessment, training, empathy, and communication skills. This case study examines the six-month therapy of one terminally ill inmate, using a client-centered approach. Drawing from existential therapy, the review of meaningful life events in the client's life clarifies current goals and the value of the current final stage of life. Ethical issues that arose are discussed, including pain management and compassionate release. Creative solutions to these ethical dilemmas were implemented through consideration of the overt and underlying goals of the inmate, the necessary rules and protocols of the prison, and in conjunction with professional codes of ethics.
Deep brain stimulation for disorders of consciousness: Systematic review of cases and ethics.
Vanhoecke, Jonathan; Hariz, Marwan
A treatment for patients suffering from prolonged severely altered consciousness is not available. The success of Deep Brain Stimulation (DBS) in diseases such as Parkinson's, dystonia and essential tremor provided a renewed impetus for its application in Disorders of Consciousness (DoC). To evaluate the rationale for DBS in patients with DoC, through systematic review of literature containing clinical data and ethical considerations. Articles from PubMed, Embase, Medline and Web of Science were systematically reviewed. The outcomes of 78 individual patients reported in 19 articles from 1968 onwards were pooled and elements of ethical discussions were compared. There is no clear clinical evidence that DBS is a treatment for DoC that can restore both consciousness and the ability to communicate. In patients who benefitted, the outcome of DBS is often confounded by the time frame of spontaneous recovery from DoC. Difficult ethical considerations remain, such as the risk of increasing self-awareness of own limitations, without improving overall wellbeing, and the issues of proxy consent. DBS is far from being evident as a possible future therapeutic avenue for patients with DoC. Double-blind studies are lacking, and many clinical and ethical issues have to be addressed. In the rare cases when DBS for patients with DoC is considered, this needs to be evaluated meticulously on a case by case basis, with comprehensive overall outcome measures including psychological and quality-of-life assessments, and with the guidance of an ethical and interdisciplinary panel, especially in relation to proxy consent. Copyright © 2017 Elsevier Inc. All rights reserved.
Ethical Responsibility of Governance for Integrating Disaster Risk Reduction with Development
NASA Astrophysics Data System (ADS)
Parkash Gupta, Surya
2015-04-01
The development in the public as well as the private sectors is controlled and regulated, directly or indirectly by the governments at federal, provincial and local levels. If this development goes haphazard and unplanned, without due considerations to environmental constraints and potential hazards; it is likely to cause disasters or may get affected by disasters. Therefore, it becomes an ethical responsibility of the people involved in governance sector to integrate disaster risk reduction with development in their administrative territories through enforcement of appropriate policies, guidelines and regulatory mechanisms. Such mechanisms should address the social, scientific, economic, environmental, and legal requirements that play significant role in planning, implementation of developmental activities as well as disaster management. The paper focuses on defining the ethical responsibilities for the governance sector for integrating disaster risk reduction with development. It highlights the ethical issues with examples from two case studies, one from the Uttarakhand state and the other Odhisa state in India. The case studies illustrates how does it make a difference in disaster risk reduction if the governments own or do not own ethical responsibilities. The paper considers two major disaster events, flash floods in Uttarakhand state and Cyclone Phailin in Odhisa state, that happened during the year 2013. The study points out that it makes a great difference in terms of consequences and response to disasters when ethical responsibilities are owned by the governance sector. The papers attempts to define these ethical responsibilities for integrating disaster risk reduction with development so that the governments can be held accountable for their acts or non-actions.
McIntosh, Scott; Sierra, Essie; Dozier, Ann; Diaz, Sergio; Quiñones, Zahira; Primack, Aron; Chadwick, Gary; Ossip-Klein, Deborah J.
2012-01-01
The current ethical structure for collaborative international health research stems largely from developed countries’ standards of proper ethical practices. The result is that ethical committees in developing countries are required to adhere to standards that might impose practices that conflict with local culture and unintended interpretations of ethics, treatments, and research. This paper presents a case example of a joint international research project that successfully established inclusive ethical review processes as well as other groundwork and components necessary for the conduct of human behavior research and research capacity building in the host country. PMID:18554278
Genetic testing in congenital heart disease: ethical considerations.
Lin, Kimberly Y; D'Alessandro, Lisa C A; Goldmuntz, Elizabeth
2013-01-01
On March 16, 2012, the Ethics of the Heart 2012: Ethical and Policy Challenges in Pediatric and Adult Congenital Heart Disease Conference took place in Philadelphia, Pennsylvania. The first session focused on the ethics surrounding genetic testing in patients with congenital heart disease. Summarized here is the introductory presentation given by Dr Elizabeth Goldmuntz entitled "The Role of Genetic Testing in Congenital Heart Disease," followed by a case presentation given by Dr Lisa D'Alessandro. The case and the panel discussion that ensued highlight several ethical principles and challenges in this unique patient population.
ERIC Educational Resources Information Center
Burger, Kimberly R.
2009-01-01
The purpose of this qualitative case study was to examine the influence of the graduation coach's ethic of care on potential dropouts (at risk high school seniors) in a Georgia alternative high school. Based on Maslow's hierarchy of needs, the objective of this research was to identify if the graduation coach's ethic of care had an influence on…
Ethics On The Fly: Toward A Drone - Specific Code Of Conduct For Law Enforcement
2016-03-01
Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202- 4302, and to the Office of Management and Budget... documentary evidence of ethical frameworks for UAS currently in use by law enforcement. A comparative policy analysis is then performed to identify...Using the case study method, this thesis considered documentary evidence of ethical frameworks for UAS currently in use by law enforcement. A
2001-04-12
as elections or legislation because they hold that only God can legislate . This was seen in the seminal unification communiqué of May, 1994 in which...Kelsay, John. Islam and War: A Study in Comparative Ethics, The Gulf War and Beyond. Louisville, KY: Westminister /John Knox Press, 1993. Khadduri, Majid
ERIC Educational Resources Information Center
Rehman, Rana Rashid; Waheed, Ajmal
2014-01-01
The current research work aims to explore major activities performed by the university students during academic misconducts and their perception regarding such activities. The study further explores the ethical limits drawn by the students about academic dishonesty. Case study methodology is utilized in this research. Sixty-one post graduate and…
Justice or Care? Ethical Reasoning of Preservice Social Studies Teachers
ERIC Educational Resources Information Center
Kohlmeier, Jada; Saye, John W.
2012-01-01
The authors explored the ethical reasoning of 27 preservice teachers in the first course of a 4-course social studies education program. The students discussed 2 historically analogous cases that focused on 1 of 4 value problem areas: consent of the governed, general welfare, property, and morality. The authors were interested in exploring whether…
Democracy, Ethics and Social Justice: Implications for Secondary School Leadership in Kenya
ERIC Educational Resources Information Center
Jwan, Julius O.; Kisaka, Sella T.
2017-01-01
Principals in Kenyan schools are required to adopt democratic school leadership practises as part of the government policy. Adopting an interpretive case study, this paper set out to explore the application of democracy, ethics and social justice in secondary schools in Kenya. The study was in two phases. Phase one: twelve school principals were…
Evidence-based, ethically justified counseling for fetal bilateral renal agenesis
Thomas, Alana N.; McCullough, Laurence B.; Chervenak, Frank A.; Placencia, Frank X.
2017-01-01
Background Not much data are available on the natural history of bilateral renal agenesis, as the medical community does not typically offer aggressive obstetric or neonatal care asbilateral renal agenesis has been accepted as a lethal condition. Aim To provide an evidence-based, ethically justified approach to counseling pregnant women about the obstetric management of bilateral renal agenesis. Study design A systematic literature search was performed using multiple databases. We deploy an ethical analysis of the results of the literature search on the basis of the professional responsibility model of obstetric ethics. Results Eighteen articles met the inclusion criteria for review. With the exception of a single case study using serial amnioinfusion, there has been no other case of survival following dialysis and transplantation documented. Liveborn babies die during the neonatal period. Counseling pregnant women about management of pregnancies complicated by bilateral renal agenesis should be guided by beneficence-based judgment informed by evidence about outcomes. Conclusions Based on the ethical analysis of the results from this review, without experimental obstetric intervention, neonatal mortality rates will continue to be 100%. Serial amnioinfusion therefore should not be offered as treatment, but only as approved innovation or research. PMID:28222038
Barchi, Francis H; Kasimatis-Singleton, Megan; Kasule, Mary; Khulumani, Pilate; Merz, Jon F
2013-02-01
Little empirical data are available on the extent to which capacity-building programs in research ethics prepare trainees to apply ethical reasoning skills to the design, conduct, or review of research. A randomized controlled trial was conducted in Botswana in 2010 to assess the effectiveness of a case-based intervention using email to augment in-person seminars. University faculty and current and prospective IRB/REC members took part in a semester-long training program in research ethics. Participants attended two 2-day seminars and were assigned at random to one of two on-line arms of the trial. Participants in both arms completed on-line international modules from the Collaborative Institutional Training Initiative. Between seminars, intervention-arm participants were also emailed a weekly case to analyze in response to set questions; responses and individualized faculty feedback were exchanged via email. Tests assessing ethics knowledge were administered at the start of each seminar. The post-test included an additional section in which participants were asked to identify the ethical issues highlighted in five case studies from a list of multiple-choice responses. Results were analyzed using regression and ANOVA. Of the 71 participants (36 control, 35 intervention) enrolled at the first seminar, 41 (57.7%) attended the second seminar (19 control, 22 intervention). In the intervention arm, 19 (54.3%) participants fully completed and 8 (22.9%) partially completed all six weekly cases. The mean score was higher on the post-test (30.3/40) than on the pre-test (28.0/40), and individual post- and pre-test scores were highly correlated (r = 0.65, p < 0.0001). Group assignment alone did not have an effect on test scores (p > 0.84), but intervention-arm subjects who completed all assigned cases answered an average of 3.2 more questions correctly on the post-test than others, controlling for pre-test scores (p = 0.003). Completion of the case-based intervention improved respondents' test scores, with those who completed all six email cases scoring roughly 10% better than those who failed to complete this task and those in the control arm. There was only suggestive evidence that intensive case work improved ethical issue identification, although there was limited ability to assess this outcome due to a high drop-out rate.
2013-01-01
Background Little empirical data are available on the extent to which capacity-building programs in research ethics prepare trainees to apply ethical reasoning skills to the design, conduct, or review of research. A randomized controlled trial was conducted in Botswana in 2010 to assess the effectiveness of a case-based intervention using email to augment in-person seminars. Methods University faculty and current and prospective IRB/REC members took part in a semester-long training program in research ethics. Participants attended two 2-day seminars and were assigned at random to one of two on-line arms of the trial. Participants in both arms completed on-line international modules from the Collaborative Institutional Training Initiative. Between seminars, intervention-arm participants were also emailed a weekly case to analyze in response to set questions; responses and individualized faculty feedback were exchanged via email. Tests assessing ethics knowledge were administered at the start of each seminar. The post-test included an additional section in which participants were asked to identify the ethical issues highlighted in five case studies from a list of multiple-choice responses. Results were analyzed using regression and ANOVA. Results Of the 71 participants (36 control, 35 intervention) enrolled at the first seminar, 41 (57.7%) attended the second seminar (19 control, 22 intervention). In the intervention arm, 19 (54.3%) participants fully completed and 8 (22.9%) partially completed all six weekly cases. The mean score was higher on the post-test (30.3/40) than on the pre-test (28.0/40), and individual post- and pre-test scores were highly correlated (r = 0.65, p < 0.0001). Group assignment alone did not have an effect on test scores (p > 0.84), but intervention-arm subjects who completed all assigned cases answered an average of 3.2 more questions correctly on the post-test than others, controlling for pre-test scores (p = 0.003). Conclusions Completion of the case-based intervention improved respondents’ test scores, with those who completed all six email cases scoring roughly 10% better than those who failed to complete this task and those in the control arm. There was only suggestive evidence that intensive case work improved ethical issue identification, although there was limited ability to assess this outcome due to a high drop-out rate. PMID:23368699
Linking Ethics and Language in the Technical Communication Classroom.
ERIC Educational Resources Information Center
Sims, Brenda R.
1993-01-01
Discusses research on ethics and technical communication and examines specific methods that writers may use to manipulate language and to present information unethically. Suggests questions designed to teach students how to analyze situations that may involve such manipulation and misrepresentation. Concludes with two case studies illustrating…
Evaluating the ethical acceptability of animal research.
Bout, Henriëtte J; Fentener van Vlissingen, J Martje; Karssing, Edgar D
2014-11-01
The ethical acceptability of animal research is typically evaluated on a case-by-case basis. Legislation such as Directive 2010/63/EU on the protection of animals used for scientific purposes provides guidance for ethical evaluation of animal use proposals but does not dictate the outcome, leaving this determination to the ethical review committees of individual institutions. The authors assess different ethics models and how these are reflected in the guidelines of Directive 2010/63/EU. They also describe a matrix for carrying out harm-benefit analyses of animal use proposals, which they identified by examining the practices of three ethical review committees in the Netherlands. Finally, they discuss how this matrix can be applied by ethical review committees at other institutions.
Overview of psychiatric ethics IV: the method of casuistry.
Robertson, Michael; Ryan, Christopher; Walter, Garry
2007-08-01
The aim of this paper is to describe the method of ethical analysis known as casuistry and consider its merits as a basis of ethical deliberation in psychiatry. Casuistry approximates the legal arguments of common law. It examines ethical dilemmas by adopting a taxonomic approach to 'paradigm' cases, using a technique akin to that of normative analogical reasoning. Casuistry offers a useful method in ethical reasoning through providing a practical means of evaluating the merits of a particular course of action in a particular clinical situation. As a method ethical moral reasoning in psychiatry, casuistry suffers from a paucity of paradigm cases and its failure to fully contextualize ethical dilemmas by relying on common morality theory as its basis.
Clarinval, Caroline; Biller-Andorno, Nikola
2014-06-23
This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context.
Case Study in Ethics of Research: The Bucharest Early Intervention Project
Zeanah, Charles H.; Fox, Nathan A.; Nelson, Charles A.
2014-01-01
The Bucharest Early Intervention Project is the first ever randomized controlled trial of foster care as an alternative to institutional care for young abandoned children. This paper examines ethical issues in the conceptualization and implementation of the study, which involved American investigators conducting research in another country, as well as vulnerable participants. We organize discussion of ethical questions about the study around several key issues. These include the nature and location of the vulnerable study population, the social value of conducting the study, risks and benefits of participating in the study to participants, and the post-trial obligations of the investigators. In discussing how these questions were addressed as the study was designed and after it was initiated, we describe our attempts to wed sound scientific practices with meaningful ethical protections for participants. PMID:22373763
5 CFR 2638.504 - Director's finding.
Code of Federal Regulations, 2010 CFR
2010-01-01
... facts upon which the finding is based and a reference to the specific ethics provision in issue. A copy....504 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS OFFICE OF GOVERNMENT ETHICS AND EXECUTIVE AGENCY ETHICS PROGRAM RESPONSIBILITIES Corrective and Remedial Action in Cases Involving...
Increasing Effectiveness in Teaching Ethics to Undergraduate Business Students.
ERIC Educational Resources Information Center
Lampe, Marc
1997-01-01
Traditional approaches to teaching business ethics (philosophical analysis, moral quandaries, executive cases) may not be effective in persuading undergraduates of the importance of ethical behavior. Better techniques include values education, ethical decision-making models, analysis of ethical conflicts, and role modeling. (SK)
An Analysis of Ethical Issues in Governmental Communication.
ERIC Educational Resources Information Center
Turner, John R.
A research review examined the ethical responsibilities of a communicator in contemporary American society, particularly in governmental communication. Various scholars have suggested standards of ethical governmental communication and have questioned the ethics of governmental officials in several cases. Ethical analysis of President Ronald…
Engineering ethics in Puerto Rico: issues and narratives.
Frey, William J; O'Neill-Carrillo, Efraín
2008-09-01
This essay discusses engineering ethics in Puerto Rico by examining the impact of the Colegio de Ingenieros y Agrimensores de Puerto Rico (CIAPR) and by outlining the constellation of problems and issues identified in workshops and retreats held with Puerto Rican engineers. Three cases developed and discussed in these workshops will help outline movements in engineering ethics beyond the compliance perspective of the CIAPR. These include the Town Z case, Copper Mining in Puerto Rico, and a hypothetical case researched by UPRM students on laptop disposal. The last section outlines four future challenges in engineering ethics pertinent to the Puerto Rican situation.
Everyday ethics issues in the outpatient clinical practice of pediatric residents.
Moon, Margaret; Taylor, Holly A; McDonald, Erin L; Hughes, Mark T; Carrese, Joseph A
2009-09-01
To describe the ethics issues that pediatric residents encounter during routine care in an outpatient teaching clinic. Qualitative study including in-depth interviews with pediatric residents and direct observation of interactions between preceptors and residents in a pediatric teaching clinic. The Johns Hopkins Harriet Lane Pediatric Primary Care Clinic, March 20 through April 11, 2006. A convenience sample including all pediatric faculty preceptors supervising at the clinic during the 19 half-day sessions that occurred during the observation period (N = 15) and the pediatric residents seeing patients during these clinic sessions (N = 50). Main Outcome Measure Field notes of preceptor-resident discussions about patient care were made and transcribed for qualitative analysis. Qualitative analysis of the ethics content of cases presented by residents in this pediatric teaching clinic identified 5 themes for categorizing ethics challenges: (1) promoting the child's best interests in complex and resource-poor home and social settings; (2) managing the therapeutic alliance with parents and caregivers; (3) protecting patient privacy and confidentiality; (4) balancing the dual roles of learner and health care provider; and (5) using professional authority appropriately. Qualitative analysis of the ethics content of directly observed preceptor-resident case discussions yielded a set of themes describing the ethics challenges facing pediatric residents. The themes are somewhat different from the lists of residents' ethics experiences developed using recall or survey methods and may be very different from the ideas usually included in hospital-based ethics discussions. This may have implications for improving ethics education during residency training.
Citizen Science on Your Smartphone: An ELSI Research Agenda.
Rothstein, Mark A; Wilbanks, John T; Brothers, Kyle B
2015-01-01
The prospect of newly-emerging, technology-enabled, unregulated citizen science health research poses a substantial challenge for traditional research ethics. Unquestionably, a significant amount of research ethics study is needed to prepare for the inevitable, widespread introduction of citizen science health research. Using the case study of mobile health (mHealth) research, this article provides an ethical, legal, and social implications (ELSI) research agenda for citizen science health research conducted outside conventional research institutions. The issues for detailed analysis include the role of IRBs, recruitment, inclusion and exclusion criteria, informed consent, confidentiality and security, vulnerable participants, incidental findings, and publication and data sharing. © 2015 American Society of Law, Medicine & Ethics, Inc.
Understanding bureaucracy in health science ethics: toward a better institutional review board.
Bozeman, Barry; Slade, Catherine; Hirsch, Paul
2009-09-01
Research involving human participants continues to grow dramatically, fueled by advances in medical technology, globalization of research, and financial and professional incentives. This creates increasing opportunities for ethical errors with devastating effects. The typical professional and policy response to calamities involving human participants in research is to layer on more ethical guidelines or strictures. We used a recent case-the Johns Hopkins University/Kennedy Kreiger Institute Lead Paint Study-to examine lessons learned since the Tuskegee Syphilis Study about the role of institutionalized science ethics in the protection of human participants in research. We address the role of the institutional review board as the focal point for policy attention.
Learning for Oneself: A Confucian-Inspired Case for Moral Formation in Ethics Pedagogy
ERIC Educational Resources Information Center
Duperon, Matthew
2018-01-01
This article explores the disconnection between ethical theory and ethical practice in ethics courses at secular U.S. colleges and universities. In such contexts academic ethics focuses almost exclusively on "ethical reasoning" and leaves the business of practical moral formation of students in the realm of "student life." I…
ERIC Educational Resources Information Center
Allen, Bruce C.; Herreid, Clyde Freeman
1998-01-01
Presents a conflict scenario for a case study on whether there is evidence of past life on Mars. Includes details about the use of this case study in developing an interdisciplinary approach to scientific ethics. (DDR)
Students' medical ethics rounds: a combinatorial program for medical ethics education.
Beigy, Maani; Pishgahi, Ghasem; Moghaddas, Fateme; Maghbouli, Nastaran; Shirbache, Kamran; Asghari, Fariba; Abolfat-H Zadeh, Navid
2016-01-01
It has long been a common goal for both medical educators and ethicists to develop effective methods or programs for medical ethics education. The current lecture-based courses of medical ethics programs in medical schools are demonstrated as insufficient models for training "good doctors''. In this study, we introduce an innovative program for medical ethics education in an extra-curricular student-based design named Students' Medical Ethics Rounds (SMER). In SMER, a combination of educational methods, including theater-based case presentation, large group discussion, expert opinions, role playing and role modeling were employed. The pretest-posttest experimental design was used to assess the impact of interventions on the participants' knowledge and attitude regarding selected ethical topics. A total of 335 students participated in this study and 86.57% of them filled the pretest and posttest forms. We observed significant improvements in the knowledge (P < 0.0500) and attitude (P < 0.0001) of participants. Interestingly, 89.8% of participants declared that their confidence regarding how to deal with the ethical problems outlined in the sessions was increased. All of the applied educational methods were reported as helpful. We found that SMER might be an effective method of teaching medical ethics. We highly recommend the investigation of the advantages of SMER in larger studies and interdisciplinary settings.
Students’ medical ethics rounds: a combinatorial program for medical ethics education
Beigy, Maani; Pishgahi, Ghasem; Moghaddas, Fateme; Maghbouli, Nastaran; Shirbache, Kamran; Asghari, Fariba; Abolfat-h Zadeh, Navid
2016-01-01
It has long been a common goal for both medical educators and ethicists to develop effective methods or programs for medical ethics education. The current lecture-based courses of medical ethics programs in medical schools are demonstrated as insufficient models for training “good doctors’’. In this study, we introduce an innovative program for medical ethics education in an extra-curricular student-based design named Students’ Medical Ethics Rounds (SMER). In SMER, a combination of educational methods, including theater-based case presentation, large group discussion, expert opinions, role playing and role modeling were employed. The pretest-posttest experimental design was used to assess the impact of interventions on the participants’ knowledge and attitude regarding selected ethical topics. A total of 335 students participated in this study and 86.57% of them filled the pretest and posttest forms. We observed significant improvements in the knowledge (P < 0.0500) and attitude (P < 0.0001) of participants. Interestingly, 89.8% of participants declared that their confidence regarding how to deal with the ethical problems outlined in the sessions was increased. All of the applied educational methods were reported as helpful. We found that SMER might be an effective method of teaching medical ethics. We highly recommend the investigation of the advantages of SMER in larger studies and interdisciplinary settings. PMID:27471586
Measuring Quality in Ethics Consultation.
Bliss, Sally E; Oppenlander, Jane; Dahlke, Jacob M; Meyer, Gordon J; Williford, Eva M; Macauley, Robert C
2016-01-01
For all of the emphasis on quality improvement-as well as the acknowledged overlap between assessment of the quality of healthcare services and clinical ethics-the quality of clinical ethics consultation has received scant attention, especially in terms of empirical measurement. Recognizing this need, the second edition of Core Competencies for Health Care Ethics Consultation1 identified four domains of ethics quality: (1) ethicality, (2) stakeholders' satisfaction, (3) resolution of the presenting conflict/dilemma, and (4) education that translates into knowledge. This study is the first, to our knowledge, to directly measure all of these domains. Here we describe the quality improvement process undertaken at a tertiary care academic medical center, as well as the tools developed to measure the quality of ethics consultation, which include post-consultation satisfaction surveys and weekly case conferences. The information gained through these tools helps to improve not only the process of ethics consultation, but also the measurement and assurance of quality. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.
Clark, Phillip G; Cott, Cheryl; Drinka, Theresa J K
2007-12-01
Interprofessional teamwork is an essential and expanding form of health care practice. While moral issues arising in teamwork relative to the patient have been explored, the analysis of ethical issues regarding the function of the team itself is limited. This paper develops a conceptual framework for organizing and analyzing the different types of ethical issues in interprofessional teamwork. This framework is a matrix that maps the elements of principles, structures, and processes against individual, team, and organizational levels. A case study is presented that illustrates different dimensions of these topics, based on the application of this framework. Finally, a set of conclusions and recommendations is presented to summarize the integration of theory and practice in interprofessional ethics, including: (i) importance of a framework, (ii) interprofessional ethics discourse, and (iii) interprofessional ethics as an emerging field. The goal of this paper is to begin a dialogue and discussion on the ethical issues confronting interprofessional teams and to lay the foundation for an expanding discourse on interprofessional ethics.
Avoiding evasion: medical ethics education and emotion theory.
Leget, C
2004-10-01
Beginning with an exemplary case study, this paper diagnoses and analyses some important strategies of evasion and factors of hindrance that are met in the teaching of medical ethics to undergraduate medical students. Some of these inhibitions are inherent to ethical theories; others are connected with the nature of medicine or cultural trends. It is argued that in order to avoid an attitude of evasion in medical ethics teaching, a philosophical theory of emotions is needed that is able to clarify on a conceptual level the ethical importance of emotions. An approach is proposed with the help of the emotion theory Martha Nussbaum works out in her book Upheavals of thought. The paper ends with some practical recommendations.
Herkert, Joseph R
2005-07-01
Engineering ethics entails three frames of reference: individual, professional, and social. "Microethics" considers individuals and internal relations of the engineering profession; "macroethics" applies to the collective social responsibility of the profession and to societal decisions about technology. Most research and teaching in engineering ethics, including online resources, has had a "micro" focus. Mechanisms for incorporating macroethical perspectives include: integrating engineering ethics and science, technology and society (STS); closer integration of engineering ethics and computer ethics; and consideration of the influence of professional engineering societies and corporate social responsibility programs on ethical engineering practice. Integrating macroethical issues and concerns in engineering ethics involves broadening the context of ethical problem solving. This in turn implies: developing courses emphasizing both micro and macro perspectives, providing faculty development that includes training in both STS and practical ethics; and revision of curriculum materials, including online resources. Multidisciplinary collaboration is recommended 1) to create online case studies emphasizing ethical decision making in individual, professional, and societal contexts; 2) to leverage existing online computer ethics resources with relevance to engineering education and practice; and 3) to create transparent linkages between public policy positions advocated by professional societies and codes of ethics.
The Development of a Humanitarian Health Ethics Analysis Tool.
Fraser, Veronique; Hunt, Matthew R; de Laat, Sonya; Schwartz, Lisa
2015-08-01
Introduction Health care workers (HCWs) who participate in humanitarian aid work experience a range of ethical challenges in providing care and assistance to communities affected by war, disaster, or extreme poverty. Although there is increasing discussion of ethics in humanitarian health care practice and policy, there are very few resources available for humanitarian workers seeking ethical guidance in the field. To address this knowledge gap, a Humanitarian Health Ethics Analysis Tool (HHEAT) was developed and tested as an action-oriented resource to support humanitarian workers in ethical decision making. While ethical analysis tools increasingly have become prevalent in a variety of practice contexts over the past two decades, very few of these tools have undergone a process of empirical validation to assess their usefulness for practitioners. A qualitative study consisting of a series of six case-analysis sessions with 16 humanitarian HCWs was conducted to evaluate and refine the HHEAT. Participant feedback inspired the creation of a simplified and shortened version of the tool and prompted the development of an accompanying handbook. The study generated preliminary insight into the ethical deliberation processes of humanitarian health workers and highlighted different types of ethics support that humanitarian workers might find helpful in supporting the decision-making process.
MOMENTS OF UNCERTAINTY: ETHICAL CONSIDERATIONS AND EMERGING CONTAMINANTS
Cordner, Alissa; Brown, Phil
2013-01-01
Science on emerging environmental health threats involves numerous ethical concerns related to scientific uncertainty about conducting, interpreting, communicating, and acting upon research findings, but the connections between ethical decision making and scientific uncertainty are under-studied in sociology. Under conditions of scientific uncertainty, researcher conduct is not fully prescribed by formal ethical codes of conduct, increasing the importance of ethical reflection by researchers, conflicts over research conduct, and reliance on informal ethical standards. This paper draws on in-depth interviews with scientists, regulators, activists, industry representatives, and fire safety experts to explore ethical considerations of moments of uncertainty using a case study of flame retardants, chemicals widely used in consumer products with potential negative health and environmental impacts. We focus on the uncertainty that arises in measuring people’s exposure to these chemicals through testing of their personal environments or bodies. We identify four sources of ethical concerns relevant to scientific uncertainty: 1) choosing research questions or methods, 2) interpreting scientific results, 3) communicating results to multiple publics, and 4) applying results for policy-making. This research offers lessons about professional conduct under conditions of uncertainty, ethical research practice, democratization of scientific knowledge, and science’s impact on policy. PMID:24249964
Mercer, Tony
2013-01-01
This paper begins by examining the ethical issues in public health and attempts to resolve them. It then considers three different paradigms responding to heroin addiction and their underlying moral philosophy. Firstly it examines prohibition and abstinence only treatment as an example of deontological ethics and harm reduction approaches as an example of a utilitarian ethics. Policy and practice problems resulting from weaknesses in the underlying philosophies are examined along with the futile debate between abstinence only and harm reduction approaches. A third paradigm, 'recovery' is examined as an example of Aristotelian virtue ethics. The paper concludes by considering the wider implications of this case study in terms of the need for further bioethical enquiry in public health and proposes virtue ethics as a paradigm within which ethical issues can be identified and debated.
