Ethics--Business Educators Teach Students To Do the Right Thing!

ERIC Educational Resources Information Center

Keying In, 1997

1997-01-01

This issue focuses on teaching ethics in business education programs. Exploring the teaching of ethics in both high school and college, the newsletter first presents an overview of ethics and the study of ethics and makes a case for teaching ethics in business education courses. Following a short commentary on the difficulty of teaching ethics is…

Computer ethics and teritary level education in Hong Kong

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

Wong, E.Y.W.; Davison, R.M.; Wade, P.W.

1994-12-31

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 ethicalmore » 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.« less

Nurse managers' experience with ethical issues in six government hospitals in Malaysia: A cross-sectional study

PubMed Central

2011-01-01

Background Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues. Methods A cross-sectional study was conducted in August-September, 2010 involving 417 (69.2%) of total 603 nurse managers in the six Malaysian government hospitals. Data were collected using three-part self-administered questionnaire. Part I was regarding participants' demographics. Part II was about the frequency and areas of management where ethical issues were experienced, and scoring of the importance of 11 pre-identified ethical issues. Part III asked how they dealt with ethical issues in general; ways to deal with the 11 pre-identified ethical issues, and perceived stress level. Data were analyzed using descriptive statistics, cross-tabulations and Pearson's Chi-square. Results A total of 397 (95.2%) participants experienced ethical issues and 47.2% experienced them on weekly to daily basis. Experiencing ethical issues were not associated with areas of practice. Top area of management where ethical issues were encountered was "staff management", but "patient care" related ethical issues were rated as most important. Majority would "discuss with other nurses" in dealing generally with the issues. For pre-identified ethical issues regarding "patient care", "discuss with doctors" was preferred. Only 18.1% referred issues to "ethics committees" and 53.0% to the code of ethics. Conclusions Nurse managers, regardless of their areas of practice, frequently experienced ethical issues. For dealing with these, team-approach needs to be emphasized. Proper understanding of the code of ethics is needed to provide basis for reasoning. PMID:22085735

Stem Cells and Society: An Undergraduate Course Exploring the Intersections among Science, Religion, and Law

ERIC Educational Resources Information Center

Pierret, Chris; Friedrichsen, Patricia

2009-01-01

The intersection of science and our society has led to legal and ethical issues in which we all play a part. To support development of scientific literacy, college science courses need to engage students in difficult dialogues around ethical issues. We describe a new course, Stem Cells and Society, in which students explore the basic biology of…

Ethical Evaluation of Mental Health Social Research: Agreement Between Researchers and Ethics Committees.

PubMed

Mondragón Barrios, Liliana; Guarneros García, Tonatiuh; Jiménez Tapia, Alberto

2017-07-01

The objective of this article is to compare various ethical issues considered by social scientists and research ethics committees in the evaluation of mental health social research protocols. We contacted 47 social scientists and 10 members of ethics committees in Mexico with two electronic national surveys that requested information from both groups related to the application of ethical principles in mental health social research. The results showed no significant difference between these groups in the value placed on the ethical issues explored. Based on this finding, we make proposals to strengthen the collaboration between the two groups.

Ethical Implications of Technological Advances on Business Communication.

ERIC Educational Resources Information Center

Herschel, Richard T.; Andrews, Patricia Hayes

1997-01-01

Explores ethical issues heightened by use of technology, and examines a means for managing these ethical concerns. Argues that ethical problems are not inherent in technological advances, but rather it is how human beings choose to use these new tools that may lead to ethical dilemmas in business contexts. (SR)

Ethics and accountability in nursing people with HIV infection.

PubMed

Murray, E M

This article considers ethical issues in relation to exercising accountability when nursing people with human immunodeficiency virus (HIV) infection or acquired immune deficiency syndrome (AIDS). A range of issues will be explored, some of which may be considered contentious.

Thinking ethically about genetic inheritance: liberal rights, communitarianism and the right to privacy for parents of donor insemination children.

PubMed

Burr, J; Reynolds, P

2008-04-01

The issue of genetic inheritance, and particularly the contradictory rights of donors, recipients and donor offspring as to the disclosure of donor identities, is ethically complicated. Donors, donor offspring and parents of donor offspring may appeal to individual rights for confidentiality or disclosure within legal systems based on liberal rights discourse. This paper explores the ethical issues of non-disclosure of genetic inheritance by contrasting two principle models used to articulate the problem--liberal and communitarian ethical models. It argues that whilst the latter provides a more constructive avenue to providing an ethics for donation than the competing and contradictory positions represented in a liberal rights approach, it raises issues of ethical judgement and authority that remain problematic. This ethical discussion is supported by a field study, funded by the Wellcome Trust, exploring the perceptions and experiences of recipients of donor sperm and their partners towards donor anonymity. The field study provides the empirical basis of an argument for making ethical judgements on the grounds of the community good rather than individual rights, that nevertheless recognises that both are inherently problematic.

Future issues in transplantation ethics: ethical and legal controversies in xenotransplantation, stem cell, and cloning research.

PubMed

Shapiro, Robyn S

2008-07-01

With little prospect of developing a sufficient supply of human transplantable organs to meet the large and growing demand, attention has turned to xenotransplantation, as well as stem cell and cloning research, as possible approaches for alleviating this allograft shortage. This article explores ethical and legal issues that surround developments in these fields.

Caring for one and all - Exploring ethical challenges in an ICU.

PubMed

Jones, Jennifer; Mitchell, Marion; Milligan, Eleanor

2016-08-01

This discussion paper explores some of the complex ethical and moral issues confronting contemporary critical care nurses. In contemporary healthcare discussions, there is an increased appreciation of the complexity of ethical challenges, the multiplicity of stakeholders and that a broad range of possible and practical outcomes exist. Furthermore, many scholars also acknowledge the limitations of principle based ethical frameworks. In seeking to build critical care nurses' capacity to negotiate the complex - and often conflicting - ethical challenges, the authors have adopted a person-centred, values-based approach in this case study. Furthermore, by exploring these complex issues, this paper supports and builds upon critical care nurses' decision making capacities in the clinical area. This case study has been purposefully left open-ended with the aim of inviting the reader to consider the questions posed in a collegial, collaborative manner within the particular context in which she/he is embedded. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Electronic tracking for people with dementia: an exploratory study of the ethical issues experienced by carers in making decisions about usage.

PubMed

White, Eleanor Bantry; Montgomery, Paul

2014-03-01

Electronic tracking through GPS (global positioning system) is being used to monitor and locate people with dementia who are vulnerable to becoming lost. Through a review of the literature and an original study, this article examined ethical issues associated with use in a domestic setting. The qualitative study consisted of in-depth interviews with 10 carers who were using electronic tracking. The study explored the values, beliefs and contextual factors that motivated carers to use electronic tracking. It examined the extent of involvement of the person with dementia in decision-making and it explored the various ethical dilemmas encountered by carers when introducing the tracking system. As an issue that emerged from the interviews, specific attention was paid to exploring covert usage. From the study findings, recommendations have been made for research and practice about the use of electronic tracking in dementia care.

Marriage and Family Counseling: Ethics in Context

ERIC Educational Resources Information Center

Southern, Stephen; Smith, Robert L.; Oliver, Marvarene

2005-01-01

Codes of ethics typically provide rules and guidelines for best practices in marriage and family counseling. An emerging model for ethical decision making emphasizes the ethics of virtues and aspirations. Exploring fundamental models of helping, as well as contemporary issues in community systems, affords context for examining the professional…

Ethical Concerns: Negotiating Truth and Trust

ERIC Educational Resources Information Center

McGarvey, Lynn M.; Sterenberg, Gladys

2009-01-01

Few studies in mathematics education explicitly address ethical issues arising from student interactions. The ethical concerns held by students are expressed in their words, actions, and interactions. The purpose of this article is to explore the ethical nature of copying as it arises in a mathematics classroom. We investigate the basis for…

The Dawning of the Ethics of Environmental Robots.

PubMed

van Wynsberghe, Aimee; Donhauser, Justin

2017-10-23

Environmental scientists and engineers have been exploring research and monitoring applications of robotics, as well as exploring ways of integrating robotics into ecosystems to aid in responses to accelerating environmental, climatic, and biodiversity changes. These emerging applications of robots and other autonomous technologies present novel ethical and practical challenges. Yet, the critical applications of robots for environmental research, engineering, protection and remediation have received next to no attention in the ethics of robotics literature to date. This paper seeks to fill that void, and promote the study of environmental robotics. It provides key resources for further critical examination of the issues environmental robots present by explaining and differentiating the sorts of environmental robotics that exist to date and identifying unique conceptual, ethical, and practical issues they present.

Transplant Ethics: Let's Begin the Conversation Anew : A Critical Look at One Institute's Experience with Transplant Related Ethical Issues.

PubMed

Shafran, David; Smith, Martin L; Daly, Barbara J; Goldfarb, David

2016-06-01

Standardizing consultation processes is increasingly important as clinical ethics consultation (CEC) becomes more utilized in and vital to medical practice. Solid organ transplant represents a relatively nascent field replete with complex ethical issues that, while explored, have not been systematically classified. In this paper, we offer a proposed taxonomy that divides issues of resource allocation from viable solutions to the issue of organ shortage in transplant and then further distinguishes between policy and bedside level issues. We then identify all transplant related ethics consults performed at the Cleveland Clinic (CC) between 2008 and 2013 in order to identify how consultants conceptually framed their consultations by the domains they ascribe to the case. We code the CC domains to those in the Core Competencies for Healthcare Consultation Ethics in order to initiate a broader conversation regarding best practices in these highly complex cases. A discussion of the ethical issues underlying living donor and recipient related consults ensues. Finally, we suggest that the ethical domains prescribed in the Core Competencies provide a strong starting ground for a common intra-disciplinary language in the realm of formal CEC.

Imagery as Ethical Inquiry.

ERIC Educational Resources Information Center

Green, Gaye Leigh

2000-01-01

Discusses five realms to explore when distinguishing the efficacy of images. Explores six ethical issues that the use of images raise, such as misconception and sensationalism. Proposes a strategy for analyzing controversial images and illustrates the use of this methodology by analyzing the use of "Joe Camel" in advertising. (CMK)

Developing Communities of Enquiry: Dealing with Social and Ethical Issues in Science at Key Stage 3

ERIC Educational Resources Information Center

Dunlop, Lynda; Humes, Gill; Clarke, Linda; Martin, Valerie McKelvey

2011-01-01

Reproductive technologies, drug discovery and exploration of the universe are areas of contemporary research that raise issues for individuals and society. Forward Thinking, Northern Ireland uses the development of communities of enquiry to promote discussion of these and other social and ethical issues in science with students aged 11-14 years.…

Expansion and Validation of the PAPA Framework

ERIC Educational Resources Information Center

Woodward, Belle; Martin, Nancy; Imboden, Thomas

2011-01-01

In recent years, ethics has drawn increased interest from information technology and computer science practitioners as well as from academicians. This article investigates the issues outlined in the PAPA framework in today's environment and explores the possibility that new issues have emerged. Findings indicate that the ethicality of property…

Nurses' perceptions of ethical issues in the care of older people.

PubMed

Rees, Jenny; King, Lindy; Schmitz, Karl

2009-07-01

The aim of this thematic literature review is to explore nurses' perceptions of ethical issues in the care of older people. Electronic databases were searched from September 1997 to September 2007 using specific key words with tight inclusion criteria, which revealed 17 primary research reports. The data analysis involved repeated reading of the findings and sorting of those findings into four themes. These themes are: sources of ethical issues for nurses; differences in perceptions between nurses and patients/relatives; nurses' personal responses to ethical issues; and the patient-nurse relationship. The findings reveal that ageism is one of the major sources of the ethical issues that arise for nurses caring for older people. Education and organizational change can combat ageist attitudes. Wider training is required in the care of older people, workplace skills, palliative care and pain management for older people. The demands of a changing global demography will necessitate further research in this field.

Ethics, engineers and drama.

PubMed

Monk, John

2009-03-01

This paper describes four plays which illustrate ethical themes relevant to engineers and which could be used as a resource for engineers who wish to explore ethical topics and their relationship with professional practice. The plays themselves have been chosen because a character in the play is involved in engineering activities. Each play is analysed to highlight some of the ethical issues the play raises. Often ethical topics are presented in abstract terms but the plays relate ethical issues to individuals and individual actions in specific situations that connect either directly or figuratively to practical situations engineers find themselves in. The paper describes how the resources have or could be used in an educational programme.

An Exploration of Ethical Issues in Research in Children’s Health and the Environment

PubMed Central

Paulson, Jerome A.

2006-01-01

The consideration of ethical issues relating to pediatric environmental health is a recent phenomenon. Discussions of biomedical ethics, research on children, and environmental health research have a longer history. In the late 1990s, researchers at the Kennedy Krieger Institute in Baltimore, Maryland, undertook a study to compare the effectiveness of several methods of reducing lead risk in housing. In a preliminary finding in the case of Grimes v. Kennedy Krieger Institute, Inc., a Maryland court questioned the ethics of performing research on children when there is no prospect of direct benefit to those children and whether parents can consent to such research. This case dramatically raised the profile of ethical issues among the pediatric environmental health research community. To broaden the discussion of these issues and in response to the Kennedy-Krieger case, the Children’s Environmental Health Network held a working meeting on 5 and 6 March 2004 to explore this topic. The articles in this mini-monograph were prepared by the authors as a result of the workshop and represent their opinions. This article is an introduction to the workshop and a summary of the articles to follow. PMID:17035150

Ethical issues in ageing.

PubMed

Fenech, Frederick F

2003-01-01

Population ageing, in both the developed and developing world, has put increasing demands on health resources; this has brought to the fore various ethical issues related to ageing. This paper examines moral issues that confront people as they grow old as well as those who are involved with them. The concepts of autonomy, dignity, justice and intergenerational solidarity are explored. Living wills and the role of a proxy could help to deal with the common ethical dilemmas related to death and dying. Positive action by governments to overcome ageism is recommended. The need to establish ethical guidelines, which take into consideration differences in religion, culture, ethnicity and race, is highlighted.

The Ethics of PI: A Polemical Overview.

ERIC Educational Resources Information Center

Stewart, Jim

2003-01-01

Suggests that Human Resource Development (HRD) is in and of itself an ethical endeavor. Starts with a brief discussion about human performance improvement, next explores the issue of ethics, and then brings the two together to demonstrate the truth and validity of the argument that performance improvement (PI) is an ethical endeavor. (AEF)

Ethics and community-based participatory research: perspectives from the field.

PubMed

Bastida, Elena M; Tseng, Tung-Sung; McKeever, Corliss; Jack, Leonard

2010-01-01

Exploring the importance of ethical issues in the conduct of community-based participatory research (CBPR) continues to be an important topic for researchers and practitioners. This article uses the Beyond Sabor Project, a CBPR project implemented in the Lower Rio Grande Valley, as a case example to discuss ethical issues such as the importance of increasing community involvement in research, ensuring that communities benefit from the research, sharing leadership roles, and sensitive issues regarding data collection and sharing. Thereafter, this article concludes with a brief discussion of six principles that can inform the practice of ethical conduct when implementing CBPR studies. This article also lists additional reading resources on the importance of ethics in the conduct of CBPR.

An investigation of how university sports team athletic therapists and physical therapists experience ethical issues.

PubMed

Riendeau, Catherine; Parent-Houle, Valérie; Lebel-Gabriel, Marie Eve; Gauvin, Patrick; Liu, Le Yu; Pearson, Isabelle; Hunt, Matthew R

2015-03-01

Qualitative study using interpretive description methodology. The purpose of this study was to better understand how ethical issues are experienced by university sports team athletic therapists and physical therapists. In clinical practice, sports teams are associated with a range of ethical issues. Issues commonly reported in the literature include confidentiality, return-to-play decisions, conflicts of interest, advertising, doping, and use of local anesthetic. To date, there has been limited examination of how athletic therapists and physical therapists involved with sports teams experience these ethical issues, and limited exploration of how these ethical issues, when encountered, are shaped by therapists' professional roles and responsibilities. Semi-structured interviews were conducted with 11 athletic or physical therapists working with sports teams in 5 Canadian provinces. The data were analyzed inductively, using a recursive approach and constant comparative techniques. Four key themes were developed relating to the participants' experiences of ethical issues: establishing and maintaining professional boundaries, striving for respectful and effective collaboration, seeking answers to ethical concerns, and living with the repercussions of challenging decisions. While many ethical issues reported by participants resemble those faced by sports medicine physicians, they are experienced in distinctive ways, due to differences in professional roles and identities. Issues concerning professional boundaries were also more prominent for the study participants than the literature has reported them to be for sports medicine physicians. Effective communication and enhanced collaboration appear to be key elements in managing these ethical challenges.

Space Exploration: Challenges in Medicine, Research, and Ethics

NASA Technical Reports Server (NTRS)

Davis, Jeffrey R.

2007-01-01

This viewgraph presentation describes the challenges that space exploration faces in terms of medicine, research and ethics. The topics include: 1) Effects of Microgravity on Human Physiology; 2) Radiation; 3) Bone; 4) Behavior and Performance; 5) Muscle; 6) Cardiovascular; 7) Neurovestibular; 8) Food and Nutrition; 9) Immunology and Hematology; 10) Environment; 11) Exploration; 12) Building Block Approach; 13) Exploration Issues; 14) Life Sciences Contributions; 15) Health Care; and 17) Habitability.

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

ERIC Educational Resources Information Center

Wolfendale, Sheila

1999-01-01

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

Choosing Values: Public-Private Relationships in a Global Economy

ERIC Educational Resources Information Center

DiMatteo, Larry A.; Maurer, Virginia G.

2015-01-01

This article presents a case study that engages students on the legal and ethical issues of doing business abroad. It explores the scenario of direct foreign investment by an American company in a less developed country. This development imbalance necessarily implicates issues of ethical relativism and home-host country standards. Students are…

Advances in Graduate Marketing Curriculum: Paying Attention to Ethical, Social, and Sustainability Issues

ERIC Educational Resources Information Center

Weber, James

2013-01-01

This research explores the impact of coercive, mimetic, and normative isomorphic pressures on the coverage and offering of courses addressing ethical, social, and sustainability issues (ESSI) in business schools' graduate marketing curricula. Data from the Aspen Institute's Beyond Grey Pinstripes program are analyzed to detect if significant…

Exhaust All Measures: Ethical Issues in Pediatric End-of-Life Care.

PubMed

Thieleman, Kara J; Wallace, Cara; Cimino, Andrea N; Rueda, Heidi A

2016-01-01

The death of a child may have a profound impact on parents, family members, and health care providers who provided care for the child. Unique challenges are faced by parents of seriously ill children as they must serve as the legal authority for health care decisions of children under age 18, although the child's wishes must also be considered. Social workers must balance core social work values, bioethical values, and psychosocial issues presented by such situations. While studies have been conducted with physicians and nurses regarding ethical issues in pediatric end-of-life care settings, little is known about how social workers experience these conflicts. This article utilizes two vignettes to illustrate potential ethical issues in this setting and applies the National Association of Social Workers Standards for Palliative and End of Life Care (NASW, 2004 ) to explore options for their resolution. These vignettes provide descriptions of possible reactions in this setting and can be used as a basis for further exploration of ethics in pediatric end-of-life care from a social work perspective.

Socioscience and Ethics in Science Classrooms: Teacher Perspectives and Strategies

ERIC Educational Resources Information Center

Sadler, Troy D.; Amirshokoohi, Aidin; Kazempour, Mahsa; Allspaw, Kathleen M.

2006-01-01

This study explored teacher perspectives on the use of socioscientific issues (SSI) and on dealing with ethics in the context of science instruction. Twenty-two middle and high school science teachers from three US states participated in semi-structured interviews, and researchers employed inductive analyses to explore emergent patterns relative…

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

PubMed

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

2015-12-01

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

A Qualitative Examination of Ethical and Legal Considerations Regarding Dating Violence

ERIC Educational Resources Information Center

Sikes, April; Walley, Cynthia; Hays, Danica G.

2012-01-01

Despite the increased attention to dating violence among adolescents and young adults, limited information is available on ethical and legal considerations specific to this population. Therefore, this qualitative study explores 21 trainees' and practitioners' conceptualization of ethical and legal issues pertaining to adolescent dating violence.…

Ethical Challenges in the Teaching of Multicultural Course Work

ERIC Educational Resources Information Center

Fier, Elizabeth Boyer; Ramsey, MaryLou

2005-01-01

The authors explore the ethical issues and challenges frequently encountered by counselor educators of multicultural course work. Existing ethics codes are examined, and the need for greater specificity with regard to teaching courses of multicultural content is addressed. Options for revising existing codes to better address the challenges of…

Ethical Responsibility in Communication: A Selected, Annotated Bibliography. Fourth Edition.

ERIC Educational Resources Information Center

Johannesen, Richard L.

Representing works published between 1970 and 1984, this annotated bibliography identifies a variety of readings that explore fundamental issues of ethics in interpersonal, public, and mass communication, and that examine from an ethical viewpoint how to and whether to employ particular communication tactics or techniques. The bibliography…

Lessons from Adult Education: Identifying and Exploring Emerging Ethical Issues in Technologically Enhanced Performance

ERIC Educational Resources Information Center

Mabry, Christie Knittel; O'Driscoll, Tony

2003-01-01

Technologically Enhanced Performance (TEP) is the application of technology to improve the performance of knowledge workers. TEP is both an intellectual and ideological complement to the field of Adult Education. As such, much can be learned about ethical issues associated with implementing TEP from the established research and literature base in…

Thinking Ethically about Professional Practice in Adapted Physical Activity

ERIC Educational Resources Information Center

Goodwin, Donna L.; Rossow-Kimball, Brenda

2012-01-01

There has been little critical exploration of the ethical issues that arise in professional practice common to adapted physical activity. We cannot avoid moral issues as we inevitably will act in ways that will negatively affect the well-being of others. We will make choices, which in our efforts to support others, may hurt by violating dignity or…

Perspectives on Child Abuse and Labour: Global Ethical Ideals Versus African Cultural Realities

ERIC Educational Resources Information Center

Ajayi, A. O.; Torimiro, D. O.

2004-01-01

This article focuses on the global and African postures on the issues of child abuse and child labour. The global ethical ideals of the issues are characterized within their various theoretical perspectives while the African cultural realities are explored through the use of focus group discussion sessions, which were organized in six rural…

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

PubMed

Praestegaard, Jeanette; Gard, Gunvor

2013-02-01

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

Ethical Considerations of Children's Digital Image-Making and Image-Audiancing in Early Childhood Environments

ERIC Educational Resources Information Center

Eckhoff, Angela

2015-01-01

This research examines a multi-year investigation of preschoolers' experiences participating in a media-driven exploration of informal play experiences as a means to engage children as artists, researchers, and documenters of their own worlds. In this writing, I will explore the ethical issues that arise for adult researchers engaged in…

Ethical issues in molecular medicine of relevance to surgeons

PubMed Central

Bernstein, Mark; Bampoe, Joseph; Daar, Abdallah S.

2004-01-01

The technology associated with the care of surgical patients and the level of sophistication of biomedical research accompanying it are evolving at a rapid pace. Both new and old bioethical issues are assuming increasing levels of prominence and importance, particularly in this age of molecular medicine. The authors explore bioethical issues pertinent and relevant to surgeons. Four specific areas that are exemplary by presenting both major scientific and ethical challenges are briefly addressed: privacy of information, stem cells, gene therapy, and conflict of interest in biomedical research. All of these can be generalized to all surgeons. As bioethical issues today play a greater role in surgical practice than they did even a decade ago, it is hoped that this brief review on ethical issues in molecular medicine will help stimulate present and future generations of surgeons in thinking about the ethical dimensions of their work. PMID:15646439

Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa.

PubMed

Mamotte, Nicole; Wassenaar, Douglas; Koen, Jennifer; Essack, Zaynab

2010-03-09

Africa continues to bear a disproportionate share of the global HIV/AIDS, tuberculosis (TB) and malaria burden. The development and distribution of safe, effective and affordable vaccines is critical to reduce these epidemics. However, conducting HIV/AIDS, TB, and/or malaria vaccine trials simultaneously in developing countries, or in populations affected by all three diseases, is likely to result in numerous ethical challenges. In order to explore convergent ethical issues in HIV/AIDS, TB and malaria vaccine trials in Africa, the Ethics, Law and Human Rights Collaborating Centre of the WHO/UNAIDS African AIDS Vaccine Programme hosted a consultation on the Convergent Ethical Issues in HIV/AIDS, TB and Malaria Vaccine Trials in Africa in Durban, South Africa on the 10-11 February 2009. Key cross cutting ethical issues were prioritized during the consultation as community engagement; ancillary care obligations; care and treatment; informed consent; and resource sharing. The consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields.

Public health ethics: the voices of practitioners.

PubMed

Bernheim, Ruth Gaare

2003-01-01

Public health ethics is emerging as a new field of inquiry, distinct not only from public health law, but also from traditional medical ethics and research ethics. Public health professional and scholarly attention is focusing on ways that ethical analysis and a new public health code of ethics can be a resource for health professionals working in the field. This article provides a preliminary exploration of the ethical issues faced by public health professionals in day-to-day practice and of the type of ethics education and support they believe may be helpful.

Ethical, legal, social, and policy issues in the use of genomic technology by the U.S. Military

PubMed Central

Mehlman, Maxwell J.; Li, Tracy Yeheng

2014-01-01

Advances in genomic science are attracting the interest of the U.S. military for their potential to improve medical care for members of the military and to aid in military recruitment, training, specialization, and mission accomplishment. While researchers have explored the ethical, legal, and social issues raised by the use of genomic science in a wide variety of contexts, there has been virtually no examination of these issues in connection with the use of genomics by the military. This article identifies potential uses of genomic science by the military, proposes an applicable ethical and legal framework, and applies the framework to provide ethical and legal guidance for military decision-makers. PMID:25937933

What Is the (ethical) Role of Scientists?

NASA Astrophysics Data System (ADS)

Oreskes, N.

2014-12-01

Many scientists are reluctant to speak out on issues of broad societal importance for fear that doing so crosses into territory that is not the scientists' domain. Others fear that scientists lose credibility when they address ethical and moral issues. A related concern is that discussing social or ethical questions runs the risk of politicizing science. Yet history shows that in the past, scientists often have spoken out on broad issues of societal concern, often (although not always) effectively. This paper explores the conditions under which scientists may be effective spokesmen and women on ethical and moral choices, and suggests some criteria by which scientists might decide when and whether it is appropriate for them to speak out beyond the circles of other technical experts.

Risk and supervised exercise: the example of anorexia to illustrate a new ethical issue in the traditional debates of medical ethics

PubMed Central

Giordano, S

2005-01-01

Sport and physical activity is an area that remains relatively unexplored by contemporary bioethics. It is, however, an area in which important ethical issues arise. This paper explores the case of the participation of people with anorexia nervosa in exercise. Exercise is one of the central features of anorexia. The presence of anorexics in exercise classes is becoming an increasingly sensitive issue for instructors and fitness professionals. The ethics of teaching exercise to anorexics has, however, seldom, if ever, been addressed. Codes of ethics and legislation do not offer guidelines pertinent to the case and it is left unclear whether anorexics should be allowed to participate in exercise classes. It is shown by this paper that there are strong ethical reasons to let anorexics participate in exercise classes. However, the paper also explains why, despite these apparently cogent ethical reasons, there is no moral obligation to allow a person with anorexia to take part in exercise/sports activities. PMID:15634747

The ethical framing of personalized medicine.

PubMed

Joly, Yann; Saulnier, Katie M; Osien, Gladys; Knoppers, Bartha M

2014-10-01

Personalized medicine encompasses the use of biological information such as genomics to provide tailored interventions for patients. The review explores the ethical, legal, and social issues that have emerged with personalized medicine and must be considered because of the complex nature of providing individualized care within a clinical setting. Recent studies found that the use of personalized medicine presents challenges in multiple areas: biobanking and informed consent, confidentiality, genetic discrimination, return of results, access to treatment, clinical translation, direct-to-consumer genetic testing, emerging duties, and knowledge mobilization. Although personalized medicine provides benefits in treating patients in a manner that is more suited to their genetic profile, there are challenges that must be discussed to ensure the protection and fair treatment of individuals. The issues concerning personalized medicine are widespread, and range from individual privacy to the stratification and discrimination of sub-populations based on ethnicity. These issues have considerable impact on the individual and society. A thorough exploration of these ethical issues may identify novel challenges as well as potential avenues for resolution.

Identifying veterinary students' capacity for moral behavior concerning animal ethics issues.

PubMed

Verrinder, Joy M; Phillips, Clive J C

2014-01-01

Veterinarians face unique animal ethics challenges as practitioners and policy advisors to government and industry. Changing societal attitudes, cultural diversity, and the often conflicting needs and interests of patients and clients contribute to moral distress. Yet little has been done to identify veterinarians' capacity to address these animal ethics issues. In this study, first-year and final-year veterinary students in an Australian university were surveyed to explore moral sensitivity, moral motivation, and moral character and their relationship with moral reasoning. The majority of students were concerned about animal ethics issues and had experienced moral distress in relation to the treatment of animals. Most believed that veterinarians should address the wider social issues of animal protection and that veterinary medicine should require a commitment to animals' interests over owners'/caregivers' interests. There was less agreement that the veterinary profession was sufficiently involved in addressing animal ethics issues. The principal motivators for studying veterinary medicine were, in declining importance, enjoyment in working with animals, helping sick and injured animals, and improving the way animals are treated. However, most students had taken little or no action to address animal ethics issues. These results suggest that both first- and fifth-year veterinary students are sensitive to animal ethics issues and are motivated to prioritize the interests of animals but have little experience in taking action to address these issues. Further research is needed to determine ways to identify and assess these moral behavior components in veterinary education to develop veterinarians' capacity to address animal ethics issues.

'A band of brothers'-an exploration of the range of medical ethical issues faced by British senior military clinicians on deployment to Afghanistan: a qualitative study.

PubMed

Bernthal, Elizabeth M; Draper, H J A; Henning, J; Kelly, J C

2017-06-01

To identify and explore features of ethical issues that senior clinicians faced as deployed medical directors (DMDs) to the British Field Hospital in Afghanistan as well as to determine the ethical training requirements for future deployments. A qualitative study in two phases conducted from November 2014 to June 2015. Phase 1 analysed 60 vignettes of cases that had generated ethical dilemmas for DMDs. Phase 2 included focus groups and an interview with 13 DMDs. Phase 1 identified working with limited resources, dual conflict of meeting both clinical and military obligations and consent of children as the most prevalent ethical challenges. Themes found in Phase 2 included sharing clinical responsibilities with clinicians from other countries and not knowing team members' ways of working, in addition to the themes from Phase 1. This study has drawn together examples of scenarios to form a repository that will aid future training. Recommendations included undertaking ethics training together as a team before, during and after deployment which must include all nationalities who are assigned to the same operational tour, so that different ethical views can be explored beforehand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Ethical Challenges and Complexities of Including People with Intellectual Disability as Participants in Research

ERIC Educational Resources Information Center

Iacono, Teresa

2006-01-01

The aim of this article is to consider the implications for research involving people with intellectual disability--a vulnerable group--of ethics committees' attempts to apply these guidelines. The issue explored is whether committees such as Human Research Ethics Committees (HRECS) and Institutional Review Boards (IRBs) are becoming increasingly…

Emerging Dental Specialties and Ethics.

PubMed

Brown, Ronald S; Mashni, Michael

2015-01-01

This paper discusses ethical dimensions related to the formal recognition of emerging dental specialties. It explores several issues related to the potential emergence of several new dental specialty areas. There are good reasons that dentistry should open the door to these new specialties, and patients would benefit. The ethical considerations for and against formal acceptance are examined.

