Price, David W.
Discusses the dimensions of ethics in administrative practice, identifies some of the characteristic circumstances that frequently precipitate ethical dilemmas, and suggests strategies for addressing ethical dilemmas. (Author)
It is difficult to speak of ethic dilemmas in a society that has relativism as the oficial philosophical and political doctrine, i.e., stable values and behavior references, are denied, both in health care and in any other area of human knowledge. In the field of medical sciences it is even pretended to pass from the observational methodology to a field of manipulation and manipulability. It is the very Ethic that is presented as a dilemma. In these conditions one needs to know the lines of thought that are defended, to replace and make disappear the stable ethic references: ecletism, historicism, scientificism, pragmatism, and nihilism itself, that lead to the 'new ethic paradigm', that has created by itself a pseudo-spirituality. The truth is we are adrift in the 'Ethic of Convenience' which changes according to the majorities. In this setting the way to go is to rediscover the abandoned ethic values: only with an objective ethic, with sound references and foundations, it is possible to re-establish and perfect the patient-physician relationship, for a better social health. And this begins with the ethic problem of human life.
Lawrence, Jeanette A.; Crisham, Patricia
Six ethical dilemmas related to nursing practice were developed and presented to registered and trainee nurses for their resolution. A non-nurse group of university students also gave decisions about what a nurse should do in each ethically-loaded situation. A dilemma was classified as recurrent if its core problem was spontaneously mentioned by…
Levitt, E; Taylor, S
School nurses must consider the ethical principles that guide everyday practice. Autonomy, beneficence, justice, and nonmaleficence are the ethical principles most often confronted in the school setting. When beneficent care-giving begins to conflict with the family's decision-making autonomy, paternalism, a form of beneficence, affects the family's autonomy. This creates an ethical dilemma for the school nurse who guides his or her practice by ethical principles but who also must decide when it is appropriate to refer a child or family to a medical provider for further evaluation. A case study is presented to illustrate a specific ethical dilemma. The ethical dilemma is described using a model that examines external factors, professional responsibilities, and possible courses of action. The discussion includes cultural considerations and barriers pertinent to the case example.
Payne, Stephen L., Ed.; Charnov, Bruce H., Ed.
Ethical dilemmas faced by many academicians in the course of their work activities and role demands are described in eight articles and 24 case illustrations. Article titles and authors are as follows: "The Academician as Good Citizen" (Bruce H. Charnov); "Fundamental Means to Ethical Teaching" (Gordon A. Walter, Mary Ann Von Glinow); "Concern for…
Myers, Michael F; Herb, Alice
A sound clinical education should include the opportunity for medical students to engage in a spirited and informed discussion with faculty about the ethical challenges they will undoubtedly face. Unfortunately, in many medical schools today this goal is thwarted by many factors, including denial that a problem exists, relentless system overload, unprofessional behavior, breakdown in communication, and inertia. What is worse is that this problem is not new, and the fallout is not insignificant. Another potential contributing factor is burnout, which is well documented in a high percentage of medical students, residents, and faculty, and two of its most serious consequences are patient dissatisfaction and medical error.The authors draw on hundreds of student reflections on ethical dilemmas submitted during classroom exercises to examine persistent themes. They posit that classroom and didactic teaching is not enough to enable students to face ethical dilemmas. The authors call for a major culture change in medical education: "buy in" from top administration, especially the dean (and associate/assistant deans), chairs of all departments, and clerkship and residency training directors; the appointing of an ombudsperson and/or ethicist to oversee and resolve issues as they arise; instructional workshops and materials to enhance and impart skills for all teachers; remediation or retiring of errant faculty; and ongoing research and dialogue between and among medical centers about novel solutions.
Ethical dilemmas can be challenging for the nutrition support clinician who is accustomed to evidence-based practice. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle's virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, nonmaleficence, and justice). Adopting a step-by-step approach can simplify the process of resolving ethical problems.
Toker, A; Salzer, L
Allocation of medical resources, especially resources with absolute scarcity such as organs for transplant, is a difficult task. Medical, surgical, and ethical considerations should be evaluated. In solid organ transplantation, ethics committees are the gate keepers that deal with moral philosophy when moral values are in conflict. Often, no good solution to a dilemma in these medical ethics exists. Our case presents split living liver donation for retransplantation in a mentally disabled girl, with few medical ethics principles at stake.
Pratt, Cornelius B.
Presents arguments for and against the acceptance, in 1990, of two controversial client accounts by the public relations agency Hill & Knowlton. Examines the ethical implications of both accounts and concludes that whatever ethical infractions may have occurred reflect the agency's dominant public relations practices, not necessarily the "greedy…
Whisenant, Warren A.; Pedersen, Paul M.; Clavio, Galen
Athletic administrators and decision makers within interscholastic athletics are expected to embrace a code of ethics that serves as a set of rules to guide their professional behavior. Included within this code are areas of controversy that present gender-related ethical dilemmas for administrators. Three specific ethical dilemmas involve (1)…
Haines, A; de B White, C; Gleisner, J
The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured destruction and increasing the risk of nuclear war. Medical planning and civil defence preparations for nuclear war have recently been increased in several countries although there is little evidence that they will be of significant value in the aftermath of a nuclear conflict. These developments have raised new ethical dilemmas for those in health professions. If there is any risk of use of weapons of mass destruction, then support for deterrence with these weapons as a policy for national or global security appears to be incompatible with basic principles of medical ethics and international law. The primary medical responsibility under such circumstances is to participate in attempts to prevent nuclear war. PMID:6668585
Schumann, Paul L.; Scott, Timothy W.; Anderson, Philip H.
This article makes two contributions to the teaching of business ethics literature. First, it describes the steps involved in developing effective ethical dilemmas to incorporate into a computer-based business simulation. Second, it illustrates these steps by presenting two ethical dilemmas that an instructor can incorporate into any business…
Ruiz López, Justo; Navarro Zaragoza, Javier; Carrillo Navarro, Francisco; Luna Maldonado, Aurelio
After reviewing the existing bibliography in the last 20 years, we concluded that there is a lack of information regarding the ethical conflicts that affect to pediatrics in their daily practice. It produces certain degree of uncertainty in these professionals at the time of solving these problems. We made a systematic search in the main data bases, finding more than 150 articles related, of which 80 were considered outstanding. After studying them, we have found 40 ethical dilemmas, related to some principle of solution and that we described in this article. Through them we can find such important dilemmas as those related to physical disability, palliative care or consent from children.
Narruhn, Robin; Schellenberg, Ingra R
The use of traditional ethical methodologies is inadequate in addressing a constructed maternal-fetal rights conflict in a multicultural obstetrical setting. The use of caring ethics and a relational approach is better suited to address multicultural conceptualizations of autonomy and moral distress. The way power differentials, authoritative knowledge, and informed consent are intertwined in this dilemma will be illuminated by contrasting traditional bioethics and a caring ethics approach. Cultural safety is suggested as a way to develop a relational ontology. Using caring ethics and a relational approach can alleviate moral distress in health-care providers, while promoting collaboration and trust between providers and their patients and ultimately decreasing reproductive disparities. This article examines how a relational approach can be applied to a cross-cultural reproductive dilemma.
Levinson, Meira, Ed.; Fay, Jacob, Ed.
Educators and policy makers confront challenging questions of ethics, justice, and equity on a regular basis. Should teachers retain a struggling student if it means she will most certainly drop out? Should an assignment plan favor middle-class families if it means strengthening the school system for all? These everyday dilemmas are both utterly…
Farnam, C R
The transplant of cells from fetal tissue shows promise as a therapy for certain diseases. The use and research of fetal tissue, and methods of obtaining the tissue, have raised ethical dilemmas. Consideration must be given concerning the mother, the fetus, and the tissue recipient.
Macauley, Robert C
Perhaps no other field of medicine illustrates the ethical dilemmas occasioned by the explosion of technology more than neurology. Many dilemmas which at first appear to be ethical, however, are actually biotechnical, informational, or interpersonal in nature. For those which are, indeed, ethical, a review of existing information and acquisition of additional data can often serve to identify the proper response. When the optimal course of action remains unclear, the comprehensive, structured approach described in this chapter is both philosophically rigorous and clinically relevant. It takes into account a variety of critical considerations - including rights, duties, consequences, virtues, and similar cases - while utilizing both inductive and deductive methods. The end result is the "least bad" of available options, or, at the very least, a practical response which preserves future options and avoids crucial mistakes.
This article explores a cross-occupational approach for dealing with ethical dilemmas by comparing teaching and nursing. Findings indicate more shared patterns of ethical dilemmas (such as caring for needs for others versus following formal codes) than dilemmas specific to teaching (e.g., advancing universal values versus advancing knowledge) or…
Buelow, Janet R.; Mahan, Pamela L.; Garrity, April W.
Ethical dilemmas are experienced by all individuals, but are especially prevalent among healthcare professionals. Universities and colleges preparing students to work and provide care in this arena are currently addressing this challenge through traditional ethics courses and lectures. However, student perspectives of the major ethical dilemmas in…
Babalola, Olubukola; Grant-Kels, Jane M; Parish, Lawrence Charles
Physicians often face tremendous pressures and incentives to publish, sometimes leading to a compromise of ethical standards, either consciously or unconsciously. From the vantage of ethical authorship, we discuss what constitutes authorship; avoidance of ghost authorship; plagiarism, as well as self-plagiarism and duplicate publication; falsification; and fabrication. Editors also face ethical challenges, including how best to manage peer-review bias, to address reviewer tardiness, and to locate reviewers with appropriate expertise and professionalism. Editors need to deal with authors who fragment their work into multiple publications to enhance their curriculum vitae ("salami factor"), as well as to manage the financial benefits of advertising and to avoid conflicts of interest for the journal. Both authors and editors should be straightforward and principled throughout the publication process.
Bardoel, E. Anne; Haslett, Tim
This article demonstrates how the system archetype "drifting goals" can be used in the classroom to explore ethical dilemmas. System archetypes provide a framework that shifts the focus from seeing ethical dilemmas as stemming solely from the acts of individuals to exploring the systemic structures that are responsible for generic patterns of…
This article identifies and discusses ethical dilemmas inherent when undertaking research with children or other vulnerable populations: power relations, risks and benefits, and informed consent and confidentiality (Maguire, 2005). Ethical dilemmas often arise when researchers attempt to merge the interests of their research and the interests of…
Woloshin, Phyllis Lerman
This report describes a study undertaken to assess student choices in medical ethical dilemmas. Medical ethical dilemmas are interpreted to include problems such as abortion, euthanasia, sterilization, experimentation on humans, allocation of scarce medical resources, and physician and health personnel training. The major purpose of the study was…
Garcia, J G; Froehlich, R J; Cartwright, B; Letiecq, D; Forrester, L E; Mueller, R O
This study tested an eight-factor model of client actions/decisions in terms of the extent to which professionals counseling persons with HIV/AIDS believed that those actions/decisions presented ethical dilemmas, and the frequency with which they encountered such actions. A confirmatory factor analysis lent initial support for the hypothetical eight-factor ethical-dilemma model for the ratings regarding the extent to which the participants believed those items constituted ethical dilemmas. Similar results were obtained for the frequency ratings, but in this case a second, competing model was equally plausible. Several significant predictors of participant ratings were found and are discussed.
Chima, S C; Mamdoo, F
Termination of pregnancy (TOP) or feticide for severe fetal anomalies is ethically and morally challenging and maybe considered illegal in countries with restrictive abortion laws. While diagnostic modalities such as fetal ultrasound, magnetic resonance imaging, and genetic screening have improved prenatal diagnosis, these technologies remain scarce in many African countries making diagnosis and counseling regarding TOP difficult. Ethical dilemmas such as women's autonomy rights may conflict with fetus' right to personhood, and doctor's moral obligations to society. In liberal jurisdictions, previable fetuses may not have legal rights of personhood; therefore, appropriate action would be to respect pregnant women's decisions regarding TOP. However, in countries with restrictive abortion laws the fetus maybe imbued with the right of personhood at conception, making TOP illegal and exposing doctors and patients to potential criminal prosecution. Birth of a severely disabled baby with independent legal rights creates further conflicts between parents and clinicians complicating healthcare decision-making. Irrespective of the maternal decision to accept or refuse TOP, the psychological and emotional impact of an impaired fetus or neonate, often lead to moral distress and posttraumatic stress reactions in parents. Doctors have legal and ethical obligations to provide an accurate antenatal diagnosis with full disclosure to enable informed decision making. Failure to provide timely or accurate diagnosis may lead to allegations of negligence with potential liability for "wrongful birth" or "wrongful life" following birth of severely disabled babies. Mismanagement of such cases also causes misuse of scarce healthcare resources in resource-poor countries. This paper describes ethical challenges in clinical management of two neonates born following declined and failed feticide for severe central nervous system anomalies with a critical appraisal of the relevant literature.
Thomas, Theodore H.
This module represents one portion of the National Training and Development Service Urban Management Curriculum Development Project. It focuses on the issue of ethics in urban management performance and is designed to demonstrate that ethical dilemmas are a personal, complex, everyday managerial problem, and to enlarge the range of ethical options…
Norberg, Katarina; Johansson, Olof
Being a skillful school leader presumes the competence to judge the ethical consequences of actions. This implies a need for all school agents to discover and analyze what values are at stake and, in turn, reconcile didactic rationality with ethical rationality. This article aims to explore ethical dilemmas in daily school practice, experienced…
Jenlink, Patrick M.; Jenlink, Karen Embry
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…
Calleja-Sordo, Elisa Constanza; de Hoyos, Adalberto; Méndez-Jiménez, Jorge; Altamirano-Bustamante, Nelly F; Islas-Andrade, Sergio; Valderrama, Alejandro; García-Peña, Carmen; Altamirano-Bustamante, Myriam M
The purpose of this study is to determine empirically the state of the art of the medical care, when healthcare personal is confronted with ethical dilemmas related with the care they give to the geriatric population. An observational, longitudinal, prospective and qualitative study was conducted by analyzing the correlation between healthcare personnel-patient relationship, and ethical judgments regarding dilemmas that arise in daily clinical practice with geriatric patients. Mexican healthcare personnel with current active practices were asked to write up an ethical dilemma that arose frequently or that had impacted their medical practice. From the narrative input, we were able to draw up a database with 421 dilemmas, and those corresponding to patients 60 years and older were selected (n = 54, 12.8 %). The axiological analysis of the narrative dilemmas of geriatric patients was made using dialectical empiricism. The axiological analysis values found most frequently were classified into three groups: the impact of healthcare, the roles of the physician, and refusal of therapy; the healthcare role of educator, caring for the patients' life and the risk of imminent death where the values found more often. The persistence and universality of certain dilemmas in geriatrics calls for awareness and requires a good training in the ethical discernment of these dilemmas. This would help to improve substantially the care and the life quality of this population.
Ethical dilemmas from a national purposive sample of Turkish counsellors (N = 172) were collected using critical incidents technique. Content analysis was performed with open coding guided by the classification of American Counseling Association code of ethics. Incidents regarding confidentiality and privacy (56.4%), with 37.1% involving incidents…
Mortari, Luigina; Harcourt, Deborah
This article will explore some of the ethical dilemmas that confront researchers when they seek to invite children's participation in research. It firstly tracks the historical landscape of ethical research and will examine the influence of the United Nations Convention on the Rights of the Child (UNCRC) on participatory research with children.…
Researchers cannot always rely on traditional methods for solving research dilemmas. In a research project that explored the friendships and social relationships of four students with severe disabilities in four secondary schools in New Zealand, the author uses poetic re-presentation to solve several ethical and pragmatic research dilemmas. Within…
Paulson, Steve; Comfort, Christopher P; Lee, Barbara Coombs; Shemie, Sam; Solomon, Mildred Z
The ability of modern medicine to prolong life has raised a variety of difficult legal, ethical, and social issues on which reasonable minds can differ. Among these are the morality of euthanasia in cases of deep coma or irreversible injury, as well as the Dead Donor Rule with respect to organ harvesting and transplants. As science continues to refine and develop lifesaving technologies, questions remain as to how much medical effort and financial resources should be expended to prolong the lives of patients suspended between life and death. At what point should death be considered irreversible? What criteria should be used to determine when to withhold or withdraw life-prolonging treatments in cases of severe brain damage and terminal illness? To explore these complex dilemmas, Steve Paulson, executive producer and host of To the Best of Our Knowledge, moderated a discussion panel. Pediatrician Sam Shemie, hospice medical director Christopher P. Comfort, bioethicist Mildred Z. Solomon, and attorney Barbara Coombs Lee examined the underlying assumptions and considerations that ultimately shape individual and societal decisions surrounding these issues. The following is an edited transcript of the discussion that occurred November 12, 2013, 7:00-8:30 PM, at the New York Academy of Sciences in New York City.
Denardin, Daniela; Telles, Jorge Alberto B.; Betat, Rosilene da Silveira; Fell, Paulo Renato K.; da Cunha, André Campos; Targa, Luciano Vieira; Zen, Paulo Ricardo G.; Rosa, Rafael Fabiano M.
OBJECTIVE To review the history, epidemiology, etiology, gestational aspects, diagnosis and prognosis of imperfect twinning. DATA SOURCES Scientific articles were searched in PubMed, SciELO and Lilacs databases, using the descriptors "conjoined twins", "multiple pregnancy", "ultrasound", "magnetic resonance imaging" and "prognosis". The research was not delimited to a specific period of time and was supplemented with bibliographic data from books. DATA SYNTHESIS: The description of conjoined twins is legendary. The estimated frequency is 1/45,000-200,000 births. These twins are monozygotic, monochorionic and usually monoamniotic. They can be classified by the most prominent fusion site, by the symmetry between the conjoined twins or by the sharing structure. The diagnosis can be performed in the prenatal period or after birth by different techniques, such as ultrasound, magnetic resonance imaging and echocardiography. These tests are of paramount importance for understanding the anatomy of both fetuses/children, as well as for prognosis and surgical plan determination. CONCLUSIONS Although imperfect twinning is a rare condition, the prenatal diagnosis is very important in order to evaluate the fusion site and its complexity. Hence, the evaluation of these children should be multidisciplinary, involving mainly obstetricians, pediatricians and pediatric surgeons. However, some decisions may constitute real ethical dilemmas, in which different points should be discussed and analyzed with the health team and the family. PMID:24142323
When clients and health care providers differ in their understanding of what is right or wrong, an ethical dilemma may arise. Such dilemmas occur in everyday clinical practice. Health care providers have the professional responsibility to analyze these dilemmas. A clinical case study of an ethical dilemma that occurred in a cross-cultural context is examined. The language of the client and provider differed, and no interpreter service was available. Given these conditions, the provider's ethical dilemma was whether, and if so how, to give safe, satisfying care that respected the needs of a client with limited English proficiency. Measuring the morality of the provider's decisions and actions using Rawls' ethical theory of social justice finds deficits. A 10-step Bioethical Decision-Making Model by Thompson is used to demonstrate one method for analyzing the moral dimension of a clinical scenario focusing on the decisions and actions taken by a midwife. Scrutinizing ethically challenging clinical encounters will result in better understanding of the moral dimensions of practice.
Henderson, Kathryn L.; Malone, Stefanie L.
Learning to navigate ethical dilemmas is important in counseling students' training. According to the Council for the Accreditation of Counseling and Related Educational Programs (2009 standards, counseling students must receive ethics education. A common goal for counselor educators is to assist students in translating ethical theory into…
Turner, Helen N
An ethical dilemma that is not uncommon to encounter when caring for children occurs when parental preference does not appear to be in the child's best interest. Challenges facing the health care team are further amplified when the family's cultural background does not match that of the team. A case study will be used to illustrate the challenges of a pediatric palliative care ethical dilemma further complicated by cultural diversity. Review of the child's medical condition, patient/parent preferences, quality of life, and contextual features will be followed by an analysis and recommendations for resolution of this challenging situation.
Levinas's ethics has in the last decades exerted a significant influence on Nursing and Caring Science. The core of Levinas's ethics - his analyses of how our subjectivity is established in the ethical encounter with our neighbour or the Other - is applied both to healthcare practice and in the project of building an identity of Nursing and Caring Science. Levinas's analyses are highly abstract and metaphysical, and also non-normative. Thus, his analyses cannot be applied directly to practical problems and questions. Theorists in Nursing and Caring Science are generally aware of this. Nevertheless, many of them use Levinas's analyses to explore and solve questions of practical and normative character. This article focuses on the challenges and dilemmas of using Levinas in this manner. The article is divided into two parts. The first part presents some central ideas of Levinas's ethics based on the latter part of his authorship. The main focus is on the radicalism of Levinas's critique of the symbolic order (which includes concepts, categories, knowledge, etc.) - or as he puts it 'the said' - as a basis for subjectivity and responsibility. Levinas's notions of saying, anarchy, and singularity accentuate this point of view. These notions refer to conditions in the language, which counteract the symbolic order in the ethical encounter to such an extent that it becomes an incomprehensible. Levinas gives the argumentation a metaphysical frame: The encounter with the incomprehensible is an encounter with the Holy, which is not the ontological God, but a metaphysical desire. It is a mystery as to what this means, and herein lies possibly the main challenge when using Levinas's ethics in science and research: How to maintain the radicalism of his critique of the symbolic order when this is to be communicated in a scientific context that expects clarification of statements and ideas? The second part of the article explores this question by examining how some theorists use
Most moral dilemmas in medicine are analysed using the four principles with some consideration of consequentialism but these frameworks have limitations. It is not always clear how to judge which consequences are best. When principles conflict it is not always easy to decide which should dominate. They also do not take account of the importance of the emotional element of human experience. Virtue ethics is a framework that focuses on the character of the moral agent rather than the rightness of an action. In considering the relationships, emotional sensitivities, and motivations that are unique to human society it provides a fuller ethical analysis and encourages more flexible and creative solutions than principlism or consequentialism alone. Two different moral dilemmas are analysed using virtue ethics in order to illustrate how it can enhance our approach to ethics in medicine.
Csikai, Ellen L.
Ethical dilemmas are inherent in every health care setting. A sample of hospice social workers with no direct access to a hospice ethics committee (N = 110) was surveyed regarding ethical issues in hospice care, how the issues were managed, and the extent to which social workers participated in resolution of ethical dilemmas. Common issues…
Over the past half century, Albert Camus's story "The Guest" has attracted a great deal of scholarly attention. "The Guest" focuses on the ethical dilemmas faced by Daru, a school teacher in Algeria, and the two visitors he receives one day: Balducci, a gendarme, and an unnamed Arab prisoner. This paper addresses Camus's text from an educational…
Cranston, Neil; Ehrich, Lisa C.; Kimber, Megan
Purpose: The purpose of this paper is to report on research into the ethical dilemmas faced by school heads from seven independent schools in Australia. Design/methodology/approach: Data for the research were gathered by semi-structured in-depth interviews with the Heads, all of whom were experienced school leaders. All the schools had religious…
The aim of this study is to explore ethical dilemmas in critical incidents and the emerged responses that these incidents elicit. Most teachers try to suppress these incidences because of the unpleasant feelings they evoke. Fifty teachers participated in the study. A three-stage coding process derived from grounded theory was utilized. A taxonomy…
Alexander, Leslie B.; Richman, Kenneth A.
This article addresses ethical dilemmas experienced by street-level research and evaluation workers recruiting and gathering data in community-based research projects. The authors focus on a subgroup of street-level research workers, whom they call research extenders (REs), employed because they share important characteristics with the target…
Although student nurses are taught ethics, the theoretical dimension is not enough. Students must be given support and guidance in their practice to enable them to carry out ethical reflection and to adapt their nursing approach.
Secundy, Marian Gray
A survey of black and white family physicians in the District of Columbia is described. The survey provides insight into decision-making processes and the ability to recognize ethical dilemmas in medical practice. Comments were elicited to hypothetical case vignettes typical of ethical conflict in office practice. Findings note physician ability to recognize ethical dilemmas in day-to-day aspects of medical practice. Methods of decision making and rationale for decisions made, however, appear to be inconsistent, nonuniversal, and individualistic without evidence of specific models or criteria. No significant differences were noted between black and white physicians. The need in physician training for clarification and development of criteria is evident. PMID:4078929
The discourse on physicians and ethics in the Nazi regime usually refers to the violation of medical ethics by Nazi doctors who as a guild and as individuals applied their professional knowledge, training and status in order to facilitate murder and medical "experimentation". In the introduction to this article I will give a brief outline of this vast subject. In the main article I wish to bear witness to the Jewish physicians in the ghettos and the camps who tried to the best of their ability to apply their professional training according to ethical principles in order to prolong life as best as they could, despite being forced to exist and work under the most appalling conditions. These prisoner doctors were faced with impossible existential, ethical and moral dilemmas that they had not encountered beforehand. This paper addresses some of these ethical quandaries that these prisoner doctors had to deal with in trying to help their patients despite the extreme situations they found themselves in. This is an overview of some of these ethical predicaments and does not delve into each one separately for lack of space, but rather gives the reader food for thought. Each dilemma discussed deserves an analysis of its own in the context of professionalism and medical ethics today.
Prilleltensky, Isaac; Valdes, Laura Sanchez; Rossiter, Amy; Walsh-Bowers, Richard
This article is the second one in a series dealing with mental health ethics in Cuba. It reports on ethical dilemmas, resources and limitations to their resolution, and recommendations for action. The data, obtained through individual interviews and focus groups with 28 professionals, indicate that Cubans experience dilemmas related to (a) the interests of clients, (b) their personal interests, and (c) the interests of the state. These conflicts are related to power differentials among (a) clients and professionals, (b) professionals from different disciplines, and (c) professionals and organizational authorities. Resources to solve ethical dilemmas include government support, ethics committees, and collegial dialogue. Limitations include minimal training in ethics, lack of safe space to discuss professional disagreements, and little tolerance for criticism. Recommendations to address ethical dilemmas include better training, implementation of a code of ethics, and provision of safe space to discuss ethical dilemmas. The findings are discussed in light of the role of power in applied ethics.
During times of war, physicians are sometimes faced with the conflict of their professional duties to ensure the ethical principles of beneficence, non-maleficence, patient autonomy, and self-determination, within the framework of the proper ethical conduct in the practice of medicine, and the obligation and duties placed upon the physician by the state in times of war. Many ethical dilemmas may occur for the physician on the battlefield or elsewhere in the war region, including the treatment of detainees and the priority of treating wounded enemy soldiers or civilians first. When physicians are faced with a conflict between following state or national policies and following international principles of humanitarian law and medical ethics, the physician should opt for the latter. Physicians should not participate in any way in human rights abuses of detainees or prisoners when deployed in a war zone. Physicians must maintain the principles and standards and ethical considerations of their noble profession at all times.
Pope, Nakia; Green, Susan K.; Johnson, Robert L.; Mitchell, Mark
The current spotlight on assessment in education raises ethical issues as practices evolve. This study documents ethical conflicts faced by teachers in the United States regarding assessment of students. Critical incidents generated by practising teachers revealed a majority of reported conflicts related to score pollution, and conflicts…
Pereda Vicandi, M
Today you can ask if you can apply ethics to organizations because much of the greater overall impact decisions are not made by private individuals, are decided by organizations. Any organization is legitimate because it satisfies a need of society and this legitimacy depends if the organization does with quality. To offer a good service, quality service, organizations know they need to do well, but seem to forget that should do well not only instrumental level, must also make good on the ethical level. Public health care organizations claim to promote attitudes and actions based on ethics, level of their internal functioning and level of achievement of its goals, but increased awareness and analysis of its inner workings can question it. Such entities, for its structure and procedures, may make it difficult for ethical standards actually govern its operation, also can have negative ethical consequences at the population level. A healthcare organization must not be organized, either structurally or functionally, like any other organization that offers services. In addition, members of the organization can not simply be passive actors. It is necessary that operators and users have more pro-ethical behaviors. Operators from the professionalism and users from liability.
Lincourt, John; Johnson, Robert
This is an examination of three main strategies used by engineering educators to integrate ethics into the engineering curriculum. They are: (1) the standalone course, (2) the ethics imperative mandating ethics content for all engineering courses, and (3) outsourcing ethics instruction to an external expert. The expectations from each approach are discussed and their main limitations described. These limitations include the insular status of the stand-alone course, the diffuse and uneven integration with the ethics imperative, and the orphaned status of ethics using the outside expert. A fourth option is proposed--a special modular option. This strategy avoids the limitations of earlier approaches and harmonizes well with curricular objectives and professional values. While some help is provided by a professional ethicist, the headliner for the series of seminars is a high-profile engineer who shares an ethics dilemma encountered in professional practice. Students discuss the case and propose solutions. The goal is to make ethics applicable to real-life problems facing working engineers and to help change behaviors.
Leeman, C P; Cohen, M A; Parkas, V
Denial of alcohol or drug abuse, and of its possible consequences, can complicate medical and psychiatric care. We present the case of an HIV-positive bus driver with substance abuse who initially denied ongoing use of alcohol and of other drugs, but later admitted to both. The psychiatrist's duty to protect the patient's confidentiality, coupled with concerns about public safety, created an ethical dilemma. In discussing this dilemma we stress the importance of preserving confidentiality, both to facilitate treatment and also to further the safety of others.
Space tourism is an important new venture, however it raises several issues that must be addressed; namely, the medical implications associated with space flight and potential for ethical problems surrounding the safety of such travel. It seems highly likely that businesses involved in space tourism could find themselves liable for any passenger deaths or injuries, if they are found to have been negligent. This paper, therefore, discusses such issues as the medical facilities that need to be made available on board a space facility, and the companies' duty to disclose to potential passengers the risks associated with microgravity and the likelihood of space sickness, loss of bone density, disease, and pregnancy.
The vast expansion of patients treated with of extra corporeal membrane oxygenation (ECMO) emerge novel ethical questions about the use of this new technology. In regard the indications, duration of support and timing of withdrawal of support, these questions sometimes create disagreement among surrogates, between health care team and surrogates, and even disagreement among health care team, these disagreements occurs because of the extreme emergency of support initiation, the ambiguity of the outcome as well as lack of clarity on the intended treatment direction, whether it is ineffective, bridge to recovery or bridge to lifetime mechanical support or transplant. In this article we discuss these questions through patients’ scenarios. PMID:28361077
Hartley, Michael T.; Cartwright, Brenda Y.
Purpose: This study surveyed current and projected ethical dilemmas of rehabilitation counselors. Method: As a mixed-methods approach, the study used both quantitative and qualitative analyses. Results: Of the 211 participants who completed the survey, 116 (55.0%) reported an ethical dilemma. Based on the descriptions, common themes involved roles…
Beveridge, Scott; Garcia, Jorge; Siblo, Matt
Purpose: To examine the nature of ethical dilemmas most frequently reported by rehabilitation counselors in the private and public sectors and determine if significant differences exist in how practitioners experience ethical dilemmas in these two settings. Method: A mixed-methods internet-based survey design was utilized and included descriptive,…
Kirsner, R S; Federman, D G
Over the past several years, there has been a growing interest in population-based medicine. Some elements in healthcare have used population-based medicine as a technique to decrease healthcare expenditures. However, in their daily practice of medicine, physicians must grapple with the question of whether they incorporate population-based medicine when making decisions for an individual patient. They therefore may encounter an ethical dilemma. Physicians must remember that the physician-patient relationship is of paramount importance and that even well-conducted research may not be applicable to an individual patient.
Abstract Scenarios where the results of well-intentioned scientific research can be used for both good and harmful purposes give rise to what is now widely known as the “dual-use dilemma”. There has been growing debate about the dual-use nature of life science research with implications for making biological weapons. This paper reviews several controversial publications that have been the focus of debates about dual-use life science research and critically examines relevant policy developments, particularly in the United States of America. Though the dual-use dilemma is inherently ethical in nature, the majority of debates about dual-use research have primarily involved science and security experts rather than ethicists. It is important that there is more ethical input into debates about the governance of dual-use research. PMID:19784453
Huggins, M; Bloch, M; Kanani, S; Quarrell, O W; Theilman, J; Hedrick, A; Dickens, B; Lynch, A; Hayden, M
The goal of predictive testing is to modify the risk for currently healthy individuals to develop a genetic disease in the future. Such testing using polymorphic DNA markers has had major application in Huntington disease. The Canadian Collaborative Study of Predictive Testing for Huntington Disease has been guided by major principles of medical ethics, including autonomy, beneficence, confidentiality, and justice. Numerous ethical and legal dilemmas have arisen in this program, challenging these principles and occasionally casting them into conflict. The present report describes these dilemmas and offers our approach to resolving them. These issues will have relevance to predictive-testing programs for other adult-onset disorders. PMID:1971997
Thirty-two hospital social workers, fourteen of them directors of social work services and eighteen direct practitioners, were interviewed about their perception of the factors influencing social workers' contribution to the resolution of ethical dilemmas in general hospitals in Israel. Findings revealed that while ethical decision-making in hospitals is an interdisciplinary process, social workers' contribution to the process is affected by rivalry between social workers and other members of the health team, personality differences, type of ward and the nature of the ethical dilemma. Participants of the study had quite a clear perception of their role and of the unique knowledge-base social work can offer, including knowledge of the individual and family life course, understanding and skills in coping with diseases, and systems thinking. In order to increase their influence in ethical decision-making, the hospital social workers felt they must put more effort into developing their relationships with the other professionals involved in ethical decision-making both by making themselves more indispensable and by making their contribution explicit through greater documentation of their activities. The findings also implied that in order to gain more power and be accepted as equal partners in multidisciplinary teams, hospital social workers should improve their communication skills when interacting with representatives of other heath care professions.
Ethical dilemma case-based examination (ethics Script Concordance Test, eSCT) is a written examination that can be delivered to a large group of examinees for the purpose of measuring high-level thinking. As it accommodates for diverse responses from experts, ethics SCT allows partial credits. The framework of ethics SCT includes a vignette with an ethical dilemma and a leading question, which asks the examinee to "agree" or "disagree", plus the shifts of prior decision by adding new information. In this article, the following tips for constructing this type of examination are provided: use "true" dilemmas, select an appropriate ethical issue, target high-level cognitive tasks, list key components, keep a single central theme, device quality scoring system, be important and plausible, be clear, select quality experts, validate, know the limitation, and be familiar with test materials. The use of eSCT to measure ethical reasoning ability appears to be both viable and desirable.
Kolay Akfert, Serpil
The purpose of this study is to determine the ethical dilemmas experiencing by the counsellors who work at different conditions and what they do to solve these dilemmas as well as the obstacles they have to deal with while resolving the dilemmas. This is a qualitative study in which multi-state pattern was used. For this research, 40 counsellors…
Yönt, Gülendam Hakverdioğlu; Korhan, Esra Akin; Dizer, Berna; Gümüş, Fatma; Koyuncu, Rukiye
Nurses are more likely to face the dilemma of whether to resort to physical restraints or not and have a hard time making that decision. This is a descriptive study. A total of 55 nurses participated in the research. For data collection, a question form developed by researchers to determine perceptions of ethical dilemmas by nurses in the application of physical restraint was used. A descriptive analysis was made by calculating the mean, standard deviation, and maximum and minimum values. The nurses expressed (36.4%) having difficulty in deciding to use physical restraint. Nurses reported that they experience ethical dilemmas mainly in relation to the ethic principles of nonmaleficence, beneficence, and convenience. We have concluded that majority of nurses working in critical care units apply physical restraint to patients, although they are facing ethical dilemmas concerning harm and benefit principles during the application.