Making an Ethical Decision: A Utilitarian Strategy.
ERIC Educational Resources Information Center
Price, Sandra J.
1992-01-01
By identifying and weighing the effects of an act on each constituency, a matrix based on John Stuart Mill's theories of utilitarianism illuminates and helps resolve complex ethical dilemmas. Application of the approach is illustrated with a simulated case study concerning the issue of reputation in a small private college. (Author/MSE)
Cheating, Ethics and the Student of Professional Psychology: A Case Study.
ERIC Educational Resources Information Center
Rubin, Simon Shimshon
Although cheating is reportedly endemic in colleges, the honor system is believed to have reduced its incidence. Cheating in a graduate, clinical psychology training program touches serious fundamental issues with academic, ethical, intrapersonal, interpersonal, and professional implications. The responsibility of the teacher is to respond…
Fulfilling an Ethical Obligation: An Educative Research Assistantship
ERIC Educational Resources Information Center
McGinn, Michelle K.; Niemczyk, Ewelina K.; Saudelli, Mary Gene
2013-01-01
Scant research evidence is available about the day-to-day workings of research assistantships or the educational possibilities they provide for research assistants and their academic supervisors. This case study documents the equitable, educative, and ethical nature of one research assistantship at a Canadian university. Data sources include audio…
Suguitan, G; Arakama, M-H I; Danguilan, R
2017-03-01
In the latter part of 2009, the Department of Health of the Philippines prohibited kidney transplantation with non-related kidney donors. Hence, the National Kidney and Transplant Institute created a Hospital Transplant Ethics Committee. This study describes directed non-related kidney donation at the National Kidney and Transplant Institute. This retrospective study reviewed the profiles of recipients and directed living non-related kidney transplant donors submitted to the Hospital Transplant Ethics Committee. A total 74 recipients and donors were reviewed by the Hospital Transplant Ethics Committee in 2014. Donors initiated the talks about being a donor (75%) to repay the good deeds that were done by the recipient for them or their families; examples of which are: sometime in their lives they needed financial assistance for hospitalization for their relatives and it was the patient who paid the hospital bill; or because they pitied the recipient, whom they found to be a good person, thus they would want to give one of their kidneys. Seventy-four (100%) said that they were not expecting anything in return for this act but wanted to be of help to the recipient. Of these 74 cases, 70 cases (95%) were approved and the others were disapproved. With a Hospital Transplant Ethics Committee in place, directed kidney donation is a valuable tool as an additional source of kidney donor without violating any ethical issues. Copyright © 2016. Published by Elsevier Inc.
ERIC Educational Resources Information Center
Guclu, Timur
2013-01-01
This study has two main areas: first, the study evaluates whether the ethical leadership style of a direct supervisor has an impact on the police officers' perception of the integrity violations; second, the study scrutinizes whether police officers' moral judgment of integrity violations makes a difference in the amount of such violations. The…
Malone, Ruth E; Yerger, Valerie B; McGruder, Carol; Froelicher, Erika
2006-11-01
Community-based participatory research (CBPR) addresses the social justice dimensions of health disparities by engaging marginalized communities, building capacity for action, and encouraging more egalitarian relationships between researchers and communities. CBPR may challenge institutionalized academic practices and the understandings that inform institutional review board deliberations and, indirectly, prioritize particular kinds of research. We present our attempt to study, as part of a CBPR partnership, cigarette sales practices in an inner-city community. We use critical and communitarian perspectives to examine the implications of the refusal of the university institutional review board (in this case, the University of California, San Francisco) to approve the study. CBPR requires expanding ethical discourse beyond the procedural, principle-based approaches common in biomedical research settings. The current ethics culture of academia may sometimes serve to protect institutional power at the expense of community empowerment.
A taste of ethical consumption at a slow food festival.
Williams, Lauren T; Germov, John; Fuller, Sascha; Freij, Maria
2015-08-01
This paper examines the motives and experiences of attendees at a Slow Food festival to gain an understanding of how people engage with ethical consumer projects. Slow Food is a global social movement aimed at promoting food that is regionally, ethically, and sustainably produced, and convivially consumed. The movement uses culinary tourist events, such as food festivals and farmers' markets, to promote its philosophy and attract new members. There have been no empirical studies of ethical consumption using a Slow Food event as a case study. This study uses an ethnographic approach and a framework of virtue ethics to explore the views of people attending a major Slow Food festival in the city of Melbourne, Australia. Semi-structured interviews were conducted in situ with 33 participants (19 consumers and 14 stallholders) to discover their rationales for attending the festival, and their perspectives on ethical consumption. Transcripts were coded and thematically analysed, resulting in three themes reflecting varying degrees of public virtues (altruistic motivations) and private virtues (personal wellbeing): the quest for virtuous lifestyles through ethical consumption, the importance of co-production, and the challenges of putting ethical consumer projects like Slow Food into daily practice. The findings reveal the manner in which virtue ethics affects foodways and highlights the contingent and challenging nature of practising ethical eating. Copyright © 2015 Elsevier Ltd. All rights reserved.
Esquerda, Montse; Pifarré, Josep; Roig, Helena; Busquets, Ester; Yuguero, Oriol; Viñas, Joan
2018-04-04
In the last decades, bioethics has been incorporated into the academic training of the Medical Schools. Some studies analyze the ethical-moral development of medical students and the effect of ethical education in other countries. This evaluation is done by measuring Kohlberg's moral reasoning (virtuous doctors), or ethical sensitivity to resolve clinical cases (physicians with ethical skills). The following study is proposed to assess the impact of bioethics training on these two variables, in Spanish medical students. Observational cross-sectional study. SITE: Faculty of Medicine, University of Lleida. 175 students from third year of medicine (78 before bioethics and 97 after bioethics, in different courses) were conducted. Bioethics course. A socio-demographic questionnaire, the Rest Defining Issue test scale, and Problem Identification Test with clinical vignettes were administered. A consistent and significant correlation has been found between moral reasoning and ethical sensitivity. Women presented greater post-conventional reasoning. There were no changes in Kohlberg's stage of global moral reasoning with ethical training. There were changes in ethical sensitivity with bioethical training, with a significantly and globally improvement. In our study, training in bioethics does not improve moral development but rather the ethical problem solving skills. It is asked if this improvement is enough to train doctors prepared for the new challenges. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.
Nalette, Ernest
2010-06-01
Constrained practice is routinely encountered by physical therapists and may limit the physical therapist's primary moral responsibility-which is to help the patient to become well again. Ethical practice under such conditions requires a certain moral character of the practitioner. The purposes of this article are: (1) to provide an ethical analysis of a typical patient case of constrained clinical practice, (2) to discuss the moral implications of constrained clinical practice, and (3) to identify key moral principles and virtues fostering ethical physical therapist practice. The case represents a common scenario of discharge planning in acute care health facilities in the northeastern United States. An applied ethics approach was used for case analysis. The decision following analysis of the dilemma was to provide the needed care to the patient as required by compassion, professional ethical standards, and organizational mission. Constrained clinical practice creates a moral dilemma for physical therapists. Being responsive to the patient's needs moves the physical therapist's practice toward the professional ideal of helping vulnerable patients become well again. Meeting the patient's needs is a professional requirement of the physical therapist as moral agent. Acting otherwise requires an alternative position be ethically justified based on systematic analysis of a particular case. Skepticism of status quo practices is required to modify conventional individual, organizational, and societal practices toward meeting the patient's best interest.
Samuel, Gabrielle; Cribb, Alan; Owens, John; Williams, Clare
2016-09-01
In this paper we contribute to "sociology in bioethics" and help clarify the range of ways sociological work can contribute to ethics scholarship. We do this using a case study of an innovative neurotechnology, functional magnetic resonance imaging, and its use to attempt to diagnose and communicate with severely brain-injured patients. We compare empirical data from interviews with relatives of patients who have a severe brain injury with perspectives from mainstream bioethics scholars. We use the notion of an "ethical landscape" as an analogy for the different ethical positions subjects can take-whereby a person's position relative to the landscape makes a difference to the way they experience and interact with it. We show that, in comparison to studying abstract ethics "from above" the ethical landscape, which involves universal generalizations and global judgements, studying ethics empirically "from the ground," within the ethical landscape foregrounds a more plural and differentiated picture. We argue it is important not to treat empirical ethics as secondary to abstract ethics, to treat on-the-ground perspectives as useful only insofar as they can inform ethics from above. Rather, empirical perspectives can illuminate the plural vantage points in ethical judgments, highlight the "lived" nature of ethical reasoning, and point to all ethical vantage points as being significant. This is of epistemic importance to normative ethics, since researchers who pay attention to the various positions in and trajectories through the ethical landscape are unlikely to think about ethics in terms of abstract agency-as can happen with top-down ethics-or to elide agency with the agency of policymakers. Moreover, empirical perspectives may have transformative implications for people on the ground, especially where focus on the potential harms and benefits they face brings their experiences and interests to the forefront of ethical and policy discussion.
I Know What Not to Do. Now What? Rethinking Business Ethics Education
ERIC Educational Resources Information Center
Johnson, Ryan; Swicegood, Philip; Williams, Nancy
2013-01-01
Most business ethics classes are supplemented with cases, the majority of which have a negative orientation. We empirically measure the preponderance of negative-oriented cases found in the top selling textbooks used in many business ethics courses. However, neuroscience research indicates that a negative orientation is less effective than a…
[Ethical case discussions in the intensive care unit : from testing to routine].
Meyer-Zehnder, B; Barandun Schäfer, U; Albisser Schleger, H; Reiter-Theil, S; Pargger, H
2014-06-01
The daily work of many healthcare professionals has become more complex and demanding in recent years. Apart from purely medical issues, ethical questions and problems arise quite often. Managing these problems requires ethical knowledge. Questions about the usefulness of a therapy and treatment occur especially at the end of life. So-called medical futility, a useless futile therapy, is often perceived by nurses and physicians in intensive care units who themselves often develop symptoms of depression or burnout. The clinical ethical model METAP (acronym from module, ethics, therapy decision, allocation and process) provides methods and criteria that allow the clinical team to treat and solve ethical issues according to a solution-oriented approach. The ethical decision-making of this model addresses these issues according to a series of sequential stages in the form of a so-called escalation model. When it is not possible to tackle and solve an ethical problem or dilemma in one stage, one moves to the next. The implementation of this approach in everyday practice requires the commitment of all team members in addition to certain basic conditions. In a surgical intensive care unit a fixed date in the schedule is reserved for ethical case discussions (level 3 of the escalation model). At this level a team member who has been specified according to a quarterly plan is responsible for the organization and performance of the discussion. All protocols of the 44 ethical case discussions in 41 patients between January 2011 and July 2012 were collected and summarized. A short questionnaire to all participants recorded their assessment of the benefits for the patient and the team as well as their perception of personal stress reduction. Also queried was the impact of this method on the collaboration between nurses and physicians and the ethical competence. Ethical case discussions among the care team took place regularly (44 case discussions between January 2011 and June 2012). The duration of these discussions ranged from 30 to 60 min. On average 6.2 persons took part, including 2.7 nurses and 3.2 physicians. Of the 41 patients (16 female, 25 male) for whom a discussion was carried out, 23 died during the continued hospital stay. The respondents (response rate 52 %) assessed the benefit for patients and team as high (slightly higher benefit for physicians than nurses) and 55 % of physicians and 71 % of nurses perceived a reduction in the burden of decision-making in difficult cases due to the case discussions. All physicians and 66 % of the nurses reported an improvement in the cooperation between the professional groups and 80 % of the nurses and more than half of the physicians noticed an increase in their own ethical competence. A methodically structured ethical decision-making process can and should be integrated into the clinical routine. This process requires a fixed place in everyday practice and the defined responsibility for the actual organization and performance. Support by medical and nursing management personnel is also essential for the implementation. The regular occurrence of ethical case discussions among the care team relieves the participants and improves collaboration between nurses and physicians.
Fazly Bazzaz, Bibi Seddigheh; Sadeghi, Ramin
2012-09-01
Ethical misconduct is not a new issue in the history of science and literature. However, ethical misconducts in science have grown considerably in the modern era which is due to emphasis on the scientific proliferation in research institutes and gauging scientists according to their publications. In the current case series, several misconducts occurring over the previous years in Mashhad University of Medical Sciences (Mashhad, Iran) either for Journals or Faculty members were gathered and specific recommendations were provided to avoid similar events in the future. All recommendations are according to Committee on Publication Ethics (COPE).
Cultural diversity and the case against ethical relativism.
Brannigan, M
2000-01-01
The movement to respect cultural diversity, known as multiculturalism, poses a daunting challenge to healthcare ethics. Can we construct a defensible passage from the fact of cultural differences to any claims regarding morality? Or does multiculturalism lead to ethical relativism? Macklin argues that, in view of a leading distinction between universalism in ethics and moral absolutism, the only reasonable passage avoids both absolutism and relativism. She presents a strong case against ethical relativism and its pernicious consequences for cross-cultural issues in healthcare. She also provides sound criteria for the assessment of a culture's moral progress.
ERIC Educational Resources Information Center
Research for Better Schools, Inc., Philadelphia, PA.
Recognizing that similar approaches to moral education operate differently in different school settings, this paper assesses the methods and impact of a moral education course (Skills for Ethical Action, SEA) in six junior high school settings. SEA is an instructional program designed to teach seventh, eighth, and ninth grade students a…
Engaging the Bible in GCSE and A Level Religious Studies: Environmental Stewardship as a Test Case
ERIC Educational Resources Information Center
Horrell, David G.; Davis, Anna
2014-01-01
This article explores the potential for critical and informed engagement with biblical texts to form a key element of the study of Christian perspectives on ethical issues at GCSE and A level. Given the current dominance of philosophical and ethical topics, and weaknesses in the engagement with biblical texts within existing curriculum materials,…
The ethics of donor human milk banking.
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.
Clarinval, Caroline; Biller-Andorno, Nikola
2014-01-01
Introduction: This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Methods: Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. Discussion: These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. Conclusion: This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context. PMID:24987575
The Ethics of School Administration.
ERIC Educational Resources Information Center
Strike, Kenneth A.; And Others
This is the first book in the Teachers College Press series, Professional Ethics in Education, which is devoted to the examination of ethical issues in all educational settings. The book's purpose is to teach a range of ethical concepts and the process of ethical reasoning to educational administrators. Organized around cases, each chapter begins…
School Board Ethics: On Thin Ice?
ERIC Educational Resources Information Center
Natale, Jo Anna
1990-01-01
Cites cases of ethical violations, such as patronage and nepotism in hiring practices, in some school districts. Advises school board members to review their personal and professional ethics and to consider measures that will help guide decisions when ethical dilemmas arise. Formal ethics training is recommended for all educators. (MLF)
Exploring the Ethics of Observational Research: The Case of an HIV Study in Tanzania
Norris, Alison; Jackson, Ashley; Khoshnood, Kaveh
2013-01-01
Background Observational studies have generally been viewed as incurring minimal risk to participants, resulting in fewer ethical obligations for investigators than intervention studies. In 2004, the lead author (AN) carried out an observational study measuring sexual behavior and the prevalence of HIV, syphilis, and herpes simplex virus type 2 (HSV-2), among Tanzanian agricultural plantation residents (results reported elsewhere). This article uses an ethical lens to consider the consequences of the observational study and explore what, if any, effects it had on participants and their community. Methods Using a case study approach, we critically examine three core principles of research ethics—respect for persons/autonomy; beneficence/nonmaleficence; and distributive justice—as manifested in the 2004 observational study. We base our findings on three sources: discussions with plantation residents following presentations of observational research findings; in-depth interviews with key informants; and researcher observations. Results The observational research team was found to have ensured confidentiality and noncoercive recruitment. Ironically, maintenance of confidentiality and voluntary participation led some participants to doubt study results. Receiving HIV test results was important for participants and contributed to changing community norms about HIV testing. Conclusions Observational studies may act like de facto intervention studies and thus incur obligations similar to those of intervention studies. We found that ensuring respect for persons may have compromised the principles of beneficence and distributive justice. While in theory these three ethical principles have equal moral force, in practice, researchers may have to prioritize one over the others. Careful community engagement is necessary to promote well-considered ethical decisions. PMID:24069546
Schuman, N J; Turner, J E
1997-01-01
Chairside dental ethics necessitates special consideration by the faculty member-dentist, the dental student, and the patient. The patient must always be aware of treatment options, in addition to learning the health status of the oral hard and soft tissues, costs, and time to be involved to accomplish proposed treatment. What may seem like a burden to an individual practitioner is actually only the necessities incurred by any self governing profession. Fifty-two consecutive dental patients had their cases reviewed for the ethical behavior of the dentist-practitioner, student, and patient. Categories reviewed were informed consent (100%), agreement, compromise, economic issues, conflict, and institutional issues. The results were: 1. Agreement: 17 cases, 2. Compromise: 21 cases, 3. Economic Issues: 4 cases, 4. Conflict: 6 cases, and 5. Institutional Issues: 4 cases. Fourteen percent of all patients were minors. Ninety percent of the patients were treated. Of those 10% not treated, five percent were for medical reasons, and five percent of the patients refused treatment. These results were placed in the Ozar Model 9 and were categorized as follows: 1. Appropriate pain free oral function: 22 cases, 2. Patient Autonomy: 14 cases, 3. Life and health: 9 cases, 4. Preferred practice values: 6 cases, and 5. Other external considerations: 1 case. This template demonstrated appropriate ethical behavior on the part of dentists, students, and patients, especially with a 90% treatment group, and only 5% refusing treatment. The 52 consecutive patients were characteristic of the University of Tennessee's overall patient pool. No identifiable differences were found between patients regardless of gender, age, or race.
Ethics Committee Consultation and Extracorporeal Membrane Oxygenation.
Courtwright, Andrew M; Robinson, Ellen M; Feins, Katelyn; Carr-Loveland, Jennifer; Donahue, Vivian; Roy, Nathalie; McCannon, Jessica
2016-09-01
The clinical ethics literature on extracorporeal membrane oxygenation (ECMO) has been focused primarily on identifying hypothetical ethical dilemmas that may arise with the use of this technology. Little has been written on the actual experience with ECMO-related ethical questions. To describe the role of an ethics consultation service during the expansion of a single-center ECMO program in a cardiothoracic surgery intensive care unit (CSICU) and to identify common ethical themes surrounding the use of ECMO. We conducted a retrospective, descriptive cohort study of all ECMO ethics consultation cases in the CSICU at a large academic hospital between 2013 and 2015. During the study period, 113 patients were placed on ECMO in the CSICU, 45 (39.5%) of whom were seen by the ethics committee. In 2013, 10 of 46 (21.7%) patients received ethics consults. By 2015, 28 of 30 (93.3%) of patients were seen by ethics consultants. Initial consultation occurred at a median of 2 days (interquartile range, 1-6 d) following initiation of ECMO. The most common ethical issue involved disagreement about the ongoing use of ECMO, which included multiple axes: Disagreement among health care providers, disagreement among surrogates, and disagreement between health care providers and surrogates over stopping or continuing ECMO. In our experience with integrating ethics consultation into the routine care of ECMO patients, most of the ethical questions more closely resembled traditional concerns about the appropriate use of any life-sustaining treatment rather than the novel dilemmas imagined in the current literature.
Cannaerts, Nancy; Gastmans, Chris; Dierckx de Casterlé, Bernadette
2014-12-01
To review the literature on perceptions of nursing students and/or educators on the contribution of ethics education to ethical competence in nursing students. Nurses do not always demonstrate the competencies necessary to engage in ethical practice. Educators continue to debate about the best ways to teach ethics to nurses so that they can develop ethical competencies. MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science. A total of 15 articles with a quantitative, qualitative, or mixed-methods design published between January 1992 and March 2012 were analyzed. According to students and educators, ethics education increases ethical perception of nursing students and the development of reflective and analytical skills. However, its contribution to the development of ethical behavior was barely mentioned. The accounts of students and educators revealed essential features of effective ethics education: active involvement of students in case study discussions and use of ethical frameworks. The use of activating educational strategies requires a safe learning environment where students can openly reflect on values at stake in their care practice. A better understanding of how students learn to develop ethical skills and of influencing factors can guide educators to develop ethics courses for nursing curriculum. Future research needs to focus on the methodological accuracy of sampling and measuring instruments. © The Author(s) 2014.
Merryman, W David
2008-03-01
The following hypothetical case study was developed for bioengineering students and is concerned with choosing between two devices used for development of a pediatric tissue engineered heart valve (TEHV). This case is intended to elicit assessment of the devices, possible future outcomes, and ramifications of the decision making. It is framed in light of two predominant ethical theories: utilitarianism and rights of persons. After the case was presented to bioengineering graduate students, they voted on which device should be released. The results revealed that these bioengineering students preferred the more reliable (and substantially more expensive) design, though this choice precludes the majority of the world from having access to this technology. This case is intended to examine and explore where the balance lies between design, cost, and adequate distribution of biomedical devices.
Using MultiMedia Content to Present Business Ethics: An Empirical Study
ERIC Educational Resources Information Center
Stanwick, Peter A.
2010-01-01
The purpose of this study is to empirically examine whether presenting a multimedia case study enhances the learning experience of students in an undergraduate management class. A questionnaire was administered before and after the presentation of the case study and the results showed that the multimedia case did indeed enhance the learning…
Soininen, Päivi; Putkonen, Hanna; Joffe, Grigori; Korkeila, Jyrki; Välimäki, Maritta
2014-06-04
Despite improvements in psychiatric inpatient care, patient restrictions in psychiatric hospitals are still in use. Studying perceptions among patients who have been secluded or physically restrained during their hospital stay is challenging. We sought to review the methodological and ethical challenges in qualitative and quantitative studies aiming to describe patients' perceptions of coercive measures, especially seclusion and physical restraints during their hospital stay. Systematic mixed studies review was the study method. Studies reporting patients' perceptions of coercive measures, especially seclusion and physical restraints during hospital stay were included. Methodological issues such as study design, data collection and recruitment process, participants, sampling, patient refusal or non-participation, and ethical issues such as informed consent process, and approval were synthesized systematically. Electronic searches of CINALH, MEDLINE, PsychINFO and The Cochrane Library (1976-2012) were carried out. Out of 846 initial citations, 32 studies were included, 14 qualitative and 18 quantitative studies. A variety of methodological approaches were used, although descriptive and explorative designs were used in most cases. Data were mainly collected in qualitative studies by interviews (n = 13) or in quantitative studies by self-report questionnaires (n = 12). The recruitment process was explained in 59% (n = 19) of the studies. In most cases convenience sampling was used, yet five studies used randomization. Patient's refusal or non-participation was reported in 37% (n = 11) of studies. Of all studies, 56% (n = 18) had reported undergone an ethical review process in an official board or committee. Respondents were informed and consent was requested in 69% studies (n = 22). The use of different study designs made comparison methodologically challenging. The timing of data collection (considering bias and confounding factors) and the reasons for non-participation of eligible participants are likewise methodological challenges, e.g. recommended flow charts could aid the information. Other challenges identified were the recruitment of large and representative samples. Ethical challenges included requesting participants' informed consent and respecting ethical procedures.
Ethics case reflection sessions: Enablers and barriers.
Bartholdson, Cecilia; Molewijk, Bert; Lützén, Kim; Blomgren, Klas; Pergert, Pernilla
2018-03-01
In previous research on ethics case reflection (ECR) sessions about specific cases, healthcare professionals in childhood cancer care were clarifying their perspectives on the ethical issue to resolve their main concern of consolidating care. When perspectives were clarified, consequences in the team included 'increased understanding', 'group strengthening' and 'decision grounding'. Additional analysis of the data was needed on conditions that could contribute to the quality of ECR sessions. The aim of this study was to explore conditions for clarifying perspectives during ECR sessions. Data were collected from observations and interviews and the results emerged from an inductive analysis using grounded theory. Participants and research context: Six observations during ECR sessions and 10 interviews were performed with healthcare professionals working in childhood cancer care and advanced paediatric homecare. Ethical considerations: The study was approved by a regional ethical review board. Participants were informed about their voluntary involvement and that they could withdraw their participation without explaining why. Two categories emerged: organizational enablers and barriers and team-related enablers and barriers. Organizational enablers and barriers included the following sub-categories: the timing of the ECR session, the structure during the ECR session and the climate during the ECR session. Sub-categories to team-related enablers and barriers were identified as space for inter-professional perspectives, varying levels of ethical skills and space for the patient's and the family's perspectives. Space for inter-professional perspectives included the dominance of a particular perspective that can result from hierarchical positions. The medical perspective is relevant for understanding the child's situation but should not dominate the ethical reflection. Conditions for ECR sessions have been explored and the new knowledge can be used when training facilitators as well as for those who organize/implement ECR sessions. Awareness of space for different perspectives, including the possible medical advantage over the nursing perspective, could reduce the somewhat unilateral attention and contribute to an inter-professionally shared reflection.
The ethics of providing hope in psychotherapy.
Dembo, Justine Sarah; Clemens, Norman A
2013-07-01
The instillation of hope is a common factor in most psychotherapies. A considerable literature exists on the ethics of providing false or positively biased hope in non-psychiatric medical settings, and ethicists have generally concluded that this practice is unethical. However, the literature on the ethics of encouraging hope in psychotherapy, especially in the case of treatment-resistant mental illness, is sparse. The author explores two clinical cases with the intention of examining the nature of hope, false hope, positive illusions, and denial, as they relate to our definitions of mental health and psychotherapy. The cases highlight the ethics of balancing an acknowledgment of likely treatment futility with a desire to hope. Clinical psychological studies on depressive realism and optimistic bias indicate that some degree of positive bias, referred to by some authors as "the optimal margin of illusion," is in fact necessary to promote what we define as "good mental health;" conversely, stark realism is correlated with mild to moderate depression. An examination of the existential literature, including Ernest Becker's work, The Denial of Death, indicates that without the defense mechanism of denial, human beings tend to experience paralytic despair as a result of being fallible, mortal creatures in a frightening world. The combination of these diverse bodies of literature, along with the surprising outcomes of our case examples, leads to an unexpected conclusion: it may occasionally be ethical to encourage some degree of optimistic bias, and perhaps even positive illusion, when treating patients in psychotherapy.
Evaluating clinical ethics support in mental healthcare: a systematic literature review.
Hem, Marit Helene; Pedersen, Reidar; Norvoll, Reidun; Molewijk, Bert
2015-06-01
A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased insight into moral issues through systematic reflection; (b) there was improved cooperation among multidisciplinary team members; (c) it was uncertain whether clinical ethics support services led to better patient care; (d) the issue of patient and client participation is complex; and (e) the implementation process is challenging. Clinical ethics support services have mainly been studied through the experiences of the participating facilitators and healthcare professionals. Hence, there is limited knowledge of whether and how various types of clinical ethics support services influence the quality of care and how patients and relatives may evaluate clinical ethics support services. Based on the six excluded 'grey zone articles', in which there was an implicit focus on ethics reflection, other ways of working with ethical reflection in practice are discussed. Implementing and evaluating clinical ethics support services as approaches to clinical ethics support that are more integrated into the development of good practice are in focus. In order to meet some of the shortcomings of the field of clinical ethics support services, a research project that aims to strengthen ethics support in the mental health services, including patients' and caregivers' views on ethical challenges, is presented. © The Author(s) 2014.
NASA Astrophysics Data System (ADS)
Sethy, Satya Sundar
2017-11-01
'Professional Ethics' has been offered as a compulsory course to undergraduate engineering students in a premier engineering institution of India. It was noticed that students' perceptions and attitudes were frivolous and ornamental towards this course. Course instructors and institution authorities were motivated to find out the factors contributing to this awkwardness. For this purpose, a questionnaire was prepared and administrated to 336 students registered for the July-November 2014 semester. The study found two factors contributing to students' indifference towards the Professional Ethics course. First, most of the students did not have self-interest to join the engineering programme, and while pursuing their study, they decided to switch to a different field upon completion of their engineering study. Second, students who desired to be engineers in their future believed that engineering code of ethics is not really referred to in most of the engineering jobs, and therefore Professional Ethics course is only meant for classroom discussions.
Philosophical Provocation: The Lifeblood of Clinical Ethics.