Dilemmas with Dilemmas...Exploring the Suitability of Dilemma Stories as a Way of Addressing Ethical Issues in Science Education.

ERIC Educational Resources Information Center

Settelmaier, Elisabeth

Traditionally, many science educators have taught science without addressing ethical questions. However, the inclusion of moral discourse in science teaching may help educators to bring to the fore problematic issues in relation to science, and it may offer an opportunity for students to practice their future engagement in the public discourse…

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

PubMed Central

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

2014-01-01

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

Physicians' and nurses' expectations and objections toward a clinical ethics committee.

PubMed

Jansky, Maximiliane; Marx, Gabriella; Nauck, Friedemann; Alt-Epping, Bernd

2013-11-01

The study aimed to explore the subjective need of healthcare professionals for ethics consultation, their experience with ethical conflicts, and expectations and objections toward a Clinical Ethics Committee. Staff at a university hospital took part in a survey (January to June 2010) using a questionnaire with open and closed questions. Descriptive data for physicians and nurses (response rate = 13.5%, n = 101) are presented. Physicians and nurses reported similar high frequencies of ethical conflicts but rated the relevance of ethical issues differently. Nurses stated ethical issues as less important to physicians than to themselves. Ethical conflicts were mostly discussed with staff from one's own profession. Respondents predominantly expected the Clinical Ethics Committee to provide competent support. Mostly, nurses feared it might have no influence on clinical practice. Findings suggest that experiences of ethical conflicts might reflect interprofessional communication patterns. Expectations and objections against Clinical Ethics Committees were multifaceted, and should be overcome by providing sufficient information. The Clinical Ethics Committee needs to take different perspectives of professions into account.

Withdrawal of ventilation at the patient's request in MND: a retrospective exploration of the ethical and legal issues that have arisen for doctors in the UK.

PubMed

Phelps, Kay; Regen, Emma; Oliver, David; McDermott, Chris; Faull, Christina

2017-06-01

Ventilatory support has benefits including prolonging survival for respiratory failure in motor neurone disease (MND). At some point some patients may wish to stop the intervention. The National Institute of Health and Care Excellence (NICE) guidance recommends research is needed on ventilation withdrawal. There is little literature focusing on the issues doctors encounter when withdrawing ventilation at the request of a patient. To identify and explore with doctors the ethical and legal issues that they had encountered in the withdrawal of ventilation at the request of a patient with MND. A retrospective thematic analysis of interviews of 24 doctors (including palliative care, respiratory, neurology and general practice) regarding their experiences with withdrawal of ventilation support from patients with MND. Respondents found withdrawal of ventilation at the request of patients with MND to pose legal, ethical and moral challenges in five themes: ethical and legal rights to withdrawal from treatment; discussions with family; discussions with colleagues; experiences of legal advice; issues contributing to ethical complexity. Though clear about the legality of withdrawal of treatment in theory, the practice led to ethical and moral uncertainty and mixed feelings. Many respondents had experienced negative reactions from other healthcare professionals when these colleagues were unclear of the distinction between palliation of symptoms, withdrawal of treatment and assisted death. Legal, ethical and practical guidance is needed for professionals who support a patient with MND who wishes to withdraw from ventilation. Open discussion of the ethical challenges is needed as well as education and support for professionals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Withdrawal of ventilation at the patient's request in MND: a retrospective exploration of the ethical and legal issues that have arisen for doctors in the UK

PubMed Central

Phelps, Kay; Regen, Emma; Oliver, David; McDermott, Chris; Faull, Christina

2017-01-01

Background Ventilatory support has benefits including prolonging survival for respiratory failure in motor neurone disease (MND). At some point some patients may wish to stop the intervention. The National Institute of Health and Care Excellence (NICE) guidance recommends research is needed on ventilation withdrawal. There is little literature focusing on the issues doctors encounter when withdrawing ventilation at the request of a patient. Aim To identify and explore with doctors the ethical and legal issues that they had encountered in the withdrawal of ventilation at the request of a patient with MND. Method A retrospective thematic analysis of interviews of 24 doctors (including palliative care, respiratory, neurology and general practice) regarding their experiences with withdrawal of ventilation support from patients with MND. Results Respondents found withdrawal of ventilation at the request of patients with MND to pose legal, ethical and moral challenges in five themes: ethical and legal rights to withdrawal from treatment; discussions with family; discussions with colleagues; experiences of legal advice; issues contributing to ethical complexity. Though clear about the legality of withdrawal of treatment in theory, the practice led to ethical and moral uncertainty and mixed feelings. Many respondents had experienced negative reactions from other healthcare professionals when these colleagues were unclear of the distinction between palliation of symptoms, withdrawal of treatment and assisted death. Conclusions Legal, ethical and practical guidance is needed for professionals who support a patient with MND who wishes to withdraw from ventilation. Open discussion of the ethical challenges is needed as well as education and support for professionals. PMID:26362794

Ethics and the Space Explorer

NASA Astrophysics Data System (ADS)

Mendell, W.

2002-01-01

Ethics is not a word often encountered at meetings of space activists or in work groups planning a space future. Yet, the planning of space exploration ought to have ethical dimensions because space workers are not disconnected from the remainder of society in either their professional disciplines, in their institutions, or in the subject matter they choose to study. As a scientist, I have been trained in the schema of research. Although the scientific method is noted for its system of self -correction in the form of peer review, sharing of information, and repeatability of new findings, the enterprise of universal knowledge still depends heavily on an ethical system rooted in honesty in the reporting of findings and in the processing of data. As a government employee, I receive annual "ethical training". However, the training consists almost entirely of reminders to obey various laws governing the activities and the external relationships of government employees. For 20 years l have been involved in discussions of possible futures for human exploration of space beyond low Earth orbit. Many scenarios ranging from lunar landing to Martian settlement have been discussed without any mention of possible ethical issues. l remember hearing Apollo astronaut Harrison Schmitt once remark that space exploration was attractive because technology can be employed in its purest form in the conquest of space. His point was that the challenge was Man against Nature, a struggle in which the consequences or side effects of technology was not an issue. To paraphrase, in space you do not need an environmental impact study. I wish to analyze this proposition with regard to contexts in which people initiate, or plan to initiate, activities in space. Depending on the situation, space can be viewed as a laboratory, as a frontier, as a resource, as an environment, or as a location to conduct business. All of these associations and contexts also are found in our everyday activities on Earth, and by analogy ethical issues exist that translate into the spatial dimension.

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

NASA Astrophysics Data System (ADS)

Löfström, Erika; Pyhältö, Kirsi

2015-11-01

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

Cultivating engineering ethics and critical thinking: a systematic and cross-cultural education approach using problem-based learning

NASA Astrophysics Data System (ADS)

Chang, Pei-Fen; Wang, Dau-Chung

2011-08-01

In May 2008, the worst earthquake in more than three decades struck southwest China, killing more than 80,000 people. The complexity of this earthquake makes it an ideal case study to clarify the intertwined issues of ethics in engineering and to help cultivate critical thinking skills. This paper first explores the need to encourage engineering ethics within a cross-cultural context. Next, it presents a systematic model for designing an engineering ethics curriculum based on moral development theory and ethic dilemma analysis. Quantitative and qualitative data from students' oral and written work were collected and analysed to determine directions for improvement. The paper also presents results of an assessment of this interdisciplinary engineering ethics course. This investigation of a disaster is limited strictly to engineering ethics education; it is not intended to assign blame, but rather to spark debate about ethical issues.

Ethical challenges with awake craniotomy for tumor.

PubMed

Kirsch, Brandon; Bernstein, Mark

2012-01-01

Awake brain surgery is useful for the treatment of a number of conditions such as epilepsy and brain tumor, as well as in functional neurosurgery. Several studies have been published regarding clinical results and outcomes of patients who have undergone awake craniotomy but few have dealt with related ethical issues. The authors undertake to explore broadly the ethical issues surrounding awake brain surgery for tumor resection to encourage further consideration and discussion. Based on a review of the literature related to awake craniotomy and in part from the personal experience of the senior author, we conducted an assessment of the ethical issues associated with awake brain tumor surgery. The major ethical issues identified relate to: (1) lack of data; (2) utilization; (3) conflict of interest; (4) informed consent; (5) surgical innovation; and (6) surgical training. The authors respectfully suggest that the selection of patients for awake craniotomy needs to be monitored according to more consistent, objective standards in order to avoid conflicts of interest and potential harm to patients.

Ethical issues associated with the use of animal experimentation in behavioral neuroscience research.

PubMed

Ohl, Frauke; Meijboom, Franck

2015-01-01

This chapter briefly explores whether there are distinct characteristics in the field of Behavioral Neuroscience that demand specific ethical reflection. We argue that although the ethical issues in animal-based Behavioral Neuroscience are not necessarily distinct from those in other research disciplines using animal experimentation, this field of endeavor makes a number of specific, ethically relevant, questions more explicit and, as a result, may expose to discussion a series of ethical issues that have relevance beyond this field of science. We suggest that innovative research, by its very definition, demands out-of-the-box thinking. At the same time, standardization of animal models and test procedures for the sake of comparability across experiments inhibits the potential and willingness to leave well-established tracks of thinking, and leaves us wondering how open minded research is and whether it is the researcher's established perspective that drives the research rather than the research that drives the researcher's perspective. The chapter finishes by introducing subsequent chapters of this book volume on Ethical Issues in Behavioral Neuroscience.

The ethics of patenting human embryonic stem cells.

PubMed

Chapman, Audrey R

2009-09-01

Just as human embryonic stem cell research has generated controversy about the uses of human embryos for research and therapeutic applications, human embryonic stem cell patents raise fundamental ethical issues. The United States Patent and Trademark Office has granted foundational patents, including a composition of matter (or product) patent to the Wisconsin Alumni Research Foundation (WARF), the University of Wisconsin-Madison's intellectual property office. In contrast, the European Patent Office rejected the same WARF patent application for ethical reasons. This article assesses the appropriateness of these patents placing the discussion in the context of the deontological and consequentialist ethical issues related to human embryonic stem cell patenting. It advocates for a patent system that explicitly takes ethical factors into account and explores options for new types of intellectual property arrangements consistent with ethical concerns.

[Public health, genetics and ethics].

PubMed

Kottow, Miguel H

2002-10-01

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

Restructuring University Degree Programmes: A New Opportunity for Ethics Education?

ERIC Educational Resources Information Center

Escamez, Juan; Lopez, Rafaela Garcia; Jover, Gonzalo

2008-01-01

This article explores the possibilities of reinforcing ethics education at the university level within the context of new internationalisation processes. The situation in Spain is used as a case study. The article begins with a review of the rationale behind this issue and goes on to analyse the place of the ethical dimension in education in the…

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

PubMed

Ronen, Gabriel M; Rosenbaum, Peter L

2017-05-01

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

Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa

PubMed Central

2010-01-01

Background Africa continues to bear a disproportionate share of the global HIV/AIDS, tuberculosis (TB) and malaria burden. The development and distribution of safe, effective and affordable vaccines is critical to reduce these epidemics. However, conducting HIV/AIDS, TB, and/or malaria vaccine trials simultaneously in developing countries, or in populations affected by all three diseases, is likely to result in numerous ethical challenges. Methods In order to explore convergent ethical issues in HIV/AIDS, TB and malaria vaccine trials in Africa, the Ethics, Law and Human Rights Collaborating Centre of the WHO/UNAIDS African AIDS Vaccine Programme hosted a consultation on the Convergent Ethical Issues in HIV/AIDS, TB and Malaria Vaccine Trials in Africa in Durban, South Africa on the 10-11 February 2009. Results Key cross cutting ethical issues were prioritized during the consultation as community engagement; ancillary care obligations; care and treatment; informed consent; and resource sharing. Conclusion The consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields. PMID:20211030

Truth-telling, decision-making, and ethics among cancer patients in nursing practice in China.

PubMed

Ling, Dong-Lan; Yu, Hong-Jing; Guo, Hui-Ling

2017-01-01

Truth-telling toward terminally ill patients is a challenging ethical issue in healthcare practice. However, there are no existing ethical guidelines or frameworks provided for Chinese nurses in relation to decision-making on truth-telling of terminal illness and the role of nurses thus is not explicit when encountering this issue. The intention of this paper is to provide ethical guidelines or strategies with regards to decision-making on truth-telling of terminal illness for Chinese nurses. This paper initially present a case scenario and then critically discuss the ethical issue in association with ethical principles and philosophical theories. Instead of focusing on attitudes toward truth disclosure, it aims to provide strategies regarding this issue for nurses. It highlights and discusses some of the relevant ethical assumptions around the perceived role of nurses in healthcare settings by focusing on nursing ethical virtues, nursing codes of ethics, and philosophical perspectives. And Confucian culture is discussed to explicate that deontology does not consider family-oriented care in China. Treating each family individually to explore the family's beliefs and values on this issue is essential in healthcare practice and nurses should tailor their own approach to individual needs regarding truth-telling in different situations. Moreover, the Chinese Code of Ethics should be modified to be more specific and applicable. Finally, a narrative ethics approach should be applied and teamwork between nurses, physicians and families should be established to support cancer patients and to ensure their autonomy and hope. Ethical considerations: This paper was approved by the Ethics Committee of The Second Affiliated Hospital of Guangzhou Medical University. The authors have obtained consent to use the case study and it has been anonymised to preserve the patient's confidentiality.

Awareness of ethical issues in medical education: an interactive teach-the-teacher course.

PubMed

Chiapponi, Costanza; Dimitriadis, Konstantinos; Özgül, Gülümser; Siebeck, Robert G; Siebeck, Matthias

2016-01-01

We conducted an international, interdisciplinary teach-the-teacher course to sensitize physicians from different countries to ethical issues in medical education. The purpose of this study was to assess the effects of this course. Before and after participating in a short session on ethical issues in medical education, 97 physicians from different countries in Africa, Asia, and Europe completed a self-assessment questionnaire on their competence and interest in this field. The short session consisted of working in small groups to identify, analyze and discuss ethical dilemmas described in case vignettes adapted from published examples or written by medical students. In addition to the questionnaire, we conducted a large-group experience to explore four basic orientations of participants in ethical thinking: relativism, intentionalism, consequentialism, and absolutism. We found a significant self-perceived increase in the participants' ability to identify and describe ethical issues and students' dilemmas, in their knowledge about these issues and teaching professionalism, and in their ability to describe both students' perspectives and teachers' and students' behaviors. In addition, participants' feeling of understanding their own culturally learned patterns of determining what is right and wrong increased after taking part in the course. The four contrasting basic ethical orientations showed no significant differences between participants regarding nationality, age, or gender. Ethics of education is an important issue for medical teachers. Teachers' self-perceived competence can be increased by working on case vignettes in small groups.

Awareness of ethical issues in medical education: an interactive teach-the-teacher course

PubMed Central

Chiapponi, Costanza; Dimitriadis, Konstantinos; Özgül, Gülümser; Siebeck, Robert G.; Siebeck, Matthias

2016-01-01

Purpose: We conducted an international, interdisciplinary teach-the-teacher course to sensitize physicians from different countries to ethical issues in medical education. The purpose of this study was to assess the effects of this course. Method: Before and after participating in a short session on ethical issues in medical education, 97 physicians from different countries in Africa, Asia, and Europe completed a self-assessment questionnaire on their competence and interest in this field. The short session consisted of working in small groups to identify, analyze and discuss ethical dilemmas described in case vignettes adapted from published examples or written by medical students. In addition to the questionnaire, we conducted a large-group experience to explore four basic orientations of participants in ethical thinking: relativism, intentionalism, consequentialism, and absolutism. Results: We found a significant self-perceived increase in the participants’ ability to identify and describe ethical issues and students’ dilemmas, in their knowledge about these issues and teaching professionalism, and in their ability to describe both students’ perspectives and teachers’ and students’ behaviors. In addition, participants’ feeling of understanding their own culturally learned patterns of determining what is right and wrong increased after taking part in the course. The four contrasting basic ethical orientations showed no significant differences between participants regarding nationality, age, or gender. Conclusion: Ethics of education is an important issue for medical teachers. Teachers’ self-perceived competence can be increased by working on case vignettes in small groups. PMID:27275510

Research ethics consultation: ethical and professional practice challenges and recommendations.

PubMed

Sharp, Richard R; Taylor, Holly A; Brinich, Margaret A; Boyle, Mary M; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

2015-05-01

The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical and Translational Science Award Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: (1) managing multiple institutional roles and responsibilities, (2) managing sensitive information, and (3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services.

Research Ethics Consultation: Ethical and Professional Practice Challenges and Recommendations

PubMed Central

Sharp, Richard R.; Taylor, Holly A.; Brinich, Margaret A.; Boyle, Mary M.; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

2015-01-01

The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include: assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical Translational Science Award (CTSA) Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: 1) managing multiple institutional roles and responsibilities, 2) managing sensitive information, and 3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services. PMID:25607942

Ethics and managed care.

PubMed

Perkel, R L

1996-03-01

Managed care presents physicians with potential ethical dilemmas different from dilemmas in traditional fee-for-service practice. The ethical assumptions of managed care are explored, with special attention to the evolving dual responsibilities of physicians as patient advocates and as entrepreneurs. A number of proposals are described that delineate issues in support of and in opposition to managed care. Through an understanding of how to apply basic ethics principles to managed care participation, physicians may yet hold on to the basic ethic of the fiduciary doctor-patient relationship.

[Ethical issues in nursing leadership].

PubMed

Wang, Shu-Fang; Hung, Chich-Hsiu

2005-10-01

Social transition causes shifts and changes in the relationship between health professionals and their patients. In their professional capacity, it is important today for nurses to handle ethical dilemmas properly, in a manner that fosters an ethical environment. This article investigates the ethical concerns and decision processes of nurses from a knowledge construction perspective, and examines such issues as patient needs, staff perceptions, organizational benefits, and professional image. The decision making methods commonly used when facing ethical dilemma explored in this study include the traditional problem solving, nursing process, MORAL model, and Murphy's methods. Although decision making for ethical dilemmas is governed by no universal rule, nurses are responsible to try to foster a trusting relationship between employee and employer, health care providers and patients, and the organization and colleagues. When decision making on ethical dilemmas is properly executed quality care will be delivered and malpractice can be reduced.

Opportunity to discuss ethical issues during clinical learning experience.

PubMed

Palese, Alvisa; Gonella, Silvia; Destrebecq, Anne; Mansutti, Irene; Terzoni, Stefano; Morsanutto, Michela; Altini, Pietro; Bevilacqua, Anita; Brugnolli, Anna; Canzan, Federica; Ponte, Adriana Dal; De Biasio, Laura; Fascì, Adriana; Grosso, Silvia; Mantovan, Franco; Marognolli, Oliva; Nicotera, Raffaela; Randon, Giulia; Tollini, Morena; Saiani, Luisa; Grassetti, Luca; Dimonte, Valerio

2018-01-01

Undergraduate nursing students have been documented to experience ethical distress during their clinical training and felt poorly supported in discussing the ethical issues they encountered. Research aims: This study was aimed at exploring nursing students' perceived opportunity to discuss ethical issues that emerged during their clinical learning experience and associated factors. An Italian national cross-sectional study design was performed in 2015-2016. Participants were invited to answer a questionnaire composed of four sections regarding: (1) socio-demographic data, (2) previous clinical learning experiences, (3) current clinical learning experience quality and outcomes, and (4) the opportunity to discuss ethical issues with nurses in the last clinical learning experience (from 0 - 'never' to 3 - 'very much'). Participants and research context: Participants were 9607 undergraduate nursing students who were attending 95 different three-year Italian baccalaureate nursing programmes, located at 27 universities in 15 Italian regions. Ethical considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after the research protocol was approved by an ethics committee. Overall, 4707 (49%) perceived to have discussed ethical issues 'much' or 'very much'; among the remaining, 3683 (38.3%) and 1217 (12.7%) students reported the perception of having discussed, respectively, 'enough' or 'never' ethical issues emerged in the clinical practice. At the multivariate logistic regression analysis explaining 38.1% of the overall variance, the factors promoting ethical discussion were mainly set at the clinical learning environment levels (i.e. increased learning opportunities, self-directed learning, safety and nursing care quality, quality of the tutorial strategies, competences learned and supervision by a clinical nurse). In contrast, being male was associated with a perception of less opportunity to discuss ethical issues. Nursing faculties should assess the clinical environment prerequisites of the settings as a context of student experience before deciding on their accreditation. Moreover, the nursing faculty and nurse managers should also enhance competence with regard to discussing ethical issues with students among clinical nurses by identifying factors that hinder this learning opportunity in daily practice.

A Pedagogical Model for Ethical Inquiry into Socioscientific Issues In Science

NASA Astrophysics Data System (ADS)

Saunders, Kathryn J.; Rennie, Léonie J.

2013-02-01

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.

More than the Beatles: The Legacy of a Decade for Community Psychology's Contributions to Evaluation Ethics

ERIC Educational Resources Information Center

Morris, Michael

2015-01-01

This essay explores the implications of the zeitgeist that emerged in the United States during the 1960s for the conceptualization of ethical issues in evaluation and community psychology, and how perspectives from the latter field might enhance ethical practice in the former. Special attention is paid to articulations of social justice,…

Ethics Considerations in Global Mobile Phone-Based Surveys of Noncommunicable Diseases: A Conceptual Exploration

PubMed Central

Labrique, Alain B; Gionfriddo, Kara; Pariyo, George; Gibson, Dustin G; Pratt, Bridget; Deutsch-Feldman, Molly; Hyder, Adnan A

2017-01-01

Mobile phone coverage has grown, particularly within low- and middle-income countries (LMICs), presenting an opportunity to augment routine health surveillance programs. Several LMICs and global health partners are seeking opportunities to launch basic mobile phone–based surveys of noncommunicable diseases (NCDs). The increasing use of such technology in LMICs brings forth a cluster of ethical challenges; however, much of the existing literature regarding the ethics of mobile or digital health focuses on the use of technologies in high-income countries and does not consider directly the specific ethical issues associated with the conduct of mobile phone surveys (MPS) for NCD risk factor surveillance in LMICs. In this paper, we explore conceptually several of the central ethics issues in this domain, which mainly track the three phases of the MPS process: predata collection, during data collection, and postdata collection. These include identifying the nature of the activity; stakeholder engagement; appropriate design; anticipating and managing potential harms and benefits; consent; reaching intended respondents; data ownership, access and use; and ensuring LMIC sustainability. We call for future work to develop an ethics framework and guidance for the use of mobile phones for disease surveillance globally. PMID:28476723

Ethical issues in microbicide clinical trials for HIV prevention.

PubMed

Gangestad, Angelina K; Salata, Robert A

2012-01-01

Women account for half of new infections with HIV annually. Heterosexual transmission is the most common route of infection in resource limited settings (RLS). An effective microbicide would help decrease transmission of HIV and potentially enable women to have more control in sexual relationships. Research into microbicides is done predominantly in RLS. In addition, there will be different issues and challenges to consider with respect to rectal microbicide use in men. There exist several ethical issues around microbicide development and clinical research which we explore in this review. Respect for persons, including autonomy and protection of vulnerable populations, beneficence, and justice are explored as they relate to microbicide research. Improving standards of care in RLS, trial design, and informed consent are discussed in more detail. Special populations including pregnant women, adolescents, and men who have sex with men are considered in more detail. A multipronged approach to HIV prevention will be necessary to have an impact on HIV prevention. A continued discussion around ethical issues in regard to study design, interpretation of results and implementation of compounds brought to market will remain critically important.

ESHRE Task Force on Ethics and Law 21: genetic screening of gamete donors: ethical issues.

PubMed

Dondorp, W; De Wert, G; Pennings, G; Shenfield, F; Devroey, P; Tarlatzis, B; Barri, P; Diedrich, K; Eichenlaub-Ritter, U; Tüttelmann, F; Provoost, V

2014-07-01

This Task Force document explores the ethical issues involved in the debate about the scope of genetic screening of gamete donors. Calls for expanded donor screening arise against the background of both occasional findings of serious but rare genetic conditions in donors or donor offspring that were not detected through present screening procedures and the advent of new genomic technologies promising affordable testing of donors for a wide range of conditions. Ethical principles require that all stakeholders' interests are taken into account, including those of candidate donors. The message of the profession should be that avoiding all risks is impossible and that testing should remain proportional.

World-View Entrapment: Moral-Ethical Implications for Gifted Education.

ERIC Educational Resources Information Center

Ambrose, Don

2000-01-01

This article explores the moral-ethical implications of the mechanistic world view and related issues such as technological determinism, social Darwinism, and androcentrism. It finds that educational approaches reinforced by the mechanistic world view include positivistic approaches to curriculum, instruction, and research. Recommendations for…

Ethical issues in human genome epidemiology: a case study based on the Japanese American Family Study in Seattle, Washington.

PubMed

Austin, Melissa A

2002-04-01

Recent completion of the draft sequence of the human genome has been greeted with both excitement and skepticism, and the potential of this accomplishment for advancing public health has been tempered by ethical concerns about the protection of human subjects. This commentary explores ethical issues arising in human genome epidemiology by using a case study approach based on the ongoing Japanese American Family Study at the University of Washington in Seattle (1994-2003). Ethical issues encountered in designing the study, collecting the data, and reporting the study results are considered. When developing studies, investigators must consider whether to restrict the study to specific racial or ethnic groups and whether community involvement is appropriate. Once the study design is in place, further ethical issues emerge, including obtaining informed consent for DNA banking and protecting the privacy and confidentiality of family members. Finally, investigators must carefully consider whether to report genotype results to study participants and whether pedigrees illustrating the results of the study will be published. Overall, the promise of genomics for improving public health must be pursued based on the fundamental ethical principles of respect for persons, beneficence, and justice.

Exporting DBCP and other banned pesticides: consideration of ethical issues.

PubMed

Lowry, L K; Frank, A L

1999-01-01

Many developed countries permit the export of pesticides that are banned, restricted, or unregistered within their own borders. This practice, which leads to the exposure of agricultural workers in developing countries to high levels of pesticides that are not permitted in the country of manufacture, raises many ethical issues as well as economic, social, political, and public health issues. Worldwide attempts to control export of such pesticides, through the FAO/UNEP Prior Informed Consent program, moves this issue in the right direction. This article explores the current U.S. and international practices, using the specific example of export of DBCP to banana-producing countries. The actions taken by multinational corporations, manufacturers of the pesticides, and public health officials in both the exporting and importing countries are explored, along with the impacts on workers, local economies, governments, and the environment.

Ethical and scientific issues of nanotechnology in the workplace.

PubMed

Schulte, Paul A; Salamanca-Buentello, Fabio

2007-01-01

In the absence of scientific clarity about the potential health effects of occupational exposure to nanoparticles, a need exists for guidance in decision making about hazards, risks, and controls. An identification of the ethical issues involved may be useful to decision makers, particularly employers, workers, investors, and health authorities. Because the goal of occupational safety and health is the prevention of disease in workers, the situations that have ethical implications that most affect workers have been identified. These situations include the a) identification and communication of hazards and risks by scientists, authorities, and employers; b) workers' acceptance of risk; c) selection and implementation of controls; d) establishment of medical screening programs; and e) investment in toxicologic and control research. The ethical issues involve the unbiased determination of hazards and risks, nonmaleficence (doing no harm), autonomy, justice, privacy, and promoting respect for persons. As the ethical issues are identified and explored, options for decision makers can be developed. Additionally, societal deliberations about workplace risks of nanotechnologies may be enhanced by special emphasis on small businesses and adoption of a global perspective.

Ethical and scientific issues of nanotechnology in the workplace.

PubMed

Schulte, Paul A; Salamanca-Buentello, Fabio

2007-01-01

In the absence of scientific clarity about the potential health effects of occupational exposure to nanoparticles, a need exists for guidance in decisionmaking about hazards, risks, and controls. An identification of the ethical issues involved may be useful to decision makers, particularly employers, workers, investors, and health authorities. Because the goal of occupational safety and health is the prevention of disease in workers, the situations that have ethical implications that most affect workers have been identified. These situations include the a) identification and communication of hazards and risks by scientists, authorities, and employers; b) workers' acceptance of risk; c) selection and implementation of controls; d) establishment of medical screening programs; and e) investment in toxicologic and control research. The ethical issues involve the unbiased determination of hazards and risks, nonmaleficence (doing no harm), autonomy, justice, privacy, and promoting respect for persons. As the ethical issues are identified and explored, options for decision makers can be developed. Additionally, societal deliberations about workplace risks of nanotechnologies may be enhanced by special emphasis on small businesses and adoption of a global perspective.

Ethical and Scientific Issues of Nanotechnology in the Workplace

PubMed Central

Schulte, Paul A.; Salamanca-Buentello, Fabio

2007-01-01

In the absence of scientific clarity about the potential health effects of occupational exposure to nanoparticles, a need exists for guidance in decisionmaking about hazards, risks, and controls. An identification of the ethical issues involved may be useful to decision makers, particularly employers, workers, investors, and health authorities. Because the goal of occupational safety and health is the prevention of disease in workers, the situations that have ethical implications that most affect workers have been identified. These situations include the a) identification and communication of hazards and risks by scientists, authorities, and employers; b) workers’ acceptance of risk; c) selection and implementation of controls; d) establishment of medical screening programs; and e) investment in toxicologic and control research. The ethical issues involve the unbiased determination of hazards and risks, nonmaleficence (doing no harm), autonomy, justice, privacy, and promoting respect for persons. As the ethical issues are identified and explored, options for decision makers can be developed. Additionally, societal deliberations about workplace risks of nanotechnologies may be enhanced by special emphasis on small businesses and adoption of a global perspective. PMID:17366812

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

PubMed

Lorenz, Susan G

2008-06-01

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

Permitting patients to pay for participation in clinical trials: the advent of the P4 trial.

PubMed

Shaw, David; de Wert, Guido; Dondorp, Wybo; Townend, David; Bos, Gerard; van Gelder, Michel

2017-06-01

In this article we explore the ethical issues raised by permitting patients to pay for participation (P4) in clinical trials, and discuss whether there are any categorical objections to this practice. We address key considerations concerning payment for participation in trials, including patient autonomy, risk/benefit and justice, taking account of two previous critiques of the ethics of P4. We conclude that such trials could be ethical under certain strict conditions, but only if other potential sources of funding have first been explored or are unavailable.

Methodological and ethical issues related to qualitative telephone interviews on sensitive topics.

PubMed

Mealer, Meredith; Jones Rn, Jacqueline

2014-03-01

To explore the methodological and ethical issues of conducting qualitative telephone interviews about personal or professional trauma with critical care nurses. The most common method for conducting interviews is face-to-face. However, there is evidence to support telephone interviewing on a variety of sensitive topics including post-traumatic stress disorder (PTSD). Qualitative telephone interviews can limit emotional distress because of the comfort experienced through virtual communication. Critical care nurses are at increased risk of developing PTSD due to the cumulative exposure to work-related stress in the intensive care unit. We explored the methodological and ethical issues of conducting qualitative telephone interviews, drawing on our experiences communicating with a group of critical care nurses. Qualitative research interviews with 27 critical care nurses. Fourteen of the nurses met the diagnostic criteria for PTSD; 13 did not and had scores consistent with high levels of resilience. This is a methodology paper on the authors' experiences of interviewing critical care nurses on sensitive topics via the telephone. The authors found that establishing rapport and connections with the participants and the therapeutic use of non-verbal communication were essential, and fostered trust and compassion. The ethical issues of this mode of communication include protecting the privacy and confidentiality associated with the disclosure of sensitive information, and minimising the risk of psychological harm to the researcher and participants. Qualitative telephone interviews are a valuable method of collecting information on sensitive topics. This paper explores a method of interviewing in the workplace. It will help inform interventions to promote healthy adaptation following trauma exposure in the intensive care unit.