Newton, M J
It is often assumed that the central problem in a medical ethics issue is determining which course of action is morally correct. There are some aspects of ethical issues that will yield to such analysis. However, at the core of important medical moral problems is an irreducible dilemma in which all possible courses of action, including inaction, seem ethically unsatisfactory. When facing these issues ethical behaviour depends upon an individual's understanding and acceptance of this painful dilemma without recourse to external moral authority. PMID:3806633
Kenny, Belinda J.; Lincoln, Michelle; Blyth, Katrina; Balandin, Susan
Background: Speech pathologists are confronted by ethical issues when they need to make decisions about client care, address team conflict, and fulfil the range of duties and responsibilities required of health professionals. However, there has been little research into the specific nature of ethical dilemmas experienced by speech pathologists and…
Miller, Seumas; Selgelid, Michael J
The dual-use dilemma arises in the context of research in the biological and other sciences as a consequence of the fact that one and the same piece of scientific research sometimes has the potential to be used for bad as well as good purposes. It is an ethical dilemma since it is about promoting good in the context of the potential for also causing harm, e.g., the promotion of health in the context of providing the wherewithal for the killing of innocents. It is an ethical dilemma for the researcher because of the potential actions of others, e.g., malevolent non-researchers who might steal dangerous biological agents, or make use of the original researcher's work. And it is a dilemma for governments concerned with the security of their citizens, as well as their health. In this article we construct a taxonomy of types of "experiments of concern" in the biological sciences, and thereby map the terrain of ethical risk. We then provide a series of analyses of the ethical problems and considerations at issue in the dual-use dilemma, including the impermissibility of certain kinds of research and possible restrictions on dissemination of research results given the risks to health and security. Finally, we explore the main available institutional responses to some of the specific ethical problems posed by the dual-use dilemma in the biological sciences.
Tarvydas, Vilia; Barros-Bailey, Mary
This study reports the results of an international qualitative study conducted to inform the process of revising the Commission on Rehabilitation Counselor Certification's Code of Professional Ethics for Rehabilitation Counselors. The online survey gathered information regarding ethical dilemmas from a sample of certified rehabilitation counselors…
Garcia, Jorge; Froehlic, Robert; McGuire-Kuletz, Maureen; Rejiester, Nicole
This study examined which of two training models delivered through the internet led to better cultural competence in resolving ethical dilemmas with a sample of rehabilitation professionals. One type of training involved teaching a transcultural integrative model of ethical decision-making while the other training involved using the same…
Chih, An-Hsuan; Su, Peijen; Hu, Wen-Yu; Yao, Chien-An; Cheng, Shao-Yi; Lin, Yen-Chun; Chiu, Tai-Yuan
The current ethical dilemmas met by healthcare professionals were never compared with those 15 years ago when the palliative care system was newly developing in Taiwan. The aim of the study was to investigate the ethical dilemmas met by palliative care physicians and nurses in 2013 and compare the results with the survey in 1998. This cross-sectional study surveyed 213 physicians and nurses recruited from 9 representative palliative care units across Taiwan in 2013. The compared survey in 1998 studied 102 physicians and nurses from the same palliative care units. All participants took a questionnaire to survey the "frequency" and "difficulty" of 20 frequently encountered ethical dilemmas, which were grouped into 4 domains by factor analysis. The "ethical dilemma" scores were calculated and then compared across 15 years by Student's t tests. A general linear model analysis was used to identify significant factors relating to a high average "ethical dilemma" score in each domain. All of the highest-ranking ethical dilemmas in 2013 were related to insufficient resources. Physicians with less clinical experience had a higher average "ethical dilemma" score in clinical management. Physicians with dissatisfaction in providing palliative care were associated a higher average "ethical dilemma" score in communication. Nurses reported higher "ethical dilemma" scores in all items of resource allocation in 2013. Further analysis confirmed that, in 2013, nurses had a higher average "ethical dilemma" score in resource allocation after adjustment for other relating factors. Palliative care nursing staff in Taiwan are more troubled by ethical dilemmas related to insufficient resources than they were 15 years ago. Training of decision making in nurses under the framework of ethical principles and community palliative care programs may improve the problems. To promote the dignity of terminal cancer patients, long-term fundraising plans are recommended for countries in which the
Medeiros, Marlise Barros de; Pereira, Eliane Ramos; Silva, Rose Mary Costa Rosa Andrade; Silva, Marcos Andrade
The study aimed to reflect, based on the theoretical framework of Max Scheler, about the ethical dilemmas experienced by nurses in the ICU, and about the values that guide their actions and decisions,. This is qualitative research, and ten ICU nurses have been interviewed at a university hospital. It was identified the experience of ethical dilemmas related to the terminality related to the limits of intervention and use of material resources, as well as the issue of blood transfusion in case of religious restrictions. The values identified were: respect, dignity of the patient, scientific knowledge, humility, passion for the profession and love of God. The theory of values is an important tool for nursing because it allows the approach of an ethics of humanizing praxis, especially in situations of ethical dilemmas.
Marcus, Brian S; Shank, Gary; Carlson, Jestin N; Venkat, Arvind
Ethics consultation is a commonly applied mechanism to address clinical ethical dilemmas. However, there is little information on the viewpoints of health care providers towards the relevance of ethics committees and appropriate application of ethics consultation in clinical practice. We sought to use qualitative methodology to evaluate free-text responses to a case-based survey to identify thematically the views of health care professionals towards the role of ethics committees in resolving clinical ethical dilemmas. Using an iterative and reflexive model we identified themes that health care providers support a role for ethics committees and hospitals in resolving clinical ethical dilemmas, that the role should be one of mediation, rather than prescription, but that ultimately legal exposure was dispositive compared to ethical theory. The identified theme of legal fears suggests that the mediation role of ethics committees is viewed by health care professionals primarily as a practical means to avoid more worrisome medico-legal conflict.
Philip-Watson, Joanna; Khan, Shahid A.A.; Hadjipavlou, Marios; Rane, Abhay; Knoll, Thomas
Live surgical broadcasts (LSBs) are becoming increasingly popular in urological conferences. These activities can provide excellent training opportunities, as they allow the audience to view an operation conducted by world-renowned surgeons, and have the ability to interact with them in real time. However, several ethical considerations have been raised with this practice, which the participating surgeons and conference organisers must appreciate and address carefully. In this article we highlight the ethical considerations related to LSBs and advise on how these should be addressed. We also present the latest recommendations made by the European Association of Urology Live Surgery Committee and discuss alternatives to LSB. PMID:26019946
Zydziunaite, V; Suominen, T
Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. Purpose: To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. Methods: The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (n=278) were nurse managers. The data were analyzed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. Results: The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients', relatives' and nurse managers' needs. Conclusions: Nurse managers exhibited leadership styles oriented to maintenance, focusing more on the "doing the job" than on managing the decision-making in ethical dilemmas.
Ong, W Y; Yee, C M; Lee, A
By definition, an ethical dilemma involves the need to choose from among two or more morally acceptable options or between equally unacceptable courses of action, when one choice prevents selection of the other. Advances in medicine, increasing economic stress, rise of patient self-determination and differing values between healthcare workers and patients are among the many factors contributing to the frequency and complexity of ethical issues in healthcare. In the cancer patient near the end of life, common ethical dilemmas include those dealing with artificial nutrition and hydration, truth-telling and disagreements over management plans. It would stand the clinician in good stead to be aware of these issues and have an approach toward dealing with such problems. In addition, organisations have a responsibility to ensure that systems are in place to minimise its occurrence and ensure that staff are supported through the process of resolving dilemmas and conflicts that may arise.
Campbell-Page, Ruth M; Shaw-Ridley, Mary
This article describes two ethical dilemmas encountered by our research team during a project working with undocumented immigrants in Toronto, Canada. This article aims to be transparent about the problems the research team faced, the processes by which we sought to understand these problems, how solutions were found, and how the ethical dilemmas were resolved. Undocumented immigrants are a vulnerable community of individuals residing in a country without legal citizenship, immigration, or refugee status. There are more than half a million undocumented immigrants in Canada. Through an academic-community partnership, a study was conducted to understand the experiences of undocumented immigrants seeking health care in Toronto. The lessons outlined in this article may assist others in overcoming challenges and ethical dilemmas encountered while doing research with vulnerable communities.
Philosophy tries to provide rules and principles enabling us to solve the ethical dilemmas we face in a wide sense, and, also, in particular fields as (geo)sciences. One alleged goal of ethics is to figure out how to solve ethical dilemmas. But, is it possible to solve such dilemmas? And what can we do if we cannot? An ethical dilemma is a problem that offers an alternative between two or more solutions, none of which proves to be fully acceptable in practice. Dilemmas arise because of conflict between the rightness or wrongness of the actions/means and the goodness or badness of the consequences/ends. They involve an apparent conflict between moral imperatives, in which to follow one would result in violating another. Can a geoscientist answer those dilemmas that appear in the exercise of his/her profession? Always? In some cases? Not at all? What if we cannot? Have we? As geoscientists, we hold the knowledge (our scientific principles), not perfect, thus fallible, and always subject to changes and improvements. If we have to do what is right, based on our principles, despite potentially bad consequences, then we have to be sure that the principle is an absolute true. But, are our scientific principles such a true? Deontological theories may deny that consequences are of any concern, provided the intention was a good one. However, if our principles are not perfect (and we know that): can we answer in one or other direction to geoethical dilemmas in good faith? Although, if a geoscientist action does usually go for the best consequences, sometimes bad consequences may be accepted. But, who have to decide to accept the bad consequences? If ethical dilemmas with a conflict between means and ends cannot simply be solved by a geoscientist, where is our duty? If there is no real solution to the conflict of the right with the good, in the sense that a solution usually seems to be expected, what has to be our professional attitude? When we have duties of omission and when
Mattick, C R
There are potential religious, cultural and ethical dilemmas facing patients who are undergoing orthodontic treatment. Opinions were collected from religious and cultural leaders, as well as from non-religious groups who take an ethical standpoint on certain medical or dental treatment. Factors relating to ingredients in orthodontic products, timing of orthodontic appointments, and the effects of religious fasting are all discussed. It is important to recognize all patients' opinions and beliefs when planning and undertaking orthodontic treatment.
Minkler, Meredith; Fadem, Pamela; Perry, Martha; Blum, Klaus; Moore, Leroy; Rogers, Judith
Participatory action research (PAR) is a collaborative approach to inquiry for education and social change that is gaining increasing prominence in health education. This case study explores the use of PAR by and with a community of people with disabilities in addressing a polarizing issue in that community: death with dignity or physician-assisted suicide legislation. Following a brief review of the debate within the community about this issue and the goals, methods, and findings of this project, the authors examine four key ethical challenges. These are dilemmas in issue selection when the community is deeply divided over a problem area, inclusion and exclusion in study team makeup and sample selection, insider/outsider issues, and how best to use findings in ways that can unite and strengthen the community. The implications of these issues for health educators and others engaged in community-based PAR efforts are presented.
This article focuses on the complexity of researching institutional culture and the ethical dilemmas posed in representing staff according to race and gender, drawing on three qualitative studies undertaken at a previously white South African university between 2000 and 2007. During the research process, issues of representation became a concern…
Cwikel, Julie G.; Cnaan, Ram A.
Describes second wave information technology in social work as characterized by modern databases, decision-support systems, expert systems, electronic networks, and therapeutic applications that have greater impact on direct practice. Assesses ethical dilemmas posed by use of second-wave information technology in social work practice to encourage…
Bent-Goodley, Tricia B.
This article examines findings from three focus groups conducted about resolving ethical dilemmas in the area of domestic violence. The study's findings point to the need to increase content on domestic violence throughout the social work curriculum and provide educational opportunities for field instructors and local professionals. Helping…
Batchelor, C E M; McKeegan, D E F
The scale of the ethical challenges faced by veterinary surgeons and their perceived stressful consequences were investigated via a short questionnaire, completed by 58 practising veterinary surgeons. Respondents were asked to report how frequently they faced ethical dilemmas, and to rate on a simple numerical scale (zero to 10) how stressful they found three common scenarios. Fifty seven per cent of respondents reported that they faced one to two dilemmas per week, while 34 per cent stated they typically faced three to five dilemmas per week. The three scenarios provided were all rated as highly stressful with 'client wishing to continue treatment despite poor animal welfare' rated as the most stressful (median 9). The female veterinary surgeons gave two of the scenarios significantly higher stress ratings than the male veterinary surgeons. Stress ratings were not influenced by number of years in practice (which ranged from one to more than 25 years). The results show that veterinary surgeons regularly face ethical dilemmas and that they find these stressful. This has implications for the wellbeing of veterinary surgeons and supports the case for increased provision of training and support, especially for those who entered the profession before undergraduate ethics teaching was widely available.
Catacutan, Maria Rosario G.; de Guzman, Allan B.
This phenomenological study intends to capture and describe Filipino college deans' lived experiences of ethical dilemmas as they carry out their work as administrators. Using semi-structured in-depth interviews and following Collaizzi's method, data was collected and subjected to cool and warm analyses yielding a set of themes and sub-themes that…
This article explores the ethical tensions and dilemmas that arose for 2 U.S. social work students during an 8-month international clinical internship in northern Uganda. These students encountered cultural differences related to issues of confidentiality, autonomy, and self-determination. Student experiences were analyzed using the cultural…
Sexual harassment in the workplace poses something of an ethical dilemma for career guidance practice. This is because it is now known that about half of all working women in the UK are likely to be victims at some stage of their employment and that the effects on individuals are invariably negative and can be positively harmful. What, therefore,…
Vaughan, George B.; And Others
Focusing primarily on issues that can be directly influenced by actions of the governing board or president, the nine chapters of this book explore the ethical dilemmas of leadership in today's community colleges. In "Leaders on a Tightrope: The Risks and Tensions of Community College Leadership," George B. Vaughan provides an overview of some of…
Mangan, Katherine S.
Spurred by public dissatisfaction with the legal profession and expansion of the bar exam's ethics section, law schools are trying to invigorate the field of legal ethics, giving students more exposure to moral and ethical conflicts they are likely to face as professionals. Some legal experts say law schools should do more to integrate ethical…
Samtani B, Suraj; Jadue Z, Mariana; Beca I, Juan Pablo
It is indispensable for physicians to understand and recognize the fusion of different cultures, to deliver the best possible service to patients with different cultural backgrounds, especially when ethical-medical problems are involved. The Hindu community in Chile differs in significant ways with the western culture. This is especially true for some issues such as the belief in reincarnation or gender inequality, among others. These discrepancies can be relevant for the analysis of several bioethical problems. Therefore, it is necessary to understand the different beliefs, traditions and Hindu visions. We hereby present a review of Hinduism, its relation with medical practice and, as an example, a case of abortion in a Hindu family. Reviewing the traditions, beliefs and methods will help to understand and respect the beliefs of different cultures in contemporary and globalized bioethics.
Moon, Bruce L.
This viewpoint addresses ethical questions regarding the provision of art therapy as a pro bono service, a term from Latin roots that mean "for the public good." Approaches to ethical reasoning are discussed using the case of pro bono art therapy in a residential treatment program for adolescents.
Stacks, Don W.; Wright, Donald K.
In order to justify ethical instruction for media students, 109 university students in basic communication courses were asked to confront a moral-ethical problem, specifically, the request for information that a sponsoring company or organization wished suppressed. Respondents were randomly assigned to one of four conditions: working for a public…
Billiot, Mary Jo; Daniel, David; Glandon, Sid; Glandon, TerryAnn
We examine the effect of different contexts in an educational process on measures of ethical sensitivity and levels of moral reasoning of accounting majors in the first Intermediate Accounting course. The educational process compared a context that centers on ethical issues with one that focuses on technical accounting issues. At the end of the…
van Baarle, Eva; Bosch, Jolanda; Widdershoven, Guy; Verweij, Desiree; Molewijk, Bert
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…
Due to their understanding of self-management, healthcare team members responsible for depressed older persons can experience an ethical dilemma. Each team member contributes important knowledge and experience pertaining to the management of depression, which should be reflected in the management plan. The aim of this study was to explore healthcare team members’ reflections on the ethical dilemmas involved in promoting self-management among depressed older persons. A qualitative design was used and data were collected by means of focus group interviews. The results revealed one main theme: ‘Lack of trust in the community health care system’s commitment to bringing about effectiveness and change, based on three themes; ‘Struggling to ensure the reliable transfer of information about depressed older persons to professionals and family members’, ‘Balancing autonomy, care and dignity’ and ‘Differences in the understanding of responsibility’. Lack of engagement on the part of and trust between the various professional categories who work in the community are extremely counterproductive and have serious implications for patient dignity as well as safety. In conclusion, ethical dilemmas occur when staff members are unable to act in accordance with their professional ethical stance and deliver an appropriate standard of care. PMID:24106261
Within the 32 years of its existence our attitude towards artificial enteral nutrition via PEG-tubes has changed in a fundamental way: in our modern understanding nutrition via PEG is supportive, early, preventive, and in many cases temporary. PEG-feeding is not an alternative but a possible supplement to normal oral food intake and requires an individual medical indication as well as an ethical justification. This does not follow standardised algorithmic thinking but is decided on an individual base taking personal wishes, resources, and needs of the individual patient into account. Nutrition via PEG-tube is not a terminal basic or even symbolic treatment at the end of life. The present dilemma of the PEG is that the public discussion primarily focus one-sided on the problems of PEG-placement in multimorbid, elderly, and/or demented patients or patients in end-stage tumour diseases where indeed PEG-placement is neither medically nor ethically justified - we still place PEG-tubes to often in the wrong patients! On the other hand we still consider supportive and in many cases temporary nutrition via PEG too rare and even too late in those patients which clearly could benefit from an early, supportive, and preventive PEG-treatment on the base of our present evidence-based scientific knowledge - we still consider PEG-treatment not adequately and in most cases too late in the right patients! Placing a PEG-tube is not the second last step before death and physicians have to accept the ethically given limits of medical treatment by realizing our modern understanding of the benefits and limits of supportive artificial nutrition via PEG.
Objective. To study the effects of an early professional development series in a pharmaceutical care laboratory (PCL) course on first-year pharmacy students’ perceptions of the importance of professional attitudes and action. Design. Three hundred thirty-four first-year students enrolled in a PCL course participated in a new required learning activity centered on development of professional attitudes and behaviors. Students discussed situational dilemmas in pharmacy practice in small groups, highlighting application of the Oath of a Pharmacist and the Pharmacists’ Code of Ethics. Assessment. Students completed an optional questionnaire at the beginning and end of the semester to assess change in their attitudes and behaviors related to professionalism in pharmacy practice. Conclusion. While students entered their training with a strong appreciation for professionalism, they felt more confident in applying the Oath of a Pharmacist and the Pharmacists Code of Ethics to dilemmas in practice following the new learning activity. PMID:26889068
Settle, Peggy Doyle
Nurses working in a newborn intensive care unit report that treatment decision disagreements for infants in their care may lead to ethical dilemmas involving all health-care providers. Applying Rest's Four-Component Model of Moral Action as the theoretical framework, this study examined the responses of 224 newborn intensive care unit nurses to the Nurses Ethical Involvement Survey. The three most frequent actions selected were as follows: talking with other nurses, talking with doctors, and requesting a team meeting. The multiple regression analysis indicates that newborn intensive care unit nurses with greater concern for the ethical aspects of clinical practice (p = .001) and an increased perception of their ability to influence ethical decision making (p = .018) were more likely to display Nurse Activism. Future research is necessary to identify other factors leading to and inhibiting Nurse Activism as these findings explained just 8.5% of the variance.
We should recognize that we have a responsibility to people who live outside our own borders, and view ourselves as part of the global community. Looking at China we are faced with ethical dilemmas which require consideration. First, there is the ethical dilemma of business versus health. The opening and development of the tobacco business in China, which includes vigorous marketing, is considered against the health consequences of tobacco use which is estimated to cost 600,000 lives annually in China, rising to 2 million by 2,025 without effective tobacco control programmes. A second ethical dilemma is employment versus impoverishment, in which the opportunities for work in the tobacco industry are considered against a background of malnutrition caused in part by a proportion of household budgets used to buy tobacco, and the erosion of the land, as trees are used to produce tobacco. Gains have already been made in tobacco control in China, with the way open for much development in the future.
Electronic health records (EHRs) facilitate several innovations capable of reforming health care. Despite their promise, many currently unanswered legal, ethical, and financial questions threaten the widespread adoption and use of EHRs. Key legal dilemmas that must be addressed in the near-term pertain to the extent of clinicians' responsibilities for reviewing the entire computer-accessible clinical synopsis from multiple clinicians and institutions, the liabilities posed by overriding clinical decision support warnings and alerts, and mechanisms for clinicians to publically report potential EHR safety issues. Ethical dilemmas that need additional discussion relate to opt-out provisions that exclude patients from electronic record storage, sale of deidentified patient data by EHR vendors, adolescent control of access to their data, and use of electronic data repositories to redesign the nation's health care delivery and payment mechanisms on the basis of statistical analyses. Finally, one overwhelming financial question is who should pay for EHR implementation because most users and current owners of these systems will not receive the majority of benefits. The authors recommend that key stakeholders begin discussing these issues in a national forum. These actions can help identify and prioritize solutions to the key legal, ethical, and financial dilemmas discussed, so that widespread, safe, effective, interoperable EHRs can help transform health care. PMID:21422090
Polygraph interrogations are used by half of all surveyed juvenile sex offender (JSO) treatment programs in the United States. This is a distinctive and controversial practice that is rarely if ever used with other juvenile delinquent populations, and that is rarely used or is banned from JSO treatment programs in other countries. Clinical polygraphy is an ethically sensitive issue because it involves mental health therapists in involuntary coercive interrogations of minors. This article reviews core mental health professional ethics principles for juveniles. JSO polygraphy is used as an illustrative issue for applying human rights principles to a practice in light of its benefits, risks, and available alternatives.
Albright, Dianne E.; Hazler, Richard J.
Euthanasia is considered an important social issue of the 1990s. Mental health professionals should understand the differences between voluntary, involuntary, passive, and active euthanasia; mercy killing, and assisted suicide. Encourages counselors to ethically formulate client-supportive positions to help clients face life-and-death decisions.…
Ambery, Mary Elizabeth; Steinbrunner, Ruth K.
Learning to be PROactive, as the title of this article suggests, means Pooling one's knowledge, Reflecting respect, and Opening oneself to action. It recognizes early childhood educators' promises to their field of practice, based on widely held beliefs and principles. Educators can apply professional ethics to everyday problem solving and their…
This paper focuses on the ethical position of the ethnographer when encountering unethical activities. Ethnography affords a rich insight into cultures, often behind previously secure doors but it is also a demanding science. Our gatekeepers control our access and our relationships with them can determine our destiny. This paper offers an exchange…
Traditionally, many science educators have taught science without addressing ethical questions. However, the inclusion of moral discourse in science teaching may help educators to bring to the fore problematic issues in relation to science, and it may offer an opportunity for students to practice their future engagement in the public discourse…
Greene, C. H.; Kammen, D. M.
For over 200 years, fossil fuels have been the basis for an industrial revolution that has delivered a level of prosperity to modern society unimaginable during the previous 5000 years of human civilization. However, society's dependence on fossil fuels is coming to an end for two reasons. The first reason is because our fossil fuel reserves are running out, oil in this century, natural gas during the next century, and coal a few centuries later. The second reason is because fossil fuels are having a devastating impact on the habitability of our planet, disrupting our climate system and acidifying our oceans. So the question is not whether we will discontinue using fossil fuels, but rather whether we will stop using them before they do irreparable damage to the Earth's life-support systems. Within our geoscience community, climate scientists have determined that a majority of existing fossil fuel reserves must remain unburned if dangerous climate change and ocean acidification are to be avoided. In contrast, Exxon-Mobil, Shell, and other members of the fossil fuel industry are pursuing a business model that assumes all of their reserves will be burned and will not become stranded assets. Since the geosciences have had a long and mutually beneficial relationship with the fossil fuel industry, this inherent conflict between climate science and industrial interests presents an ethical dilemma for many geoscientists. This conflict is further heightened by the fossil fuel divestment movement, which is underway at over 400 college and university campuses around the world. This presentation will explore some of the ethical and financial issues being raised by the divestment movement from a geoscientist's perspective.
Manzar, Nabeel; Manzar, Bushra; Hussain, Nuzhat; Hussain, M Fawwad Ahmed; Raza, Sajjad
To determine the knowledge, attitude, and ethical concerns of medical students and graduates with regard to Embryonic Stem Cell (ESC) research. This questionnaire based descriptive study was conducted at the Civil Hospital Karachi (CHK), Pakistan from February to July 2008. A well structured questionnaire was administered to medical students and graduate doctors, which included their demographic profile as well as questions in line with the study objective. Informed consent was taken and full confidentiality was assured to the participants. Data were entered in a Statistical Package for Social Sciences (SPSS version.12) and analyzed. A total of 204 male and 216 female medical students and doctors were administered questionnaires out of which 105 males (51.4%) and 108 females (50%) were aware of the embryonic stem cell research and its ethical implications. Forty percent males and 47% of females were of the opinion that life begins at conception. Forty-six percent males and 39% females were in favor of stem cell research while only 31% males and 28% females supported the ESC research. Less than 1/3 of students supported using frozen embryos for research purposes while more than 2/3 indicated that they were unlikely to support abortion for stem cell research purposes. The majority of the students were in favor of stem cell research with some reservations regarding ESC research. A sizeable number of students withheld their views, reflecting their poor understanding of medical ethics. The result of the study indicates a need for incorporating bioethics into the medical curriculum.
Simberkoff, M S; Hartigan, P M; Hamilton, J D; Deykin, D; Gail, M; Bartlett, J G; Feorino, P; Redfield, R; Roberts, R; Collins, D
Ethical dilemmas caused by external events and an interim subset analysis raised concerns about continuing a long-term VA clinical trial comparing early with later zidovudine therapy for symptomatic human immunodeficiency virus (HIV) infection. The first external event was the early termination of other, apparently similar, trials conducted by the AIDS Clinical Trials Group (ACTG) and the announced clear benefits for the zidovudine-treated patients. Interim analysis of the VA trial at this time did not show similar benefits. Subset analyses were performed to explore factors that might explain the different results. These suggested a difference in response to zidovudine in white and minority groups. The Data Monitoring Board and a special advisory panel reviewed these data and concluded that, since the VA results were neutral overall and the subset analyses based on small numbers, the trial should continue. By conference call, the study cochairmen and biostatistician discussed this decision with study personnel without revealing interim results, and study personnel passed the information on to patients at the participating centers. The second event was in March 1990, when the Food and Drug Administration (FDA) approved earlier use of zidovudine, which applied to patients still in the VA trial. Patients were asked to reaffirm their participation by signing a new informed consent that explained the findings reported by the ACTG, the FDA-approved revised recommendations, and the rationale for continuation of the VA trial. The consent form emphasized that continued masked therapy was optional and that unmasked treatment and follow-up would be provided to patients requesting it. Seventy-four percent of the participants chose to continue masked therapy. We conclude that when new external data are announced, informed participation in a long-term clinical trial may require a revised consent form and that it is ethical and practical to present this without disclosure of
Fox, Ellen; And Others
This article reviews the 25-year history of undergraduate medical ethics education. Alternatives to the traditional model that focus more directly on students' personal values, attitudes, and behavior, are discussed. Three incipient trends are identified: everyday ethics, student ethics, and macro-ethics. Specific course and curricula are used as…
Vishnu, Nagalapuram; Kulkarni, Aditya V; Vidhyalakshmi, Sreenivasan; Sambandam, Swaminathan; Garg, Prerna; LeelaKrishnan, Venkatakrishnan; Janarthan, Krishnaveni; Singh, Gursharan; Kaur, Maninder; Chitra, TV
The Fibrolamellar variant of Hepatocellular Carcinoma (FLHCC) is a rare form of liver cancer that presents in the 3rd decade of life, is rarely associated with cirrhosis or chronic Hepatitis B/C virus infection, and usually presents with normal serum alpha-fetoprotein (AFP) levels. FLHCC presenting during pregnancy is extremely rare, with only 4 cases reported. We present a case of FLHCC in pregnancy and discuss the dilemmas in management. A 26 year-old primigravida, 26 weeks of gestation presented with a month's history of obstructive jaundice secondary. Investigations revealed a mass in the left lateral segment of the liver with extension down the left hepatic duct into the common bile duct. Following an emergency caesarean section at 31 weeks, she underwent a left hepatectomy with extrahepatic bile duct excision. The postoperative course was uneventful. Histopathology showed FLHCC. In conclusion, liver tumors presenting during pregnancy should be managed in a multidisciplinary setup with facilities for neonatal intensive care. Management depends on the presumed pathology, period of gestation and family preferences. PMID:28317045
This article discusses health literacy and cultural factors that have implications for the ethical practice of health education. It specifically focuses on recent data that speaks to the challenges in carrying out patient education from the perspective of comprehension and equitable distribution of health-related information across diverse cultures and communities. It discusses strategies for reducing the negative impact of low health literacy among diverse groups and the importance of acknowledging this pervasive problem in the context of ensuring equity in the optimal delivery of health promotion messages.
Gollogly, Laragh; Momen, Hooman
Editors of scientific journals need to be conversant with the mechanisms by which scientific misconduct is amplified by publication practices. This paper provides definitions, ways to document the extent of the problem, and examples of editorial attempts to counter fraud. Fabrication, falsification, duplication, ghost authorship, gift authorship, lack of ethics approval, non-disclosure, 'salami' publication, conflicts of interest, auto-citation, duplicate submission, duplicate publications, and plagiarism are common problems. Editorial misconduct includes failure to observe due process, undue delay in reaching decisions and communicating these to authors, inappropriate review procedures, and confounding a journal's content with its advertising or promotional potential. Editors also can be admonished by their peers for failure to investigate suspected misconduct, failure to retract when indicated, and failure to abide voluntarily by the six main sources of relevant international guidelines on research, its reporting and editorial practice. Editors are in a good position to promulgate reasonable standards of practice, and can start by using consensus guidelines on publication ethics to state explicitly how their journals function. Reviewers, editors, authors and readers all then have a better chance to understand, and abide by, the rules of publishing.
Hodgson, Jan; Gaff, Clara
When a new genetic condition is diagnosed within a family, genetic counselors often describe a sense of responsibility towards other at risk family members to be appropriately informed about their status. Successful communication of genetic information in families is contingent on many factors. While a small number of probands directly state their intention not to inform their relatives, many who do intend to communicate this information appear to be unsuccessful for a wide range of reasons and may benefit from follow up support from a genetic counselor. Drawing on the reciprocal-engagement model (REM) of genetic counseling practice we explore how enhancing family communication about genetics raises a number of ethical and professional challenges for counselors-and describe how we resolved these. A subsequent manuscript will describe the counseling framework we have developed to enhance family communication about genetics.
Grant, Scott B.; Modi, Parth K.
Futility has been a contentious topic in medicine for several decades. Surgery in critical or end-of-life situations often raises difficult questions about futility. In this article, we discuss the definition of futility, methods for resolving futility disputes, and some ways to reframe the futility debate to a more fruitful discussion about the goals of care, better communication between surgeon and patient/surrogate, and palliative surgical care. Many definitions of futile therapy have been discussed. The most controversial of these is “qualitative futility” which describes a situation in which the treatment provided is likely to result in an unacceptable quality of life. This is an area of continued controversy because it has been impossible to identify universally held beliefs about acceptable quality of life. Many authors have described methods for resolving futility disputes, including community standards and legalistic multi-step due process protocols. Others, however, have abandoned the concept of futility altogether as an unhelpful term. Reframing the issue of futility as one of inadequate physician–patient communication, these authors have advocated for methods of improving communication and strengthening the patient–physician relationship. Finally, we discuss the utilization of consultants who may be of use in resolving futility disputes: ethics committees, palliative care specialists, pastoral care teams, and dedicated patient advocates. Involving these specialists in a futility conflict can help improve communication and provide invaluable assistance in arriving at the appropriate treatment decision. PMID:24849199
Grant, Scott B; Modi, Parth K; Singer, Eric A
Futility has been a contentious topic in medicine for several decades. Surgery in critical or end-of-life situations often raises difficult questions about futility. In this article, we discuss the definition of futility, methods for resolving futility disputes, and some ways to reframe the futility debate to a more fruitful discussion about the goals of care, better communication between surgeon and patient/surrogate, and palliative surgical care. Many definitions of futile therapy have been discussed. The most controversial of these is "qualitative futility" which describes a situation in which the treatment provided is likely to result in an unacceptable quality of life. This is an area of continued controversy because it has been impossible to identify universally held beliefs about acceptable quality of life. Many authors have described methods for resolving futility disputes, including community standards and legalistic multi-step due process protocols. Others, however, have abandoned the concept of futility altogether as an unhelpful term. Reframing the issue of futility as one of inadequate physician-patient communication, these authors have advocated for methods of improving communication and strengthening the patient-physician relationship. Finally, we discuss the utilization of consultants who may be of use in resolving futility disputes: ethics committees, palliative care specialists, pastoral care teams, and dedicated patient advocates. Involving these specialists in a futility conflict can help improve communication and provide invaluable assistance in arriving at the appropriate treatment decision.
Mankind has been using animals already for a long time for food, for transport and as companion. The use of animals in experimental research parallels the development of medicine, which had its roots in ancient Greece (Aristotle, Hippocrate). With the Cartesian philosophy in the 17th century, experiments on animals could be performed without great moral problems. The discovery of anaesthetics and Darwin's publication on the Origin of Species, defending the biological similarities between man and animal, contributed to the increase of animal experimentation. The increasing demand for high standard animal models together with a critical view on the use of animals led to the development of Laboratory Animal Science in the 1950s with Russell and Burch's three R's of Replacement, Reduction and Refinement as guiding principles, a field that can be defined as a multidisciplinary branch of science, contributing to the quality of animal experiments and to the welfare of laboratory animals. The increased interest in and concern about animal welfare issues led to legislative regulations in many countries and the establishment of animal ethics committees.
Loeser, John D; Cahana, Alex
The world of health care and the world of business have fundamentally different ethical standards. In the past decades, business principles have progressively invaded medical territories, leading to often unanticipated consequences for both patients and providers. Multidisciplinary pain management has been shown to be more effective than all other forms of health care for chronic pain patients; yet, fewer and fewer multidisciplinary pain management facilities are available in the United States. The amazing increase in interventional procedures and opioid prescriptions has not led to a lessening of the burden of chronic pain patients. Ethical dilemmas abound in the treatment of chronic pain patients: many are not even thought about by providers, administrators, insurance companies, or patients. We call for increased pain educational experiences for all types of health care providers and the separation of business concepts from pain-related health care.
Rengert, Arlene C.; Monk, Janice J.
Describes a college-level geography unit on the socioeconomic influences affecting urban migration of women in Latin America. In role-playing modules, students explore dilemmas influencing individual migration decisions, Peace Corps project planning, and long-term international aid programs for urban Peruvian women. (AM)
Luxardo, Natalia; Colombo, Graciela; Iglesias, Gabriela
The purpose of this article is to examine some obstacles and dilemmas related to methodological strategies and ethical considerations that arose during the fieldwork of research focused on family violence during the stages of pregnancy and childbirth in adolescent females in Buenos Aires during 2007. From this study, we are able to contribute some…
Fullerton, Jami A.; Kendrick, Alice; McKinnon, Lori Melton
A national survey of 1,045 advertising students measured opinions about the ethical nature of advertising and ethical dilemmas in the advertising business. More than nine out of ten students agreed that working for a company with high ethical standards was important. Students rated all twelve workplace dilemmas presented as somewhat unethical. For…
The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis.
Pregnancy interruption or abortion may be spontaneous or induced for medical, legal, demographic, and personal reasons. Different events that are present during the woman´s gravid period were described, paying attention to the differences in between fertilization and conception. These issues are very important because people or institutions mix these concepts and posit that pregnancy or conception starts at fertilization in opposition to the actual medical and scientific knowledge. In Mexico there are several millions of spontaneous and induced abortions without medical care, responsible for the high maternal-infant mortality rates. To avoid this undesirable situation, it has been proposed to follow the established WHO guidelines and adopt national health policies to re-orientate population goals on life quality, gender equity, universal public health services, and to promote the new holistic concepts of reproductive and sexual health such as: family planning, use of anti-fertility methods, adolescent reproductive health, sexually transmitted diseases, maternal and newborn health, peri- and post-menopausal women's health, and prevention, diagnosis, and opportune treatment of mammary, cervical-uterine, and ovarian cancers. Finally, it is recommended to revise our national health policies and existing laws on abortion de-penalization.