McCullough, Laurence B
2017-02-01
The daily work of the clinical ethics teacher and clinical ethics consultant falls into the routine of classifying clinical cases by ethical type and proposing ethically justified alternatives for the professionally responsible management of a specific type of case. Settling too far into this routine creates the risk of philosophical inertia, which is not good either for the clinical ethicist or for the field of clinical ethics. The antidote to this philosophical inertia and resultant blinkered vision of clinical ethics is sustained, willing exposure to philosophical provocation. The papers in this clinical ethics issue of the Journal of Medicine and Philosophy provide just such philosophical provocation related to core topics in clinical ethics: the distinction between clinical practice and clinical research; telemedicine, or medicine at a distance; illness narratives; the concept of the placebo effect; and sex reassignment. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
ERIC Educational Resources Information Center
Bai, Heesoon
2004-01-01
In addressing the theme of ethics as an everyday activity, this essay makes a case for the primacy of preventive ethics over interventional ethics. Preventive ethics aims at creating a condition of viability and wellbeing for all members of the earth community, an ethical ideal that follows from the thesis that all life-phenomena are…
Why We Do Not Have Ethical Conduct: A Response to Dr. Sternberg
ERIC Educational Resources Information Center
Carson, Jamin
2014-01-01
In "We Need to Teach for Ethical Conduct," Dr. Robert Sternberg argued that students act unethically because they are unable to transfer principles of ethics into practice. While I agree that this is partially the case, it is also the case that unethical behavior is a result of the prevailing educational-philosophy: radical…
Scientific Ethics in Chemical Education
NASA Astrophysics Data System (ADS)
Kovac, Jeffrey
1996-10-01
Scientific ethics is a subset of professional ethics, the special rules of conduct adhered to by people engaged in those pursuits called professions. It is distinct from, but consistent with, both ordinary morality and moral theory. The codes of professional ethics derive from the two bargains that define a profession: the internal code of practice and the external bargain between the profession and society. While the informal code of professional conduct is well understood by working scientists, it is rarely explicitly included in the chemistry curriculum. Instead, we have relied on informal methods to teach students scientific ethics, a strategy that is haphazard at best. In this paper I argue that scientific ethics can and must be taught as part of the chemistry curriculum and that this is the best done through the case-study method. Many decisions made by working scientists have both a technical and an ethical component. Students need to learn how to make good decisions in professional ethics. The alternative is, at best, sloppy science and, at worst, scientific misconduct.
Ethics Instruction in Undergraduate Astronomy and Physics
NASA Astrophysics Data System (ADS)
Pilachowski, Catherine A.; van Zee, L.; Bacher, A. D.; Durisen, R. H.
2009-01-01
Instruction in research ethics is now included as part of the formal undergraduate curriculum in astronomy and physics at Indiana University. Traditionally, students learn research ethics through informal mentoring by research advisors. However, a more formal approach is encouraged by funding agencies, professional societies, and common sense. Following the booklet, "On Being a Scientist: Responsible Conduct in Research" (1995, National Academy Press), our ethics program is built around a "case study" approach using scenarios involving real life situations that students are likely to encounter as undergraduates or beginning graduate students. Students discuss possible resolutions of the ethical questions involved. Discussion topics include reporting data, data rights, credit for ideas, and professional behavior. Scenarios for graduate students involve ethical concerns more appropriate for their career stage, including conflicts of interest, authorship, and collaboration. The answers are not clear-cut, and students must grapple with shades of gray to help them define what the limits of ethical behavior are. The scenarios are available on the Web at www.astro.indiana.edu/education/ethics.html
Ethics and community-based participatory research: perspectives from the field.
Bastida, Elena M; Tseng, Tung-Sung; McKeever, Corliss; Jack, Leonard
2010-01-01
Exploring the importance of ethical issues in the conduct of community-based participatory research (CBPR) continues to be an important topic for researchers and practitioners. This article uses the Beyond Sabor Project, a CBPR project implemented in the Lower Rio Grande Valley, as a case example to discuss ethical issues such as the importance of increasing community involvement in research, ensuring that communities benefit from the research, sharing leadership roles, and sensitive issues regarding data collection and sharing. Thereafter, this article concludes with a brief discussion of six principles that can inform the practice of ethical conduct when implementing CBPR studies. This article also lists additional reading resources on the importance of ethics in the conduct of CBPR.
Integrating ethics in design through the value-sensitive design approach.
Cummings, Mary L
2006-10-01
The Accreditation Board of Engineering and Technology (ABET) has declared that to achieve accredited status, 'engineering programs must demonstrate that their graduates have an understanding of professional and ethical responsibility.' Many engineering professors struggle to integrate this required ethics instruction in technical classes and projects because of the lack of a formalized ethics-in-design approach. However, one methodology developed in human-computer interaction research, the Value-Sensitive Design approach, can serve as an engineering education tool which bridges the gap between design and ethics for many engineering disciplines. The three major components of Value-Sensitive Design, conceptual, technical, and empirical, exemplified through a case study which focuses on the development of a command and control supervisory interface for a military cruise missile.
Xu, Yu; Zhang, Jianhui
2005-11-01
This theoretical study examines the ethics of international nurse recruitment from the conceptual framework of stakeholder interests. It argues that there are stakeholders at individual, institutional, national and international levels, with overlapping but, more often, different or even conflicting interests. Depending on the interests of given stakeholders, different conclusions regarding the ethics of international nurse recruitment may be reached. There is no right or wrong with these varying ethical positions because they reflect different beliefs and philosophies that are not amenable to value judgment. To illustrate and support this line of argument, this article analyzes the underpinnings of two ethical standards published by the International Council of Nurses and the UK Department of Health. In addition, a case study on China augments the argument by demonstrating limitations of the one-size-fits-all approach to the issue. The most important question in understanding and evaluating the ethical standards of international nurse recruitment is to know whose interests they are designed to represent and protect.
The Development and Assessment of an NIH-Funded Research Ethics Training Program
DuBois, James M.; Dueker, Jeffrey M.; Anderson, Emily E.; Campbell, Jean
2015-01-01
In an effort to increase the number of researchers with skills “in identifying and addressing the ethical, legal, and social implications of their research,” the National Institutes of Health (NIH) solicited training grant proposals from 1999 to 2004 and subsequently funded approved programs. The authors describe the content, format, and outcomes of one such training program that ran from 2002–2006 and shares key lessons learned about program formats and assessment methods. Jointly developed by the Saint Louis University Center for Health Care Ethics and the Missouri Institute of Mental Health Continuing Education department, the training program focused on mental health research and adopted a train-the-trainer model. It was offered in onsite and distance-learning formats. Key outcomes of the program included educational products (such as 70 case studies posted on the course website, a textbook, and an instructional DVD) and program completion by 40 trainees. Assessment involved pre- and post-testing focused on knowledge of research ethics, ethical problem-solving skills, and levels of confidence in addressing ethical issues in mental health research. The program succeeded in increasing participants’ knowledge of ethical issues and their beliefs that they could identify issues, identify problem-solving resources, and solve ethical problems. However, scores on the case-based problem-solving assessment dropped in post-testing, apparently due to diminished confidence about the right course of action in the specific dilemma presented; the implications of this finding for ethics assessment are discussed. Overall satisfaction was high and dropout rates were low, but 3 times higher for distance-learners than onsite participants. PMID:18520469
Ethics rounds do not improve the handling of ethical issues by psychiatric staff.
Silén, Marit; Haglund, Kristina; Hansson, Mats G; Ramklint, Mia
2015-08-01
One way to support healthcare staff in handling ethically difficult situations is through ethics rounds that consist of discussions based on clinical cases and are moderated by an ethicist. Previous research indicates that the handling of ethically difficult situations in the workplace might have changed after ethics rounds. This, in turn, would mean that the "ethical climate", i.e. perceptions of how ethical issues are handled, would have changed. To investigate whether ethics rounds could improve the ethical climate perceived by staff working in psychiatry outpatient clinics. In this quasi-experimental study, six inter-professional ethics rounds led by a philosopher/ethicist were conducted at two psychiatry outpatient clinics. Changes in ethical climate were measured at these clinics as well as at two control clinics at baseline and after the intervention period using the instrument Hospital Ethical Climate Survey. Within-groups comparisons of median sum scores of ethical climate showed that no statistically significant differences were found in the intervention group before or after the intervention period. The median sum scores for ethical climate were significantly higher, both at baseline and after the intervention period (P ≤ 0.001; P = 0.046), in the intervention group. Ethics rounds in psychiatric outpatient clinics did not result in significant changes in ethical climate. Outcomes of ethics rounds might, to a higher degree, be directed towards patient-related outcomes rather than towards the staff's working environment, as the questions brought up for discussion during the ethics rounds concerned patient-related issues.
Awareness of ethical issues in medical education: an interactive teach-the-teacher course.
Chiapponi, Costanza; Dimitriadis, Konstantinos; Özgül, Gülümser; Siebeck, Robert G; Siebeck, Matthias
2016-01-01
We conducted an international, interdisciplinary teach-the-teacher course to sensitize physicians from different countries to ethical issues in medical education. The purpose of this study was to assess the effects of this course. Before and after participating in a short session on ethical issues in medical education, 97 physicians from different countries in Africa, Asia, and Europe completed a self-assessment questionnaire on their competence and interest in this field. The short session consisted of working in small groups to identify, analyze and discuss ethical dilemmas described in case vignettes adapted from published examples or written by medical students. In addition to the questionnaire, we conducted a large-group experience to explore four basic orientations of participants in ethical thinking: relativism, intentionalism, consequentialism, and absolutism. We found a significant self-perceived increase in the participants' ability to identify and describe ethical issues and students' dilemmas, in their knowledge about these issues and teaching professionalism, and in their ability to describe both students' perspectives and teachers' and students' behaviors. In addition, participants' feeling of understanding their own culturally learned patterns of determining what is right and wrong increased after taking part in the course. The four contrasting basic ethical orientations showed no significant differences between participants regarding nationality, age, or gender. Ethics of education is an important issue for medical teachers. Teachers' self-perceived competence can be increased by working on case vignettes in small groups.
Awareness of ethical issues in medical education: an interactive teach-the-teacher course
Chiapponi, Costanza; Dimitriadis, Konstantinos; Özgül, Gülümser; Siebeck, Robert G.; Siebeck, Matthias
2016-01-01
Purpose: We conducted an international, interdisciplinary teach-the-teacher course to sensitize physicians from different countries to ethical issues in medical education. The purpose of this study was to assess the effects of this course. Method: Before and after participating in a short session on ethical issues in medical education, 97 physicians from different countries in Africa, Asia, and Europe completed a self-assessment questionnaire on their competence and interest in this field. The short session consisted of working in small groups to identify, analyze and discuss ethical dilemmas described in case vignettes adapted from published examples or written by medical students. In addition to the questionnaire, we conducted a large-group experience to explore four basic orientations of participants in ethical thinking: relativism, intentionalism, consequentialism, and absolutism. Results: We found a significant self-perceived increase in the participants’ ability to identify and describe ethical issues and students’ dilemmas, in their knowledge about these issues and teaching professionalism, and in their ability to describe both students’ perspectives and teachers’ and students’ behaviors. In addition, participants’ feeling of understanding their own culturally learned patterns of determining what is right and wrong increased after taking part in the course. The four contrasting basic ethical orientations showed no significant differences between participants regarding nationality, age, or gender. Conclusion: Ethics of education is an important issue for medical teachers. Teachers’ self-perceived competence can be increased by working on case vignettes in small groups. PMID:27275510
ERIC Educational Resources Information Center
Conn, Cynthia E.
2008-01-01
An integrated approach to teaching resume construction in the business communication classroom focuses on simultaneously (a) emphasizing writing-related proficiencies and (b) encouraging ethical and moral orientations to this task. This article provides a resume construction exemplar that operationalizes these two pedagogical goals. The techniques…
ERIC Educational Resources Information Center
Tillery, Denise
2001-01-01
Argues that the philosophical hermeneutics of Hans-Georg Gadamer provides a useful theoretical framework from which to discuss ethical issues in the technical communication classroom. Analyzes a previously published case study to demonstrate how hermeneutics can shed light on the ways that writers can be unconscious of ethical problems in their…
Ethics at the End of Life: A Teaching Tool
ERIC Educational Resources Information Center
Wallace, Cara L.; Thielman, Kara J.; Cimino, Andrea N.; Rueda, Heidi L. Adams
2017-01-01
Social workers rarely receive education and training in the areas of grief, bereavement, and death and dying, which may lead to difficulties in compassionately and ethically addressing concerns in end-of-life or grief-related contexts. This article presents actual and potential outcomes from three challenging end-of-life case studies using…
ERIC Educational Resources Information Center
Heydon, Rachel M.; Wang, Ping
2006-01-01
Through a case study of a key Canadian early childhood education program, The Kindergarten Program (Ontario Ministry of Education and Training, 1998a), we explore the relationship between curricular paradigms and early childhood education (ECE) models, and the opportunities that each creates for enacting ethical teaching and learning…
Creating Cultures of Integrity: Ethics Education in UK Business Schools
ERIC Educational Resources Information Center
Bell, Emma; Caulfield, Paul; Hibbert, Paul; Jennings, Paul
2014-01-01
Recent corporate scandals and responses by regulators have created an environment in which there is a heightened awareness of business ethics. This report presents a series of case studies exploring how the current curricula in UK business schools could be scoped differently to give new business leaders the tools required for strong ethical…
ERIC Educational Resources Information Center
Sethy, Satya Sundar
2017-01-01
"Professional Ethics" has been offered as a compulsory course to undergraduate engineering students in a premier engineering institution of India. It was noticed that students' perceptions and attitudes were frivolous and ornamental towards this course. Course instructors and institution authorities were motivated to find out the factors…
Choosing Values: Public-Private Relationships in a Global Economy
ERIC Educational Resources Information Center
DiMatteo, Larry A.; Maurer, Virginia G.
2015-01-01
This article presents a case study that engages students on the legal and ethical issues of doing business abroad. It explores the scenario of direct foreign investment by an American company in a less developed country. This development imbalance necessarily implicates issues of ethical relativism and home-host country standards. Students are…
A Hands-On Approach for Teaching Denial of Service Attacks: A Case Study
ERIC Educational Resources Information Center
Trabelsi, Zouheir; Ibrahim, Walid
2013-01-01
Nowadays, many academic institutions are including ethical hacking in their information security and Computer Science programs. Information security students need to experiment common ethical hacking techniques in order to be able to implement the appropriate security solutions. This will allow them to more efficiently protect the confidentiality,…
ERIC Educational Resources Information Center
Torres, Mario S., Jr.
2012-01-01
Recent studies of school discipline (Skiba, Michael, Nardo, & Peterson, 2002; see also, NAACP Legal Defense and Education Fund, n.d.) have called for greater scrutiny over treatment of students in varying demographic contexts. Minimal research, however, has grappled with the ethics of disciplinary practices using legal data. Utilizing…
Erratt, Tamie D
2011-08-01
There are many barriers to ethics education of students attending medical and dental schools. The question is asked, "Should more attention be given to addressing students' ethics education during their undergraduate years of preparation for professional healthcare programs?" This qualitative study utilizes digitally recorded personal interviews with two undergraduate pre-healthcare students, one medical student, one recently matriculated dental student, one undergraduate pre-healthcare faculty member, three dental school faculty members, and three medical school faculty members. Interview participants discuss areas of personal knowledge and experience concerning: the admissions process and screening of potential medical/dental students for ethical traits and behaviors, influences on student ethical development, undergraduate pre-healthcare ethics training, and preferred college major for pre-healthcare students. The study concludes that undergraduate pre-healthcare programs should take the initiative to be proactive and deliberate in strengthening the positive influences on students. Strategies include: 1) humanities curricula to broaden perspectives and increase non-prejudice; 2) mentoring and modeling by older students, faculty, and community and professional volunteers; 3) ethical case study discussions in class or extracurricular activities; and 4) volunteer/service learning activities. Additionally, curriculum learning is enhanced by the use of reflection and writing, discussions, and media.
Fessler, D M T
2003-08-01
To evaluate existing ethical guidelines for the treatment of hunger strikers in light of findings on psychological changes that accompany the cessation of food intake. Electronic databases were searched for (a) editorials and ethical proclamations on hunger strikers and their treatment; (b) studies of voluntary and involuntary starvation, and (c) legal cases pertaining to hunger striking. Additional studies were gathered in a snowball fashion from the published material cited in these databases. Material was included if it (a) provided ethical or legal guidelines; (b) shed light on psychological changes accompanying starvation, or (c) illustrated the practice of hunger striking. Authors' observations, opinions, and conclusions were noted. Although the heterogeneous nature of the sources precluded statistical analysis, starvation appears to be accompanied by marked psychological changes. Some changes clearly impair competence, in which case physicians are advised to follow advance directives obtained early in the hunger strike. More problematic are increases in impulsivity and aggressivity, changes which, while not impairing competence, enhance the likelihood that patients will starve themselves to death.
Ethical conflicts in caring for patients with cochlear implants.
McCormick, Thomas R
2010-10-01
Although the use of cochlear implants as a treatment designed to help deaf individuals hear has a relatively brief history, the use of this therapy has given rise to a number of ethical conflicts. This article identifies ethical conflicts in cochlear implantation therapy and shows how ethical principles that are commonly accepted in health care ethics may guide decision making in resolving these issues. Furthermore, clinicians are often confronted with particular cases in which ethical conflicts arise. A useful paradigm for the clinical context, the 4-box method, is offered as a means of organizing the facts of a "case" so that the important facts are considered, and a principled approach to decision making can be used in working toward a resolution.
Medical ethics on film: towards a reconstruction of the teaching of healthcare professionals.
Volandes, Angelo
2007-11-01
The clinical vignette remains the standard means by which medical ethics are taught to students in the healthcare professions. Although written or verbal vignettes are useful as a pedagogic tool for teaching ethics and introducing students to real cases, they are limited, since students must imagine the clinical scenario. Medical ethics are almost universally taught during the early years of training, when students are unfamiliar with the clinical reality in which ethics issues arise. Film vignettes fill in that imaginative leap. By providing vivid details with images, film vignettes offer rich and textured details of cases, including the patient's perspective and the clinical reality. Film vignettes provide a detailed ethnography that allows for a more complete discussion of the ethical issues. Film can serve as an additional tool for teaching medical ethics to members of the healthcare professions.
Shattered, Suffering, and Silenced: Sharon's Story.
Shafer, Michaela R
2016-01-01
This chapter presents a case study of a 30-year-old female news reporter in Albuquerque, New Mexico, named Sharon Fullilove. The case is presented as a personal narrative by her mother, who is a critical care nurse, former chief nurse, Level I trauma unit commander, and colonel in the U.S. Air Force. The narrative is followed by excerpts from Sharon's chart that confirm a series of decisions made by both the hospital and the providers. The subsequent narrative is meant to give the reader an opportunity to reflect on the variety of clinical ethics questions that emerge when a patient enters into a contract with a physician and hospital for care. The goal is not to perform a thorough ethical analysis of the case but to let the reader experience what it is like when best practice standards, attention to patient care, and compassionate concern for family members are set aside. The case concludes with a set of broad questions that can be used for further discussion. Hopefully, this case will bring to the forefront the centrality of ethics in professional decision-making within the context of medical care.
Diagnosing dementia: Ethnography, interactional ethics and everyday moral reasoning.
Hillman, Alexandra
2017-02-01
This article highlights the contribution of ethnography and qualitative sociology to the ethical challenges that frame the diagnosis of dementia. To illustrate this contribution, the paper draws on an ethnographic study of UK memory clinics carried out between 2012 and 2014. The ethnographic data, set alongside other studies and sociological theory, contest the promotion of a traditional view of autonomy; the limiting of the point of ethical interest to a distinct moment of diagnosis disclosure; and the failure to recognise risk and uncertainty in the building of clinical 'facts' and their communication. In addressing these specific concerns, this article contributes to the wider debate over the relationship between sociology and bioethics (medical ethics). At the heart of these debates lies more fundamental questions: how can we best understand and shape moral decision-making and ethics that guide behaviour in medical practice, and what should be the guiding ideas, concepts and methods to inform ethics in the clinic? Using the case of dementia diagnosis, this article illustrates the benefits of an ethnographic approach, not just for understanding this ethical problem but also for exploring if and how a more empirically informed ethics can help shape healthcare practices for the better.
Diagnosing dementia: Ethnography, interactional ethics and everyday moral reasoning
Hillman, Alexandra
2016-01-01
This article highlights the contribution of ethnography and qualitative sociology to the ethical challenges that frame the diagnosis of dementia. To illustrate this contribution, the paper draws on an ethnographic study of UK memory clinics carried out between 2012 and 2014. The ethnographic data, set alongside other studies and sociological theory, contest the promotion of a traditional view of autonomy; the limiting of the point of ethical interest to a distinct moment of diagnosis disclosure; and the failure to recognise risk and uncertainty in the building of clinical ‘facts’ and their communication. In addressing these specific concerns, this article contributes to the wider debate over the relationship between sociology and bioethics (medical ethics). At the heart of these debates lies more fundamental questions: how can we best understand and shape moral decision-making and ethics that guide behaviour in medical practice, and what should be the guiding ideas, concepts and methods to inform ethics in the clinic? Using the case of dementia diagnosis, this article illustrates the benefits of an ethnographic approach, not just for understanding this ethical problem but also for exploring if and how a more empirically informed ethics can help shape healthcare practices for the better. PMID:28255279
2014-01-01
Background Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers’ experiences and perceived importance of outcomes of Moral Case Deliberation. Methods A multi-item instrument for assessing outcomes of Moral Case Deliberation (MCD) was constructed through an iterative process, founded on a literature review and modified through a multistep review by ethicists and health care providers. The instrument measures perceived importance of outcomes before and after MCD, as well as experienced outcomes during MCD and in daily work. A purposeful sample of 86 European participants contributed to a Delphi panel and content validity testing. The Delphi panel (n = 13), consisting of ethicists and ethics researchers, participated in three Delphi-rounds. Health care providers (n = 73) participated in the content validity testing through ‘think-aloud’ interviews and a method using Content Validity Index. Results The development process resulted in the European Moral Case Deliberation Outcomes Instrument (Euro-MCD), which consists of two sections, one to be completed before a participant’s first MCD and the other after completing multiple MCDs. The instrument contains a few open-ended questions and 26 specific items with a corresponding rating/response scale representing various MCD outcomes. The items were categorised into the following six domains: Enhanced emotional support, Enhanced collaboration, Improved moral reflexivity, Improved moral attitude, Improvement on organizational level and Concrete results. Conclusions A tentative instrument has been developed that seems to cover main outcomes of Moral Case Deliberation. The next step will be to test the Euro-MCD in a field study. PMID:24712735
Svantesson, Mia; Karlsson, Jan; Boitte, Pierre; Schildman, Jan; Dauwerse, Linda; Widdershoven, Guy; Pedersen, Reidar; Huisman, Martijn; Molewijk, Bert
2014-04-08
Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers' experiences and perceived importance of outcomes of Moral Case Deliberation. A multi-item instrument for assessing outcomes of Moral Case Deliberation (MCD) was constructed through an iterative process, founded on a literature review and modified through a multistep review by ethicists and health care providers. The instrument measures perceived importance of outcomes before and after MCD, as well as experienced outcomes during MCD and in daily work. A purposeful sample of 86 European participants contributed to a Delphi panel and content validity testing. The Delphi panel (n = 13), consisting of ethicists and ethics researchers, participated in three Delphi-rounds. Health care providers (n = 73) participated in the content validity testing through 'think-aloud' interviews and a method using Content Validity Index. The development process resulted in the European Moral Case Deliberation Outcomes Instrument (Euro-MCD), which consists of two sections, one to be completed before a participant's first MCD and the other after completing multiple MCDs. The instrument contains a few open-ended questions and 26 specific items with a corresponding rating/response scale representing various MCD outcomes. The items were categorised into the following six domains: Enhanced emotional support, Enhanced collaboration, Improved moral reflexivity, Improved moral attitude, Improvement on organizational level and Concrete results. A tentative instrument has been developed that seems to cover main outcomes of Moral Case Deliberation. The next step will be to test the Euro-MCD in a field study.
Miranda, J Jaime; Yamin, Alicia Ely
2008-01-01
Health professionals view medical ethics as a discipline that provides the basis for more adequate patient care. In recent years the concepts of quality of care and human rights - with their attending discourses - have joined the concept of medical ethics among the paradigms to consider in care for humans both at the individual and health policy levels. The current study seeks to analyze such paradigms, based on a case study of sexual and reproductive health policies in Peru in the last 10 years.
Computer Ethics: A Slow Fade from Black and White to Shades of Gray
ERIC Educational Resources Information Center
Kraft, Theresa A.; Carlisle, Judith
2011-01-01
The expanded use of teaching case based analysis based on current events and news stories relating to computer ethics improves student engagement, encourages creativity and fosters an active learning environment. Professional ethics standards, accreditation standards for computer curriculum, ethics theories, resources for ethics on the internet,…
Evaluating non-disclosure of errors and healthcare organization: a case of bioethics consultation.
Colucci, Massimiliano; Aprile, Anna; Pegoraro, Renzo
2015-11-01
Sometimes medical errors should not be disclosed. We report a case of semen samples exchange, during a homologous artificial insemination procedure, where a bioethics consultation was required. The bioethics consultation addressed ethical and legal elements in play, supporting non-disclosure to some of the subjects involved. Through a proper methodology, gathering factual and juridical elements, a consultant can show when a moral dilemma between values and rights-privacy versus fatherhood, in our case-is unsubstantial, in a given context, because of the groundlessness of the value or the right itself. However, being the error elicited by organizational factors, a broader ethical pronouncement was needed. Under such circumstances, ethical evaluation should engage in a sort of 'ethical-based root-cause analysis', linking ethical principles to quality aims and showing the opportunity to integrate ethical methodology in healthcare management. From this perspective, errors may become an incentive to promote high-quality organizations, attending to the central value of person even through the organizational process.
Bridging the Gap between Social Acceptance and Ethical Acceptability.
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.
How would you decide? Helping geoscience students consider ethical dimensions in a gescience context
NASA Astrophysics Data System (ADS)
Bank, C. G.; Ryan, A. M.
2017-12-01
This presentation shows an example of infusing ethics into geoscience teaching, and a preliminary analysis of student answers to an exam question to establish whether this example can be used in an effective way. We presented a case study on floods in two distribution geoscience courses, and provided students with criteria to come to an ethical decision. One course was taught in winter 2016 and the other in summer 2016 with a total of 358 students. Pre- and post-questionnaires allow only limited conclusions because just 33 students answered both. In the exam we asked students if they would evacuate a small aboriginal settlement to prevent flooding in a large city. We coded their answers according to the criteria (stakeholders, contributions by geoscientists, alternative options, and assumptions) they were provided in class. While students did well listing stakeholders and recalling contributions by geoscientists they struggled to provide alternative options. Still, many of them verbalized assumptions inherent in their thoughts and nearly half of students recognized that this is a complex problem. We posit that a case study is a valid way to encourage students to link ethics to a geoscience issue, and propose that our framework may empower geoscience educators who do not necessarily feel comfortable teaching ethics to add this element to their teaching toolkit.
Socio-ethical education in nanotechnology engineering programmes: a case study in Malaysia.
Balakrishnan, Balamuralithara; Er, Pek Hoon; Visvanathan, Punita
2013-09-01
The unique properties of nanotechnology have made nanotechnology education and its related subjects increasingly important not only for students but for mankind at large. This particular technology brings educators to work together to prepare and produce competent engineers and scientists for this field. One of the key challenges in nanotechnology engineering is to produce graduate students who are not only competent in technical knowledge but possess the necessary attitude and awareness toward the social and ethical issues related to nanotechnology. In this paper, a research model has been developed to assess Malaysian nanotechnology engineering students' attitudes and whether their perspectives have attained the necessary objectives of ethical education throughout their programme of study. The findings from this investigation show that socio ethical education has a strong influence on the students' knowledge, skills and attitudes pertaining to socio ethical issues related to nanotechnology.
Todd, E Michelle; Watts, Logan L; Mulhearn, Tyler J; Torrence, Brett S; Turner, Megan R; Connelly, Shane; Mumford, Michael D
2017-12-01
Despite the growing body of literature on training in the responsible conduct of research, few studies have examined the effectiveness of delivery formats used in ethics courses (i.e., face-to-face, online, hybrid). The present effort sought to address this gap in the literature through a meta-analytic review of 66 empirical studies, representing 106 ethics courses and 10,069 participants. The frequency and effectiveness of 67 instructional and process-based content areas were also assessed for each delivery format. Process-based contents were best delivered face-to-face, whereas contents delivered online were most effective when restricted to compliance-based instructional contents. Overall, hybrid courses were found to be most effective, suggesting that ethics courses are best delivered using a blend of formats and content areas. Implications and recommendations for future development of ethics education courses in the sciences are discussed.
The right not to hear: the ethics of parental refusal of hearing rehabilitation.
Byrd, Serena; Shuman, Andrew G; Kileny, Sharon; Kileny, Paul R
2011-08-01
To explore the ethics of parental refusal of auditory-oral hearing rehabilitation. Case study with medical ethical discussion and review. Two young brothers present with severe-to-profound congenital sensorineural hearing loss. The parents, both of whom have normal hearing and work as sign language interpreters, have decided to raise their children with American Sign Language as their only form of communication. They have chosen not to pursue cochlear implantation nor support the use of hearing aids. This case raises significant questions concerning whether hearing rehabilitation should be mandated, and if there are circumstances in which parental preferences should be questioned or overridden with regard to this issue. In addition, legal concerns may be raised regarding the possible need to file a report with Child Protective Services. Although similar cases involving the Deaf community have historically favored parental rights to forego hearing rehabilitation with either cochlear implantation or hearing aids, we explore whether conclusions should be different because the parents in this case are not hearing impaired. The ethics of parental rights to refuse hearing rehabilitation are complex and strikingly context-dependent. A comprehensive appreciation of the medical, practical, and legal issues is crucial prior to intervening in such challenging situations. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Scientific misconduct and science ethics: a case study based approach.