Review paper: Organ transplants: ethical, social, and religious issues in a multicultural society.

PubMed

Robson, Noor Zurani Md Haris; Razack, Azad Hassan; Dublin, Norman

2010-07-01

Recent advances in the fields of organ donation and organ transplant have introduced new hope for the treatment of serious diseases. However, this promise has been accompanied by several issues. The most common issue raised is ethical implications, but in a multicultural society like Malaysia, additional concerns arise pertaining to social and religious issues. These concerns needs to be addressed as attitudes toward and acceptability of organ donation varies according to social, culture, and religion. The diverse cultural, religious, and traditional concepts pertaining to organ donation may hamper its acceptability and cause a lack of willingness to donate organs. The purpose of this article is to briefly explore the ethical issues involved in organ transplant and the various religious opinions on organ donation. It is hoped that this knowledge and understanding may benefit both health care providers and patients in a multicultural society like Malaysia.

Ethical and Logistical Issues Raised by the Advanced Donation Program "Pay It Forward" Scheme.

PubMed

Ross, Lainie Friedman; Rodrigue, James R; Veatch, Robert M

2017-10-01

The advanced donation program was proposed in 2014 to allow an individual to donate a kidney in order to provide a voucher for a kidney in the future for a particular loved one. In this article, we explore the logistical and ethical issues that such a program raises. We argue that such a program is ethical in principle but there are many logistical issues that need to be addressed to ensure that the actual program is fair to both those who do and do not participate in this program. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Ethical and policy issues in rehabilitation medicine.

PubMed

Caplan, Arthur L; Callahan, Daniel; Haas, Janet

1987-08-01

The field of medical rehabilitation is relatively new.... Until recently, the ethical problems of this new field were neglected. There seemed to be more pressing concerns as rehabilitation medicine struggled to establish itself, sometimes in the face of considerable skepticism or hostility. There also seemed no pressing moral questions of the kind and intensity to be encountered, say, in high-technology acute care medicine or genetic engineering.... Those in biomedical ethics could and did easily overlook the quiet, less obtrusive issues of rehabilitation.... The Hastings Center set out in 1985 to rectify that situation.... To explore the issues, the Center assembled a group of practitioners in the field, Hastings Center staff members, and individuals experienced in other areas of medical ethics.... The report that follows was written by Arthur Caplan and Daniel Callahan, assisted by Dr. Janet Haas of the Moss Rehabilitation Hospital in Philadelphia....

Employment Counseling and Organizational Ethical Values

ERIC Educational Resources Information Center

Valentine, Sean

2004-01-01

Employment counseling is commonly used in companies to assist employees with various personal and professional challenges that are confronted in the workplace. Such guidance could affect the degree to which employees believe a company proactively supports an ethical orientation; the purpose of this study was to explore this issue. A self-report…

Postmortem Confidentiality: An Ethical Issue

ERIC Educational Resources Information Center

Bradley, Loretta J.; Hendricks, Bret; Kabell, Douglas R.

2011-01-01

In an era of increased need and expectation for confidentiality, the counseling record of the deceased client challenges confidentiality. Using ethical codes and legal mandates, the authors explore whether the counseling record of a deceased client should be released when the client's will and the client's counseling records are silent on this…

Ethical Reasoning of U.S. High School Seniors Exploring Just versus Unjust Laws

ERIC Educational Resources Information Center

Kohlmeier, Jada; Saye, John W.

2014-01-01

Because a pluralistic democracy is inherently conflictual, public deliberation of issues holds the potential to expand the thinking of participants by revealing new insights, perspectives, information, or logics into the participants' consideration. These are ethical questions that ask citizens to decide whether policies, actions, and decisions…

Qualitative research with small connected communities: generating new knowledge while upholding research ethics.

PubMed

Damianakis, Thecla; Woodford, Michael R

2012-05-01

Qualitative researchers have a dual mission: to generate knowledge through rigorous research and to uphold ethical standards and principles. Qualitative researchers often conduct studies with small connected communities in which relationships exist among community members. When engaging such communities, researchers might face ethical issues in upholding confidentiality standards while they work to achieve their dual mandate. Qualitative scholars have paid little attention to the ethical challenges that might arise in this context. Drawing on our experiences conducting studies with such communities, we expand the dialogue concerning qualitative research ethics by making explicit conceptual and practical tensions that emerge at various stages of the research process; articulating our respective reflective processes; and exploring issues associated with strategies for upholding confidentiality. We conclude with lessons learned to guide researchers who might face similar challenges.

Physicians’ Professionally Responsible Power: A Core Concept of Clinical Ethics

PubMed Central

McCullough, Laurence B.

2016-01-01

The gathering of power unto themselves by physicians, a process supported by evidence-based practice, clinical guidelines, licensure, organizational culture, and other social factors, makes the ethics of power—the legitimation of physicians’ power—a core concept of clinical ethics. In the absence of legitimation, the physician’s power over patients becomes problematic, even predatory. As has occurred in previous issues of the Journal, the papers in the 2016 clinical ethics issue bear on the professionally responsible deployment of power by physicians. This introduction explores themes of physicians’ power in papers from an international group of authors who address autonomy and trust, the virtues of perinatal hospice, conjoined twins in ethics and law, addiction and autonomy in clinical research on addicting substances, euthanasia of patients with dementia in Belgium, and a pragmatic approach to clinical futility. PMID:26671961

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

PubMed

Omery, A

1991-09-01

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

Conflicts of interest between physicians and the pharmaceutical industry and special interest groups.

PubMed

Schetky, Diane H

2008-01-01

Health care in the United States is a tangled web of competing interest groups beneath which ethical conflicts of interest flourish. Physicians, professional organizations, and academic medical centers must continually evaluate their relationships with the pharmaceutical industry as they relate to personal, professional, and institutional ethical values. This article explores the relevant pressing ethical issues and proposals for changing course and managing these potentially troublesome relationships.

Ethics in oncology: consulting for the investment industry.

PubMed

Berlin, Jordan; Bruinooge, Suanna S; Tannock, Ian F

2007-02-01

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 vignettes@asco.org. Martin D. Abeloff, MD, Chair, Ethics Committee.

The ethics of everyday practice in primary medical care: responding to social health inequities

PubMed Central

2010-01-01

Background Social and structural inequities shape health and illness; they are an everyday presence within the doctor-patient encounter yet, there is limited ethical guidance on what individual physicians should do. This paper draws on a study that explored how doctors and their professional associations ought to respond to the issue of social health inequities. Results Some see doctors as bound by a notion of care that is blind to a patient's social position, while others respond to this issue through invoking notions of justice and human rights where access to care is a prime focus. Both care and justice orientations however conceal important tensions linked to the presence of bioethical principles underpinning these. Other normative ethical theories like deontology, virtue ethics and utilitarianism do not provide adequate guidance on the problem of social health inequities either. Conclusion This paper explores if Bauman's notion of "forms of togetherness" provides the basis of a relational ethical theory that can help to develop a response to social health inequities of relevance to individual physicians. This theory goes beyond silence on the influence of social position of health and avoids amoral regulatory approaches to monitoring equity of care provision. PMID:20438627

Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives.

PubMed

Silva, Diego S; Gibson, Jennifer L; Robertson, Ann; Bensimon, Cécile M; Sahni, Sachin; Maunula, Laena; Smith, Maxwell J

2012-03-26

Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.

Between universalism and relativism: a conceptual exploration of problems in formulating and applying international biomedical ethical guidelines.

PubMed

Tangwa, G B

2004-02-01

In this paper, the author attempts to explore some of the problems connected with the formulation and application of international biomedical ethical guidelines, with particular reference to Africa. Recent attempts at revising and updating some international medical ethical guidelines have been bedevilled by intractable controversies and wrangling regarding both the content and formulation. From the vantage position of relative familiarity with both African and Western contexts, and the privilege of having been involved in the revision and updating of one of the international ethical guidelines, the author reflects broadly on these issues and attempts prescribing an approach from both the theoretical and practical angles liable to mitigate, if not completely eliminate, some of the problems and difficulties.

Tut and the Titanic and Finding History Beneath the Sea.

ERIC Educational Resources Information Center

Hennessey, Gail Skroback; Ballard, Robert

1988-01-01

Two articles discuss the controversy about exploration of the shipwrecked Titanic. Suggested are questions for discussion and activities to stimulate student interest and to explore ethical issues involved in the treatment of historic artifacts. (CB)

Ethical issues that confront nurses in private hospitals in the Western Cape Metropolitan area.

PubMed

Stellenberg, Ethelwynn L; Dorse, Alta J

2014-06-06

Nurses are faced daily with a variety of ethical issues which could be as a result of budget cuts, target setting, the shortage of nurses and expertise. The objectives of the study were to identify ethical issues related to patient care, to describe ethical issues related to patient diversity, rights and human dignity. To describe ethical issues related to caring in nursing and to the workplace environment. A quantitative explorative descriptive research design was applied. A stratified sample of (n = 142/5%) was drawn from all nurses and caregivers (N = 2990) working in a selected group of eight private hospitals. Self-administered questionnaires were used to collect the data. Statistical tests were applied to determine statistical relationships between variables. RESULTS included (95%) of respondents provided safe and committed care to their patients, (99%) loved to care for their patients and (93%) believed in the Nurses' Pledge of Service. Fifty percent (50%) of the respondents indicated verbal abuse from patients and only (59%) experienced openness and transparency in the work environment. Analysis further identified that the caregivers did not respect the noble tradition of the profession and experienced the most verbal abuse. This study has identified ethical issues which may give rise to conflict within the workplace environment if not adequately addressed by management. The study further showed that the use of caregivers not regulated in nursing practice may pose as a threat to the safety of the patient.

Ethnographic analysis of everyday ethics in the care of nursing home residents with dementia: a taxonomy.

PubMed

Powers, B A

2001-01-01

The concept of everyday ethics was used to emphasize the moral basis of ordinary issues of daily living affecting quality of life for nursing home residents with dementia. To critically examine ethical issues of daily living affecting nursing home residents with dementia and to construct a descriptive taxonomy inductively derived from ethnographic fieldwork data. Combined anthropological methods of participant observation and in-depth interviewing were used in the natural setting of a 147-bed, voluntary, not-for-profit nursing home. Experiences of 30 residents, their family members, and nursing home staff were explored. In addition, the records of 10 ethics committee cases involving residents with dementia further enlarged the database. The taxonomy of everyday ethical issues includes the following four domains: (a) learning the limits of intervention; (b) tempering the culture of surveillance and restraint; (c) preserving the integrity of the individual; and (d) defining community norms and values. Each is representative of constellations of concerns that are grounded in the cultural and moral environment of the nursing home. Results highlight the challenges of recognizing the ethical in the ordinary, and of resolving everyday issues in ways that enhance quality of life for residents with dementia and those (family and staff) who care for them.

Predictors of Ethical Stress, Moral Action and Job Satisfaction in Health Care Social Workers

PubMed Central

O'Donnell, Patricia; Farrar, Adrienne; BrintzenhofeSzoc, Karlynn; Conrad, Ann Patrick; Danis, Marion; Grady, Christine; Taylor, Carol; Ulrich, Connie M.

2016-01-01

Value conflicts can be a source of ethical stress for social workers in health care settings. That stress, unless mediated by the availability of ethical resource services, can lead to social workers' dissatisfaction with their positions and careers, and possibly result in needed professionals leaving the field. This study explored social workers' experiences in dealing with ethical issues in health care settings. Findings showed the inter-relationship between selected individual and organizational factors and overall ethical stress, the ability to take moral actions, the impact of ethical stress on job satisfaction, and the intent to leave position. PMID:18551828

Should Researchers Protect the Good Name and Reputation of Institutions in Which Research Is Done?

ERIC Educational Resources Information Center

Uys, L. R.

2008-01-01

The article explores the issue of protecting the good name and reputation of institutions and organisations in which research is being done. It explores current ethical codes in this regard, as well as legal provision for such protection. The issue of balancing the right of the researchers to share information about institutions in which research…

Values and Ethics in Child and Youth Care Practice

ERIC Educational Resources Information Center

Gharabaghi, Kiaras

2008-01-01

The implications of the practitioner's personal values are explored in relation to the professional issues of child and youth care practice. Values are inevitably a component of decision-making and therefore are integrally connected to ethics in the field. The prevalence of subjectivity over objectivity is emphasized in relation to in-the-moment…

Malaysian University Students' Attitudes to Academic Dishonesty and Business Ethics

ERIC Educational Resources Information Center

Ahmad, Zauwiyah; Simun, Maimun; Mohammad, Junaini

2008-01-01

Academic dishonesty is believed to have predictive ability for subsequent behaviours in the workplace. This study adds to the literature by investigating Malaysian business students' attitudes to academic dishonesty and their attitudes to ethics issues in business. This study also explores the association between these two constructs. The form of…

Biotechnology, Ethics and Education

ERIC Educational Resources Information Center

Fitzsimons, Peter John

2007-01-01

Fundamental differences between current and past knowledge in the field of biotechnology mean that we now have at our disposal the means to irreversibly change what is meant by "human nature". This paper explores some of the ethical issues that accompany the (as yet tentative) attempt to increase scientific control over the human genetic code in…

The Writer's Mind: Ethics in the Teaching of Technical Writing.

ERIC Educational Resources Information Center

Rubens, Philip M.

As opposed to being a "closed" text (tightly constrained by physical formats, corporate style, and specialized vocabulary), technical writing is actually "open" in the sense that such a text can be interpreted subjectively by an informed audience. Three ethical issues that should be explored in teaching technical writing include personality--the…

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

ERIC Educational Resources Information Center

Corbin, Joanne

2012-01-01

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

Ethical Values in Russian Education Today: A Moral Maze

ERIC Educational Resources Information Center

Kliucharev, Grigory; Muckle, James

2005-01-01

In this article, the complexity or possible confusion in public attitudes to ethical issues is explored. The characteristics of the 'Soviet person' as once instilled in schoolchildren are listed and elucidated. Results of nationwide surveys of the Russian population carried out most recently in 2004 are used to illustrate the values that Russian…

On withholding nutrition and hydration in the terminally ill: has palliative medicine gone too far?

PubMed Central

Craig, G M

1994-01-01

This paper explores ethical issues relating to the management of patients who are terminally ill and unable to maintain their own nutrition and hydration. A policy of sedation without hydration or nutrition is used in palliative medicine under certain circumstances. The author argues that this policy is dangerous, medically, ethically and legally, and can be disturbing for relatives. The role of the family in management is discussed. This issue requires wide debate by the public and the profession. PMID:7527863

Donation after cardiac death and the emergency department: ethical issues.

PubMed

Simon, Jeremy R; Schears, Raquel M; Padela, Aasim I

2014-01-01

Organ donation after cardiac death (DCD) is increasingly considered as an option to address the shortage of organs available for transplantation, both in the United States and worldwide. The procedures for DCD differ from procedures for donation after brain death and are likely less familiar to emergency physicians (EPs), even as this process is increasingly involving emergency departments (EDs). This article explores the ED operational and ethical issues surrounding this procedure. © 2013 by the Society for Academic Emergency Medicine.

Legal and ethical issues associated with Advance Care Directives in an Australian context.

PubMed

Denniss, D L

2016-12-01

The need for appropriate mechanisms guiding end-of-life care is increasingly vital. This commentary compares the use of Advance Care Directives (ACD) in New South Wales and South Australia in order to highlight the inconsistency in Australian legislation, before exploring common problems, legal concerns and ethical issues associated with their application in an adult population. The benefits and detriments of statutory legislation for ACD are also evaluated. © 2016 Royal Australasian College of Physicians.

Social and ethical dimensions of nanoscale science and engineering research.

PubMed

Sweeney, Aldrin E

2006-07-01

Continuing advances in human ability to manipulate matter at the atomic and molecular levels (i.e. nanoscale science and engineering) offer many previously unimagined possibilities for scientific discovery and technological development. Paralleling these advances in the various science and engineering sub-disciplines is the increasing realization that a number of associated social, ethical, environmental, economic and legal dimensions also need to be explored. An important component of such exploration entails the identification and analysis of the ways in which current and prospective researchers in these fields conceptualize these dimensions of their work. Within the context of a National Science Foundation funded Research Experiences for Undergraduates (REU) program in nanomaterials processing and characterization at the University of Central Florida (2002-2004), here I present for discussion (i) details of a "nanotechnology ethics" seminar series developed specifically for students participating in the program, and (ii) an analysis of students' and participating research faculty's perspectives concerning social and ethical issues associated with nanotechnology research. I conclude with a brief discussion of implications presented by these issues for general scientific literacy and public science education policy.

Ethical issues in the reuse of qualitative data: perspectives from literature, practice, and participants.

PubMed

Yardley, Sarah J; Watts, Kate M; Pearson, Jennifer; Richardson, Jane C

2014-01-01

In this article, we explore ethical issues in qualitative secondary analysis through a comparison of the literature with practitioner and participant perspectives. To achieve this, we integrated critical narrative review findings with data from two discussion groups: qualitative researchers and research users/consumers. In the literature, we found that theoretical debate ran parallel to practical action rather than being integrated with it. We identified an important and novel theme of relationships that was emerging from the perspectives of researchers and users. Relationships were significant with respect to trust, sharing data, transparency and clarity, anonymity, permissions, and responsibility. We provide an example of practice development that we hope will prompt researchers to re-examine the issues in their own setting. Informing the research community of research practitioner and user perspectives on ethical issues in the reuse of qualitative data is the first step toward developing mechanisms to better integrate theoretical and empirical work.

The Wiley Protocol: an analysis of ethical issues.

PubMed

Rosenthal, M Sara

2008-01-01

: This review explores the ethical issues surrounding an unregulated protocol that is advertised to women through consumer books, the popular press, and the Internet, known as the Wiley Protocol. : A content analysis of relevant documents was conducted, followed by telephone interviews with investigators and former participants to verify facts. : The Wiley Protocol is an example of unregulated research involving potentially unsafe doses of bioidentical hormones applied to an unselected population of women. This protocol fails to use research ethics guidelines such as informed consent, investigator expertise, sound methodology, standardized data collection, and data safety monitoring. : Clinical ethics breaches include lack of full disclosure of risks, coercive influences, as well as misinformation about the study goals and safety. Breaches of professional ethics include conflicts of interest with respect to financial incentives, patient accrual, and inadequate standards of awareness and proficiency among participating investigators. It appears evident that the failure to regulate nutriceuticals and products of compounding pharmacy has provided the opportunity for these ethical violations.

Systematic and transparent inclusion of ethical issues and recommendations in clinical practice guidelines: a six-step approach.

PubMed

Mertz, Marcel; Strech, Daniel

2014-12-04

Clinical practice guidelines (CPGs), a core tool to foster medical professionalism, differ widely in whether and how they address disease-specific ethical issues (DSEIs), and current manuals for CPG development are silent on this issue. The implementation of an explicit method faces two core challenges: first, it adds further complexity to CPG development and requires human and financial resources. Second, in contrast to the in-depth treatment of ethical issues that is standard in bioethics, the inclusion of DSEIs in CPGs need to be more pragmatic, reductive, and simplistic, but without rendering the resulting recommendations useless or insufficiently justified. This paper outlines a six-step approach, EthicsGuide, for the systematic and transparent inclusion of ethical issues and recommendations in CPGs. The development of EthicsGuide is based on (a) methodological standards in evidence-based CPG development, (b) principles of bioethics, (c) research findings on how DSEIs are currently addressed in CPGs, and (d) findings from two proof-of-concept analyses of the EthicsGuide approach. The six steps are 1) determine the DSEI spectrum and the need for ethical recommendations; 2) develop statements on which to base ethical recommendations; 3) categorize, classify, condense, and paraphrase the statements; 4) write recommendations in a standard form; 5) validate and justify recommendations, making any necessary modifications; and 6) address consent. All six steps necessarily come into play when including DSEIs in CPGs. If DSEIs are not explicitly addressed, they are unavoidably dealt with implicitly. We believe that as ethicists gain greater involvement in decision-making about health, personal rights, or economic issues, they should make their methods transparent and replicable by other researchers; and as ethical issues become more widely reflected in CPGs, CPG developers have to learn how to address them in a methodologically adequate way. The approach proposed should serve as a basis for further discussion on how to reach these goals. It breaks open the black box of what ethicists implicitly do when they develop recommendations. Further, interdisciplinary discussion and pilot tests are needed to explore the minimal requirements that guarantee a simplified procedure which is still acceptable and does not become mere window dressing.

Between universalism and relativism: a conceptual exploration of problems in formulating and applying international biomedical ethical guidelines

PubMed Central

Tangwa, G

2004-01-01

In this paper, the author attempts to explore some of the problems connected with the formulation and application of international biomedical ethical guidelines, with particular reference to Africa. Recent attempts at revising and updating some international medical ethical guidelines have been bedevilled by intractable controversies and wrangling regarding both the content and formulation. From the vantage position of relative familiarity with both African and Western contexts, and the privilege of having been involved in the revision and updating of one of the international ethical guidelines, the author reflects broadly on these issues and attempts prescribing an approach from both the theoretical and practical angles liable to mitigate, if not completely eliminate, some of the problems and difficulties. PMID:14872078

Stakeholder perspectives on ethical challenges in HIV vaccine trials in South Africa.

PubMed

Essack, Zaynab; Koen, Jennifer; Barsdorf, Nicola; Slack, Catherine; Quayle, Michael; Milford, Cedilia; Lindegger, Graham; Ranchod, Chitra; Mukuka, Richard

2010-04-01

There is little published literature on the ethical concerns of stakeholders in HIV vaccine trials. This study explored the ethical challenges identified by various stakeholders, through an open-ended, in-depth approach. While the few previous studies have been largely quantitative, respondents in this study had the opportunity to spontaneously identify the issues that they perceived to be of priority concern in the South African context. Stakeholders spontaneously identified the following as ethical priorities: informed consent, social harms, collaborative relationships between research stakeholders, the participation of children and adolescents, access to treatment for participants who become infected with HIV, physical harms, fair participant and community selection, confidentiality, benefits, and payment. While there is some speculation that research in developing countries poses special ethical challenges, overall no issues were identified that have not been anticipated in international guidance, literature and popular frameworks. However, the South African context affords a distinctive gloss to these expected issues; for example, respondents were concerned that the predominant selection of black participants may perpetuate racist practices of apartheid. Stakeholders should be aware of contextual factors impacting on the implementation of ethical principles. We make a series of recommendations for South African trials, including amendments to the ethical-legal framework and research policies, and, for further research.

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

PubMed

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

2016-01-01

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

Balancing Ethical Pros and Cons of Stem Cell Derived Gametes.

PubMed

Segers, Seppe; Mertes, Heidi; de Wert, Guido; Dondorp, Wybo; Pennings, Guido

2017-07-01

In this review we aim to provide an overview of the most important ethical pros and cons of stem cell derived gametes (SCD-gametes), as a contribution to the debate about reproductive tissue engineering. Derivation of gametes from stem cells holds promising applications both for research and for clinical use in assisted reproduction. We explore the ethical issues connected to gametes derived from embryonic stem cells (both patient specific and non-patient specific) as well as those related to gametes derived from induced pluripotent stem cells. The technology of SCD-gametes raises moral concerns of how reproductive autonomy relates to issues of embryo destruction, safety, access, and applications beyond clinical infertility.

Ethical responsibilities in nursing: research findings and issues.

PubMed

Cassidy, V R

1991-01-01

Discussions in the literature assert that nurses are becoming increasingly cognizant of their ethical responsibilities, but that they are often ill prepared to participate in ethical decision making. A review of selected research literature from 1970 to 1987 was undertaken to validate these assertions. A total of 12 studies related to ethical responsibilities was identified in the review; all studies were published between 1980 and 1987. The majority of studies were at the descriptive and exploratory levels and employed Kohlberg's cognitive theory of moral development as their conceptual framework. Significant findings related to educational level and ethical responsibilities were consistent across studies. Findings related to age and clinical experience were mixed; the effects of economic level, religion-religiosity, ethnicity, and other variables on ethical responsibilities were not significant. Issues raised in the light of the existing research include the use of Kohlberg's theory as a conceptual orientation in nursing groups and limited data on the reliability and validity of instruments used in measuring ethical constructs. Recommendations for future research on ethical responsibilities include the validation of Kohlberg's theory for nursing investigations, exploration of other frameworks for developing a multidimensional view of ethical responsibilities, and the use of qualitative research designs.

Ethics Considerations in Global Mobile Phone-Based Surveys of Noncommunicable Diseases: A Conceptual Exploration.

PubMed

Ali, Joseph; Labrique, Alain B; Gionfriddo, Kara; Pariyo, George; Gibson, Dustin G; Pratt, Bridget; Deutsch-Feldman, Molly; Hyder, Adnan A

2017-05-05

Mobile phone coverage has grown, particularly within low- and middle-income countries (LMICs), presenting an opportunity to augment routine health surveillance programs. Several LMICs and global health partners are seeking opportunities to launch basic mobile phone-based surveys of noncommunicable diseases (NCDs). The increasing use of such technology in LMICs brings forth a cluster of ethical challenges; however, much of the existing literature regarding the ethics of mobile or digital health focuses on the use of technologies in high-income countries and does not consider directly the specific ethical issues associated with the conduct of mobile phone surveys (MPS) for NCD risk factor surveillance in LMICs. In this paper, we explore conceptually several of the central ethics issues in this domain, which mainly track the three phases of the MPS process: predata collection, during data collection, and postdata collection. These include identifying the nature of the activity; stakeholder engagement; appropriate design; anticipating and managing potential harms and benefits; consent; reaching intended respondents; data ownership, access and use; and ensuring LMIC sustainability. We call for future work to develop an ethics framework and guidance for the use of mobile phones for disease surveillance globally. ©Joseph Ali, Alain B Labrique, Kara Gionfriddo, George Pariyo, Dustin G Gibson, Bridget Pratt, Molly Deutsch-Feldman, Adnan A Hyder. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.05.2017.

Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives

PubMed Central

2012-01-01

Background Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. Methods To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Results Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Conclusions Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans. PMID:22449119

The Role of Academic Psychiatry Faculty in the Treatment and Subsequent Evaluation and Promotion of Medical Students: An Ethical Conundrum

ERIC Educational Resources Information Center

Kavan, Michael G.; Malin, Paula Jo; Wilson, Daniel R.

2008-01-01

Objectives: This article explores ethical and practical issues associated with the Liaison Committee on Medical Education (LCME) provision that states health professionals who provide psychiatric/psychological care to medical students must have no involvement in the academic evaluation or promotion of students receiving those services. Method: The…

Using Critical Literacy to Explore Genetics and Its Ethical, Legal, and Social Issues with In-Service Secondary Teachers

ERIC Educational Resources Information Center

Gleason, Michael L.; Melancon, Megan E.; Kleine, Karynne L. M.

2010-01-01

The described interdisciplinary course helped a mixed population of in-service secondary English and biology teacher-participants increase their genetics content knowledge and awareness of Ethical, Legal, and Social Implications (ELSI) that arose from discoveries and practices associated with the Human Genome Project. This was accomplished by…

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

ERIC Educational Resources Information Center

Vaughan, George B.; And Others

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

Evoking the Moral Imagination: Using Stories to Teach Ethics and Professionalism to Nursing, Medical, and Law Students.

ERIC Educational Resources Information Center

Weisberg, Mark; Duffin, Jacalyn

1995-01-01

A program that brings together students entering demanding professions (law, medicine, and nursing) to explore issues of ethics and professionalism is described. The course uses thought-provoking stories, classroom discussion, student journals, and collaborative teaching. Lessons learned from teaching the course a number of times are also…

Ethical Issues in Covering Teen Suicide Stories: Deadly Dilemmas and Fatal Flaws.

ERIC Educational Resources Information Center

Willey, Susan

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,…

Ethical challenges in mental health research among internally displaced people: ethical theory and research implementation

PubMed Central

2013-01-01

Millions of people undergo displacement in the world. Internally displaced people (IDP) are especially vulnerable as they are not protected by special legislation in contrast to other migrants. Research conducted among IDPs must be correspondingly sensitive in dealing with ethical issues that may arise. Muslim IDPs in Puttalam district in the North-Western province of Sri Lanka were initially displaced from Northern Sri Lanka due to the conflict in 1991. In the backdrop of a study exploring the prevalence of common mental disorders among the IDPs, researchers encountered various ethical challenges. These included inter-related issues of autonomy, non-maleficence, beneficence, confidentiality and informed consent, and how these were tailored in a culture-specific way to a population that has increased vulnerability. This paper analyses how these ethical issues were perceived, detected and managed by the researchers, and the role of ethics review committees in mental health research concerning IDPs. The relevance of guidelines and methodologies in the context of an atypical study population and the benefit versus risk potential of research for IDPs are also discussed. The limitations that were encountered while dealing with ethical challenges during the study are discussed. The concept of post-research ethical conduct audit is suggested to be considered as a potential step to minimize the exploitation of vulnerable populations such as IDPs in mental health research. PMID:23497333

Ethical challenges in mental health research among internally displaced people: ethical theory and research implementation.

PubMed

Siriwardhana, Chesmal; Adikari, Anushka; Jayaweera, Kaushalya; Sumathipala, Athula

2013-03-12

Millions of people undergo displacement in the world. Internally displaced people (IDP) are especially vulnerable as they are not protected by special legislation in contrast to other migrants. Research conducted among IDPs must be correspondingly sensitive in dealing with ethical issues that may arise. Muslim IDPs in Puttalam district in the North-Western province of Sri Lanka were initially displaced from Northern Sri Lanka due to the conflict in 1991. In the backdrop of a study exploring the prevalence of common mental disorders among the IDPs, researchers encountered various ethical challenges. These included inter-related issues of autonomy, non-maleficence, beneficence, confidentiality and informed consent, and how these were tailored in a culture-specific way to a population that has increased vulnerability. This paper analyses how these ethical issues were perceived, detected and managed by the researchers, and the role of ethics review committees in mental health research concerning IDPs. The relevance of guidelines and methodologies in the context of an atypical study population and the benefit versus risk potential of research for IDPs are also discussed. The limitations that were encountered while dealing with ethical challenges during the study are discussed. The concept of post-research ethical conduct audit is suggested to be considered as a potential step to minimize the exploitation of vulnerable populations such as IDPs in mental health research.

Philosophy as news: bioethics, journalism and public policy.

PubMed

Goodman, K W

1999-04-01

News media accounts of issues in bioethics gain significance to the extent that the media influence public policy and inform personal decision making. The increasingly frequent appearance of bioethics in the news thus imposes responsibilities on journalists and their sources. These responsibilities are identified and discussed, as is (i) the concept of "news-worthiness" as applied to bioethics, (ii) the variable quality of bioethics reportage and (iii) journalists' reliance on ethicists to pass judgment. Because of the potential social and other benefits of high quality reporting on ethical issues, it is argued that journalists and their bioethics sources should explore and accommodate more productive relationships. An optimal journalism-ethics relationship will be one characterized by "para-ethics," in which journalistic constraints are noted but also in which issues and arguments are presented without oversimplification and credible disagreement is given appropriate attention.

Ethical Expert Systems

PubMed Central

Victoroff, Michael S.