Three controversial ethical issues, among others, stir the debate in health care institutions, in medical associations, and in the whole society: the care of patients in persistent vegetative state, the regulation of artificial procreation, some individual requests for reshaping an healthy body. Dealing with these dilemmas, typical of advanced medical science and technological practice, implies not only balancing carefully the burdens and benefits for suffering persons, families, equipes, hospitals, cultural and religious communities, but also imaging and realizing new visions of a just society, of a beneficent (without paternalism) medicine and generally of a good life, where each moral agent could write in front of all and in worthy, convincing ways, the next chapter of the book of his/her own life.
Ethical debate on the killing of kangaroos has polarised conservation and animal welfare science, yet at the heart of these scientific disciplines is the unifying aim of reducing harm to non-human animals. This aim provides the foundation for common ground, culminating in the development of compassionate conservation principles that seek to provide mechanisms for achieving both conservation and welfare goals. However, environmental decision-making is not devoid of human interests, and conservation strategies are commonly employed that suit entrenched positions and commercial gain, rather than valuing the needs of the non-human animals in need of protection. The case study on the wild kangaroo harvest presents just such a dilemma, whereby a conservation strategy is put forward that can only be rationalised by ignoring difficulties in the potential for realising conservation benefits and the considerable welfare cost to kangaroos. Rather than an open debate on the ethics of killing game over livestock, in this response I argue that efforts to bring transparency and objectivity to the public debate have to date been obfuscated by those seeking to maintain entrenched interests. Only by putting aside these interests will debate about the exploitation of wildlife result in humane, compassionate, and substantive conservation benefits.
Benninga, Jacques S.
Although ethical dilemmas are a constant in teachers' lives, the profession has offered little in the way of training to help teachers address such issues. This paper presents a framework, based on developmental theory, for resolving professional ethical dilemmas. The Four-Component Model of Moral Maturity, when used in conjunction with a…
Murray, C G
to cope with the operative demands and financial burden of resolving their deteriorating dental situation and so complex implant-born structures and precision removable prostheses should probably be avoided for those individuals contemplating entering a care situation. Therefore, the timing of the provision of complex dentistry poses an ethical dilemma.
This article examined the attitudes of 195 school counselors in Israel regarding (a) the decision to maintain or breach confidentiality in a variety of ethical dilemmas, and (b) the reasons given for justifying their decisions. Eighteen ethical dilemmas in three domains were presented to respondents in a questionnaire. School counselors were most…
Devitt, Brian Meldan; McCarthy, Conor
There are many ethical dilemmas that are unique to sports medicine because of the unusual clinical environment of caring for players within the context of a team whose primary objective is to win. Many of these ethical issues arise because the traditional relationship between doctor and patient is distorted or absent. The emergence of a doctor-patient-team triad has created a scenario in which the team's priority can conflict with or even replace the doctor's primary obligation to player well-being. As a result, the customary ethical norms that provide guidelines for most forms of clinical practice, such as patient autonomy and confidentiality, are not easily translated in the field of sports medicine. Sports doctors are frequently under intense pressure, whether implicit or explicit, from management, coaches, trainers and agents, to improve performance of the athlete in the short term rather than considering the long-term sequelae of such decisions. A myriad of ethical dilemmas are encountered, and for many of these dilemmas there are no right answers. In this article, a number of ethical principles and how they relate to sports medicine are discussed. To conclude, a list of guidelines has been drawn up to offer some support to doctors facing an ethical quandary, the most important of which is 'do not abdicate your responsibility to the individual player.''I am in blood Stepp'd in so far that, should I wade no more, Returning would be as tedious as to go o'er' -Macbeth: Act III, Scene IV, William Shakespeare.
Backholm, Klas; Idås, Trond
News journalists working on crisis-related assignments may experience dilemmas with regard to how to conduct their work without causing additional harm to first-hand victims. In this study, we investigated how exposure to journalistic ethical dilemmas during the Oslo/Utøya terror attack in 2011 and subsequent work-related guilt were related to the development of posttraumatic stress (PTS) reactions. Norwegian journalists (N = 371) covering the terror attack participated in a web-based survey 8-9 months after the incident. We found that females reported more ethical dilemmas during the assignment than males (n = 356, d = 0.51). We also found that being on the scene was not related to more exposure to dilemmas (n = 311, d = 0.01). Moreover, we discovered that work-related guilt had a significant indirect effect on the relationship between exposure to ethical dilemmas and severity of PTS reactions (n = 344, completely standardized indirect effect size = .11, 95% CI [.04, .19]. The results showed that exposure to ethical dilemmas may affect the development of long-term psychological impairment. We concluded that media organizations can prevent postcrisis impairment by preparing employees for possible exposure to dilemmas during crisis-related assignments.
García, E; Timmermans, D R M; van Leeuwen, E
In contrast to most Western countries, routine offer of prenatal screening is considered problematic in the Netherlands. The main argument against offering it to every pregnant woman is that women would be brought into a moral dilemma when deciding whether to use screening or not. This paper explores whether the active offer of a prenatal screening test indeed confronts women with a moral dilemma. A qualitative study was developed, based on a randomised controlled trial that aimed to assess the decision-making process of women when confronted with a test offer. A sample of 59 women was interviewed about the different factors balanced in decision-making. Participants felt themselves caught between a need for knowledge and their unwillingness to take on responsibility. Conflict was reported between wishes, preferences and ethical views regarding parenthood; however, women did not seem to be caught in a choice between two or more ethical principles. Participants balanced the interests of the family against that of the fetus in line with their values and their personal circumstances. Therefore, we conclude that they are not so much faced with an ethical dilemma as conflicting interests. We propose that caregivers should provide the opportunity for the woman to discuss her wishes and doubts to facilitate her decision. This approach would help women to assess the meaning of testing within their parental duties towards their unborn child and their current offspring.
Christen, Markus; Müller, Sabine
Understanding how the "brain produces behavior" is a guiding idea in neuroscience. It is thus of no surprise that establishing an interrelation between brain pathology and antisocial behavior has a long history in brain research. However, interrelating the brain with moral agency--the ability to act in reference to right and wrong--is tricky with respect to therapy and rehabilitation of patients affected by brain lesions. In this contribution, we outline the complexity of the relationship between the brain and moral behavior, and we discuss ethical issues of the neuroscience of ethics and of its clinical consequences. First, we introduce a theory of moral agency and apply it to the issue of behavioral changes caused by brain lesions. Second, we present a typology of brain lesions both with respect to their cause, their temporal development, and the potential for neural plasticity allowing for rehabilitation. We exemplify this scheme with case studies and outline major knowledge gaps that are relevant for clinical practice. Third, we analyze ethical pitfalls when trying to understand the brain-morality relation. In this way, our contribution addresses both researchers in neuroscience of ethics and clinicians who treat patients affected by brain lesions to better understand the complex ethical questions, which are raised by research and therapy of brain lesion patients.
LaMontagne, Ramona Marie
This qualitative study examined the perceptions of human resource managers who had faced ethical dilemmas in the workplace, to gain an understanding of how they felt their life experiences shaped their values in making ethical decisions. The experiences of ten human resource managers who believed they chose a right course of action when faced with…
Lathrop, Breanna L; Cheney, Teresa B; Hayman, Annette B
The Making Ethical Decisions about Surgical Intervention (MEDSI) tool is designed to guide health care professionals, patients, and families faced with ethically charged decisions regarding surgical interventions for pediatric patients. MEDSI is built on the principles of beneficence, nonmaleficence, and patient autonomy and created to promote truth-telling, compassion, respect for patient cultural and religious preferences, and appropriate follow up in the clinical setting. Following an overview of the 8 steps that compose MEDSI, the tool is applied to the management of intersex infants. The birth of a child with a disorder of sexual development (DSD) and ambiguous genitalia presents an ethically challenging situation for the family and health care team. The use of the MEDSI model is demonstrated in a case study involving the decision of surgical intervention in the management of an intersex child.
Carlson, John S.; Thaler, Cara L.; Hirsch, Amanda J.
Assessing, consulting, and intervening with students being treated with psychotropic medications is an increasingly common activity for school psychologists. This article reviews some of the literature providing evidence for the greater need for training in school psychopharmacology. A legal and ethical case study is presented that highlights the…
Stockall, Nancy; Dennis, Lindsay R.
This article presents a seven-step framework for decision making to solve ethical issues in special education. The authors developed the framework from the existing literature and theoretical frameworks of justice, critique, care, and professionalism. The authors briefly discuss each theoretical framework and then describe the decision-making…
Jmelnitzky, A C; Cohen, H; Fossman, E; Ovando, L; Costa Gil, J E
.9% of men (p < 0.05) indicate HIV screening test without any explanation to the patient because "he could transmit a fatal disease". In this same case, time from graduation was related to differences in option selection: 80.9% in the group > 20 years of professional exercise asked for patient consent and accepted his decision, versus 52.7 and 27.5% in 0-9 and 10-19 years group respectively (p < 0.05). Usual medical and social worries as communication (truth, informed consent), the autonomic decision of biological death versus the sacrament of life, justice in allocation resources, confidentiality and social concern, abortion, and many other controversies linked to tecno-scientific development, impact the practice of Gastroenterology in latinoamerican countries. However medical answers to ethical dilemmas are not uniform. Although our results ought to be verified by other studies they clearly suggest the needs for systematic incorporation of applicated Ethics in pre and postgraduate Gastroenterology curricula, besides the regular activities of our regional institutions.
This article focuses on the measure of involuntary treatment of mental patients in the community, not only with regard to human rights and more specifically those of persons with mental disorders, but also with regard to ethics and deontology in mental healthcare delivery service. In this light, the important role of informed consent in psychiatry with regard to the psychiatric act is examined. Informed consent of mental patients in treatment when they are in need of voluntary or involuntary hospitalization is further examined, while emphasis is being put on the case of involuntary treatment. The Convention for Human Rights and Biomedicine (Convention of Οviedo), the European Convention of Human Rights, other documents of International Organizations (UN) and specialized national legislation (A. 2071/1992, Chapter vi, Greek law) constitute basic reference and interpretation points. The examination of consent and the demarcation of the exceptions are important issues that need to be approached. More particularly, our interest lies with the article 7 of the Convention for Human Rights and Biomedicine, which specifically refers to the protection of person who suffers from a mental disorder. The opinion that informed consent in psychiatric treatment and involuntary treatment are concepts and processes which are distinct but not always mutually exclusive is enhanced. In any case, involuntary treatment causes major dilemmas as far as informed consent in the psychiatric act is concerned, as it raises issues that affect the autonomy of the person. Today, however, there are many factors which influence public politics towards the adoption of the measure of involuntary treatment within the community. How is it that this paradoxical link is legitimized and justified: involuntary treatment and community? The enactment of the above mentioned measure in many European and North American countries has created new paths in the practice of contemporary psychiatry. Nonetheless, it
Resnik, David B; Elliott, Kevin C
Social responsibility is an essential part of the responsible conduct of research that presents difficult ethical questions for scientists. Recognizing one's social responsibilities as a scientist is an important first step toward exercising social responsibility, but it is only the beginning, since scientists may confront difficult value questions when deciding how to act responsibly. Ethical dilemmas related to socially responsible science fall into at least three basic categories: 1) dilemmas related to problem selection, 2) dilemmas related to publication and data sharing, and 3) dilemmas related to engaging society. In responding to these dilemmas, scientists must decide how to balance their social responsibilities against other professional commitments and how to avoid compromising their objectivity. In this article, we will examine the philosophical and ethical basis of social responsibility in science, discuss some of the ethical dilemmas related to exercising social responsibility, and make five recommendations to help scientists deal with these issues.
Resnik, David B.; Elliott, Kevin C.
Social responsibility is an essential part of the responsible conduct of research that presents difficult ethical questions for scientists. Recognizing one’s social responsibilities as a scientist is an important first step toward exercising social responsibility, but it is only the beginning, since scientists may confront difficult value questions when deciding how to act responsibly. Ethical dilemmas related to socially responsible science fall into at least three basic categories: 1) dilemmas related to problem selection, 2) dilemmas related to publication and data sharing, and 3) dilemmas related to engaging society. In responding to these dilemmas, scientists must decide how to balance their social responsibilities against other professional commitments and how to avoid compromising their objectivity. In this article, we will examine the philosophical and ethical basis of social responsibility in science, discuss some of the ethical dilemmas related to exercising social responsibility, and make five recommendations to help scientists deal with these issues. PMID:26193168
Shapiro, Joan Poliner; Smith-Rosenberg, Carroll
This paper indicates the need for women's studies ethics courses and the examination of student concepts of morality. It proposes the ethical study of social problems not usually considered in undergraduate classes and illustrates the importance of the study of historical perspectives and situational ethics in the teaching of complex contemporary…
Kirschen, Matthew P; Friedlander, Joel A
This article presents the case of a 41-year-old airline pilot with benign paroxysmal positional vertigo who requests that his diagnosis not be disclosed to his commercial airline employer or his aviation medical examiner because it may result in the suspension of medical certification. The legal and ethical requirements for physicians reporting impaired pilots are discussed as well as practical recommendations for handling such situations. The argument is made that a physician's obligation to honor patient confidentiality should not take precedence over his or her duty to protect the safety and well-being of the airplane passengers and the general public. If the patient chooses not to self-report, a physician has an ethical obligation to report the patient's medical condition to the Federal Aviation Administration.
Umeora, Ouj; Chukwuneke, Fn
The traditional African society places an invaluable premium on procreation and, in some communities, a woman's place in her matrimony is only confirmed on positive reproductive outcome. Infertility is rife in Nigeria, and HIV/acquired immunodeficiency syndrome (AIDS) infection is a global pandemic, which has led to a drop in life expectancy across the world. In Nigeria, a number of cultural norms relating to gender roles and power dynamics constitute a serious barrier to issues of sexuality and infertility. Couples are concerned about their infertility diagnostic test being disclosed to each other, especially before marriage. This concern is understandable, especially in an environment that lacks the modern concepts and attitude toward sexual matters. This is complicated by the advent of HIV/AIDS infection and the societal mind-set that look at seropostive individuals as transgressors. At present, sexual and reproductive health rights are currently not in place because ethical issues are not given prominence by many physicians in Nigeria. A case of an infertile and seropostive discordant couple, which raised a lot of medical and ethical concerns, is presented here to awaken the consciousness of Nigerian physicians and stimulate discussions on the ethical matters such as this in clinical practice.
Fromer, Margot Joan
Starting with basic philosophic positions and principles, nursing students can be helped to analyze ethical dilemmas of increasing complexity. A hypothetical situation is presented and discussed as an example of a case study used to teach these principles. (CT)
Eriksson, Helene; Andersson, Gisela; Olsson, Louise; Milberg, Anna; Friedrichsen, Maria
In Sweden, individuals affected by severe stroke are treated in specialized stroke units. In these units, patients are attended by a multiprofessional team with a focus on care in the acute phase of stroke, rehabilitation phase, and palliative phase. Caring for patients with such a large variety in condition and symptoms might be an extra challenge for the team. Today, there is a lack of knowledge in team experiences of the dilemmas that appear and the consequences that emerge. Therefore, the purpose of this article was to study ethical dilemmas, different approaches, and what consequences they had among healthcare professionals working with the dying patients with stroke in acute stroke units. Forty-one healthcare professionals working in a stroke team were interviewed either in focus groups or individually. The data were transcribed verbatim and analyzed using content analysis. The ethical dilemmas that appeared were depending on "nondecisions" about palliative care or discontinuation of treatments. The lack of decision made the team members act based on their own individual skills, because of the absence of common communication tools. When a decision was made, the healthcare professionals had "problems holding to the decision." The devised and applied plans could be revalued, which was described as a setback to nondecisions again. The underlying problem and theme was "communication barriers," a consequence related to the absence of common skills and consensus among the value system. This study highlights the importance of palliative care knowledge and skills, even for patients experiencing severe stroke. To make a decision and to hold on to that is a presupposition in creating a credible care plan. However, implementing a common set of values based on palliative care with symptom control and quality of life might minimize the risk of the communication barrier that may arise and increases the ability to create a healthcare that is meaningful and dignified.
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.
Gombert, Karolina; Douglas, Flora; McArdle, Karen; Carlisle, Sandra
This article reflects on ethical limitations and dilemmas encountered during fieldwork of the Foodways and Futures project (2013-2016). Foodways and Futures is a qualitative action research project aimed at exploring the food choices of former homeless young people (aged 16-25) in Aberdeenshire. In Scotland, where over 13,000 young people become…
Even though principles to guide practice are crucial, there are no hard-and-fast rules for resolving ethical issues--dilemmas that are not easily resolvable because they present opposing values and outcomes that may harm to certain groups of people if not properly considered. This article describes a number of ethical dilemmas faced as a workplace…
Keith-Spiegel, Patricia; Whitley, Bernard E., Jr.; Balogh, Deborah Ware; Perkins, David V.; Wittig, Arno F.
This book discusses the most frequently encountered ethical dilemmas that can arise in higher educational settings and offers tips on how to avoid such predicaments and how to handle them when they occur. Ethical dilemmas are presented as short case scenarios. The 195 cases are grouped into 22 chapters in six parts. Part 1, "The Classroom…
Oppenheim, Daniel; Brugières, Laurence; Corradini, Nadège; Vivant, Florence; Hartmann, Olivier
The increasing complexity of present day medicine--with highly effective and yet risky treatments, individual and collective expectations, and evolving ideological and cultural landmarks--often gives rise to difficult ethical problems. Specific meetings are valuable for understanding such problems, acquiring the relevant skills and for gaining and transmitting experience on how to solve them. Parents and doctors may disagree about what is the best treatment. Such a difference of opinion is not rare but usually a solution can easily be found. This is not the case when the child is treated for a severe illness and when there is no clearly defined or satisfactory treatment for him\\her. We present how a dramatic conflict arose between the parents and the doctors faced with such a case (mostly because the staff failed to understand early enough the psychological factors at the root of the father's demands), how clinical, institutional and ethical problems were analysed during a meeting, and how they were solved.
Vrecar, Irena; Peterlin, Borut; Teran, Natasa
Introduction Over the last few years, many private companies are advertising direct-to-consumer genetic testing (DTC GT), mostly with no or only minor clinical utility and validity of tests and without genetic counselling. International professional community does not approve provision of DTC GT and situation in some EU countries has been analysed already. The aim of our study was to analyse current situation in the field of DTC GT in Slovenia and related legal and ethical issues. Materials and methods Information was retrieved through internet search, performed independently by two authors, structured according to individual private company and the types of offered genetic testing. Results Five private companies and three Health Insurance Companies offer DTC GT and it is provided without genetic counselling. Available tests include testing for breast cancer, tests with other health-related information (complex diseases, drug responses) and other tests (nutrigenetic, ancestry, paternity). National legislation is currently being developed and Council of Experts in Medical Genetics has issued an opinion about Genetic Testing and Commercialization of Genetic Tests in Slovenia. Conclusions Despite the fact that Slovenia has signed the Additional protocol to the convention on human rights and biomedicine, concerning genetic testing for health purposes, DTC GT in Slovenia is present and against all international recommendations. There is lack of or no medical supervision, clinical validity and utility of tests and inappropriate genetic testing of minors is available. There is urgent need for regulation of ethical, legal, and social aspects. National legislation on DTC GT is being prepared. PMID:25672471
van der Dam, S; Abma, T A; Kardol, M J M; Widdershoven, G A M
Our study presents an overview of the issues that were brought forward by participants of a moral case deliberation (MCD) project in two elderly care organizations. The overview was inductively derived from all case descriptions (N = 202) provided by participants of seven mixed MCD groups, consisting of care providers from various professional backgrounds, from nursing assistant to physician. The MCD groups were part of a larger MCD project within two care institutions (residential homes and nursing homes). Care providers are confronted with a wide variety of largely everyday ethical issues. We distinguished three main categories: 'resident's behavior', 'divergent perspectives on good care' and 'organizational context'. The overview can be used for agendasetting when institutions wish to stimulate reflection and deliberation. It is important that an agenda is constructed from the bottom-up and open to a variety of issues. In addition, organizing reflection and deliberation requires effort to identify moral questions in practice whilst at the same time maintaining the connection with the organizational context and existing communication structures. Once care providers are used to dealing with divergent perspectives, inviting different perspectives (e.g. family members) to take part in the deliberation, might help to identify and address ethical 'blind spots'.
Ciobanu, Ionela Elisabeta; Rusu, Darian; Stratul, Stefan-Ioan; Didilescu, Andreea Cristina; Cristache, Corina Marilena
Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur.
Ciobanu, Ionela Elisabeta; Rusu, Darian; Didilescu, Andreea Cristina
Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur. PMID:27672458
out that a member of his unit was gay , another officer stated: I guess I was always under the belief that as long as it didn’t affect their job, it...charge the Navy for a huge phone bill wrongfully accumulated due to personal use of the internet for downloading porn , one officer said this: My dilemma
'They say Islam has a solution for everything, so why are there no guidelines for this?' Ethical dilemmas associated with the births and deaths of infants with fatal abnormalities from a small sample of Pakistani Muslim couples in Britain.
This paper presents ethical dilemmas concerning the termination of pregnancy, the management of childbirth, and the withdrawal of life-support from infants in special care, for a small sample of British Pakistani Muslim parents of babies diagnosed with fatal abnormalities. Case studies illustrating these dilemmas are taken from a qualitative study of 66 families of Pakistani origin referred to a genetics clinic in Southern England. The paper shows how parents negotiated between the authoritative knowledge of their doctors, religious experts, and senior family members in response to the ethical dilemmas they faced. There was little knowledge or open discussion of the view that Islam permits the termination of pregnancy for serious or fatal abnormality within 120 days and there was considerable disquiet over the idea of ending a pregnancy. For some parents, whether their newborn baby would draw breath was a main worry, with implications for the baby's Muslim identity and for the recognition of loss the parents would receive from family and community. This concern sometimes conflicted with doctors' concerns to minimize risk to future pregnancies by not performing a Caesarean delivery if a baby is sure to die. The paper also identifies parents' concerns and feelings of wrong-doing regarding the withdrawal of artificial life-support from infants with multiple abnormalities. The conclusion considers some of the implications of these observations for the counselling and support of Muslim parents following the pre- or neo-natal diagnosis of fatal abnormalities in their children.
Shulman, Carol Herrnstadt
Faculty ethics are considered in relation to conflict of interest between academic work and nonacademic consulting jobs, confidentiality of research, the employment of faculty by intelligence agencies, and the need for self-regulation by the academic community. For faculty members who serve as consultants, ethical issues arise concerning the use…
Löfström, Erika; Pyhältö, Kirsi
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…
Ekmekci, Perihan Elif
The World Anti-Doping Code states that, there is an intrinsic value about sports that is the celebration of the human spirit, body and mind, and is reflected in values other than winning or being the first in any sports game. The spirit of sports includes ethics, fair play and honesty. Anti-doping practices are based on this ethical ground and supported all through the world. However, recently with the arguments that there is no substantial definition of the term "spirit of sports", and that the fights against doping is based on questionable ethical grounds consisting of dubious claims about fairness in sports and terms such as "level playing field". Medical ethics is involved in this discussion because of the crucial role of physicians in anti-doping policies and practices as well as developing and administering ergogenic substances or methods for athletes. This role of physicians raises ethical questions regarding physician-patient relationship, principle of non-male ficence, privacy and confidentiality of patient, and fairness and justice in the macro allocation of resources. The aim of this paper is to discuss ethical arguments on anti-doping practices and policies and, to further evaluate current anti-doping practices in the context of medical ethics.
Rao, Mamatha Punjee Raja; Panduranga, Prashanth; Al-Mukhaini, Mohammed; Al-Jufaili, Mahmood
A 51-year-old man presented to the emergency department with sustained hemodynamically unstable wide QRS tachycardia and was revived successfully by immediate direct current (DC) cardioversion. There was evidence of previous open heart surgery, possibly atrial septal defect closure. Transthoracic echocardiography showed severe Ebstein anomaly with severe tricuspid regurgitation, no residual atrial septal defect, but with severe right ventricular dysfunction. Subsequent electrocardiograms showed transient atrial fibrillation with no manifest Wolff-Parkinson-White (WPW) accessory pathway during sinus rhythm. The cause of wide QRS tachycardia in this patient may be WPW related or ventricular tachycardia. This case illustrates the diagnostic and therapeutic dilemmas in patients with wide QRS tachycardia and suspected WPW syndrome. In addition, this case demonstrates that unoperated Ebstein anomaly can present in late adult life with tachyarrhythmias.
Prock, Valencia N., Ed.; And Others
A variety of ethical issues confronting the nursing profession are examined in these proceedings. The following papers are presented: (1) "Ethics: Care & Conflict," by Leah Curtin; (2) "The Interface of Politics and Ethics in Nursing," by Mila Aroskar; (3) "Pluralistic Ethical Decision-Making," by Rita Payton; (4)…
Thatte, Urmila M.; Marathe, Padmaja A.
Following watershed amendments in Schedule Y India's star rose rather rapidly on the clinical research (especially clinical trials) horizon. Just as dramatic was the fall of this empire. At the centre of these events has been the participant and indirectly, the Ethics Committee (EC) that is established primarily to protect this individual. This paper traces the evolution of the concept of ECs in India, examines the current state of these committees in the country and suggests the way forward. The Past: The requirement for an EC to oversee clinical research was first made in the ICMR Policy Statement for Ethics published in 1980 and then again in the Schedule Y (1988). Later, both the Amended Schedule Y (2005) assigned regulatory responsibility on the EC and the ICMR Guidelines (2006) described the functioning of ECs. Several challenges including inadequate formal training, contribution from non-technical members, administrative support as well no SOPs and a heavy workload were identified. In the absence of regulatory oversight of ECs, the introduction of the Clinical Trial Registry - India (CTRI) and self-regulation through voluntary accreditation programs brought a measure of accountability and transparency. The Present: A slew of regulatory reforms led to more than 1000 ECs to be registered with CDSCO although the actual impact on participants' protection and safety of these new regulations still remains to be seen. Way Forward: A method to oversee all ECs, improved functioning of ECs including on site monitoring, central ECs for multicentric studies, the development of metrics to assess the ability of ECs to protect the participant are other ideas for the future. Conclusions: Although ECs in India have evolved from being mere rubber stamps for approval of protocols to efficiently functioning accredited ECs, yet there is much to be done for and by Ethics Committees. PMID:28194334
Farah, Martha J
Advances in neurotechnology will raise new ethical dilemmas, to which scientists and the rest of society must respond. Here I present a "toolbox" of concepts to help us analyze these issues and communicate with each other about them across differences of ethical intuition.
Young Children, 1995
Considers how to deal with an ethical dilemma concerning a caregiver's dislike for a child. Recognizes that no statement in NAEYC's Code of Ethical Conduct requires that a professional must like each child, and presents some ideals and principles from the code that may guide professionals through similar situations. (BAC)
Giubilini, Alberto; Milnes, Sharyn; Savulescu, Julian
In this review article we describe the current scope, methods, and contents of medical ethics education in medical schools in Western English speaking countries (mainly the United Kingdom, the United States, and Australia). We assess the strengths and weaknesses of current medical ethics curricula, and students' levels of satisfaction with different teaching approaches and their reported difficulties in learning medical ethics concepts and applying them in clinical practice. We identify three main challenges for medical ethics education: counteracting the bad effects of the "hidden curriculum," teaching students how to apply ethical knowledge and critical thinking to real cases in clinical practice, and shaping future doctors' right character through ethics education. We suggest ways in which these challenges could be addressed. On the basis of this analysis, we propose practical guidelines for designing, implementing, teaching, and assessing a medical ethics program within a four-year medical course.
Lindsay, R; Graham, H
Decisions based on ethics confront nurses daily. In this account, a cardiac nurse struggles with the challenge of securing health care benefits for Justin, a patient within the American system of health care. An exercise therapy that is important for his well-being is denied. The patient's nurse and an interested insurance agent develop a working relationship, resulting in a relational narrative based on Justin's care. Gadow's concept of a relational narrative and Keller's concept of a relational autonomy guide this particular case. As an ethics framework influenced by feminist ethical theory, Gadow's, Keller's and Tisdale's ideas demonstrate the fluidity with which the nurse and others can work while maintaining both autonomy and engagement without being self-sacrificing.
The World Bank is committed to "work[ing] with countries to improve the health, nutrition and population outcomes of the world's poor, and to protect[ing] the population from the impoverishing effects of illness, malnutrition and high fertility".(1) Ethical issues arise in the interpretation of these objectives and in helping countries formulate strategies and policies. It is these ethical issues--which are often not acknowledged by commentators--that are the subject of this paper. It asks why there should be a focus on the poor, and explores the link between improving the health of the poor, and reducing health inequalities between the poor and better-off. It discusses difficult ethical issues at both the global level (including debt relief and the link between country ownership and donor commitment) and the country level (including user fees and whether providing assistance to the non-poor may in the long run be a way of helping the poor).
The relationship between ethics and philosophy and jurisdiction is described; different kinds of ethics are presented. The increasing pressure of liberal points of view has boosted the ethics of utility. The ethics of care oppose a too rational utilitarianism, taking into consideration relationships such as the caregiver-patient relationship. In the multicultural society ethics of care and virtue ethics are being criticised for not giving universal answers to ethical dilemmas. Can one still define "doing good"? Is "doing good" so culturally biased that it no longer provides the basis for ethical conduct? An accurate procedural assessment of values, sometimes interpreted quite differently in different cultures, could be a tool to judge values in a less relativistic way.
Hind, Martin; Thomas, Bronwen; Hewitt-Taylor, Jaqui
Background Increasing numbers of people living with a long-term health condition are putting personal health information online, including on discussion boards. Many discussion boards contain material of potential use to researchers; however, it is unclear how this information can and should be used by researchers. To date there has been no evaluation of the views of those individuals sharing health information online regarding the use of their shared information for research purposes. Objective To explore the views of contributors to online diabetes discussion boards with regards to if (and how) they feel their contributions to boards should be used by health researchers. Methods A qualitative approach was employed using online semistructured asynchronous (email) interviews. Interpretative description methodology was used to assess the interview transcripts, and quotations were extracted and anonymized to support each theme. Results 26 interviews were carried out. Participants agreed that forum posts are in the public domain and that aggregated information could be freely used by researchers. This was agreed to be a good way of ensuring that the view of people living with diabetes is being heard in research. There was no consensus on the need for permission to use individual information, such as quotations, with some people happy for this to be freely used and others feeling that permission is necessary. Conclusions Participants acknowledged the dichotomy of having placed information into the public domain in an unrestricted way, with some interviewees also wanting to retain control of its use. The Internet is a new research location, and rather than trying to apply traditional ethical norms to this new genre, a new modus operandi is required. The authors propose introducing new norms for presenting research carried out with online discussion boards. PMID:23748147
Vevaina, J R; Nora, L M; Bone, R C
Bioethics is the discipline of ethics dealing with moral problems arising in the practice of medicine and the pursuit of biomedical research. Physicians may confront ethical dilemmas regularly in their individual relationships with patients and in institutional and societal decisions on health care policy. Ethical problem solving requires the application of certain ethical rules and principles to specific situations. Although ethical theories differ, certain ethical rules and principles appear consistently. These include nonmaleficence, beneficence, respect for individual autonomy, confidentiality, and justice. This article discusses some of the ethical issues that arise in clinical practice, including informed consent, do-not-resuscitate orders, noninitiation and termination of medical therapy, genetic intervention, allocation of scarce health resources, and infection with the human immunodeficiency virus (HIV). Some of these problems require ethical analysis at the bedside; others require physician involvement on a broader level. Perspectives on the different ethical issues are presented; however, absolute answers to these ethical dilemmas are not provided. Interpretation of the ethical principles and the application of these principles to each clinical situation demands the thoughtful attention of the practitioner.
The World Bank is committed to "work[ing] with countries to improve the health, nutrition and population outcomes of the world's poor, and to protect[ing] the population from the impoverishing effects of illness, malnutrition and high fertility".1 Ethical issues arise in the interpretation of these objectives and in helping countries formulate strategies and policies. It is these ethical issues—which are often not acknowledged by commentators—that are the subject of this paper. It asks why there should be a focus on the poor, and explores the link between improving the health of the poor, and reducing health inequalities between the poor and better-off. It discusses difficult ethical issues at both the global level (including debt relief and the link between country ownership and donor commitment) and the country level (including user fees and whether providing assistance to the non-poor may in the long run be a way of helping the poor). Key Words: World Bank • poverty • health • population • health economics • global ethics PMID:11479358
Kimber, Megan; Campbell, Marilyn
Acting in the best interests of students is central to the moral and ethical work of schools. Yet tensions can arise between principals and school counsellors as they work from at times opposing professional paradigms. In this article we report on principals' and counsellors' responses to scenarios covering confidentiality and the law,…
Mitchell, Jennifer M.; Yordy, Eric D.
This article describes a model that aims to create a greater ability to recognize the negative aspects of making unethical decisions. To this end, the authors developed an ethical decision-making model to aid students through the process of analyzing these situations--a model that is easy to remember and apply. Through this model, the COVER model,…
Kauffman, James M.; Hallahan, Daniel P.
Ethical issues regarding children with disabilities have long involved their treatment after they are born. These issues remain important, but children may be deliberately created with or without characteristics that are usually thought of as disabilities. Preimplantation genetic diagnosis (PGD) and related technologies that involve human…
Still, Julie; Kassabian, Vibiana
Discusses ethical issues concerning public Internet access in academic libraries. Highlights include intellectual freedom, censorship, technical aspects of limiting or restricting use, legal liability for public use of computers for illegal purposes such as child pornography, and the importance of priority use of terminals by the primary academic…
Newman, Anne; Glass, Ronald David
This essay examines several ethical and epistemological issues that arise when philosophers conduct empirical research focused on, or in collaboration with, community groups seeking to bring about systemic change. This type of research can yield important policy lessons about effective community-driven reform and how to incorporate the voices of…
A study examined news coverage by "The Saint Petersburg Times" of a local double teen suicide in August 1993. Focusing on how the story was covered, the study explored the newspaper's decision-making process, analyzing the process in relation to standard philosophical methods in ethics and recognized journalistic principles. As background,…
Pedigo, Kerry; Marshall, Verena
Globalisation has seen diverse cultures becoming increasingly entwined and interdependent as business organisations operate in a borderless world. When organisations operate internationally they often find that countries differ in what is considered wrong or right. The objectives of the research were to identify cross-cultural ethical dilemmas…
Basile, Michael L.
This paper explores Max Weber's study of the origins of the secularization of the Puritan work ethic and examines the hybridized category of secular science expert. The hybrid construct provides an opening for the critical analysis of the concrete activity of development from two perspectives, the structural and the individual. The individual…
Van Auken, Stuart
The author sought to determine whether business faculty values and background can discriminate between a yes or no response to the introduction of an ethically challenged product. The results reveal that two competing views of the enterprise (stakeholder vs. stockholder) along with a faculty member's departmental membership do discriminate in the…
Bush, Victoria D.; Smith, Rachel Korthage; Bush, Alan J.
A large body of pedagogical research exists on developing curricula and ethics training tools to prepare college graduates for entering the workforce. However, many college students are "already" in the workforce while they attend school. Many of these jobs are entry-level or frontline employee positions in retail or service industries,…
Lennon, Sean M.; Byford, Jeffrey M.; Cox, J. T.