Consoli, Luca
2006-07-01
The Schön misconduct case has been widely publicized in the media and has sparked intense discussions within and outside the scientific community about general issues of science ethics. This paper analyses the Report of the official Committee charged with the investigation in order to show that what at first seems to be a quite uncontroversial case, turns out to be an accumulation of many interesting and non-trivial questions (of both ethical and philosophical interest). In particular, the paper intends to show that daily scientific practices are structurally permeated by chronic problems; this has serious consequences for how practicing scientists assess their work in general, and scientific misconduct in particular. A philosophical approach is proposed that sees scientific method and scientific ethics as inextricably interwoven. Furthermore, the paper intends to show that the definition of co-authorship that the members of the Committee use, although perhaps clear in theory, proves highly problematic in practice and raises more questions that it answers. A final plea is made for a more self-reflecting attitude of scientists as far as the moral and methodological profile of science is concerned as a key element for improving not only their scientific achievements, but also their assessment of problematic cases.
A Second Opinion: A Case Narrative on Clinical Ethics Mediation.
Weinstein, Michael S
2015-01-01
Contrasting traditional and common forms of ethics consultation with bioethics mediation, I describe the case of a "second opinion" consultation in the care of a patient with advanced cancer for whom treatment was futile. While the initial ethics consultation, performed by a colleague, led to a recommendation that some may deem ethical, the process failed to involve key stakeholders and failed to explore the underlying values and reasons for the opinions voiced by various stakeholders. The process of mediation ultimately led to creative solutions in which all stakeholders could reach consensus on a plan of care. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.
2010-01-01
Background Concern has been growing in the academic literature and popular media about the licensing, introduction and adoption of surgical devices before full effectiveness and safety evidence is available to inform clinical practice. Our research will seek empirical survey evidence about the roles, responsibilities, and information and policy needs of the key stakeholders in the introduction into clinical practice of new surgical devices for pelvic floor surgery, in terms of the underlying ethical principals involved in the economic decision-making process, using the example of pelvic floor procedures. Methods/Design Our study involves three linked case studies using, as examples, selected pelvic floor surgery devices representing Health Canada device safety risk classes: low, medium and high risk. Data collection will focus on stakeholder roles and responsibilities, information and policy needs, and perceptions of those of other key stakeholders, in seeking and using evidence about new surgical devices when licensing and adopting them into practice. For each class of device, interviews will be used to seek the opinions of stakeholders. The following stakeholders and ethical and economic principles provide the theoretical framework for the study: Stakeholders - federal regulatory body, device manufacturers, clinicians, patients, health care institutions, provincial health departments, and professional societies. Clinical settings in two centres (in different provinces) will be included. Ethics - beneficence, non-maleficence, autonomy, justice. Economics - scarcity of resources, choices, opportunity costs. For each class of device, responses will be analysed to compare and contrast between stakeholders. Applied ethics and economic theory, analysis and critical interpretation will be used to further illuminate the case study material. Discussion The significance of our research in this new area of ethics will lie in providing recommendations for regulatory bodies, device manufacturers, clinicians, health care institutions, policy makers and professional societies, to ensure surgical patients receive sufficient information before providing consent for pelvic floor surgery. In addition, we shall provide a wealth of information for future study in other areas of surgery and clinical management, and provide suggestions for changes to health policy. PMID:20738887
Ross, Sue; Weijer, Charles; Gafni, Amiram; Ducey, Ariel; Thompson, Carmen; Lafreniere, Rene
2010-08-26
Concern has been growing in the academic literature and popular media about the licensing, introduction and adoption of surgical devices before full effectiveness and safety evidence is available to inform clinical practice. Our research will seek empirical survey evidence about the roles, responsibilities, and information and policy needs of the key stakeholders in the introduction into clinical practice of new surgical devices for pelvic floor surgery, in terms of the underlying ethical principals involved in the economic decision-making process, using the example of pelvic floor procedures. Our study involves three linked case studies using, as examples, selected pelvic floor surgery devices representing Health Canada device safety risk classes: low, medium and high risk. Data collection will focus on stakeholder roles and responsibilities, information and policy needs, and perceptions of those of other key stakeholders, in seeking and using evidence about new surgical devices when licensing and adopting them into practice. For each class of device, interviews will be used to seek the opinions of stakeholders. The following stakeholders and ethical and economic principles provide the theoretical framework for the study: Stakeholders--federal regulatory body, device manufacturers, clinicians, patients, health care institutions, provincial health departments, and professional societies. Clinical settings in two centres (in different provinces) will be included. Ethics--beneficence, non-maleficence, autonomy, justice. Economics--scarcity of resources, choices, opportunity costs.For each class of device, responses will be analysed to compare and contrast between stakeholders. Applied ethics and economic theory, analysis and critical interpretation will be used to further illuminate the case study material. The significance of our research in this new area of ethics will lie in providing recommendations for regulatory bodies, device manufacturers, clinicians, health care institutions, policy makers and professional societies, to ensure surgical patients receive sufficient information before providing consent for pelvic floor surgery. In addition, we shall provide a wealth of information for future study in other areas of surgery and clinical management, and provide suggestions for changes to health policy.
Melia, K M
1994-01-01
This paper raises the questions: 'What do we expect from nursing ethics?' and 'Is the literature of nursing ethics any different from that of medical ethics?' It is suggested that rather than develop nursing ethics as a separate field writers in nursing ethics should take a lead in making the patient the central focus of health care ethics. The case is made for empirical work in health care ethics and it is suggested that a good way of setting about this is to ask practising nurses about the real ethical problems they encounter. PMID:8035446
Smebye, Kari Lislerud; Kirkevold, Marit; Engedal, Knut
2016-01-19
Caring for people with dementia living in their own homes is a challenging care issue that raises ethical dilemmas of how to balance autonomy with their safety and well-being. The theoretical framework for this study consisted of the concepts of autonomy, beneficence, non-maleficence, paternalism and from the ethics of care. The aim of this study was to explore ethical dilemmas concerning autonomy that were identified when persons with dementia wished to live at home. This Norwegian study had a qualitative, hermeneutic design and was based on nine cases. Each case consisted of of a triad: the person with dementia, the family carer and the professional caregiver. Inclusion criteria for the persons with dementia were: (1) 67 years or older (2) diagnosed with dementia (3) Clinical Dementia Rating score 2 i.e. dementia of moderate degree (4) able to communicate verbally and (5) expressed a wish to live at home. The family carers and professional caregivers registered in the patients' records were included in the study. An interview guide was used in interviews with family carers and professional caregivers. Field notes were written after participant observation of interactions between persons with dementia and professional caregivers during morning care or activities at a day care centre. By means of deductive analysis, autonomy-related ethical dilemmas were identified. The final interpretation was based on perspectives from the theoretical framework. The analysis revealed three main ethical dilemmas: When the autonomy of the person with dementia conflicted with (1) the family carer's and professional caregiver's need to prevent harm (non-maleficence) (2) the beneficence of family carers and professional caregivers (3) the autonomy of the family carer. In order to remain living in their own homes, people with dementia accepted their dependence on others in order to uphold their actual autonomy and live in accordance with their identified values. Paternalism could be justified in light of beneficence and non-maleficence and within an ethics of care.
Food for thought: ethics case discussion as slow nourishment in a fast world.
Higgs, Roger
2015-01-01
Case discussion offers important opportunities to do good medical ethics, but do we understand what the benefits might be? This paper looks at the 'Case Conference' series in the JME, its origins and methods, examines some cases in outline, and reviews issues that arise that are not usually taken into account. Cases are harder to publish now, not least because of ethical constraints. Ways past this apparently paradoxical outcome are suggested. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
[Ethics and values in professional training in health: a case study].
Finkler, Mirelle; Caetano, João Carlos; Ramos, Flávia Regina Souza
2013-10-01
The scope of this research was to analyze the ethical dimension of the training of health professionals, specifically in Dentistry. Interviews were conducted with teachers, in addition to observation of academic activities and focus groups with students of two undergraduate courses. Data analysis revealed some elements of the hidden curriculum that influences the ethical dimension of training. The results discussed here suggest different ethical concepts in the academic environment with the predominance of an implicit code of ethics, the consequences of which require attention in the management of daily ethical conflicts. Based on common sense and a lack of intentionality of the academic staff with respect to the ethical training of students, it is imperative to know the values + they cherish in order to understand their moral development and identify a bioethical benchmark upon which the pedagogical-ethical issue is grounded. By way of conclusion, it is essential to assume individual and collective teaching responsibility for the ethical dimension of training in order that the professional training also has the potential for the integrated training of the human being as a whole.
Oberbichler, S; Hackl, W O; Hörbst, A
2017-10-18
Long-term data collection is a challenging task in the domain of medical research. Many effects in medicine require long periods of time to become traceable e.g. the development of secondary malignancies based on a given radiotherapeutic treatment of the primary disease. Nevertheless, long-term studies often suffer from an initial lack of available information, thus disallowing a standardized approach for their approval by the ethics committee. This is due to several factors, such as the lack of existing case report forms or an explorative research approach in which data elements may change over time. In connection with current medical research and the ongoing digitalization in medicine, Long Term Medical Data Registries (MDR-LT) have become an important means of collecting and analyzing study data. As with any clinical study, ethical aspects must be taken into account when setting up such registries. This work addresses the problem of creating a valid, high-quality ethics committee proposal for medical registries by suggesting groups of tasks (building blocks), information sources and appropriate methods for collecting and analyzing the information, as well as a process model to compile an ethics committee proposal (EsPRit). To derive the building blocks and associated methods software and requirements engineering approaches were utilized. Furthermore, a process-oriented approach was chosen, as information required in the creating process of ethics committee proposals remain unknown in the beginning of planning an MDR-LT. Here, we derived the needed steps from medical product certification. This was done as the medical product certification itself also communicates a process-oriented approach rather than merely focusing on content. A proposal was created for validation and inspection of applicability by using the proposed building blocks. The proposed best practice was tested and refined within SEMPER (Secondary Malignoma - Prospective Evaluation of the Radiotherapeutics dose distribution as the cause for induction) as a case study. The proposed building blocks cover the topics of "Context Analysis", "Requirements Analysis", "Requirements Validation", "Electronic Case Report (eCRF) Design" and "Overall Concept Creation". Additional methods are attached with regards to each topic. The goals of each block can be met by applying those methods. The proposed methods are proven methods as applied in e.g. existing Medical Data Registry projects, as well as in software or requirements engineering. Several building blocks and attached methods could be identified in the creation of a generic ethics committee proposal. Hence, an Ethics Committee can make informed decisions on the suggested study via said blocks, using the suggested methods such as "Defining Clinical Questions" within the Context Analysis. The study creators have to confirm that they adhere to the proposed procedure within the ethic proposal statement. Additional existing Medical Data Registry projects can be compared to EsPRit for conformity to the proposed procedure. This allows for the identification of gaps, which can lead to amendments requested by the ethics committee.
ERIC Educational Resources Information Center
Mathur, Sarup R.; Corley, Kathleen M.
2014-01-01
This article argues for the need to discuss the topic of ethics in the classroom and presents five frameworks of ethics that have been applied to education. A case analysis used in workshops with educators in the field of Special Education is described, and the benefits of sharing narratives are discussed. The authors offer suggestions, grounded…
Inequality and Ethics in Pediatric HIV Remission Research: From Mississippi to South Africa and Back
Crane, Johanna T.; Rossouw, Theresa M.
2017-01-01
In March 2013 a group of physician-researchers made the startling announcement that a baby in Mississippi had been ‘functionally cured’ of HIV (Persaud et al., 2013a). However, hopes that the discovery might indicate a pediatric cure for HIV were significantly tempered in July 2014, when doctors announced that the child had a detectable viral load. Nonetheless, the case remains unprecedented, and NIH-funded trials to build on the findings are in the planning stages (NIAID, 2014). Whether addressing HIV ‘cure’ or temporary ‘remission’, scrutiny of the ‘Mississippi baby’ case has focused largely on scientific and technical questions, with only introductory attention to ethical questions. By contrast, the social inequalities and gaps in care that made the discovery possible—and their ethical implications for pediatric HIV remission more globally—have gone largely unexamined. This paper describes the some of the structural inequalities surrounding the ‘Mississippi baby’ case and a parallel case of an HIV-infected infant in South Africa, where proof-of-concept studies of the approach used in Mississippi are in the early stages. We argue that an ethical program of research into infant HIV remission ought to be ‘structurally competent’, and not bracket the gaps in care that allow antenatal transmission to occur. To this end, we recommend that pediatric remission studies consider including a social science research component focused on social protection and barriers to care for HIV-positive pregnant women. PMID:27458074
The "four quadrants" approach to clinical ethics case analysis; an application and review.
Sokol, D K
2008-07-01
In 1982, Jonsen, Siegler and Winslade published Clinical Ethics, in which they described the "four quadrants" approach, a new method of analysing clinical ethics cases. Although the book is now in its 6th edition, a literature search has revealed only one academic paper demonstrating the method at work. This paper is an attempt to start filling this gap. As a way of describing and testing the approach, I apply the four quadrants method to a detailed clinical ethics case. The analysis is interspersed with reflections on the method itself. It is hoped that this experiment will encourage ethicists and clinicians to devote more attention to this neglected approach.
A Systematic Literature Review of US Engineering Ethics Interventions.
Hess, Justin L; Fore, Grant
2018-04-01
Promoting the ethical formation of engineering students through the cultivation of their discipline-specific knowledge, sensitivity, imagination, and reasoning skills has become a goal for many engineering education programs throughout the United States. However, there is neither a consensus throughout the engineering education community regarding which strategies are most effective towards which ends, nor which ends are most important. This study provides an overview of engineering ethics interventions within the U.S. through the systematic analysis of articles that featured ethical interventions in engineering, published in select peer-reviewed journals, and published between 2000 and 2015. As a core criterion, each journal article reviewed must have provided an overview of the course as well as how the authors evaluated course-learning goals. In sum, 26 articles were analyzed with a coding scheme that included 56 binary items. The results indicate that the most common methods for integrating ethics into engineering involved exposing students to codes/standards, utilizing case studies, and discussion activities. Nearly half of the articles had students engage with ethical heuristics or philosophical ethics. Following the presentation of the results, this study describes in detail four articles to highlight less common but intriguing pedagogical methods and evaluation techniques. The findings indicate that there is limited empirical work on ethics education within engineering across the United States. Furthermore, due to the large variation in goals, approaches, and evaluation methods described across interventions, this study does not detail "best" practices for integrating ethics into engineering. The science and engineering education community should continue exploring the relative merits of different approaches to ethics education in engineering.
Ethical issues when using social media for health outside professional relationships.
DeCamp, Matthew
2015-04-01
Social media have the potential to revolutionize health and healthcare, but fulfilling this potential requires attention to the ethical issues social media may raise. This article reviews the major ethical issues arising when social media are used for research, public health, mobile health applications, and global health. It focuses on social media use outside fiduciary relationships between healthcare professionals and patients. Emphasis is given to the potential of social media in these contexts, the ethical issues relatively unique to each, and where possible how existing ethical principles and frameworks could help navigate these issues. In some cases social media create the circumstance for particular ethical issues but also facilitate managing them, such as in informed consent for research. In other cases, disagreement exists about whether social media - despite their potential - should be used for certain purposes, such as in public health surveillance (where confidentiality represents a significant ethical concern). In still others, ethical uncertainty exists about how social media will affect ethical issues, such as inequality in global health. As social media technologies continue to develop, identifying and managing the ethical issues they raise will be critical to their success in improving health while preserving fundamental ethical values.
Lewis, J C; Tomkins, S; Sampson, J R
2001-01-01
Objectives—To assess the process involved in obtaining ethical approval for a single-centre study involving geographically dispersed subjects with an uncommon genetic disorder. Design—Observational data of the application process to 53 local research ethics committees (LRECs) throughout Wales, England and Scotland. The Multicentre Research Ethics Committee (MREC) for Wales had already granted approval. Results—Application to the 53 LRECs required 24,552 sheets of paper and took two months of the researcher's time. The median time taken for approval was 39 days with only seven (13%) of committees responding within the recommended 21 days. In at least nineteen cases (36%) a subcommittee considered the application. Thirty-three committees (62%) accepted the proposal without amendments but, of the remainder, four (8%) requested changes outside of the remit of LRECs. Discussion—Difficulties still exist with the system for obtaining ethical approval for studies involving a single centre but with patients at multiple sites, as is often required for genetic observational research. As such studies differ from true multicentre studies, it may be advantageous to develop a separate and specific process of application to ensure that resources are not unnecessarily expended in the quest for ethical approval. Key Words: Research ethics • MREC • LREC PMID:11579194
Fessler, D
2003-01-01
Design: Electronic databases were searched for (a) editorials and ethical proclamations on hunger strikers and their treatment; (b) studies of voluntary and involuntary starvation, and (c) legal cases pertaining to hunger striking. Additional studies were gathered in a snowball fashion from the published material cited in these databases. Material was included if it (a) provided ethical or legal guidelines; (b) shed light on psychological changes accompanying starvation, or (c) illustrated the practice of hunger striking. Authors' observations, opinions, and conclusions were noted. Conclusions: Although the heterogeneous nature of the sources precluded statistical analysis, starvation appears to be accompanied by marked psychological changes. Some changes clearly impair competence, in which case physicians are advised to follow advance directives obtained early in the hunger strike. More problematic are increases in impulsivity and aggressivity, changes which, while not impairing competence, enhance the likelihood that patients will starve themselves to death. PMID:12930863
Taylor, Holly A; Wilfond, Benjamin S
2013-01-01
This case explores the ethical landscape around recontacting a subject's relatives to return genetic research results when the informed consent form signed by the original cohort of subjects is silent on whether investigators may share new information with the research subject's family. As a result of rapid advances in genetic technology, methods to identify genetic markers can mature during the life course of a study. In this case, the investigators identified the genetic mutation responsible for the disorder after a number of their original subjects had died. The researchers now have the ability to inform relatives of the subject about their risk of developing the same disease. Mark Rothstein, JD, from the University of Louisville School of Medicine, provides an overview of the medical/scientific, legal, and ethical issues underlying this case. Lauren Milner, PhD, and colleagues at Stanford University explore how the relationship between researcher and subject affect this debate. Seema Shah, JD, and colleagues at the National Institutes of Health and University of California, Los Angeles (UCLA) discuss whether and how requirements of the duty to warn are applicable in this case.
It's not all about moral reasoning: Understanding the content of Moral Case Deliberation.
Svantesson, Mia; Silén, Marit; James, Inger
2018-03-01
Moral Case Deliberation is one form of clinical ethics support described as a facilitator-led collective moral reasoning by healthcare professionals on a concrete moral question connected to their practice. Evaluation research is needed, but, as human interaction is difficult to standardise, there is a need to capture the content beyond moral reasoning. This allows for a better understanding of Moral Case Deliberation, which may contribute to further development of valid outcome criteria and stimulate the normative discussion of what Moral Case Deliberation should contain. To explore and compare the content beyond moral reasoning in the dialogue in Moral Case Deliberation at Swedish workplaces. A mixed-methods approach was applied for analysing audio-recordings of 70 periodic Moral Case Deliberation meetings at 10 Swedish workplaces. Moral Case Deliberation facilitators and various healthcare professions participated, with registered nurses comprising the majority. Ethical considerations: No objection to the study was made by an Ethical Review Board. After oral and written information was provided, consent to be recorded was assumed by virtue of participation. Other than 'moral reasoning' (median (md): 45% of the spoken time), the Moral Case Deliberations consisted of 'reflections on the psychosocial work environment' to a varying extent (md: 29%). Additional content comprised 'assumptions about the patient's psychosocial situation' (md: 6%), 'facts about the patient's situation' (md: 5%), 'concrete problem-solving' (md: 6%) and 'process' (md: 3%). The findings suggest that a restorative function of staff's wellbeing in Moral Case Deliberation is needed, as this might contribute to good patient care. This supports outcome criteria of improved emotional support, which may include relief of moral distress. However, facilitators need a strategy for how to proceed from the participants' own emotional needs and to develop the use of their emotional knowing to focus on the ethically difficult patient situation.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Malone, C.
1995-12-01
Objective resolution of environmental issues involves questions of facts and values, and, for environmental issues to be resolved ethically, a proper synthesis of environmental facts with questions of ethics must occur. In this case study, the proposal by the U.S. Department of Energy (DOE) to use the Yucca Mountain site in southwest Nevada as a deep geologic repository for the permanent disposal of the nation`s high-level nuclear waste is examined in part in the context of the {open_quotes}Code of Ethics and Standards of Practice for Environmental Professionals{close_quotes} adopted by the National Association of Environmental Professionals (NAEP). Current plans are thatmore » a repository at the Yucca Mountain site would begin functioning in 2010 and would be sealed after about 150 years. The requirement that a geologic repository must isolate nuclear waste from the environment for at least 10,000 years poses unique challenges to environmental professionals. This case study also analyzes the challenges in terms of the implications of a new federal Executive Order on Ecosystem Management and corresponding internal orders within all federal agencies to conform to the Executive Order. The imposition of the principles and practices of ecosystem-based resource management on federal agencies provides an opportunity to also address, in the context of the DOE Yucca Mountain Project, (1) the ecosystem approach to environmental management, (2) concepts of holistic resource management planning, and (3) the concepts of sustainability and biodiversity. Within this framework there are important implications for environmental ethics and professional practice that must remain at the forefront of concerns of the NAEP over the next two decades.« less
Cross-border data exchange - a case study on international collaboration gone wrong
NASA Astrophysics Data System (ADS)
Yanko-Hombach, Valentina
2016-04-01
The subject of ethics in science has become a hot topic recently (Gleick, 2011). As publication pressure on researchers increases and use of the internet allows faster turn-around, the quality of the peer review process has suffered. This presentation describes one case of scientific ethics violation in which the editors of a high-ranking scientific journal improperly permitted publication of a paper that was based upon unethical acquisition of data and failed to acknowledge scientific collaboration and exchange of intellectual property. We will present "Case description" and "Ethical issues" with a hope that our experience draws attention to important ethical issues in international collaborative research, and prevents such misconduct in the future. Since international research involves cooperation and coordination among many people in different disciplines and institutions across national borders, ethical standards should promote values that are essential to integrity and collaborative work, including trust, accountability, mutual respect, and fairness. One lesson to be learned is not to engage in collaboration without a written agreement stating clearly who is responsible for what and how the results of collaborative research are to be shared. This is especially important in cases of international collaborations, particularly those involving smaller or developing nations who often do not have the high-tech facilities of developed nations. There is also need to establish clear regulations regarding co-authorship on papers in which intellectual property and significant financial investment was made to allow the research to proceed. As such, a system of ethics to guide the practice of science from data collection to publication and beyond is timely and much needed to protect the integrity of scientific collaboration. It will keep science moving forward by validating research findings and confirming or raising questions about results. References Benos, D. J., Fabres, J., Farmer, J., Gutierrez, J.P., Hennessy, K., Kosek, D., Joo Hyoung Lee, Olteanu, D., Russell, T., Shaikh, F., Wang, K. 2005. Ethics and scientific publication. Adv. Physiol. Educ. 29: 59-74. Gleick, P. 2011. AGU's new task force on scientific ethics and integrity begins work. EOS 92(47): 22. Guidelines for responsible conduct of research. http://www.provost.pitt.edu/documents/GUIDELINES FOR ETHICAL PRACTICES IN RESEARCH-FINALrevised2-March 2011.pdf
Gallagher, Bernard; Berman, Anne H.; Bieganski, Justyna; Jones, Adele D.; Foca, Liliana; Raikes, Ben; Schiratzki, Johanna; Urban, Mirjam; Ullman, Sara
2016-01-01
Although international research is increasing in volume and importance, there remains a dearth of knowledge on similarities and differences in “national human research ethics” (NHREs), that is, national ethical guidelines (NEGs), Institutional Review Boards (IRBs), and research stakeholder’ ethical attitudes and behaviors (EABs). We begin to address this situation by reporting upon our experiences in conducting a multinational study into the mental health of children who had a parent/carer in prison. The study was conducted in 4 countries: Germany, Great Britain, Romania, and Sweden. Data on NHREs were gathered via a questionnaire survey, two ethics-related seminars, and ongoing contact between members of the research consortium. There was correspondence but even more so divergence between countries in the availability of NEGs and IRBs and in researcher’ EABs. Differences in NHREs have implications particularly in terms of harmonization but also for ethical philosophy and practice and for research integrity. PMID:27746664
Threats to bioethical principles in medical practice in Brazil: new medical ethics code period.
Gracindo, G C L; da Silva Gallo, J H; Nunes, R
2018-03-15
We aimed to outline the profile of medical professionals in Brazil who have violated the deontological norms set forth in the ethics code of the profession, and whose cases were judged by the higher tribunal for medical ethics between 2010 and 2016. This survey was conducted using a database formed from professional ethics cases extracted from the plenary of the medical ethics tribunal of the Federal Council of Medicine. These were disciplinary ethics cases that were judged at appeal level between 2010 and 2016. Most of these professionals were male (88.5%) and their mean age was 59.9 years (SD=11.62) on the date of judgment of their appeals, ranging from 28 to 95 years. Most of them were based in the southeastern region of Brazil (50.89%). Articles 1 and 18 of the medical ethics code were the rules most frequently violated. The sentence given most often was the cancellation of their professional license (37.6%) and the acts most often sentenced involved malpractice, imprudence, and negligence (18.49%). It is acknowledged that concern for the principles of bioethics was present in the appeal decisions made by the plenary of the medical ethics tribunal of the Federal Council of Medicine.
Aristotle Meets Youth Work: A Case for Virtue Ethics
ERIC Educational Resources Information Center
Bessant, Judith
2009-01-01
What ethical framework provides the best guide for contemporary youth work is the central question in this article. An account is provided of why the two dominant ethical frameworks, namely, utilitarianism and deontic ethics, are not appropriate. It is argued that virtue ethics is most relevant because it specifies the nature of social goods, and…
Bustard, John D
2018-04-01
In spite of the acknowledged importance of professional ethics, technical students often show little enthusiasm for studying the subject. This paper considers how such engagement might be improved. Four guiding principles for promoting engagement are identified: (1) aligning teaching content with student interests; (2) taking a pragmatic rather than a philosophical approach to issue resolution; (3) addressing the full complexity of real-world case studies; and (4) covering content in a way that students find entertaining. The use of these principles is then discussed with respect to the specific experience of developing and presenting a master's module in Ethical and Legal Issues in Cyber Security at Queens University Belfast. One significant aspect of the resulting design is that it encourages students to see ethical issues in systemic terms rather than from an individual perspective, with issues emerging from a conflict between different groups with different vested interests. Case studies are used to examine how personal and business priorities create conflicts that can lead to negative press, fines and punitive legal action. The module explores the reasons why organisations may be unaware of the risks associated with their actions and how an inappropriate response to an ethical issue can significantly aggravate a situation. The module has been delivered in three successive years since 2014 and been well received on each occasion. The paper describes the design of the module and the experience of delivering it, concluding with a discussion of the effectiveness of the approach.
Medical ethics on film: towards a reconstruction of the teaching of healthcare professionals
Volandes, Angelo
2007-01-01
The clinical vignette remains the standard means by which medical ethics are taught to students in the healthcare professions. Although written or verbal vignettes are useful as a pedagogic tool for teaching ethics and introducing students to real cases, they are limited, since students must imagine the clinical scenario. Medical ethics are almost universally taught during the early years of training, when students are unfamiliar with the clinical reality in which ethics issues arise. Film vignettes fill in that imaginative leap. By providing vivid details with images, film vignettes offer rich and textured details of cases, including the patient's perspective and the clinical reality. Film vignettes provide a detailed ethnography that allows for a more complete discussion of the ethical issues. Film can serve as an additional tool for teaching medical ethics to members of the healthcare professions. PMID:17971475
Opening the black box of ethics policy work: evaluating a covert practice.
Frolic, Andrea; Drolet, Katherine; Bryanton, Kim; Caron, Carole; Cupido, Cynthia; Flaherty, Barb; Fung, Sylvia; McCall, Lori
2012-01-01
Hospital ethics committees (HECs) and ethicists generally describe themselves as engaged in four domains of practice: case consultation, research, education, and policy work. Despite the increasing attention to quality indicators, practice standards, and evaluation methods for the other domains, comparatively little is known or published about the policy work of HECs or ethicists. This article attempts to open the "black box" of this health care ethics practice by providing two detailed case examples of ethics policy reviews. We also describe the development and application of an evaluation strategy to assess the quality of ethics policy review work, and to enable continuous improvement of ethics policy review processes. Given the potential for policy work to impact entire patient populations and organizational systems, it is imperative that HECs and ethicists develop clearer roles, responsibilities, procedural standards, and evaluation methods to ensure the delivery of consistent, relevant, and high-quality ethics policy reviews.
Ethical issues in the evaluation and treatment of death row inmates.