1985-01-01

The title is a double entendre. The discussion approaches expert systems from two directions: “What ethical hazards are created by expert systems in medicine?” and “Would it be ethical to design an expert system for solving problems in bioethics?” Computers present new ethical problems to society, some of which are unprecedented. These can be categorized under several rubrics. The paper describes a rudimentary scheme for understanding ethical issues raised by computers, in general, and medical expert systems, in particular. It focuses on bioethical implications of AI in medicine; explores norms, assumptions and taboos; and highlights certain ethical pitfalls. Principles are elucidated, for building ethically sound systems. Finally, a proposal is discussed, for the design of an expert system for moral problem solving, and the ethical implications of this notion are analyzed.

Brainwashing, LSD, and CIA: historical and ethical perspective.

PubMed

Buckman, J

1977-01-01

The history of various attempts at thought control and chemical warfare is briefly reviewed. Brainwashing, thought control, industrial and national espionage, and covert activities are becoming more sophisticated. These issues have been revived and accentuated by the Vietnam war, the Middle East Crisis, Watergate, the CIA investigations and the Patty Hearst trial. Historical perspective and the ethical implications of these activities are explored. It is suggested that there is a growing level of individual and international mistrust amounting to paranoia and complicating the issues of individual freedom, civil rights and human experimentation.

Mandating doctors to attend counter-terrorism workshops is medically unethical.

PubMed

Summerfield, Derek

2016-04-01

This is a brief exploration of the ethical issues raised for psychiatrists, and for universities, schools and wider society, by the demand that they attend mandatory training as part of the UK government's Prevent counter-terrorism strategy. The silence on this matter to date on the part of the General Medical Council, medical Royal Colleges, and the British Medical Association is a failure of ethical leadership. There is also a civil liberties issue, reminiscent of the McCarthyism of 1950s USA. We should refuse to attend.

Ethical aspects of surrogacy.

PubMed

Walters, W A

1989-08-01

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

A qualitative description of service providers' experiences of ethical issues in HIV care.

PubMed

Sabone, Motshedisi B; Mogobe, Keitshokile Dintle; Matshediso, Ellah; Shaibu, Sheila; Ntsayagae, Esther I; Corless, Inge B; Cuca, Yvette P; Holzemer, William L; Dawson-Rose, Carol; Baez, Solymar S Soliz; Rivero-Mendz, Marta; Webel, Allison R; Eller, Lucille Sanzero; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Wantland, Dean; Nicholas, Patrice K; Lingren, Teri; Portillo, Carmen J; Sefcik, Elizabeth; Long-Middleton, Ellen

2018-01-01

Managing HIV treatment is a complex multi-dimensional task because of a combination of factors such as stigma and discrimination of some populations who frequently get infected with HIV. In addition, patient-provider encounters have become increasingly multicultural, making effective communication and provision of ethically sound care a challenge. This article explores ethical issues that health service providers in the United States and Botswana encountered in their interaction with patients in HIV care. A descriptive qualitative design was used to collect data from health service providers and patients using focused group discussions. This article is based on responses from health service providers only. Participants and context: This article is based on 11 focused group discussions with a total sample of 71 service providers in seven US sites and one Botswana site. Ethical considerations: Ethical review boards at all the study sites reviewed the study protocol and approved it. Ethical review boards of the study's coordinating centers, Rutgers University and the University of California at San Francisco, also approved it. The study participants provided a written informed consent to participate. HIV service providers encountered ethical challenges in all the four Beauchamp and Childress' biomedical ethics of respect for patients' autonomy, beneficence, justice, and nonmaleficence. The finding that HIV service providers encounter ethical challenges in their interaction with patients is supported by prior studies. The ethical challenges are particularly prominent in multicultural care and resource-constrained care environments. Provision of HIV care is fraught with ethical challenges that tend to pose different issues depending on a given care environment. It is important that strong partnerships are developed among key stakeholders in HIV care. In addition, health service providers need to be provided with resources so they can provide quality and ethically sound care.

Exploring the Relationship between Internet Ethics in University Students and the Big Five Model of Personality

ERIC Educational Resources Information Center

Karim, Nor Shahriza Abdul; Zamzuri, Nurul Hidayah Ahmad; Nor, Yakinah Muhamad

2009-01-01

The widespread use of the Internet and the convenient mechanism it provides, such as easy access, easy downloads, and easy copy and paste functions have made many types of unethical behaviors easier, particularly those involving students in academic settings. Among the issues in ethics within the academic environment that can be triggered by the…

Ethical and Legal Issues Associated with the Use of Aversives in the Public Schools: The SIBIS Controversy.

ERIC Educational Resources Information Center

Jacob-Timm, Susan

1996-01-01

Explores four types of intervention available in treating self-injurious behavior (SIB). One effective, although controversial, treatment in reducing SIB involves use of Self-Injurious Behavior Inhibiting System (SIBIS), a device which delivers a mild electric shock following a blow to the head. Reviews and explains the ethical and legal issues…

Engaging the Bible in GCSE and A Level Religious Studies: Environmental Stewardship as a Test Case

ERIC Educational Resources Information Center

Horrell, David G.; Davis, Anna

2014-01-01

This article explores the potential for critical and informed engagement with biblical texts to form a key element of the study of Christian perspectives on ethical issues at GCSE and A level. Given the current dominance of philosophical and ethical topics, and weaknesses in the engagement with biblical texts within existing curriculum materials,…

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

ERIC Educational Resources Information Center

Allegretti, Joseph G.

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

Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study

PubMed Central

Hiriscau, Elisabeta Ioana; Stingelin-Giles, Nicola; Wasserman, Danuta; Reiter-Theil, Stella

2016-01-01

Research with minors, especially for preventive purposes, e.g., suicide prevention, investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. We present a Delphi study exploring the ethical implications of the needs formulated by researchers in an international pre-conference who would benefit from ethics support and guidance in conducting Mental Health Research with minors. The resulting List of Ethical Issues (LEI) was submitted to a 2-rounds Delphi process via the Internet, including 34 multidisciplinary experts. In the first round, the experts reviewed the LEI and completed a questionnaire. Results from this round were analyzed and grouped in nine categories comprising 40 items. In the second round, the experts had to agree/disagree with the needs expressed in the LEI leading to a final list of 25 ethical issues considered relevant for Mental Health Research with minors such as: confidentiality of the sensitive data, competence for consenting alone and risk of harm and stigma related to the methodology used in research. It was shown that studies like SEYLE (Saving and Empowering Young Lives in Europe) trigger among researchers wishes to obtain specific recommendations helping to comply with standards for good practice in conducting research with minors. PMID:27187425

Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study.

PubMed

Hiriscau, Elisabeta Ioana; Stingelin-Giles, Nicola; Wasserman, Danuta; Reiter-Theil, Stella

2016-05-11

Research with minors, especially for preventive purposes, e.g., suicide prevention, investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. We present a Delphi study exploring the ethical implications of the needs formulated by researchers in an international pre-conference who would benefit from ethics support and guidance in conducting Mental Health Research with minors. The resulting List of Ethical Issues (LEI) was submitted to a 2-rounds Delphi process via the Internet, including 34 multidisciplinary experts. In the first round, the experts reviewed the LEI and completed a questionnaire. Results from this round were analyzed and grouped in nine categories comprising 40 items. In the second round, the experts had to agree/disagree with the needs expressed in the LEI leading to a final list of 25 ethical issues considered relevant for Mental Health Research with minors such as: confidentiality of the sensitive data, competence for consenting alone and risk of harm and stigma related to the methodology used in research. It was shown that studies like SEYLE (Saving and Empowering Young Lives in Europe) trigger among researchers wishes to obtain specific recommendations helping to comply with standards for good practice in conducting research with minors.

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

PubMed

Tulay, Pinar

2016-01-01

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

Methodological and ethical issues in research using social media: a metamethod of Human Papillomavirus vaccine studies.

PubMed

Gustafson, Diana L; Woodworth, Claire F

2014-12-02

Online content is a primary source of healthcare information for internet-using adults and a rich resource for health researchers. This paper explores the methodological and ethical issues of engaging in health research using social media. A metamethod was performed on systematically selected studies that used social media as a data source for exploring public awareness and beliefs about Human Papillomaviruses (HPV) and HPV vaccination. Seven electronic databases were searched using a variety of search terms identified for each of three concepts: social media, HPV vaccine, and research method. Abstracts were assessed for eligibility of inclusion; six studies met the eligibility criteria and were subjected to content analysis. A 10-item coding scheme was developed to assess the clarity, congruence and transparency of research design, epistemological and methodological underpinnings and ethical considerations. The designs of the six selected studies were sound, although most studies could have been more transparent about how they built in rigor to ensure the trustworthiness and credibility of findings. Statistical analysis that intended to measure trends and patterns did so without the benefit of randomized sampling and other design elements for ensuring generalizability or reproducibility of findings beyond the specified virtual community. Most researchers did not sufficiently engage virtual users in the research process or consider the risk of privacy incursion. Most studies did not seek ethical approval from an institutional research board or permission from host websites or web service providers. The metamethod exposed missed opportunities for using the dialogical character of social media as well as a lack of attention to the unique ethical issues inherent in operating in a virtual community where social boundaries and issues of public and private are ambiguous. This suggests the need for more self-conscious and ethical research practices when using social media as a data source. Given the relative newness of virtual communities, researchers and ethics review boards must work together to develop expertise in evaluating the design of studies undertaken with virtual communities. We recommend that the principles of concern for welfare, respect for person, and justice to be applied in research using social media.

Engineers' Responsibilities for Global Electronic Waste: Exploring Engineering Student Writing Through a Care Ethics Lens.

PubMed

Campbell, Ryan C; Wilson, Denise

2017-04-01

This paper provides an empirically informed perspective on the notion of responsibility using an ethical framework that has received little attention in the engineering-related literature to date: ethics of care. In this work, we ground conceptual explorations of engineering responsibility in empirical findings from engineering student's writing on the human health and environmental impacts of "backyard" electronic waste recycling/disposal. Our findings, from a purposefully diverse sample of engineering students in an introductory electrical engineering course, indicate that most of these engineers of tomorrow associated engineers with responsibility for the electronic waste (e-waste) problem in some way. However, a number of responses suggested attempts to deflect responsibility away from engineers towards, for example, the government or the companies for whom engineers work. Still other students associated both engineers and non-engineers with responsibility, demonstrating the distributed/collective nature of responsibility that will be required to achieve a solution to the global problem of excessive e-waste. Building upon one element of a framework for care ethics adopted from the wider literature, these empirical findings are used to facilitate a preliminary, conceptual exploration of care-ethical responsibility within the context of engineering and e-waste recycling/disposal. The objective of this exploration is to provide a first step toward understanding how care-ethical responsibility applies to engineering. We also hope to seed dialogue within the engineering community about its ethical responsibilities on the issue. We conclude the paper with a discussion of its implications for engineering education and engineering ethics that suggests changes for educational policy and the practice of engineering.

Physicians' Professionally Responsible Power: A Core Concept of Clinical Ethics.

PubMed

McCullough, Laurence B

2016-02-01

The gathering of power unto themselves by physicians, a process supported by evidence-based practice, clinical guidelines, licensure, organizational culture, and other social factors, makes the ethics of power--the legitimation of physicians' power--a core concept of clinical ethics. In the absence of legitimation, the physician's power over patients becomes problematic, even predatory. As has occurred in previous issues of the Journal, the papers in the 2016 clinical ethics issue bear on the professionally responsible deployment of power by physicians. This introduction explores themes of physicians' power in papers from an international group of authors who address autonomy and trust, the virtues of perinatal hospice, conjoined twins in ethics and law, addiction and autonomy in clinical research on addicting substances, euthanasia of patients with dementia in Belgium, and a pragmatic approach to clinical futility. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Research ethics and the use of visual images in research with people with intellectual disability.

PubMed

Boxall, Kathy; Ralph, Sue

2009-03-01

The aim of this paper is to encourage debate about the use of creative visual approaches in intellectual disability research and discussion about Internet publication of photographs. Image-based research with people with intellectual disability is explored within the contexts of tighter ethical regulation of social research, increased interest in the use of visual methodologies, and rapid escalation in the numbers of digital images posted on the World Wide Web. Concern is raised about the possibility that tighter ethical regulation of social research, combined with the multitude of ethical issues raised by the use of image-based approaches may be discouraging the use of creative visual approaches in intellectual disability research. Inclusion in research through the use of accessible research methods is also an ethical issue, particularly in relation to those people who have hitherto been underrepresented in research. Visual approaches which have the potential to include people with profound and multiple intellectual disabilities are also discussed.

The ethical commitments of academic faculty in psychiatric education.

PubMed

Green, Stephen A

2006-01-01

This article explores the commitment of faculty to ethics training in psychiatric education. Although psychiatry has insufficiently addressed the profession's need for ethics training in education, program directors acknowledge its critical importance, and its positive impact has been demonstrated. Additionally, residents often seek ethics training as part of their instruction. The author suggests that academic faculty could respond to the profession's inadequate treatment of ethics training by helping trainees develop moral agency--the ability to recognize, assess, and respond to ethical dilemmas; decide what constitutes right or wrong care; and act accordingly. The author also describes how this objective could be met by promoting professionalism and offering didactic instruction that address substantive and process issues regarding psychiatric care. Specific recommendations are provided.

Deep brain stimulation in the media: over-optimistic portrayals call for a new strategy involving journalists and scientists in ethical debates.

PubMed

Gilbert, Frédéric; Ovadia, Daniela

2011-01-01

Deep brain stimulation (DBS) is optimistically portrayed in contemporary media. This already happened with psychosurgery during the first half of the twentieth century. The tendency of popular media to hype the benefits of DBS therapies, without equally highlighting risks, fosters public expectations also due to the lack of ethical analysis in the scientific literature. Media are not expected (and often not prepared) to raise the ethical issues which remain unaddressed by the scientific community. To obtain a more objective portrayal of DBS in the media, a deeper collaboration between the science community and journalists, and particularly specialized ones, must be promoted. Access to databases and articles, directly or through science media centers, has also been proven effective in increasing the quality of reporting. This article has three main objectives. Firstly, to explore the past media coverage of leukotomy, and to examine its widespread acceptance and the neglect of ethical issues in its depiction. Secondly, to describe how current enthusiastic coverage of DBS causes excessive optimism and neglect of ethical issues in patients. Thirdly, to discuss communication models and strategies to enhance media and science responsibility.

Deep Brain Stimulation in the Media: Over-Optimistic Portrayals Call for a New Strategy Involving Journalists and Scientists in Ethical Debates

PubMed Central

Gilbert, Frédéric; Ovadia, Daniela

2011-01-01

Deep brain stimulation (DBS) is optimistically portrayed in contemporary media. This already happened with psychosurgery during the first half of the twentieth century. The tendency of popular media to hype the benefits of DBS therapies, without equally highlighting risks, fosters public expectations also due to the lack of ethical analysis in the scientific literature. Media are not expected (and often not prepared) to raise the ethical issues which remain unaddressed by the scientific community. To obtain a more objective portrayal of DBS in the media, a deeper collaboration between the science community and journalists, and particularly specialized ones, must be promoted. Access to databases and articles, directly or through science media centers, has also been proven effective in increasing the quality of reporting. This article has three main objectives. Firstly, to explore the past media coverage of leukotomy, and to examine its widespread acceptance and the neglect of ethical issues in its depiction. Secondly, to describe how current enthusiastic coverage of DBS causes excessive optimism and neglect of ethical issues in patients. Thirdly, to discuss communication models and strategies to enhance media and science responsibility. PMID:21617733

An innovative approach to teaching bioethics in management of healthcare.

PubMed

Aleksandrova-Yankulovska, Silviya

2016-03-01

Bioethical courses were introduced in the curricula in medical universities in Bulgaria in 1990s. In the beginning, the courses were mainly theoretical, and systematic case analyses and discussions of movies were introduced later on. The benefits of using films to teach ethics have been previously analyzed in the literature; however, to our knowledge such studies in Bulgaria are yet lacking. The aim of this study was to survey the opinions of students and analyze the results from the application of movies in bioethics teaching in a medical university in the north of Bulgaria. A survey was carried out among 92 students in the management of healthcare. Two movies were used, and separate protocols for film discussion were developed. The study was conducted anonymously and with students' free informed consent. The students distinguished in total 21 different dilemmas and concepts in the first movie. The ethical dilemmas were classified into five groups: general ethical issues, deontological issues, special ethical issues, principles of bioethics, and theories of ethics. The second movie focused students' attention on the issues of death and dying. In total, 18 elements of palliative care were described by the students. The range of different categories was a positive indicator of an increased ethical sensitivity. The students evaluated the movies' discussions as a generally positive educational approach. They perceived the experience as contributing to their better understanding of bioethical issues. The innovative approach was well accepted by the students. The introduction of movies in the courses of bioethics had the potential to provide vivid illustrations of bioethical issues and to contribute to the exploration of specific theses and arguments. The presentation and discussion should be preceded by accumulation of theoretical knowledge. The future of effective bioethics education lays in the interactive involvement of students. © The Author(s) 2014.

Ethical issues and addiction.

PubMed

Lambert, Binta; Scheiner, Melissa; Campbell, Deborah

2010-04-01

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

Ethical use of social media to facilitate qualitative research.

PubMed

Lunnay, Belinda; Borlagdan, Joseph; McNaughton, Darlene; Ward, Paul

2015-01-01

Increasingly, qualitative health researchers might consider using social media to facilitate communication with participants. Ambiguity surrounding the potential risks intrinsic to social media could hinder ethical conduct and discourage use of this innovative method. We used some core principles of traditional human research ethics, that is, respect, integrity, and beneficence, to design our photo elicitation research that explored the social influences of drinking alcohol among 34 underage women in metropolitan South Australia. Facebook aided our communication with participants, including correspondence ranging from recruitment to feeding back results and sharing research data. This article outlines the ethical issues we encountered when using Facebook to interact with participants and provides guidance to researchers planning to incorporate social media as a tool in their qualitative studies. In particular, we raise the issues of privacy and confidentiality as contemporary risks associated with research using social media. © The Author(s) 2014.

Ethical problems in pediatrics: what does the setting of care and education show us?

PubMed

Guedert, Jucélia Maria; Grosseman, Suely

2012-03-16

Pediatrics ethics education should enhance medical students' skills to deal with ethical problems that may arise in the different settings of care. This study aimed to analyze the ethical problems experienced by physicians who have medical education and pediatric care responsibilities, and if those problems are associated to their workplace, medical specialty and area of clinical practice. A self-applied semi-structured questionnaire was answered by 88 physicians with teaching and pediatric care responsibilities. Content analysis was performed to analyze the qualitative data. Poisson regression was used to explore the association of the categories of ethical problems reported with workplace and professional specialty and activity. 210 ethical problems were reported, grouped into five areas: physician-patient relationship, end-of-life care, health professional conducts, socioeconomic issues and health policies, and pediatric teaching. Doctors who worked in hospitals as well as general and subspecialist pediatricians reported fewer ethical problems related to socioeconomic issues and health policies than those who worked in Basic Health Units and who were family doctors. Some ethical problems are specific to certain settings: those related to end-of-life care are more frequent in the hospital settings and those associated with socioeconomic issues and public health policies are more frequent in Basic Health Units. Other problems are present in all the setting of pediatric care and learning and include ethical problems related to physician-patient relationship, health professional conducts and the pediatric education process. These findings should be taken into consideration when planning the teaching of ethics in pediatrics. This research article didn't reports the results of a controlled health care intervention. The study project was approved by the Institutional Ethical Review Committee (Report CEP-HIJG 032/2008).

[Reflections on qualitative research. Interview of Luisa Saiani with Luigina Mortari].

PubMed

Mortari, Luigina; Saiani, Luisa

2013-01-01

Reflections on qualitative research. Interview of Luisa Saiani to Luigina Mortari. Luigina Mortari, an internationally known expert of epistemology and qualitative research, was interviewed to explore her thoughts on issues relevant for qualitative research: when a research question can be considered relevant; key methodological elements; ethical issues.

Cultivating Engineering Ethics and Critical Thinking: A Systematic and Cross-Cultural Education Approach Using Problem-Based Learning

ERIC Educational Resources Information Center

Chang, Pei-Fen; Wang, Dau-Chung

2011-01-01

In May 2008, the worst earthquake in more than three decades struck southwest China, killing more than 80,000 people. The complexity of this earthquake makes it an ideal case study to clarify the intertwined issues of ethics in engineering and to help cultivate critical thinking skills. This paper first explores the need to encourage engineering…

Viewpoint discrimination and contestation of ideas on its merits, leadership and organizational ethics: expanding the African bioethics agenda.

PubMed

Chima, Sylvester C; Mduluza, Takafira; Kipkemboi, Julius

2013-01-01

The 3rd Pan-African Ethics Human Rights and Medical Law (3rd EHRML) conference was held in Johannesburg on July 7, 2013, as part of the Africa Health Congress. The conference brought together bioethicists, researchers and scholars from South Africa, Zimbabwe, Kenya and Nigeria working in the field of bioethics as well as students and healthcare workers interested in learning about ethical issues confronting the African continent. The conference which ran with a theme of "Bioethical and legal perspectives in biomedical research and medical practice in Africa with a focus on: Informed consent, HIV-AIDS & Tuberculosis, leadership & organizational ethics, patients and healthcare workers rights," was designed to expand the dialogue on African bioethics beyond the traditional focus on research ethics and the ethical dilemmas surrounding the conduct of biomedical research in developing countries. This introductory article highlights some of areas of focus at the conference including issues of leadership, organizational ethics and patients and healthcare workers rights in Africa. We analyze the importance of free speech, public debate of issues, argumentation and the need to introduce the teaching and learning of ethics to students in Africa in accordance with UNESCO guidelines. This article also focuses on other challenges confronting Africa today from an ethical standpoint, including the issues of poor leadership and organizational ethics which are main contributors to the problems prevalent in African countries, such as poverty, poor education and healthcare delivery systems, terrorism, social inequities, infrastructural deficits and other forms of 'structural violence' confronting vulnerable African communities. We believe that each of the eight articles included in this supplement, which have been rigorously peer-reviewed are a good example of current research on bioethics in Africa, and explore some new directions towards broadening the African bioethics agenda as we move forward to a new dawn for Africa in the 21st century.

Viewpoint discrimination and contestation of ideas on its merits, leadership and organizational ethics: expanding the African bioethics agenda

PubMed Central

2013-01-01

The 3rd Pan-African Ethics Human Rights and Medical Law (3rd EHRML) conference was held in Johannesburg on July 7, 2013, as part of the Africa Health Congress. The conference brought together bioethicists, researchers and scholars from South Africa, Zimbabwe, Kenya and Nigeria working in the field of bioethics as well as students and healthcare workers interested in learning about ethical issues confronting the African continent. The conference which ran with a theme of "Bioethical and legal perspectives in biomedical research and medical practice in Africa with a focus on: Informed consent, HIV-AIDS & Tuberculosis, leadership & organizational ethics, patients and healthcare workers rights," was designed to expand the dialogue on African bioethics beyond the traditional focus on research ethics and the ethical dilemmas surrounding the conduct of biomedical research in developing countries. This introductory article highlights some of areas of focus at the conference including issues of leadership, organizational ethics and patients and healthcare workers rights in Africa. We analyze the importance of free speech, public debate of issues, argumentation and the need to introduce the teaching and learning of ethics to students in Africa in accordance with UNESCO guidelines. This article also focuses on other challenges confronting Africa today from an ethical standpoint, including the issues of poor leadership and organizational ethics which are main contributors to the problems prevalent in African countries, such as poverty, poor education and healthcare delivery systems, terrorism, social inequities, infrastructural deficits and other forms of 'structural violence' confronting vulnerable African communities. We believe that each of the eight articles included in this supplement, which have been rigorously peer-reviewed are a good example of current research on bioethics in Africa, and explore some new directions towards broadening the African bioethics agenda as we move forward to a new dawn for Africa in the 21st century. PMID:24564890

A matter of accuracy. Nanobiochips in diagnostics and in research: ethical issues as value trade-offs.

PubMed

Le Roux, Ronan

2015-04-01

The paper deals with the introduction of nanotechnology in biochips. Based on interviews and theoretical reflections, it explores blind spots left by technology assessment and ethical investigations. These have focused on possible consequences of increased diffusability of a diagnostic device, neglecting both the context of research as well as increased accuracy, despite it being a more essential feature of nanobiochip projects. Also, rather than one of many parallel aspects (technical, legal and social) in innovation processes, ethics is considered here as a ubiquitous system of choices between sometimes antagonistic values. Thus, the paper investigates what is at stake when accuracy is balanced with other practical values in different contexts. Dramatic nanotechnological increase of accuracy in biochips can raise ethical issues, since it is at odds with other values such as diffusability and reliability. But those issues will not be as revolutionary as is often claimed: neither in diagnostics, because accuracy of measurements is not accuracy of diagnostics; nor in research, because a boost in measurement accuracy is not sufficient to overcome significance-chasing malpractices. The conclusion extends to methodological recommendations.

Improving Student Engagement in the Study of Professional Ethics: Concepts and an Example in Cyber Security.

PubMed

Bustard, John D

2018-04-01

In spite of the acknowledged importance of professional ethics, technical students often show little enthusiasm for studying the subject. This paper considers how such engagement might be improved. Four guiding principles for promoting engagement are identified: (1) aligning teaching content with student interests; (2) taking a pragmatic rather than a philosophical approach to issue resolution; (3) addressing the full complexity of real-world case studies; and (4) covering content in a way that students find entertaining. The use of these principles is then discussed with respect to the specific experience of developing and presenting a master's module in Ethical and Legal Issues in Cyber Security at Queens University Belfast. One significant aspect of the resulting design is that it encourages students to see ethical issues in systemic terms rather than from an individual perspective, with issues emerging from a conflict between different groups with different vested interests. Case studies are used to examine how personal and business priorities create conflicts that can lead to negative press, fines and punitive legal action. The module explores the reasons why organisations may be unaware of the risks associated with their actions and how an inappropriate response to an ethical issue can significantly aggravate a situation. The module has been delivered in three successive years since 2014 and been well received on each occasion. The paper describes the design of the module and the experience of delivering it, concluding with a discussion of the effectiveness of the approach.

[Ethical and legal issues in late stage of dementia].

PubMed

Fernandes, Lia

2008-01-01

As we enter the 21st century, growth of the elderly population, the costs of care, and the advances of medical science and technology will continue to have an impact on the patient-physician relationship. Transformation of the health care system will also raise ethical issues inherent to changing roles. The special nature of Alzheimer's patients and the natural course of their disease require special care on the part of physicians to meet the ethical challenges and establish medical goals, in conjunction with their patients and their families. In spite of these rapid advances in biomedical sciences, were not sufficiently developed in the most fitness answers, regarding special moral and ethical attitudes, which must be taken into account, in particular when we try to understand the experience of people with dementia. This article explores emerging issues in relation to awareness in dementia and its impact on legal and ethical matters. The different approaches and principles demonstrated in relation to ethical issues are discussed, with an exploration of the concepts of mental capacity, testamentary capacity, power of attorney, court of protection, advance directives, decision making, participation in research and treatment, informed consent and older people driving. The tensions that exist between the imperatives of doing no harm and of maintaining autonomy in addressing legal and ethical issues are highlighted. The review emphasizes the importance of considering competency and awareness as being multi-faceted, to be understood in the context of social interaction, trying to deal with the challenge of protecting, but not overprotecting, people with dementia. Late stage of dementia is a terminal disease where the goal of the care may not be prolongation of life at all costs, but rather achievement: quality of life, dignity and comfort. In the initial late dementia, quality of life is the target, treating medical problems and psychiatric symptoms. The dignity of people with severe dementia will be preserved, mostly when this influences patient's behaviour, maximizing individual Independence in daily living activities. Finally, comfort is the last and the most important goal of care in late stages of dementia, using appropriate medical strategies and eliminating aggressive interventions (cardiopulmonary resuscitation, acute care setting, tube feeding and antibiotic treatment). The future work will focus on promoting more evidence-based decision-making on treatment and guidelines for prognostic information. Physician must be knowledgeable about broadly intersecting medical, legal, finance and ethics, underlying the long-term management of dementia.

Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations.

PubMed

Reilly, T; Crawford, G; Lobo, R; Leavy, J; Jancey, J

2016-04-01

Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap.

Ethical issues with service animals.

PubMed

Wenthold, Nora; Savage, Teresa A

2007-01-01

The beneficial aspects of canines who provide services to people with disabilities have resulted in an explosion of a category of dogs that are bred and/or trained just for service purposes. Over the past 30 years, the role of most service dogs has become more prominent and more demanding. There are also concerns as to the well-being of these animals and questions regarding realistic expectations of them. The purpose of this article is to explore the utilization of service dogs in a rehabilitation health care setting. More specifically, ethical issues that are pertinent to the service dog's role will be identified and resolutions recommended.

Ethics issues in social media-based HIV prevention in low- and middle-income countries.

PubMed

Chiu, Chingche J; Menacho, Luis; Fisher, Celia; Young, Sean D

2015-07-01

Questions have been raised regarding participants' safety and comfort when participating in e-health education programs. Although researchers have begun to explore this issue in the United States, little research has been conducted in low- and middle-income countries, where Internet and social media use is rapidly growing. This article reports on a quantitative study with Peruvian men who have sex with men who had previously participated in the Harnessing Online Peer Education (HOPE) program, a Facebook-based HIV education program. The survey assessed participants' ethics-relevant perspectives during recruitment, consent, intervention, and follow-up.

Ethics, EBM, and hospital management.

PubMed

Biller-Andorno, N; Lenk, C; Leititis, J

2004-04-01

Matters of hospital management do not figure prominently on the medical ethics agenda. However, management decisions that have to be taken in the area of hospital care are in fact riddled with ethical questions and do have significant impact on patients, staff members, and the community being served. In this decision making process evidence based medicine (EBM) plays an increasingly important role as a tool for rationalising as well as rationing health care resources. In this article, ethical issues of hospital management and the role of EBM will be explored, with particular reference to disease management programs, diagnosis related groups, and clinical pathways as recent developments in the German health care system.

Cultural and hierarchical influences: ethical issues faced by Taiwanese nursing students.

PubMed

Yeh, Mei-Yu; Wu, Shu-Mei; Che, Hui-Lian

2010-05-01

OBJECTIVES Improving nurses' competence in resolving clinical ethical issues must start with ethics education in training and clinical practice. However, many students complain that they cannot apply classroom learning to actual clinical scenarios. This study explored ethical issues and dilemmas, and their impact experienced by student nurses in clinical practice. METHODS Focus groups were conducted with 44 first-year student nurses from a 2-year college course in northern Taiwan. Interviews were tape-recorded and verbatim transcripts were analysed using content analysis. RESULTS Students expressed and discussed their views in eight focus groups. Analysis of interviews revealed five themes: frustration at inability to help some patients; oppression caused by lower status; lack of honesty and ethical courage; powerlessness, and self-encouragement in adversity. CONCLUSIONS Taiwanese nurse ethics training was only recently introduced and the curriculum has not addressed the clinical reality in Taiwan. This reality includes limitations arising from the medical hierarchy and the socio-cultural role of families in medical decision making, which may inhibit ethical judgements and decision making. In clinical dilemmas, the most common problems faced by Taiwanese nursing students involved not knowing how to handle some situations, inability to abide by principles, and a lack of appropriate role models. Hence, we suggest that nursing ethics education should: (i) integrate scenarios involving ethical dilemmas into daily routines; (ii) give students opportunities to discuss their feelings about their experiences; (iii) allow teachers and students to talk about scenarios with ethical implications, and (iv) provide students with opportunities to reflect on clinical scenarios in order to clarify their values and learn how to respect the value of life.

Pedagogy and Purpose: Moral Imagination and the Teaching of Medical Ethics.