The Trolley Problem as defined in this paper is a series, or continuation, of increasingly difficult ethical riddles successfully implemented in a classroom environment to spur complex, critical thinking and dialogue. The activity is designed upon the scenario of a runaway train with different and challenging choices, segueing neatly into group…
Aoki, Ryuta; Funane, Tsukasa; Koizumi, Hideaki
Recent advances in technologies for neuroscientific research enable us to investigate the neurobiological substrates of the human ethical sense. This article introduces several findings in "the brain science of ethics" obtained through "brain-observation" and "brain-manipulation" approaches. Studies over the past decade have revealed that several…
Crawshaw, Marilyn A; Glaser, Adam W; Pacey, Allan A
Increased awareness of the importance of fertility concerns to teenage cancer survivors is leading to growing numbers of male teenagers being offered sperm banking at the time of diagnosis. This is now extending to males diagnosed with other conditions where gonadotoxic agents are used in treatment. The storage of sperm in these circumstances is a challenging aspect of health care, given the complex issues and timescale involved. UK law has been enacted to protect legal minors from the potentially harmful effects of exposure to pornographic materials, yet there is reason to suppose that their use in this context could have therapeutic benefit in aiding successful masturbation. This paper uses material gained through consultation with the eleven largest UK sperm banks and 94 male teenage cancer survivors, to discuss the associated legal and ethical dilemmas, including those around the role of parents/carers. Findings suggest that there is variable practice in sperm banks, that almost a quarter of teenage males wanted access to soft porn when banking sperm, and half wanted to bring in their own materials. It concludes that there is an urgent need for any legal barriers to the therapeutic use of pornographic materials to be understood and examined.
Griffiths, Dorothy E.
The work of the family physician is occasionally enlivened by an unusual patient problem. The particular episode described and discussed in this case report called into question the moral and ethical standards of both medicine and society. Issues of responsibility for unacceptable behaviour by an individual are examined within an historical context, and the reader is left to ponder his or her own answer to the questions raised. PMID:21249106
Aguinis, H; Handelsman, M M
This article addresses the ethics of utilizing the bogus pipeline (BPL) procedure in social psychological research. A debate is presented between 2 positions: One challenges the use of the BPL based on ethical principles, and the other confronts these challenges. The debate addresses the void in previous BPL literature regarding concerns about the ethics of using this technique, and raises awareness about potential ethical dilemmas faced by BPL users. The BPL is discussed from utilitarian and deontological ethical perspectives.
Tarzian, Anita J; Wocial, Lucia D
For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here.
Yost, J. Kelley
This paper discusses ethical considerations involved in breach of confidentiality in counseling dangerous clients, i.e., those who have the potential to inflict bodily harm on others. The ethical basis for confidentiality is presented in a model for decision making in ethical dilemmas which encompasses three evaluative levels or tiers: ethical…
Löfström, Erika; Pyhältö, Kirsi
This study focused on exploring students' and supervisors' perceptions of ethical problems in doctoral supervision in the natural sciences. Fifteen supervisors and doctoral students in one research community in the natural sciences were interviewed about their practices and experiences in the doctoral process and supervision. We explored to what extent doctoral students and supervisors experienced similar or different ethical challenges in the supervisory relationship and analyzed how the experiences of ethical dilemmas in supervision could be understood in light of the structure and practices of natural science research groups. The data were analyzed by theory-driven content analysis. Five ethical principles, namely non-maleficence, beneficence, autonomy, fidelity and justice, were used as a framework for identifying ethical issues. The results show that one major question that appears to underpin many of the emerging ethical issues is that the supervisors and students have different expectations of the supervisory role. The second important observation is that doctoral students primarily described their own experiences, whereas the supervisors described their activities as embedded in a system and elaborated on the causes and consequences at a system level.
Porter, Russell; Broussard, Amelia; Duckett, Todd
It is imperative for divinity and health administration programs to improve their level of ethics education for their graduates who work as health administration chaplains. With an initial presentation of the variation of ethical dilemmas presented in health care facilities covering social, organizational, and patient levels, we indicate the need…
Neely, Erica L
Additive manufacturing has spread widely over the past decade, especially with the availability of home 3D printers. In the future, many items may be manufactured at home, which raises two ethical issues. First, there are questions of safety. Our current safety regulations depend on centralized manufacturing assumptions; they will be difficult to enforce on this new model of manufacturing. Using current US law as an example, I argue that consumers are not capable of fully assessing all relevant risks and thus continue to require protection; any regulation will likely apply to plans, however, not physical objects. Second, there are intellectual property issues. In combination with a 3D scanner, it is now possible to scan items and print copies; many items are not protected from this by current intellectual property laws. I argue that these laws are ethically sufficient. Patent exists to protect what is innovative; the rest is properly not protected. Intellectual property rests on the notion of creativity, but what counts as creative changes with the rise of new technologies.
A physician-patient relationship is essential for the well-being of the patient, for without a strong and trusting relationship between both individuals, the patient may not receive the best care that they deserve. There are many legal policies and ethical principles a physician must follow when caring for a patient. It is both the legal and moral duty of the physician to act in the best interests of their patients, while making sure to respect them regardless of background and personal behaviours. The relationship is secured with both trust and respect, for without trust, the patient may hold back from stating their conditions which will result in the physician not providing them with all the care they require. Sometimes, lack of some of these key characteristics of the physician-patient relationship and other circumstances, may cause either the patient or the physician to terminate the relationship. Termination of a relationship creates a difficult situation for the patient, and therefore there are only specific situations where a physician may have permission to follow through and terminate their relationship. Both the law and ethical principles play a role in the decisions made by the physician in regards to their relationship with the patient, but regardless, the physician has the obligation to make sure their patient is receiving care by one means or another.
With the world's population aging, there is an increase in the number of demented elderly. It is vital to study this phenomenon in epidemiological and clinical studies, particularly the effects on the increasing numbers of demented elderly. Researchers need to understand the factors predicting the general decline in the demented elderly. However, before any research is undertaken, it is necessary to obtain approval from the Local Internal Review Board. This committee is responsible to maintain accepted national and international ethical standards. The basis for recruitment to a study is the signature on the informed consent form, where the patient is required to understand the study, internalize the study's aim, to consider all options and finally, to express an opinion. Potential elderly participants need to have their judgment evaluated before signing the form. In cases where the subject is incapable, some countries, including Israel, require that there be a legal guardianship. This is a long and complicated process that causes researchers not to recruit demented patients into a study which may actually be beneficial to all. Some countries allow a proxy to sign informed consent forms to permit the demented subject to participate in the study. Often the threshold may depend on the invasiveness of the intervention. The problem of proxies to sign informed consent form troubles researchers worldwide. This article addresses the history and development of ethics in research, and raises the issue to promote an official policy for proxy consent signing.
Casey, Murray Joseph; O'Brien, Richard; Rendell, Marc; Salzman, Todd
The Catholic Church proscribes methods of birth control other than sexual abstinence. Although the U.S. Food and Drug Administration (FDA) recognizes abstinence as an acceptable method of birth control in research studies, some pharmaceutical companies mandate the use of artificial contraceptive techniques to avoid pregnancy as a condition for participation in their studies. These requirements are unacceptable at Catholic health care institutions, leading to conflicts among institutional review boards, clinical investigators, and sponsors. Subjects may feel coerced by such mandates to adopt contraceptive techniques inconsistent with their personal situation and beliefs; women committed to celibacy or who engage exclusively in non-heterosexual activities are negatively impacted. We propose principles to insure informed consent to safeguard the rights of research subjects at Catholic institutions while mitigating this ethical conflict. At the same time, our proposal respects the interests of pharmaceutical research agencies and Catholic moral precepts, and fully abides by regulatory guidance.
This study describes the clinical characteristics and examines hospital costs involved in the care of 117 patients undergoing Continuous Renal Replacement Therapy (CRRT) between January 1999 and August 2002. The majority (70.9%) of the patients undergoing CRRT expired in the hospital. Statistically significant differences were found with respect to the length of stay for discharge status and gender; and with respect to costs for surgery versus no surgery and gender. Significant differences were also found between discharge status and gender, age, and cardiovascular surgery. The results of this study raise economic and ethical questions related to the cost/benefit of CRRT and the futility of the treatment. Hospitals should ensure that they have utilization protocols in place for CRRT, promote cooperation between intensive care unit (ICU) physicians and nephrologists, and create multi-disciplinary CRRT teams in an effort to maximize the effectiveness of therapy and minimize costs.
Stephen Hancocks' elegant editorial of 11 December 2011 raises interesting questions which deserve discussion. Most experienced dentists would agree that the less that is done to teeth for cosmetic reasons, the lesser are the risks of disappointment, failure of expectation, or threat of litigation. Yet there is an increasing number of cases where aesthetics are the primary concern for dentists and patients alike and some patients are consenting to treatment without being properly informed of the destructive nature of the procedures to their sound tooth tissue and structures to achieve the desired 'cosmetic' outcome. This raises ethical issues, as much of this overtreatment is unnecessarily destructive and goes against the healing and caring principles of the dental profession.
Phua, Kai-Lit; Hue, J W
Scientists and policy makers issuing predictions and warnings of impending natural disaster are faced with two major challenges, that is, failure to warn and issuing a false alarm. The consequences of failure to warn can be serious for society overall, for example, significant economic losses, heavy infrastructure and environmental damage, large number of human casualties, and social disruption. Failure to warn can also have serious for specific individuals, for example, legal proceedings against disaster research scientists, as in the L'Aquila earthquake affair. The consequences of false alarms may be less serious. Nevertheless, false alarms may violate the principle of nonmaleficence (do no harm), affect individual autonomy (eg, mandatory evacuations), and may result in the "cry wolf" effect. Other ethical issues associated with natural disasters include the promotion of global justice through international predisaster technical assistance and postdisaster aid. Social justice within a particular country is promoted through greater postdisaster aid allocation to the less privileged.
Wanyonyi, Sikolia; Muriithi, Francis G
Vaginal birth after Caesarean section (VBAC) has long been practised in low resource settings using unconventional methods. This not only poses danger to the woman and her baby, but could also have serious legal and ethical implications. The adoption of this practice has been informed by observational studies with many deficiencies; this is so despite other studies from settings in which the standard of care is much better that show that elective repeat Caesarean section (ERCS) may actually be safer than VBAC. This raises questions about whether we should insist on a dangerous practice when there are safer alternatives. We highlight some of the challenges faced in making this decision, and discuss why the fear of ERCS may not be justified after all in low resource settings. Since a reduction in rates of Caesarean section may not be applicable in these regions, because their rates are already low, the emphasis should instead be on adequate birth spacing and safer primary operative delivery.
This document contains nine papers from the social and ethical issues section of an international conference on vocational education and training (VET) for lifelong learning in the information era. The following papers are included: "Attitudes of University Faculty Members toward Students with Disabilities" (Marie F. Kraska);…
Wertz, D C; Fletcher, J C; Mulvihill, J J
To provide a basis for international discussion of ethical problems, we studied responses of medical geneticists in 18 countries to questionnaires about 14 clinical cases and five screening situations. Of 1,053 asked to participate, 677 (64%) responded. There was greater than or equal to 75% consensus on five cases involving (1) disclosure of (1) conflicting diagnostic findings, (2) disclosure of ambiguous results, (3) disclosure of controversial interpretations, (4) protection of mother's confidentiality in cases of false paternity, and (5) nondirective counseling about 45,X and XYY syndrome. A majority (51%-60%) would disclose the diagnosis to relatives at risk for Huntington disease or hemophilia A, against the patient's wishes; would disclose which parent carries a translocation causing Down syndrome; and would disclose XY genotype in a female. As reproductive options for patients with disorders not diagnosable prenatally, 84% would discuss artificial insemination by a donor, 66% would discuss in vitro fertilization with donor egg, and 46% would discuss surrogate motherhood. In all, 85% would perform prenatal diagnosis for (or would refer) parents who refuse abortion, 75% for maternal anxiety, and 42% for selection of fetal sex. Screening questions showed that 72% believed that workplace screening should be voluntary and that results should be confidential. PMID:2339711
Gasparyan, Armen Yuri; Yessirkepov, Marlen; Diyanova, Svetlana N; Kitas, George D
Publishing scholarly articles in traditional and newly-launched journals is a responsible task, requiring diligence from authors, reviewers, editors, and publishers. The current generation of scientific authors has ample opportunities for publicizing their research. However, they have to selectively target journals and publish in compliance with the established norms of publishing ethics. Over the past few years, numerous illegitimate or predatory journals have emerged in most fields of science. By exploiting gold Open Access publishing, these journals paved the way for low-quality articles that threatened to change the landscape of evidence-based science. Authors, reviewers, editors, established publishers, and learned associations should be informed about predatory publishing practices and contribute to the trustworthiness of scholarly publications. In line with this, there have been several attempts to distinguish legitimate and illegitimate journals by blacklisting unethical journals (the Jeffrey Beall's list), issuing a statement on transparency and best publishing practices (the Open Access Scholarly Publishers Association's and other global organizations' draft document), and tightening the indexing criteria by the Directory of Open Access Journals. None of these measures alone turned to be sufficient. All stakeholders of science communication should be aware of multiple facets of unethical practices and publish well-checked and evidence-based articles.
Yessirkepov, Marlen; Diyanova, Svetlana N.; Kitas, George D.
Publishing scholarly articles in traditional and newly-launched journals is a responsible task, requiring diligence from authors, reviewers, editors, and publishers. The current generation of scientific authors has ample opportunities for publicizing their research. However, they have to selectively target journals and publish in compliance with the established norms of publishing ethics. Over the past few years, numerous illegitimate or predatory journals have emerged in most fields of science. By exploiting gold Open Access publishing, these journals paved the way for low-quality articles that threatened to change the landscape of evidence-based science. Authors, reviewers, editors, established publishers, and learned associations should be informed about predatory publishing practices and contribute to the trustworthiness of scholarly publications. In line with this, there have been several attempts to distinguish legitimate and illegitimate journals by blacklisting unethical journals (the Jeffrey Beall's list), issuing a statement on transparency and best publishing practices (the Open Access Scholarly Publishers Association's and other global organizations' draft document), and tightening the indexing criteria by the Directory of Open Access Journals. None of these measures alone turned to be sufficient. All stakeholders of science communication should be aware of multiple facets of unethical practices and publish well-checked and evidence-based articles. PMID:26240476
Devor, Marshall; Rappaport, Isabelle; Rappaport, Z Harry
Pain has variously been used as a means of punishment, extracting information, or testing commitment, as a tool for education and social control, as a commodity for sacrifice, and as a draw for sport and entertainment. Attitudes concerning these uses have undergone major changes in the modern era. Normative convictions on what is right and wrong are generally attributed to religious tradition or to secular-humanist reasoning. Here, we elaborate the perspective that ethical choices concerning pain have much earlier roots that are based on instincts and brain-seated empathetic responses. They are fundamentally a function of brain circuitry shaped by processes of Darwinian evolution. Social convention and other environmental influences, with their idiosyncrasies, are a more recent, ever-changing overlay. We close with an example in which details on the neurobiology of pain processing, specifically the question of where in the brain the experience of pain is generated, affect decision making in end-of-life situations. By separating innate biological substrates from culturally imposed attitudes (memes), we may arrive at a more reasoned approach to a morality of pain prevention.
Johnson, Kevin W
The case of Brase v Rees was presented before the US Supreme Court to consider the constitutionality of death by lethal injection as practiced in the state of Kentucky. The 3-drug combination of sodium thiopental, pancuronium bromide, and potassium chloride is a key aspect in question. Capital punishment conflicts with medical and nursing code of ethics preventing providers who are skilled at difficult intravenous (IV) access, assessment of appropriate sedation, and involvement without fear of disciplinary action. Therefore, untrained or undertrained personnel from the prison have been delegated these duties. Cases in which failure to establish or maintain IV access has led to executions lasting up to 90 minutes before the execution was complete. Participation by skilled medical personnel has been a debate between the medical and legal communities since the inception of lethal injection. Healthcare should reevaluate the ethical and moral principle of beneficence as the legal system attempts to evaluate the constitutionality of lethal injection. Can a nurse or doctor step out of the role of medical professional, use knowledge and skill to make death by lethal injection more humane, and not violate the ethical principle of "do no harm"?
Israel is a multicultural state that has absorbed, and is continually absorbing people of different cultures who immigrate to Israel, a situation that could create conflicts in the physician-patient relationship. In this article, I will present several cases in which diversity of culture can lead to conflict, and suggest a way of communication that can help prevent the conflicts arising from those situations.
The UK government's Prevent programme affects professionals and the people who rely on their services across the public sector, particularly now that workers are legally bound to report their concerns about individuals they believe to be at risk of radicalisation. This article discusses the risks that the strategy presents to the work of teachers and the bonds of trusts between staff and students. PMID:27087992
Lynch, William T.; Kline, Ronald
Offers ways of applying science and technology studies to the teaching of engineering ethics. Suggests modifications of both detailed case studies on engineering disasters and hypothetical, ethical dilemmas employed in engineering ethics classes. (Author/CCM)
Schloss, Alexander J
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.
Warnock, Carla Jean Pease
All US governmental, public, and private healthcare facilities and their staff fall under some form of regulatory requirement to provide opportunities for spiritual health assessment and care as a component of holistic healthcare. As often the case with regulations, these facilities face the predicament of funding un-reimbursable care. However, chaplains and nurses who provide most patient spiritual care are paid using funds the facility obtains from patients, private, and public sources. Furthermore, Veteran healthcare services, under the United States Department of Veterans Affairs (VA), are provided with taxpayer funds from local, state, and federal governments. With the recent legal action by the Freedom From Religion Foundation, Inc. (FFRF) against the Veterans Administration, the ethical dilemma surfaces between taxpayers funding holistic healthcare and the first amendment requirement for separation of church and state.
Dukewich, Kristie R.; Wood, Suzanne
Educators are regularly confronted with moral dilemmas for which there are no easy solutions. Increasing course sizes and program enrolments, coupled with a new consumerist attitude towards education, have only further exacerbated the quantity and quality of students' requests for special academic consideration (Macfarlane, 2004). Extensions, late…
Eberholst, Mads Kaemsgaard; Hartley, Jannie Møller; Olsen, Maria Bendix
This article looks at journalism students' experiences in a course that simulates an online newsroom. On the basis of a quantitative survey and more qualitative reflections from the students, we explore the dilemmas that students experience "working" as online journalists and how these are related to broader issues of journalistic…
One of the ongoing debates in Canadian higher education is the dilemma of the brain drain and the seemingly conflicting goals between the strategies and intentions of various government departments. While Citizenship and Immigration Canada aims to recruit the brightest students from across the globe to study in Canada and to enable their long-term…
‘THEY SAY ISLAM HAS A SOLUTION FOR EVERYTHING, SO WHY ARE THERE NO GUIDELINES FOR THIS?’ ETHICAL DILEMMAS ASSOCIATED WITH THE BIRTHS AND DEATHS OF INFANTS WITH FATAL ABNORMALITIES FROM A SMALL SAMPLE OF PAKISTANI MUSLIM COUPLES IN BRITAIN
This paper presents ethical dilemmas concerning the termination of pregnancy, the management of childbirth, and the withdrawal of life-support from infants in special care, for a small sample of British Pakistani Muslim parents of babies diagnosed with fatal abnormalities. Case studies illustrating these dilemmas are taken from a qualitative study of 66 families of Pakistani origin referred to a genetics clinic in Southern England. The paper shows how parents negotiated between the authoritative knowledge of their doctors, religious experts, and senior family members in response to the ethical dilemmas they faced. There was little knowledge or open discussion of the view that Islam permits the termination of pregnancy for serious or fatal abnormality within 120 days and there was considerable disquiet over the idea of ending a pregnancy. For some parents, whether their newborn baby would draw breath was a main worry, with implications for the baby's Muslim identity and for the recognition of loss the parents would receive from family and community. This concern sometimes conflicted with doctors' concerns to minimize risk to future pregnancies by not performing a Caesarean delivery if a baby is sure to die. The paper also identifies parents' concerns and feelings of wrong-doing regarding the withdrawal of artificial life-support from infants with multiple abnormalities. The conclusion considers some of the implications of these observations for the counselling and support of Muslim parents following the pre- or neo-natal diagnosis of fatal abnormalities in their children. PMID:21649685
Davis, Charles K.
This paper presents two focused minicases that an instructor can use in a typical information systems overview course. The first of these deals with a serious ethical dilemma and the second with the politics of information technology executive management. For each case, a discussion of how to use the minicase effectively and a suggested solution…
Undy, Harry, Ed.
Published for secondary school youth in England, the PROBE series presents provocative information and discussion questions on topical themes. The focus of this issue is on aspects of medicine which raise moral dilemmas for doctors, patients, and society in general. This issue contains case studies which illustrate ethical questions raised by the…
Kallio, Brenda R.
With the advent of globalization and the growing concept that schools are marketplaces of ideas, educational administrators need guidance in ethical decision making. Moral dilemma is defined, ethical models are presented, and a process is described in which facts, resolution options, and values are reflected upon and decisions made based on…
Combs, M R; Bredehoeft, S J
The Transfusion Service at Duke University Hospital has changed antibody detection methods from the use of albumin in indirect antiglobulin tests to low-ionic-strength solution (LISS), and from LISS to polyethylene glycol (PEG) in an effort to enhance the rapid detection of clinically significant antibodies. In 1996, staffing issues required the consideration of automation. Although previous studies indicated that the gel test was not as sensitive as PEG for detection of clinically significant antibodies, we chose to implement the gel test to be used with the Tecan MegaFlex-ID. We performed a retrospective analysis of identified antibodies and transfusion reactions to compare the outcomes of one year's experience with gel and PEG. We found comparable detection of potentially clinically significant antibodies by both methods and significantly fewer unwanted or clinically insignificant antibodies detected with the use of gel. Fewer delayed serologic transfusion reactions and no transfusion-associated hemolytic events occurred in the year that gel was used. Although we initially found the selection of the gel test to be a dilemma, our ultimate decision appears to have successfully protected patient safety and balanced sensitivity with specificity.
Cameron, Robyn Ann; O'Leary, Conor
Ethical instruction is critical in accounting education. However, does accounting ethics teaching actually instil core ethical values or simply catalogue how students should act when confronted with typical accounting ethical dilemmas? This study extends current literature by distinguishing between moral/ethical and legal/ethical matters and then…
Arguments are advanced, on a pragmatic basis, for preferring a 'situational' approach to medical ethical problems, rather than an approach based on any one of the dogmatic formulations on offer. The consequences of such a preference are exemplified in relation to confidentiality; and in relation to the ethical dilemmas which surround the beginning and the end of terrestrial human life.
Lev-Ran, Shaul; Nitzan, Uri; Fennig, Shmuel
Harm reduction is a general term for pragmatic interventions aimed at reducing problematic behaviors. Emerging from addiction treatments, it is based on the understanding that people will continue to behave in ways that pose a risk to them and their communities, and that an important goal of any treatment program is to minimize the harm associated with these behaviors. Despite its evidence based background, harm reduction is not readily applied in general psychiatry. This is mainly due to the complex ethical dilemmas arising within harm reduction practices, as well as a lack of scientific knowledge and theoretical frameworks essential for dealing with such ethical dilemmas. In this paper we introduce the fundamental theoretical and scientific base of harm reduction strategies, and present three clinical examples of the complex ethical dilemmas arising when working within a harm reduction practice. We finally present a theoretical framework for dealing with the ethical dilemmas and argue this may make harm reduction strategies more accessible in general psychiatry.
Smith, Nick L.
In contrast with nonindigenous workers, to what extent do unique ethical problems arise when indigenous field-workers participate in field studies? Three aspects of study design and operation are considered: data integrity issues, risk issues, and protection issues. Although many of the data quality issues that arise with the use of indigenous…
Van Niekerk, Leesa Micole; Martin, Frances
A survey of 1,015 Australian registered nurses found that those who felt adequately consulted by physicians were significantly more likely to initiate consultation. Nurses dissatisfied with their relationship with physicians were more likely to experience ethical conflicts related to pain management. Level of satisfaction with this relationship…
Chakrabarti, Sudipta; Ghosh, Suman; Sarkar, Ranu
Solid Pseudopapillary Tumour (SPT) is a rare and distinctive pancreatic exocrine neoplasm. Even Rarely, such primary SPT may originate from ectopic pancreatic tissues. We are hereby presenting one such unique case, where a 50-year-old female presented with pain and a mid-abdominal lump. Radiology revealed a well-defined outline located adjacent to the tail of pancreas. The excised mass was 19×14×7cm in dimension having zones of haemorrhage, necrosis and cystic spaces filled with necrotic debris. Microscopic examination confirmed the diagnosis of SPT. SPT originating in extrapancreatic location may mimic an ovarian cystic tumours or mesenteric cysts, its proper identification is crucial.
Krawczyk, Rosemary; Kudzma, Elizabeth
Courses in theoretical ethics are unrelated to the moral delemmas that nurses encounter in practice, according to the authors. They present a method for moral education in nursing curricula utilizing seminars for dilemma discussion that can help students to progress in moral judgment. (MF)
Warnick, Bryan R.; Bitters, Todd A.; Falk, Thomas M.; Kim, Sang Hyun
Teacher use of social networking sites such as Facebook has presented some ethical dilemmas for policy makers. In this article, we argue that schools are justified in taking action against teachers when evidence emerges from social networking sites that teachers are (a) doing something that is illegal, (b) doing something that reflects badly on…
Børsen, Tom; Danborg, Pia Brandt
One of the most important Techno-Anthropological intellectual virtues is the ability to make contextualized ethical judgments of new and emerging technologies. This Techno-Anthropological core competence is especially relevant in Health Information Systems Technologies, which is a field characterized by inherent ethical dilemmas such as the pros and cons of regulation of research databases with sensitive information, or storing and application of tissue and blood samples. In this paper we present a method to make 'proper and quick' ethical estimates in Health Information. The method guides its user to make ethical judgments by splitting the judgment process into four steps: (1) Identification of intended beneficial consequences, potential misuse, unintended side effects and long-term consequences for culture and society. (2) Linkage of intended consequences, misuse, side effects and cultural implications to appropriate ethical values. (3) Identification of ethical dilemmas related to a specific use of the Health Information Systems Technology under assessment. (4) Formulation of appropriate technological and institution design criteria that can transcend the identified ethical dilemmas. The methodology will be applied to a the discussions at a hearing on ethical challenges accompanying research involving health data organized by the Danish Council of Ethics and the case of risk reducing breast cancer surgery based on diagnosed genetic predisposition to breast cancer.
Prabhu, Neeta; Alexander, Sherene; Wong, Peter; Cameron, Angus
Erythromelalgia is an extremely rare neurovascular disorder, characterized by symptoms of red, hot, and painful extremities. There is considerable confusion regarding the etiology and pathogenesis of this condition, and the diagnosis is essentially a clinical one. This condition may occur in isolation or in association with other myeloproliferative disorders. Unfortunately, no therapy is effective consistently in managing the symptoms, although early diagnosis can aid in psychological counseling and minimizing the frequency and severity of the attacks. The purpose of this report was to describe the case of a child presenting with premature loss of primary teeth and the difficulties in determining the final diagnosis of erythromelalgia, which responded positively to low-grade aspirin therapy.
The ethical development of information systems is but one of those sensitive scenarios associated with computer technology that has a tremendous impact on individuals and social life. The significance of these issues of concern cannot be overstated. However, since computer ethics is meant to be everybody's responsibility, the result can often be…
Perri, David F.; Callanan, Gerard A.; Rotenberry, Paul F.; Oehlers, Peter F.
Purpose: The purpose of this paper is to present a teaching methodology for improving the understanding of ethical decision making. This pedagogical approach is applicable in college courses and in corporate training programs. Design/methodology/approach: Participants are asked to analyze a set of eight ethical dilemmas with differing situational…
National Association of Elementary School Principals (NAESP), 2005
This document presents a code of ethics for early childhood educators that offers guidelines for responsible behavior and sets forth a common basis for resolving ethical dilemmas encountered in early education. It represents the English and Spanish versions of the revised code. Its contents were approved by the NAEYC Governing Board in April 2005…
Semendeferi, Ioanna; Tsiamyrtzis, Panagiotis; Dcosta, Malcolm; Pavlidis, Ioannis
We present a graduate science ethics course that connects cases from the historical record to present realities and practices in the areas of social responsibility, authorship, and human/animal experimentation. This content is delivered with mixed methods, including films, debates, blogging, and practicum; even the instructional team is mixed, including a historian of science and a research scientist. What really unites all of the course's components is the experiential aspect: from acting in historical debates to participating in the current scientific enterprise. The course aims to change the students' culture into one deeply devoted to the science ethics cause. To measure the sought after cultural change, we developed and validated a relevant questionnaire. Results of this questionnaire from students who took the course, demonstrate that the course had the intended effect on them. Furthermore, results of this questionnaire from controls indicate the need for cultural change in that cohort. All these quantitative results are reinforced by qualitative outcomes.
Santos Salas, Anna; Cameron, Brenda L
Understanding how a nurse acts in a particular situation reveals how nurses enact their ethics in day-to-day nursing. Our ethical frameworks assist us when we experience serious ethical dilemmas. Yet how a nurse responds in situations of daily practice is contingent upon all the presenting cues that build the current moment. In this article, we look at how a home care nurse responds to the ethical opening that arises when the nurse enters a person's home. We discuss how the home presents the nurse with knowledge that informs the provision of ethical nursing care. The analysis is based on findings from an interpretive research study in palliative home care in Canada. Through interpretive analysis of a nursing situation we delineate how the nurse engages with the whole and acts inside the moment. The analysis shows how home care nurses are ethically determined to engage with whatever is going on in a patient's home.
Describes a required ethics course designed for juniors and seniors at a small Connecticut boarding school. Students explore the ethics of care and justice, examine ethical assumptions behind the school's disciplinary system, consider a series of dilemmas, and discuss complex topics such as abortion, euthanasia, and racism. A sidebar outlines…
Smith, M J
Unique among professional codes of ethics is the Texas & New Mexico Hospice Organization's Code of Ethics. Where other codes concentrate only on principles-based ethics, this new code identifies five models of bioethics currently used in resolving ethical dilemmas. This report's primary purpose analyzes the code's four precepts in the context of (1) principles-based ethics, (2) casuistic-based ethics, (3) covenant-based ethics, (4) evidence-based ethics and narrative-based ethics. The second purpose is to present the practicality of these often esoteric concepts in the day-to-day work of palliative care providers. Indications are that this code of ethics, because of its broad scope, is more useful than other principles-based-only codes.
Lambert, Binta; Scheiner, Melissa; Campbell, Deborah
The epidemic of substance abuse continues to pose a significant challenge to clinicians nationwide. Although there is a tendency to simply associate drug abuse with poverty, the problem affects every social stratum gender and race; and pregnant women are no exception. Caring for pregnant, substance-using women and their infants presents complex legal and ethical issues. Debate is ongoing about whether criminal penalties should be imposed on women based solely on their use of alcohol and other drugs during pregnancy. Furthermore, controversies persist about the rights and wishes of pregnant women versus the interests of their fetuses. For health professionals, conflict arises when the pregnant woman chooses behaviors that have the potential to harm the developing fetus. The ethical dilemma arises from competing autonomy-based and beneficence-based obligations to the maternal-fetal dyad. This chapter explores the ethics-based conflicts in the delivery of health care to drug abusing pregnant women.
Huey, Wayne C.
Discusses ethical dilemmas inherent in the school setting that result from conflicts in counselor responsibilities to pupils, parents, and school. An ethical dilemma involving a pregnant student who is considering an abortion is described, and some possible counselor responses are discussed. (Author)
Until very recently, ethical issues were given little attention in administrator-preparation programs. This digest in Spanish outlines the ethical responsibilities of school leaders and the dilemmas that they face. It offers the following suggestions for resolving ethical dilemmas: (1) Leaders should have and be willing to act on a definite sense…
Gunby, Susan Sweat
This paper on ethical issues in the gerontological nursing curriculum explores meanings of the concept of ethics and differences between ethical decision making and other decision-making processes. Four mind-sets about health care that influence the analysis of ethical dilemmas, identified by M. Aroskar, are described. The contributions of…
Pellegrino, Edmund D
In this brief annual review of ethical issues in medicine, Pellegrino focuses on two issues, AIDS and surrogate mothers. The AIDS epidemic has generated debate over public health needs vs. individual rights, modification of sexual practices, screening programs to detect infected persons, confidentiality of test results, experimental therapies, and the duty of physicians to care for AIDS patients. Surrogate motherhood arrangements have become one of the more controversial of the new reproductive technologies. The publicity that accompanied the custody battle over New Jersey's "Baby M" intensified debate over the commercialization of childbearing and the regulation of reproduction. Pellegrino concludes that physicians, along with ethicists and policymakers, have an obligation to "lead society in careful and judicious deliberation" of the ethical issues raised by AIDS and by reproductive technologies.
To illustrate the sorts of ethical quandaries institutional advancement professionals face, five fictitious case studies were compiled, including the matching gift muddle, deception dilemma, public relations predicament, vexing vendor, and the plagiarism puzzle. (MLW)
Andrianov, Andrei; Kanke, Victor; Kuptsov, Ilya; Murogov, Viktor
This article analyzes the present status, development trends, and problems in the ethics of nuclear technology in light of a possible revision of its conceptual foundations. First, to better recognize the current state of nuclear technology ethics and related problems, this article focuses on presenting a picture of the evolution of the concepts and recent achievements related to technoethics, based on the ethics of responsibility. The term 'ethics of nuclear technology' describes a multidisciplinary endeavor to examine the problems associated with nuclear technology through ethical frameworks and paradigms. Second, to identify the reasons for the intensification of efforts to develop ethics in relation to nuclear technology, this article presents an analysis of the recent situation and future prospects of nuclear technology deployment. This includes contradictions that have aggravated nuclear dilemmas and debates stimulated by the shortcomings of nuclear technology, as well as the need for the further development of a nuclear culture paradigm that is able to provide a conceptual framework to overcome nuclear challenges. Third, efforts in the field of nuclear technology ethics are presented as a short overview of particular examples, and the major findings regarding obstacles to the development of nuclear technology ethics are also summarized. Finally, a potential methodological course is proposed to overcome inaction in this field; the proposed course provides for the further development of nuclear technology ethics, assuming the axiological multidisciplinary problematization of the main concepts in nuclear engineering through the basic ethical paradigms: analytical, hermeneutical, and poststructuralist.
Airth-Kindree, Norah M M; Kirkhorn, Lee-Ellen C
We offer an educational innovation called Ethical Grand Rounds (EGR) as a teaching strategy to enhance ethical decision-making. Nursing students participate in EGR-flexible ethical laboratories, where they take stands on ethical dilemmas, arguing for--or against--an ethical principle. This process provides the opportunity to move past normative ethics, that is, an ideal ethical stance in accord with ethical conduct codes, to applied ethics, what professional nurses would do in actual clinical practice, given the constraints that exist in contemporary care settings. EGR serves as a vehicle to translate "what ought to be" into "what is."
Sessums, Laura L; Collen, Jacob F; O'Malley, Patrick G; Jackson, Jeffery L; Roy, Michael J
The Global War on Terrorism brings significant ethical challenges for military physicians. From Abu Ghraib to Guantanamo Bay, the actions of health care providers have come under considerable scrutiny. Military providers have dual roles as military officers and medical professionals, which have the potential to come into conflict. Often they are inadequately prepared to manage this conflict. We review pertinent historical precedents, applicable laws, ethical guidelines, and military regulations. We also present examples of ethical challenges deployed clinicians have faced and their ethical solution. Finally, we propose a practical strategy to educate physicians on how to manage complex ethical dilemmas in war time settings.