Matthews, Daryl; Wendler, Sheila
2006-09-01
To summarize recent ethical analyses of psychiatrists' participation in the evaluation and treatment of death row inmates. Psychiatric participation in death penalty cases remains highly controversial in the United States, whereas there appears to be a more worldwide consensus that it is ethically inappropriate. Psychiatrists working in death penalty settings are functioning in a complex ethical arena, and must consider the implications of their decisions to participate and/or abstain from various activities with great care and attention to the circumstances of the individual cases at hand.
Fournier, Véronique; Spranzi, Marta; Foureur, Nicolas; Brunet, Laurence
2015-01-01
Several approaches to clinical ethics consultation (CEC) exist in medical practice and are widely discussed in the clinical ethics literature; different models of CECs are classified according to their methods, goals, and consultant's attitude. Although the "facilitation" model has been endorsed by the American Society for Bioethics and Humanities (ASBH) and is described in an influential manual, alternative approaches, such as advocacy, moral expertise, mediation, and engagement are practiced and defended in the clinical ethics field. Our Clinical Ethics Center in Paris was founded in 2002 in the wake of the Patients' Rights Act, and to date it is the largest center that provides consultation services in France. In this article we shall describe and defend our own approach to clinical ethics consultation, which we call the "Commitment Model," in comparison with other existing models. Indeed commitment implies, among other meanings, continuity through time, a series of coherent actions, and the realization of important social goals. By drawing on a recent consultation case, we shall describe the main steps of our consultation procedure: interviews with major stakeholders, including patients and proxies; case conferences; and follow up. We shall show why we have chosen the term "commitment" to represent our approach at three different but interrelated levels: commitment towards patients, within the case conference group, and towards society as a whole. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.
A Case of Attempted Suicide in Huntington's Disease: Ethical and Moral Considerations.
Furfari, Kristin; Zehnder, Nichole; Abbott, Jean
2016-01-01
A 62-year-old female with Huntington's disease presented after a suicide attempt. Her advance directive stated that she did not want intubation or resuscitation, which her family acknowledged and supported. Despite these directives, she was resuscitated in the emergency department and continued to state that she would attempt suicide again. Her suicidality in the face of a chronic and advancing illness, and her prolonged consistency in her desire to take her own life, left careproviders wondering how to provide ethical, respectful care to this patient. Tension between the ethical principles of autonomy and beneficence is central in this case. The patient's narrative demonstrated that her suicide was an autonomous decision, free from coercion or disordered thinking from mental illness. Beneficence then would seem to necessitate care aligned with the patient's desire to end her life, which created ethical uneasiness for her family and careproviders. The case highlights several end-of-life ethical considerations that have received much recent attention. With ongoing discussions about the legalization of aid in dying across the country, caregivers are challenged to understand what beneficence means in people with terminal illnesses who want a say in their death. This case also highlights the profound moral distress of families and careproviders that arises in such ethically challenging scenarios. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.
Lewis, J C; Tomkins, S; Sampson, J R
2001-10-01
To assess the process involved in obtaining ethical approval for a single-centre study involving geographically dispersed subjects with an uncommon genetic disorder. Observational data of the application process to 53 local research ethics committees (LRECs) throughout Wales, England and Scotland. The Multicentre Research Ethics Committee (MREC) for Wales had already granted approval. Application to the 53 LRECs required 24,552 sheets of paper and took two months of the researcher's time. The median time taken for approval was 39 days with only seven (13%) of committees responding within the recommended 21 days. In at least nineteen cases (36%) a subcommittee considered the application. Thirty-three committees (62%) accepted the proposal without amendments but, of the remainder, four (8%) requested changes outside of the remit of LRECs. Difficulties still exist with the system for obtaining ethical approval for studies involving a single centre but with patients at multiple sites, as is often required for genetic observational research. As such studies differ from true multicentre studies, it may be advantageous to develop a separate and specific process of application to ensure that resources are not unnecessarily expended in the quest for ethical approval.
Dealing with ethical challenges: a focus group study with professionals in mental health care.
Molewijk, Bert; Hem, Marit Helene; Pedersen, Reidar
2015-01-16
Little is known about how health care professionals deal with ethical challenges in mental health care, especially when not making use of a formal ethics support service. Understanding this is important in order to be able to support the professionals, to improve the quality of care, and to know in which way future ethics support services might be helpful. Within a project on ethics, coercion and psychiatry, we executed a focus group interview study at seven departments with 65 health care professionals and managers. We performed a systematic and open qualitative analysis focusing on the question: 'How do health care professionals deal with ethical challenges?' We deliberately did not present a fixed definition or theory of ethical challenge. We categorized relevant topics into three subthemes: 1) Identification and presence of ethical challenges; 2) What do the participants actually do when dealing with an ethical challenge?; and 3) The significance of facing ethical challenges. Results varied from dealing with ethical challenges every day and appreciating it as a positive part of working in mental health care, to experiencing ethical challenges as paralyzing burdens that cause a lot of stress and hinder constructive team cooperation. Some participants reported that they do not have the time and that they lack a specific methodology. Quite often, informal and retrospective ad-hoc meetings in small teams were organized. Participants struggled with what makes a challenge an ethical challenge and whether it differs from a professional challenge. When dealing with ethical challenges, a number of participants experienced difficulties handling disagreement in a constructive way. Furthermore, some participants plead for more attention for underlying intentions and justifications of treatment decisions. The interviewed health care professionals dealt with ethical challenges in many different ways, often in an informal, implicit and reactive manner. This study revealed nine different categories of what health care professionals implicitly or explicitly conceive as 'ethical challenges'. Future research should focus on how ethics support services, such as ethics reflection groups or moral case deliberation, can be of help with respect to dealing with ethical challenges and value disagreements in a constructive way.
Teaching the Interactionist Model of Ethics: Two Brief Case Studies
ERIC Educational Resources Information Center
Tomlinson, Edward C.
2009-01-01
This article draws on the interactionist model of ethics as a framework to help students answer two key questions they will confront in their future careers: (a) How can I, as a professional manager, deter clearly unethical behavior among my subordinates? and (b) How can I avoid engaging in clearly unethical behavior myself? For each of these…
Unethical Scholarship Today: A Preliminary Typology.
ERIC Educational Resources Information Center
Cooper, Douglas W.
Today many signs point to an uneasy concern among scholars regarding the ethics of their peers. All too frequently the press reports cases of ethical breaches in many fields of scholarship. Over the years a few people have continued to note and study patterns of deviant and unethical behavior in scholarship. But in spite of the need to…
The Code of Professional Responsibility and the College and University Lawyer
ERIC Educational Resources Information Center
Williams, Omer S. J.
1975-01-01
Background and history of the Canons of Ethics and Code of Professional Responsibility, adopted by the American Bar Association in 1969, are briefly outlined, and, as a case study, certain contexts in which ethical questions may arise for the college or university lawyer are discussed. Focus is on the lawyer as advisor. (JT)
Citizenship, Secularity and the Ethics and Religious Culture Program of Quebec
ERIC Educational Resources Information Center
Zaver, Arzina; DeMartini, Ashley
2016-01-01
This article focuses on some of the broader complexities of citizenship in Quebec, paying particular attention to the Quiet Revolution and Bill 60 (Charter of Values) in order to understand how these historical events shape contemporary politics. Using a case study of the Ethics and Religious Culture Program (ERC) in Quebec, we seek to highlight…
Virtue Ethics and the Narrative Identity of American Librarianship 1876 to Present
ERIC Educational Resources Information Center
Burgess, John Timothy Freedom
2013-01-01
The purpose of this study is to propose a means of reconciling the competing ideas of library and information science's identity, thereby strengthening professional autonomy. I make the case that developing a system of virtue ethics for librarianship would be an effective way to promote that reconciliation. The first step in developing virtue…
Towards an Ethical Music Education? Looking through the Lens of Levinas
ERIC Educational Resources Information Center
Jourdan, Kathryn
2012-01-01
What happens when pupils encounter unfamiliar musical expressions in the music classroom? What responsibility do we have towards those whose music we "use"? Underlying these concerns is the need for an ethical underpinning for music education. Drawing on a year-long ethnographically informed case study of music-making in the lives of a…
An Ecological Perspective of Power in Transformational Learning: A Case Study of Ethical Vegans.
ERIC Educational Resources Information Center
McDonald, Barbara; Cervero, Ronald M.; Courtenay, Bradley C.
1999-01-01
In-depth interviews with 12 ethical vegans revealed the process of becoming vegetarian. Transformative learning proved to be a journey rather than a one-time decision. Mezirow's transformative theory does not adequately account for the power relations central to this process. Therefore, transformative learning should be viewed more holistically.…
Surrender - A Soldier’s Legal, Ethical, and Moral Obligations; with Philippine Case Study.
1989-06-02
69 - this view. Contemporary philosophers John Rawles , Alan Gerwirth, and Henry Shue, among others, express the conviction that each person can claim a...34 Machiavelli , Management, and Moral Leadership," in Military Ethics, edited by Wakin, Wenker, and Kempf, p.38. 48 Ibid., pp. 41 and 44. 49 Morris Janowitz
Sources of bias in clinical ethics case deliberation.
Magelssen, Morten; Pedersen, Reidar; Førde, Reidun
2014-10-01
A central task for clinical ethics consultants and committees (CEC) is providing analysis of, and advice on, prospective or retrospective clinical cases. However, several kinds of biases may threaten the integrity, relevance or quality of the CEC's deliberation. Bias should be identified and, if possible, reduced or counteracted. This paper provides a systematic classification of kinds of bias that may be present in a CEC's case deliberation. Six kinds of bias are discussed, with examples, as to their significance and risk factors. Possible remedies are suggested. The potential for bias is greater when the case deliberation is performed by an individual ethics consultant than when an entire clinical ethics committee is involved. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
The ethics of placebo-controlled trials: methodological justifications.
Millum, Joseph; Grady, Christine
2013-11-01
The use of placebo controls in clinical trials remains controversial. Ethical analysis and international ethical guidance permit the use of placebo controls in randomized trials when scientifically indicated in four cases: (1) when there is no proven effective treatment for the condition under study; (2) when withholding treatment poses negligible risks to participants; (3) when there are compelling methodological reasons for using placebo, and withholding treatment does not pose a risk of serious harm to participants; and, more controversially, (4) when there are compelling methodological reasons for using placebo, and the research is intended to develop interventions that can be implemented in the population from which trial participants are drawn, and the trial does not require participants to forgo treatment they would otherwise receive. The concept of methodological reasons is essential to assessing the ethics of placebo controls in these controversial last two cases. This article sets out key considerations relevant to considering whether methodological reasons for a placebo control are compelling. © 2013.
Migration: a core public health ethics issue.
Wild, V; Dawson, A
2018-05-01
In this article, we outline the link between migration, public health and ethics. Discussing relevant arguments about migration from the perspective of public health and public health ethics. Critical review of theories and frameworks, case-based analysis and systematic identification and discussion of challenges. Migration is a core issue of public health ethics and must take a case-based approach: seeking to identify the specific ethical dimensions and vulnerabilities in each particular context. Public health as a practice, built upon the core value of justice, requires the protection and promotion of migrants' well-being (even if this produces tension with immigration services). Ethical analysis should take all phases of migration into account: before, during and after transit. We argue that migration policies, at least as they relate to migrants' well-being, should be founded upon a shared humanity, respect for human rights and on the idea that effective public health cannot and should not be confined within the borders and to the citizens of any host country. We make the case for migration to be seen as a core issue of public health ethics. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Ethics and proposals: A case study
DOE Office of Scientific and Technical Information (OSTI.GOV)
Agnew, M.J.
1992-01-01
Who can read about ethics in technical communication at 2 a.m. when you have to face an ethical problem the next day at work In the middle of ethical turmoil, examining the balance of power can be helpful in finding the best course of action, particularly if the situation is sales- or marketing-related. The author points out that it never hurts to examine honestly all sides of a situation, including checking the balance of power, to see what you would do. In fact, it's the only way to start preparing yourself for your next dilemma. And because all communication canmore » be seen as at least persuasive, if not downright marketing-oriented, each of us may have the opportunity to face our own ethical issues.« less
Ethics and proposals: A case study
DOE Office of Scientific and Technical Information (OSTI.GOV)
Agnew, M.J.
1992-08-01
Who can read about ethics in technical communication at 2 a.m. when you have to face an ethical problem the next day at work? In the middle of ethical turmoil, examining the balance of power can be helpful in finding the best course of action, particularly if the situation is sales- or marketing-related. The author points out that it never hurts to examine honestly all sides of a situation, including checking the balance of power, to see what you would do. In fact, it`s the only way to start preparing yourself for your next dilemma. And because all communication canmore » be seen as at least persuasive, if not downright marketing-oriented, each of us may have the opportunity to face our own ethical issues.« less
Provider biases and choices: the role of gender.
Wertz, D C
1993-09-01
Genetic counseling provides a unique opportunity to test the influence of gender on moral reasoning. The theories of Carol Gilligan on women's "relationship based" framework for ethical decision making were contrasted with Kohlberg's research on men's resolution of conflicts based on abstract, universal principles in an impersonal and fair manner. Discussion also focussed on the theories of sociologists, such as Kanter's that a profession prestige and income as well as the proportion of women in profession determine the approach to ethical problems. This study reports on survey data in 1985 and 1986 collected from medical geneticists in 19 countries that had at least 10 medical geneticists, with at least one available to distribute questionnaires, and the appropriate geographic distribution. The survey did not include genetic counselors and allied professionals. The questionnaire asked for responses to 14 case studies, 4 questions on genetic screening and access to test results, and 12 questions on the goals and conduct of genetic counseling. 62% responded. Sociodemographic data were also collected and analyzed in stepwise logistic regressions. THe results showed that gender was the single most important determinant of ethical decision making and ethical reasoning. There were gender differences in responses to 6 of the 14 cases and, in the US, for a 7th case: sex selection. In the US, women were 4.4 times more likely to counsel indirectly about XYY fetuses and 3.6 more likely to bring up issues like false paternity or genetic carriers in other family members. Patient autonomy was an issued in a case involving a 25-year-old woman who demanded prenatal diagnosis with no genetic or medical indications and another case involving a couple desiring a son after having 4 daughters. Rights based responses were provided by 49% and relationship based responses by 44%. Gilligan's hypothesis was not supported. Similar results were found in a survey of genetic counselors, who were 94% women. A summary of other studies involving actual practices was given. Further research is needed to determine the processes of professionals' self definition, ethical views, and extent to which views and practices are gender or profession related; training programs may affect provider attitudes.
Key, Kent D
2017-10-01
As the Flint community endeavors to recover and move forward in the aftermath of the Flint water crisis, distrust of scientific and governmental authorities must be overcome. Future community engagement in research will require community-level protections ensuring that no further harm is done to the community. A community ethics review explores risks and benefits and complements institutional review board (IRB) review. Using the case of Flint, I describe how community-level ethical protections can reestablish a community's trust. All IRBs reviewing protocols that include risk to communities and not merely individual participants should consider how community members are engaged in the proposed research and identify and respond to questions and domains of concern from community members. © 2017 American Medical Association. All Rights Reserved.
Patients who make terrible therapeutic choices.
Curzer, Howard J
2014-01-01
The traditional approaches to dental ethics include appeals to principles, duties (deontology), and consequences (utilitarianism). These approaches are often inadequate when faced with the case of a patient who refuses reasonable treatment and does not share the same ethical framework the dentist is using. An approach based on virtue ethics may be helpful in this and other cases. Virtue ethics is a tradition going back to Plato and Aristotle. It depends on forming a holistic character supporting general appropriate behavior. By correctly diagnosing the real issues at stake in a patient's inappropriate oral health choices and working to build effective habits, dentists can sometimes respond to ethical challenges that remain intractable given rule-based methods.
32 CFR 776.85 - Effect of separate proceeding.
Code of Federal Regulations, 2010 CFR
2010-07-01
... that issue during an ethics investigation. A subsequent ethics investigation based on such misconduct... the basis for ethics charges under this instruction, the Rules Counsel may dispense with the preliminary inquiry and proceed directly with an ethics investigation. (c) In those cases in which a covered...
Teaching Ethics across the Public Relations Curriculum.
ERIC Educational Resources Information Center
Hutchison, Liese L.
2002-01-01
Suggests ways of incorporating ethics across the undergraduate public relations curriculum. Reviews current coverage of ethics in public relations principles, writing, cases, and textbooks. Suggests other methods that teachers can use to incorporate ethical pedagogical tools in all public relations courses in an effort to develop students' ethical…
How best shall we serve? Case study.
Rabkin, M T; Bayley, C; Beauchamp, D E
1993-01-01
Four disparate proposals for hospital programs, varying in their funding requirements and revenue-generating capacity, have been made to the chief executive officer (CEO) of a metropolitan nonprofit general hospital that has always prided itself on being responsive to community needs. Although the hospital faces severe financial pressures, the CEO has determined that one of the proposals can be supported. Three commentaries on this case discuss what ethical criteria should be considered in evaluating the four proposals, and what role the hospital ethics committee should play in the decision.
ERIC Educational Resources Information Center
Abraham, Nithin Susan; Abulencia, James Patrick
2011-01-01
This study focuses on the effectiveness of incorporating the Laboratory for Innovative Technology and Engineering Education (LITEE) Lorn Manufacturing case into a senior level chemical engineering unit operations course at Manhattan College. The purpose of using the case study is to demonstrate the relevance of ethics to chemical engineering…
Epistemology as Ethics in Research and Policy: The Use of Case Studies
ERIC Educational Resources Information Center
Elliott, John; Lukes, Dominik
2008-01-01
This article examines the ethnographic case study in education in the context of policy making with particular emphasis on the practice of research and policy making. The central claim of the article is that it is impossible to establish a transcendental epistemology of the case study on instrumental rationality. Instead it argues for the notion…
Beyond a code of ethics: phenomenological ethics for everyday practice.
Greenfield, Bruce; Jensen, Gail M
2010-06-01
Physical therapy, like all health-care professions, governs itself through a code of ethics that defines its obligations of professional behaviours. The code of ethics provides professions with a consistent and common moral language and principled guidelines for ethical actions. Yet, and as argued in this paper, professional codes of ethics have limits applied to ethical decision-making in the presence of ethical dilemmas. Part of the limitations of the codes of ethics is that there is no particular hierarchy of principles that govern in all situations. Instead, the exigencies of clinical practice, the particularities of individual patient's illness experiences and the transformative nature of chronic illnesses and disabilities often obscure the ethical concerns and issues embedded in concrete situations. Consistent with models of expert practice, and with contemporary models of patient-centred care, we advocate and describe in this paper a type of interpretative and narrative approach to moral practice and ethical decision-making based on phenomenology. The tools of phenomenology that are well defined in research are applied and examined in a case that illustrates their use in uncovering the values and ethical concerns of a patient. Based on the deconstruction of this case on a phenomenologist approach, we illustrate how such approaches for ethical understanding can help assist clinicians and educators in applying principles within the context and needs of each patient. (c) 2010 John Wiley & Sons, Ltd.
Graduate Ethics Curricula for Future Geospatial Technology Professionals (Invited)
NASA Astrophysics Data System (ADS)
Wright, D. J.; Dibiase, D.; Harvey, F.; Solem, M.
2009-12-01
Professionalism in today's rapidly-growing, multidisciplinary geographic information science field (e.g., geographic information systems or GIS, remote sensing, cartography, quantitative spatial analysis), now involves a commitment to ethical practice as informed by a more sophisticated understanding of the ethical implications of geographic technologies. The lack of privacy introduced by mobile mapping devices, the use of GIS for military and surveillance purposes, the appropriate use of data collected using these technologies for policy decisions (especially for conservation and sustainability) and general consequences of inequities that arise through biased access to geospatial tools and derived data all continue to be challenging issues and topics of deep concern for many. Students and professionals working with GIS and related technologies should develop a sound grasp of these issues and a thorough comprehension of the concerns impacting their use and development in today's world. However, while most people agree that ethics matters for GIS, we often have difficulty putting ethical issues into practice. An ongoing project supported by NSF seeks to bridge this gap by providing a sound basis for future ethical consideration of a variety of issues. A model seminar curriculum is under development by a team of geographic information science and technology (GIS&T) researchers and professional ethicists, along with protocols for course evaluations. In the curricula students first investigate the nature of professions in general and the characteristics of a GIS&T profession in particular. They hone moral reasoning skills through methodical analyses of case studies in relation to various GIS Code of Ethics and Rules of Conduct. They learn to unveil the "moral ecologies" of a profession through actual interviews with real practitioners in the field. Assignments thus far include readings, class discussions, practitioner interviews, and preparations of original case studies. Curricula thus far are freely available via gisprofessionalethics.org.
ERIC Educational Resources Information Center
McBride, Dawn L.
2010-01-01
Selected clinical and ethical issues associated with providing supervision involving family violence cases are outlined. It is argued that supervisees helping clients with trauma histories require skills beyond learning how to process the trauma with their clients. Advocacy, social action, and coordinating case conferences are some of the…
Martin, Graeme B; Kadokawa, Hiroya
2006-02-01
In response to changes in society and thus the marketplace, we need a vision for the future of our animal industries, including both on-farm and off-farm activities, that is "clean, green and ethical". Using small ruminants as a case study, we describe three "clean, green and ethical" strategies that farmers could use to improve reproductive performance. The first allows control of the timing of reproductive events by using socio-sexual signals (the "male effect") to induce synchronised ovulation in females. The second strategy, "focus feeding", is based on using short periods of nutritional supplements that are precisely timed and specifically designed for each event in the reproductive process (eg, gamete production, embryo survival, fetal programming, colostrum production). The third strategy aims to maximize offspring survival by a combination of management, nutrition and genetic selection for behaviour (temperament). All of these approaches involve non-pharmacological manipulation of the endogenous control systems of the animals and complement the detailed information from ultrasound that is now becoming available. Importantly, these approaches all have a solid foundation in reproductive biology. In several cases, they are currently used in commercial practice, but there is still room for improvement through both basic and applied research. Ultimately, these "clean, green and ethical" tools can be cost-effective, increase productivity and, at the same time, greatly improve the image of meat and milk industries in society and the marketplace.
Evidence-based, ethically justified counseling for fetal bilateral renal agenesis.
Thomas, Alana N; McCullough, Laurence B; Chervenak, Frank A; Placencia, Frank X
2017-07-26
Not much data are available on the natural history of bilateral renal agenesis, as the medical community does not typically offer aggressive obstetric or neonatal care asbilateral renal agenesis has been accepted as a lethal condition. To provide an evidence-based, ethically justified approach to counseling pregnant women about the obstetric management of bilateral renal agenesis. A systematic literature search was performed using multiple databases. We deploy an ethical analysis of the results of the literature search on the basis of the professional responsibility model of obstetric ethics. Eighteen articles met the inclusion criteria for review. With the exception of a single case study using serial amnioinfusion, there has been no other case of survival following dialysis and transplantation documented. Liveborn babies die during the neonatal period. Counseling pregnant women about management of pregnancies complicated by bilateral renal agenesis should be guided by beneficence-based judgment informed by evidence about outcomes. Based on the ethical analysis of the results from this review, without experimental obstetric intervention, neonatal mortality rates will continue to be 100%. Serial amnioinfusion therefore should not be offered as treatment, but only as approved innovation or research.
Rethinking Research Ethics: The Case of Postmarketing Trials
London, Alex John; Carlisle, Benjamin
2015-01-01
Phase IV studies are often criticized for poor scientific standards. Yet they provide an important resource for addressing evidence shortfalls in drug safety, comparative effectiveness, and real-world utility. Current research ethics policies, and contemplated revisions to them, do not provide an adequate framework for preventing social harms that result from poor post-marketing research practice. Rather than focus exclusively on the welfare and interests of human volunteers, research policies and ethics should also safeguard the integrity of the research enterprise as a system for producing reliable medical evidence. We close by briefly describing how an integrity framework might be implemented for phase IV studies. PMID:22556237
Ethical issues in field research: balancing competing values.
O'Neill, P
1990-04-01
An ethical issue becomes a dilemma when the psychologist is pulled in different directions by competing values. This paper will focus on the conflict between experimental and ethical values inherent in field research. The problem has special significance in community psychology, which gives priority to studying, in natural settings, those affected by social problems. An example is given of research that required observation of family interaction in the homes of convicted child abusers. The case demonstrates that the value of ecological validity often conflicts with the need to protect privacy and obtain uncoerced consent. Other ethical constraints, including the duty to report lawbreaking and to protect the public from harm, may threaten research validity.
The Ethics of Archival Research
ERIC Educational Resources Information Center
McKee, Heidi A.; Porter, James E.
2012-01-01
What are the key ethical issues involved in conducting archival research? Based on examination of cases and interviews with leading archival researchers in composition, this article discusses several ethical questions and offers a heuristic to guide ethical decision making. Key to this process is recognizing the person-ness of archival materials.…
5 CFR 2634.1007 - Cases in which Certificates of Divestiture will not be issued.
Code of Federal Regulations, 2011 CFR
2011-01-01
... ETHICS GOVERNMENT ETHICS EXECUTIVE BRANCH FINANCIAL DISCLOSURE, QUALIFIED TRUSTS, AND CERTIFICATES OF... issued. The Director of the Office of Government Ethics, in his or her sole discretion, may deny a... a contract to renovate office space at his agency. The Department's designated agency ethics...
76 FR 31393 - Federal Acquisition Regulation; Federal Acquisition Circular 2005-52; Introduction
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-31
... 2010-017 Robinson. Ethics Programs. VI Technical Amendments... SUPPLEMENTARY INFORMATION: Summaries for... technology that is a commercial item. Item V--Oversight of Contractor Ethics Programs (FAR Case 2010-017... Code of Business Ethics and Conduct. Contracting officers may ask to see a contractor's code of ethics...
Building locally relevant ethics curricula for nursing education in Botswana.
Barchi, F; Kasimatis Singleton, M; Magama, M; Shaibu, S
2014-12-01
The goal of this multi-institutional collaboration was to develop an innovative, locally relevant ethics curriculum for nurses in Botswana. Nurses in Botswana face ethical challenges that are compounded by lack of resources, pressures to handle tasks beyond training or professional levels, workplace stress and professional isolation. Capacity to teach nursing ethics in the classroom and in professional practice settings has been limited. A pilot curriculum, including cases set in local contexts, was tested with nursing faculty in Botswana in 2012. Thirty-three per cent of the faculty members indicated they would be more comfortable teaching ethics. A substantial number of faculty members were more likely to introduce the International Council of Nurses Code of Ethics in teaching, practice and mentoring as a result of the training. Based on evaluation data, curricular materials were developed using the Code and the regulatory requirements for nursing practice in Botswana. A web-based repository of sample lectures, discussion cases and evaluation rubrics was created to support the use of the materials. A new master degree course, Nursing Ethics in Practice, has been proposed for fall 2015 at the University of Botswana. The modular nature of the materials and the availability of cases set within the context of clinical nurse practice in Botswana make them readily adaptable to various student academic levels and continuing professional development programmes. The ICN Code of Ethics for Nursing is a valuable teaching tool in developing countries when taught using locally relevant case materials and problem-based teaching methods. The approach used in the development of a locally relevant nursing ethics curriculum in Botswana can serve as a model for nursing education and continuing professional development programmes in other sub-Saharan African countries to enhance use of the ICN Code of Ethics in nursing practice. © 2014 International Council of Nurses.
Human research ethics committees in technical universities.
Koepsell, David; Brinkman, Willem-Paul; Pont, Sylvia
2014-07-01
Human research ethics has developed in both theory and practice mostly from experiences in medical research. Human participants, however, are used in a much broader range of research than ethics committees oversee, including both basic and applied research at technical universities. Although mandated in the United States, the United Kingdom, Canada, and Australia, non-medical research involving humans need not receive ethics review in much of Europe, Asia, Latin America, and Africa. Our survey of the top 50 technical universities in the world shows that, where not specifically mandated by law, most technical universities do not employ ethics committees to review human studies. As the domains of basic and applied sciences expand, ethics committees are increasingly needed to guide and oversee all such research regardless of legal requirements. We offer as examples, from our experience as an ethics committee in a major European technical university, ways in which such a committee provides needed services and can help ensure more ethical studies involving humans outside the standard medical context. We provide some arguments for creating such committees, and in our supplemental article, we provide specific examples of cases and concerns that may confront technical, engineering, and design research, as well as outline the general framework we have used in creating our committee. © The Author(s) 2014.
Bazrafcan, Leila; Takmil, Farnaz; Shokrpour, Nasrin
2018-06-18
Problem-based learning (PBL) has become a distinct approach in learning. To assess the effectiveness of PBL in teaching ethics to medical students and the effect it has on their ethical reasoning, we decided to hold a PBL ethics workshop and then evaluate them based on pretest and posttest. This quasi-experimental comparative study in Shiraz University of Medical Sciences was designed based on pretest-posttest nonequivalent groups. After obtaining their consent, 120 health care providers were randomly selected and assigned in 4 groups and then asked to attend the ethics workshop. For measuring the participants' ethical reasoning through pretesting and posttesting, a case study consisting of 21 multiple-choice questions (cognitive domain-apply level) was performed. Data were then collected using a questionnaire, which was completed by the participants and analyzed using SPSS software (version 17). The comparison between the participants' attitude and knowledge toward ethics before and after the workshop revealed that all indices in the cognitive domain were changed (P < .001). The scores of pretest and posttest were significantly different. As to the results of our study, the PBL groups showed a more positive learning attitude and higher motivation in comparison with the control group who were subjected to traditional-based method of learning. The result of our study suggests that PBL can and should be used as an alternative method in teaching ethics in medical students because it is more effective and motivates the students.