PubMed

Hart, Curtis W

2016-04-01

This essay is an exploration of the development of moral imagination as an important outcome in the teaching of medial ethics. It is contextualized within the growth of professionalism and pays attention to the formation of character of physicians in their formal training and in the first phase of their careers. Issues around formation as it is understood historically in the vocation of the clergy are also considered. Finally, there is discussion of the place rites of passage as they figure in the lives of those who teach medical ethics.

Stressful ethical issues in uremia therapy.

PubMed

Friedman, Eli A

2010-08-01

The objectives of this review are to introduce and explore the following representative ethical problems generated by modern renal replacement therapy: (1) reviewing the historical origin of medical ethics with specific reference to nephrology; (2) recognizing the complex stresses surrounding assignment of a deceased donor renal transplant to a geriatric patient while young patients continue waiting for a donor kidney; and (3) appreciating the concept of futility and support for a uremic patient opting for death rather than further uremia therapy as the best in choice in coping with renal failure.

Ethical analysis in public health.

PubMed

Roberts, Marc J; Reich, Michael R

2002-03-23

Public-health regularly encounters serious ethical dilemmas, such as rationing scarce resources, influencing individuals to change their behaviour, and limiting freedom to diminish disease transmission. Yet unlike medical ethics, there is no agreed-upon framework for analysing these difficulties. We offer such a framework. It distinguishes three philosophical views, often invoked in public-health discourse: positions based on outcomes (utilitarianism), positions focused on rights and opportunities (liberalism), and views that emphasise character and virtue (communitarianism). We explore critical variations within each approach, and identify practical problems that arise in addressing the ethical dimensions of health policy. We conclude by examining challenges posed by the feminist argument of ethics-of-care and by postmodern views about the nature of ethics. Health professionals need enhanced skills in applied philosophy to improve the coherence, transparency, and quality of public deliberations over ethical issues inherent in health policy.

Expanding the live kidney donor pool: ethical considerations regarding altruistic donors, paired and pooled programs.

PubMed

Patel, Shaneel Rajendra; Chadha, Priyanka; Papalois, Vassilios

2011-06-01

In renal transplant, there is a well-known deficiency in organ supply relative to demand. Live donation provides superior results when compared with deceased donation including a better rate of graft success and fewer immunologic complications. This deficiency in organs leads to significant morbidity and mortality rates. Alternative avenues have been extensively explored that may expand the live donor pool. They include altruistic donation as well as paired and pooled exchange programs. Altruistic donation is a truly selfless act from a donor unknown to the recipient. Kidney paired donation involves 2 incompatible donor-recipient pairs swapping donors to produce compatibility. Pooled donation involves at least 2 pairs, and can take the form of domino chains in which altruistic input sets up a chain of transplants, in which each recipient's incompatible donor makes a donation for the next recipient. Despite application of these various methods, there lie extensive ethical issues surrounding them. Misconceptions frequently occur; for instance, the perceived benefit that donating an organ to a loved one is greater for a related donor than for an altruistic one. Additionally, it is frequently believed that immunologic incompatibility offers coerced donors liberation from surgery, and that overcoming these barriers by introducing exchange programs provides vulnerable donors less protection. This article explores these and other complex ethical issues surrounding the various methods of expanding the donor pool. The authors offer opinions that challenge the ethical issues and attempt to overcome those views that hinder progress in the field.

Early indicators and risk factors for ethical issues in clinical practice.

PubMed

Pavlish, Carol; Brown-Saltzman, Katherine; Hersh, Mary; Shirk, Marilyn; Nudelman, Olga

2011-03-01

Nurses in all clinical settings encounter ethical issues that frequently lead to moral distress. This critical incident study explored nurses' descriptions of ethically difficult situations to identify risk factors and early indicators of ethical conflicts. Employing the critical incident technique, researchers developed a questionnaire that collected information on ethically difficult situations, their risk factors and early indicators, nurse actions, and situational outcomes. Two nurse researchers independently analyzed and categorized data using a constant comparison technique. Most of the ethically difficult situations pertained to end-of-life care for children and adults. Conflicts in interpersonal relationships were prevalent. Nurses were especially moved by patient and family suffering and concerned about patient vulnerability, harm-benefit ratio, and patient autonomy. Researchers discovered risk factor categories for patients, families, healthcare providers, and health systems. Additionally, researchers found subcategories in six major categories of early indicators: signs of conflict, patient suffering, nurse distress, ethics violation, unrealistic expectations, and poor communication. Nurses are keenly aware of pertinent risk factors and early indicators of unfolding ethical conflicts. Many nurses reported feeling powerless in the face of ethical conflict. Research that develops interventions to strengthen nurses' voices in ethically difficult situation is warranted. Nurses are in a key position to identify patient situations with a high risk for ethical conflict. Initiating early ethics consultation and interventions can alter the course of pending conflicts and diminish the potential for patient and family suffering and nurses' moral distress. © 2011 Sigma Theta Tau International.

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

PubMed

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

2011-09-01

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

Ethics and the pharmaceutical industry.

PubMed

Green, Stephen

2008-06-01

Relationships between the pharmaceutical industry and the medical profession enhance the potential for physicians to become involved in conflicts of interest. Whether or not these rise to a level that violates standards of medical ethics depends on the degree to which they detract from the quality of health care and its cost, the objectivity of research, and the profession's integrity. This paper explores those issues from two perspectives--the micro-level of the medical profession and the macro-level of society. Practices and policies that affect varied aspects of the interaction between the pharmaceutical industry and the medical profession--such as education, research and marketing--are discussed. The reader is asked to reflect on the ethics of issues raised; the author offers suggestions for mitigating conflicts of interest and, in turn, the potential for unethical medical care.

Qualitative research ethics on the spot: Not only on the desktop.

PubMed

Øye, Christine; Sørensen, Nelli Øvre; Glasdam, Stinne

2016-06-01

The increase in medical ethical regulations and bureaucracy handled by institutional review boards and healthcare institutions puts the researchers using qualitative methods in a challenging position. Based on three different cases from three different research studies, the article explores and discusses research ethical dilemmas. First, and especially, the article addresses the challenges for gatekeepers who influence the informant's decisions to participate in research. Second, the article addresses the challenges in following research ethical guidelines related to informed consent and doing no harm. Third, the article argues for the importance of having research ethical guidelines and review boards to question and discuss the possible ethical dilemmas that occur in qualitative research. Research ethics must be understood in qualitative research as relational, situational, and emerging. That is, that focus on ethical issues and dilemmas has to be paid attention on the spot and not only at the desktop. © The Author(s) 2015.

How Should We Value a Planet?

NASA Astrophysics Data System (ADS)

Haqq-Misra, J.

2014-04-01

The idea that a planet or its biota may be intrinsically valuable, apart from its usefulness to humans, is contentious among ethicists, while difficulties abound in attempting to decide what is objectively better or worse for a planet or life. As a way of dissecting the issue of value and life, I present a two-axis comparative tool for ethical frameworks that considers the intrinsic or instrumental value placed upon organisms, environments, planetary systems, and space. I discuss ethical considerations relevant to contemporary space exploration, near-future human exploration of Solar System bodies, and long-term possibilities of interplanetary colonization. This allows for more transparent discussions of value with regard to future space exploration or the discovery of extraterrestrial life.

Engineers’ Responsibilities for Global Electronic Waste: Exploring Engineering Student Writing Through a Care Ethics Lens

PubMed Central

Campbell, Ryan C.; Wilson, Denise

2016-01-01

This paper provides an empirically informed perspective on the notion of responsibility using an ethical framework that has received little attention in the engineering-related literature to date: ethics of care. In this work, we ground conceptual explorations of engineering responsibility in empirical findings from engineering student’s writing on the human health and environmental impacts of “backyard” electronic waste recycling/disposal. Our findings, from a purposefully diverse sample of engineering students in an introductory electrical engineering course, indicate that most of these engineers of tomorrow associated engineers with responsibility for the electronic waste (e-waste) problem in some way. However, a number of responses suggested attempts to deflect responsibility away from engineers towards, for example, the government or the companies for whom engineers work. Still other students associated both engineers and non-engineers with responsibility, demonstrating the distributed/collective nature of responsibility that will be required to achieve a solution to the global problem of excessive e-waste. Building upon one element of a framework for care ethics adopted from the wider literature, these empirical findings are used to facilitate a preliminary, conceptual exploration of care-ethical responsibility within the context of engineering and e-waste recycling/disposal. The objective of this exploration is to provide a first step toward understanding how care-ethical responsibility applies to engineering. We also hope to seed dialogue within the engineering community about its ethical responsibilities on the issue. We conclude the paper with a discussion of its implications for engineering education and engineering ethics that suggests changes for educational policy and the practice of engineering. PMID:27368195

Educational Research: Educational Purposes, the Nature of Knowledge and Ethical Issues

ERIC Educational Resources Information Center

López-Alvarado, Julio

2017-01-01

Educational research should aim at improving educational practice by analysing the world of Education to understand it and make it better. It should be a critical, reflective and professionally oriented activity. Educational research should have three objectives: to explore issues and find answers to questions (for academics), to share policy…

Consensual Faculty--Student Sexual Relationships in Counselor Education: Recommendations for Counselor Educators' Decision Making

ERIC Educational Resources Information Center

Kress, Victoria E; Dixon, Andrea

2007-01-01

The authors explore the issue of consensual sexual relationships between counselor educators and students. The American Counseling Association's (2005) "ACA Code of Ethics" is consulted, and the complex issues associated with these relationships are discussed. A case example is provided that generates suggestions to guide counselor educators'…

Issues in Accountability for Saskatchewan Schools. SIDRU Research Report No. 9.

ERIC Educational Resources Information Center

Cooper, Elizabeth

Issues of accountability in enterprises that provide educational services at the individual and institutional levels are explored in this paper. Two conceptions of accountability are addressed: accountability as measurement and as ethics. A major source of confusion is the disagreement between the two ways of thinking about the meaning and…

Critical Issues in Conducting Research with Immigrant Children

ERIC Educational Resources Information Center

Kirova, Anna; Emme, Michael

2007-01-01

In this article, we explore critical issues in research with immigrant and refugee children. In particular, we examine the implications of various critiques of research methodologies, the ethical implications of researching children in the light of the United Nations (UN; 1989) "Convention on the Rights of the Child," and the new approach to…

Prioritising Healthcare Workers for Ebola Treatment: Treating Those at Greatest Risk to Confer Greatest Benefit.

PubMed

Satalkar, Priya; Elger, Bernice E; Shaw, David M

2015-08-01

The Ebola epidemic in Western Africa has highlighted issues related to weak health systems, the politics of drug and vaccine development and the need for transparent and ethical criteria for use of scarce local and global resources during public health emergency. In this paper we explore two key themes. First, we argue that independent of any use of experimental drugs or vaccine interventions, simultaneous implementation of proven public health principles, community engagement and culturally sensitive communication are critical as these measures represent the most cost-effective and fair utilization of available resources. Second, we attempt to clarify the ethical issues related to use of scarce experimental drugs or vaccines and explore in detail the most critical ethical question related to Ebola drug or vaccine distribution in the current outbreak: who among those infected or at risk should be prioritized to receive any new experimental drugs or vaccines? We conclude that healthcare workers should be prioritised for these experimental interventions, for a variety of reasons. © 2015 John Wiley & Sons Ltd.

Ethical issues in astrobiology: a Christian perspective (Invited)

NASA Astrophysics Data System (ADS)

Randolph, R. O.

2009-12-01

With its focus on the origin, extent, and future of life, Astrobiology raises exciting, multidisciplinary questions for science. At the same time, Astrobiology raises important questions for the humanities. For instance, the prospect of discovering extraterrestrial life - either intelligent or unintelligent - raises questions about humans’ place in the universe and our relationship with nature on planet Earth. Fundamentally, such questions are rooted in our understanding of what it means to be human. From a Christian perspective, the foundational claim about human nature is that all persons bear the "imago dei", the image of God. This concept forms the basis for how humans relate to one another (dignity) and how humans relate to nature (stewardship). For many Christians the "imago dei" also suggests that humans are at the center of the universe. The discovery of extraterrestrial life would be another scientific development - similar to evolution - that essentially de-centers humanity. For some Christian perspectives this de-centering may be problematic, but I will argue that the discovery of extraterrestrial life would actually offer a much needed theological corrective for contemporary Christians’ understanding of the "imago dei". I will make this argument by examining two clusters of ethical issues confronting Astrobiology: 1. What ethical obligations would human explorers owe to extraterrestrial life? Are there ethical obligations to protect extraterrestrial ecosystems from harm or exploitation by human explorers? Do our ethical considerations change, if the extraterrestrial life is a “second genesis;” in other words a form of life completely different and independent from the carbon-based life that we know on Earth? 2. Do we have an ethical obligation to promote life as much as we can? If human explorers discover extraterrestrial life and through examination determine that it is struggling to survive, do we have an ethical obligation to assist that ecological community to become stronger? If after a thorough investigation we determine that no life exists and that a planet is nothing more than a lifeless body of rocks and dust, do we have an ethical obligation to attempt the creation of life through a process called planetary ecosynthesis? Or, do we have the opposite obligation to respect the rocks and dust for what they are, and refrain from any attempts to engineer life on a lifeless planet? While these two clusters of issues pose new ethical questions, I will argue that from a Christian perspective the framework for responding to these challenges would remain the Genesis Creation stories and the concept of the "imago dei". However, the new ethical challenges posed by Astrobiology require a re-framing of the "imago dei" that is closer to the intent of the original scriptures and that predicts simultaneously the presence of extraterrestrial life and the de-centering of humanity.

"My love-hate relationship": Ethical issues associated with nurses' interactions with industry.

PubMed

Grundy, Quinn

2014-08-01

Ethical issues associated with nurses' interactions with industry have implications for the safety, quality, and cost of healthcare. To date, little work has explored nurse-industry interactions and their associated ethical issues empirically. A phenomenological study was conducted to explore registered nurses' interactions with industry in clinical practice. Five registered nurses working in direct patient care were recruited and individual, in-depth interviews were conducted. The University's Committee on Human Research approved the study. Nurses frequently interacted with industry in their practice and felt ambivalent about these interactions. Nurses described systemic cuts to multiple "goods" central to nursing practice, including patient support, but paradoxically relied on industry resources to deliver these "goods." They relied on a particular conception of trust to navigate these interactions but were left to do so individually on the basis of their experience. Conflicts of interest arose as a result of multiple competing interests, and were frequently mediated through nurses' superiors. Nursing as a profession requires a guiding narrative to aid nurses in interpreting and navigating interactions with industry. A conception of trust that incorporates both the work of caring and attention to social justice could form the basis of these interactions, but would require that nursing take a much more critical stance toward marketing interactions. © The Author(s) 2013.

The right not to hear: the ethics of parental refusal of hearing rehabilitation.

PubMed

Byrd, Serena; Shuman, Andrew G; Kileny, Sharon; Kileny, Paul R

2011-08-01

To explore the ethics of parental refusal of auditory-oral hearing rehabilitation. Case study with medical ethical discussion and review. Two young brothers present with severe-to-profound congenital sensorineural hearing loss. The parents, both of whom have normal hearing and work as sign language interpreters, have decided to raise their children with American Sign Language as their only form of communication. They have chosen not to pursue cochlear implantation nor support the use of hearing aids. This case raises significant questions concerning whether hearing rehabilitation should be mandated, and if there are circumstances in which parental preferences should be questioned or overridden with regard to this issue. In addition, legal concerns may be raised regarding the possible need to file a report with Child Protective Services. Although similar cases involving the Deaf community have historically favored parental rights to forego hearing rehabilitation with either cochlear implantation or hearing aids, we explore whether conclusions should be different because the parents in this case are not hearing impaired. The ethics of parental rights to refuse hearing rehabilitation are complex and strikingly context-dependent. A comprehensive appreciation of the medical, practical, and legal issues is crucial prior to intervening in such challenging situations. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

The Right Not To Hear: The Ethics of Parental Refusal of Hearing Rehabilitation

PubMed Central

Byrd, Serena; Shuman, Andrew G.; Kileny, Sharon; Kileny, Paul R.

2015-01-01

Objective To explore the ethics of parental refusal of auditory-oral hearing rehabilitation. Study Design Case study with medical ethical discussion and review. Methods Two young brothers present with severe-to-profound congenital sensorineural hearing loss. The parents, both of whom have normal hearing and work as sign language interpreters, have decided to raise their children with American Sign Language as their only form of communication. They have chosen not to pursue cochlear implantation nor support the use of hearing aids. Discussion This case raises significant questions concerning whether hearing rehabilitation should be mandated, and if there are circumstances in which parental preferences should be questioned or overridden with regard to this issue. In addition, legal concerns may be raised regarding the possible need to file a report with child protective services. Although similar cases involving the Deaf community have historically favored parental rights to forego hearing rehabilitation with either cochlear implantation or hearing aids, we explore whether conclusions should be different because the parents in this case are not hearing impaired. Conclusions The ethics of parental rights to refuse hearing augmentation are complex and strikingly context-dependent. A comprehensive appreciation of the medical, practical and legal issues is crucial prior to intervening in such challenging situations. PMID:21792972

Dynamics and ethics of comprehensive preimplantation genetic testing: a review of the challenges.

PubMed

Hens, Kristien; Dondorp, Wybo; Handyside, Alan H; Harper, Joyce; Newson, Ainsley J; Pennings, Guido; Rehmann-Sutter, Christoph; de Wert, Guido

2013-01-01

Genetic testing of preimplantation embryos has been used for preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS). Microarray technology is being introduced in both these contexts, and whole genome sequencing of blastomeres is also expeted to become possible soon. The amount of extra information such tests will yield may prove to be beneficial for embryo selection, will also raise various ethical issues. We present an overview of the developments and an agenda-setting exploration of the ethical issues. The paper is a joint endeavour by the presenters at an explorative 'campus meeting' organized by the European Society of Human Reproduction and Embryology in cooperation with the department of Health, Ethics & Society of the Maastricht University (The Netherlands). The increasing amount and detail of information that new screening techniques such as microarrays and whole genome sequencing offer does not automatically coincide with an increasing understanding of the prospects of an embryo. From a technical point of view, the future of comprehensive embryo testing may go together with developments in preconception carrier screening. From an ethical point of view, the increasing complexity and amount of information yielded by comprehensive testing techniques will lead to challenges to the principle of reproductive autonomy and the right of the child to an open future, and may imply a possible larger responsibility of the clinician towards the welfare of the future child. Combinations of preconception carrier testing and embryo testing may solve some of these ethical questions but could introduce others. As comprehensive testing techniques are entering the IVF clinic, there is a need for a thorough rethinking of traditional ethical paradigms regarding medically assisted reproduction.

Teaching GeoEthics Across the Geoscience Curriculum

NASA Astrophysics Data System (ADS)

Mogk, D. W.; Geissman, J. W.; Kieffer, S. W.; Reidy, M.; Taylor, S.; Vallero, D. A.; Bruckner, M. Z.

2014-12-01

Ethics education is an increasingly important component of the pre-professional training of geoscientists. Funding agencies (NSF) require training of graduate students in the responsible conduct of research, employers are increasingly expecting their workers to have basic training in ethics, and the public demands that scientists abide by the highest standards of ethical conduct. Yet, few faculty have the requisite training to effectively teach about ethics in their classes, or even informally in mentoring their research students. To address this need, an NSF-funded workshop was convened to explore how ethics education can be incorporated into the geoscience curriculum. Workshop goals included: examining where and how geoethics topics can be taught from introductory courses for non-majors to modules embedded in "core" geoscience majors courses or dedicated courses in geoethics; sharing best pedagogic practices for "what works" in ethics education; developing a geoethics curriculum framework; creating a collection of online instructional resources, case studies, and related materials; applying lessons learned about ethics education from sister disciplines (biology, engineering, philosophy); and considering ways that geoethics instruction can contribute to public scientific literacy. Four major themes were explored in detail: (1) GeoEthics and self: examining the internal attributes of a geoscientist that establish the ethical values required to successfully prepare for and contribute to a career in the geosciences; (2) GeoEthics and the geoscience profession: identifying ethical standards expected of geoscientists if they are to contribute responsibly to the community of practice; (3) GeoEthics and society: exploring geoscientists' responsibilities to effectively and responsibly communicate the results of geoscience research to inform society about issues ranging from geohazards to natural resource utilization in order to protect public health, safety, and economic security; (4) GeoEthics and Earth: explicating geoscientists' responsibilities to provide stewardship towards of the Earth based on their knowledge of Earth's composition, architecture, history, dynamic processes, and complex systems. Workshop resources can be accessed at serc.carleton.edu/geoethics/

The Moral Stake in Education: Contested Premises and Practices.

ERIC Educational Resources Information Center

Goodman, Joan F.; Lesnick, Howard

This book offers preservice and inservice teachers an examination of ethics and a number of philosophies on how to teach morality. It discusses he extent to which teaching is intertwined with moral issues and explores the fundamental concepts of morality and virtue. It also explores the various and occasionally conflicting viewpoints on moral…

Exploring the Counselor's Role in "Right to Die" Decisions.

ERIC Educational Resources Information Center

Farrugia, David

1993-01-01

Explores issues related to "right to die." Makes case for counselors to assist clients and families with concerns related to refusal or withdrawal of medical treatment in cases of terminal illness or in cases where quality of life is severely impaired such as permanent comatose state. Presents historical, ethical, and legal perspectives.…

Exploring eHealth Ethics and Multi-Morbidity: Protocol for an Interview and Focus Group Study of Patient and Health Care Provider Views and Experiences of Using Digital Media for Health Purposes.

PubMed

Townsend, Anne; Adam, Paul; Li, Linda C; McDonald, Michael; Backman, Catherine L

2013-10-17

eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to medical consultations (telemedicine) and multiple forms of health education, support, and tools. By providing increased and anytime access to information, opportunities to exchange experiences with others, and self-management support, eHealth has been heralded as transformational. It has the potential to accelerate the shift from traditional "passive patient" to an informed, engaged, and empowered "patient as partner," equipped to take part in shared decision-making, and take personal responsibility for self-managing their illness. The objective of our study is to examine how people with chronic illness use eHealth in their daily lives, how it affects patient-provider relationships, and the ethical and practical ramifications for patients, providers, and service delivery. This two-phase qualitative study is ongoing. We will purposively sample 60-70 participants in British Columbia, Canada. To be eligible, patient participants have to have arthritis and at least one other chronic health condition; health care providers (HCPs) need a caseload of patients with multi-morbidity (>25%). To date we have recruited 36 participants (18 patients, 18 HCPs). The participants attended 7 focus groups (FGs), 4 with patients and 3 with rehabilitation professionals and physicians. We interviewed 4 HCPs who were unable to attend a FG. In phase 2, we will build on FG findings and conduct 20-24 interviews with equal numbers of patients and HCPs (rehabilitation professionals and physicians). As in the FGs conducted in phase I, the interviews will use a semistructured, but flexible, discussion guide. All discussions are being audiotaped and transcribed verbatim. Constant comparisons and a narrative approach guides the analyses. A relational ethics conceptual lens is being applied to the data to identify emergent ethical issues. This study explores ethical issues in eHealth. Our goal is to identify the role of eHealth in the lives of people with multiple chronic health conditions and to explore how eHealth impacts the patient role, self-managing, and the patient-HCP relationship. The ethical lens facilitates a systematic critical analysis of emergent ethical issues for further investigation and pinpoints areas of practice that require interventions as eHealth develops and use increases both within and outside of the clinical setting. The potential benefits and burdens of eHealth need to be identified before an ethical framework can be devised.

Chinese nurses' perceived barriers and facilitators of ethical sensitivity.

PubMed

Huang, Fei Fei; Yang, Qing; Zhang, Jie; Khoshnood, Kaveh; Zhang, Jing Ping

2016-08-01

An overview of ethical sensitivity among Chinese registered nurses is needed to develop and optimize the education programs and interventions to cultivate and improve ethical sensitivity. The study was conducted to explore the barriers to and facilitators of ethical sensitivity among Chinese registered nurses working in hospital settings. A convergent parallel mixed-methods research design was adopted. In the cross-sectional quantitative study, the Chinese Moral Sensitivity Questionnaire-revised version was used to assess the levels of ethical sensitivity among registered nurses, and the scores were correlated with key demographics, training experiences in ethics, and workplace cultural environments (n = 306). In the qualitative study, semi-structured interviews were used to elicit the nurses' perceptions of the barriers and facilitators in nurturing ethical sensitivity (n = 15). The data were collected from February to June 2014. This study was approved by the Institutional Review Boards of Yale University and Central South University. Despite moderately high overall Chinese Moral Sensitivity Questionnaire-revised version scores, the ethical sensitivity among Chinese nurses lags in practice. Barriers to ethical sensitivity include the lack of knowledge related to ethics, lack of working experience as a nurse, the hierarchical organizational climate, and the conformist working attitude. The positive workplace cultural environments and application of ethical knowledge in practice were considered potential facilitators of ethical sensitivity. The findings of this study were compared with studies from other countries to examine the barriers and facilitators of ethical sensitivity in Chinese nurses. This mixed-methods study showed that even though the Chinese nurses have moderately high sensitivity to the ethical issues encountered in hospitals, there is still room for improvement. The barriers to and facilitators of ethical sensitivity identified here offer new and important strategies to support and enhance the nurses' sensitivity to ethical issues. © The Author(s) 2015.

Ethics in radiology: wait lists queue jumping.

PubMed

Cunningham, Natalie; Reid, Lynette; MacSwain, Sarah; Clarke, James R

2013-08-01

Education in ethics is a requirement for all Royal College residency training programs as laid out in the General Standards of Accreditation for residency programs in Canada. The ethical challenges that face radiologists in clinical practice are often different from those that face other physicians, because the nature of the physician-patient interaction is unlike that of many other specialties. Ethics education for radiologists and radiology residents will benefit from the development of teaching materials and resources that focus on the issues that are specific to the specialty. This article is intended to serve as an educational resource for radiology training programs to facilitate teaching ethics to residents and also as a continuing medical education resource for practicing radiologists. In an environment of limited health care resources, radiologists are frequently asked to expedite imaging studies for patients and, in some respects, act as gatekeepers for specialty care. The issues of wait lists, queue jumping, and balancing the needs of individuals and society are explored from the perspective of a radiologist. Copyright © 2013 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Print Me an Organ? Ethical and Regulatory Issues Emerging from 3D Bioprinting in Medicine.

PubMed

Gilbert, Frederic; O'Connell, Cathal D; Mladenovska, Tajanka; Dodds, Susan

2018-02-01

Recent developments of three-dimensional printing of biomaterials (3D bioprinting) in medicine have been portrayed as demonstrating the potential to transform some medical treatments, including providing new responses to organ damage or organ failure. However, beyond the hype and before 3D bioprinted organs are ready to be transplanted into humans, several important ethical concerns and regulatory questions need to be addressed. This article starts by raising general ethical concerns associated with the use of bioprinting in medicine, then it focuses on more particular ethical issues related to experimental testing on humans, and the lack of current international regulatory directives to guide these experiments. Accordingly, this article (1) considers whether there is a limit as to what should be bioprinted in medicine; (2) examines key risks of significant harm associated with testing 3D bioprinting for humans; (3) investigates the clinical trial paradigm used to test 3D bioprinting; (4) analyses ethical questions of irreversibility, loss of treatment opportunity and replicability; (5) explores the current lack of a specific framework for the regulation and testing of 3D bioprinting treatments.

Competitive Intelligence.

ERIC Educational Resources Information Center

Bergeron, Pierrette; Hiller, Christine A.

2002-01-01

Reviews the evolution of competitive intelligence since 1994, including terminology and definitions and analytical techniques. Addresses the issue of ethics; explores how information technology supports the competitive intelligence process; and discusses education and training opportunities for competitive intelligence, including core competencies…

Ethical dilemmas in pediatric and adolescent psychogenic nonepileptic seizures.

PubMed

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

2014-08-01

To date, only a very narrow window of ethical dilemmas in psychogenic nonepileptic seizures (PNES) has been explored. Numerous distinct ethical dilemmas arise in diagnosing and treating pediatric and adolescent patients with PNESs. Important ethical values at stake include trust, transparency, confidentiality, professionalism, autonomy of all stakeholders, and justice. In order to further elucidate the ethical challenges in caring for this population, an ethical analysis of the special challenges faced in four specific domains is undertaken: (1) conducting and communicating a diagnosis of PNESs, (2) advising patients about full transparency and disclosure to community including patients' peers, (3) responding to requests to continue antiepileptic drugs, and (4) managing challenges arising from school policy and procedure. An analysis of these ethical issues is essential for the advancement of best care practices that promote the overall well-being of patients and their families. Copyright © 2014 Elsevier Inc. All rights reserved.

Ethical Dilemmas in Pediatric and Adolescent Psychogenic Non-Epileptic Seizures

PubMed Central

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

2014-01-01

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

Emerging issues in paediatric health research consent forms in Canada: working towards best practices.

PubMed

Dove, Edward S; Avard, Denise; Black, Lee; Knoppers, Bartha M

2013-01-30

Obtaining a research participant's voluntary and informed consent is the bedrock of sound ethics practice. Greater inclusion of children in research has led to questions about how paediatric consent operates in practice to accord with current and emerging legal and socio-ethical issues, norms, and requirements. Employing a qualitative thematic content analysis, we examined paediatric consent forms from major academic centres and public organisations across Canada dated from 2008-2011, which were purposively selected to reflect different types of research ethics boards, participants, and studies. The studies included biobanking, longitudinal studies, and gene-environment studies. Our purpose was to explore the following six emerging issues: (1) whether the scope of parental consent allows for a child's assent, dissent, or future consent; (2) whether the concepts of risk and benefit incorporate the child's psychological and social perspective; (3) whether a child's ability to withdraw is respected and to what extent withdrawal is permitted; (4) whether the return of research results includes individual results and/or incidental findings and the processes involved therein; (5) whether privacy and confidentiality concerns adequately address the child's perspective and whether standard data and/or sample identifiability nomenclature is used; and (6) whether retention of and access to paediatric biological samples and associated medical data are addressed. The review suggests gaps and variability in the consent forms with respect to addressing each of the six issues. Many forms did not discuss the possibility of returning research results, be they individual or general/aggregate results. Forms were also divided in terms of the scope of parental consent (specific versus broad), and none discussed a process for resolving disputes that can arise when either the parents or the child wishes to withdraw from the study. The analysis provides valuable insight and evidence into how consent forms address current ethical issues. While we do not thoroughly explore the contexts and reasons behind consent form gaps and variability, we do advocate and formulate the development of best practices for drafting paediatric health research consent forms. This can greatly ameliorate current gaps and facilitate harmonised and yet contextualised approaches to paediatric health research ethics.

"I wish he hadn't told me that": methodological and ethical issues in social trauma and conflict research.

PubMed

Chaitin, Julia

2003-10-01

Undertaking research on individuals who have experienced social traumas, such as being a victim or perpetrator of genocides and wars, presents difficult decisions for qualitative researchers. Deciding how to deal with these issues becomes more problematic when the researcher is a member of the society in conflict. To do this work, and to work collaboratively with researchers from the other side, sensitive ways to collect data have to be chosen. Interpretations of the materials can be no less difficult: Analyses often lead to information and understandings that may be difficult for the researcher to deal with from ethical, moral, and personal standpoints, especially when he or she is a member of the society and culture under study. In this keynote address, the author explores methodological and ethical issues connected to these topics. She brings examples from her work on the Palestinian-Israeli conflict and focuses on use of the life story methodology.

Applying a global justice lens to health systems research ethics: an initial exploration.