AE Army Ethic AEWP Army Ethic White Paper CAPE Center for the Army Profession and Ethic UCMJ Uniform Code of Military Justice U.S. United States...... justice and mercy (Kem 2006, 26). An ethical decisionmaking model helps differentiate between actual and apparent ethical dilemmas. Kem proposes a
Wong, E.Y.W.; Davison, R.M.; Wade, P.W.
This paper seeks to highlight some ethical issues relating to the increasing proliferation of Information Technology into our everyday lives. The authors explain their understanding of computer ethics, and give some reasons why the study of computer ethics is becoming increasingly pertinent. The paper looks at some of the problems that arise in attempting to develop appropriate ethical concepts in a constantly changing environment, and explores some of the ethical dilemmas arising from the increasing use of computers. Some initial research undertaken to explore the ideas and understanding of tertiary level students in Hong Kong on a number of ethical issues of interest is described, and our findings discussed. We hope that presenting this paper and eliciting subsequent discussion will enable us to draw up more comprehensive guidelines for the teaching of computer related ethics to tertiary level students, as well as reveal some directions for future research.
Manning, S S
Social workers today face some of the most complex ethical dilemmas in the history of the profession. This article presents a framework of moral citizenship to guide ethical social work practice. The framework includes the action philosophies of philosopher Hannah Arendt and Lutheran theologian Paul Tillich integrated with concepts of professional responsibility and the unique contributions of social work pioneer Charlotte Towle. Social conscience and social consciousness, including awareness, thinking, feeling, and action, are major components of the framework.
This contribution is a synthesis of the results of historical research on psychiatry during the Nazi period and some implications for present day debates in medical ethics. The focus is on three issues: the relationship between physicians and the state, the impact of eugenically and economically motivated health and social policies for psychiatry (e.g. forced sterilization, patient killing/euthanasia) and psychiatric research. Three myths are deconstructed: 1) that medical atrocities were imposed from above by Nazi politicians on apolitical physicians, 2) that mass sterilization and patient killing had nothing to do with contemporary state of the art of medical reasoning and practice and 3) that ethically unacceptable research on psychiatric patients had nothing to do with the contemporary state of the art of biomedical sciences. It is argued that the findings on these issues of Nazi medicine are not specific to Germany and the period between 1933 and 1945 but they were the extreme manifestations of some potential problems implicit in modern medicine in general.
Mortensen, Peter, Ed.; Kirsch, Gesa E., Ed.
Reflecting on the practice of qualitative literacy research, this book presents 14 essays that address the most pressing questions faced by qualitative researchers today: how to represent others and themselves in research narratives; how to address ethical dilemmas in research-participant relations; and how to deal with various rhetorical,…
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…
Genetic engineering is often looked upon with disfavour on the grounds that it involves 'tampering with nature'. Most philosophers do not take this notion seriously. However, some do. Those who do tend to understand nature in an Aristotelian sense, as the essence or form which is the final end or telos for the sake of which individual organisms live, and which also explains why they are as they are. But is this really a tenable idea? In order to secure its usage in present day ethics, I will first analyze the contexts in which it is applied today, then discuss the notion of telos as it was employed by Aristotle himself, and finally debate its merits and defend it, as far as possible, against common objections.
Walsh, Christine A.; Hewson, Jennifer; Shier, Michael; Morales, Edwin
There is limited literature describing the ethical dilemmas that arise when conducting community-based participatory research. The following provides a case example of ethical dilemmas that developed during a multi-method community-based participatory action research project with youth in Calgary, Alberta, Canada. Several ethical dilemmas emerged…
Brondani, Mario A; Rossoff, Lawrence P
The subject of ethics and the teaching of skills associated with ethical reasoning in a predoctoral dental curriculum are as important as clinical skills development, but there is no single approach to teaching ethics in dentistry. This article aims to describe the didactic approach used to teach dental ethics and ethical reasoning in the first year of the D.M.D. curriculum at the University of British Columbia. This descriptive article discusses three main pedagogies employed to teach ethics: the "hot seat" experience via a role-play with a trained actor (standardized patient, SP); small-group presentations of a case workup deconstructing an ethical dilemma; and student reflections from the SP encounters. The approach to dental ethics presented here does not profess to make an otherwise unethical person ethical, but it can give all students the tools to recognize when a dilemma exists, use a process to reason ethically, and ultimately make a good decision. The "hot seat" and the case workup approaches have had a positive impact upon students as illustrated through their reflections; however, further study is needed to better understand the implications of ethical issues in both academic and professional settings.
In order to develop moral literacy, nursing students should be exposed to both rules- and justice-based ethics and to a feminist care perspective. They can learn to analyze and understand ethical dilemmas and to tell their own stories in order to identify the influences on their decision making. (SK)
Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Schotsmans, Paul; Gastmans, Chris
As euthanasia has become a widely debated issue in many Western countries, hospitals and nursing homes especially are increasingly being confronted with this ethically sensitive societal issue. The focus of this paper is how healthcare institutions can deal with euthanasia requests on an organizational level by means of a written institutional ethics policy. The general aim is to make a critical analysis whether these policies can be considered as organizational-ethical instruments that support healthcare institutions to take their institutional responsibility for dealing with euthanasia requests. By means of an interpretative analysis, we conducted a process of reinterpretation of results of former Belgian empirical studies on written institutional ethics policies on euthanasia in dialogue with the existing international literature. The study findings revealed that legal regulations, ethical and care-oriented aspects strongly affected the development, the content, and the impact of written institutional ethics policies on euthanasia. Hence, these three cornerstones-law, care and ethics-constituted the basis for the empirical-based organizational-ethical framework for written institutional ethics policies on euthanasia that is presented in this paper. However, having a euthanasia policy does not automatically lead to more legal transparency, or to a more professional and ethical care practice. The study findings suggest that the development and implementation of an ethics policy on euthanasia as an organizational-ethical instrument should be considered as a dynamic process. Administrators and ethics committees must take responsibility to actively create an ethical climate supporting care providers who have to deal with ethical dilemmas in their practice.
Ho, Anita; MacDonald, Lisa Mei-Hwa; Unger, David
Healthcare institutions have been making increasing efforts to standardize consultation methodology and to accredit both bioethics training programs and the consultants accordingly. The focus has traditionally been on the ethics consultation as the relevant unit of ethics intervention. Outcome measures are studied in relation to consultations, and the hidden assumption is that consultations are the preferred or best way to address day-to-day ethical dilemmas. Reflecting on the data from an internal quality improvement survey and the literature, we argue that having general ethics education as a key function of ethics services may be more important in meeting the contemporaneous needs of acute care settings. An expanded and varied ethics education, with attention to the time constraints of healthcare workers' schedules, was a key recommendation brought forward by survey respondents. Promoting ethical reflection and creating a culture of ethics may serve to prevent ethical dilemmas or mitigate their effects.
Fisher, Millard J.
This paper discusses some predictive problems, trends, and dilemmas regarding education for the 21st century, and asks what the future will demand of humankind. Such topics as the information explosion, the increasingly important learning needs in a changing world, and technology versus humanity are examined. Discussion focuses on the implications…
Shaw, Doug J.; Miller, Catherine M.
Since 1950, the Prisoner's Dilemma has intrigued economists and amused fans of mathematics. It presents a situation in which two players acting to their own advantage do not do as well together as two players whose actions oppose their individual interests--hence, the dilemma. Variations of the Prisoner's Dilemma have appeared in diverse…
The decision to treat a patient in solitary confinement in psychiatry does not follow any protocol and is not made on a case-by-case basis. Team deliberation opens discussion and enables the group as a whole to take responsibility for clarifying what is to be supported by the team and implemented by the carer during treatment. When presented with complex situations, uncertainty can be a force when it calls upon an ethical dilemma.
Teboul, J. C. Bruno
Presents the case study involving a fictitious company's English-only policy and threats of legal action based on that policy. Includes the following responses: "Legal Issues Posed in the Language Dilemma" (Gregory S. Walden); "English Only: A Workplace Dilemma" (Alan Pakiela); "Problems with English-Only Policies" (Barbara Lynn Speicher); and…
Parsons, M. A.; Gearheard, S.; McNeave, C.
Local and traditional knowledge (LTK) provides rich information about the Arctic environment at spatial and temporal scales that scientific knowledge often does not have access to (e.g. localized observations of fine-scale ecological change potentially from many different communities, or local sea ice and conditions prior to 1950s ice charts and 1970s satellite records). Community-based observations and monitoring are an opportunity for Arctic residents to provide ‘frontline’ observations and measurements that are an early warning system for Arctic change. The Exchange for Local Observations and Knowledge of the Arctic (ELOKA) was established in response to the growing number of community-based and community-oriented research and observation projects in the Arctic. ELOKA provides data management and user support to facilitate the collection, preservation, exchange, and use of local observations and knowledge. Managing these data presents unique ethical challenges in terms of appropriate use of rare human knowledge and ensuring that knowledge is not lost from the local communities and not exploited in ways antithetical to community culture and desires. Local Arctic residents must be engaged as true collaborative partners while respecting their perspectives, which may vary substantially from a western science perspective. At the same time, we seek to derive scientific meaning from the local knowledge that can be used in conjunction with quantitative science data. This creates new challenges in terms of data presentation, knowledge representations, and basic issues of metadata. This presentation reviews these challenges, some initial approaches to addressing them, and overall lessons learned and future directions.
Magelssen, Morten; Pedersen, Reidar; Førde, Reidun
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.
Hightower, Bynum Blake; Klinker, JoAnn Franklin
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…
Edwards, Brett; Revill, James; Bezuidenhout, Louise
The dual-use issue is often framed as a series of paralyzing 'dilemmas' facing the scientific community as well as institutions which support innovation. While this conceptualization of the dual-use issue can be useful in certain contexts (such as in awareness-raising and as part of educational activities directed at the scientific community) its usefulness is more limited when reflecting on the governance and politics of the dual-use issue. Within this paper, key shortcomings of the dilemma framing are outlined. It is argued that many of the issues raised in the most recent debates about 'dual-use' bird flu research remain unresolved. This includes questions about the trajectories of certain lines of research, as well as broader trends in the practice and governance of science. This leads to difficult questions about current approaches to the dual-use issue within the US, as well as internationally.
Throughout the International Drama in Education Research Institute (IDIERI) 2012 conference, practitioners in keynotes, presentations and workshops mentioned ethical dilemmas that arose in their work; wondering at times if they did the "right" thing. By addressing a moral imperative, practitioners can start to identify common ethical…
Peacock, K.; Mann, M. E.
Several authors have warned that climate scientists sometimes exhibit a tendency to "err on the side of least drama" in reporting the risks associated with fossil fuel emissions. Scientists are often reluctant to comment on the implications of their work for public policy, despite the fact that because of their expertise they may be among those best placed to make recommendations about such matters as mitigation and preparedness. Scientists often have little or no training in ethics or philosophy, and consequently they may feel that they lack clear guidelines for balancing the imperative to avoid error against the need to speak out when it may be ethically required to do so. This dilemma becomes acute in cases such as abrupt ice sheet collapse where it is easier to identify a risk than to assess its probability. We will argue that long-established codes of ethics in the learned professions such as medicine and engineering offer a model that can guide research scientists in cases like this, and we suggest that ethical training could be regularly incorporated into graduate curricula in fields such as climate science and geology. We recognize that there are disanalogies between professional and scientific ethics, the most important of which is that codes of ethics are typically written into the laws that govern licensed professions such as engineering. Presently, no one can legally compel a research scientist to be ethical, although legal precedent may evolve such that scientists are increasingly expected to communicate their knowledge of risks. We will show that the principles of professional ethics can be readily adapted to define an ethical code that could be voluntarily adopted by scientists who seek clearer guidelines in an era of rapid climate change.
Therapist's role and dilemmas faced in treating a gender dysphoric client are discussed. Examines ethical and moral issues relating to transsexualism and discusses the appropriateness of art therapy as a treatment for transsexual clients. (SNR)
Gauthier, S; Leuzy, A; Racine, E; Rosa-Neto, P
There is great interest in the ethical issues associated with Alzheimer's disease (AD) and related dementias given the prevalence of AD and the evolving neuroscience landscape in matters of diagnoses and therapeutics. Much of the ethics discussion arises in the tension between the principle of not doing harm (principle of non-maleficence) in this vulnerable population and the development of effective treatments (principle of beneficence). Autonomy and capacity issues are also numerous, wide-ranging, and concern (1) day to day affairs such as driving safely and spending money wisely, (2) life-time events such as designating a legal representative in case of incapacity, making a will, (3) consenting to treatment and diagnostic procedures, (4) participating in research. The latter issue is particularly thorny and illustrates well the complexity of tackling concerns related to capacity. The impetus to protect AD patients has partly led to ethics regulation and policies making research on inapt patients more difficult because of stringent requirements for signed informed consent or for showing the value of the research to this specific patient population. New issues are arising that relate to earlier diagnosis using biomarkers and (possibly soon) the use of drugs that modify disease progression. We here summarize and discuss the different ethical issues associated with AD from a historical perspective, with emphasis on diagnostic and treatments issues.
Burgess, John Timothy Freedom
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…
One of the fundamental pedagogical questions in teaching about human rights, war, and global citizenship is how to educate students to care about strangers whom they may never know and whom they may assume they have nothing in common with. At its core, this is an ethical question that highlights a problem in articulating relations between self and…
Heimer, Carol A
Using ethnographic material collected between 2003 and 2007 in five HIV clinics in the US, South Africa, Uganda, and Thailand, this article examines "official ethics" and "ethics on the ground." It compares the ethical conundrums clinic staff and researchers confront in their daily work as HIV researchers with the dilemmas officially identified as ethical issues by bioethicists and people responsible for ethics reviews and compliance with ethics regulations. The tangled relation between ethical problems and solutions invites a comparison to Rittel and Webber's "wicked problems." Official ethics' attempts to produce universal solutions often make ethics problems even more wickedly intractable. Ethics on the ground is in part a reaction to this intractability.
Prograis, Lawrence J
More than 70 years have passed since the beginning of the Public Health Service syphilis study in Tuskegee, Alabama, and it has been over a decade since President Bill Clinton formally apologized for it and held a ceremony for the Tuskegee study participants. The official launching of the Tuskegee University National Center for Bioethics in Research and Health Care took place two years after President Clinton's apology. How might we fittingly discuss the Center's 10th Anniversary and the topic 'Commemorating 10 Years: Ethical Perspectives on Origin and Destiny'? Over a decade ago, a series of writers, many of them African Americans, wrote a text entitled 'African-American Perspectives on Biomedical Ethics'; their text was partly responsible for a prolonged reflection by others to produce a subsequent work, 'African American Bioethics: Culture, Race and Identity'. What is the relationship between the discipline of bioethics and African American culture? This and related questions are explored in this commentary.
Huhtala, Mari; Kinnunen, Ulla; Feldt, Taru
We investigated school psychologists' experiences of ethical strain (the frequency of ethical dilemmas at work and the stress caused by these dilemmas) and dilemma-related rumination outside working hours. Individual latent profiles were estimated at the study baseline based on these three dimensions. The psychologists' weekly well-being (vigor,…
Lozano, J Félix; Palau-Salvador, Guillermo; Gozálvez, Vincent; Boni, Alejandra
Agricultural engineers' jobs are especially related to sustainability and earth life issues. They usually work with plants or animals, and the aim of their work is often linked to producing food to allow people to improve their quality of life. Taking into account this dual function, the moral requirements of their day-to-day professional practice are arguably greater than those of other professions. Agricultural engineers can develop their ability to live up to this professional responsibility by receiving ethical training during their university studies, not only by taking courses specifically devoted to ethics, but also by having to deal with moral questions that are integrated into their technical courses through a program of Ethics Across the Curriculum (EAC). The authors feel that a suitable pedagogical technique for achieving this goal is the use of moral dilemmas, following Kohlberg's theory of levels of morality (1981), with the final objective of attaining a post-conventional level. This paper examines the possibilities and limitations of using moral dilemmas as a pedagogical technique for training agricultural engineers. The cases, discussions, and evaluation used in the Agricultural Engineering Department of the Technical University of Valencia (Spain) are also presented.
Hartley, Craig H.
Compares the reactions of photojournalists and the public to hypothetical ethical dilemmas confronting press photographers. Concludes that the two groups disagree significantly in their reactions to 17 of 19 ethical situations. (FL)
Chang, Pei-Fen; Wang, Dau-Chung
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.
Atuesta, Juana; Vásquez, Pablo; Roa, Juan David; Acuña, Hilda
Decision-making is one of the most difficult tasks of medical judgment, especially when cases involve paediatric patients with different cultural characteristics. It is the obligation of clinical ethics, taking the interdisciplinary approach as a tool to comprehensively analyse the clinical, social, cultural and legal aspects, among other topics, when choosing the treatment options that will be more beneficial for the patient. A clinical case, should enable this process of analysis and teamwork to be understood in practical way in order to address difficult medical problems.
Löfström, Erika; Pyhältö, Kirsi
This study focused on exploring students' and supervisors' perceptions of ethical problems in doctoral supervision in the natural sciences. Fifteen supervisors and doctoral students in one research community in the natural sciences were interviewed about their practices and experiences in the doctoral process and supervision. We explored to what…
Patricia Bizzell argues that inquiry into ethics and English studies is paralyzed by the view that "the imposition of ideological agendas...[is]...morally questionable," yet "our moral sensibility motivates us to promote particular ethic positions." The field is caught in this dilemma because its postmodern skepticism forces it…
Ferencz-Kaddari, Michall; Shifman, Annie; Koslowsky, Meni
At the core of all therapeutic and medical practice lies ethics. By applying an expanded Ajzen's Theory of Planned Behavior formulation, the present investigation tested a model for explaining psychologists' intention to behave ethically. In the pretest, dual relationships and money conflicts were seen as the most prevalent dilemmas. A total of 395 clinical psychologists filled out questionnaires containing either a dual relationship dilemma describing a scenario where a psychologist was asked to treat a son of a colleague or a money-focused dilemma where he or she was asked to treat a patient unable to pay for the service. Results obtained from applying the expanded Ajzen's model to each dilemma, generally, supported the study hypotheses. In particular, attitudes were seen as the most important predictor in both dilemmas followed by a morality component, defined here as the commitment of the psychologist to the patient included here as an additional predictor in the model. The expanded model provided a better understanding of ethical intention. Practical implications were also discussed.
Clinical trials with antidotes are difficult to perform for a variety of practical, ethical, and financial reasons. As acute poisoning is a rare event, the commercial interest in basic and clinical research is low. Poisoned patients are usually not available for normal clinical trial procedures and, if they are, they cannot give informed consent. This situation results in a dilemma: antidotes are essential drugs. A resolution of the Council of Europe requests to guarantee the optimal availability of antidotes and the improvement of their use. As comprehensive data on the efficacy of antidotes are often missing, a marketing authorisation under exceptional circumstances according to Article 14(8) of Regulation (EC) No. 276/2004, will often be the only way to get an approval, as: (1) the indications for which the product in question is intended are encountered so rarely that the applicant cannot reasonably be expected to provide comprehensive evidence ("orphan drug"), (2) in the present state of scientific knowledge, comprehensive information cannot be provided, or (3) it would be contrary to generally accepted principles of medical ethics to collect such data. Typically, data on antidotes are obtained from a patchwork of studies with animals, human tissue and a few observations from human poisoning corroborated with data from clinical observations and biochemistry. Generalisations from chemical and mechanistic similarities between groups of poisons are usual, but often lack scientific evidence. Current standards of good clinical practice can rarely be observed. Therefore, public funding and other financial support are necessary incentives to initiate trials in this important area.
Mitchell, Regina L. Garza
The blending of technology and education introduces ethical issues for colleges. In particular, those involved with online education may encounter unique dilemmas that have collegewide implications. In order for ethical decisions to be made in regard to online education, colleges must cultivate a culture of trust, define clearly the correct and…
Hollingsworth, Leslie Doty
Developments in assisted reproductive technologies have made it possible for couples to select the sex of a child prenatally. This article used the NASW Code of Ethics and information from the Ethics Committee of the American Society of Reproductive Medicine to consider ethical dilemmas related to social justice (for example, reinforcement of…
Flach, Frederic, Ed.
Volume of 4 and 5 contain lessons that provide expert information on a variety of ethical issues in professional counseling. The lessons included in these volumes may be applied toward continuing education credits. Lessons in volume 4 are: (1) "Ethics in Substance Abuse Rehabilitation" (Robert L. Hewes); (2) "Ethical Dilemmas in…
Kirby, L C; Banerjee, A; Augustine, T; Douglas, J F
Malignant melanoma is a high-risk skin cancer that, in potential transplant recipients, is considered a substantial contraindication to solid organ transplantation due to significant risk of recurrence with immunosuppression. Current guidelines stipulate waiting between 3 and 10 years after melanoma diagnosis. However, in young patients with end-stage organ failure and malignant melanoma, complex ethical and moral issues arise. Assessment of the true risk associated with transplantation in these patients is difficult due to lack of prospective data, but an autonomous patient can make a decision that clinicians may perceive to be high risk. The national and worldwide shortage of available organs also has to be incorporated into the decision to maximize the net benefit and minimize the risk of graft failure and mortality. The incidence of malignant melanoma worldwide is increasing faster than that of any other cancer and continues to pose ethically challenging decisions for transplant specialists evaluating recipients for solid organ transplantation.
Castleberry, Stephen B.
As a marketing analyst, Eric is faced with several ethical dilemmas. When asked to engage in unethical and illegal behavior, Eric must decide whether to obey his boss and fudge the numbers (the counts of product purchased in order to get reimbursed more from the manufacturer during special sales) or take the ethical route. The case consists of two…
Palermo, Josephine; Evans, Adrian
Lawyers' values might be considered to play some role in the decisions that are made in everyday legal practice. This study aimed to explore the effects of personal value hierarchies on ethical decision making within the context of several ethical dilemmas. A questionnaire was administered utilizing hypothetical situations presented in 11 ethical scenarios and including the Rokeach Value Survey. Logistic regression results suggested that different personal values were significant predictors of reported behavioral choices on respective ethical scenarios. However, the most important values associated with behavior consistent with ethical conduct in scenarios were 'honesty' and 'equality'. The implications of results are discussed in the contexts of ethics education in a tertiary educational environment and in relation to regulation for the professions.
This study attempts to describe Jewish teachers' perceptions about their ethical dilemmas based on stories derived from the Bible. Sixty teachers were asked to submit descriptions of their ethical dilemmas to the study website; submissions were then discussed in focus groups. The findings were grouped by the ATLAS.ti into five categories: Telling…
Holzweiss, Peggy; Walker, Daniel
While ethical standards exist in higher education, they are often vague and do not identify the dilemmas new professionals are likely to encounter on the job. This article highlights results of a qualitative study identifying ethical dilemmas experienced by administrators in the field and compares results to the ethical framework developed by…
Bugarín-González, R; Bugarín-Diz, C
Gender violence is a health problem that occasionally gives rise to ethical dilemmas for the family doctor. One of the most important conflict is probably when a patient admits to being abused by her partner, but appeals to keep the information confidential, and refuses to present an injury report. There also other problematic situations. This essay attempts to reflect on these issues and help professionals in making decisions.
The criteria for determining what it is to do good medical ethics are the quality of ethical analysis and ethical justifications for decisions and actions. Justifications for decisions and actions rely on ethical principles, be they the 'famous four' or subsidiary ethical principles relevant to specific contexts. Examples from clinical ethics, research ethics and public health ethics reveal that even when not stated explicitly, principles are involved in ethical justifications. Principles may come into conflict, however, and the resolution of an ethical dilemma requires providing good reasons for preferring one principle over another.
Cook, Rebecca J; Dickens, Bernard M
Intimate partner violence (IPV), usually men's violence against women, appears universal. It may be associated with pregnancy, but this may be because pregnant women receive more medical attention. Violence may cause bruises, abrasions, and cuts, but its extremes include hospitalization, death, and suicide. IPV is often disclosed when women are asked why they feel in poor health or depressed. A legal dilemma arises when healthcare providers consider that intervention such as law-enforcement is appropriate, but patients refuse approval. Patients may fatalistically accept violence, or fear loss of support for their children and themselves if their partners are held in custody. Legal reforms, such as punishing spousal rape, may provide some protection of women's autonomy. Ethical dilemmas concern intervention without patients' approval, and whether treating violent injuries without taking preventive action breaches the principle to Do No Harm. Professional advocacy and social action have been urged to expose and reduce IPV.
Eyal, Ori; Berkovich, Izhak; Schwartz, Talya
Purpose: Scholars have adopted a multiple ethical paradigms approach in an attempt to better understand the bases upon which everyday ethical dilemmas are resolved by educational leaders. The aim of this study is to examine the ethical considerations in ethical judgments of aspiring principals. Design/methodology/approach: To examine the ethical…
Qualters, Donna M.; McDaniels, Melissa; Cohen, Perrin
Although universities often teach ethics courses, they do not always teach students how to apply ethical course content to ethical dilemmas they encounter on a day-to-day basis. The Awareness-Investigation-Responding (AIR) model of ethical inquiry bridges this gap by scaffolding the reflective process and empowering students to make more caring,…
Pettit, John D., Jr.; And Others
Outlines a theoretical framework of ethics, power, and communication in the workplace, which provides a backdrop for viewing ethical decisions. Explains that business managers are often caught in a dilemma between job pressures and personal ethical codes. Proposes communication as a means of fostering more ethical organizational behavior. (SG)
Favaloro, Emmanuel J; Bonar, Roslyn; Survela, Lesley; McDonald, David; Koutts, Jerry; Sioufi, John; Marsden, Katherine
A prothrombotic and hemorrhagic state can separately manifest in one patient and can potentially cause several diagnostic problems. We report an intriguing case as an example of a potential hemostasis-based diagnostic dilemma. A 29-year-old female patient presented with a personal history of menorrhagia and other mucosal bleeding and renal ovarian thrombosis. Previous investigations had uncovered several diagnostic anomalies, including von Willebrand disease (VWD), factor V Leiden (FVL), antiphospholipid syndrome, and thrombocytopaenia. Previous therapy in this patient included heparin and warfarin for the thrombosis and desmopressin acetate (DDAVP) and antifibrinolytic therapy for surgical management. Subsequent laboratory testing with fresh samples consistently confirmed an equivocal (borderline normal/abnormal) level of von Willebrand factor (VWF) and FVL with activated protein C resistance (APCR). A patient sample, differentially labeled according to the tests being performed, was later distributed for blind testing to participants within several modules of the RCPA Quality Assurance Program (QAP). Most participants reported a low level of VWF consistent with possible mild Type 1 VWD, and most (but not all) reported a positive finding for APCR. All participants correctly reported the sample as heterozygous for the FVL mutation, negative for the Prothrombin gene mutation G20210A, and heterozygous for the methylenetetrahydrofolate reductase (MTHFR) mutation C677T. Interestingly, a significant number of laboratories performing Protein S testing using clot-based procedures also identified a false Protein S deficiency. In conclusion, this exercise showed how, either depending on the clinical review and specific laboratory investigation and tests performed, a pro-bleeding diagnosis (of either VWD or thrombocytopenia) or pro-thrombophilia risk (Antiphospholipid Syndrome or FVL/APCR or false Protein S deficiency) could potentially and differentially arise in the one
Gericke, C A; Riesberg, A; Busse, R
This essay outlines the moral dilemma of funding orphan drug research and development. To date, ethical aspects of priority setting for research funding have not been an issue of discussion in the bioethics debate. Conflicting moral obligations of beneficence and distributive justice appear to demand very different levels of funding for orphan drug research. The two types of orphan disease, rare diseases and tropical diseases, however, present very different ethical challenges to questions about allocation of research funds. The dilemma is analysed considering utilitarian and rights based theories of justice and moral obligations of non-abandonment and a professional obligation to advance medical science. The limitations of standard economic evaluation tools and other priority setting tools used to inform health policy decision makers on research funding decisions are outlined.
Jordan, Bertrand R; Tsai, Daniel Fu Chang
This paper examines some ethical issues arising from whole-genome association studies for multigenic diseases, focusing on the case of autism. Events occurring following the announcement of a genetic test for autism in France (2005-2009) are described to exemplify the ethical controversies that can arise when genetic testing for autism is applied prematurely and inappropriately promoted by biotech companies. The authors argue that genetic tests assessing one or a few genes involved in highly multigenic disorders can only be useful if: (1) the genetic linkage found in the scientific study must be statistically convincing, reproducible and also applicable to the population to which the individual considered belongs (scientific validity); (2) the relative risk conferred by the 'high-risk' allele should be high enough to be significant to the patient (significant impact); (3) use of the test should lead to some improvement of outcome for the patient, resulting from adapted treatment if available, or at least from adjustment of lifestyle (or life goals) prompted by the new knowledge generated (clinical utility). Decisions concerning genetic testing for autism involve scientific judgement, value judgement and good knowledge of a constantly evolving therapeutic environment. The implementation of genetic tests for highly multigenic diseases thus requires strong mechanisms to ensure that they are used in a fashion that can benefit patients, and these mechanisms must be able to cope with rapid progress in scientific knowledge and therapeutic intervention.
Trudell, B; Whatley, M H
In view of the recent proliferation of school sexual abuse prevention programs and materials, this article critically examines current assumptions about the role of elementary school personnel in prevention and possible unintended consequences of such assumptions. These unintended consequences include emphasizing a simple solution to a complex social problem and contributing to victim blaming. Some dilemmas that arise for classroom teachers around predeveloped curricular materials and mandatory reporting are also explored. Teacher use of predeveloped materials may mean a diminishing of wider teaching skills and reduction of complex concepts to brief, noncontroversial interventions that may serve to mystify sexuality and unduly frighten students. Mandatory reporting, as it is frequently presented to teachers, can create further dilemmas by obscuring the ethical decisions inherent in the process, assuming consistently positive outcomes after reporting, and neglecting the context in which teachers work. The authors suggest that educators should be aware of these possible unintended consequences and dilemmas in order to maintain a broad perspective on child sexual abuse and to focus their efforts more effectively within a larger network addressing the problem.
Finkelhor, David; Lannen, Patricia
The goal of this commentary is to articulate some issues and dilemmas raised by various efforts to mobilize international action around child abuse and neglect (CAN). We will start by proposing a typology of international mobilization strategies, noting that initiatives to promote CAN programming in new settings have tended to emphasize one of three vectors: governments, professionals, or international NGOs. There are pros and cons to each emphasis, which we discuss. We also review the debates around some of the following dilemmas: Should low-income countries be a top priority for CAN mobilization? Are there cultural and institutional capacities that need to be present in a country in order for CAN programs to work or be ethical? Are some CAN programs more likely to be internationally transferable than others and why so? Has the field adequately considered whether non-CAN programming (e.g., family planning) might actually be more effective at preventing maltreatment than CAN programming? Does the field give adequate acknowledgment that policies and practices emanating from high-resourced and Western countries may not always be the best to disseminate? Are we relying too much on a model of program transplantation over a model of local cultivation? Should we aim for modest rather than ambitious accomplishments in international mobilization? How much emphasis should be placed on the priority dissemination of evidence-based programming? We conclude with some suggestions in the service of clarifying these dilemmas and making some of these decisions more evidence based.
This paper suggests that design ethics can be enriched by considering ethics beyond the traditional approaches of deontology, teleology, and virtue ethics. Design practice and design ethics literature tend to frame ethics in design according to these approaches. The paper argues that a fundamental and concrete ethical understanding of design ethics can also be found in Sartrean Existentialism, a philosophy centered on the individual and his/her absolute freedom. Through the analysis of four core concepts of Sartrean Existentialism that define a specific ethics, the paper illustrates why such philosophical approach is relevant to design ethics. The paper also shows how Sartrean Existentialism and its ethics apply to critical issues of professional practice in design such as professional engagement and design decision-making. The paper finally argues that Sartre's philosophy and ethics is a perspective that offers the designer in design practice a solid ground to engage his/her ethical dilemma.
Oishi, Koji; Cebrian, Manuel; Abeliuk, Andres; Masuda, Naoki
The Internet has enabled the emergence of collective problem solving, also known as crowdsourcing, as a viable option for solving complex tasks. However, the openness of crowdsourcing presents a challenge because solutions obtained by it can be sabotaged, stolen, and manipulated at a low cost for the attacker. We extend a previously proposed crowdsourcing dilemma game to an iterated game to address this question. We enumerate pure evolutionarily stable strategies within the class of so-called reactive strategies, i.e., those depending on the last action of the opponent. Among the 4096 possible reactive strategies, we find 16 strategies each of which is stable in some parameter regions. Repeated encounters of the players can improve social welfare when the damage inflicted by an attack and the cost of attack are both small. Under the current framework, repeated interactions do not really ameliorate the crowdsourcing dilemma in a majority of the parameter space. PMID:24526244
Oishi, Koji; Cebrian, Manuel; Abeliuk, Andres; Masuda, Naoki
The Internet has enabled the emergence of collective problem solving, also known as crowdsourcing, as a viable option for solving complex tasks. However, the openness of crowdsourcing presents a challenge because solutions obtained by it can be sabotaged, stolen, and manipulated at a low cost for the attacker. We extend a previously proposed crowdsourcing dilemma game to an iterated game to address this question. We enumerate pure evolutionarily stable strategies within the class of so-called reactive strategies, i.e., those depending on the last action of the opponent. Among the 4096 possible reactive strategies, we find 16 strategies each of which is stable in some parameter regions. Repeated encounters of the players can improve social welfare when the damage inflicted by an attack and the cost of attack are both small. Under the current framework, repeated interactions do not really ameliorate the crowdsourcing dilemma in a majority of the parameter space.
Buxton, Margaret; Phillippi, Julia C; Collins, Michelle R
The importance of ethical conduct in health care was acknowledged as early as the fifth century in the Hippocratic Oath and continues to be an essential element of clinical practice. Providers face ethical dilemmas that are complex and unfold over time, testing both practitioners' knowledge and communication skills. Students learning to be health care providers need to develop the knowledge and skills necessary to negotiate complex situations involving ethical conflict. Simulation has been shown to be an effective learning environment for students to learn and practice complex and overlapping skills sets. However, there is little guidance in the literature on constructing effective simulation environments to assist students in applying ethical concepts. This article describes realistic simulations with trained, standardized patients that present ethical problems to graduate-level nurse-midwifery students. Student interactions with the standardized patients were monitored by faculty and peers, and group debriefing was used to help explore students' emotions and reactions. Student feedback postsimulation was exceedingly positive. This simulation could be easily adapted for use by health care education programs to assist students in developing competency with ethics.
Carmack, Heather J; DeGroot, Jocelyn M
More people are turning to the Internet to communicate about dying, death, and grief experiences. This theoretical article explores the ethical dilemmas, challenges, and opportunities presented to researchers interested in exploring how death and grief are communicated online. Weaving together the literatures of computer-mediated communication and thanatology (dying and death), we discuss the ways in which many common ethical dilemmas uniquely manifest related to death and grief. We also explore the emotional impact studying death and grief online has on researchers and the importance of thinking about researcher emotions on scholars who study these issues. We end with recommendations of how to move forward in the dialogue about ethics and studying death and grief online.
Perry, Joshua E; Moore, Ilene N; Barry, Bruce; Clayton, Ellen Wright; Carrico, Amanda R
Writing in 1999, legal ethics scholar Brad Wendel noted that "[v]ery little empirical work has been done on the moral decision making of lawyers." Indeed, since the mid-1990s, few empirical studies have attempted to explore how attorneys deliberate about ethical dilemmas they encounter in their practice. Moreover, while past research has explored some of the ethical issues confronting lawyers practicing in certain specific areas of practice, no published data exists probing the moral mind of health care lawyers. As signaled by the creation of a regular column "devoted to ethical issues arising in the practice of health law" in the Journal of Law, Medicine & Ethics, the time to address the empirical gap in the professional ethics literature is now. Accordingly, this article presents data collected from 120 health care lawyers. Presenting this population with a number of hypothetical scenarios relating to how they would respond when confronting an ethical dilemma without an obvious solution or when facing a situation in which their personal values were in tension with their professional obligations, this article represents a first step toward better understanding how lawyers who practice in health care settings understand and resolve the moral discomfort they encounter in their professional lives.