Why should ethics approval be required prior to publication of health promotion research?
Newson, Ainsley J; Lipworth, Wendy
2015-12-01
Most academic journals that publish studies involving human participants require evidence that the research has been approved by a human research ethics committee (HREC). Yet journals continue to receive submissions from authors who have failed to obtain such approval. In this paper, we provide an ethical justification of why journals should not, in general, publish articles describing research that has no ethics approval, with particular attention to the health promotion context. Using theoretical bioethical reasoning and drawing on a case study, we first rebut some potential criticisms of the need for research ethics approval. We then outline four positive claims to justify a presumption that research should, in most instances, be published only if it has been undertaken with HREC approval. We present four justifications for requiring ethics approval before publication: (1) HREC approval adds legitimacy to the research; (2) the process of obtaining HREC approval can improve the quality of an intervention being investigated; (3) obtaining HREC approval can help mitigate harm; and (4) obtaining HREC approval demonstrates respect for persons. This paper provides a systematic and comprehensive assessment of why research ethics approval should generally be obtained before publishing in the health promotion context. So what? Journals such as the Health Promotion Journal of Australia have recently begun to require research ethics approval for publishing research. Health promotion researchers will be interested in learning the ethical justification for this change.
House, Darlene R; Marete, Irene; Meslin, Eric M
2016-01-01
While considerable attention has been focused on understanding the myriad of ethical analysis in international research in low and middle income countries, new issues always arise that have not been anticipated in guidelines or studied extensively. The disruption of medical care arising as a direct result of political actions, including strikes, postelection violence and related activities, is one such issue that leaves physician-researchers struggling to manage often conflicting professional responsibilities. This paper discusses the ethical conflicts that arise for physician-researchers, particularly when disruption threatens the completion of a study or completion is possible but at the expense of not addressing unmet medical needs of patients. We review three pragmatic strategies and the ethical issues arising from each: not starting research, stopping research that has already started, and continuing research already initiated. We argue that during episodes of medical care disruption, research that has been started can be continued only if the ethical standards imposed at the beginning of the study can continue to be met; however, studies that have been approved but not yet started should not begin until the disruption has ended and ethical standards can again be assured. PMID:26474601
Dialectical principlism: an approach to finding the most ethical action.
Weinstock, Robert
2015-03-01
Most forensic psychiatrists occasionally face complex situations in forensic work in which ethics dilemmas cause discomfort. They want to determine the most ethical action, but the best choice is unclear. Fostering justice is primary in forensic roles, but secondary duties such as traditional biomedical ethics and personal values like helping society, combating racism, and being sensitive to cultural issues can impinge on or even outweigh the presumptive primary duty in extreme cases. Similarly, in treatment the psychiatrists' primary duty is to patients, but that can be outweighed by secondary duties such as protecting children and the elderly or maintaining security. The implications of one's actions matter. In forensic work, if the psychiatrist determines that he should not assist the party who wants to hire him, despite evidence clearly supporting its side, the only ethical option becomes not to accept the case at all, because the evidence does not support the better side. Sometimes it can be ethical to accept cases only for one side. In ethics-related dilemmas, I call the method of prioritizing and balancing all types of conflicting principles, duties, and personal and societal values in a dialectic to resolve conflicts among them dialectical principlism. This approach is designed to help determine the most ethical action. It is aspirational and is not intended to get the psychiatrist into trouble. © 2015 American Academy of Psychiatry and the Law.
A Second Opinion: A Case Narrative on Clinical Ethics Mediation.
Weinstein, Michael S
2015-01-01
Contrasting traditional and common forms if ethics consultation with bioethics mediation. I describe the case of a "second opinion" consultation in the care of a patient with advanced cancer for whom treatment was futile. While the initial ethics consultation, performed by a colleague, let to a recommendation that some may deem ethical, the process failed to involve key stakeholders and failed to explore the underlying values and reasons for the opinions voiced by various stakeholders. The process of mediation ultimately led to creative solutions in which all stakeholders could reach consensus on a plan of care.
ERIC Educational Resources Information Center
Zaver, Arzina
2015-01-01
In 2008, the Québec Ministry of Education introduced the Ethics and Religious Culture (ERC) program. Though the ERC is a positive step forward in promoting and fostering much-needed religious literacy skills, the implications of a "neutral" professional posture asked of its teachers have been difficult to translate into the classroom.…
ERIC Educational Resources Information Center
Sun, Jing-Ping
2011-01-01
For three decades, the scholars in the area of values in educational administration and the moral dimension of leadership have conceptually argued for and empirically explored the centrality of values to educational administration. This centrality may be expressed as the roles and nature of values in decision-making and conflict resolution.…
The Use of Ethical Frameworks for Implementing Science as a Human Endeavour in Year 10 Biology
ERIC Educational Resources Information Center
Yap, Siew Fong; Dawson, Vaille
2014-01-01
This research focuses on the use of ethical frameworks as a pedagogical model for socio-scientific education in implementing the "Science as a Human Endeavour" (SHE) strand of the Australian Curriculum: Science in a Year 10 biology class in a Christian college in metropolitan Perth, Western Australia. Using a case study approach, a mixed…
Elite Entanglements and the Demand for a Radically Un/Ethical Position: The Case of Wienie Night
ERIC Educational Resources Information Center
Gaztambide-Fernández, Rubén A.
2015-01-01
Sociologist Colin Bell pointed out that sociology "can be easily seen as thoroughly implicated in the power structure of society" (1978, p. 25). One way in which this implication is expressed is the way that ethical concerns have become institutionalized and regimented. This article puts forward the argument that a true study of elites…
The Morality of Employee Theft: Teaching about Ethics and Deviant Behavior in the Workplace
ERIC Educational Resources Information Center
Kidwell, Roland E., Jr.; Kochanowski, Susan M.
2005-01-01
Deviant behavior at work is an important topic for management education because of its prevalence and cost to both organizations and people. This article demonstrates how the ethical ramifications of workplace activities identified as deviant can be actively discussed by students and by educators in the classroom by using an original case study.…
A Better State of War: Surmounting the Ethical Cliff in Cyber Warfare
2014-06-01
This study analyzes the emergent field of cyber warfare through the lens of commonly-accepted tenets of ethical warfare. By comparing the...foundational understanding of concepts that determine the justice of wars (jus ad bellum) and justice in war (jus en bello) with the capabilities cyber warfare offers...analyzing how cyber warfare affects each of the core concepts introduced above. The fourth chapter presents a case study that tests the theoretical
Study of Medical Ethics Areas of Concern in the Greater San Antonio Area
2006-06-01
healthcare decisions often involve individuals other than patients and providers. Nurses , social workers, case managers, and members of the clergy...decisions. A survey published in the Australian Journal of Advanced Nursing (Johnstone, Da Costa, & Turale 2004) reported that only 8.3 percent of nurses ...and Fry, reported that 21 percent of respondents had no ethics education in their basic nursing programs. Since their basic program studies, 53
Dempsey, Joshua; Stamets, Justin; Eggleson, Kathleen
2017-06-01
The Nanosilver Linings role play case offers participants first-person experience with interpersonal interaction in the context of the wicked problems of emerging technology macroethics. In the fictional scenario, diverse societal stakeholders convene at a town hall meeting to consider whether a nanotechnology-enabled food packaging industry should be offered incentives to establish an operation in their economically struggling Midwestern city. This original creative work was built with a combination of elements, selected for their established pedagogical efficacy (e.g. active learning, case-based learning) and as topical dimensions of the realistic scenario (e.g. nanosilver in food packaging, occupational safety and health). The product life cycle is used as a framework for integrated consideration of scientific, societal, and ethical issues. The Nanosilver Linings hypothetical case was delivered through the format of the 3-hour workshop Ethics when Biocomplexity meets Human Complexity, providing an immersive, holistic ethics learning experience for STEM graduate students. Through their participation in the Nanosilver Linings case and Ethics when Biocomplexity meets Human Complexity workshop, four cohorts of science and engineering doctoral students reported the achievement of specific learning objectives pertaining to a range of macroethics concepts and professional practices, including stakeholder perspectives, communication, human values, and ethical frameworks. Automated text analysis of workshop transcripts revealed differences in sentiment and in ethical framework (consequentialism/deontology) preference between societal stakeholder roles. These resources have been recognized as ethics education exemplars by the U.S. National Academy of Engineering .
Four Roles of Ethical Theory in Clinical Ethics Consultation.
Magelssen, Morten; Pedersen, Reidar; Førde, Reidun
2016-09-01
When clinical ethics committee members discuss a complex ethical dilemma, what use do they have for normative ethical theories? Members without training in ethical theory may still contribute to a pointed and nuanced analysis. Nonetheless, the knowledge and use of ethical theories can play four important roles: aiding in the initial awareness and identification of the moral challenges, assisting in the analysis and argumentation, contributing to a sound process and dialogue, and inspiring an attitude of reflexivity. These four roles of ethical theory in clinical ethics consultation are described and their significance highlighted, while an example case is used as an illustration throughout.
Teaching Business Ethics in Accounting Classes.
ERIC Educational Resources Information Center
D'Aquila, Jill M.
1999-01-01
Accounting graduates must be able to recognize and resolve ethical dilemmas. Ethics should be taught frequently and in short doses, using such methods as videotapes, discussions of current events, and cases of real company practices. (SK)
Ethical conflicts and the process of reflection in undergraduate nursing students in Brazil.
Ramos, Flávia Regina Souza; Brehmer, Laura Cavalcanti de Farias; Vargas, Mara Ambrosina; Trombetta, Ana Paula; Silveira, Luciana Ramos; Drago, Laila
2015-06-01
Nursing students on clinical placements as part of their professional training are routinely faced with situations involving ethical conflicts. The initial act of perceiving a situation as causing an ethical dilemma is the result of both the students' personal values, drawn from their culture and families, and of the professional knowledge and values that they have acquired through training and experience. Nursing students' experiences on clinical placements in primary care settings were investigated in order to identify situations that they perceived as involving ethical conflict and describe the elements they took into consideration during their decision-making processes in these situations. The research design was qualitative descriptive case study. Around 50 students from three different intakes to a nursing degree answered a questionnaire and discussed it in focus groups. The study was designed in accordance with the principles guiding research with human beings and was approved by the Human Research Ethics Committee. Synthesised into two principal axes: (a) ethical conflicts in primary care, linked with the domains of working processes, professional nursing ethics and human and social rights and (b) students' decision-making processes - realisation, reflection and intervention. The student nurses saw themselves both as actors and spectators in situations involving ethical problems and demanding moral deliberation, demonstrating the ability to base their arguments soundly. They tended to emphasise the possibilities offered by dialogue and that different ethical values must be respected to find fair solutions to ethical problems. © The Author(s) 2014.
2014-01-01
Background Despite improvements in psychiatric inpatient care, patient restrictions in psychiatric hospitals are still in use. Studying perceptions among patients who have been secluded or physically restrained during their hospital stay is challenging. We sought to review the methodological and ethical challenges in qualitative and quantitative studies aiming to describe patients’ perceptions of coercive measures, especially seclusion and physical restraints during their hospital stay. Methods Systematic mixed studies review was the study method. Studies reporting patients’ perceptions of coercive measures, especially seclusion and physical restraints during hospital stay were included. Methodological issues such as study design, data collection and recruitment process, participants, sampling, patient refusal or non-participation, and ethical issues such as informed consent process, and approval were synthesized systematically. Electronic searches of CINALH, MEDLINE, PsychINFO and The Cochrane Library (1976-2012) were carried out. Results Out of 846 initial citations, 32 studies were included, 14 qualitative and 18 quantitative studies. A variety of methodological approaches were used, although descriptive and explorative designs were used in most cases. Data were mainly collected in qualitative studies by interviews (n = 13) or in quantitative studies by self-report questionnaires (n = 12). The recruitment process was explained in 59% (n = 19) of the studies. In most cases convenience sampling was used, yet five studies used randomization. Patient’s refusal or non-participation was reported in 37% (n = 11) of studies. Of all studies, 56% (n = 18) had reported undergone an ethical review process in an official board or committee. Respondents were informed and consent was requested in 69% studies (n = 22). Conclusions The use of different study designs made comparison methodologically challenging. The timing of data collection (considering bias and confounding factors) and the reasons for non-participation of eligible participants are likewise methodological challenges, e.g. recommended flow charts could aid the information. Other challenges identified were the recruitment of large and representative samples. Ethical challenges included requesting participants’ informed consent and respecting ethical procedures. PMID:24894162
Fraternization in Accounting Firms: A Case Study
ERIC Educational Resources Information Center
Heinze, Tim; Kizirian, Tim; Leese, Wallace
2004-01-01
This case study sheds light on how to avoid risks caused by manager-subordinate dating relationships (fraternization) such as employee misunderstandings, retaliation charges, favoritism complaints, wrongful termination lawsuits, and sexual harassment lawsuits, as well as associated ethical risks. Risk avoidance can be accomplished through a better…
[Clinical ethics consultation - an integrative model for practice and reflection].
Reiter-Theil, Stella
2008-07-01
Broad evidence exists that health care professionals are facing ethical difficulties in patient care demanding a spectrum of useful ethics support services. Clinical ethics consultation is one of these forms of ethics support being effective in the acute setting. An authentic case is presented as an illustration. We introduce an integrative model covering the activities being characteristic for ethics consultation and going beyond "school"-specific approaches. Finally, we formulate some do's and don'ts of ethics consultation that are considered to be key issues for successful practice.
The Shirts on Our Backs: Teleological Perspectives on Factory Safety in Bangladesh
ERIC Educational Resources Information Center
Dhooge, Lucien J.
2016-01-01
This case study addresses the issue of factory safety in the garment industry through an examination of two recent catastrophic failures in Bangladesh. The case study was designed for students in Business Ethics in the MBA curriculum at the Scheller College of Business at the Georgia Institute of Technology. The case study has also been adapted…
Brain matters: from environmental ethics to environmental neuroethics.
Cabrera, Laura Y; Tesluk, Jordan; Chakraborti, Michelle; Matthews, Ralph; Illes, Judy
2016-02-15
The ways in which humans affect and are affected by their environments have been studied from many different perspectives over the past decades. However, it was not until the 1970s that the discussion of the ethical relationship between humankind and the environment formalized as an academic discipline with the emergence of environmental ethics. A few decades later, environmental health emerged as a discipline focused on the assessment and regulation of environmental factors that affect living beings. Our goal here is to begin a discussion specifically about the impact of modern environmental change on biomedical and social understandings of brain and mental health, and to align this with ethical considerations. We refer to this focus as Environmental Neuroethics, offer a case study to illustrate key themes and issues, and conclude by offering a five-tier framework as a starting point of analysis.
Joh, Hee-Kyung; Shin, Jwa-Seop
2009-09-01
Small group discussions are useful tools in medical ethics education. We aimed to assess student satisfaction with specific components of a small group discussion and to evaluate student self-assessment of the objectives of education. A structured questionnaire was developed after a literature review and a focus group interview. Components of the small group discussion were categorized by discussion case (self, other), individual activities (self-study, making materials, presentation experience), and group activities (preclass/in-class/postclass/plenary discussion, instructor's comments). The items for student self-assessment were: "To specify ethical issue in actual practice", "To get new knowledge", "To consider doctor's entity", "Empathy to others", "To get multidimensional viewpoint", "Viewpoint change", "To deliver my thought clearly", and "Ability to confront the medical ethics dilemma in the future". After the survey, an in-depth interview was performed to determine the reason behind the students' answers. A total of 121 students responded, for whom overall satisfaction and self-assessment were high. Students reported greater satisfaction with self-case, presentation experience, in-class discussion, and instructor's comments but less satisfaction with self-study before class and postclass discussion. Student self-assessment was highest in the ability to specify an ethical issue and lowest for viewpoint change and self-confidence. After multivariate analysis, higher student self-assessment was associated with greater satisfaction with the small group discussion. To improve the quality of medical ethics education, close investigation and monitoring of each component of the small group discussion and student achievement are essential, as is continuous feedback.
Approaches to rationing antiretroviral treatment: ethical and equity implications.
Bennett, Sara; Chanfreau, Catherine
2005-01-01
Despite a growing global commitment to the provision of antiretroviral therapy (ART), its availability is still likely to be less than the need. This imbalance raises ethical dilemmas about who should be granted access to publicly-subsidized ART programmes. This paper reviews the eligibility and targeting criteria used in four case-study countries at different points in the scale-up of ART, with the aim of drawing lessons regarding ethical approaches to rationing. Mexico, Senegal, Thailand and Uganda have each made an explicit policy commitment to provide antiretrovirals to all those in need, but are achieving this goal in steps--beginning with explicit rationing of access to care. Drawing upon the case-studies and experiences elsewhere, categories of explicit rationing criteria have been identified. These include biomedical factors, adherence to treatment, prevention-driven factors, social and economic benefits, financial factors and factors driven by ethical arguments. The initial criteria for determining eligibility are typically clinical criteria and assessment of adherence prospects, followed by a number of other factors. Rationing mechanisms reflect several underlying ethical theories and the ethical underpinnings of explicit rationing criteria should reflect societal values. In order to ensure this alignment, widespread consultation with a variety of stakeholders, and not only policy-makers or physicians, is critical. Without such explicit debate, more rationing will occur implicitly and this may be more inequitable. The effects of rationing mechanisms upon equity are critically dependent upon the implementation processes. As antiretroviral programmes are implemented it is crucial to monitor who gains access to these programmes. PMID:16175829
The Intercollegiate Ethics Bowl: An Active Learning Experience
ERIC Educational Resources Information Center
Meyer, Tracy
2012-01-01
This paper introduces the Intercollegiate Ethics Bowl (IEB) as a means of promoting active learning in the realm of marketing ethics. The cases discussed in the competition are based on current ethical issues and require students to provide a coherent analysis of what are generally complex, ambiguous, and highly viewpoint dependent issues. The…
George Williams in Thailand: An Ethical Decision-Making Exercise
ERIC Educational Resources Information Center
James, Constance R.; Smith, J. Goosby
2007-01-01
This article presents a classroom ethical decision-making exercise designed to help students make reasoned ethical decisions while gaining insight into their own and others' ethical decision-making strategies. During the exercise, students individually analyze an original mini-case, then meet in small groups to reach consensus on the advice and…
Ethical Issues in Paediatric Practice - Part I: General Principles
Attard-Montalto, S
2001-01-01
Clinical problems with ethical implications pose an ever increasing dilemma in everyday medical practice, and this is particularly the case with ethical issues involving children and those unable to take their own decisions. In this editorial we shall review some of the general principles that guide medical ethical problems. PMID:22368603
A Framework for Professional Ethics Courses in Teacher Education
ERIC Educational Resources Information Center
Warnick, Bryan R.; Silverman, Sarah K.
2011-01-01
Evidence suggests that professional ethics is currently a neglected topic in teacher education programs. In this article, the authors revisit the question of ethics education for teachers. The authors propose an approach to the professional ethics of teaching that employs a case-analysis framework specifically tailored to address the practice of…
Martin, P A
1999-01-01
Arguing that a consensus-based method of bioethical decision making can transform ethical pluralism into an ethical whole, author examines the theory of three consensus-based models--clinical pragmatism, ethics facilitation, and mediation--and develops a practical guide to ethics facilitation that includes a hypothetical case.
The Care Dialog: the "ethics of care" approach and its importance for clinical ethics consultation.
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.
Giordano, S
2005-01-01
Sport and physical activity is an area that remains relatively unexplored by contemporary bioethics. It is, however, an area in which important ethical issues arise. This paper explores the case of the participation of people with anorexia nervosa in exercise. Exercise is one of the central features of anorexia. The presence of anorexics in exercise classes is becoming an increasingly sensitive issue for instructors and fitness professionals. The ethics of teaching exercise to anorexics has, however, seldom, if ever, been addressed. Codes of ethics and legislation do not offer guidelines pertinent to the case and it is left unclear whether anorexics should be allowed to participate in exercise classes. It is shown by this paper that there are strong ethical reasons to let anorexics participate in exercise classes. However, the paper also explains why, despite these apparently cogent ethical reasons, there is no moral obligation to allow a person with anorexia to take part in exercise/sports activities. PMID:15634747
The effect of teaching medical ethics on medical students' moral reasoning.
Self, D J; Wolinsky, F D; Baldwin, D C
1989-12-01
A study assessed the effect of incorporating medical ethics into the medical curriculum and the relative effects of two methods of implementing that curriculum, namely, lecture and case-study discussions. Results indicate a statistically significant increase (p less than or equal to .0001) in the level of moral reasoning of students exposed to the medical ethics course, regardless of format. Moreover, the unadjusted posttest scores indicated that the case-study method was significantly (p less than or equal to .03) more effective than the lecture method in increasing students' level of moral reasoning. When adjustment were made for the pretest scores, however, this difference was not statistically significant (p less than or equal to .18). Regression analysis by linear panel techniques revealed that age, gender, undergraduate grade-point average, and scores on the Medical College Admission Test were not related to the changes in moral-reasoning scores. All of the variance that could be explained was due to the students' being in one of the two experimental groups. In comparison with the control group, the change associated with each experimental format was statistically significant (lecture, p less than or equal to .004; case study, p less than or equal to .0001). Various explanations for these findings and their implications are given.
Steps toward improving ethical evaluation in health technology assessment: a proposed framework.
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.
Bandini, Julia I; Courtwright, Andrew; Zollfrank, Angelika A; Robinson, Ellen M; Cadge, Wendy
2017-06-01
Previous research has suggested that individuals who identify as being more religious request more aggressive medical treatment at end of life. These requests may generate disagreement over life-sustaining treatment (LST). Outside of anecdotal observation, however, the actual role of religion in conflict over LST has been underexplored. Because ethics committees are often consulted to help mediate these conflicts, the ethics consultation experience provides a unique context in which to investigate this question. The purpose of this paper was to examine the ways religion was present in cases involving conflict around LST. Using medical records from ethics consultation cases for conflict over LST in one large academic medical centre, we found that religion can be central to conflict over LST but was also present in two additional ways through (1) religious coping, including a belief in miracles and support from a higher power, and (2) chaplaincy visits. In-hospital mortality was not different between patients with religiously versus non-religiously centred conflict. In our retrospective cohort study, religion played a variety of roles and did not lead to increased treatment intensity or prolong time to death. Ethics consultants and healthcare professionals involved in these cases should be cognisant of the complex ways that religion can manifest in conflict over LST. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Richter, E.; Barach, P.; Berman, T.; Ben-David, G; Weinberger, Z.
2001-01-01
To examine the ethical issues involved in governmental decisions with potential health risks, we review the history of the decision to raise the interurban speed limit in Israel in light of its impact on road death and injury. In 1993, the Israeli Ministry of Transportation initiated an "experiment" to raise the interurban speed limit from 90 to 100 kph. The "experiment" did not include a protocol and did not specify cut-off points for early termination in the case of adverse results. After the raise in the speed limit, the death toll on interurban roads rose as a result of a sudden increase in speeds and case fatality rates. The committee's decision is a case study in unfettered human experimentation and public health risks when the setting is non-medical and lacks a defined ethical framework. The case study states the case for extending Helsinki type safeguards to experimentation in non-medical settings. Key Words: Declaration of Helsinki • human experimentation • speed limit PMID:11314157
Principles of Biomedical Ethics
Athar, Shahid
2012-01-01
In this presentation, I will discuss the principles of biomedical and Islamic medical ethics and an interfaith perspective on end-of-life issues. I will also discuss three cases to exemplify some of the conflicts in ethical decision-making. PMID:23610498
A systematic format for resolving ethical issues in clinical periodontics.
Schloss, Alexander J
2012-01-01
Ethical dilemmas are becoming increasingly common in dentistry and periodontics. Clinicians, challenged with such dilemmas, may not know how to apply the appropriate moral reasoning needed to resolve these situations especially when any of the five fundamental principles of ethics that form the foundation of the American Dental Association Principles of Ethics and Code of Professional Conduct--patient autonomy, nonmaleficence, beneficence, justice, and veracity--come into conflict with each other. The author describes one clinical case that presented with an ethical dilemma. An analytic framework, used in medicine, is introduced and used to solve the clinical case on whether to proceed with periodontal surgery on a patient who is not aware of his terminal prognosis from metastatic prostate cancer. Upon using the analytic framework, recommendations are made on the ethically appropriate path for the periodontist to follow in providing care for the patient's periodontal problem consistent with the principles of patient autonomy, respect for persons, and veracity.
Furthering the sceptical case against virtue ethics in nursing ethics.
Holland, Stephen
2012-10-01
In a recent article in this journal I presented a sceptical argument about the current prominence of virtue ethics in nursing ethics. Daniel Putman has responded with a defence of the relevance of virtue in nursing. The present article continues this discussion by clarifying, defending, and expanding the sceptical argument. I start by emphasizing some features of the sceptical case, including assumptions about the nature of sceptical arguments, and about the character of both virtue ethics and nursing ethics. Then I respond to objections of Putman's such as that, according to virtue ethics, virtue is relevant to the whole of a human life, including one's behaviour in a professional context; and that eudaimonia should be central in explaining and motivating a nurse's decision to enter the profession. Having argued that these objections are not compelling, I go on to discuss an interesting recent attempt to reassert the role of virtue ethics in the ethics of professions, including nursing. This centres on whether role-specific obligations - e.g. the obligations that arise for a moral agent qua lawyer or mother - can be accommodated in a virtue ethics approach. Sean Cordell has argued that the difficulty of accommodating role-specific obligations results in an 'institution-shaped gap' in virtue ethics. He suggests a way of meeting this difficulty that appeals to the ergon of institutions. I endorse the negative point that role-specific obligations elude virtue ethics, but argue that the appeal to the ergon of institutions is unsuccessful. The upshot is further support for scepticism about the virtue ethics approach to nursing ethics. I end by gesturing to some of the advantages of a sceptical view of virtue ethics in nursing ethics. © 2012 Blackwell Publishing Ltd.
Ethics: A Theory of Medical Ethics.
Brody, Howard
This book review characterizes Robert Veatch's A Theory of Medical Ethics as a "third-generation" treatise that looks beyond case- and issue-oriented analysis to develop the theoretical bases of a "true system of medical ethics." Veatch proposes a "draft medical ethical covenant" based on a "triple contract" model, in which the moral principles of contract keeping, autonomy, honesty, avoiding killing, and justice govern the physician's relationship to both individual patients and society.
Bridging the education-action gap: a near-peer case-based undergraduate ethics teaching programme.
Kong, Wing May; Knight, Selena
2017-10-01
Undergraduate ethics teaching has made significant progress in the past decade, with evidence showing that students and trainee doctors feel more confident in identifying and analysing ethical issues. There is general consensus that ethics education should enable students and doctors to take ethically appropriate actions, and nurture moral integrity. However, the literature reports that doctors continue to find it difficult to take action when faced with perceived unethical behaviour. This has been evident in recent healthcare scandals, in which care has fallen below acceptable ethical standards, despite the presence of professional ethical guidelines and competencies. The National Foundation Training Programme forms the first 2 years of training for new UK doctors. We designed a Foundation Doctor (FD)-led teaching programme in which medical students were invited to bring cases and experiences from clinical placements for small group discussion facilitated by FDs. The aim was to enable students to act ethically in practice through developing moral sensitivity and moral identity, together with skills in ethical reasoning and tools to address barriers to taking ethical action. FDs were chosen as facilitators, based on the evidence that near-peer is an effective form of teaching in medicine and may provide positive role models for students. This article reviews the background rationale for the programme and its design. Important themes emerging from the case discussions are explored. Student and FD facilitator feedbacks are evaluated, and practical challenges to the implementation of this type of programme are discussed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Case reports: Publication standards in forensic psychiatry.
Hanson, Annette; Martinez, Richard; Candilis, Philip J
2014-01-01
Psychiatrists who publish case reports are required to seek informed consent from their subjects on the basis of the ethics-related obligation to maintain patient confidentiality. Academic journals have developed editorial standards to fulfill this obligation. Forensic evaluations do not create a doctor-patient relationship in the traditional sense, and information obtained through a forensic evaluation may also be found in the public domain. This public exposure is particularly likely, given the development of open access publishing standards, online journals, and increasing professional involvement in social media. This article outlines the ethics of informed consent in published case reports for general and forensic psychiatry and offers recommendations for forensic case study publishing. The authors suggest changes in the current requirements stated in The Journal for publication of case reports. © 2014 American Academy of Psychiatry and the Law.