PubMed

Pratt, Bridget; Hyder, Adnan A

2015-03-01

Recent scholarship has considered what, if anything, rich people owe to poor people to achieve justice in global health and the implications of this for international research. Yet this work has primarily focused on international clinical research. Health systems research is increasingly being performed in low and middle income countries and is essential to reducing global health disparities. This paper provides an initial description of the ethical issues related to priority setting, capacity-building, and the provision of post-study benefits that arise during the conduct of such research. It presents a selection of issues discussed in the health systems research literature and argues that they constitute ethical concerns based on their being inconsistent with a particular theory of global justice (the health capability paradigm). Issues identified include the fact that priority setting for health systems research at the global level is often not driven by national priorities and that capacity-building efforts frequently utilize one-size-fits-all approaches.

Ethical issues in the transformation of health policy in South Africa.

PubMed

Pillay, Y G

1992-07-01

There have, of late, been repeated calls for the transformation of the South African health care system. While there are political and economic consequences involved, there are also bio-ethical sequelae. This paper attempts to explore some of the bio-ethical dilemmas that confront both the 'consumers' and the architects of a new health policy (including the State; professional health groupings, e.g. the Medical Association of South Africa; and the so-called progressive health organisations, e.g. the National Medical and Dental Association and the South African Health Workers' Congress). While the literature has focused on libertarian and utilitarian ethical theories, communitarian perspectives are not often mentioned. This paper attempts to redress this perceived deficit.

The ethics of stem cells revisited.

PubMed

de Miguel-Beriain, Iñigo

2015-03-01

Stem cells constitute one of the most promising tools for regenerative medicine. Thus, it seems morally compelling to explore all the sources that might provide us with them. However, some of these sources, such as somatic cell nuclear transfer, embryo destruction, or even induced pluripotency obtained by reprogramming have raised deep ethical issues. The aim of this paper is to reflect on the stem cell ethical debate at the current moment through an analysis of the academic literature. It will also provide an analysis of the ethical implications of the most relevant scientific advances that have happened in recent months or those which seem about to merge. Copyright © 2014 Elsevier B.V. All rights reserved.

Environmental Issues Conflict Unit. Teacher's Guide and Student Book.

ERIC Educational Resources Information Center

Fagerstrom, Richard A.; Borad, Bruce

The two separate manuals focus on environmental issues of interest to secondary students. An introductory unit deals with basic ecology and is followed by another unit that explores man's ethic toward the use of environment. Emphasis is upon two major ecological conflicts: one over the use of a wilderness area, and the other over the use of living…

The marginalisation of Indigenous students within school mathematics and the math wars: seeking resolutions within ethical spaces

NASA Astrophysics Data System (ADS)

Russell, Gale L.; Chernoff, Egan J.

2013-03-01

In mathematics education, there are (at least) two seemingly disparate and unethical issues that have been allowed to continue unresolved for decades: the math wars (traditional versus reform teaching and learning of mathematics) and the marginalisation of Indigenous students within K-12 mathematics. Willie Ermine, an Indigenous scholar, has proposed the use of ethical spaces to explore and analyse occurrences of unethical situations arising between the "intersection of Indigenous law and Canadian Legal systems" (Ermine, Indigenous Law Journal 6(1):193-203, 2007). This paper brings Ermine's notion of ethical spaces to the field of mathematics education research as the theoretical framework for analysing the aforementioned issues. The result of this analysis is a potential single theoretical resolution to both dilemmas that can also serve as a significant factor in the processes of decolonisation.

When an adult female seeks ritual genital alteration: ethics, law, and the parameters of participation.

PubMed

Cantor, Julie D

2006-04-01

Ritual genital cutting for women, a common practice in Africa and elsewhere around the world, remains dangerous and controversial. In recent years, a 14-year-old girl living in Sierra Leone exsanguinated and died following a ritualistic genital cutting. Hoping to avoid that fate, women with backgrounds that accept ritual genital cutting may, when they reach majority age, ask plastic surgeons to perform genital alterations for cultural reasons. Although plastic surgeons routinely perform cosmetic procedures, unique ethical and legal concerns arise when an adult female patient asks a surgeon to spare her the tribal elder's knife and alter her genitalia according to tradition and custom. Misinformation and confusion about this issue exist. This article explores the ethical and legal issues relevant to this situation and explains how the thoughtful surgeon should proceed.

Inernational research in health care management: its need in the 21st century, methodological challenges, ethical issues, pitfalls, and practicalities.

PubMed

Buttigieg, Sandra C; Rathert, Cheryl; D'Aunno, Thomas A; Savage, Grant T

2015-01-01

This commentary argues in favor of international research in the 21st century. Advances in technology, science, communication, transport, and infrastructure have transformed the world into a global village. Industries have increasingly adopted globalization strategies. Likewise, the health sector is more internationalized whereby comparisons between diverse health systems, international best practices, international benchmarking, cross-border health care, and cross-cultural issues have become important subjects in the health care literature. The focus has now turned to international, collaborative, cross-national, and cross-cultural research, which is by far more demanding than domestic studies. In this commentary, we explore the methodological challenges, ethical issues, pitfalls, and practicalities within international research and offer possible solutions to address them. The commentary synthesizes contributions from four scholars in the field of health care management, who came together during the annual meeting of the Academy of Management to discuss with members of the Health Care Management Division the challenges of international research. International research is worth pursuing; however, it calls for scholarly attention to key methodological and ethical issues for its success. This commentary addresses salient issues pertaining to international research in one comprehensive account.

Ethical aspects of transformational leadership.

PubMed

Cassidy, V R; Koroll, C J

1994-10-01

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

Moral communities.

PubMed

Chambers, David W

2006-11-01

This article explores the twin issues of whether organizations can act as ethical agents and what it means to exert moral influence over others. A discursive perspective is advanced that characterizes ethics as the action of communities based on promises. The received view of ethics as either the universal principles or individual responsibility is criticized as inadequate. Moral influence within community is considered under the various headings of democracy, office, brotherhood, agency, witness, and promise making. Moral influence among communities can include the damaging methods of "the superior position," coercion and misrepresentation, and appeal to third parties and the sound methods of rhetoric and promise making.

Physician-Assisted Suicide and Euthanasia in the Intensive Care Unit: A Dialogue on Core Ethical Issues

PubMed Central

Goligher, Ewan C.; Ely, E. Wesley; Sulmasy, Daniel P.; Bakker, Jan; Raphael, John; Volandes, Angelo E.; Patel, Bhavesh M.; Payne, Kate; Hosie, Annmarie; Churchill, Larry; White, Douglas B.; Downar, James

2016-01-01

Objective Many patients are admitted to the intensive care unit at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia (PAS/E) holds implications for the practice of critical care medicine. The objective of this manuscript is to explore core ethical issues related to PAS/E from the perspective of healthcare professionals and ethicists on both sides of the debate. Synthesis We identified four issues highlighting the key areas of ethical tension central to evaluating PAS/E in medical practice: (1) the benefit or harm of death itself, (2) the relationship between PAS/E and withholding or withdrawing life support, (3) the morality of a physician deliberately causing death, and (4) the management of conscientious objection related to PAS/E in the critical care setting. We present areas of common ground as well as important unresolved differences. Conclusions We reached differing positions on the first three core ethical questions and achieved significant agreement on how critical care clinicians should manage conscientious objections related to PAS/E. The alternative positions presented in this paper may serve to promote open and informed dialogue within the critical care community. PMID:28098622

Physician-Assisted Suicide and Euthanasia in the ICU: A Dialogue on Core Ethical Issues.

PubMed

Goligher, Ewan C; Ely, E Wesley; Sulmasy, Daniel P; Bakker, Jan; Raphael, John; Volandes, Angelo E; Patel, Bhavesh M; Payne, Kate; Hosie, Annmarie; Churchill, Larry; White, Douglas B; Downar, James

2017-02-01

Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting. We present areas of common ground and important unresolved differences. We reached differing positions on the first three core ethical questions and achieved unanimity on how critical care clinicians should manage conscientious objections related to physician-assisted suicide and euthanasia. The alternative positions presented in this article may serve to promote open and informed dialogue within the critical care community.

Evaluating Research Ethics Training in the Maryland Sea Grant REU Program

NASA Astrophysics Data System (ADS)

Allen, M. R.; Kumi, G. A.; Kumi, B. C.; Moser, F. C.

2016-02-01

The NSF's Research Experiences for Undergraduates (REU) program is an opportunity to cultivate responsible research practices in researchers at an early stage in their career. However, teaching responsible research conduct and science ethics in this program has been challenging because of a lack of consensus regarding which instructional methods are most effective for educating students about ethical concepts and establishing the process of ethical decision-making. Over the last 15 years, Maryland Sea Grant's REU ethics program has evolved by exploring different teaching models and looking for ways to effectively engage upper level undergraduates throughout their summer experience in ethical responsibility training. Since 2007, we have adopted a concerted experiential learning approach that includes an ethics seminar, role playing, case studies, and reflection. Currently, our summer long ethics training includes: 1) an interactive seminar; 2) a workshop with role playing and case studies; 3) 1-2 readings; and 4) a roundtable discussion with faculty mentors and their mentees to discuss researchers' real-world experiences with ethical dilemmas. Within the last 3 years, we have expanded our student learning outcomes assessments by administering pre- and post-program surveys to assess ethical skills students acquire through the program. Reevaluations administered three and six years after the REU experience will measure long term effectiveness of the training. Results from the first group of students reveal a greater awareness of ethical issues following our summer program. Students show a high level of competence about "black and white" issues (falsification, fabrication, plagiarism), but are more challenged by ethical "gray areas" such as data ownership and authorship. Results suggest many undergraduates come to research programs with basic ethics training, but benefit from our additional focus on complex ethical dilemmas.

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

PubMed Central

de Melo-Martín, Inmaculada; Sondhi, Dolan

2011-01-01

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

Engaging High School Students as Co-Researchers in Qualitative Research: Logistical, Methodological and Ethical Issues.

ERIC Educational Resources Information Center

Miller, Dana L.; McVea, Kristine L. S. P.; Creswell, John W.; Harter, Lynn; Mickelson, William; McEntarffer, Rob

This paper explores six phases of a research project designed specifically to engage high school students as co-researchers in a multisite qualitative study exploring perceptions of tobacco use among high school students in four schools. It describes how university researchers collaborated with the high school students and summarizes seven major…

Ethics in international health research: a perspective from the developing world.

PubMed Central

Bhutta, Zulfiqar Ahmed

2002-01-01

Health research plays a pivotal role in addressing inequities in health and human development, but to achieve these objectives the research must be based on sound scientific and ethical principles. Although it is accepted that ethics play a central role in health research in developing countries, much of the recent debate has focused on controversies surrounding internationally sponsored research and has taken place largely without adequate participation of the developing countries. The relationship between ethical guidelines and regulations, and indigenously sponsored and public health research has not been adequately explored. For example, while the fundamental principles of ethical health research, such as community participation, informed consent, and shared benefits and burdens, remain sacrosanct other issues, such as standards of care and prior agreements, merit greater public debate within developing countries. In particular, the relationship of existing ethical guidelines to epidemiological and public health research merits further exploration. In order to support health research in developing countries that is both relevant and meaningful, the focus must be on developing health research that promotes equity and on developing local capacity in bioethics. Only through such proactive measures can we address the emerging ethical dilemmas and challenges that globalization and the genomics revolution will bring in their wake. PMID:11953789

Business Ethics 101 for the biotech industry.

PubMed

MacDonald, Chris

2004-01-01

Biotechnology companies face ethical challenges of two distinct types: bioethical challenges faced on account of the nature of work in the life sciences, and corporate ethical challenges on account of their nature as commercial entities. The latter set of challenges has received almost no attention at all in the academic literature or media. This paper begins to remedy that lacuna, examining ethical issues that arise specifically on account of the status of biotech companies as commercial entities. The focus here is on three representative issues: product safety, corporate social responsibility, and corporate governance. It is argued that each of these issues poses particular ethical challenges for companies in the biotech sector. In the area of product safety, it is noted that biotech companies face particular challenges in determining what counts as a "safe" product, given the contentious nature of what might count as a "harm" in the biotech field. In the area of corporate social responsibility, the adoption of a "stakeholder approach" and an attempt to manage the social consequences of products pose special challenges for biotech companies. This is due to the enormous range of groups and individuals claiming to have a stake in the doings of such companies, and the trenchant controversies over just what the social consequences of various biotechnologies might be. In the area of corporate governance, biotech companies need to seek out and follow best practices regarding the ways in which information, authority, and influence flow between a company's shareholders, managers, and Board of Directors, if they are to avoid duplicating the ethical and financial scandal that brought down ImClone. An important meta-issue, here--one that renders each of these corporate ethical challenges more vexing--is the difficulty of finding the appropriate benchmarks for ethical corporate behavior in a field as controversial, and as rapidly evolving, as biotechnology. Three programmatic suggestions can be made: Firstly, scholars and others interested in the ethical performance of the biotech sector must seek out and build opportunities for richer interdisciplinary collaboration. Secondly, companies within the biotech sector must seek out expertise and build capacity and competency in dealing with the corporate ethical issues that arise in their sector. Finally, companies in the biotech sector should explore the opportunities for collective problem solving afforded by the existence of local, national, and international industry associations such as the Biotechnology Industry Organization, BIOTECanada, and EuropaBio.

The full spectrum of ethical issues in dementia care: systematic qualitative review.

PubMed

Strech, Daniel; Mertz, Marcel; Knüppel, Hannes; Neitzke, Gerald; Schmidhuber, Martina

2013-06-01

Integrating ethical issues in dementia-specific training material, clinical guidelines and national strategy plans requires an unbiased awareness of all the relevant ethical issues. To determine systematically and transparently the full spectrum of ethical issues in clinical dementia care. We conducted a systematic review in Medline (restricted to English and German literature published between 2000 and 2011) and Google books (with no restrictions). We applied qualitative text analysis and normative analysis to categorise the spectrum of ethical issues in clinical dementia care. The literature review retrieved 92 references that together mentioned a spectrum of 56 ethical issues in clinical dementia care. The spectrum was structured into seven major categories that consist of first- and second-order categories for ethical issues. The systematically derived spectrum of ethical issues in clinical dementia care presented in this paper can be used as training material for healthcare professionals, students and the public for raising awareness and understanding of the complexity of ethical issues in dementia care. It can also be used to identify ethical issues that should be addressed in dementia-specific training programmes, national strategy plans and clinical practice guidelines. Further research should evaluate whether this new genre of systematic reviews can be applied to the identification of ethical issues in other cognitive and somatic diseases. Also, the practical challenges in addressing ethical issues in training material, guidelines and policies need to be evaluated.

Ethics in Community-University-Artist Partnered Research: Tensions, Contradictions and Gaps Identified in an 'Arts for Social Change' Project.

PubMed

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.

Whose life is it anyway? An exploration of five contemporary ethical issues that pertain to the psychiatric nursing care of the person who is suicidal: part one.

PubMed

Cutcliffe, John R; Links, Paul S

2008-08-01

It is self-evident that ethical issues are important topics for consideration for those involved in the care of the person who is suicidal. Nevertheless, despite the obvious relationship between Mental Health nurses and care of the person who is suicidal, such nurses have hitherto been mostly silent on these matters. As a result, this two-part paper focuses on a number of contemporary issues which might help inform the ethical discourse and resultant Mental Health nursing care of the person who is suicidal. Part one of this paper focuses on the issues: Whose life is it anyway? Harming of our bodies and the inconsistency in ethical responses and, Is suicide ever a reasonable thing to do? The authors find that this contemporary view within the suicidology academe and the corresponding legal position in most western (developed) countries is that the individual owns his/her own body. Yet given that contemporary mental healthcare policy and associated practice positions do not reflect view, this can easily lead to the scenario where a Mental Health nurse is faced with a major ethical dilemma, and the corresponding probability of moral distress. The authors also find that it is inaccurate to posit a simple positive correlation between the potential seriousness and/or extent of bodily harm and the degree of paternalistic removal of an individual's rights to personal body ownership. Lastly, the authors find that the relevant theoretical and ethical literature in this area suggests, at least for some and under certain conditions, suicide can be the right thing to do.

Organizational ethics in managed behavioral health care: perspectives from executives and leaders.

PubMed

Sharar, David A; Huff, Stan; Ackerson, Barry

2003-01-01

Managed behavioral health care (MBHC) is frequently criticized on ethical grounds for the way it undermines classical ideals of professionalism in mental health and addiction treatment. There is an implied assumption that practitioners who are executives and leaders in MBHC companies have moved away from clinical ethics to the adoption of business and financial models. This qualitative study explores perceptions of organizational ethical issues from the point of view of leaders working in MBHC settings and how their perspectives contribute to our current schemas for analyzing the ethical complexities of MBHC. Twenty-seven participants from across the United States were interviewed using an interview guide that relied on open-ended questions and probes. Inquiry findings present four major themes and describe participant material in a way that enhances sensitivity and understanding to organizational ethics in MBHC and behavioral health services and research.

Ethics in practice: managed care and the changing health care environment: medicine as a profession managed care ethics working group statement.

PubMed

Povar, Gail J; Blumen, Helen; Daniel, John; Daub, Suzanne; Evans, Lois; Holm, Richard P; Levkovich, Natalie; McCarter, Alice O; Sabin, James; Snyder, Lois; Sulmasy, Daniel; Vaughan, Peter; Wellikson, Laurence D; Campbell, Amy

2004-07-20

Cost pressures and changes in the health care environment pose ethical challenges and hard choices for patients, physicians, policymakers, and society. In 2000 and 2001, the American College of Physicians, with the Harvard Pilgrim Health Care Ethics Program, convened a working group of stakeholders--patients, physicians, and managed care representatives, along with medical ethicists--to develop a statement of ethics for managed care. The group explored the impact of a changing health care environment on patient-physician relationships and how to best apply the principles of professionalism in this environment. The statement that emerged offers guidance on preserving the patient-clinician relationship, patient rights and responsibilities, confidentiality and privacy, resource allocation and stewardship, the obligation of health plans to foster an ethical environment for the delivery of care, and the clinician's responsibility to individual patients, the community, and the public health, among other issues.

Law, ethics and pandemic preparedness: the importance of cross-jurisdictional and cross-cultural perspectives.

PubMed

Bennett, Belinda; Carney, Terry

2010-04-01

To explore social equity, health planning, regulatory and ethical dilemmas in responding to a pandemic influenza (H5N1) outbreak, and the adequacy of protocols and standards such as the International Health Regulations (2005). This paper analyses the role of legal and ethical considerations for pandemic preparedness, including an exploration of the relevance of cross-jurisdictional and cross-cultural perspectives in assessing the validity of goals for harmonisation of laws and policies both within and between nations. Australian and international experience is reviewed in various areas, including distribution of vaccines during a pandemic, the distribution of authority between national and local levels of government, and global and regional equity issues for poorer countries. This paper finds that questions such as those of distributional justice (resource allocation) and regulatory frameworks raise important issues about the cultural and ethical acceptability of planning measures. Serious doubt is cast on a 'one size fits all' approach to international planning for managing a pandemic. It is concluded that a more nuanced approach than that contained in international guidelines may be required if an effective response is to be constructed internationally. The paper commends the wisdom of reliance on 'soft law', international guidance that leaves plenty of room for each nation to construct its response in conformity with its own cultural and value requirements. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

Public participation in genetic databases: crossing the boundaries between biobanks and forensic DNA databases through the principle of solidarity

PubMed Central

Machado, Helena; Silva, Susana

2015-01-01

The ethical aspects of biobanks and forensic DNA databases are often treated as separate issues. As a reflection of this, public participation, or the involvement of citizens in genetic databases, has been approached differently in the fields of forensics and medicine. This paper aims to cross the boundaries between medicine and forensics by exploring the flows between the ethical issues presented in the two domains and the subsequent conceptualisation of public trust and legitimisation. We propose to introduce the concept of ‘solidarity’, traditionally applied only to medical and research biobanks, into a consideration of public engagement in medicine and forensics. Inclusion of a solidarity-based framework, in both medical biobanks and forensic DNA databases, raises new questions that should be included in the ethical debate, in relation to both health services/medical research and activities associated with the criminal justice system. PMID:26139851

Ethics in the marketing of medical services.

PubMed

Latham, Stephen R

2004-09-01

This paper deals with the ethics of marketing medical services by physicians, medical groups, hospitals and other mainstream medical caregivers in the United States. It does not deal with pharmaceutical marketing, since that raises a number of special issues, some of them legal and some having to do with the unique culture of pharmaceutical marketing, which really ought to be dealt with separately. Nor does it touch on the little-explored field of marketing alternative and complementary medicine. It begins with a general description of what is included in "the marketing process." It then briefly tours some of the difficulties faced by those who would market medical services ethically, and ends with some comments on the relevance of professionalism to ethical marketing.

Ongoing ethical issues concerning authorship in biomedical journals: an integrative review

PubMed Central

Kornhaber, Rachel Anne; McLean, Loyola M; Baber, Rodney J

2015-01-01

Health professionals publishing within the field of health sciences continue to experience issues concerning appropriate authorship, which have clinical, ethical, and academic implications. This integrative review sought to explore the key issues concerning authorship from a bioethical standpoint, aiming to explore the key features of the authorship debate. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases of peer-reviewed research, published between 2009 and 2014, limited to English language research, with search terms developed to reflect the current issues of authorship. From among the 279 papers identified, 20 research papers met the inclusion criteria. Findings were compiled and then arranged to identify themes and relationships. The review incorporated a wide range of authorship issues encompassing equal-credited authors, honorary (guest/gift) and ghost authorship, perception/experiences of authorship, and guidelines/policies. This review suggests that the International Committee of Medical Journal Editors’ (ICMJE) recommended guidelines for authorship are not reflected in current authorship practices within the domain of health sciences in both low-and high-impact-factor journals. This devaluing of the true importance of authorship has the potential to affect the validity of authorship, diminish the real contributions of the true authors, and negatively affect patient care. PMID:26257520

Ongoing ethical issues concerning authorship in biomedical journals: an integrative review.

PubMed

Kornhaber, Rachel Anne; McLean, Loyola M; Baber, Rodney J

2015-01-01

Health professionals publishing within the field of health sciences continue to experience issues concerning appropriate authorship, which have clinical, ethical, and academic implications. This integrative review sought to explore the key issues concerning authorship from a bioethical standpoint, aiming to explore the key features of the authorship debate. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases of peer-reviewed research, published between 2009 and 2014, limited to English language research, with search terms developed to reflect the current issues of authorship. From among the 279 papers identified, 20 research papers met the inclusion criteria. Findings were compiled and then arranged to identify themes and relationships. The review incorporated a wide range of authorship issues encompassing equal-credited authors, honorary (guest/gift) and ghost authorship, perception/experiences of authorship, and guidelines/policies. This review suggests that the International Committee of Medical Journal Editors' (ICMJE) recommended guidelines for authorship are not reflected in current authorship practices within the domain of health sciences in both low-and high-impact-factor journals. This devaluing of the true importance of authorship has the potential to affect the validity of authorship, diminish the real contributions of the true authors, and negatively affect patient care.

Exploring Understandings of Inclusion in Schools in Zambia and Tanzania Using Reflective Writing and Photography

ERIC Educational Resources Information Center

Miles, Susie

2011-01-01

In this article I explore insights gained from participating in an exploratory, small-scale study led by the Enabling Education Network (EENET) in 17 schools in northern Zambia and five schools in Tanzania. Facilitating South-based research, while based in a Northern university, raises complex ethical issues about voice and control which are…

Ethical reflection on the harm in reproductive decision‐making

PubMed Central

Murtagh, G M

2007-01-01

Advances in reproductive technologies continue to present ethical problems concerning their implementation and use. These advances have preoccupied bioethicists in their bid to gauge our moral responsibilities and obligations when making reproductive decisions. The aim of this discussion is to highlight the importance of a sensibility to differences in moral perspective as part of our ethical inquiry in these matters. Its focal point is the work of John Harris, who has consistently addressed the ethical issues raised by advancing reproductive technologies. The discussion is aimed at a central tenet of Harris's position on reproductive decision‐making—namely, that in some instances, giving birth to a worthwhile life may cause harm and will therefore be morally wrong. It attempts to spell out some of the implications of Harris's position that the author takes to involve a misplaced generality. To support this claim, some examples are explored that demonstrate the variety of ways in which concepts (such as harm) may manifest themselves as moral considerations within the context of reproductive decision‐making. The purpose is to demonstrate that Harris's general conception of the moral limits of reproductive autonomy obscures the issues raised by particular cases, which in themselves may reveal important directions for our ethical inquiry. PMID:18055903

Exploring eHealth Ethics and Multi-Morbidity: Protocol for an Interview and Focus Group Study of Patient and Health Care Provider Views and Experiences of Using Digital Media for Health Purposes

PubMed Central

Adam, Paul; Li, Linda C; McDonald, Michael; Backman, Catherine L

2013-01-01

Background eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to medical consultations (telemedicine) and multiple forms of health education, support, and tools. By providing increased and anytime access to information, opportunities to exchange experiences with others, and self-management support, eHealth has been heralded as transformational. It has the potential to accelerate the shift from traditional "passive patient" to an informed, engaged, and empowered "patient as partner," equipped to take part in shared decision-making, and take personal responsibility for self-managing their illness. Objective The objective of our study is to examine how people with chronic illness use eHealth in their daily lives, how it affects patient-provider relationships, and the ethical and practical ramifications for patients, providers, and service delivery. Methods This two-phase qualitative study is ongoing. We will purposively sample 60-70 participants in British Columbia, Canada. To be eligible, patient participants have to have arthritis and at least one other chronic health condition; health care providers (HCPs) need a caseload of patients with multi-morbidity (>25%). To date we have recruited 36 participants (18 patients, 18 HCPs). The participants attended 7 focus groups (FGs), 4 with patients and 3 with rehabilitation professionals and physicians. We interviewed 4 HCPs who were unable to attend a FG. In phase 2, we will build on FG findings and conduct 20-24 interviews with equal numbers of patients and HCPs (rehabilitation professionals and physicians). As in the FGs conducted in phase I, the interviews will use a semistructured, but flexible, discussion guide. All discussions are being audiotaped and transcribed verbatim. Constant comparisons and a narrative approach guides the analyses. A relational ethics conceptual lens is being applied to the data to identify emergent ethical issues. Results This study explores ethical issues in eHealth. Our goal is to identify the role of eHealth in the lives of people with multiple chronic health conditions and to explore how eHealth impacts the patient role, self-managing, and the patient-HCP relationship. The ethical lens facilitates a systematic critical analysis of emergent ethical issues for further investigation and pinpoints areas of practice that require interventions as eHealth develops and use increases both within and outside of the clinical setting. Conclusions The potential benefits and burdens of eHealth need to be identified before an ethical framework can be devised. PMID:24135260

The Full Spectrum of Clinical Ethical Issues in Kidney Failure. Findings of a Systematic Qualitative Review.

PubMed

Kahrass, Hannes; Strech, Daniel; Mertz, Marcel

2016-01-01

When treating patients with kidney failure, unavoidable ethical issues often arise. Current clinical practice guidelines some of them, but lack comprehensive information about the full range of relevant ethical issues in kidney failure. A systematic literature review of such ethical issues supports medical professionalism in nephrology, and offers a solid evidential base for efforts that aim to improve ethical conduct in health care. To identify the full spectrum of clinical ethical issues that can arise for patients with kidney failure in a systematic and transparent manner. A systematic review in Medline (publications in English or German between 2000 and 2014) and Google Books (with no restrictions) was conducted. Ethical issues were identified by qualitative text analysis and normative analysis. The literature review retrieved 106 references that together mentioned 27 ethical issues in clinical care of kidney failure. This set of ethical issues was structured into a matrix consisting of seven major categories and further first and second-order categories. The systematically-derived matrix helps raise awareness and understanding of the complexity of ethical issues in kidney failure. It can be used to identify ethical issues that should be addressed in specific training programs for clinicians, clinical practice guidelines, or other types of policies dealing with kidney failure.

The Full Spectrum of Clinical Ethical Issues in Kidney Failure. Findings of a Systematic Qualitative Review

PubMed Central

Kahrass, Hannes; Strech, Daniel; Mertz, Marcel

2016-01-01

Background When treating patients with kidney failure, unavoidable ethical issues often arise. Current clinical practice guidelines some of them, but lack comprehensive information about the full range of relevant ethical issues in kidney failure. A systematic literature review of such ethical issues supports medical professionalism in nephrology, and offers a solid evidential base for efforts that aim to improve ethical conduct in health care. Aim To identify the full spectrum of clinical ethical issues that can arise for patients with kidney failure in a systematic and transparent manner. Method A systematic review in Medline (publications in English or German between 2000 and 2014) and Google Books (with no restrictions) was conducted. Ethical issues were identified by qualitative text analysis and normative analysis. Results The literature review retrieved 106 references that together mentioned 27 ethical issues in clinical care of kidney failure. This set of ethical issues was structured into a matrix consisting of seven major categories and further first and second-order categories. Conclusions The systematically-derived matrix helps raise awareness and understanding of the complexity of ethical issues in kidney failure. It can be used to identify ethical issues that should be addressed in specific training programs for clinicians, clinical practice guidelines, or other types of policies dealing with kidney failure. PMID:26938863

Ethical Considerations for Clinical Trials in Inflammatory Bowel Disease

PubMed Central

Becker, Samuel; Siegler, Mark

2014-01-01

Although advancements in the field of inflammatory bowel disease (IBD) include effective therapies for many patients with Crohn’s disease and ulcerative colitis, there remains a large unmet need, and there is a large number of investigational agents in the pipeline. Drug development through clinical trials is critical to understanding the safety and efficacy of new therapies in the affected human population, and the need for ethical trial design is of the utmost importance. This paper explores the ethical issues of clinical trials in IBD, focusing on placebo-controlled trials, vulnerable patients, exposure to monoclonal antibodies, globalization of trials, and surgical advances. PMID:24799837

Innovation in surgical technology and techniques: Challenges and ethical issues.

PubMed

Geiger, James D; Hirschl, Ronald B

2015-06-01

The pace of medical innovation continues to increase. The deployment of new technologies in surgery creates many ethical challenges including how to determine safety of the technology, what is the timing and process for deployment of a new technology, how are patients informed before undergoing a new technology or technique, how are the outcomes of a new technology evaluated and how are the responsibilities of individual patients and society at large balanced. Ethical considerations relevant to the implementation of ECMO and robotic surgery are explored to further discussion of how we can optimize the delicate balance between innovation and regulation. Copyright © 2015 Elsevier Inc. All rights reserved.

Six Challenges for Ethical Conduct in Science.

PubMed

Niemi, Petteri

2016-08-01

The realities of human agency and decision making pose serious challenges for research ethics. This article explores six major challenges that require more attention in the ethics education of students and scientists and in the research on ethical conduct in science. The first of them is the routinization of action, which makes the detection of ethical issues difficult. The social governance of action creates ethical problems related to power. The heuristic nature of human decision making implies the risk of ethical bias. The moral disengagement mechanisms represent a human tendency to evade personal responsibility. The greatest challenge of all might be the situational variation in people's ethical behaviour. Even minor situational factors have a surprisingly strong influence on our actions. Furthermore, finally, the nature of ethics itself also causes problems: instead of clear answers, we receive a multitude of theories and intuitions that may sometimes be contradictory. All these features of action and ethics represent significant risks for ethical conduct in science. I claim that they have to be managed within the everyday practices of science and addressed explicitly in research ethics education. I analyse them and suggest some ways in which their risks can be alleviated.

What Is Everyday Ethics? A Review and a Proposal for an Integrative Concept.