The present research examined pet ownership, current pet diet, and guilt associated with pet diet among a fairly large sample of non-meat-eaters (n=515). It specifically focused on the conflict that pits feeding one's pet an animal-based diet that may be perceived as best promoting their well-being with concerns over animal welfare and environmental degradation threatened by such diets, here labeled the vegetarian's dilemma. Questionnaire responses indicated that ethically motivated meat abstainers were more likely to own pets and owned more of them than those motivated by health concerns or a combination of ethical and health concerns. Vegans and those resisting meat on ethical grounds were more likely to feed their pet a vegetarian diet and expressed the greatest concerns over feeding their pet an animal-based diet. For vegans and ethical meat abstainers, it is suggested that questions concerning what to feed their pet approaches a tragic tradeoff contrasting two sacred values: protecting the well-being of their pets and protecting the well-being of other animals and the environment. For meat abstainers motivated by health concerns, this constitutes a relatively easy moral problem because the primary concern for such individuals is the health of their pet with less or no regard for other ramifications of the decision, i.e., harming other animals or the environment.
Kromberg, Jennifer G R; Wessels, Tina-Marié
The practice of genetic counselling gives rise to many ethical dilemmas, and counsellors need to be familiar with the principles of biomedical ethics. The primary principles include respect for autonomy, beneficence, non-maleficence and justice. A case of identical twins at 50% risk for Huntington's disease, in which only one twin sought predictive testing for this dominantly inherited disease, created several ethical dilemmas. Another case where predictive testing was carried out on two young children, at high risk, by a laboratory at the request of an adoption agency and a doctor, with a view to giving information to the foster parents, also posed many ethical conundrums for the counsellor. The ethical issues that arose in these cases are discussed in this paper.
Botella, Juan; Narvaez, Maria; Martinez-Molina, Agustin; Rubio, Victor J.; Santacreu, Jose
Risk propensity (RP) is a trait characterized by an increased probability of engaging in behaviors that have some potential danger or harm but also provide an opportunity for some benefit. In the present study, a new RP task with several dilemmas was explored. Each dilemma includes the initial set plus successive approximations for estimating the…
Stanwick, Peter A.
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…
In today's organizations, ethical challenges relate to areas like fraud, right to privacy for consumers, social responsibility, and trade restrictions. For Information Technology (IT) specifically, these can translate to considerations on how technology is used to violate people's privacy, how automation leads to job reductions, or how management…
Hill, T P
Thirty years ago, the idea that culture and philosophy could provide a foundation for normative medical ethics was more easily entertained than it is today when the very notion of a norm, whether culturally, philosophically or ethically derived, is in itself a problem. In large measure this comes from our contemporary embrace of cultural and philosophical pluralism and an increasing tendency to exchange the difficult belief in abstract and universally applicable norms for the more accessible notion that ethical values are cultural and relative derivatives. Despite this, in the face of the unprecedented ethical dilemmas presented by modern medicine, we have attempted to apply traditional ethical norms and analysis to modern medicine to establish a consensus for its right practice. Unfortunately, the attempt has not been successful, so that wherever we turn we find that ethical problems in medicine remain intractable and unresolved. That, in turn, has prompted a certain scepticism about the efficacy of ethics in medicine. In order to understand why we have reached this impasse, it is essential to realize that we have seriously underestimated the way science and technology have informed and, as a consequence, transformed the practice of medicine. Contributing to this, our tendency to think of technology simply as a way of doing things has blinded us to the fact that it is more fundamentally a way of thinking, knowing and valuing.(ABSTRACT TRUNCATED AT 250 WORDS)
Lévesque, Lise; Ozdemir, Vural; Gremmen, Bart; Godard, Béatrice
Nutrigenomics is a subspecialty of nutrition science which aims to understand how gene-diet interactions influence individuals' response to food, disease susceptibility, and population health. Yet ethical enquiry into this field is being outpaced by nutrigenomics bioscience. The ethical issues surrounding nutrigenomics face the challenges of a rapidly evolving field which bring forward the additional dimension of crossdisciplinary integrative research between social and biomedical sciences. This article outlines the emerging nutrigenomics definitions and concepts and analyzes the existing ethics literature concerning personalized nutrition and presents "points to consider" over ethical issues regarding future nutrigenomics applications. The interest in nutrigenomics coincides with a shift in emphasis in medicine and biosciences toward prevention of future disease susceptibilities rather than treatment of already established disease. Hence, unique ethical issues emerge concerning the extent to which nutrigenomics can alter our relation to food, boundaries between health and disease, and the folklore of medical practice. Nutrigenomics can result in new social values, norms, and responsibilities for both individuals and societies. Nutrigenomics is not only another new application of "-omics" technologies in the context of gene-diet interactions. Nutrigenomics may fundamentally change the way we perceive human illness while shifting the focus and broadening the scope of health interventions from patients to healthy individuals. In resource- and time-limited healthcare settings, this creates unique ethical dilemmas and distributive justice issues. Ethical aspects of nutrigenomics applications should be addressed proactively, as this new science develops and increasingly coalesces with other applications of genomics in medicine and public health.
Weidman, Justin; Coombs, Dawan
Students had just participated in an experiential learning exercise where they played dodgeball using marshmallows, but the unique context of the game introduced ethical dilemmas that integrated ethics education into a technical education classroom setting. Research shows that "Engineering curriculum and activities at the K-12 level should be…
Journal of Health Education, 1994
The Association for the Advancement of Health Education's code of ethics for health educators provides a common set of values to guide health educators in resolving ethical dilemmas, focusing on responsibility to the public, to the profession, and to employers in delivering health education and in research and evaluation. (SM)
A new interactive computer simulation designed to teach sales ethics is described. Simulation learner objectives include gaining a better understanding of legal issues in selling; realizing that ethical dilemmas do arise in selling; realizing the need to be honest when selling; seeing that there are conflicting demands from a salesperson's…
Lasser, Jon; Klose, Laurie McGarry; Robillard, Rachel
Ethical codes and licensing rules provide foundational guidance for practicing school psychologists, but these sources fall short in their capacity to facilitate effective decision-making. When faced with ethical dilemmas, school psychologists can turn to decision-making models, but step-wise decision trees frequently lack the situation…
Leuter, Cinzia; Petrucci, Cristina; Mattei, Antonella; Tabassi, Gianpietro; Lancia, Loreto
Ethical difficulties arise in healthcare practices. However, despite extensive research findings that demonstrate that most nurses are involved in recurrent ethical problems, institutions are not always able to effectively support nursing care professionals. The limited availability of ethics consultation services and traditional nursing training fails to meet the frequent and strong requests by health workers to support their ethical dilemmas. A questionnaire was administered to 374 nurses attending a specialist training and a lifetime learning programme in Italy. The respondents reported a high frequency of ethically sensitive situations, and they described the poor development of ethics support and a scarcity of ethics training programmes. The results suggest the importance of promoting ethics services that include consultation and ethics training. A need for systematic ethics educational activities was identified for improving the capacity of nurses to manage ethical issues in patient care.
Haldane, J J
Contemporary medical ethics is generally concerned with the application of ethical theory to medico-moral dilemmas and with the critical analysis of the concepts of medicine. This paper presents an alternative programme: the development of a medical philosophy which, by taking as its starting point the two questions: what is man? and, what constitutes goodness in life? offers an account of health as one of the primary concepts of value. This view of the subject resembles that implied by ancient theories of goodness, and in later sections of the paper it is shown how Aristotle points us towards a coherent theory of human nature as psycho-physical, which overcomes the inadequacies of dualism and physicalist reductionism. What is on offer therefore, is the prospect of an integrated account of human nature and of what constitutes its flourishing: to be healthy is to be an active unity-of-parts in equilibrium.
Dailor, A. Nichole; Jacob, Susan
Practitioner-members of the National Association of School Psychologists (N = 208) completed questionnaires regarding their ethics training, preparedness, the types of ethical transgressions and dilemmas encountered in the previous year, and the strategies used to solve problems. Respondents who received multilevel training in ethics (ethics…
Starting with a complex clinical situation we introduce basic concepts of clinical ethics. We explain why well-defined terms are needed and demonstrate how these terms can be used as practical tools for approaching and resolving ethical dilemmas in a professional decision-making process. It will be outlined how the use of these terms may contribute to the understanding of the ways in which moral values are perceived and communication skills can be improved.
Donoho, Casey; Heinze, Timothy; Kondo, Christopher
Sales career opportunities are growing, and the number of women in sales is increasing. Educators must adequately prepare both men and women for today's ethical sales dilemmas. Using the Personal Selling Ethics Scale, the current study analyzes the impact of idealism and relativism on the sales ethics evaluations of men and women. Results indicate…
Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor
The scientific and technological advances have been surprising, more in the two last decades, but they don't go united with to the ethical values of the medical professional practice, it has been totally escaped, specially when the biological subsistence, the maintenance of the life through apparatuses and the mechanisms that prolong the existence are who undergoes an alteration that until recently time was mortal shortly lapse. It is common listening that exist a crisis in the medical profession, but what really is it of human values, which as soon and taken into nowadays, actually professional account, which gives rise to a dehumanization towards the life, the health, the disease, the suffering and the death. The ideal of the doctor to give to service to the man in its life and health, as well to be conscious that the last biological process that must fulfill is the death, and when it appears, does not have considered as a actually professional failure. It has protect to the patient as the extreme cruelty therapeutic, that it has right a worthy death. It's taking to the birth of the hospital ethics committees, they have like function to analyze, to advise and to think about the ethical dilemmas that appear actually clinical or in the biomedical investigation. In 1982 in the UEA only 1% of its hospitals had a ethics committees; by 1988, it was 67% and the 100% in 2000. In Mexico the process of the formation by these committees begins, only in the Military Central Hospital, to count the ethics committee on 1983, also the Hospital no. 14 of the IMSS in Guadalajara, it works with regularity from 1995, with internal teaching of bioethic. The Secretariat of Health has asked the formation of the bioethical committees in each hospital, and order the it was be coordinated by the National Committee of Bioética. The integration of these committees is indispensable that their members have the knowledge necessary of bioética. The Mexican Society of Ortopedia, conscious of
Thornton, J. G.; Lilford, R. J.
An informal clinical ethics committee was set up to advise on ethical problems in prenatal diagnosis in Leeds. It was used twice in six months but was not called on again in the subsequent year, and we describe this experience. In North America similar committees are often used to advise on clinical moral dilemmas, and we review the published evidence from there and discuss some of the advantages and problems. Our committee's advice may have altered clinicians' actions considerably, but perhaps doctors in Britain are not yet ready to surrender this aspect of clinical autonomy. PMID:7549638
Thompson, Morris M.
According to the Code of Ethics of the American Society for Photogrammetry and Remote Sensing (ASPRS), the principles on which ethics are founded consist of honesty, justice, and courtesy, forming a moral philosophy associated with mutual interest among men. We will cover in particular the ethical problems of publication of photogrammetric material in the various media. There are many such problems, and we often face a dilemma in selecting a course which is the right thing to do.
This paper suggests that medical ethics is often based on assumptions, commonly shared in modern medicine, which can cause problems and which need to be questioned. Two contrasting yet complementary ways of thinking about ethical dilemmas in neonatal care are described as the 'separation' and the 'attachment' approaches. The contribution of medical ethics to the substance and quality of discussions between doctors and parents is considered. PMID:2952801
Zwi, A B; Grove, N J; MacKenzie, C; Pittaway, E; Zion, D; Silove, D; Tarantola, D
Issues of power and consent, confidentiality, trust, and benefit, risks to researchers, and potential harm to participants, are all contested when working with different cultures and within environments marked by violence and insecurity. Difficulty resolving these dilemmas may paralyse ethics committees, may fail to give the guidance sought by researchers, and will not help populations who are among the world's most vulnerable. Even where efforts are made to respond to ethical guidelines and to improve practice, considerable impediments are present in many developing countries, including lack of formal ethical review structures in unstable settings, lack of required skills, limited political and institutional recognition of ethical issues, competing interests, and limitations in clinical and research practice (Elsayed 2004, Macklin 2004). In conflict settings, these limitations are more marked, and the responsibilities of the researcher for ethical practice are greater, but the mechanisms for oversight are weaker. Moreover, the constant focus on vulnerabilities and problems, and the often almost total lack of recognition of strengths and resilience, can further disempower already exploited groups and individuals. The capacity of refugees and communities in conflict to take an active role in the research process is seldom acknowledged, and undermines the potential for more innovative research which can help generate the evidence for better policy and practice.
Lyons, Rachel; Reinisch, Courtney
Social media is a growing and popular means of communication. It is understandable that health care providers may not share identifying information on patients through these sources. Challenges arise when patients and family members wish to record the care provided in the emergency department. The health care provider may be faced with an ethical and possibly legal dilemma when social media is present in the emergency department. This article seeks to discuss the legal and ethical principles surrounding social media in the emergency department.
Ladd, Lawrence R.
Released in conjunction with the "Sustaining an Ethical Culture on Campus" webcast, this essay in the "Perspectives" series examines the complexities of the role of the chief financial officer. This white paper focuses on how the financial leader of an institution must balance technical knowledge along with stellar…
Brandenburg, Robyn; Gervasoni, Ann
The ethical practice underpinning self-study research has been addressed extensively in the literature of self-study of teacher education practices. Less attention has been paid to how researchers deal with ethical tensions and dilemmas when they arise unexpectedly during self-study research. In this article, we examine how the extrapolation and…
Martins, Julia; Fortmüller, Richard; Powell, Owen
Economics and business students regularly behave less prosocially than others. Can ethics training reverse this tendency? Results from a repeated public goods experiment reveal that it can. Students who attend an interactive lecture on social dilemmas show significantly more cooperation than others. However, the lecture does not appear to increase…
Kim, Hye Won
This paper explores the challenges and dilemmas raised by my own experience of researching an immigrant Korean child at an ethnic Sunday School where I taught. I review the ethical and methodological challenges raised in my interactions with the child as an insider researcher from the ways I approached consent forms through to interview…
Matejić, Bojana; Kesić, Vesna
The ethics of reproductive health covers a wide field of different issues, from the ethical dimensions of assisted reproduction, life of newborns with disabilities to the never-ending debate on the ethical aspects of abortion. Furthermore, increasing attention is paid to the ethical dimensions of using stem cells taken from human embryos, the creation of cloned embryos of patients for possible self-healing, and the increasingly present issue of reproductive cloning. Development of vaccines against human papillomavirus (HPV) has introduced new ethical aspects related to reproductive health and the need for a consensus of clinical and public-healthcare population. Today immunization with HPV vaccine is a measure for the primary prevention of cervical cancer and it provides effective protection against certain types of viruses included in the vaccine. The most often mentioned issues of discussions on ethical concerns about HPV vaccination are the recommended age of girls who should be informed and vaccinated (12-14 years), attitudes and fears of parents concerning discussion with their preadolescent daughters on issues important for their future sexual behavior, dilemma on the vaccination of boys and the role of the chosen pediatrician in providing information on the vaccination. In Serbia, two HPV vaccines have been registered but the vaccination is not compulsory. Up-till-now there has been no researches on the attitudes of physicians and parents about HPV vaccination. Nevertheless, it is very important to initiate education of general and medical public about the fact that the availability of vaccine, even if we disregard all aforementioned dilemmas, does not lead to the neglect of other preventive strategies against cervical cancer, primarily screening. The National Program for Cervical Cancer Prevention involves organized screening, i.e. regular cytological examinations of the cervical smear of all women aged 25-69 years, every three years, regardless of the
Abma, Tineke A
In nursing ethics the role of narratives and dialogue has become more prominent in recent years. The purpose of this article is to illuminate a relational-narrative approach to ethics in the context of palliative nursing. The case study presented concerns a difficult relationship between oncology nurses and a husband whose wife was hospitalized with cancer. The husband's narrative is an expression of depression, social isolation and the loss of hope. He found no meaning in the process of dying and death. The oncology nurses were not able to recognize his emotional and existential problems. A narrative perspective inspired by relational ethics indicates that participants may develop a relational narrative that seeks good for all involved in a situation. In palliative nursing this entails open communication about the fragility of life and approaching death. In relational narratives, answers to these ethical dilemmas are co-authored, contingent and contextual.
Clinical trials present an ethical dilemma for pharmaceutical companies. While companies may want to undertake and report these trials in an ethical manner, negative results can significantly affect product sales. There is accumulating evidence that company-financed trials are biased in favor of the product that the company makes. Ethical conduct in this article is defined as whether the trials are conducted in the best interests of the participants and/or reported in the best interests of patients. Nine examples of how clinical trials are violating multiple articles in the Declaration of Helsinki are discussed using concrete case reports from the literature. The recognition of ethical problems in company run trials is not something new, but to date no meaningful action has been taken to resolve this issue. What is necessary is to separate the financing of clinical trials from their conduct. PMID:25848540
Rakowski, Cathy A.
Contends that sociologists confront criticism of the nature and ends of sociological research and ethical dilemmas in the study of social problems and people. Provides suggestions for ending neocolonial attitudes among social science researchers. (CFR)
you ever seen or heard in your commands that Bronze Star Medals (BSM) for service are reserved for platoon sergeants wartime service and above...Cross, Bronze Star Medal, Air Medal or Army Commendation Medal for wartime service or achievement. Now the Distinguished Flying Cross and Air Medal...responsibility in wartime service. The Legion ofMerit reserved for Brigade level of responsibility. The Bronze Star Medal reserved for Battalion
1. In the psychiatric community, two highly profitable diagnoses currently are filling psychiatric hospitals: dissociative disorder and multiple personality disorder. Certainly these patients need help, and psychiatric nurses are well-qualified to plan their scope of care. However, when the hospital reported on in this article exploited these diagnoses by encouraging practices that extended lengths of stay and restricted patient's rights, the nurses were forced to speak out as advocates for the patients. 2. The dissociative disorder unit housed 10 patients billed at an intensive care unit rate of $1,200 per day. One patient's average fee per day was $1,560; multiply this by 10 patients, and the hospital received $15,600 per day from this unit alone. 3. Financial calculation is not what nurses are used to thinking about; indeed, it somehow seems unbefitting to link nursing care with any mention of monetary gain. Yet, this is exactly the sort of information that nurses must have in order to understand how hospital politics may influence their situation.
Desai, Geetha; Chaturvedi, Santosh K
Medically unexplained symptoms (MUS) are common across health settings. These are defined as "physical symptoms that prompt sufferer to seek healthcare but remain unexplained after an appropriate medical evaluation". Expectedly, MUS are often associated with significant health-seeking behaviours that add to the burden on health resources.
This article argues that the English legislative regime is ineffective in regulating international surrogacy, particularly with regard to commercial payments. It suggests that if English law views surrogacy as exploitative, we have a responsibility to protect women both in England and abroad, and the only way to do so effectively is to create a domestic system of regulation that caters adequately for the demand in this country. This requires a system of authorisation for surrogacy before it is undertaken; ex-post facto examinations of agreements completed in other jurisdictions, after the child is already living with the commissioning parents, cannot be seen as an acceptable compromise, as authorisation will inevitably be granted in the child's best interests.
This paper examines the methodological dilemmas associated with analytical framing as an aspect of the research process. Doing qualitative research potentially changes a researcher--changes their sense of self, who they think they are, who they want to become. The paper examines the ethical dilemma of what that change might mean--for the project,…
Nowadays, clinicians are faced with multifaceted ethical concerns, and it is often argued that students of medicine should be well trained in clinical ethics and have a minimum level of ethical sensitivity and critical analysis. Consequently, most medical colleges have introduced programs in biomedical ethics. It is often pointed out that there is a gap separating ethical theories from concrete moral dilemmas. This problem became less pervasive as case-studies started being used. Nevertheless, vignettes are mostly presented as an addendum to a unit and often engage the students only "temporarily." It is my contention that this can be remedied if students were given a venue that will allow them to appreciate as many particulars of the situation as possible, to engage in the case not merely as inactive spectators, rather to get entangled in the case just enough to be involved yet remain sufficiently detached to be able to exercise critical analysis. This is possible through medical drama which, I will argue, is a narrative genre that enhances emotional engagement, cognitive development, and moral imagination allowing for a more ethically sensitive student in training. To do that, reference will be made to the medical drama "House MD."
Recent trends in immigration to Poland are reviewed, including both voluntary migration and migration forced by extreme political or economic circumstances. Data are also presented on illegal immigrants and on their countries of origin.
Nejadsarvari, Nasrin; Ebrahimi, Ali; Ebrahimi, Azin; Hashem-Zade, Haleh
Currently, cosmetic surgery is spread around the world. Several factors are involved in this rapidly evolving field such as socio-economic development, changes in cultural norms, globalization and the effects of Western culture, advertising, media, and mental disorders. Nowadays the cosmetic surgery is becoming a profitable business, which deals exclusively with human appearance and less from the perspective of beauty based on physical protests and considering factors such as sex, age, and race. The morality of plastic surgery subspecialty has undergone many moral dilemmas in the past few years. The role of the patient regardless of his unrealistic dreams has questionable ethical dimension. The problem is the loss of human values and replacing them with false values, of pride and glory to a charismatic person of higher status, that may underlie some of the posed ethical dilemmas. Cosmetic surgery has huge difference with the general principle of legal liability in professional orientation, because the objective for cosmetic surgeries is different from common therapeutic purposes. To observe excellence in the medical profession, we should always keep in mind that these service providers, often as a therapist (healer) must maintain a commitment and priority for patient safety and prior to any action, a real apply for this service recipient should be present. Also, patient–physician confidentiality is the cornerstone of medical ethics. In this review, we study the issues addressed and the ways that they can be resolved. PMID:27853683
Nejadsarvari, Nasrin; Ebrahimi, Ali; Ebrahimi, Azin; Hashem-Zade, Haleh
Currently, cosmetic surgery is spread around the world. Several factors are involved in this rapidly evolving field such as socio-economic development, changes in cultural norms, globalization and the effects of Western culture, advertising, media, and mental disorders. Nowadays the cosmetic surgery is becoming a profitable business, which deals exclusively with human appearance and less from the perspective of beauty based on physical protests and considering factors such as sex, age, and race. The morality of plastic surgery subspecialty has undergone many moral dilemmas in the past few years. The role of the patient regardless of his unrealistic dreams has questionable ethical dimension. The problem is the loss of human values and replacing them with false values, of pride and glory to a charismatic person of higher status, that may underlie some of the posed ethical dilemmas. Cosmetic surgery has huge difference with the general principle of legal liability in professional orientation, because the objective for cosmetic surgeries is different from common therapeutic purposes. To observe excellence in the medical profession, we should always keep in mind that these service providers, often as a therapist (healer) must maintain a commitment and priority for patient safety and prior to any action, a real apply for this service recipient should be present. Also, patient-physician confidentiality is the cornerstone of medical ethics. In this review, we study the issues addressed and the ways that they can be resolved.
Friedman, Allon N
Jewish medical ethics is arguably the oldest recorded system of bioethics still in use. It should be of interest to practicing nephrologists because of its influence on the ethical systems of Christianity, Islam, and Western secular society; because of the extensive written documentation of rabbinical response in addressing a broad range of bioethical dilemmas; and in understanding the values of patients who choose to adhere to religious Jewish law. The goal of this review is to provide a brief overview of the basic principles underlying mainstream traditional Jewish medical ethics, apply them to common clinical scenarios experienced in nephrology practice, and contrast them with that of secular medical ethics.
Cuerda-Galindo, E; Sierra-Valenti, X; González-López, E; López-Muñoz, F
Even after the Nuremberg code was published, research on syphilis often continued to fall far short of ethical standards. We review post-World War II research on this disease, focusing on the work carried out in Guatemala and Tuskegee. Over a thousand adults were deliberately inoculated with infectious material for syphilis, chancroid, and gonorrhea between 1946 and 1948 in Guatemala, and thousands of serologies were performed in individuals belonging to indigenous populations or sheltered in orphanages. The Tuskegee syphilis study, conducted by the US Public Health Service, took place between 1932 and 1972 with the aim of following the natural history of the disease when left untreated. The subjects belonged to a rural black population and the study was not halted when effective treatment for syphilis became available in 1945.
Fowler, Marsha D; Davis, Anne J
The large body of literature labeled "ethics in nursing education" is entirely devoted to curricular matters of ethics education in nursing schools, that is, to what ought to be the ethics content that is taught and what theory or issues ought to be included in all nursing curricula. Where the nursing literature actually focuses on particular ethical issues, it addresses only single topics. Absent from the literature, however, is any systematic analysis and explication of ethical issues or dilemmas that occur within the context of nursing education. The objective of this article is to identify the spectrum of ethical issues in nursing education to the end of prompting a systematic and thorough study of such issues, and to lay the groundwork for research by identifying and provisionally typologizing the ethical issues that occur within the context of academic nursing.
Yi, Richard; Rachlin, Howard
As in studies of self-control, a tit-for-tat contingency in an iterated prisoner's dilemma game creates a conflict between maximization of local and global reinforcement. The present experiments examine this conflict in a multiplayer prisoner's dilemma game. Versus tit for tat, cooperation corresponds to self-control; defection, always immediately…
Hansman, Catherine A.
This article examines practical problems encountered in mentoring adult learners in higher education through stories of ethical dilemmas. Each incident illustrates the power that mentors possess and the ethical challenges of using this power to help or hurt proteges. Each example addresses an aspect of such power; the power to remove oneself as a…
Researching actual or purported sexual contact between teachers and students raises many difficult ethical issues, questions and dilemmas, which may help to explain why few have ventured into the field. This experientially based paper addresses key problem areas under the headings of: the ethics of researching a sensitive taboo topic; the ethics…
Hess, Joanne D.
Issues of practice, licensure, and education for associate and bachelor's degree nursing indicate a lack of consensus. The perspective of an ethic of care highlights moral dilemmas that must be resolved because the current state of nursing education and practice is ethically dubious. (SK)
Gruber, Verena; Schlegelmilch, Bodo B.
Ethics education provided by universities in general, and MBA programs aimed at future business leaders in particular, has come under intense public scrutiny because of corporate scandals and ethical dilemmas. To date, academic research has been mainly devoted to the characteristics of instruction formats and their effectiveness, characteristics…
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…
Arena, Lydia E., Ed.
Published once each semester by Manhattan College (New York), the report serves as a resource for faculty and students as they deal with professional ethical dilemmas and conflicts in their course work and work lives; it also helps to further the Center for Professional Ethics basic purpose of promoting greater sensitivity to the ethical…
Stefkovich, Jacqueline A.; O'Brien, G. Michaele
Shapiro and Stefkovich in their 2001 book on ethics propose a framework for examining ethical dilemmas. At the heart of this conceptualization is "the best interests of the student." Yet a review of the literature reveals this term is interpreted broadly and few systematic attempts have been made to define it. In response to this lack of clarity,…
Kim, Mijung; Roth, Wolff-Michael
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…
Olley, Rivka I.
It is incumbent upon each school psychologist to engage in ethical behavior based on current ethical codes guiding school psychology. The school psychologist is often the team member most knowledgeable regarding federal and state laws mandating educational services. Sometimes ethical dilemmas that school psychologists face are the result of a…
Swann, Stephanie; Herbert, Sarah E.
Examines ethical dilemmas arising when treating adolescents with gender dysphoria, discussing ethical and legal issues pertinent to treating any adolescent and highlighting gender dysphoric adolescents. Reviews legal decisions, existing data on adolescent decision making, and ethical principles for resolving complex situations. Illustrates ethical…
Tillman, Robert L.
A group of 255 civil engineering students in cooperative education programs responded to 12 hypothetical professional ethics situations in core areas of public interest. Findings showed that (1) co-op influences change from rule-based to act-based ethics; (2) students face ethical dilemmas during co-op; and (3) students considered the consequences…
Meiswinkel, Lauren B.
This book provides the clarifying principles and practices for societal leaders who need to know there is a process, the Theory E project, that sheds light on the ethical leadership difference for the concrete dilemmas facing all key leaders. The book discusses ethical leadership communication in terms of the ethical leader's upper, downward, and…
Speck, Bruce W.
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)
Green, James; Walker, Keith
While numerous philosophical essays offer speculative explanations of how persons should make ethical decisions, empirical investigations of the phenomenon of ethical decision-making are limited to just a few studies in the discipline of business management. This investigation focused on the ethical dilemmas confronted by educators, with emphasis…
Carbo, Toni; Almagno, Stephen
Discusses the history and evolution of information ethics at the University of Pittsburgh and describes a course that was developed in the School of Information Sciences that includes the need for moral instruction and ethical reflection, resolving moral dilemmas, and ethical issues in librarianship, information technology, and management.…
Hozien, Wafa Ismail
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…
Miñano, Rafael; Uruburu, Ángel; Moreno-Romero, Ana; Pérez-López, Diego
This paper presents an experience in developing professional ethics by an approach that integrates knowledge, teaching methodologies and assessment coherently. It has been implemented for students in both the Software Engineering and Computer Engineering degree programs of the Technical University of Madrid, in which professional ethics is studied as a part of a required course. Our contribution of this paper is a model for formative assessment that clarifies the learning goals, enhances the results, simplifies the scoring and can be replicated in other contexts. A quasi-experimental study that involves many of the students of the required course has been developed. To test the effectiveness of the teaching process, the analysis of ethical dilemmas and the use of deontological codes have been integrated, and a scoring rubric has been designed. Currently, this model is also being used to develop skills related to social responsibility and sustainability for undergraduate and postgraduate students of diverse academic context.
Kottow, Miguel H
Genetics research has shown enormous developments in recent decades, although as yet with only limited clinical application. Bioethical analysis has been unable to deal with the vast problems of genetics because emphasis has been put on the principlism applied to both clinical and research bioethics. Genetics nevertheless poses its most complex moral dilemmas at the public level, where a social brand of ethics ought to supersede the essentially interpersonal perspective of principlism. A more social understanding of ethics in genetics is required to unravel issues such as research and clinical explorations, ownership and patents, genetic manipulation, and allocation of resources. All these issues require reflection based on the requirements of citizenry, consideration of common assets, and definition of public policies in regulating genetic endeavors and protecting the society as a whole Bioethics has privileged the approach to individual ethical issues derived from genetic intervention, thereby neglecting the more salient aspects of genetics and social ethics.
Suhonen, Riitta; Stolt, Minna; Virtanen, Heli; Leino-Kilpi, Helena
The aim of the study was to report the results of a systematically conducted literature review of empirical studies about healthcare organizations' ethics and management or leadership issues. Electronic databases MEDLINE and CINAHL yielded 909 citations. After a two stage application of the inclusion and exclusion criteria 56 full-text articles were included in the review. No large research programs were identified. Most of the studies were in acute hospital settings from the 1990s onwards. The studies focused on ethical challenges, dilemmas in practice, employee moral distress and ethical climates or environments. Study samples typically consisted of healthcare practitioners, operational, executive and strategic managers. Data collection was mainly by questionnaires or interviews and most of the studies were descriptive, correlational and cross-sectional. There is need to develop conceptual clarity and a theoretical framework around the subject of organizational ethics and the breadth of the contexts and scope of the research needs to be increased.
Ploumpidis, D; Garanis-Papadatos, T; Economou, M
The following paper is based on a Concerted Action which focused on the "Ethical aspects of deistinstutionalisation in mental health care" in 2001. It investigates the development and the ethical dilemmas posed by deinstitutionalization in Greece. This movement has recently undergone a very active phase but the transition from the traditional model of psychiatric care to the community based system unavoidably creates many ethical problems related to the professionals' attitude towards individual liberties, dignity and other fundamental rights of mentally ill persons. These problems exist not only in the level of the therapist-patient relationship but in the level of policy making as well as its implementation. Moreover, the paper deals with specific ethical problems such as stigmatisation and isolation in the community context, as well as the role of the family.
Yarbrough, Susan; Klotz, Linda
The population of most non-dominant ethnic groups in the USA is growing dramatically. Faculty members are challenged to develop curricula that adequately prepare our future nurses. An increased focus on clinical ethics has resulted from the use of sophisticated technology, changes in health care financing, an increasing elderly population and the shift of care from inpatient to outpatient settings. Nurses frequently face situations demanding resolution of ethical dilemmas involving cultural differences. Nursing curricula must include content on both ethics and cultural sensitivity. Active student participation is an important element providing a foundation for ethical practice. A proposed educational format was introduced with graduating baccalaureate students. In a pilot study, curricular content on cultural sensitivity and ethical practice was taught in separate modules. Students were then asked to identify and problem solve an ethical dilemma involving patients and professional caregivers from vastly different cultures. Course faculty members provided discussion questions to guide the students' thinking.
Rest, James R.
This study describes moral dilemmas that young adults (ages 18-24) formulate spontaneously and examines the relationship between these dilemmas and the subjects' environment and scores on a standardized test. Fifty-two subjects were tested both in 1976 and 1978, creating 104 subject-oriented dilemmas. Thirty-two were in college, 17 were not, and…
Fielding, H A
The development of bioethics primarily at the cognitive level further perpetuates the tendency to construe all aspects of our lives, including our bodies, as technical systems. For example, if we consider the moral issue of organ sales without taking our embodiment into account there appear to be no sound arguments for opposing such sales. However, it is important to consider the aspects of the phenomenal body that challenge rational deliberation by exploring an embodied approach to the ethical dilemma produced by a proposed kidney exchange as presented in one of Krzysztof Kieślowski's Dekalog films. What is sought is a description of a body-measure that would serve as a critique of strictly cognitive bioethical deliberations.
McCrary, B F
Military aviation physicians are frequently placed in conflicting ethical situations regarding the areas of patient loyalty, confidentiality, and reporting of findings or hazards. The American College of Occupational and Environmental Medicine has developed a set of guidelines for ethical conduct to assist physicians providing occupational health services. This paper attempts to show that these guidelines can be applied similarly by physicians providing aeromedical services. These guidelines can be helpful in resolving ethical dilemmas that can occur in the daily practice of aviation medicine.
The mental health film festival is based on the respect of the patient as a subject and is a place where psychic suffering can be expressed. As a film is destined to be shown, there is a dilemma between the aesthetic and the therapeutic aspects and, it's in this link that the ethical dimension concerned by this kind of activity takes place.
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…
Bradley, Loretta J.; Hendricks, Bret
The proliferation of the use of e-mail and texting has created some ethical dilemmas for family counselors. Although e-mail can expand and encourage communication, it is not problem free and, in fact, can pose problems. There are issues with privacy, confidentiality, and maintaining an appropriate professional relationship. Family counselors…
Maintains that many traditional economics classroom experiments unfairly label, deride, or denigrate altruistic behavior and moral motivation. Describes several in-class experiments, the prisoners' dilemma, dictator games, and double auction experiments and discusses their inherent bias against moral considerations. Examines the ethical problems…
Price, Sandra J.
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)
Peirce, Anne Griswold; Smith, Jennifer A
Ethical questions dealt with by nurses who have Doctor of Nursing Practice (DNP) degrees include traditional bioethical questions, but also business and legal ethics. Doctorally prepared nurses are increasingly in positions to make ethical decisions rather than to respond to decisions made by others. The traditional master's-degree advanced practice nursing curriculum does not address the extended expertise and decision-making skills needed by DNP practitioners as they face these new types of ethical dilemmas. We propose that a curricular framework that addresses clinical, research, business, and legal ethics is needed by all DNP students.