Weerasinghe, Manjula; Konradsen, Flemming; Eddleston, Michael; Pearson, Melissa; Gunnell, David; Hawton, Keith; Jayamanne, Shaluka; Pabasara, Chathurani; Jayathilaka, Tharidu; Dissanayaka, Kalpani; Rajapaksha, Sandamali; Thilakarathna, Prasanna; Agampodi, Suneth
2015-01-01
Introduction Pesticide self-poisoning is one of the most frequently used methods of suicide worldwide, killing over 300 000 people annually. Around 15–20% of pesticide self-poisonings occur soon after the person has bought the pesticide from a shop. We aim to determine the characteristics of individuals who purchase pesticides directly from shops and how they differ from individuals who access pesticides from other sources such as home, home garden or farmland. This information will help inform possible vendor/shop-based intervention strategies aimed at reducing access to pesticides used for self-harm. Methods and analysis This study will investigate risk factors associated with purchasing pesticides for acts of self-poisoning from pesticide shops, including cases identified over a 9-month period using a population-based case–control group approach. Four interviewer-administered data collection tools will be used for this study: a semistructured questionnaire, Beck Suicidal Intent Scale (SIS), Clinical Interview Schedule—Sinhalese version (CIS-Sn) and Alcohol Use Disorders Identification Test (AUDIT). Each case (expected n=33) will be compared with two groups of individuals: (1) those who have self-poisoned using pesticides from the home, home garden or farmland and (2) those who bought pesticides from the same shops as the above cases, but not did not self-poison. Logistic regression models will be used to identify risk factors of purchasing pesticides for self-poisoning from shops. Ethics and dissemination The study has received ethical approval from the Ethical Review Committee of the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka. A sensitive data collection technique will be used and ethical issues will be considered throughout the study. Results will be disseminated in scientific peer-reviewed articles. PMID:25995242
The pre-employment medical--ethical dilemmas for GPs.
Thuraisingham, Chandramani; Nalliah, Sivalingam
2013-04-01
In many workplaces, employment is conditional on a successful pre-employment medical examination. This examination is usually conducted by a general practitioner on the employers' panel of approved clinics or by an in-house company doctor. This article uses a case study to illustrate some of the ethical dilemmas that may be faced by GPs in the course of performing a pre-employment medical examination. Ethical issues discussed in this article include: Is it ethical for employers (based on physicians' reports) to select workers based on 'absence of illness' rather than 'fitness for work'? Should physicians divulge the illness of potential workers to third parties? What are the boundaries of a clinician's duty of care in the pre-employment medical examination setting?
Reputational Risk, Academic Freedom and Research Ethics Review
Hedgecoe, Adam
2015-01-01
Drawing on scholarship around academic freedom and new public management, this article explores the way in which research ethics committees in UK universities (URECs) can come to exhibit behaviour – common in their US equivalents – that prioritises the reputational protection of their host institution over and above academic freedom and the protection of research subjects. Drawing on two case studies the article shows both how URECs can serve to restrict research that may be ‘embarrassing’ for a university and how, in high profile cases, university management come to use such committees as mechanisms for internal discipline. PMID:27330226
Kidd, Ian James
2012-09-01
Medical humanities have a central role to play in combating biopiracy. Medical humanities scholars can articulate and communicate the complex structures of meaning and significance which human beings have invested in their ways of conceiving health and sickness. Such awareness of the moral significance of medical heritage is necessary to ongoing legal, political, and ethical debates regarding the status and protection of medical heritage. I use the Indian Traditional Knowledge Digital Library as a case study of the role of medical humanities in challenging biopiracy by deepening our sense of the moral value of medical heritage.
When the science fails and the ethics works: 'Fail-safe' ethics in the FEM-PrEP study.
Kingori, Patricia
2015-12-01
This paper will explore the concept of 'fail safe' ethics in the FEM PrEP trial, and the practice of research and ethics on the ground. FEM-PrEP examined the efficacy of PrEP in African women after promising outcomes in research conducted with MSM. This was a hugely optimistic time and FEM-PrEP was mobilised using rights-based ethical arguments that women should have access to PrEP. This paper will present data collected during an ethnographic study of frontline research workers involved in FEM-PrEP. During our discussions, 'fail-safe' ethics emerged as concept that encapsulated their confidence that their ethics could not fail. However, in 2011, FEM-PrEP was halted and deemed a failure. The women involved in the study were held responsible because contrary to researcher's expectations they were not taking the oral PrEP being researched. This examination of FEM-PrEP will show that ethical arguments are increasingly deployed to mobilise, maintain and in some cases stop trials in ways which, at times, are superseded or co-opted by other interests. While promoting the interests of women, rights-based approaches are argued to indirectly justify the continuation of individualised, biomedical interventions which have been problematic in other women-centred trials. In this examination of FEM-PrEP, the rights-based approach obscured: ethical concerns beyond access to PrEP; the complexities of power relationships between donor and host countries; the operations of the HIV industry in research-saturated areas and the cumulative effect of unfilled expectations in HIV research and how this has shaped ideas of research and ethics.
The New AVA Statement of Professional Ethics in Volunteer Administration.
ERIC Educational Resources Information Center
Seel, Keith
1996-01-01
Core ethical values of the Association for Volunteer Administration are citizenship and philanthropy, respect, responsibility, caring, justice and fairness, and trustworthiness. An ethical decision-making model shows how to apply these standards to actual cases. (SK)
Thompson, Megan M; Jetly, Rakesh
2014-01-01
There is growing evidence that modern missions have added stresses and ethical complexities not seen in previous military operations and that there are links between battlefield stressors and ethical lapses. Military ethicists have concluded that the ethical challenges of modern missions are not well addressed by current military ethics educational programs. Integrating the extant research in the area, we propose that scenario-based operational ethics training in high-intensity military field training settings may be an important adjunct to traditional military ethics education and training. We make the case as to why this approach will enhance ethical operational preparation for soldiers, supporting their psychological well-being as well as mission effectiveness.
Thompson, Megan M.; Jetly, Rakesh
2014-01-01
There is growing evidence that modern missions have added stresses and ethical complexities not seen in previous military operations and that there are links between battlefield stressors and ethical lapses. Military ethicists have concluded that the ethical challenges of modern missions are not well addressed by current military ethics educational programs. Integrating the extant research in the area, we propose that scenario-based operational ethics training in high-intensity military field training settings may be an important adjunct to traditional military ethics education and training. We make the case as to why this approach will enhance ethical operational preparation for soldiers, supporting their psychological well-being as well as mission effectiveness. PMID:25206947
ERIC Educational Resources Information Center
Arthur, James; Carr, David
2013-01-01
This article has three broad aims. The first is to draw attention what is probably the largest empirical study of moral, values and character education in the United Kingdom to the present date. The second is to outline--sufficient for present purposes--a plausible conceptual or theoretical case for placing a particular virtue-ethical concept of…
Moral Dilemmas in a Military Context. a Case Study of a Train the Trainer Course on Military Ethics
ERIC Educational Resources Information Center
van Baarle, Eva; Bosch, Jolanda; Widdershoven, Guy; Verweij, Desiree; Molewijk, Bert
2015-01-01
Moral competence is important for soldiers who have to deal with complex moral dilemmas in practice. However, openly dealing with moral dilemmas and showing moral competence is not always easy within the culture of a military organization. In this article, based on analysis of experiences during a train the trainer course on military ethics, we…
ERIC Educational Resources Information Center
Chang, Pei-Fen; Wang, Dau-Chung
2011-01-01
In May 2008, the worst earthquake in more than three decades struck southwest China, killing more than 80,000 people. The complexity of this earthquake makes it an ideal case study to clarify the intertwined issues of ethics in engineering and to help cultivate critical thinking skills. This paper first explores the need to encourage engineering…
Ethical Issues in Internet Research: International Good Practice and Irish Research Ethics Documents
ERIC Educational Resources Information Center
Felzmann, Heike
2013-01-01
This chapter discusses the main research ethical concerns that arise in internet research and reviews existing research ethical guidance in the Irish context in relation to its application to internet research. The chapter begins with a brief outline of high profile cases in the early history of the internet that highlighted specific emerging…
Commodifying animals: ethical issues in genetic engineering of animals.
Almond, B
2000-03-01
The genetic modification of living beings raises special ethical concerns which go beyond general discussion of animal rights or welfare. Although the goals may be similar, biotechnology has accelerated the process of modification of types traditionally carried out by cross-breeding. These changes are discussed in relation to two areas: biomedicine, and animal husbandry. Alternative ethical approaches are reviewed, and it is argued that the teleological thesis underlying virtue ethics has special relevance here. The case for and the case against genetic engineering and patenting of life-forms are examined, and conclusions are drawn which favour regulation, caution and respect for animals and animal species.
Taking emotion seriously: meeting students where they are.
Sunderland, Mary E
2014-03-01
Emotions are often portrayed as subjective judgments that pose a threat to rationality and morality, but there is a growing literature across many disciplines that emphasizes the centrality of emotion to moral reasoning. For engineers, however, being rational usually means sequestering emotions that might bias analyses-good reasoning is tied to quantitative data, math, and science. This paper brings a new pedagogical perspective that strengthens the case for incorporating emotions into engineering ethics. Building on the widely established success of active and collaborative learning environments, in particular the problem-based learning (PBL) philosophy and methodology, the paper articulates new strategies for incorporating emotion into engineering ethics education. An ethics education pilot study is analyzed to explore how PBL can engage students' emotions. Evidence suggests that PBL empowers students to cultivate value for engineering ethics and social responsibility, and in doing so, redefine the societal role of the engineer. Taking students' emotions seriously in engineering ethics offers an effective strategy to meaningfully engage students in ethical learning.
Mello, Anahi Guedes de
2016-10-01
Anthropology has increasingly questioned the hegemony of biomedical knowledge in ethical review processes of social research projects prevailing in Brazil, which was governed until 2012 by the Human Research Ethics Committee of each institution under the auspices of the National Research Ethics Commission (CONEP). This was mandated through Resolution No. 196/1996 prevailing in 2012 when this field research was conducted. The scope of this study is to recount and reflect upon the barriers to obtaining approval in 2012 for my master's research project from the Human Research Ethics Committee of the Federal University of Santa Catarina (CEP/UFSC) in Florianopolis. In this ethnographic experience, in the light of Crip theory, I observed how the "disability," "vulnerability" and "inability" categories are articulated to reveal the ableism and the primacy of the biomedical model in the case of an ethics review at UFSC regarding the participation and legal capacity of persons with disabilities as subjects of research.
Mariño, Tania Cruz; Armiñán, Rubén Reynaldo; Cedeño, Humberto Jorge; Mesa, José Miguel Laffita; Zaldivar, Yanetza González; Rodríguez, Raúl Aguilera; Santos, Miguel Velázquez; Mederos, Luis Enrique Almaguer; Herrera, Milena Paneque; Pérez, Luis Velázquez
2011-06-01
Predictive testing protocols are intended to help patients affected with hereditary conditions understand their condition and make informed reproductive choices. However, predictive protocols may expose clinicians and patients to ethical dilemmas that interfere with genetic counseling and the decision making process. This paper describes ethical dilemmas in a series of five cases involving predictive testing for hereditary ataxias in Cuba. The examples herein present evidence of the deeply controversial situations faced by both individuals at risk and professionals in charge of these predictive studies, suggesting a need for expanded guidelines to address such complexities.
How Cuba's Latin American School of Medicine challenges the ethics of physician migration.
Huish, Robert
2009-08-01
This paper demonstrates a working alternative to the accepted ethics of physician migration. A dominant cosmopolitan ethics encourages upward mobility of physicians in a globalized labour force, and this ultimately advances the position of individuals rather than improving public health-care service for vulnerable communities in the global South. Cuba's Escuela Latinoamericana de Medicina (ELAM) challenges this trend as its institutional ethics furnishes graduates with appropriate skills, knowledge and service ethics to deliver quality care in marginalized areas. This paper provides an analysis of how ELAM trains physicians in community-oriented service for marginalized areas in the global South. The principle finding of this analysis is that ELAM exhibits a working alternative to the accepted ethics of physician migration, as it encourages graduates to practice in marginalized communities rather than feed the migration pipeline into the North. Arguably, ELAM serves as an important case study in how a medical school's ethics can work to bring graduates closer to the communities that are in desperate need of their skills and of their compassion.
Teaching ethics to engineers - a research-based perspective
NASA Astrophysics Data System (ADS)
Bowden, Peter
2010-10-01
This paper describes research underpinning a course, developed in Australia, on ethics for engineers. The methodology used, that of identifying the principal ethical issues facing the discipline and designing the course around these issues, would be applicable to other disciplines and in other countries. The course was based on the assumption that identifying the major ethical issues in the discipline, and subsequently presenting and analysing them in the classroom, would provide the future professional with knowledge of the ethical problems that they were likely to face on graduation. The student has then to be given the skills and knowledge to combat these concerns, should he/she wish to. These findings feed into several components of the course, such as the development of a code of ethics, the role of a professional society or industry association and the role of ethical theory The sources employed to identify the issues were surveys of the literature and about 30 case studies, in Australia and overseas. The issues thus identified were then put before a sample of engineering managers to assess the relevance to the profession.
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)
[Issues of the practical value of ethics in healthcare].
Liubarskiene, Zita
2007-01-01
In November 2006, the "Journal of Medical Ethics" published an article where prominent medical specialists stated that medical ethics, as a teaching and a theory, has no practical value. The article was based on the physicians' clinical experience and view that the theory of ethics has little in common with its application in daily practice and provides generalized guidelines for behavior, but is ineffective in decision-making in individual cases. At the same time, when describing conflict situations in healthcare, Lithuanian public press raises the role of ethics to the absolute and states that the lack or violation of ethics is the sole cause of all problems in healthcare, and there would be no problems if physicians behaved morally. From the viewpoint of an ethics professional, both controversial opinions deserve attention, and this paper is devoted to the analysis of these opinions. Ethical collisions and conflicts emerging in providing healthcare are not signs of the helplessness of medical ethics. Both viewpoints - the one disclaiming the role of medical ethics and the one attributing the absolute role to medical ethics - are equally erroneous. Decisions of the society and physicians are aggravated by health policy and the organization of healthcare in the country, as well as by a concrete individual's level of ethical thinking, worldview, and knowledge. Sometimes ethical collisions arise when there is a conflict among ethical principles themselves, and healthcare specialists have to decide which principle should be given priority. There are cases where setting priorities is impossible, and one has to admit that one single specialist is unable to solve the problem without his/her colleagues' assistance. Collective and collegial professionals' work helps to solve such ethical collisions.
The ethics of pharmaceutical research funding: a social organization approach.
Gray, Garry C
2013-01-01
This paper advances a social organization approach to examining unethical behavior. While unethical behaviors may stem in part from failures in individual morality or psychological blind spots, they are both generated and performed through social interactions among individuals and groups. To illustrate the value of a social organization approach, a case study of a medical school professor's first experience with pharmaceutical-company-sponsored research is provided in order to examine how funding arrangements can constrain research integrity. The case illustrates three significant ways that institutional corruption can occur in the research process. First, conflicts of norms between pharmaceutical companies, universities, and affiliated teaching hospitals can result in compromises and self-censorship. Second, normal behavior is shaped through routine interactions. Unethical behaviors can be (or can become) normal behaviors when they are produced and reproduced through a network of social interactions. Third, funding arrangements can create networks of dependency that structurally distort the independence of the academic researcher in favor of the funder's interests. More broadly, the case study demonstrates how the social organization approach deepens our understanding of the practice of ethics. © 2013 American Society of Law, Medicine & Ethics, Inc.
Geoethical implications for geoarchaeology. The Laacher See and AD 536 case studies
NASA Astrophysics Data System (ADS)
Riede, Felix; Price, Neil; Andersen, Per
2017-04-01
Environmental catastrophes represent profound challenges faced by societies today. Numerous scholars in the climate sciences as well as the Humanities have argued for a greater ethical engagement with these pressing issues. At the same time, several disciplines concerned with hazards are moving towards formalized ethical codes or promises that guide not only the dissemination of data but oblige scientists to relate to fundamentally political issues. With its starting point in the recently proposed geoethical promise, this paper reports on two case studies of how past natural hazards have affected vulnerable societies in Europe's past. We ask whether cases of past calamities and their societal effects should not play a greater role in public debates and whether geo-archaeologists working with past environmental hazards should be more outspoken in their ethical considerations. We offer no firm answers, but suggest that geo-archaeologists engage with debates of human-environment relations at this interface between politics, public affairs and science. We argue for greater communication between the human and natural sciences and further suggest that outreach institutions such as museums - both natural and cultural - could and perhaps should play a key role in staging such engagements.
Bernthal, Elizabeth M; Draper, H J A; Henning, J; Kelly, J C
2017-06-01
To identify and explore features of ethical issues that senior clinicians faced as deployed medical directors (DMDs) to the British Field Hospital in Afghanistan as well as to determine the ethical training requirements for future deployments. A qualitative study in two phases conducted from November 2014 to June 2015. Phase 1 analysed 60 vignettes of cases that had generated ethical dilemmas for DMDs. Phase 2 included focus groups and an interview with 13 DMDs. Phase 1 identified working with limited resources, dual conflict of meeting both clinical and military obligations and consent of children as the most prevalent ethical challenges. Themes found in Phase 2 included sharing clinical responsibilities with clinicians from other countries and not knowing team members' ways of working, in addition to the themes from Phase 1. This study has drawn together examples of scenarios to form a repository that will aid future training. Recommendations included undertaking ethics training together as a team before, during and after deployment which must include all nationalities who are assigned to the same operational tour, so that different ethical views can be explored beforehand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Everyday ethics: learning from an ‘ordinary’ consultation in general practice
2011-01-01
The author uses a constructed case to analyse some of the ethical decisions that UK general practitioners face in everyday settings. A variety of ethical frameworks and empirical primary healthcare literature are used to demonstrate how ethical tools may be used by clinicians in primary healthcare to reflect on their decisions in practice. The GP consultation context can make ‘on the spot’ ethical decisions difficult and varied. PMID:25949652
Goetghebeur, Mireille M; Wagner, Monika; Samaha, Dima; O'Neil, William; Badgley, Danielle; Castro-Jaramillo, Hector; Abrishami, Payam; Sarria-Santamera, Antonio; Cleemput, Irina; Tringali, Michele
2017-01-01
Tackling ethical dilemmas faced by reimbursement decision makers requires deeper understanding of values on which health technology assessment (HTA) agencies are founded and how trade-offs are made. This was explored in this study including the case of rare disease. Representatives from eight HTA explored values on which institutions are founded using a narrative approach and reflective multicriteria (developed from EVIDEM, criteria derived from ethical imperatives of health care). Trade-offs between criteria and the impact of incorporating defined priorities (including for rare diseases) were explored through a quantitative values elicitation exercise. Participants reported a diversity of substantive and procedural values with a common emphasis on scientific excellence, stakeholder involvement, independence, and transparency. Examining the ethical imperatives behind EVIDEM criteria was found to be useful to further explore substantive values. Most criteria were deemed to reflect institutions' values, while 70 percent of the criteria were reported by at least half of participants to be considered formally by their institutions. The quantitative values elicitation highlighted the difficulty to balance imperatives of "alleviating or preventing patient suffering," "serving the whole population equitably," "upholding healthcare system sustainability," and "making decisions informed by evidence and context" but may help share the ethical reasoning behind decisions. Incorporating "Priorities" (including for rare diseases) helped reveal trade-offs from other criteria and their underlying ethical imperatives. Reflective multicriteria are useful to explore substantive values of HTAs, reflect how these values and their ethical underpinnings can be operationalized into criteria, and explore the ethical reasoning at the heart of the healthcare debate.
Logar, Tea; Le, Phuoc; Harrison, James D; Glass, Marcia
2015-03-01
Recent studies show that returning global health trainees often report having felt inadequately prepared to deal with ethical dilemmas they encountered during outreach clinical work. While global health training guidelines emphasize the importance of developing ethical and cultural competencies before embarking on fieldwork, their practical implementation is often lacking and consists mainly of recommendations regarding professional behavior and discussions of case studies. Evidence suggests that one of the most effective ways to teach certain skills in global health, including ethical and cultural competencies, is through service learning. This approach combines community service with experiential learning. Unfortunately, this approach to global health ethics training is often unattainable due to a lack of supervision and resources available at host locations. This often means that trainees enter global health initiatives unprepared to deal with ethical dilemmas, which has the potential for adverse consequences for patients and host institutions, thus contributing to growing concerns about exploitation and "medical tourism." From an educational perspective, exposure alone to such ethical dilemmas does not contribute to learning, due to lack of proper guidance. We propose that the tension between the benefits of service learning on the one hand and the respect for patients' rights and well-being on the other could be resolved by the application of a simulation-based approach to global health ethics education.
Tan, Daniel Y B; Ter Meulen, Bastiaan C; Molewijk, Albert; Widdershoven, Guy
2018-06-01
Ethical dilemmas in general are characterised by a choice between two mutually excluding options neither of which is satisfactory, because there always will be a form of moral damage. Within the context of medicine several ethics support services have been developed to support healthcare professionals in dealing with ethical dilemmas, including moral case deliberation. In this article, we describe how moral case deliberation works in daily practice, illustrated with a case example from the neurology ward. The article is meant as an introduction to moral case deliberation according to the dilemma method. We show its relevance to the clinic and the context needed to put it into practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
The Case of Ms D: A Family's Request for Posthumous Procurement of Ovaries.
Guidry-Grimes, Laura
2016-01-01
The MedStar Washington Hospital Center clinical ethics team became involved in a case when the family requested the posthumous removal of a patient's ovaries for future reproductive use. This case presents a novel question for clinical ethicists, since the technology for posthumous female reproduction is still in development. In the bioethics literature, the standard position is to refuse to comply with such a request, unless there is explicit consent or evidence of explicit conversations that demonstrate the deceased would have wanted this option pursued. Ms D's case, we suggest, offers an exception to this default position; complying with the family's request could have been ethically permissible in this case, had it been medically feasible. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.
The Hidden Ethics Curriculum in Two Canadian Psychiatry Residency Programs: A Qualitative Study.
Gupta, Mona; Forlini, Cynthia; Lenton, Keith; Duchen, Raquel; Lohfeld, Lynne
2016-08-01
The authors describe the hidden ethics curriculum in two postgraduate psychiatry programs. Researchers investigated the formal, informal, and hidden ethics curricula at two demographically different postgraduate psychiatry programs in Canada. Using a case study design, they compared three sources: individual interviews with residents and with faculty and a semi-structured review of program documents. They identified the formal, informal, and hidden curricula at each program for six ethics topics and grouped the topics under two thematic areas. They tested the applicability of the themes against the specific examples under each topic. Results pertaining to one of the themes and its three topics are reported here. Divergences occurred between the curricula for each topic. The nature of these divergences differed according to local program characteristics. Yet, in both programs, choices for action in ethically challenging situations were mediated by a minimum standard of ethics that led individuals to avoid trouble even if this meant their behavior fell short of the accepted ideal. Effective ethics education in postgraduate psychiatry training will require addressing the hidden curriculum. In addition to profession-wide efforts to articulate high-level values, program-specific action on locally relevant issues constitutes a necessary mechanism for handling the impact of the hidden curriculum.
Durocher, Evelyne; Kinsella, Elizabeth Anne; McCorquodale, Lisa; Phelan, Shanon
2016-09-03
Ethical tensions arise daily in health care practice and are frequently related to health care system structures or policies. Collective case study methodology was adopted to examine ethical tensions reported by occupational therapists practicing in different settings in Southwestern Ontario, Canada. Inductive analysis involving multiple layers of coding was conducted. This article focuses on tensions related to systemic constraints. Participants reported ethical tensions related to balancing client priorities with those of health care services. Four themes related to systemic constraints were identified including imposed practices, ineffective processes, resource limitations, and lack of services. Therapists' aims could be seen to align with an "ethic of care" and were seen to be in tension in light of systemic constraints. The findings raise issues related to occupational justice, particularly related to occupational alienation in occupational therapy practice, and open conversations related to neoliberalist health care agendas. © The Author(s) 2016.
Encompassing multiple moral paradigms: a challenge for nursing educators.
Caldwell, Elizabeth Shirin; Lu, Hongyan; Harding, Thomas
2010-03-01
Providing ethically competent care requires nurses to reflect not only on nursing ethics, but also on their own ethical traditions. New challenges for nurse educators over the last decade have been the increasing globalization of the nursing workforce and the internationalization of nursing education. In New Zealand, there has been a large increase in numbers of Chinese students, both international and immigrant, already acculturated with ethical and cultural values derived from Chinese Confucian moral traditions. Recently, several incidents involving Chinese nursing students in morally conflicting situations have led to one nursing faculty reflecting upon how moral philosophy is taught to non-European students and the support given to Chinese students in integrating the taught curriculum into real-life clinical practice settings. This article uses a case study involving a Chinese student to reflect on the challenges for both faculty members and students when encountering situations that present ethical dilemmas.
Ethics approval: responsibilities of journal editors, authors and research ethics committees.
Bain, Luchuo Engelbert
2017-01-01
Meaningful progress of medicine depends on research that must ultimately involve human subjects. Obtaining ethical approval therefore, especially in medical sciences, should be a moral reflex for researchers. This unfortunately is not the case, with numerous researchers bypassing the ethics approval procedure, or simply unaware of its importance. Good research involves risks taken by research participants and uses tax payers' money in the process. These mandates the research endeavor to aim at attaining the highest degree of respect for the sacrifices made by others for science. Most researchers mistake scientific clearance or approval, for ethics approval. For a study to be ethical sound, it must be scientifically sound. This is only one of the activities carried out during protocol review. It is not uncommon for sensitive ethical concerns, especially in the social sciences to be overlooked and considered not to be accompanied by any serious risks for the research participants.The researcher has the responsibility of systematically consulting the competent ethics committee for advice and consequent approvals or ethical waivers. Journal editors and reviewers have the duty to systematically evaluate the ethical soundness of manuscripts submitted for review. Capacity building in research ethics and institutional support for Research Ethics Committees to speed up protocol review could reduce the incentive of carrying out research in human subjects without ethics approvals. It is hypocritical and idle to continue to expect optimal reviews on time and of good quality, from ethics committees functioning purely on altruistic grounds. Capacity building for researchers in research ethics, and institutional reforms and support for Research Ethics Committees appear not to have received the attention they truly deserve.
Food Culture, Preferences and Ethics in Dysphagia Management.
Kenny, Belinda
2015-11-01
Adults with dysphagia experience difficulties swallowing food and fluids with potentially harmful health and psychosocial consequences. Speech pathologists who manage patients with dysphagia are frequently required to address ethical issues when patients' food culture and/ or preferences are inconsistent with recommended diets. These issues incorporate complex links between food, identity and social participation. A composite case has been developed to reflect ethical issues identified by practising speech pathologists for the purposes of illustrating ethical concerns in dysphagia management. The case examines a speech pathologist's role in supporting patient autonomy when patients and carers express different goals and values. The case presents a 68-year-old man of Australian/Italian heritage with severe swallowing impairment and strong values attached to food preferences. The case is examined through application of the dysphagia algorithm, a tool for shared decision-making when patients refuse dietary modifications. Case analysis revealed the benefits and challenges of shared decision-making processes in dysphagia management. Four health professional skills and attributes were identified as synonymous with shared decision making: communication, imagination, courage and reflection. © 2015 John Wiley & Sons Ltd.
Cartwright, Juliana C.; Nelson, Christine A.; Knafl, Kathleen
2012-01-01
Abstract Background Ethical concerns were identified as a potential barrier to advancing palliative and end-of-life science at the 2004 National Institutes of Health State of the Science Meeting. However, data are lacking about the nature of ethical concerns and strategies for balancing the need to advance science with human subjects protections. Methods A qualitative case-study design was used to follow 43 end-of-life studies from proposal development through the review process and implementation. Investigators participated in semi-structured telephone interviews and provided document data regarding their experiences with grant and IRB reviews. Using constant comparative analysis within and across cases, the investigators identified commonly encountered and unique concerns and strategies for managing these concerns. Findings Investigator strategies fell into two broad categories: 1) Recruitment and consent strategies related to subject identification and enrollment; and 2) Protocol-related strategies related to the process of data collection. These strategies shared the overarching meta-themes of compassion, as evidenced by a heightened sensitivity to the needs of the population, coupled with vigilance, as evidenced by close attention to the possible effects of study participation on the participants' well-being, clinical care, and the needs of research staff. Conclusions Ethical concerns have led to the development of compassionate and vigilant strategies designed to balance the potential for risk of harm with the need to advance the science of palliative and end-of-life care. These strategies can be used by investigators to address ethical concerns and minimize barriers to the development of palliative and end-of-life care science. PMID:22731516
Hickman, Susan E; Cartwright, Juliana C; Nelson, Christine A; Knafl, Kathleen
2012-08-01
Ethical concerns were identified as a potential barrier to advancing palliative and end-of-life science at the 2004 National Institutes of Health State of the Science Meeting. However, data are lacking about the nature of ethical concerns and strategies for balancing the need to advance science with human subjects protections. A qualitative case-study design was used to follow 43 end-of-life studies from proposal development through the review process and implementation. Investigators participated in semi-structured telephone interviews and provided document data regarding their experiences with grant and IRB reviews. Using constant comparative analysis within and across cases, the investigators identified commonly encountered and unique concerns and strategies for managing these concerns. Investigator strategies fell into two broad categories: 1) Recruitment and consent strategies related to subject identification and enrollment; and 2) Protocol-related strategies related to the process of data collection. These strategies shared the overarching meta-themes of compassion, as evidenced by a heightened sensitivity to the needs of the population, coupled with vigilance, as evidenced by close attention to the possible effects of study participation on the participants' well-being, clinical care, and the needs of research staff. Ethical concerns have led to the development of compassionate and vigilant strategies designed to balance the potential for risk of harm with the need to advance the science of palliative and end-of-life care. These strategies can be used by investigators to address ethical concerns and minimize barriers to the development of palliative and end-of-life care science.