PubMed

Zizzo, Natalie; Bell, Emily; Racine, Eric

2016-01-01

"Everyday ethics" is a term that has been used in the clinical and ethics literature for decades to designate normatively important and pervasive issues in healthcare. In spite of its importance, the term has not been reviewed and analyzed carefully. We undertook a literature review to understand how the term has been employed and defined, finding that it is often contrasted to "dramatic ethics." We identified the core attributes most commonly associated with everyday ethics. We then propose an integrative model of everyday ethics that builds on the contribution of different ethical theories. This model proposes that the function of everyday ethics is to serve as an integrative concept that (1) helps to detect current blind spots in bioethics (that is, shifts the focus from dramatic ethics) and (2) mobilizes moral agents to address these shortcomings of ethical insight. This novel integrative model has theoretical, methodological, practical, and pedagogical implications, which we explore. Because of the pivotal role that moral experience plays in this integrative model, the model could help to bridge empirical ethics research with more conceptual and normative work. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Inclusion of ethical issues in dementia guidelines: a thematic text analysis.

PubMed

Knüppel, Hannes; Mertz, Marcel; Schmidhuber, Martina; Neitzke, Gerald; Strech, Daniel

2013-08-01

Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care. To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained. Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors' Summary.

Inclusion of Ethical Issues in Dementia Guidelines: A Thematic Text Analysis

PubMed Central

Knüppel, Hannes; Schmidhuber, Martina; Neitzke, Gerald

2013-01-01

Background Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care. Methods and Findings To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained. Conclusions Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors' Summary PMID:23966839

The ethics of HIV research in developing nations.

PubMed

Resnik, David B

1998-10-01

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

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

PubMed

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

2016-06-01

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

Cultural diversity in nanotechnology ethics.

PubMed

Schummer, Joachim

2011-01-01

Along with the rapid worldwide advance of nanotechnology, debates on associated ethical issues have spread from local to international levels. However unlike science and engineering issues, international perceptions of ethical issues are very diverse. This paper provides an analysis of how sociocultural factors such as language, cultural heritage, economics and politics can affect how people perceive ethical issues of nanotechnology. By attempting to clarify the significance of sociocultural issues in ethical considerations my aim is to support the ongoing international dialogue on nanotechnology. At the same time I pose the general question of ethical relativism in engineering ethics, that is to say whether or not different ethical views are irreconcilable on a fundamental level.

The full spectrum of ethical issues in the care of patients with ALS: a systematic qualitative review.

PubMed

Seitzer, F; Kahrass, H; Neitzke, G; Strech, D

2016-02-01

Dealing systematically with ethical issues in amyotrophic lateral sclerosis (ALS) care requires an unbiased awareness of all the relevant ethical issues. The aim of the study was to determine systematically and transparently the full spectrum of ethical issues in ALS care. We conducted a systematic review in Medline and Google Books (restricted to English and German literature published between 1993 and 2014). We applied qualitative text analysis and normative analysis to categorise the spectrum of ethical issues in ALS care. The literature review retrieved 56 references that together mentioned a spectrum of 103 ethical issues in ALS care. The spectrum was structured into six major categories that consist of first and second-order categories of ethical issues. The systematically derived spectrum of ethical issues in ALS care presented in this paper raises awareness and understanding of the complexity of ethical issues in ALS care. It also offers a basis for the systematic development of informational and training materials for health professionals, patients and their relatives, and society as a whole. Finally, it supports a rational and fair selection of all those ethical issues that should be addressed in health policies, position papers and clinical practice guidelines. Further research is needed to identify ways to systematically select the most relevant ethical issues not only in the clinical environment, but also for the development of clinical practice guidelines.

Exploring the relevance of social justice within a relational nursing ethic.

PubMed

Woods, Martin

2012-01-01

In the last few decades, a growing number of commentators have questioned the appropriateness of the 'justice view' of ethics as a suitable approach in health care ethics, and most certainly in nursing. Essentially, in their ethical deliberations, it is argued that nurses do not readily adopt the high degree of impartiality and objectivity that is associated with a justice view; instead their moral practices are more accurately reflected through the use of alternative approaches such as relational or care-based ethics. Yet, it has also been argued that this viewpoint does not necessarily 'do justice' to the broader moral responsibilities of nurses towards humanity in general, i.e. to the wider socio-cultural and socio-political issues in society, and to the concept of social justice in particular. This criticism has triggered a much closer examination of relational and care-based ethics in nursing at levels beyond individual responsiveness within relationships and brought into the spotlight the need for a more ethically refined nursing response to an increasingly complex set of socio-cultural inequalities. This article explores a relational ethic within nursing practices with contemporary ideas regarding social justice. In particular, it is argued that the synergy between the two actually produces an ethic that is capable of not only challenging the continuing predominance of justice-based ethics within health care, but of replacing it. Subsequently, in the discussion that follows, it is suggested that a combined social justice and relational care-based approach, as a social ethic, should guide the moral deliberations and actions of nurses. It is maintained that such an approach is not only possible, but crucial if nurses are to realize their full potential as ethical agents for individual and social good. © 2011 Blackwell Publishing Ltd.

Closure of population biobanks and direct-to-consumer genetic testing companies.

PubMed

Zawati, Ma'n H; Borry, Pascal; Howard, Heidi Carmen

2011-09-01

Genetic research gained new momentum with the completion of the Human Genome Project in 2003. Formerly centered on the investigation of single-gene disorders, genetic research is increasingly targeting common complex diseases and in doing so is studying the whole genome, the environment and its impact on genomic variation. Consequently, biobanking initiatives have emerged around the world as a tool to sustain such progress. Whether they are small scale or longitudinal, public or private, commercial or non-commercial, biobanks should consider the possibility of closure. Interestingly, while raising important ethical issues, this topic has hardly been explored in the literature. Indeed, ethical issues associated with sale, insolvency, end of funding, or transfer of materials to other entities (which are all issues either related to or possible consequences of closure) are seldom the subject of discussion. In an attempt to fill this gap, this paper will discuss-using population and direct-to-consumer (DTC) genetic testing companies' biobanks as case studies-(1) international and national normative documents addressing the issue of closure and (2) the internal policies of population biobanks and DTC genetic testing companies. The analysis will inform the debate on biobank closure and elucidate the underlying ethical issues, which include, but are not limited to informed consent, storage and privacy.

Social responsibility of nursing: a global perspective.

PubMed

Tyer-Viola, Lynda; Nicholas, Patrice K; Corless, Inge B; Barry, Donna M; Hoyt, Pamela; Fitzpatrick, Joyce J; Davis, Sheila M

2009-05-01

This study addresses social responsibility in the discipline of nursing and implications for global health. The concept of social responsibility is explicated and its relevance for nursing is examined, grounded in the American Nurses Association Code of Ethics and the International Council of Nurses Code of Ethics. Social justice, human rights, nurse migration, and approaches to nursing education are discussed within the framework of nursing's social responsibility. Strategies for addressing nursing workforce issues and education within a framework of social responsibility are explored.

Compelling truth: legal protection of the infosphere against big data spills

PubMed Central

2016-01-01

The paper explores whether legal and ethical concepts that have been used to protect the natural environment can also be leveraged to protect the ‘infosphere’, a neologism used by Luciano Floridi to characterize the totality of the informational environment. We focus, in particular, on the interaction between allocation of (intellectual) property rights and ‘communication duties’, in particular, data breach notification duties. This article is part of the themed issue ‘The ethical impact of data science’. PMID:28336793

Ethics roundtable debate: Child with severe brain damage and an underlying brain tumour

PubMed Central

Gunn, Scott; Hashimoto, Satoru; Karakozov, Michael; Marx, Thomas; Tan, Ian KS; Thompson, Dan R; Vincent, Jean-Louis

2004-01-01

A young person presents with a highly malignant brain tumour with hemiparesis and limited prognosis after resection. She then suffers an iatrogenic cardiac and respiratory arrest that results in profound anoxic encephalopathy. A difference in opinion between the treatment team and the parent is based on a question of futile therapy. Opinions from five intensivists from around the world explore the differences in ethical and legal issues. A Physician-ethicist comments on the various approaches. PMID:15312199

Compelling truth: legal protection of the infosphere against big data spills.

PubMed

Schafer, Burkhard

2016-12-28

The paper explores whether legal and ethical concepts that have been used to protect the natural environment can also be leveraged to protect the 'infosphere', a neologism used by Luciano Floridi to characterize the totality of the informational environment. We focus, in particular, on the interaction between allocation of (intellectual) property rights and 'communication duties', in particular, data breach notification duties.This article is part of the themed issue 'The ethical impact of data science'. © 2016 The Author(s).

Theoretical frameworks used to discuss ethical issues in private physiotherapy practice and proposal of a new ethical tool.

PubMed

Drolet, Marie-Josée; Hudon, Anne

2015-02-01

In the past, several researchers in the field of physiotherapy have asserted that physiotherapy clinicians rarely use ethical knowledge to solve ethical issues raised by their practice. Does this assertion still hold true? Do the theoretical frameworks used by researchers and clinicians allow them to analyze thoroughly the ethical issues they encounter in their everyday practice? In our quest for answers, we conducted a literature review and analyzed the ethical theoretical frameworks used by physiotherapy researchers and clinicians to discuss the ethical issues raised by private physiotherapy practice. Our final analysis corpus consisted of thirty-nine texts. Our main finding is that researchers and clinicians in physiotherapy rarely use ethical knowledge to analyze the ethical issues raised in their practice and that gaps exist in the theoretical frameworks currently used to analyze these issues. Consequently, we developed, for ethical analysis, a four-part prism which we have called the Quadripartite Ethical Tool (QET). This tool can be incorporated into existing theoretical frameworks to enable professionals to integrate ethical knowledge into their ethical analyses. The innovative particularity of the QET is that it encompasses three ethical theories (utilitarism, deontologism, and virtue ethics) and axiological ontology (professional values) and also draws on both deductive and inductive approaches. It is our hope that this new tool will help researchers and clinicians integrate ethical knowledge into their analysis of ethical issues and contribute to fostering ethical analyses that are grounded in relevant philosophical and axiological foundations.

Ethical difficulties in clinical practice: experiences of European doctors

PubMed Central

Hurst, S A; Perrier, A; Pegoraro, R; Reiter‐Theil, S; Forde, R; Slowther, A‐M; Garrett‐Mayer, E; Danis, M

2007-01-01

Background Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services. Methods A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK. Results Survey respondents (n = 656, response rate 43%) ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority (17.6%) reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision‐making capacity (94.8%), disagreement among caregivers (81.2%) and limitation of treatment at the end of life (79.3%). The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct (47.5%), someone capable of providing specific advice (41.1%), help in weighing outcomes (36%) and clarification of the issues (35.9%). Few of the types of help expected to be useful varied among countries. Conclusion Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. PMID:17209113

Ethical issues when using social media for health outside professional relationships.

PubMed

DeCamp, Matthew

2015-04-01

Social media have the potential to revolutionize health and healthcare, but fulfilling this potential requires attention to the ethical issues social media may raise. This article reviews the major ethical issues arising when social media are used for research, public health, mobile health applications, and global health. It focuses on social media use outside fiduciary relationships between healthcare professionals and patients. Emphasis is given to the potential of social media in these contexts, the ethical issues relatively unique to each, and where possible how existing ethical principles and frameworks could help navigate these issues. In some cases social media create the circumstance for particular ethical issues but also facilitate managing them, such as in informed consent for research. In other cases, disagreement exists about whether social media - despite their potential - should be used for certain purposes, such as in public health surveillance (where confidentiality represents a significant ethical concern). In still others, ethical uncertainty exists about how social media will affect ethical issues, such as inequality in global health. As social media technologies continue to develop, identifying and managing the ethical issues they raise will be critical to their success in improving health while preserving fundamental ethical values.

The elusive ideal of inclusiveness: lessons from a worldwide survey of neurologists on the ethical issues raised by whole-genome sequencing.

PubMed

Hurlimann, Thierry; Jaitovich Groisman, Iris; Godard, Béatrice

2017-04-11

The anticipation of ethical issues that may arise with the clinical use of genomic technologies is crucial to envision their future implementation in a manner sensitive to local contexts. Yet, populations in low- and middle-income countries are underrepresented in studies that aim to explore stakeholders' perspectives on the use of such technologies. Within the framework of a research project entitled "Personalized medicine in the treatment of epilepsy", we sought to increase inclusiveness by widening the reach of our survey, inviting neurologists from around the world to share their views and practices regarding the use of whole-genome sequencing in clinical neurology and its associated ethics. We discuss herein the compelling scientific and ethical reasons that led us to attempt to recruit neurologists worldwide, despite the lack, in many low- or middle-income countries, of access to genomic technologies. Recruitment procedures and their results are presented and discussed, as well as the barriers we faced. We conclude that inclusive recruitment remains a challenging, albeit necessary and legitimate, endeavour.

An Interdisciplinary Approach to Lesbian, Gay, Bisexual, and Transgender Clinical Competence, Professional Training, and Ethical Care: Introduction to the Special Issue.

PubMed

Bidell, Markus P; Stepleman, Lara M

2017-01-01

There are exigent reasons to foster lesbian, gay, bisexual, and transgender (LGBT) competence, training, and ethical care for health professionals within an interdisciplinary paradigm. LGBT individuals experience serious health and psychosocial disparities; moreover, these inequalities can be amplified when other aspects of diversity such as race, ethnicity, age, gender, religion, disability, and socioeconomic status intersect with sexual orientation and gender identity (Institute of Medicine [IOM], 2011). While the origins of LGBT health and psychosocial disparities are manifold, deficiencies in professional training, ethical care, and clinical competence are underlying contributors (IOM, 2011). In addition, LGBT clinical competency advancements are often siloed within the various health care disciplines-thus advances by one group of health professionals often have limited impact for those practicing in different health and human service fields. This special issue explores LGBT clinical competence, professional training, and ethical care within an interdisciplinary context and, to our knowledge, represents the first attempt to address LGBT clinical competence from a multidisciplinary health care perspective.

Emerging issues in paediatric health research consent forms in Canada: working towards best practices

PubMed Central

2013-01-01

Background Obtaining a research participant’s voluntary and informed consent is the bedrock of sound ethics practice. Greater inclusion of children in research has led to questions about how paediatric consent operates in practice to accord with current and emerging legal and socio-ethical issues, norms, and requirements. Methods Employing a qualitative thematic content analysis, we examined paediatric consent forms from major academic centres and public organisations across Canada dated from 2008–2011, which were purposively selected to reflect different types of research ethics boards, participants, and studies. The studies included biobanking, longitudinal studies, and gene-environment studies. Our purpose was to explore the following six emerging issues: (1) whether the scope of parental consent allows for a child’s assent, dissent, or future consent; (2) whether the concepts of risk and benefit incorporate the child’s psychological and social perspective; (3) whether a child’s ability to withdraw is respected and to what extent withdrawal is permitted; (4) whether the return of research results includes individual results and/or incidental findings and the processes involved therein; (5) whether privacy and confidentiality concerns adequately address the child’s perspective and whether standard data and/or sample identifiability nomenclature is used; and (6) whether retention of and access to paediatric biological samples and associated medical data are addressed. Results The review suggests gaps and variability in the consent forms with respect to addressing each of the six issues. Many forms did not discuss the possibility of returning research results, be they individual or general/aggregate results. Forms were also divided in terms of the scope of parental consent (specific versus broad), and none discussed a process for resolving disputes that can arise when either the parents or the child wishes to withdraw from the study. Conclusions The analysis provides valuable insight and evidence into how consent forms address current ethical issues. While we do not thoroughly explore the contexts and reasons behind consent form gaps and variability, we do advocate and formulate the development of best practices for drafting paediatric health research consent forms. This can greatly ameliorate current gaps and facilitate harmonised and yet contextualised approaches to paediatric health research ethics. PMID:23363554

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

PubMed

Ilkilic, Ilhan; Paul, Norbert W

2009-03-01

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

Everyday ethics in internal medicine resident clinic: an opportunity to teach.

PubMed

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

2011-07-01

Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor-resident interactions. This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor-Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor-System Interaction (financial issues; doctor-system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their interactions with residents. Ethics education is important and residents may regard teaching about the ethics-related issues they actually encounter to be highly relevant. A better understanding of the barriers to teaching is needed in order to promote education about everyday ethics in the out-patient setting. © Blackwell Publishing Ltd 2011.

Everyday ethics in internal medicine resident clinic: an opportunity to teach

PubMed Central

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

2011-01-01

OBJECTIVES Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor–resident interactions. METHODS This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. RESULTS Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor–Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor–System Interaction (financial issues; doctor–system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). CONCLUSIONS In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their interactions with residents. Ethics education is important and residents may regard teaching about the ethics-related issues they actually encounter to be highly relevant. A better understanding of the barriers to teaching is needed in order to promote education about everyday ethics in the out-patient setting. PMID:21649704

Great expectations: teaching ethics to medical students in South Africa.

PubMed

Behrens, Kevin Gary; Fellingham, Robyn

2014-12-01

Many academic philosophers and ethicists are appointed to teach ethics to medical students. We explore exactly what this task entails. In South Africa the Health Professions Council's curriculum for training medical practitioners requires not only that students be taught to apply ethical theory to issues and be made aware of the legal and regulatory requirements of their profession, it also expects moral formation and the inculcation of professional virtue in students. We explore whether such expectations are reasonable. We defend the claim that physicians ought to be persons of virtuous character, on the grounds of the social contract between society and the profession. We further argue that since the expectations of virtue of health care professionals are reasonable, it is also sound reasoning to expect ethics teachers to try to inculcate such virtues in their students, so far as this is possible. Furthermore, this requires of such teachers that they be suitable role models of ethical practice and virtue, themselves. We claim that this applies to ethics teachers who are themselves not members of the medical profession, too, even though they are not bound by the same social contract as doctors. We conclude that those who accept employment as teachers of ethics to medical students, where as part of their contractual obligation they are expected to inculcate moral values in their students, ought to be prepared to accept their responsibility to be professionally ethical, themselves. © 2013 John Wiley & Sons Ltd.

Socioscience and ethics in science classrooms: Teacher perspectives and strategies

NASA Astrophysics Data System (ADS)

Sadler, Troy D.; Amirshokoohi, Aidin; Kazempour, Mahsa; Allspaw, Kathleen M.

2006-04-01

This study explored teacher perspectives on the use of socioscientific issues (SSI) and on dealing with ethics in the context of science instruction. Twenty-two middle and high school science teachers from three US states participated in semi-structured interviews, and researchers employed inductive analyses to explore emergent patterns relative to the following two questions. (1) How do science teachers conceptualize the place of ethics in science and science education? (2) How do science teachers handle topics with ethical implications and expression of their own values in their classrooms? Profiles were developed to capture the views and reported practices, relative to the place of ethics in science and science classrooms, of participants. Profile A comprising teachers who embraced the notion of infusing science curricula with SSI and cited examples of using controversial topics in their classes. Profile B participants supported SSI curricula in theory but reported significant constraints which prohibited them from actualizing these goals. Profile C described teachers who were non-committal with respect to focusing instruction on SSI and ethics. Profile D was based on the position that science and science education should be value-free. Profile E transcended the question of ethics in science education; these teachers felt very strongly that all education should contribute to their students' ethical development. Participants also expressed a wide range of perspectives regarding the expression of their own values in the classroom. Implications of this research for science education are discussed.

Mediating patienthood-from an ethics of to an ethics with technology.

PubMed

Kiran, Asle H

2017-01-01

The changes that happen to healthcare services after the implementation of new assistive healthcare technologies (also called 'welfare technology' in the Nordic countries) concern more than increased efficiency and reducing healthcare expenditure. Of particular interest from an ethical point of view are the manners in which technologies shape the roles and identities of care receivers and healthcare personnel. The notion of 'patienthood' is explored in this paper as something that is both challenged by new technologies, and as something that is opened up for active and potentially positive reshaping when care receivers support their illness or frailty with assistive healthcare technologies. This dual effect of technologies (as both challenge and opportunity) requires a rethinking of ethics of technologies, which for most part have been preoccupied with ethical issues prior to the implementation of a new technology into a healthcare service. Ethics of technology should also contribute to the concrete efforts of care receivers to establish something approximating a 'good patienthood' in relation to a new technology, making it opportune to dub it, instead, an ethics with technology. This paper explores how assistive healthcare technologies impact on care receivers and the care situation, and in relation to the notion of patienthood, before turning to what this implies for an ethics that has as its goal to support care receivers to reach a life with the technology that is in line with their own notions of well-being and a good life. © 2016 John Wiley & Sons Ltd.

Medical dominance within research ethics committees.

PubMed

Humphreys, Stephen; Thomas, Hilary; Martin, Robyn

2014-01-01

Qualitative research is reported which explores the perceptions of members of the U.K.'s independent Phase I ethics committees (IECs) about key issues identified following a literature review. Audio-recorded interviews were conducted with ten expert and ten lay members from all IECs except the one to which the lead author was attached. Transcripts were thematically analyzed following a broadly hermeneutical approach. The findings-dealing with such matters as recruitment strategies and length of service; attitudes towards member categories, published ethics guidelines, and the adequacy of insurance; levels of training and views on achieving a recognised level of competence-have an intrinsic interest, but it is when the findings are considered collectively using Freidson's theory of professional dominance that they reveal the influence the medical profession can have in shaping ethics review.

A foundation for public health ethics at Tuskegee University in the 21st century.

PubMed

Warren, Rueben C; Tarver, Will L

2010-08-01

This commentary is a reflection on Tuskegee University's National Center for Bioethics in Research and Health Care on the health and ethical challenges of the 21st century. The Center has dedicated the last 10 years to addressing the unresolved biomedicine and public health issues and/or the ethical dilemmas that plague the nation's health. The authors believe that health disparities continue to worsen because the approach under-appreciates the ethical dilemma that plagues health policy and health disparities. The authors discuss synergies and the paradigmatic differences between science and medicine, religion, spirituality, and faith. They also discuss the importance of considering these relationships if improvements in the health of people of African descent are expected. The concept of Optimal Health is explored.

The nature and ethics of natural experiments.

PubMed

Dawson, Angus; Sim, Julius

2015-10-01

Natural experiments are an important methodology often used to answer research questions that would, otherwise, be impossible to address, or employed because of ethical concerns about the use of randomisation to interventions that carry known risks. The UK Medical Research Council (MRC) recently produced an extremely useful document discussing the nature and significance of natural experiments within medical and public health research. In this paper, however, we suggest that the MRC document's definition of the term 'natural experiment' is insufficiently precise. In response, we offer a taxonomy of different types of natural experiments and related methods, and explore the ethical implications of these different types. We argue that while the ethical issues that may arise within natural experiments in relation to risks of harm or informed consent may differ from those within the randomised controlled trial, they are not thereby less pressing. The implications of the argument are explored and recommendations made for those involved in research governance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Ethical issues recognized by critical care nurses in the intensive care units of a tertiary hospital during two separate periods.

PubMed

Park, Dong Won; Moon, Jae Young; Ku, Eun Yong; Kim, Sun Jong; Koo, Young-Mo; Kim, Ock-Joo; Lee, Soon Haeng; Jo, Min-Woo; Lim, Chae-Man; Armstrong, John David; Koh, Younsuck

2015-04-01

This research aimed to investigate the changes in ethical issues in everyday clinical practice recognized by critical care nurses during two observation periods. We conducted a retrospective analysis of data obtained by prospective questionnaire surveys of nurses in the intensive care units (ICU) of a tertiary university-affiliated hospital in Seoul, Korea. Data were collected prospectively during two different periods, February 2002-January 2003 (Period 1) and August 2011-July 2012 (Period 2). Significantly fewer cases with ethical issues were reported in Period 2 than in Period 1 (89 cases [2.1%] of 4,291 ICU admissions vs. 51 [0.5%] of 9,302 ICU admissions, respectively; P < 0.001). The highest incidence of cases with identified ethical issues in both Periods occurred in MICU. The major source of ethical issues in Periods 1 and 2 was behavior-related. Among behaviorrelated issues, inappropriate healthcare professional behavior was predominant in both periods and mainly involved resident physicians. Ethical issue numbers regarding end-oflife (EOL) care significantly decreased in the proportion with respect to ethical issues during Period 2 (P = 0.044). In conclusion, the decreased incidence of cases with identified ethical issues in Period 2 might be associated with ethical enhancement related with EOL and improvements in the ICU care environment of the studied hospital. However, behaviorrelated issues involving resident physicians represent a considerable proportion of ethical issues encountered by critical care nurses. A systemic approach to solve behavior-related issues of resident physicians seems to be required to enhance an ethical environment in the studied ICU.

Ethics and the electronic health record in dental school clinics.

PubMed

Cederberg, Robert A; Valenza, John A

2012-05-01

Electronic health records (EHRs) are a major development in the practice of dentistry, and dental schools and dental curricula have benefitted from this technology. Patient data entry, storage, retrieval, transmission, and archiving have been streamlined, and the potential for teledentistry and improvement in epidemiological research is beginning to be realized. However, maintaining patient health information in an electronic form has also changed the environment in dental education, setting up potential ethical dilemmas for students and faculty members. The purpose of this article is to explore some of the ethical issues related to EHRs, the advantages and concerns related to the use of computers in the dental operatory, the impact of the EHR on the doctor-patient relationship, the introduction of web-based EHRs, the link between technology and ethics, and potential solutions for the management of ethical concerns related to EHRs in dental schools.

Evaluating moral reasoning in nursing education.

PubMed

McLeod-Sordjan, Renee

2014-06-01

Evidence-based practice suggests the best approach to improving professionalism in practice is ethics curricula. However, recent research has demonstrated that millennium graduates do not advocate for patients or assert themselves during moral conflicts. The aim of this article is the exploration of evaluation techniques to evaluate one measurable outcome of ethics curricula: moral reasoning. A review of literature, published between 1995 and 2013, demonstrated that the moral orientations of care and justice as conceptualized by Gilligan and Kohlberg are utilized by nursing students to solve ethical dilemmas. Data obtained by means of reflective journaling, Ethics of Care Interview (ECI) and Defining Issues Test (DIT), would objectively measure the interrelated pathways of care-based and justice-based moral reasoning. In conclusion, educators have an ethical responsibility to foster students' ability to exercise sound clinical judgment, and support their professional development. It is recommended that educators design authentic assessments to demonstrate student's improvement of moral reasoning. © The Author(s) 2013.

The place of care in ethical theory.

PubMed

Veatch, R M

1998-04-01

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

Exploring gender, age, time and space in research with older Pakistani Muslims in the United Kingdom: formalised research 'ethics' and performances of the public/private divide in 'the field'.

PubMed

Zubair, Maria; Victor, Christina

2015-05-01

In recent years, there has been an increasing interest in researching ageing ethnic minority populations in the West. However, older people from such minority communities have received comparatively little attention in wide-ranging discussions on appropriate research methodologies. By a process of critically reflecting on our experiences of undertaking fieldwork for our Economic and Social Research Council New Dynamics of Ageing study of 'Families and Caring in South Asian Communities', this paper maps out the key methodological and ethical challenges we faced and, in the process, highlights the importance of developing socially appropriate research methodologies and ethical frameworks for research with such populations. With a reflexive approach, we specifically explore the significance of gender, age, time and space to the fieldwork processes and the 'field' relationships formed at various stages of the research process. In particular, we explore three key emergent issues which conflicted with our formal research protocols and presented particular challenges for us and our older Pakistani Muslim participants: (a) structuring of time in daily life; (b) gendered use of public and private spaces; and (c) orality of informal social contexts and relationships. Using illustrations from our fieldwork which reveal the particular significance of these issues to our fieldwork experiences and performativities of public/private identities, we highlight important tensions between formalised ethical and methodological dimensions of conducting funded research and the realities of being in 'the field'. We conclude the paper by emphasising the need to explore further not only the ways in which researchers can adopt more socially and culturally sensitive data collection processes and methodologies at the micro level of their interactions with research participants, but also contextualising the particular challenges experienced by researchers and their participants in terms of the wider research frameworks and agendas as well as the broader social contexts within which they live and work.

Evaluation of moral case deliberation at the Dutch Health Care Inspectorate: a pilot study.

PubMed

Seekles, Wike; Widdershoven, Guy; Robben, Paul; van Dalfsen, Gonny; Molewijk, Bert

2016-05-21

Moral case deliberation (MCD) as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics support on the level of health care regulation, employees of regulatory bodies are regularly confronted with moral challenges. This pilot study describes and evaluates the use of MCD at the Dutch Health Care Inspectorate (IGZ). The objective of this pilot study is to investigate: 1) the current way of dealing with moral issues at the IGZ; 2) experience with and evaluation of MCD as clinical ethics support, and 3) future preferences and (perceived) needs regarding clinical ethics support for dealing with moral questions at the IGZ. We performed an explorative pilot study. The research questions were assessed by means of: 1) interviews with MCD participants during four focus groups; and 2) interviews with six key stakeholders at the IGZ. De qualitative data is illustrated by data from questionnaires on MCD outcomes, perspective taking and MCD evaluation. Professionals do not always recognize moral issues. Employees report a need for regular and structured moral support in health care regulation. The MCD meetings are evaluated positively. The most important outcomes of MCD are feeling secure and learning from others. Additional support is needed to successfully implement MCD at the Inspectorate. We conclude that the respondents perceive moral case deliberation as a useful form of clinical ethics support for dealing with moral questions and issues in health care regulation.

Negotiating Sexuality and Masculinity in School Sport: An Autoethnography

ERIC Educational Resources Information Center

Carless, David

2012-01-01

This autoethnography explores challenging and ethically sensitive issues around sexual orientation, sexual identity and masculinity in the context of school sport. Through storytelling, I aim to show how sometimes ambiguous encounters with heterosexism, homophobia and hegemonic masculinity through sport problematise identity development for young…

Online Counseling: New Entity, New Challenges

ERIC Educational Resources Information Center

Barnett, Jeffrey E.

2005-01-01

Mallen, Vogel, and colleagues explore the developing field of online counseling from the unique perspective of counseling psychology. They examine the body of available research and relevant clinical, ethical, legal, and practical issues and make recommendations for counseling psychologists who desire to participate in online counseling. This…

Stem Cells and Society: An Undergraduate Course Exploring the Intersections among Science, Religion, and Law

PubMed Central

Friedrichsen, Patricia

2009-01-01

The intersection of science and our society has led to legal and ethical issues in which we all play a part. To support development of scientific literacy, college science courses need to engage students in difficult dialogues around ethical issues. We describe a new course, Stem Cells and Society, in which students explore the basic biology of stem cell research and the controversy surrounding it. As part of the course, we highlight the nature of science, looking at the methods and norms within the scientific community. To gain a perspective on the current stem cell controversy, we examine the public debates in the 1970s surrounding in vitro fertilization, the stem cell initiative in Missouri, and the personal and religious viewpoints that have emerged relative to the stem cell debate. In the Stem Cells and Society course, students are challenged to develop and clarify their own personal positions concerning embryonic stem cell research. These positions are grounded in science, religion or personal philosophy, and law. PMID:19255139

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

PubMed

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

2017-04-04

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

Modified Policy-Delphi study for exploring obesity prevention priorities

PubMed Central

Haynes, Emily; Palermo, Claire; Reidlinger, Dianne P

2016-01-01

Introduction Until now, industry and government stakeholders have dominated public discourse about policy options for obesity. While consumer involvement in health service delivery and research has been embraced, methods which engage consumers in health policy development are lacking. Conflicting priorities have generated ethical concern around obesity policy. The concept of ‘intrusiveness’ has been applied to policy decisions in the UK, whereby ethical implications are considered through level of intrusiveness to choice; however, the concept has also been used to avert government regulation to address obesity. The concept of intrusiveness has not been explored from a stakeholder's perspective. The aim is to investigate the relevance of intrusiveness and autonomy to health policy development, and to explore consensus on obesity policy priorities of under-represented stakeholders. Methods and analysis The Policy-Delphi technique will be modified using the James Lind Alliance approach to collaborative priority setting. A total of 60 participants will be recruited to represent three stakeholder groups in the Australian context: consumers, public health practitioners and policymakers. A three-round online Policy-Delphi survey will be undertaken. Participants will prioritise options informed by submissions to the 2009 Australian Government Inquiry into Obesity, and rate the intrusiveness of those proposed. An additional round will use qualitative methods in a face-to-face discussion group to explore stakeholder perceptions of the intrusiveness of options. The novelty of this methodology will redress the balance by bringing the consumer voice forward to identify ethically acceptable obesity policy options. Ethics and dissemination Ethical approval was granted by the Bond University Health Research Ethics Committee. The findings will inform development of a conceptual framework for analysing and prioritising obesity policy options, which will be relevant internationally and to ethical considerations of wider public health issues. The findings will be disseminated through peer-reviewed publications, conference presentations and collaborative platforms of policy and science. PMID:27601495

77 FR 38631 - Request for Comments on Ethical Issues Associated with the Development of Medical Countermeasures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Request for Comments on Ethical Issues Associated with the... ethical issues associated with the development of medical countermeasures for children, including ethical considerations surrounding clinical research with children, ethical considerations surrounding pediatric medical...