The ethical distinction between good and evil has preoccupied man since the beginning of human history. Man, unlike other animals, is capable of comparing himself with his peers; this ability leads to a constant concern with the image he is projecting rather than with becoming truly good. Ethical principles may be subordinated to other demands of the personal image, but personal goodness can only be achieved by constant effort throughout life. The medical doctor is occupied in curing the ill, but must also be preoccupied by the welfare of the patient. In the present atmosphere of abdication of ethics in the international, national, and personal realms, an abdication of medical ethics is also apparent in the dehumanization of medical attitudes at all levels and in the substitution of personal interest instead of concern for the welfare of others. Violations of medical confidences are another example. The question of whether or not to tell the truth about their conditions to dying patients should be considered in the light of the higher goal of preserving the patient's dignity as well as emotional and physical health. Ethical dilemmas are involved in the increasing resort to technology within medicine and to its occasionally indiscriminate, inappropriate, or inappropriately withheld use. A related issue is the elevation of specializations above general clinical medicine. The frantic desire to maintain the body in a young-looking state through cosmetic surgery and other means may lead to neglect of the inner life and to other vices; the physician should set an example by enriching himself through reading, art, and other means. To the extent that contraceptive usage forms part of a refusal to sacrifice for others and of the need for constant pleasure without responsibility, it is a serious ethical problem. Artificial insemination with sperm of men considered genetically superior, in vitro fertilization, and genetic engineering are associated with very complex ethical
Barker, Chris; Martin, Brian
There is a burgeoning amount of research into happiness and greatly increased popular attention, so it seems logical to add a course on happiness to the university curriculum. We encountered, in developing and running such a course, a number of dilemmas that the topic of happiness makes especially acute. Should the teacher remain separate from the…
D'Auria, John; King, Matthew
Distinguishing between problems that have solutions and dilemmas that need to be managed, the authors identify three overarching questions from the School ABC case that center around data and perceptions. Because the ability to talk openly and honestly about difficult issues is critical to the health of a school, the authors consider the obstacles…
Related to the often applied cooperation models of social dilemmas, we deal with scenarios in which defection dominates cooperation, but an intermediate fraction of cooperators, that is, "partial cooperation," would maximize the overall performance of a group of individuals. Of course, such a solution comes at the expense of cooperators that do not profit from the overall maximum. However, because there are mechanisms accounting for mutual benefits after repeated interactions or through evolutionary mechanisms, such situations can constitute "dilemmas" of partial cooperation. Among the 12 ordinally distinct, symmetrical 2 x 2 games, three (barely considered) variants are correspondents of such dilemmas. Whereas some previous studies investigated particular instances of such games, we here provide the unifying framework and concisely relate it to the broad literature on cooperation in social dilemmas. Complementing our argumentation, we study the evolution of partial cooperation by deriving the respective conditions under which coexistence of cooperators and defectors, that is, partial cooperation, can be a stable outcome of evolutionary dynamics in these scenarios. Finally, we discuss the relevance of such models for research on the large biodiversity and variation in cooperative efforts both in biological and social systems.
Dana, Joyce A.
Women are challenged most by cultural norms, particularly sex-role norms, religious and political ideologies, and gender-structured opportunities that favor men. Although some stereotypes have loosened a bit, dilemmas remain for women who aspire to fill school district leadership positions. The author's predicament is not unique. It is something…
Cedo, Kelli M.; Dickerson, William E.
This case study creates a dilemma that many school districts face. Public education is under-funded. Principals are expected to be the instructional leaders and are held accountable for student achievement. Is it appropriate then for public schools to have local businesses as benefactors when teaching personnel are involved? The conflict between…
Granberg, Donald; Brown, Thad A.
Examines people's behavior in the Monty Hall Dilemma (MHD), in which a person must make two decisions to win a prize. In a series of five studies, found that people misapprehend probabilities in the MHD. Discusses the MHD's relation to illusion of control, belief perseverance, and the status quo bias. (RJM)
Ashmore, Timothy M.
Presents a computerized version of the Prisoner's Dilemma game, which runs on several Apple computers. Makes a case for utilizing the program in interpersonal, small group, and social conflict communication classes. Describes the four computerized versions of the game: rational, partially rational, nonrational, and assumed rational. (JD)
Saunders, Kathryn J.; Rennie, Léonie J.
Internationally there is concern that many science teachers do not address socioscientific issues (SSI) in their classrooms, particularly those that are controversial. However with increasingly complex, science-based dilemmas being presented to society, such as cloning, genetic screening, alternative fuels, reproductive technologies and vaccination, there is a growing call for students to be more scientifically literate and to be able to make informed decisions on issues related to these dilemmas. There have been shifts in science curricula internationally towards a focus on scientific literacy, but research indicates that many secondary science teachers lack the support and confidence to address SSI in their classrooms. This paper reports on a project that developed a pedagogical model that scaffolded teachers through a series of stages in exploring a controversial socioscientific issue with students and supported them in the use of pedagogical strategies and facilitated ways of ethical thinking. The study builds on existing frameworks of ethical thinking. It presents an argument that in today's increasingly pluralistic society, these traditional frameworks need to be extended to acknowledge other worldviews and identities. Pluralism is proposed as an additional framework of ethical thinking in the pedagogical model, from which multiple identities, including cultural, ethnic, religious and gender perspectives, can be explored.
Fieldwork as a part of social science research brings the researcher closest to the subject of research. It is a dynamic process where there is an exchange between the researcher, participants, stakeholders, gatekeepers, the community and the larger sociopolitical context in which the research problem is located. Ethical dilemmas that surface during fieldwork often pose a unique challenge to the researcher. This paper is based on field experiences during an action research study conducted with a human rights perspective. It discusses the role conflict that researchers face during fieldwork in a situation of humanitarian crisis. It raises issues pertaining to the need to extend the ethical decision-making paradigm to address ethical dilemmas arising during the course of fieldwork.
Fletcher, J C; Evans, M I
Ethics in reproductive genetics comprise descriptive ethics and normative ethics. Ethical problems before prenatal diagnosis involve genetic counseling and informed consent for the choice patients must make. Prenatal diagnosis using amniocentesis is controversial. An international survey of geneticists showed that 25% would do prenatal diagnosis for sex selection, and 17% would refer the couple elsewhere. Hungary (60%), India (37%), the US (34%), Canada (30%), Greece (29%), and Sweden (28%) would do prenatal diagnosis. The statistical incidence of positive findings after prenatal diagnosis does not exceed 4% of all cases when most couples choose abortion. Respect for parental choice and for nondirective counseling was supported in responses to 3 cases in the international survey that also had disclosure dilemmas included with abortion choices. 84% of respondents would be nondirective for XYY and 88% for XO. In India, Hungary, Turkey, and Norway, 46%, 40%, 40%, and 33%, respectively, would advise aborting an XO (Turner) fetus. A survey of 737 genetics and obstetricians and ethicists and clergy showed acceptability of abortion in singleton pregnancies and in twins associated strongly with the trimester of pregnancy, indication for selective termination, and fetal number. Prior group review of risks and benefits of experimental fetal therapy, case selection for experimental fetal therapy, the optimal informed-consent process for fetal therapy, twin pregnancies, refusal of proven fetal therapy, the lack of federal support for research in fetal diagnosis (preimplantation embryo diagnosis) and therapy, and sources of a moral obligation are also addressed. The Belmont Report on the ethics of biomedical research in the US proposed ethical principles to guide research with human subjects including the fetus: respect for parsons, beneficence, and justice.
Horne, Zachary; Powell, Derek
Moral dilemmas often pose dramatic and gut-wrenching emotional choices. It is now widely accepted that emotions are not simply experienced alongside people’s judgments about moral dilemmas, but that our affective processes play a central role in determining those judgments. However, much of the evidence purporting to demonstrate the connection between people’s emotional responses and their judgments about moral dilemmas has recently been called into question. In the present studies, we reexamined the role of emotion in people’s judgments about moral dilemmas using a validated self-report measure of emotion. We measured participants’ specific emotional responses to moral dilemmas and, although we found that moral dilemmas evoked strong emotional responses, we found that these responses were only weakly correlated with participants’ moral judgments. We argue that the purportedly strong connection between emotion and judgments of moral dilemmas may have been overestimated. PMID:27385365
Haahr, Anita; Norlyk, Annelise; Hall, Elisabeth Oc
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.
Dell, Evelyn M.; Varpio, Lara; Petrosoniak, Andrew; Gajaria, Amy
Objectives To explore and characterize the ethical and safety challenges of global health experiences as they affect medical students in order to better prepare trainees to face them. Methods Semi-structured interviews were conducted with 23 Canadian medical trainees who had participated in global health experiences during medical school. Convenience and snowball sampling were utilized. Using Moustakas’s transcendental phenomenological approach, participant descriptions of ethical dilemmas and patient/trainee safety problems were analyzed. This generated an aggregate that illustrates the essential meanings of global health experience ethical and safety issues faced. Results We interviewed 23 participants who had completed 38 electives (71%, n=27, during pre-clinical years) spend-ing a mean 6.9 weeks abroad, and having visited 23 countries. Sixty percent (n=23) had pre-departure training while 36% (n=14) had post-experience debriefing. Three macro-level themes were identified: resource disparities and provision of care; navigating clinical ethical dilemmas; and threats to trainee safety. Conclusions Medical schools have a responsibility to ensure ethical and safe global health experiences. However, our findings suggest that medical students are often poorly prepared for the ethical and safety dilemmas they encounter during these electives. Medical students require intensive pre-departure training that will prepare them emotionally to deal with these dilemmas. Such training should include discussions of how to comply with clinical limitations. PMID:25341214
Recent ethical and moral lapses, defined as decisions or actions not in line with the Air Force Core Values, are not isolated occurrences. Rather...that can create a moral dilemma for Airmen. Positive and negative behavioral drivel> detennine the choices of an individual who is faced with such...a dilemma. An organization can also influence the individual’s decision-making through separate negative drivers collectively referred to as moral
Gogoll, Jan; Müller, Julian F
The recent progress in the development of autonomous cars has seen ethical questions come to the forefront. In particular, life and death decisions regarding the behavior of self-driving cars in trolley dilemma situations are attracting widespread interest in the recent debate. In this essay we want to ask whether we should implement a mandatory ethics setting (MES) for the whole of society or, whether every driver should have the choice to select his own personal ethics setting (PES). While the consensus view seems to be that people would not be willing to use an automated car that might sacrifice themselves in a dilemma situation, we will defend the somewhat contra-intuitive claim that this would be nevertheless in their best interest. The reason is, simply put, that a PES regime would most likely result in a prisoner's dilemma.
Wadensten, Barbro; Wenneberg, Stig; Silén, Marit; Ping Fen Tang; Ahlström, Gerd
The aim of this study was to compare Swedish and Chinese nurses' experiences of ethical dilemmas and workplace distress in order to deepen understanding of the challenges neuroscience nurses encounter in different cultures. Qualitative interviews from two previously performed empirical studies in Sweden and China were the basis of this comparative study. Four common content areas were identified in both studies: ethical dilemmas, workplace distress, quality of nursing and managing distress. The themes formulated within each content area were compared and synthesized into novel constellations by means of aggregated concept analysis. Despite wide differences in the two health care systems, the nurse participants had similar experiences with regard to work stress and a demanding work situation. They were struggling with similar ethical dilemmas, which concerned seriously ill patients and the possibilities of providing good care. This indicates the importance of providing nurses with the tools to influence their own work situation and thereby reducing their work-related stress.
da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins
Objective: to know the ethical problems experienced by oncology nurses. Method: descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Results: two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. Conclusion: for the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude. PMID:26626012
Sanders, L M; Giudice, L; Raffin, T A
Now that the Clinton Administration has overturned the ban on federal funding for fetal tissue transplantation, old ethical issues renew their relevance and new ethical issues arise. Is fetal tissue transplantation necessary and beneficial? Are fetal rights violated by the use of fetal tissue in research? Is there a moral danger that the potential of fetal tissue donation will encourage elective abortions? Should pregnant women be allowed to designate specific fetal transplant recipients? What criteria should be used to select fetal tissue transplants? Whose consent should be required for the use of fetal tissue for transplantation? We review the current state of clinical research with fetal tissue transplantation, the legal history of fetal tissue research, the major arguments against the use of fetal tissue for transplantation, and the new postmoratorium ethical dilemmas. We include recommendations for guidelines to govern the medical treatment of fetal tissue in transplantation.
Monod, Stéfanie; Chiolero, René; Büla, Christophe; Benaroyo, Lazare
Providing or withholding nutrition in severely disabled elderly persons is a challenging dilemma for families, health professionals, and institutions. Despite limited evidence that nutrition support improves functional status in vulnerable older persons, especially those suffering from dementia, the issue of nutrition support in this population is strongly debated. Nutrition might be considered a basic need that not only sustains life but provides comfort as well by patients and their families. Consequently, the decision to provide or withhold nutrition support during medical care is often complex and involves clinical, legal, and ethical considerations. This article proposes a guide for health professionals to appraise ethical issues related to nutrition support in severely disabled older persons. This guide is based on an 8-step process to identify the components of a situation, analyze conflicting values that result in the ethical dilemma, and eventually reach a consensus for the most relevant plan of care to implement in a specific clinical situation. A vignette is presented to illustrate the use of this guide when analyzing a clinical situation.
Iozzi, Louis A.; And Others
The dual purpose of this module is to introduce students (grades 10-11) to current/emerging environmental issues and to emphasize the moral/ethical decision-making related to these issues. The module is organized into 12 topic areas, each containing a dilemma story, introductory reading material, sample student responses, and questions. Dilemmas…
Virgo, Simon; Urai, Janos L.
the micro veins is low. This behavior suggests that the vein does not influence the fracture propagation of the younger vein, which means at such low intersection angles that the strength of vein and host rock must be very similar. This contrasting behaviour can be observed in one single outcrop and for veins belonging to the same set. We present and discuss several mechanisms that are able to resolve this dilemma. Possible resolutions are (1) intrinsic and random strength variation (2) complex temporal evolution of the strength heterogeneity (3) a different growth mechanism of micro veins and crack-seal veins, e.g. subcritical vs. critical fracture growth.
Dunn Cavelty, Myriam
Current approaches to cyber-security are not working. Rather than producing more security, we seem to be facing less and less. The reason for this is a multi-dimensional and multi-faceted security dilemma that extends beyond the state and its interaction with other states. It will be shown how the focus on the state and "its" security crowds out consideration for the security of the individual citizen, with detrimental effects on the security of the whole system. The threat arising from cyberspace to (national) security is presented as possible disruption to a specific way of life, one building on information technologies and critical functions of infrastructures, with relatively little consideration for humans directly. This non-focus on people makes it easier for state actors to militarize cyber-security and (re-)assert their power in cyberspace, thereby overriding the different security needs of human beings in that space. Paradoxically, the use of cyberspace as a tool for national security, both in the dimension of war fighting and the dimension of mass-surveillance, has detrimental effects on the level of cyber-security globally. A solution out of this dilemma is a cyber-security policy that is decidedly anti-vulnerability and at the same time based on strong considerations for privacy and data protection. Such a security would have to be informed by an ethics of the infosphere that is based on the dignity of information related to human beings.
Cassidy, V R
Case studies are widely used as a teaching strategy for a variety of topics in various disciplines. They are particularly valued as a teaching strategy in the teaching of ethics because they provide a context for understanding the complexities of situations involving ethical dilemmas. This article describes the successful use of two literary works as case studies in teaching master's students about the ethical issues in human experimentation. Pygmalion and Flowers for Algernon were selected to exemplify the ethical considerations important in the conduct of research with human subjects. Students found the assignment both personally and professionally stimulating and recommended continued use of the assignment in the course.
... scientific community also publishes more data on the dangers of second-hand smoke. 1995 Boots Pharmaceuticals pressures ... critic Jeremy Rifkin, protest the patenting of plants, animals, and human body parts in Washington, DC. 1996 ...
Hussein, Ghaiath M. A.
The provision of health care service in resource-poor settings is associated with a broad set of ethical issues. Devakumar's case discusses the ethical issues related to the inability to treat in a cholera clinic patients who do not have cholera. This paper gives a closer look on the context in which Devakumar's case took place. It also analyses the potential local and organizational factors that gives rise to ethical dilemmas and aggravate them. It also proposes a framework to help in the proactive handling of the factors that leads to ethical dilemmas and resolving the ethical issues as they appear. It adopts the four principles of autonomy, beneficence, non-maleficence and justice as universal and prima facie principles, but with the inclusion of a local understanding of what of each of these principles means. It is based on a collaborative approach that involves the beneficiaries and other partners in the field to help share information and resources, as well as adopting the provision of a wider service to the whole community. This is done by asking three basic questions: (a) who are the relevant stakeholders? (b) what ought to be the ethical principles in place? and (c) how should we take, implement and follow the decision about service provision? PMID:20336229
Wyne, Mudasser F.
It is hard to define a single set of ethics that will cover an entire computer users community. In this paper, the issue is addressed in reference to code of ethics implemented by various professionals, institutes and organizations. The paper presents a higher level model using hierarchical approach. The code developed using this approach could be…
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
Pharmacy is an ethical profession. The aim of this study was to investigate the history of pharmacy ethics in Iran. In the ancient Persia, medical and pharmaceutical ethics were related to religious rules, and everybody had to respect it. The ethical rules were similar to some current pharmacy ethics. During Islamic era, the pharmacy ethics were edited according to the Islamic rules. After introduction of European pharmacy into Iran, the pharmacy ethics did not change and was regarded as before. By presentation of bioethics and medical ethics in recent years, new activities are carried out for better manipulation of their rules in health professions including pharmacy. PMID:23908727
Huang, Zhiming; Alonso-Sanz, Ramón; Situ, Haozhen
We study how quantum noise affects the solution of quantum Samaritan's dilemma. Serval most common dissipative and nondissipative noise channels are considered as the model of the decoherence process. We find that the solution of quantum Samaritan's dilemma is stable under the influence of the amplitude damping, the bit flip and the bit-phase flip channel.
Huang, Zhiming; Alonso-Sanz, Ramón; Situ, Haozhen
We study how quantum noise affects the solution of quantum Samaritan's dilemma. Serval most common dissipative and nondissipative noise channels are considered as the model of the decoherence process. We find that the solution of quantum Samaritan's dilemma is stable under the influence of the amplitude damping, the bit flip and the bit-phase flip channel.
Kurihara, Chieko; Cho, Kunwoo; Toohey, Richard E
The International Commission on Radiological Protection (ICRP) has established Task Group 94 (TG94) to develop a publication to clarify the ethical foundations of the radiological protection system it recommends. This TG identified four core ethical values which structure the system: beneficence and non-maleficence, prudence, justice, and dignity. Since the ICRP is an international organization, its recommendations and guidance should be globally applicable and acceptable. Therefore, first this paper presents the basic principles of the ICRP radiological protection system and its core ethical values, along with a reflection on the variation of these values in Western and Eastern cultural traditions. Secondly, this paper reflects upon how these values can be applied in difficult ethical dilemmas as in the case of the emergency and post-accident phases of a nuclear power plant accident, using the Fukushima case to illustrate the challenges at stake. We found that the core ethical values underlying the ICRP system of radiological protection seem to be quite common throughout the world, although there are some variations among various cultural contexts. Especially we found that 'prudence' would call for somewhat different implementation in each cultural context, balancing and integrating sometime conflicting values, but always with objectives to achieve the well-being of people, which is itself the ultimate aim of the radiological protection system.
In this study, the ethical decision-making of preschool teachers (N = 26) in Samsun, on the northern coast of Turkey, was examined. For this analysis, six real-life dilemmas were prepared, chosen from the problems that most often arise in kindergartens in Turkey. These dilemmas addressed the commitment of the teacher to the child, to self, to the…
While a growing body of research is uncovering the aetiology and effective treatments for allergy, research that assess the broader ethical implications of this disease is lacking significantly. This article will demonstrate both the paucity of academic research concerning ethical implications in allergy and explain why ethical analysis is integral to formulating effective health strategies for allergic disease. An exhaustive literature search of publications in French and English identified less than 35 academic articles focussed on the topic of ethics and allergy; this is a miniscule number when compared to the amount of articles published on ethical issues related to other chronic illnesses, such as obesity. It is important to demonstrate to allergy specialists the need for, and utility of, further incorporating ethical analyses in allergology; the current success of Ethical, Legal, Social Implications (ELSI) research programmes in human genetics and nanotechnology will serve as notable examples. Indeed, future research and innovation in allergy will undoubtedly encounter ethical dilemmas and the allergology community should play a significant role in helping to address these issues. However, incorporating ethical analyses in allergology does not imply that the allergology community must acquire extensive knowledge in bioethics; instead, interdisciplinary research that incorporates expertise from allergology and bioethics would enable allergy specialists to advance critical knowledge development in this largely overlooked domain of study. PMID:23388345
In this autoethnographic study, I identify and critique the ethical dimensions of the research relationship from a narrative inquiry into a transgender student's experience in school music. Josselson notes that while many scholars have discussed conducting ethical research in theoretical terms, actual dilemmas of practice are seldom written about.…
McArdle, Karen; Birchley, Jacinta; Bruce, Jayne; Hurrell, Alison; Paterson, Sandra; Stephen, Mary
Using participatory action research (PAR), this paper explores the ethical practice of students engaged in practitioner research in a higher education context. Using narrative enquiry, the paper explores the participants' experiences of practitioner research, including ethical dilemmas that resulted from a conflict of values between the…
Plackowski, Linda C.
In 1979, Delta College, in Michigan, established a bioethics requirement for all nursing students. This paper describes a project to teach one of the required ethics course to local hospitals to observe students while they work and discuss ethical dilemmas as they arose. Introductory sections discuss project rationale and procedures, indicating…
This small-scale interview study considers experiences, difficulties and dilemmas of local Special Educational Needs (SEN) professionals such as SEN caseworkers, and examines the neglected ethical dimensions of their role. It argues that fostering "ethical knowledge" (Campbell, 2003), rather than an increase in prescriptive guidance,…
This paper is the second report of a research project involving collecting information via e-survey about occasions in which graduates of a California private University have encountered ethical issues/dilemma after graduation and the role that they think their education and the ethics course they had taken played in recognition and resolution of…
Discusses some of the ethical dilemmas faced by writers who prepare marketing materials in engineering organizations. Describes social, political, economic, and legal changes in the professions during the last 30 years and the growing influence of market-driven decisions on ethical decision making. (PRA)
Like art, ethics can be a complex and scary mirror that forces us to consider, practice, and profess specific choices that speak to who we are and what we value. The author of this article observes that confronting specific ethical dilemmas within her work with young people has brought various tensions to the forefront of her practice as a…
Ryan, Michael; Martinson, David L.
Reports on a study that found that public relations practitioners respond in different ways to different moral-ethical dilemmas and that they tend to think they are accountable in some situations to an authority higher than management. Concludes that subjectivism is the prevailing moral-ethical theory of practitioners. (FL)
Annenberg Media, 2007
New, and yet familiar, hypothetical cases are debated and agonized over by eminent leaders from government, business, science and academia. "Ethics in America II" follows its predecessor by exploring gripping ethical dilemmas using the time-honored Socratic Dialogue format. The programs can be used with a discussion guide to help teachers engage…
Kuriloff, Peter J.; Andrus, Shannon H.; Ravitch, Sharon M.
In this article we argue that when university researchers engage in democratic participatory action research with schools the process requires a special type of attention to the ethical difficulties which can arise. We note how current professional standards of ethics are inadequate to fully address many of the dilemmas faced in collaborative…
Moe, Jeanne M.; Coleman, Carolee; Fink, Kristie; Krejs, Kirsti
Archaeology is a highly interdisciplinary field. Its main goal is to construct culture histories, but it uses many scientific methods in the process. Ethical dilemmas inherent in archaeology make it a good vehicle for teaching ethics and character in the classroom (Moe 2000). The interdisciplinary nature of the field makes it possible to weave…
School leadership has always been a moral undertaking. Contemporary school leaders face complex ethical dilemmas every day. A limited amount of research exists to describe the extent to which school principals feel formally prepared to be ethical leaders. The purpose of this study was to identify the relationship between the self-identified…
Fiedler, Craig R.; Van Haren, Barbara
The field of special education is wrought with ethical dilemmas. The Council for Exceptional Children has outlined its code of ethics and standards for professional practice for individuals working in the field of special education. The purpose of this study was to determine the extent to which special education administrators and teachers possess…
Czymoniewicz-Klippel, Melina T.; Brijnath, Bianca; Crockett, Belinda
Qualitative researchers are often confronted by ethical challenges when making research decisions because current guidelines and principles guiding research ethics do not wholly cover the concerns that can arise in complex social research situations. In this article, the authors explore this dilemma in relation to our experiences of conducting…
International Council for Computers in Education, Eugene, OR.
Five articles and two columns reprinted from 1984 and 1985 issues of "The Computing Teacher" address various ethical and legal issues involved in computer use. In "A Question of Ethics," Larry S. Hannah and Charles B. Matus suggest guidelines for dilemma discussion in the classroom to address social and moral issues and to help…
Frick, J. Edward; Frick, William C.
As educators, we grapple with a myriad of dilemmas and often have difficulty resolving issues that relate to curriculum and instruction, funding, facilities and supervision, to name a few. Depending on the leader(s), a variety of ethics come in to play when making decisions. The ethic of connectedness refers to community building and welfare as…
Welker, James A.; McCue, Jack D.
The distinction between authorship and other forms of credit for contribution to a publication has been a persisting controversy that has resulted in numerous guidelines outlining the expected contributions of those claiming authorship. While there have been flagrant, well-publicized deviations from widely accepted standards, they are largely outnumbered by cases that are not publicity-worthy, and therefore remain known to only those directly involved with the inappropriate conduct. We discuss the definition and ethical requirements of authorship, offer a case example of the authorship debate created by a technical tool at our institution, and review parallels that support and dispute the authorship claims of our software developers. Ultimately, we conclude that development of a technical tool that enables data collection does not adequately substitute for contributions to study design and manuscript preparation for authorship purposes. Unless the designers of such a technical tool prospectively participate as a part of the project, they would not have an adequate understanding of the publication’s genesis to defend it publicly and cannot be listed as authors. Therefore, it is incumbent upon project members to invite tool developers to participate at the beginning of such projects, and for tool developers to contribute to study design and manuscript preparation when they desire authorship listings. PMID:17068347
To better understand ethical issues involved in the field of human genetics and promote debate within the scientific community, the author surveyed scientists who engage in human genetics research about the pros, cons, and ethical implications of genetic testing. This study contributes systematic data on attitudes of scientific experts. The survey finds respondents are highly supportive of voluntary testing and the right to know one's genetic heritage. The majority consider in utero testing and consequent pregnancy termination acceptable for cases involving likelihood of serious disease but disapprove for genetic reasons they consider arbitrary, leaving a gray area of distinguishing between treatment of disorders and enhancement still to be resolved. While safeguarding patient confidentiality versus protecting at-risk third parties (kin, reproductive partners) presents a dilemma, preserving privacy from misuse by institutional third parties (employers, insurers) garners strong consensus for legislation against discrimination. Finally, a call is made for greater genetic literacy.
Jankowski, Jane; Burcher, Paul
This article presents the case of a mother who is planning a home birth with a midwife with the shared knowledge that the fetus would have congenital anomalies of unknown severity. We discuss the right of women to choose home birth, the caregivers' duty to the infant, and the careproviders' dilemma about how to respond to this request. The ethical duties of concerned careproviders are explored and reframed as professional obligations to the mother, infant, and their profession at large. Recommendations are offered based on this case in order to clarify the considerations surrounding not only home birth of a fetus with anticipated anomalies, but also to address the ethical obligations of caregivers who must navigate the unique tension between respecting the mother's wishes and the duty of the careproviders to deliver optimal care.
Frisque, Deloise A.; Kolb, Judith A.
This study examines the effects of ethics training on the attitudes, knowledge-based scores, and analysis of ethical dilemmas among office professionals. A treatment- and control-group design was used with variables of interest measured before, immediately after, and ninety days following completion of a six-hour ethics training workshop. A…
Spijkerboer, R P; van der Stel, J C; Widdershoven, G A M; Molewijk, A C
Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation (MCD) is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people's perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization.
Sternberg, Robert J.
Ethical impotence occurs when one wants to act ethically but feels powerless to do anything about the perceived unethical behavior. One may feel that one's actions will have no impact or that those actions actually will have harmful consequences to oneself and/or others. Ethical impotence can be understood in terms of an eight-step model of…
Psychologists in medical settings may be confronted with Jehovah's Witness parents refusing blood transfusions for their children as an ethical dilemma. The purpose of this discussion is to help psychologists provide informed, ethical consultations and support by investigating the values of the Jehovah's Witness community and the origin of the blood transfusion taboo, how medical and legal professionals have approached this dilemma, exploring relevant ethical principles and standards for psychologists, and suggestions for how to move toward a better understanding of harm with Jehovah's Witness families.
Civaner, Murat; Sarikaya, Ozlem; Balcioğlu, Harun
Medical ethics education in residency training is one of the hot topics of continuous medical education debates. Its importance and necessity is constantly stressed in declarations and statements on national and international level. Parallel to the major structural changes in the organization and the finance model of health care system, patient-physician relationship, identity of physicianship, social perception and status of profession are changing. Besides, scientific developments and technological advancements create possibilities that never exists before, and bring new ethical dilemmas along with. To be able to transplant human organs has created two major problems for instance; procurement of organs in sufficient numbers, and allocating them to the patients in need by using some prioritizing criteria. All those new and challenging questions force the health care workers to find authentic and justifiable solutions while keeping the basic professional values. In that sense, proper medical ethics education in undergraduate and postgraduate term that would make physician-to-be's and student-physicians acquire the core professional values and skill to notice, analyze and develop justifiable solutions to ethical problems is paramount. This article aims to express the importance of medical ethics education in residency training, and to propose major topics and educational methods to be implemented into. To this aim, first, undergraduate medical education, physician's working conditions, the exam of selection for residency training, and educational environment were revised, and then, some topics and educational methods, which are oriented to educate physicians regarding the professional values that they should have, were proposed.
Bahr, Rose Therese
This presentation focuses on ethical issues that need to be addressed within the gerontological nursing curriculum for preparing nurses to become change agents and catalysts in the health care of the older population. Ethics and ethical principles are defined, and three ethical principles are discussed: justice; beneficence; and autonomy.…
Nguyen, Nhung T.; Basuray, M. Tom; Smith, William P.; Kopka, Donald; McCulloh, Donald N.
The present study examined student learning in business ethics, particularly ethical judgment, using R. E. Reidenbach and D. P. Robin's (1990) Multidimensional Ethics Scale (MES). The authors asked 262 undergraduate students to provide ethical judgment rating, first at the beginning of the semester and again at the end of the semester. Students…
Contemporary medical ethics is far from the traditional concept of "In-Sul (benevolent art)" or "Yul-Li (倫, ethics), which emphasizes so much the personality or the character of a doctor. Nowadays, medical ethics should be considered as "professional ethics" which regulates the acts and medical practices of ordinary doctors in their daily practice. The key concepts of the professional ethics are "autonomy", "integrity", and "professional standard" established by medical organizations such as medical societies or associations. Most of Korean doctors have not been familiar with the concept of professional ethics or professionalism, which is due to the modern history of Korea. However, the concept of professional ethics is really critical to Korean doctors from the perspective of professional dignity and social respect to this profession. The current healthcare system of Korea is suffering from many problems of both private and public sector. Nonetheless, the professional ethics is urgently demanded for that very reason.
Magnavita, N; Bergamaschi, A
One of the causes of the increasing request for radiological examinations occurring in all economically developed countries is the active role played by the patient-consumer. Consumerism places the radiologist in an ethical dilemma, between the principle of autonomy on the one hand and the ethical principles of beneficence, nonmaleficence and justice on the other. The choice made by radiologists in moral dilemmas is inspired by an adherence to moral principles, which in Italy and elsewhere refer to the Judaeo-Christian tradition or to neo-Darwinian relativism. Whatever the choice, the radiologist is bound to adhere to that choice and to provide the patient with all the relevant information regarding his or her state of health.
Russell, J A
Amyotrophic lateral sclerosis (ALS) is universally fatal. Technological advances have provided a means to impact upon, without radically improving, the natural history of the disease. In addition, we now have the capability of potentially identifying patients who are pre-symptomatic carriers of the rare heritable forms of the disease. These capabilities provide the basis for the numerous ethical dilemmas that face patients, physicians, and agencies responsible for health care expenditures; dilemmas that can only be amplified between cultures. This paper attempts to address some of the major ethical issues germane to the care of ALS patients. It discusses the emergence of autonomy as the reigning principle of medical ethics in the United States and its potential conflict with the ethical dilemma of limited resource allocation. Finally, it attempts to compare and contrast, in an admittedly anecdotal and fragmentary fashion, the perspective of other cultures regarding the care of ALS patients.
Increasing the numbers of health workers and improving their skills requires that countries confront a number of ethical dilemmas. The ethical considerations in answering five important questions on enabling health workers to deal appropriately with the circumstances in which they must work are described. These include the problems of the standards of training and practice required in countries with differing levels of socioeconomic development and different priority diseases; how a society can be assured that health practitioners are properly trained; how a health system can support its workers; diversion of health workers and training institutions; and the teaching of ethical principles to student health workers. The ethics of setting standards for the skills and care provided by traditional health-care practitioners are also discussed. PMID:15868019
Recupero, Patricia R
In child and adolescent psychiatry, medical records and professional communications raise important ethical concerns for the treating or consulting clinician. Although a distinction may be drawn between internal records (eg, medical records and psychotherapy notes) and external communications (eg, consultation reports and correspondence with pediatricians), several ethical principles apply to both types of documentation; however, specific considerations may vary, depending upon the context in which the records or communications were produced. Special care is due with regard to thoroughness and honesty, collaboration and cooperation, autonomy and dignity of the patient, confidentiality of the patient and family members, maintaining objectivity and neutrality, electronic communications media, and professional activities (eg, political advocacy). This article reviews relevant ethical concerns for child and adolescent psychiatrists with respect to medical records and professional communications, drawing heavily from forensic and legal sources, and offers additional recommendations for further reading for clarification and direction on ethical dilemmas.
Conger, S.; Loch, K.D.; Helft, B.L.
Ethical dilemmas are situations in which a decision results in unpleasant consequences. The unpleasant consequences are treated as a zero-sum game in which someone always loses. Introducing information technology (IT) to a situation makes the recognition of a potential loser more abstract and difficult to identify, thus an ethical dilemma may go unrecognized. The computer mediates the human relationship which causes a lost sense of contact with a person at the other end of the computer connection. In 1986, Richard O. Mason published an essay identifying privacy, accuracy, property, and Access (PAPA) as the four main ethical issues of the information age. Anecdotes for each issue describe the injured party`s perspective to identify consequences resulting from unethical use of information and information technology. This research sought to validate Mason`s social issues empirically, but with distinct differences. Mason defined issues to raise awareness and initiate debate on the need for a social agenda; our focus is on individual computer users and the attitudes they hold about ethical behavior in computer use. This study examined the attitudes of the computer user who experiences the ethical dilemma to determine the extent to which ethical components are recognized, and whether Mason`s issues form recognizable constructs.
Rasmussen, Anna Julie; Ebbesen, Mette
During the education of scientists at the university level the students become more and more specialized. The specialization of the students is a consequence of the scientific research becoming specialized as well. In the interdisciplinary field of nanoscience the importance of specialization is also emphasized throughout the education. Being an interdisciplinary field of study the specialization in this area is not focused on scientific disciplines, but on the different branches of the research. Historically ethics has not been a priority in science education, however, in recent years the importance of such teachings has been highly recognize especially in medicine, biotechnology and engineering. The rapid development, the many new and unknown areas and the highly specialized focus of nanotechnology suggest the importance of having ethically competent researchers. In this article the importance of ethical competence in nanoscience research is argued for by an example of a dilemma that could occur in a research project. The dilemma is analyzed using two different ethical views, generating two different choices for action. It is seen that the dilemma can have more than one solution and that ethical competence can help in justifying the choice of solution in a specific situation. Furthermore it is suggested that a way to reach this competence is through education in ethics incorporated into the nanoscience education curriculum.