Medical ethics: enhanced or undermined by modes of payment?
Zweifel, Peter; Janus, Katharina
2017-01-01
In the medical literature [1, 2, 7], the view prevails that any change away from fee-for-service (FFS) jeopardizes medical ethics, defined as motivational preference in this article. The objective of this contribution is to test this hypothesis by first developing two theoretical models of behavior, building on the pioneering works of Ellis and McGuire [4] and Pauly and Redisch [11]. Medical ethics is reflected by a parameter α, which indicates how much importance the physician attributes to patient well-being relative to his or her own income. Accordingly, a weakening of ethical orientation amounts to a fall in the value of α. While traditional economic theory takes preferences as predetermined, more recent contributions view them as endogenous (see, e.g., Frey and Oberholzer-Gee [5]). The model variant based on Ellis and McGuire [4] depicts the behavior of a physician in private practice, while the one based on Pauly and Redisch [11] applies to providers who share resources such as in hospital or group practice. Two changes in the mode of payment are analyzed, one from FFS to prospective payment (PP), the other to pay-for-performance (P4P). One set of predictions relates physician effort to a change in the mode of payment; another, physician effort to a change in α, the parameter reflecting ethics. Using these two relationships, a change in ethics can observationally be related to a change in the mode of payment. The predictions derived from the models are pitted against several case studies from diverse countries. A shift from FFS to PP is predicted to give rise to a negative observed relationship between the medical ethics of physicians in private practice under a wide variety of circumstances, more so than a shift to P4P, which can even be seen as enhancing medical ethics, provided physician effort has a sufficiently high marginal effectiveness in terms of patient well-being. This prediction is confirmed to a considerable degree by circumstantial evidence coming from the case studies. As to physicians working in hospital or group practice, the prediction is again that a transition in hospital payment from FFS to PP weakens their ethical orientation. However, this prediction could not be tested because the one hospital study found relates to a transition to P4P, suggesting that this mode of payment may actually enhance medical ethics of healthcare providers working in a hospital or group practice. The claim that moving away from FFS undermines medical ethics is far too sweeping. It can only in part be justified by observed relationships, which even may suggest that a transition to P4P strengthens medical ethics.
Ethical principles in health research and review process.
Tangwa, Godfrey B
2009-11-01
In this paper I want to reflect on the fundamental ethical principles and their application in different particular contexts, especially in health research and the ethics review process. Four fundamental ethical principles have been identified and widely discussed in bioethical literature. These principles namely are: autonomy or respect for others, beneficence, non-maleficence and justice. These principles have cross-cultural validity, relevance and applicability. Every real-life situation and every concrete particular case in which ethical decision-making is called-for is unique and different from all others; but the same fundamental ethical principles are relevant and used in addressing all such cases and situations. Very often ethical problems will present themselves in the form of dilemmas and it is then necessary to use the same fundamental principles to analyze the situations, to argue persuasively and cogently with competence for the best options or choices in such situations. The issues I will be dealing with in this paper are necessarily more abstract and theoretical, but we will be discussing them from a very practical viewpoint and impulse, with a view to application in concrete real-life situations. The paper ends with some sample practical examples of cases that the reader can use to test his/her grasp of the principles, how to apply them, how to balance them in differing situations and contexts and how to adjudicate between them when they seem to be in conflict.
Progress in centralised ethics review processes: Implications for multi-site health evaluations.
Prosser, Brenton; Davey, Rachel; Gibson, Diane
2015-04-01
Increasingly, public sector programmes respond to complex social problems that intersect specific fields and individual disciplines. Such responses result in multi-site initiatives that can span nations, jurisdictions, sectors and organisations. The rigorous evaluation of public sector programmes is now a baseline expectation. For evaluations of large and complex multi-site programme initiatives, the processes of ethics review can present a significant challenge. However in recent years, there have been new developments in centralised ethics review processes in many nations. This paper provides the case study of an evaluation of a national, inter-jurisdictional, cross-sector, aged care health initiative and its encounters with Australian centralised ethics review processes. Specifically, the paper considers progress against the key themes of a previous five-year, five nation study (Fitzgerald and Phillips, 2006), which found that centralised ethics review processes would save time, money and effort, as well as contribute to more equitable workloads for researchers and evaluators. The paper concludes with insights for those charged with refining centralised ethics review processes, as well as recommendations for future evaluators of complex multi-site programme initiatives. Copyright © 2015 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Arar, Khalid; Haj, Ibrahim; Abramovitz, Ruth; Oplatka, Izhar
2016-01-01
Purpose: The purpose of this paper is to investigate ethical leadership in the context of the Arab educational system in Israel. It questions the relations of ethical leadership dimensions with decision making as well as background characteristics of the educational leaders. Design/methodology/approach: Arab educational leaders (n=150) from…
Shafran, David; Smith, Martin L; Daly, Barbara J; Goldfarb, David
2016-06-01
Standardizing consultation processes is increasingly important as clinical ethics consultation (CEC) becomes more utilized in and vital to medical practice. Solid organ transplant represents a relatively nascent field replete with complex ethical issues that, while explored, have not been systematically classified. In this paper, we offer a proposed taxonomy that divides issues of resource allocation from viable solutions to the issue of organ shortage in transplant and then further distinguishes between policy and bedside level issues. We then identify all transplant related ethics consults performed at the Cleveland Clinic (CC) between 2008 and 2013 in order to identify how consultants conceptually framed their consultations by the domains they ascribe to the case. We code the CC domains to those in the Core Competencies for Healthcare Consultation Ethics in order to initiate a broader conversation regarding best practices in these highly complex cases. A discussion of the ethical issues underlying living donor and recipient related consults ensues. Finally, we suggest that the ethical domains prescribed in the Core Competencies provide a strong starting ground for a common intra-disciplinary language in the realm of formal CEC.
DeCamp, Matthew; Tilburt, Jon C
2017-05-01
High-value care (HVC) is en vogue, but the ethics of physicians' roles in the growing number of HVC recommendations demands further attention. In this brief report, we argue that, from the standpoint of individual physicians' primary commitments and duties to individual patients, not all HVC is ethically equal. Our analysis suggests that the ethical case for HVC may be both stronger and weaker than is ordinarily supposed. In some cases, HVC is not merely a 'good thing to do' but is actually ethically obligatory. In others, it is merely permissible-or even ethically suspect. More importantly, we suggest further that understanding HVC as ethically 'obligatory, permissible, or suspect' has implications for the design and implementation of strategies that promote HVC. For example, it questions the use of adherence to certain HVC recommendations as a physician performance metric, which may already be occurring in some contexts. Properly construed, ethics does not threaten HVC but can instead help shape HVC in ways that preserve the fundamental values of the medical profession. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Should physicians tell the truth without taking social complications into account? A striking case.
Avci, Ercan
2018-03-01
The principle of respect for autonomy requires informing patients adequately and appropriately about diagnoses, treatments, and prognoses. However, some clinical cases may cause ethical dilemmas regarding telling the truth. Under the existence especially of certain cultural, social, and religious circumstances, disclosing all the relevant information to all pertinent parties might create harmful effects. Even though the virtue of telling the truth is unquestionable, sometimes de facto conditions compel physicians to act paternalistically to protect the patient/patients from imminent dangers. This article, which aims to study the issue of whether a physician should always tell the truth, analyzes an interesting case that represents the detection of misattributed paternity during pre-transplant tests for a kidney transplant from the son to the father in Turkey, where social, cultural, and religious factors have considerable impact on marital infidelity. After analyzing the concept of telling the truth and its relationship with paternalism and two major ethical theories, consequentialism and deontology, it is concluded that the value of the integrity of life and survival overrides the value of telling the truth. For this reason, in the case of a high possibility of severe and imminent threats, withholding some information is ethically justifiable.
The Evolution of End-of-Life Care: Ethical Implications for Case Management.
Fink-Samnick, Ellen
2016-01-01
This article: : Applicable to all health care sectors where case management is practiced. Few topics are more intimate and multifaceted for case managers than engaging with today's culturally diverse patient populations around end-of-life processes. The already prominent focus of this issue has been further elevated by a series of events to receive public attention. These include the Institute of Medicine's 2014 report-Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, rising numbers of patients around the globe requesting to end life on their own terms, and corresponding death with dignity initiatives and legislation.Another vital factor in the end-of-life equation involves how the latest generation of shared decision making influences the management of treatment dialogues among practitioners, patients, as well as insurance companies. Case managers are at the intersection of these complex interactions, working to achieve ethical, as well as legal accountability to the patient, employer, and profession while balancing personal perspectives. Professionals strive to effectively intervene with patients and their support systems facing end-of-life care decisions. It is essential case managers actively consider the intricacies of ethical practice and current contexts including death with dignity legislation, shared decision making, and shifts in regulations and reimbursement for end-of-life care.Case management's ethical envelope will continue to be pushed. To that end amid shifting societal constructs, professionals must have mastery of applicable codes, standards, principles, and rules essential for adherence to ethical practice.
Writing about Clients: Ethical Considerations and Options
ERIC Educational Resources Information Center
Sperry, Len; Pies, Ronald
2010-01-01
Today, the decision to prepare clinical case material for publication is a decision that cannot be taken lightly. The decision involves reviewing ethical considerations and choosing among various options to safeguard client privacy. Such options include seeking the client's permission, disguising case material, and developing composite case…
Connecting United States Air Force Core Values to Mission Accomplishment
2014-06-04
making ( Kohlberg , 2008), to published works with a specific focus on ethics in the Air Force. The case studies referenced throughout the paper are used...useful backdrop for solving this problem. Lawrence Kohlberg , an American psychologist, experimentally derived a model for moral development based...on the cognitive reasoning one employs in making moral decisions and solving ethical quandaries ( Kohlberg , 2008). How one thinks through moral and
May Stakeholders be Involved in Design Without Informed Consent? The Case of Hidden Design.
Pols, A J K
2017-06-01
Stakeholder involvement in design is desirable from both a practical and an ethical point of view. It is difficult to do well, however, and some problems recur again and again, both of a practical nature, e.g. stakeholders acting strategically rather than openly, and of an ethical nature, e.g. power imbalances unduly affecting the outcome of the process. Hidden Design has been proposed as a method to deal with the practical problems of stakeholder involvement. It aims to do so by taking the observation of stakeholder actions, rather than the outcomes of a deliberative process, as its input. Furthermore, it hides from stakeholders the fact that a design process is taking place so that they will not behave differently than they otherwise would. Both aspects of Hidden Design have raised ethical worries. In this paper I make an ethical analysis of what it means for a design process to leave participants uninformed or deceived rather than acquiring their informed consent beforehand, and to use observation of actions rather than deliberation as input for design, using Hidden Design as a case study. This analysis is based on two sets of normative guidelines: the ethical guidelines for psychological research involving deception or uninformed participants from two professional psychological organisations, and Habermasian norms for a fair and just (deliberative) process. It supports the conclusion that stakeholder involvement in design organised in this way can be ethically acceptable, though under a number of conditions and constraints.
Of missing voices and the obstetric imaginary: commentary on Jankowski and Burcher.
Cheney, Melissa
2015-01-01
In this commentary, I respond to an ethical analysis of a case study, reported by Jankowski and Burcher, in which a woman gives birth to an infant with a known heart anomaly of unknown severity, at home, attended by a midwife. Jankowski and Burcher argue that the midwife who attended this family acted unethically because she knowingly operated outside of her scope of practice. While I agree that the authors' conclusions are well supported by the portion of the story they were able to gather, the fact that the midwife and mother declined to engage in the ethics consult that informs their piece means that critical segments of the narrative are left untold. Some important additional considerations emerge from these silences. I explore the implicit assumptions of the biotechnical embrace, the roles of the political economy of hope and the obstetric imaginary in driving prenatal testing, and institutional blame for the divisiveness of the home-hospital divide in the United States. The value of Jankowski and Burcher's case study lies in its ability to highlight the intersections and potential conflicts between the principles of beneficence, patients' autonomy, and professional ethics, and to begin to chart a course for us through them. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.
The problem of privacy in transcultural research: reflections on an ethnographic study in Sri Lanka.
Monshi, Bardia; Zieglmayer, Verena
2004-01-01
Western laws and codes of ethics frequently require that private health information be treated confidentially. However, cross-cultural research shows that it is not always easy to determine what members of a culture consider to be private or how they wish private information to be handled. This article begins by presenting an ethnographic study of patient-healer relationships in Sri Lanka; researchers were surprised to find that participants' views of health and privacy differed greatly from typical Western views, and that the privacy protections they had put in place caused discomfort among participants. Building on this ethics case study, the article explores two main questions. First, can a single definition of privacy possibly do justice to the cultural variations that exist, or does a conceptual definition inevitably run the risk of ethnocentrism? Second, to what extent is strict compliance with research regulations or ethics codes ethically justifiable when following the rules will obviously cause unease in international participants?
The Case Method in Teacher Education: Alaskan Models. ERIC Digest.
ERIC Educational Resources Information Center
Kleinfeld, Judith
This ERIC digest discusses the theoretical basis of case teaching and examines its strengths and limitations as a tool for teacher education. Case teaching presents authentic, concrete teaching problems for students to analyze. The study of a classroom fight, for example, might draw discussion of racial, ethical, political, and other community…
Continuing review of ethics in clinical trials: a surveillance study in Iran
Mohamadi, Amin; Asghari, Fariba; Rashidian, Arash
2014-01-01
In recent years, notable measures have been taken to protect the rights of participants in biomedical research in Iran. The present study examines possible trends in adherence to ethical codes regarding informed consent after the development of the National Code of Ethics in Biomedical Research (NCEBR) and establishment of research ethics committees. In this retrospective study, 126 dissertations from Tehran University of Medical Sciences were evaluated for adherence to ethical codes. These dissertations were all in clinical trial design and had been presented in the years 1999 and 2009, that is, precisely before and after the development of the NCEBR. A checklist was developed to evaluate the ethical issues associated with informed consent. A single investigator retrieved and evaluated the consent forms from the dissertations. Borderline cases were discussed with other investigators to reach a consensus decision. Based on the checklist, the Standardized Ethical Score (SES) was calculated for each consent form. The mean SES and the rate of consent form attachment were compared between the two years. In total, 70 dissertations had reported obtaining informed consent from study participants, whereas consent forms were attached in only 22 dissertations (17.50%). The percentage of dissertations with the consent form attached increased over time from 12.2% in 1999 to 20.8% in 2009 (P > 0.05), but the majority still did not include a consent form. Moreover, the mean SES of consent forms was significantly higher in 1999 (0.746) than in 2009 (0.428), highlighting the need for more training of researchers and improved surveillance by the ethics committees. A great amount of effort is still needed to make the consent process more ethical, especially for dissertations as a less visible part of academic research. As for students, more systematic training focused on research ethics should be implemented prior to thesis submission. PMID:26587202
Making Choices: Ethical Decisions in a Global Context.
Bonde, Sheila; Briant, Clyde; Firenze, Paul; Hanavan, Julianne; Huang, Amy; Li, Min; Narayanan, N C; Parthasarathy, D; Zhao, Hongqin
2016-04-01
The changing milieu of research--increasingly global, interdisciplinary and collaborative--prompts greater emphasis on cultural context and upon partnership with international scholars and diverse community groups. Ethics training, however, tends to ignore the cross-cultural challenges of making ethical choices. This paper confronts those challenges by presenting a new curricular model developed by an international team. It examines ethics across a very broad range of situations, using case studies and employing the perspectives of social science, humanities and the sciences. The course has been developed and taught in a highly collaborative way, involving researchers and students at Zhejiang University, the Indian Institute of Technology, Bombay and Brown University. The article presents the curricular modules of the course, learning outcomes, an assessment framework developed for the project, and a discussion of evaluation findings.
Hatipkarasulu, Yilmaz; Gill, James H
2004-04-01
The increasing number of companies providing internet services and auction tools helped popularize the online reverse auction trend for purchasing commodities and services in the last decade. As a result, a number of owners, both public and private, accepted the online reverse auctions as the bidding technique for their construction projects. Owners, while trying to minimize their costs for construction projects, are also required to address their ethical responsibilities to the shareholders. In the case of online reverse auctions for construction projects, the ethical issues involved in the bidding technique directly reflects on the owner's ethical and social responsibilities to their shareholders. The goal of this paper is to identify the shareholder ethics and responsibilities in online reverse auctions for construction projects by analyzing the ethical issues for the parties involved in the process. The identification of the ethical issues and responsibilities requires clear definition and understanding of professional ethics and the roles of the involved parties. In this paper, first, the concept of professional ethics and social responsibility is described in a general form. To illustrate the ethical issues and responsibilities, a sample case of bidding for a construction project using online reverse auction techniques is presented in which the shareholders were actively involved in questioning the ethical issues. The issues involved in the bidding process and their reflection on the shareholder responsibilities are described and analyzed for each stage of the process. A brief discussion of the overall process is also included to address the general ethical issues involved in online reverse auctions.
Moral Conflicts and Religious Convictions: What Role for Clinical Ethics Consultants?
Moskop, John C
2018-05-03
Moral conflicts over medical treatment that are the result of differences in fundamental moral commitments of the stakeholders, including religiously grounded commitments, can present difficult challenges for clinical ethics consultants. This article begins with a case example that poses such a conflict, then examines how consultants might use different approaches to clinical ethics consultation in an effort to facilitate the resolution of conflicts of this kind. Among the approaches considered are the authoritarian approach, the pure consensus approach, and the ethics facilitation approach described in the Core Competencies for Healthcare Ethics Consultation report of the American Society for Bioethics and Humanities, as well as a patient advocate approach, a clinician advocate approach, and an institutional advocate approach. The article identifies clear limitations to each of these approaches. An analysis of the introductory case illustrates those limitations, and the article concludes that deep-seated conflicts of this kind may reveal inescapable limits of current approaches to clinical ethics consultation.
Betan, E J; Stanton, A L
1999-06-01
Ethical dilemmas are inherently challenging. By definition, clinicians decide between conflicting principles of welfare and naturally confront competing pulls and inclinations. This investigation of students' responses to an ethical scenario highlights how emotions and concerns can interfere with willingness to implement ethical knowledge. Clear-cut rules are the exception in psychotherapy, and clinicians must judge ethical issues on the basis of the unique context of each case. As such, subjectivity and emotional involvement are essential tools for determining ethical action, but they must be integrated with rational analysis. Strategies for attending to influential emotions and contextual factors in order to mobilize ethical commitment are described.
The object of environmental ethics
NASA Astrophysics Data System (ADS)
Petulla, Joseph M.
1989-05-01
Since the term “environmental ethics” began to be used a generation ago, it has covered many different kinds of environmental notions, problems, ethical systems, and forms of behavior. A variety of cases are presented and examined under two terms, environmental ethics and ecological morality, in an effort to illustrate different kinds of ethical objectives. In order to understand the connections between various strands of environmental ethics, personal and social values and subcultural norms of environmental ethics are examined under Christopher Stone's concept of moral pluralism. G. J. Warnock's notion of the “general object” of morality is proposed to integrate the variegated purposes of environmental ethics.
DiStefano, Anthony; Peters, Ruth; Tanjasiri, Sora Park; Quitugua, Lourdes; Dimaculangan, Jeany; Hui, Brian; Barrera-Ng, Angelica; Vunileva, 'Isileli; Tui'one, Vanessa; Takahashi, Lois
2013-02-01
We describe ethical issues that emerged during a one-year CBPR study of HIV and human papillomavirus (HPV) vulnerabilities and prevention in two Pacific Islander (PI) communities, and the collaborative solutions to these challenges reached by academic and community partners. In our project case study analysis, we found that ethical tensions were linked mainly to issues of mutual trust and credibility in PI communities; cultural taboos associated with the nexus of religiosity and traditional PI culture; fears of privacy breaches in small, interconnected PI communities; and competing priorities of scientific rigor versus direct community services. Mutual capacity building and linking CBPR practice to PI social protocols are required for effective solutions and progress toward social justice outcomes.
Desclaux, A
2008-04-01
Social sciences are concretely concerned by the ethics of medical research when they deal with topics related to health, since they are subjected to clearance procedures specific to this field. This raises at least three questions: - Are principles and practices of medical research ethics and social science research compatible? - Are "research subjects" protected by medical research ethics when they participate in social science research projects? - What can social sciences provide to on-going debates and reflexion in this field? The analysis of the comments coming from ethics committees about social science research projects, and of the experience of implementation of these projects, shows that the application of international ethics standards by institutional review boards or ethics committees raises many problems in particular for researches in ethnology anthropology and sociology. These problems may produce an impoverishment of research, pervert its meaning, even hinder any research. They are not only related to different norms, but also to epistemological divergences. Moreover, in the case of studies in social sciences, the immediate and differed risks, the costs, as well as the benefits for subjects, are very different from those related to medical research. These considerations are presently a matter of debates in several countries such as Canada, Brasil, and USA. From another hand, ethics committees seem to have developed without resorting in any manner to the reflexion carried out within social sciences and more particularly in anthropology Still, the stakes of the ethical debates in anthropology show that many important and relevant issues have been discussed. Considering this debate would provide openings for the reflexion in ethics of health research. Ethnographic studies of medical research ethics principles and practices in various sociocultural contexts may also contribute to the advancement of medical ethics. A "mutual adjustment" between ethics of medical research and social sciences is presently necessary: it raises new questions open for debate.
1993-01-01
Opportunities in Business: Ethical Decision Making in the Trenches, and finally a general ( Kantian ) criticism of the utilitarian ethic which strictly questions...particular-case intuitionism and is opposed to utilitarianism and Kantianism as well as the divine-command theory. The original idea can be traced back...theory, intuitionism, which was so summarily dismissed on the first page of this thesis, and Immanuel Kant’s duty-based ethic. First, what is
Teaching Communication with Ethics-Based Cases.
ERIC Educational Resources Information Center
Stevens, Betsy
1996-01-01
Argues the importance of presenting ethics and communication as twin concepts in the management communication class. Presents two cases useful in the classroom that address two contemporary issues (harassment in the workplace and the consumption of alcohol by pregnant women) that have implications for business professionals and allow students to…
Ethics Inside and Out: The Case of "Guidoriccio."
ERIC Educational Resources Information Center
Swan, John
1991-01-01
Discusses an apparent case of censorship via card catalog indexing in a Florentine research library. The challenge to the authenticity of a fresco by Simone Martini is explained, the ethics of collegiality are considered, and attempts to find redress through various library associations are recounted. (18 references) (LRW)
Case Management Ethics: High Professional Standards for Health Care's Interconnected Worlds.
Sminkey, Patrice V; LeDoux, Jeannie
2016-01-01
The purpose of this discussion is to draw attention to the considerable pressure on professional case managers today to coordinate with multiple stakeholders, with responsibilities that put them at the forefront of contact with payers and providers. This discussion raises awareness of how case managers, and board-certified case managers in particular, must demonstrate that they adhere to the highest ethical standards, as codified by the Commission for Case Manager Certification's Code of Professional Conduct for Case Managers. This discussion applies to case management practices and work settings across the full continuum of health care. As advocates for clients (individuals receiving case management services) and their families/support systems, case managers must adhere to the highest of ethical and professional standards. The Code of Professional Conduct for Case Managers is an indispensable resource for case managers to ensure that they place the public interest above their own, respect the rights and inherent dignity of clients, maintain objectivity in their relationships with clients, and act with integrity and fidelity with clients and others, as stipulated by the code.
Virtue ethics – an old answer to a new dilemma? Part 2. The case for inclusive virtue ethics
2015-01-01
Summary While Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges. This two-part paper proposes a version of virtue theory as a more grounded system of moral analysis. Part 2 examines the role of basic moral theory as the foundation to ethics and suggests how virtue theory can be used as a central framework for ethics while being inclusive of insights from deontology and consequentialism. PMID:25792615
ERIC Educational Resources Information Center
Scholl, Mark B.
2017-01-01
The author presents recommendations for writing case studies for publication in the "Journal of College Counseling." Recommendations fall into 2 categories: (a) ethical considerations and (b) criteria essential to methodological rigor (e.g., Hyett, Kenny, & Dickson-Swift, 2014). The article is intended to guide and encourage…
Effect of Case-Based Video Support on Cyberbullying Awareness
ERIC Educational Resources Information Center
Akbulut, Yavuz
2014-01-01
When it comes to safe and ethical information technology use, cyberbullying stands out. Indeed, it is seen to be a prevalent and complex problem. Prevention suggestions tend to rely on implications of descriptive and correlational studies rather than true experimental works. In this regard, the current study investigated the effect of case-based…
Goswami, Nandu; Batzel, Jerry Joseph; Hinghofer-Szalkay, Helmut
2012-09-01
Ethics should be an important component of physiological education. In this report, we examined to what extent teaching of ethics is formally being incorporated into the physiology curriculum. We carried out an e-mail survey in which we asked the e-mail recipients whether their institution offered a course or lecture on ethics as part of the physiology teaching process at their institution, using the following query: "We are now doing an online survey in which we would like to know whether you offer a course or a lecture on ethics as part of your physiology teaching curriculum." The response rate was 53.3%: we received 104 responses of a total of 195 sent out. Our responses came from 45 countries. While all of our responders confirmed that there was a need for ethics during medical education and scientific training, the degree of inclusion of formal ethics in the physiology curriculum varied widely. Our survey showed that, in most cases (69%), including at our Medical University of Graz, ethics in physiology is not incorporated into the physiology curriculum. Given this result, we suggest specific topics related to ethics and ethical considerations that could be integrated into the physiology curriculum. We present here a template example of a lecture "Teaching Ethics in Physiology" (structure, content, examples, and references), which was based on guidelines and case reports provided by experts in this area (e.g., Benos DJ. Ethics revisited. Adv Physiol Educ 25: 189-190, 2001). This lecture, which we are presently using in Graz, could be used as a base that could lead to greater awareness of important ethical issues in students at an early point in the educational process.
Deception, discrimination, and fear of reprisal: lessons in ethics from third-year medical students.
Caldicott, Catherine V; Faber-Langendoen, Kathy
2005-09-01
To systematically examine ethical conflicts reported by all State University of New York Upstate Medical University third-year students, compare them with conflicts reported in the literature, and identify content areas that compel new or renewed emphasis in national educational objectives, standard curricula, and texts. From 1999 to 2002, all third-year students submitted papers for a required bioethics course. These papers depicted ethical issues arising during clinical clerkships. The authors devised a checklist of ethical issues; after analyzing the students' papers, the authors applied the checklist to the papers to create a taxonomy. Three hundred twenty-seven students submitted 688 cases involving 40 ethical issues. The most common issues were deliberate lies or deceptions (n = 68), patients' right to refuse recommended treatment (n = 48), and insistence on futile treatment (n = 46). Students perceived overt and subtle discrimination toward patients, reflected in substandard or excessive treatment. In 81 cases (12%), students expressed reluctance to speak up about moral conflict for fear of reprisal. This fear was expressed in 18 (45%) of the 40 issues-particularly student-specific (36 [52% of 69]) and quality of care (7 [24% of 29])-and most frequently in cases involving surgery (p < .025) and obstetrics-gynecology patients (p < .01). Students discerned ethical dilemmas in both "usual and customary" and seemingly incidental situations. Students who described fear of speaking up perceived a tradeoff between academic survival and patients' interests. The cases demonstrated that students still lacked the tools to navigate ethical dilemmas effectively. The authors propose that moral courage is within the realm of professional expectations for medical students; its cultivation is an appropriate formal objective for medical education.
ERIC Educational Resources Information Center
Martin, Jennifer; Beese, Jane A.
2015-01-01
This case was developed for use in a learning-centered course with a focus on administrative leadership and ethical behavior. This case describes the experience of a new faculty member at Saint Ambrose University, as she discovers a wide range of ethical and management problems in her department. The case unfolds as we track her efforts to deal…
Does teaching by cases mislead us about morality?
Coope, C M
1996-02-01
Those who teach or are taught medical ethics with a heavy reliance on case studies should be warned first of all that the practice tends to exaggerate the degree to which morality is controversial. Secondly, they ought to realise that it is often quite unclear what problems count as moral problems. Thirdly, they will need to bear in mind that there may be -- and presumably are -- limits to what we may regard as open to discussion. It would be quite superficial to assume that ethics teachers, going along with what is generally accepted by their colleagues in this matter, would never tempt students to disregard these limits.
Does teaching by cases mislead us about morality?
Coope, C M
1996-01-01
Those who teach or are taught medical ethics with a heavy reliance on case studies should be warned first of all that the practice tends to exaggerate the degree to which morality is controversial. Secondly, they ought to realise that it is often quite unclear what problems count as moral problems. Thirdly, they will need to bear in mind that there may be -- and presumably are -- limits to what we may regard as open to discussion. It would be quite superficial to assume that ethics teachers, going along with what is generally accepted by their colleagues in this matter, would never tempt students to disregard these limits. PMID:8932725