Raphael, D D
The main purpose of this paper (1) is to draw attention to a gap between the principles of Common Law and the principles accepted by many leading medical practitioners on the ethics of allowing severely handicapped infants to die. The Common Law principles are shown in Court of Appeal judgements on two cases. The contrasting principles of many paediatricians were illustrated at the trial of Dr Leonard Arthur. The paper suggests that the gap could be closed by statutory guidance on general principles. It also argues that utilitarian concepts misrepresent the ethical issues of medical dilemmas like this one. PMID:2965246
Goodwin, Dawn; Pope, Catherine; Mort, Maggie; Smith, Andrew
In this article, the authors discuss an ethical dilemma faced by the first author during the fieldwork of an ethnographic study of expertise in anesthesia. The example, written from the perspective of the first author, addresses a number of ethical issues commonly faced, namely, the researcher-researched relationship, anonymity and confidentiality, privacy, and exploitation. She deliberates on the influences that guided her decision and in doing so highlights some of the elements that combine to shape the data. The authors argue that this process of shaping the data is a symbiotic one in which the researcher and the community being studied construct the data together.
discusses Operation Valkyrie , the attempted assassination of Hitler by senior German officers. Raymond uses the ethical dilemmas faced by these officers to...and civilian rule are subordinate to other principles. If Operation Valkyrie was legiti- mate, a Pandora’s Box is opened. Perhaps, the lid would only be...prosecuting an unjust war?3 If those not involved in Operation Valkyrie were correct in adhering to the principle of duty, other problems arise. Some might
Duisin, Dragana; Barisić, Jasmina; Nikolić-Balkoski, Gordana
Through the case presentation of a diagnostically and therapeutically interesting gender dysphoric individual, the authors wish to address diagnostic problems associated with this controversial category, illustrate dilemmas and emphasize the importance of diagnostic procedures in differentiating between primary transsexualism and other transgender states. Many questions have been triggered by this case, mainly about whether this patient should be classified as a paraphilia (transvestite, transvestite with transsexual trend), primary transsexualism or autogynephilia and about the most adequate treatment (e.g., sex-reassignment surgery, hormone therapy as a way of partial feminisation or exclusively psychotherapy). The issue of reconstructive surgery, i.e. its justification in the case of this particular condition is specifically discussed. Before any decision is made, both medical but also ethical consequences of the treatment choice need to be considered (e.g., the client is the father of two underage children).
Patients with borderline personality disorder are frequent users of inpatient mental health units, with inpatient crisis intervention often used based on the risk of suicide. However, this can present an ethical dilemma for nursing and medical staff, with these clinician responses shifting between the moral principles of beneficence and non-maleficence, dependent on the outcomes of the actions of containing or tolerating risk. This article examines the use of crisis intervention through moral duties, intentions and consequences, culminating in an action/consequence model of risk management, used to explore potential outcomes. This model may be useful in measuring adherence and violation of the principles of beneficence and non-maleficence and therefore an aid to clinical decision making.
Describes a course offered at Polytechnic University (New York) which is designed to provide an introduction to professional engineerig ethics as presented through the history of engineering, codes of conduct of professional societies, case studies and hypothetical situations. (TW)
Dresden, Elissa; McElmurry, Beverly J.; McCreary, Linda L.
Case studies depict dilemmas in nursing research involving protection of community rights and community informed consent. Outlines research guidelines derived from communitarian ethical frameworks that consider beneficence, justice, and respect for autonomy in the context of community. (Contains 58 references.) (SK)
Conjoined twins were born on 8th August 2000 in Manchester. After a 2-month period of legal fighting between their parents and the medical team, which was widely reported in the media, the twins were surgically separated on 7th November 2000. This case-report scrutinises the ethical dilemma from a fresh perspective.
Freeman, William H.
This paper deals with growing ethical dilemmas in sport as technology advances. Three aspects of sport are discussed: (l) the perpetual conflict between process (training) and product (the actual contest); (2) technophobia, the fear of the new world of technology; and (3) "technosport" or technological training. It is necessary to understand that…
Elliott, Glenda R.
Based on the core conditions of client-centered counseling and supported by aspects of psychodynamic, cognitive developmental, and behavioral theories, a perspective is introduced that provides a resolution to the dilemma experienced by counselors and counseling students whose personal values and beliefs conflict with the ethical guidelines of the…
Martinez, Melissa A.
Inspired by real-life events, this case describes the dilemma of a novice assistant principal who must balance her role as an administrator at her high school campus where a cousin's son, Eddie, recently enrolled and is proving to be disruptive the first month of school. Troubled by questions of ethics and loyalty, the issue is complicated after…
Focusing on the Human Brain Project, I discuss some social and ethical challenges raised by such programs of research: the possibility of a unified knowledge of "the brain," balancing privacy and the public good, dilemmas of "dual use," brain-computer interfaces, and "responsible research and innovation" in governance of emerging technologies.
Adlan, Abdallah A; ten Have, Henk A M J
Telling the truth is one of the most respected virtues in medical history and one of the most emphasized in the code of medical ethics. Health care providers are frequently confronted with the dilemma as to whether or not to tell the truth. This dilemma deepens when both choices are critically vicious: The choice is no longer between "right and right" or "right and wrong," it is between "wrong and wrong." In the case presented and discussed in this paper, a research team in Saudi Arabia unintentionally uncovered information regarding misattributed paternity. In such a situation and in the context of a tribal cultural system, what should the team do with this information? This case analysis demonstrates the joint application of ethical resources originating from within and outside the Saudi Arabian context. The article analyses the case based on the moral problems involved, relevant medical application, and the impact of such information in the Saudi tribal and Islamic domains. The most pertinent relevant values and secular debates on similar matters are discussed. Finally, the article aims to provide an Islamic dimension of family, fatherhood, and adultery.
Campbell, Madeleine L H
Veterinarians have a key role in providing medical care for sports horses during and between competitions, but the standard client:veterinarian relationship that exists in companion and production animal medicine is distorted by the involvement of third parties in sports medicine, resulting in distinct ethical dilemmas which warrant focused academic attention. By comparing the existing literature on human sports medicine, this article reviews the ethical dilemmas which face veterinarians treating equine athletes, and the role of regulators in contributing to or resolving those dilemmas. Major ethical dilemmas occur both between and during competitions. These include conflicts of responsibility, conflicts between the need for client confidentiality and the need to share information in order to maximise animal welfare, and the need for an evidence base for treatment. Although many of the ethical problems faced in human and equine sports medicine are similar, the duty conferred upon a veterinarian by the licensing authority to ensure the welfare of animals committed to his or her care requires different obligations to those of a human sports medicine doctor. Suggested improvements to current practice which would help to address ethical dilemmas in equine sports medicine include an enhanced system for recording equine injuries, the use of professional Codes of Conduct and Codes of Ethics to establish acceptable responses to common ethical problems, and insistence that treatment of equine athletes is evidence-based (so far as possible) rather than economics-driven.
Amey, E.B.; Russell, J.A.; Hurdelbrink, R.J.
In 1976, the U.S. Congress enacted the Resource Conservation and Recovery Act (RCRA) to further address the problem of increasing industrial and municipal waste. The main objectives of RCRA were to responsibly manage hazardous and solid waste and to procure materials made from recovered wastes. To fulfill these objectives, four main programs of waste management were developed. These programs were defined under Subtitle C, the Hazardous Waste Program; Subtitle D, the Solid Waste Program; Subtitle I, the Underground Storage Tank Program; and Subtitle J, the Medical Waste Program. Subtitle D illustrates the solid waste dilemma occurring in the United States. Under this program, states are encouraged to develop and implement their own waste management plans. These plans include the promotion of recycling solid wastes and the closing and upgrading of all environmentally unsound dumps. ?? 1996 International Association for Mathematical Geology.
Technology and population rely on each other for sustenance and growth. Technology has helped produce more food, provide better health care, better communication, faster modes of travel, better consumer durables, greater amenities, and increased the quality of life for millions of people. There has been a price in terms of the widening gap between the technology of the developed and developing countries. There has also been rapid population growth that has resulted in a host of ills. Further, technology itself has produced toxic wastes and consumed a large amount of natural resources. This situation is easily seen as a dilemma between the limitless promises of technology and the limited resources created by large populations. The solution to the dilemma is sustainable development, a concept often talked about but seldom realized. The 90s will be a crucial decade for sustainable development as population is growing by 90 million/annum. 90% of the increase is occurring in developing countries. Within each country there is a trend towards urbanization. By 2000, 75% of Latin Americans, 42% of Africans, and 37% of Asians will live in urban environments. By 2050 there should be 100s of millions of migrants running from the slowly rising sea. The survival equation is sustainability S equals resources R time ingenuity 1 over population P. This is a conceptual equation, but it does illustrate that the impact of human ingenuity is just as important as resources. World commitment must come before any meaningful change will occur. The almost universal acceptance of human rights and fundamental freedoms exceeds the will to change in decision makers and expert consultants.
Haws, David R
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
Yassi, Annalee; Spiegel, Jennifer Beth; Lockhart, Karen; Fels, Lynn; Boydell, Katherine; Marcuse, Judith
Academics from diverse disciplines are recognizing not only the procedural ethical issues involved in research, but also the complexity of everyday "micro" ethical issues that arise. While ethical guidelines are being developed for research in aboriginal populations and low-and-middle-income countries, multi-partnered research initiatives examining arts-based interventions to promote social change pose a unique set of ethical dilemmas not yet fully explored. Our research team, comprising health, education, and social scientists, critical theorists, artists and community-activists launched a five-year research partnership on arts-for-social change. Funded by the Social Science and Humanities Research Council in Canada and based in six universities, including over 40 community-based collaborators, and informed by five main field projects (circus with street youth, theatre by people with disabilities, dance for people with Parkinson's disease, participatory theatre with refugees and artsinfused dialogue), we set out to synthesize existing knowledge and lessons we learned. We summarized these learnings into 12 key points for reflection, grouped into three categories: community-university partnership concerns (n = 3), dilemmas related to the arts (n = 5), and team issues (n = 4). In addition to addressing previous concerns outlined in the literature (e.g., related to consent, anonymity, dangerous emotional terrain, etc.), we identified power dynamics (visible and hidden) hindering meaningful participation of community partners and university-based teams that need to be addressed within a reflective critical framework of ethical practice. We present how our team has been addressing these issues, as examples of how such concerns could be approached in community-university partnerships in arts for social change.
Mercuri, John J; Vigdorchik, Jonathan M; Otsuka, Norman Y
All orthopedic surgeons face moral dilemmas on a regular basis; however, little has been written about the moral dilemmas that are encountered when providing orthopedic care to pediatric patients and their families. This article aims to provide surgeons with a better understanding of how bioethics and professionalism apply to the care of their pediatric patients. First, several foundational concepts of both bioethics and professionalism are summarized, and definitions are offered for 16 important terms within the disciplines. Next, some of the unique aspects of pediatric orthopedics as a subspecialty are reviewed before engaging in a discussion of 5 common moral dilemmas within the field. Those dilemmas include the following: (1) obtaining informed consent and assent for either surgery or research from pediatric patients and their families; (2) performing cosmetic surgery on pediatric patients; (3) caring for pediatric patients with cognitive or physical impairments; (4) caring for injured pediatric athletes; and (5) meeting the demand for pediatric orthopedic care in the United States. Pertinent considerations are reviewed for each of these 5 moral dilemmas, thereby better preparing surgeons for principled moral decision making in their own practices. Each of these dilemmas is inherently complex with few straightforward answers; however, orthopedic surgeons have an obligation to take the lead and better define these kinds of difficult issues within their field. The lives of pediatric patients and their families will be immeasurably improved as a result.
Rapid scientific progress in the fields of prenatal diagnostics, obstetrics and neonatology has enabled severe malformations and hereditary diseases to be detected at a very early fetal stage and has also led to the survival of very immature newborn infants in increasing numbers. Parents, doctors and nurses must all participate in the difficult decision making with regard to therapeutic alternatives and due respect must be paid to the intersects of the child, the impact on the family, but also to the professional opinion of the attending doctors and carers. Problems of the ethical limits of prenatal diagnostics, as well as the severity of malformations or organ failure justifying termination of pregnancy or intensive care measures are discussed with reference to clinical cases. Likewise, the question of precedence of the rights of the parents and siblings to quality of life versus the right of the infant to live is broached. From the neonatological point of view candid discussion with the parents, painstaking efforts to build up an atmosphere of confidence and the provision of supportive measures on the one hand, whilst avoiding the expression of dogmatic opinions and patronizing attitudes on the other hand, are essential prerequisites in dealing with the ethical dilemmas arising in the pre- and neonatal management of such cases.
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.
The purpose of this paper is to give an overview of the ethical issues raised by neonatal screening for cystic fibrosis and to propose a structure for the ethical analysis of these issues. The structure is based on an analysis of some of the most common shortcomings of ethical analyses. The structure needs to be supplemented by facts about the present state of the art concerning effects and costs of the various screening and treatment alternatives. Such information is provided by other contributions to these proceedings.
Yin, Hongbiao; Lee, John Chi-Kin; Wang, Wenlan
Since the mid-1980s, a global resurgence of large-scale reform in the field of education has been witnessed. Implementing these reforms has created many dilemmas for change leaders. Following a three-year qualitative research project, the present study explores the dilemmas leaders faced during the implementation of the national curriculum reform…
Liu, Sheng-nan; Feng, Da-ming
Educational borrowing may cause numerous dilemmas that emerge from cross-cultural differences among teachers in the globalization. Through the case study on the flipped classroom introduced from the United States into Chinese middle schools, this article presents an examination of dilemmas that teachers encountered during educational borrowing in…
Hunt, Matthew; Schwartz, Lisa; Pringle, John; Boulanger, Renaud; Nouvet, Elysée; O'Mathúna, Dónal; Arya, Neil; Bernard, Carrie; Beukeboom, Carolyn; Calain, Philippe; de Laat, Sonya; Eckenwiler, Lisa; Elit, Laurie; Fraser, Veronique; Gillespie, Leigh-Anne; Johnson, Kirsten; Meagher, Rachel; Nixon, Stephanie; Olivier, Catherine; Pakes, Barry; Redwood-Campbell, Lynda; Reis, Andreas; Renaldi, Teuku; Singh, Jerome; Smith, Maxwell; Von Schreeb, Johan
This paper maps key research questions for humanitarian health ethics: the ethical dimensions of healthcare provision and public health activities during international responses to situations of humanitarian crisis. Development of this research agenda was initiated at the Humanitarian Health Ethics Forum (HHE Forum) convened in Hamilton, Canada in November 2012. The HHE Forum identified priority avenues for advancing policy and practice for ethics in humanitarian health action. The main topic areas examined were: experiences and perceptions of humanitarian health ethics; training and professional development initiatives for humanitarian health ethics; ethics support for humanitarian health workers; impact of policies and project structures on humanitarian health ethics; and theoretical frameworks and ethics lenses. Key research questions for each topic area are presented, as well as proposed strategies for advancing this research agenda. Pursuing the research agenda will help strengthen the ethical foundations of humanitarian health action. PMID:25687273
Vergnes, Jean-Noel; Marchal-Sixou, Christine; Nabet, Cathy; Maret, Delphine; Hamel, Olivier
Since its introduction by the Nuremberg Code and the Declaration of Helsinki, the place held by ethics in biomedical research has been continuously increasing in importance. The past 30 years have also seen exponential growth in the number of biomedical articles published. A systematic review of the literature is the scientific way of synthesising a plethora of information, by exhaustively searching out and objectively analysing the studies dealing with a given issue. However, the question of ethics in systematic reviews is rarely touched upon. This could lead to some drawbacks, as systematic reviews may contain studies with ethical insufficiencies, may be a possible way to publish unethical research and may also be prone to conflict of interest. Finally, informed consent given for an original study is not necessarily still valid at the systematic review level. There is no doubt that routine ethical assessment in systematic reviews would help to improve the ethical and methodological quality of studies in general. However, ethical issues change so much with time and location, and are so broad in scope and in context that it appears illusory to search for a universal, internationally accepted standard for ethical assessment in systematic reviews. Some simple suggestions could nevertheless be drawn from the present reflection and are discussed in the paper.
In this article, I explore an ethical and pedagogical dilemma that I encounter each semester in my world religions courses: namely, that a great number of students enroll in the courses as part of their missionary training programs, and come to class understanding successful learning to mean gathering enough information about the world's religious…
Bhardwaj, Minakshi; Macer, Darryl R J
A brief review of some of the key issues in policy relating to the ethical issues raised by medical biotechnology in developing countries is presented, using India as an example. A series of some key issues is discussed, including information obtained from interviewing Indian government policy makers. Some of the issues discussed include: Economic and social incentives to encourage biotechnology; Health policy and ethics review; Patents on drugs; Medical genetics; Relationship to traditional medical practices; Positive public attitudes to biotechnology; Limited public participation; Infrastructural hurdles; Indian progress in stem cell research; and dilemmas of expensive technologies. The results show that although the needs of developing countries are different to those of rich countries, government policy utilizing guidelines and ethics committees has evolved as mechanisms to aid ethical health care delivery in India. In all countries there may be some of these concerns that are raised here, however, the integration of traditional medicine and advanced medical technology, and access to medical services by people in need, are particularly important challenges in developing countries. Better public involvement in policy making will require education and infrastructural organization as well as mutual willingness on the part of policy makers and citizens.
Matava, Matthew J
This article provides an overview of commonly used analgesics in athletes and the ethical implications of their use in athletic settings. Given the highly competitive nature of modern-day sports and the economic impact of athletic performance at elite levels, athletes feel more compelled than ever to play with injury, which has led to the widespread use of a variety of analgesic agents. An ethical dilemma often ensues for team physicians who must balance the medical implications of these drugs with pressure from players, coaches, and management. The most commonly used agents and their ethical and rational use are discussed.
Ethics, especially in nursing, tends to be surrounded by myths and ideas that have more in common with magic than reality. This article argues from quotes of two medieval men, Thomas Aquinas and Meister Eckhart, that ethical behaviour among nurses is not something difficult or far-fetched, but something immediate, everyday, and often very simple. The more weighty ethical dilemmas are not diminished by this. Aspects of justice, compassion and courage are discussed from the point of view of relationships with clients and colleagues, and the need for (helpful) myths is stressed.
Berlin, Jordan; Bruinooge, Suanna S; Tannock, Ian F
As Ethics Committee Chair, I am pleased to introduce the first in an ongoing series of ethics vignettes. These columns, which are based on true-to-life situations that arise in oncology research and practice, are intended to identify and explore important ethical issues and provide commentary that is specific to oncology. Please look for them periodically in both the Journal of Clinical Oncology and the Journal of Oncology Practice. The idea for publishing vignettes evolved through the joint efforts of the Ethics Committee and the Board of Directors. Rather than adopt a single set of ethical principles that applies vaguely to any situation and well to none, the Committee and the Board preferred to tackle ethical dilemmas individually, specifically, and directly. Because the Ethics Committee thought the ethical and legal implications of physician interactions with the investment industry were so important and timely, it chose to address this topic in both a position article, which was previously published in the January 20, 2007, issue of the Journal of Clinical Oncology (J Clin Oncol 25:338-340, 2007) and in its first vignette column. The Ethics Committee hopes this column will be the first of several that ASCO members will find helpful as they grapple with the many ethical issues that arise in daily practice in the field of oncology. Because these columns are intended to address the concerns of ASCO members, the Committee welcomes suggestions for future topics at email@example.com. Martin D. Abeloff, MD, Chair, Ethics Committee.
Andrew, Jennifer; Robottom, Ian
Ethical issues concerning pain and suffering of animals are necessarily a consideration when it comes to killing pest or feral species in Australia. Within a continent where there are no large predators, many introduced animal species such as rabbits, foxes, horses, donkeys, camels, goats, and mice have been able to thrive, competing with the interests of farmers and graziers, and livestock and food production. These species, thus, gain the label of pest. Many methods now exist to kill these species and, consequently, ethical issues arise concerning the possible pain and suffering caused as a direct result of these methods. Yet within government and scientific communities, ethical issues are reduced to a secondary consideration without serious debate or contention. Ethical issues appear to be at odds with scientific agendas. How can environmental ethics be incorporated as part of science-based decision making that appeals to objectivity and scientific evidence? Within educational institutions as well, the same dilemma exists: How can ethical issues be addressed within the science curriculum and in the classroom? A greater understanding of various perspectives on the subject of environmental ethics and the value positions advocated by proponents of these perspectives may help teachers consider ways of handling such issues in the science classroom.
Solihu, Abdul Kabir Hussain; Ambali, Abdul Rauf
The goal of responsible engineers is the creation of useful and safe technological products and commitment to public health, while respecting the autonomy of the clients and the public. Because engineers often face moral dilemma to resolve such issues, different engineers have chosen different course of actions depending on their respective moral value orientations. Islam provides a value-based mechanism rooted in the Maqasid al-Shari'ah (the objectives of Islamic law). This mechanism prioritizes some values over others and could help resolve the moral dilemmas faced in engineering. This paper introduces the Islamic interpretive-evaluative maxims to two core issues in engineering ethics: genetically modified foods and whistleblowing. The study aims primarily to provide problem-solving maxims within the Maqasid al-Shari'ah matrix through which such moral dilemmas in science and engineering could be studied and resolved.
Chang, Dave; Bai, Heesoon
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…
Ramalingam, Rangaraj; Kadako, Nitinkumar S; Pati, Shivanand; Manjunath, C N
A 55yr old gentleman known diabetic and hypertensive presented with breathlessness and tingling sensation of both upper and lower limbs with strong family history of similar neurological problems. On extensive evaluation he was found to have amyloidic peripheral neuropathy with large pericardial effusion. Tubercular etiology was confirmed by pericardial fluid PCR and culture. Here the diagnostic dilemma was whether Amloidosis is primary, secondary to Tubercular pericardial effusion or Hereditary Amyloidosis. In the end, how we have arrived at the diagnosis of Hereditary Amyloidosis based upon the strong family history and nerve biopsy is interestingly presented in the following case report.
This chapter intends to lay out some essential ethics questions that might frame the next step of space exploration. In this, I undertake two sorts of tasks. The first is to respond to the core ethic question: Is it ethical to travel in space? The second, assuming for the moment that I can convince you that the first premise can be justified, is to comment on what ethical challenges will face us there. It is appropriate to have a philosopher comment on this at the fortieth anniversary celebration, since it was also in 1962 that the National Academy of Science first convened a panel of philosophers to comment on space travel. They asked at that time whether it was indeed a worthwhile pursuit to travel in space and what might be expected of such an effort. What is at stake in any such boundary crossing is how the changing of essential human perimeters changes our own moral status. Will such boundary crossing worsen our human condition, or will it enhance it? In this way, the geopolitical quest is then linked to the quest for ontology, Pisarro hunting for the fountain of youth, for gold, and for territory. What follows are a series of ethical claims that link the problem of discovery in the larger world and the attendant ethical dilemmas of our explorations, as well as how this exploration alters our concepts of life on Earth. In this, the role of the ethicist is to function as both a skeptic and a stranger, aware of the optimism of science and the pessimism of philosophy.
When conducting research in an international setting, in a country different than that of the researcher, unpredictable circumstances can arise. A study conducted by a novice North American researcher with a vulnerable population in northern Ghana highlights these happenings with an emphasis placed on the ethical challenges encountered. An illustration from the research is used to highlight an ethical dilemma while in the field, and how utilizing a moral decision-making framework can assist in making choices about a participant's right to autonomy, privacy, and confidentiality during the research process. Moral frameworks, however, can never be enough to solve a dilemma since guidelines only describe what to aim for and not how to interpret or use them. Researchers must therefore strive to move beyond these frameworks to employ practical wisdom or phronesis so to combine the right thing to do with the skill required to figure out what the right choice is. The skill of practical wisdom must be acquired because without it international researchers indecisively fumble around with good intentions, often leaving a situation in worse shape than they found it.
MacLeod, Rod D; Wilson, Donna M; Malpas, Phillipa
Assisting or hastening death is a dilemma with many ethical as well as practical issues facing healthcare practitioners in most countries worldwide now. Various arguments for and against assisted dying have been made over time but the call from the public for the legalisation of euthanasia and assisted suicide has never been stronger. While some studies have documented the reluctance of medical and other healthcare professionals to be involved in the practice of assisted dying or euthanasia, there is still much open debate in the public domain. Those who have the most experience of palliative care are strongest in their opposition to hastening death. This paper explores salient practical and ethical considerations for healthcare practitioners associated with assisting death, including a focus on examining the concepts of autonomy for patients and healthcare practitioners. The role of the healthcare practitioner has clearly and undoubtedly changed over time with advances in healthcare practices but the duty of care has not changed. The dilemmas for healthcare practitioners thus who have competent patients requesting hastened death extends far beyond acting within a country’s laws as they go to the very heart of the relationship between the practitioner and patient. PMID:23121745
Focuses on the issue of ethical use of the Internet in schools, and suggests that by devising and implementing acceptable use policies, and providing students with a set of ethical guidelines, schools and libraries can deal with the situation before it becomes a problem. Discusses and the need for parents to be included in policy formation and to…
Knefelkamp, L. Lee
Four books focusing on ethical issues in collegiate sports are reviewed: "Paterno by the Book,""Personal Fouls,""Never Too Young to Die: The Death of Len Bias," and "Rules of the Game: Ethics in College Sport." The themes of academic standards, student responsibility, the coach's role and responsibilities,…
Müller, H; Rehmann-Sutter, C
Gene therapy represents a new strategy to treat human disorders. It was originally conceived as a cure for severe monogenetic disorders. Since its conception, the spectrum of possible application for gene therapy has been to include the treatment of acquired diseases, such as various forms of cancer and some viral infections, most notably human immune deficiency virus (HIV) and hepatitis B virus. Since somatic gene therapy does not cause substantially new ethical problems, it has gained broad approval. This is by no means the case with germ-line gene therapy. Practically all bodies who were evaluating the related ethical aspects wanted to ban its medical application on grounds of fundamental and pragmatic considerations. In this review, practical and ethical views concerning gene therapy are summarized which were presented at the "Junitagung 1994" of the Swiss Society for Biomedical Ethics in Basle.
Dunn, Warren R; George, Michael S; Churchill, Larry; Spindler, Kurt P
Physicians have struggled with the medical ramifications of athletic competition since ancient Greece, where rational medicine and organized athletics originated. Historically, the relationship between sport and medicine was adversarial because of conflicts between health and sport. However, modern sports medicine has emerged with the goal of improving performance and preventing injury, and the concept of the "team physician" has become an integral part of athletic culture. With this distinction come unique ethical challenges because the customary ethical norms for most forms of clinical practice, such as confidentiality and patient autonomy, cannot be translated easily into sports medicine. The particular areas of medical ethics that present unique challenges in sports medicine are informed consent, third parties, advertising, confidentiality, drug use, and innovative technology. Unfortunately, there is no widely accepted code of sports medicine ethics that adequately addresses these issues.
Barker, Andrew T.
The traveler's dilemma is a generalization of the prisoner's dilemma which shows clearly a paradox of game theory. In the traveler's dilemma, the strategy chosen by analysis and theory seems obviously wrong intuitively. Here we develop a measure of evolutionary stability and show that the evolutionarily stable equilibrium is in some sense not very…
Talanquer, Vicente; Tomanek, Debra; Novodvorsky, Ingrid
We explore the potential of dilemma analysis as an assessment tool to reveal student teachers' thinking and concerns about their practice. For this purpose we analyze the dilemma analyses completed by 22 student teachers enrolled in our science teacher preparation program over a period of four semesters. Student teachers' dilemmas fall into two…
The question to be addressed in this paper is: How can the ethics of justice and the ethics of care be used complementary to each other in ethical decision making within the health care team? Various arguments are presented that justify the reasons that the ethics of justice and the ethics of care should be used complementary to each other for effective ethical decision making within the health care team. The objective is to explore and describe the compatibility of the ethics of justice and the ethics of care from two perspectives: firstly an analysis of the characteristics of the two ethical theories, and secondly the scientific-philosophical viewpoints of these theories. The two theories are incompatible when viewed from these perspectives. For a probable solution to this incompatibility arguments are presented from the perspectives of reflection and virtue-based ethics.
A professional code of ethics is essential for behaviors to be reinforced in any discipline. The American Nurses Association (ANA) has established a code of ethics for nurses to use as a framework for making ethical decisions with all aspects of health care delivered to the public. With the explosion of genetic discoveries, nurses and clients are facing new ethical dilemmas. It is important for nurses to understand how to use the ANA Code of Ethics when faced with the many complexities of ethical issues involving genetics and health care. This article illustrates how the ANA Code of Ethics can be applied in nursing practice to establish professional behaviors related to ethical issues and genetics.
Kahane, Guy; Everett, Jim A C; Earp, Brian D; Farias, Miguel; Savulescu, Julian
A growing body of research has focused on so-called 'utilitarian' judgments in moral dilemmas in which participants have to choose whether to sacrifice one person in order to save the lives of a greater number. However, the relation between such 'utilitarian' judgments and genuine utilitarian impartial concern for the greater good remains unclear. Across four studies, we investigated the relationship between 'utilitarian' judgment in such sacrificial dilemmas and a range of traits, attitudes, judgments and behaviors that either reflect or reject an impartial concern for the greater good of all. In Study 1, we found that rates of 'utilitarian' judgment were associated with a broadly immoral outlook concerning clear ethical transgressions in a business context, as well as with sub-clinical psychopathy. In Study 2, we found that 'utilitarian' judgment was associated with greater endorsement of rational egoism, less donation of money to a charity, and less identification with the whole of humanity, a core feature of classical utilitarianism. In Studies 3 and 4, we found no association between 'utilitarian' judgments in sacrificial dilemmas and characteristic utilitarian judgments relating to assistance to distant people in need, self-sacrifice and impartiality, even when the utilitarian justification for these judgments was made explicit and unequivocal. This lack of association remained even when we controlled for the antisocial element in 'utilitarian' judgment. Taken together, these results suggest that there is very little relation between sacrificial judgments in the hypothetical dilemmas that dominate current research, and a genuine utilitarian approach to ethics.
Colorado Springs, Colo.: Navpress, 1978). 2. Quoted in Andrew Stark, “What’s the Matter with Business Ethics?” Harvard Business Review , May–June 1993...39. 3. Ibid., 40. 4. Kenneth R. Andrews, “Ethics in Practice,” Harvard Business Review , September–October 1989, 99. 5. Quoted in Perspective: A
Yi, Richard; Buchhalter, August R; Gatchalian, Kirstin M; Bickel, Warren K
Previous research on college students has found that cooperation in iterated prisoner's dilemma game is correlated with preference for delayed rewards in studies of temporal discounting. The present study attempted to replicate this finding in a drug-dependent population. Thirty-one individuals who intranasally abuse prescription opioids participated in temporal discounting and iterated prisoner's dilemma game procedures during intake for a treatment study. Rate of temporal discounting was determined for each participant at two hypothetical reward magnitudes, as well as proportion of cooperation in a 60-trial iterated prisoner's dilemma game versus a tit-for-tat strategy. Cooperation in the prisoner's dilemma game and temporal discounting rates were significantly correlated in the predicted direction: individuals who preferred delayed rewards in the temporal discounting task were more likely to cooperate in the prisoner's dilemma game.
Moore, A R
'The ethical landscape', the title given to part of a course devised by Mr. Moore, is described in full in this paper. The whole course is a new adventure in medical education designed to help students to explore the ethical problems in the practice of medicine. The 'ethical landscape' is seen through discussion based on passages from literature depicting doctors' and patients' dilemmas. As the results summarized in the tables show, the students found the course well worth while, and thought that they had gained a new insight into the problems with which they would be confronted and also into their own personalities and those of their fellow students whom previously they had only known superficially. The Chairman of the course, Mr. Moore, was also subjected to assessment from his students, because on the skill of the Chairman such a course would fail or succeed. PMID:870691
Presents and analyzes moral-ethical issues that arise in administration and concludes that past descriptive, objective, and scientific approaches to administration have failed to take full account of the moral-ethical dimension of human existence. (Author/WD)
Ferreira, A. L.; Lipowski, A.; Pedro, T. B.; Santos, M.; Figueiredo, W.
We study the prisoner’s dilemma model with a noisy imitation evolutionary dynamics on directed out-homogeneous and uncorrelated directed random networks. A heterogeneous pair mean-field approximation is presented showing good agreement with Monte Carlo simulations in the limit of weak selection (high noise) where we obtain analytical predictions for the critical temptations. We discuss the phase diagram as a function of temptation, intensity of noise and coordination number of the networks and we consider both the model with and without self-interaction. We compare our results with available results for non-directed lattices and networks.
Li, Jan-Mou; Malikopoulos, Andreas; Thakur, Gautam; Vatsavai, Raju
In this paper, we present the results obtained and insights gained through the analysis of TRB contest data. We used exploratory analysis, regression, and clustering models for gaining insights into the driver behavior in a dilemma zone while driving under distraction. While simple exploratory analysis showed the distinguishing driver behavior patterns among different popu- lation groups in the dilemma zone, regression analysis showed statically signification relationships between groups of variables. In addition to analyzing the contest data, we have also looked into the possible impact of distracted driving on the fuel economy.
Biedenweg, Kelly; Monroe, Martha C.; Oxarart, Annie
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.…
Pope, Kenneth S; Gutheil, Thomas G
In the aftermath of 9-11, the American Psychological Association, one of the largest U.S. health professions, changed its ethics code so that it now runs counter to the Nuremberg Ethic. This historic post-9-11 change allows psychologists to set aside their ethical responsibilities whenever they are in irreconcilable conflict with military orders, governmental regulations, national and local laws, and other forms of governing legal authority. This article discusses the history, wording, rationale, and implications of the ethical standard that U.S. psychologists adopted 7 years ago, particularly in light of concerns over health care professionals' involvement in detainee interrogations and the controversy over psychologists' prominent involvement in settings like the Guantánamo Bay Detainment Camp and the Abu Ghraib prison. It discusses possible approaches to the complex dilemmas arising when ethical responsibilities conflict with laws, regulations, or other governing legal authority.
Collmann, Jeff R.
This presentation examines the ethical issues raised by computerized image management and communication systems (IMAC), the ethical principals that should guide development of policies, procedures and practices for IMACS systems, and who should be involved in developing a hospital's approach to these issues. The ready access of computerized records creates special hazards of which hospitals must beware. Hospitals must maintain confidentiality of patient's records while making records available to authorized users as efficiently as possible. The general conditions of contemporary health care undermine protecting the confidentiality of patient record. Patients may not provide health care institutions with information about themselves under conditions of informed consent. The field of information science must design sophisticated systems of computer security that stratify access, create audit trails on data changes and system use, safeguard patient data from corruption, and protect the databases from outside invasion. Radiology professionals must both work with information science experts in their own hospitals to create institutional safeguards and include the adequacy of security measures as a criterion for evaluating PACS systems. New policies and procedures on maintaining computerized patient records must be developed that obligate all members of the health care staff, not just care givers. Patients must be informed about the existence of computerized medical records, the rules and practices that govern their dissemination and given the opportunity to give or withhold consent for their use. Departmental and hospital policies on confidentiality should be reviewed to determine if revisions are necessary to manage computer-based records. Well developed discussions of the ethical principles and administrative policies on confidentiality and informed consent and of the risks posed by computer-based patient records systems should be included in initial and continuing
Keying In, 1997
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…