Ethics support for GPs: what should it look like?

PubMed

Clark-Grill, Monika

2016-03-01

INTRODUCTION Ethics support services for hospital clinicians have become increasingly common globally but not as yet in New Zealand. However, an initiative to change this is gathering momentum. Its slogan 'Clinical ethics is everyone's business' indicates that the aim is to encompass all of health care, not just the hospital sector. General Practitioners (GPs) deal with ethical issues on a daily basis. These issues are often quite different from ethical issues in hospitals. To make future ethics support relevant for primary care, local GPs were interviewed to find out how they might envisage ethics support services that could be useful to them. METHODS A focus group interview with six GPs and semi-structured individual interviews with three GPs were conducted. Questions included how they made decisions on ethical issues at present, what they perceived as obstacles to ethical reflection and decision-making, and what support might be helpful. FINDINGS Three areas of ethics support were considered potentially useful: Formal ethics education during GP training, access to an ethicist for assistance with analysing an ethical issue, and professional guidance with structured ethics conversations in peer groups. CONCLUSION The complex nature of general practice requires GPs to be well educated and supported for handling ethical issues. The findings from this study could serve as input to the development of ethics support services. KEYWORDS General practice; primary care; ethics; support; education.

Perspectives of Taiwanese pastoral counselors on the use of scripture and prayer in the counseling process.

PubMed

Der Pan, Peter Jen; Deng, Liang-Yu F; Tsai, Shiou Ling; Yuan, S S Jenny

2015-04-01

Interviews were carried out with 10 Christian pastoral counselors to explore their perspectives on the use of Scripture and prayer in the counseling process. Grounded Theory was utilized. Five main categories including a theological framework of pastoral counseling, counselors' considerations of using Scripture and prayer, preparation for Christian spiritual intervention, implications of spiritual resources, and ethical issues in the pastoral counseling process were generated. The results suggest the theological framework of pastoral counseling is crucial to the use of Scripture and prayer, and the issue of a neutral response should first be clarified for clients. Basic guidelines for ethically using Scripture and prayer for working with Christian clients are proposed for further pastoral counselor training, practice, and research.

Reflexive journaling on emotional research topics: ethical issues for team researchers.

PubMed

Malacrida, Claudia

2007-12-01

Traditional epistemological concerns in qualitative research focus on the effects of researchers' values and emotions on choices of research topics, power relations with research participants, and the influence of researcher standpoints on data collection and analysis. However, the research process also affects the researchers' values, emotions, and standpoints. Drawing on reflexive journal entries of assistant researchers involved in emotionally demanding team research, this article explores issues of emotional fallout for research team members, the implications of hierarchical power imbalances on research teams, and the importance of providing ethical opportunities for reflexive writing about the challenges of doing emotional research. Such reflexive approaches ensure the emotional safety of research team members and foster opportunities for emancipatory consciousness among research team members.

Teaching Ethical Reflexivity in Information Systems: How to Equip Students to Deal with Moral and Ethical Issues of Emerging Information and Communication Technologies

ERIC Educational Resources Information Center

Stahl, Bernd Carsten

2011-01-01

Teaching ethics to students of information systems (IS) raises a number of conceptual and content-related issues. The present paper starts out by developing a conceptual framework of moral and ethical issues that distinguishes between moral intuition, explicit morality, ethical theory and meta-ethical reflection. This conceptual framework…

Institutional Ethics Resources: Creating Moral Spaces.

PubMed

Hamric, Ann B; Wocial, Lucia D

2016-09-01

Since 1992, institutions accredited by The Joint Commission have been required to have a process in place that allows staff members, patients, and families to address ethical issues or issues prone to conflict. While the commission's expectations clearly have made ethics committees more common, simply having a committee in no way demonstrates its effectiveness in terms of the availability of the service to key constituents, the quality of the processes used, or the outcomes achieved. Beyond meeting baseline accreditation standards, effective ethics resources are requisite for quality care for another reason. The provision of care to the sick is a practice with profound moral dimensions. Clinicians need what Margaret Urban Walker has called "moral spaces," reflective spaces within institutions in which to explore and communicate values and ethical obligations as they undergird goals of care. Walker proposed that ethicists needed to be concerned with the design and maintenance of these moral spaces. Clearly, that concern needs to extend beyond ethicists to institutional leaders. This essay uses Walker's idea of moral space to describe individuals and groups who are actual and potential ethics resources in health care institutions. We focus on four requisite characteristics of effective resources and the challenges to achieving them, and we identify strategies to build them. In our view, such moral spaces are particularly important for nurses and their colleagues on interprofessional teams and need to be expanded and strengthened in most settings. © 2016 The Hastings Center.

From 'implications' to 'dimensions': science, medicine and ethics in society.

PubMed

Pickersgill, Martyn D

2013-03-01

Much bioethical scholarship is concerned with the social, legal and philosophical implications of new and emerging science and medicine, as well as with the processes of research that under-gird these innovations. Science and technology studies (STS), and the related and interpenetrating disciplines of anthropology and sociology, have also explored what novel technoscience might imply for society, and how the social is constitutive of scientific knowledge and technological artefacts. More recently, social scientists have interrogated the emergence of ethical issues: they have documented how particular matters come to be regarded as in some way to do with 'ethics', and how this in turn enjoins particular types of social action. In this paper, I will discuss some of this and other STS (and STS-inflected) literature and reflect on how it might complement more 'traditional' modes of bioethical enquiry. I argue that STS might (1) cast new light on current bioethical issues, (2) direct the gaze of bioethicists towards matters that may previously have escaped their attention, and (3) indicate the import not only of the ethical implications of biomedical innovation, but also how these innovative and other processes feature ethics as a dimension of everyday laboratory and clinical work. In sum, engagements between STS and bioethics are increasingly important in order to understand and manage the complex dynamics between science, medicine and ethics in society.

The ethical issues in uranium mining research in the Navajo Nation.

PubMed

Panikkar, Bindu; Brugge, Doug

2007-01-01

We explore the experience of Navajo communities living under the shadow of nuclear age fallout who were subjects of five decades of research. In this historical analysis of public health (epidemiological) research conducted in the Navajo lands since the inception of uranium mining from the 1950s untill the end of the 20th century, we analyze the successes and failures in the research initiatives conducted on Navajo lands, the ethical breaches, and the harms and benefits that this research has brought about to the community. We discuss how scientific and moral uncertainty, lack of full stakeholder participation and community wide outreach and education can impact ethical decisions made in research.

Research Ethics and Intellectual Disability: Broadening the Debates

PubMed Central

Carlson, Licia

2013-01-01

This article examines the ethical issues surrounding the inclusion of people with intellectual disabilities as research subjects. It explores subject selection, competence, risk and benefits, and authority through three tensions that emerge when considering these concepts in the context of the Disability Rights Movement and critical disability scholarship. These tensions are defined as the double dangers of inclusion and exclusion; the challenges of defining competence and risk in terms of individuals vs. groups; and the conflicts that arise when pursuing the dual goals of amelioration and elimination of disabilities. Though these tensions are not resolved, they underscore the importance of researchers engaging with critical disability perspectives in order to navigate these complex ethical questions. PMID:24058305

Law, ethics, and the clinical neurologist.

PubMed

Nora, Lois Margaret

2013-01-01

There is dynamic interplay between the disciplines of law and ethics, and the result is often laws and regulation that impact the practice of clinical neurology. This chapter explores how the disciplines of law and ethics inform and intersect with each other, and how resulting law impacts the everyday work of the clinical neurologist. Examples of how the core bioethical principles of nonmaleficence, beneficence, respect for autonomy, and justice are manifest in legislative, common, and administrative laws are presented. Examples of how these laws, in turn, impact the practice of neurology through protection of patient privacy, the avoidance of conflict of interest, and informed consent and other issues are offered. © 2013 Elsevier B.V. All rights reserved.

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

PubMed

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

2017-01-01

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

Ethical, social, and cultural issues related to clinical genetic testing and counseling in low- and middle-income countries: protocol for a systematic review.

PubMed

Zhong, Adrina; Darren, Benedict; Dimaras, Helen

2017-07-11

There has been little focus in the literature on how to build genetic testing and counseling services in low- and middle-income countries in a responsible, ethical, and culturally appropriate manner. It is unclear to what extent this area is being explored and what form further research should take. The proposed knowledge synthesis aims to fill this gap in knowledge and mine the existing data to determine the breadth of work in this area and identify ethical, social, and cultural issues that have emerged. An integrated knowledge translation approach will be undertaken by engaging knowledge users throughout the review to ensure relevance to their practice. Electronic databases encompassing various disciplines, such as healthcare, social sciences, and public health, will be searched. Studies that address clinical genetic testing and/or counseling and ethical, social, and/or cultural issues of these genetic services, and are performed in low- and middle-income countries as defined by World Bank will be considered for inclusion. Two independent reviewers will be involved in a two-stage literature screening process, data extraction, and quality appraisal. Studies included in the review will be analyzed by thematic analysis. A narrative synthesis guided by the social ecological model will be used to summarize findings. This systematic review will provide a foundation of evidence regarding ethical, social, and cultural issues related to clinical genetic testing and counseling in low- and middle-income countries. Using the social ecological model as a conceptual framework will facilitate the understanding of broader influences of the sociocultural context on an individual's experience with clinical genetic testing and counseling, thereby informing interdisciplinary sectors in future recommendations for practice and policy. PROSPERO CRD42016042894.

Ethical issues in obesity prevention for school children: a systematic qualitative review.

PubMed

Kahrass, Hannes; Strech, Daniel; Mertz, Marcel

2017-12-01

Planning and conducting preventive measures against obesity for school children is beset with ethical issues which should be known to make well-informed decisions. The goal of this study was to provide a comprehensive spectrum of these ethical issues by means of a systematic review. In this context, the study also assesses the value of different search strategies for ethical literature in public health. Literature was searched in Medline, EBSCO and others. Three different search strategies with varied scopes were applied and their output was compared. Qualitative content analysis was used for extracting and categorizing ethical issues. 109 publications (published from 1995 to 2015) were finally included. The qualitative analysis resulted in 60 potentially relevant ethical issues. The three search strategies showed substantial differences regarding their search results. The presented spectrum provides an initial evidence base for dealing with ethical issues adequately. The findings of the study further suggest that a broader scope is more fruitful for systematic reviews on ethical issues in the field of public health.

Exploring Biotechnology Using Case-Based Multimedia

ERIC Educational Resources Information Center

Bergland, Mark; Lundeberg, Mary; Klyczek, Karen; Sweet, Jennifer; Emmons, Jean; Martin, Christine; Marsh, Katherine; Werner, Joy; Jarvis-Uetz, Michelle

2006-01-01

Today, teachers face more challenges than ever, and biology teachers face a special challenge. As technology continues to expand, biology teachers have a responsibility to keep students informed of technological and scientific advances. Biology teachers must also address ethical issues associated with these advances. In this paper, the authors…

The Case of Jessica Chang.

ERIC Educational Resources Information Center

Chen, Stephen; Leong, Frederick T. L.

1997-01-01

Reports on a case study that explores the culture-related issues of Asian Americans in the workplace. Focuses on a young, second-generation, Chinese-American woman, Jessica Chang, and the employment challenges that Dr. Chang encountered. Discusses her job strategies and some of the ethical dilemmas that she faced. (RJM)

BNCI systems as a potential assistive technology: ethical issues and participatory research in the BrainAble project.

PubMed

Carmichael, Clare; Carmichael, Patrick

2014-01-01

This paper highlights aspects related to current research and thinking about ethical issues in relation to Brain Computer Interface (BCI) and Brain-Neuronal Computer Interfaces (BNCI) research through the experience of one particular project, BrainAble, which is exploring and developing the potential of these technologies to enable people with complex disabilities to control computers. It describes how ethical practice has been developed both within the multidisciplinary research team and with participants. The paper presents findings in which participants shared their views of the project prototypes, of the potential of BCI/BNCI systems as an assistive technology, and of their other possible applications. This draws attention to the importance of ethical practice in projects where high expectations of technologies, and representations of "ideal types" of disabled users may reinforce stereotypes or drown out participant "voices". Ethical frameworks for research and development in emergent areas such as BCI/BNCI systems should be based on broad notions of a "duty of care" while being sufficiently flexible that researchers can adapt project procedures according to participant needs. They need to be frequently revisited, not only in the light of experience, but also to ensure they reflect new research findings and ever more complex and powerful technologies.

Perceived comfort level of medical students and residents in handling clinical ethics issues.

PubMed

Silverman, Henry J; Dagenais, Julien; Gordon-Lipkin, Eliza; Caputo, Laura; Christian, Matthew W; Maidment, Bert W; Binstock, Anna; Oyalowo, Akinbowale; Moni, Malini

2013-01-01

Studies have shown that medical students and residents believe that their ethics preparation has been inadequate for handling ethical conflicts. The objective of this study was to determine the self-perceived comfort level of medical students and residents in confronting clinical ethics issues. Clinical medical students and residents at the University of Maryland School of Medicine completed a web-based survey between September 2009 and February 2010. The survey consisted of a demographic section, questions regarding the respondents' sense of comfort in handling a variety of clinical ethics issues, and a set of knowledge-type questions in ethics. Survey respondents included 129 medical students (response rate of 40.7%) and 207 residents (response rate of 52.7%). There were only a few clinical ethics issues with which more than 70% of the respondents felt comfortable in addressing. Only a slight majority (60.8%) felt prepared, in general, to handle clinical situations involving ethics issues, and only 44.1% and 53.2% agreed that medical school and residency training, respectively, helped prepare them to handle such issues. Prior ethics training was not associated with these responses, but there was an association between the level of training (medical students vs residents) and the comfort level with many of the clinical ethics issues. Medical educators should include ethics educational methods within the context of real-time exposure to medical ethics dilemmas experienced by physicians-in-training.

A Qualitative Study of Paramedic Duty to Treat During Disaster Response.

PubMed

Smith, Erin; Burkle, Frederick; Gebbie, Kristine; Ford, David; Bensimon, Cécile

2018-04-10

Disasters place unprecedented demands on emergency medical services and can test paramedics personal commitment as health care professionals. Despite this challenge, guidelines and codes of ethics are largely silent on the issue, providing little to no guidance on what is expected of paramedics or how they ought to approach their duty to treat in the face of risk. The objective of this research is to explore how paramedics view their duty to treat during disasters. The authors employed qualitative methods to gather Australian paramedic perspectives. Our findings suggest that paramedic decisions around duty to treat will largely depend on individual perception of risk and competing obligations. A code of ethics for paramedics would be useful, but ultimately each paramedic will interpret these suggested guidelines based on individual values and the situational context. Coming to an understanding of the legal issues involved and the ethical-social expectations in advance of a disaster may assist paramedics to respond willingly and appropriately. (Disaster Med Public Health Preparedness. 2018;page 1 of 6).

Genes and plays: bringing ELSI issues to life.

PubMed

Rothenberg, Karen H; Bush, Lynn W

2012-02-01

Ethical complexities surround the promise of genomic technology and the power of genetic information as they alter conceptions of identity and dynamics within personal and professional relationships. Creative approaches such as dramatic vignettes offer a unique analytical stage for imagining the bioethical past and future. Dramatic narratives can bring to life images of differing perspectives and values when experiencing innovations in medicine. Although the scientific landscape shifts, concerns expressed in theatre from 50 years ago parallel many contemporary ELSI (ethical, legal, and social implications) issues, highlighting the ongoing struggle to appreciate the impact of emerging genetic technologies on relationships. To illuminate these enduring concerns, we explore how perceptions and relationships have influenced-and been influenced by-genetics as portrayed through dramatic vignettes. We build on the legacy of using case vignettes as a clinical teaching modality, and believe similar value exists within the research ethics domain. The selection of dialogue discussed encompasses abbreviated excerpts from two existing and one original vignette that we staged at the ELSI 2011 Congress and various academic and health institutions.

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

PubMed

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

2016-01-01

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

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

PubMed Central

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

2016-01-01

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

Ethical considerations in the translation of regenerative biofabrication technologies into clinic and society.

PubMed

Otto, I A; Breugem, C C; Malda, J; Bredenoord, A L

2016-10-07

Biofabrication technologies have the potential to improve healthcare by providing highly advanced and personalized biomedical products for research, treatment and prevention. As the combining of emerging techniques and integrating various biological and synthetic components becomes increasingly complex, it is important that relevant stakeholders anticipate the translation of biofabricated 3D tissue products into patients and society. Ethics is sometimes regarded as a brake on scientific progress, yet from our perspective, ethics in parallel with research anticipates societal impacts of emerging technologies and stimulates responsible innovation. For the ethical assessment, the biofabrication field benefits from similarities to regenerative medicine and an increasing ethical awareness in the development of tissue-engineered products. However, the novelty of the technology itself, the increase in attainable structural complexity, and the potential for automation and personalization are distinguishing facets of biofabrication that call for a specific exploration of the ethics of biofabrication. This review aims to highlight important points of existing ethical discussions, as well as to call attention to emerging issues specific to 3D biofabrication in bench and bedside research and the translation to society.

Genomics and Ethics: The Case of Cloned and/or Transgenic Animals

PubMed Central

2003-01-01

The point of the present study is to illustrate and, if possible, promote the existing link between genomics and ethics, taking the example of cloned and transgenic animals. These ‘new animals’ raise theoretical and practical problems that concern applied ethics. We will explore more particularly an original strategy showing that it is possible, starting from philosophical questioning about the nature of identity, to use a genomic approach, based on amplification fragment length polymorphism (AFLP) and methylation-sensitive amplification polymorphism (MSAP) detection, to provide useful tools to define more rigorously what cloned animals are, by testing their genetic and epigenetic identity. We expect from the future results of this combined approach to stimulate the creativity of the philosophical and ethical reflection about the impact of biotechnology on animals, and to increase scientific involvement in such issues. PMID:18629111

Code of Ethical Conduct for Computer-Using Educators: An ICCE Policy Statement.

ERIC Educational Resources Information Center

Computing Teacher, 1987

1987-01-01

Prepared by the International Council for Computers in Education's Ethics and Equity Committee, this code of ethics for educators using computers covers nine main areas: curriculum issues, issues relating to computer access, privacy/confidentiality issues, teacher-related issues, student issues, the community, school organizational issues,…

REVIEWING HIV-RELATED RESEARCH IN EMERGING ECONOMIES: THE ROLE OF GOVERNMENT REVIEWING AGENCIES

PubMed Central

Klitzman, Robert; Sexton, Patrina; Hui, Katrina; Hanrahan, Donna; Barnes, Mark; Sugarman, Jeremy; London, Alex John

2015-01-01

Little research has explored the possible effects of government institutions in emerging economies on ethical reviews of multinational research. We conducted semi-structured, in-depth telephone interviews with 15 researchers, Research Ethics Committees (RECs) personnel, and a government agency member involved in multinational HIV Prevention Trials Network (HPTN) research in emerging economies. Ministries of Health (MOH) or other government agencies often play pivotal roles as facilitators or barriers in the research ethics approval process. Government agency RECs reviewing protocols may face particular challenges, as they can lack resources, be poorly organized, have inconsistent review processes and, limited expertise, use differing definitions of national interests, including upholding national reputation and avoiding potential exploitation and stigma of the country’s population. The MOH/governmental review body may be affected by power dynamics and politics in study reviews; may consider issues both related and unrelated to research ethics as understood elsewhere; and may prioritize particular diseases, treatments, or interventions over other topics/types of research. Poor communication and deeply-rooted tensions may exist between sponsor and host countries, impeding optimal interactions and reviews. Investigators must understand and plan for the potential effects of governmental agencies on multinational collaborative research, including preserving adequate time for agency review, and contacting these agencies beforehand to address issues that may arise. Better understanding of these issues can aid and advance appropriate global scientific collaboration. PMID:25388003

Reviewing HIV-Related Research in Emerging Economies: The Role of Government Reviewing Agencies.

PubMed

Sexton, Patrina; Hui, Katrina; Hanrahan, Donna; Barnes, Mark; Sugarman, Jeremy; London, Alex John; Klitzman, Robert

2016-04-01

Little research has explored the possible effects of government institutions in emerging economies on ethical reviews of multinational research. We conducted semi-structured, in-depth telephone interviews with 15 researchers, Research Ethics Committees (RECs) personnel, and a government agency member involved in multinational HIV Prevention Trials Network (HPTN) research in emerging economies. Ministries of Health (MOH) or other government agencies often play pivotal roles as facilitators or barriers in the research ethics approval process. Government agency RECs reviewing protocols may face particular challenges, as they can lack resources, be poorly organized, have inconsistent review processes and limited expertise, and use differing definitions of national interests, including upholding national reputation and avoiding potential exploitation and stigma of the country's population. The MOH/governmental review body may be affected by power dynamics and politics in study reviews; may consider issues both related and unrelated to research ethics as understood elsewhere; and may prioritize particular diseases, treatments, or interventions over other topics/types of research. Poor communication and deeply-rooted tensions may exist between sponsor and host countries, impeding optimal interactions and reviews. Investigators must understand and plan for the potential effects of governmental agencies on multinational collaborative research, including preserving adequate time for agency review, and contacting these agencies beforehand to address issues that may arise. Better understanding of these issues can aid and advance appropriate global scientific collaboration. © 2014 John Wiley & Sons Ltd.

A Survey of Expectations About the Role of Robots in Robot-Assisted Therapy for Children with ASD: Ethical Acceptability, Trust, Sociability, Appearance, and Attachment.

PubMed

Coeckelbergh, Mark; Pop, Cristina; Simut, Ramona; Peca, Andreea; Pintea, Sebastian; David, Daniel; Vanderborght, Bram

2016-02-01

The use of robots in therapy for children with autism spectrum disorder (ASD) raises issues concerning the ethical and social acceptability of this technology and, more generally, about human-robot interaction. However, usually philosophical papers on the ethics of human-robot-interaction do not take into account stakeholders' views; yet it is important to involve stakeholders in order to render the research responsive to concerns within the autism and autism therapy community. To support responsible research and innovation in this field, this paper identifies a range of ethical, social and therapeutic concerns, and presents and discusses the results of an exploratory survey that investigated these issues and explored stakeholders' expectations about this kind of therapy. We conclude that although in general stakeholders approve of using robots in therapy for children with ASD, it is wise to avoid replacing therapists by robots and to develop and use robots that have what we call supervised autonomy. This is likely to create more trust among stakeholders and improve the quality of the therapy. Moreover, our research suggests that issues concerning the appearance of the robot need to be adequately dealt with by the researchers and therapists. For instance, our survey suggests that zoomorphic robots may be less problematic than robots that look too much like humans.

Ethics and public integrity in space exploration

NASA Astrophysics Data System (ADS)

Greenstone, Adam F.

2018-02-01

This paper discusses the National Aeronautics and Space Administration's (NASA) work to support ethics and public integrity in human space exploration. Enterprise Risk Management (ERM) to protect an organization's reputation has become widespread in the private sector. Government ethics law and practice is integral to a government entity's ERM by managing public sector reputational risk. This activity has also increased on the international plane, as seen by the growth of ethics offices in UN organizations and public international financial institutions. Included in this area are assessments to ensure that public office is not used for private gain, and that external entities are not given inappropriate preferential treatment. NASA has applied rules supporting these precepts to its crew since NASA's inception. The increased focus on public sector ethics principles for human activity in space is important because of the international character of contemporary space exploration. This was anticipated by the 1998 Intergovernmental Agreement for the International Space Station (ISS), which requires a Code of Conduct for the Space Station Crew. Negotiations among the ISS Partners established agreed-upon ethics principles, now codified for the United States in regulations at 14 C.F.R. § 1214.403. Understanding these ethics precepts in an international context requires cross-cultural dialogue. Given NASA's long spaceflight experience, a valuable part of this dialogue is understanding NASA's implementation of these requirements. Accordingly, this paper will explain how NASA addresses these and related issues, including for human spaceflight and crew, as well as the development of U.S. Government ethics law which NASA follows as a U.S. federal agency. Interpreting how the U.S. experience relates constructively to international application involves parsing out which dimensions relate to government ethics requirements that the international partners have integrated into the ISS Crew Code of Conduct, and which relate to other areas of U.S. administrative law. It is also constructive to identify areas where national and/or cultural perspectives may differ. Another reason for heightened focus on ethics is the increasing regularity of long duration human spaceflight. In earlier days of spaceflight astronauts had little time for anything other than mission operations. The increase in inflight personal time and opportunity for personal communications heightens the importance to spacefaring nations of advising on ethics obligations in real time. Through individual and collective action, stakeholders in evolving and future government space exploration will be able to effectively address ethics compliance and reputational risk.

Having and Raising Children: Unconventional Families, Hard Choices, and the Social Good.

ERIC Educational Resources Information Center

Narayan, Uma, Ed.; Bartkowiak, Julia J., Ed.

Noting that the term "family values" has achieved prominence in the rhetoric of political debate, this book compiles essays by philosophers, political scientists, and legal scholars exploring specific issues within the legal, ethical, and political dimensions of familial relationships. Collectively, the essays point out that many…

Research Politics: Some Issues in Conducting Research for Government as a Client

ERIC Educational Resources Information Center

Diko, Nolutho; Bantwini, Bongani D.

2013-01-01

Researchers are guided by their ideological and ethical viewpoints when conducting research. Doing research for government challenges them to confront these ideals head-on. This article explores the uncertain terrain researchers sometimes have to negotiate when conducting research for government, and discusses relations between researchers and…

The Electronic Classroom: A Handbook for Education in the Electronic Environment.

ERIC Educational Resources Information Center

Boschmann, Erwin, Ed.

This book explores emerging technologies and their use in secondary and higher education and in private, corporate, and government training environments. In addition to providing specific classroom applications of technology, the book treats issues of research, technology assessment, legal, copyright, and privacy rights, ethical considerations,…

Public Health Control Measures in Response to Global Pandemics and Drug Resistance.

PubMed

Price, Polly J

2015-01-01

These teaching materials provide problem-based exercises exploring the specific powers of governments to implement control measures in response to communicable disease. Topics include global pandemic disease and, in the United States, legal issues in tuberculosis control. © 2015 American Society of Law, Medicine & Ethics, Inc.

Ethical Issues in Instructional Technology: An Exploratory Framework

ERIC Educational Resources Information Center

Lucey, Thomas A.; Grant, Michael M.

2009-01-01

Purpose: The purpose of this paper is to explore a framework for considering moral K-12 instructional technology. It seeks to examine the extent that development of technology policies consider and respect affected parties interests. Design/methodology/approach: Interpreting morality as an economic concept that involves a reconciliation of…

Alignment of Standards and Assessments as an Accountability Criterion.

ERIC Educational Resources Information Center

La Marca, Paul M.

2001-01-01

Provides an overview of the concept of alignment and the role it plays in assessment and accountability systems. Discusses some methodological issues affecting the study of alignment and explores the relationship between alignment and test score interpretation. Alignment is not only a methodological requirement but also an ethical requirement.…

Lesson Plans To Advance Discussion of Ethical Issues.

ERIC Educational Resources Information Center

Swikle, Randy G.

2002-01-01

Presents lesson plans designed to enable high school students to recognize ethical issues involving the printed media and to give students practical experience in ethical decision-making using the newspaper as a learning tool. Includes 10 ethical issues and related case studies. (RS)

Your Genes, Your Choices: Exploring the Issues Raised by Genetic Research

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

Baker, C.

1999-05-31

Your Genes, Your Choices provides accurate information about the ethical, legal, and social implications of the Human Genome Project and genetic research in an easy-to-read style and format. Each chapter in the book begins with a brief vignette, which introduces an issue within a human story, and raises a question for the reader to think about as the basic science and information are presented in the rest of the chapter.

Metaclinical issues in the treatment of psychopolitical trauma.

PubMed

Fischman, Y

1998-01-01

Metaclinical implications of psychotherapy with individuals traumatized by violent political repression are explored, with an emphasis on ethical concerns in treatment. Issues addressed include the relevance of the sociopolitical context in the conceptualization of the trauma, the challenge of transcending cultural frameworks, the clinician's role in the reversal of collective denial, the interplay of motivation and countertransference, and the impact of questions of purpose and meaning in both survivors and clinicians interacting with trauma.

Social/Ethical Issues in Predictive Insider Threat Monitoring

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

Greitzer, Frank L.; Frincke, Deborah A.; Zabriskie, Mariah

2011-01-01

Combining traditionally monitored cybersecurity data with other kinds of organizational data is one option for inferring the motivations of individuals, which may in turn allow early prediction and mitigation of insider threats. While unproven, some researchers believe that this combination of data may yield better results than either cybersecurity or organizational data would in isolation. However, this nontraditional approach creates a potential conflict between goals, such as conflicts between organizational security improvements and individual privacy considerations. There are many facets to debate. Should warning signs of a potential malicious insider be addressed before a malicious event has occurred to preventmore » harm to the organization and discourage the insider from violating the organization’s rules? Would intervention violate employee trust or legal guidelines? What about the possibilities of misuse? Predictive approaches cannot be validated a priori; false accusations can affect the career of the accused; and collection/monitoring of certain types of data may affect employee morale. In this chapter, we explore some of the social and ethical issues stemming from predictive insider threat monitoring and discuss ways that a predictive modeling approach brings to the forefront social and ethical issues that should be considered and resolved by stakeholders and communities of interest.« less

Lifestyle Vaccines and Public Health: Exploring Policy Options for a Vaccine to Stop Smoking.

PubMed

Wolters, Anna; de Wert, Guido; van Schayck, Onno C P; Horstman, Klasien

2016-07-01

Experimental vaccines are being developed for the treatment of 'unhealthy lifestyles' and associated chronic illnesses. Policymakers and other stakeholders will have to deal with the ethical issues that this innovation path raises: are there morally justified reasons to integrate these innovative biotechnologies in future health policies? Should public money be invested in further research? Focusing on the case of an experimental nicotine vaccine, this article explores the ethical aspects of 'lifestyle vaccines' for public health. Based on findings from a qualitative study into a vaccine for smoking cessation, the article articulates possible value conflicts related to nicotine vaccination as an intervention in tobacco control. The 'vaccinization' of lifestyle disease piggybacks on the achievements of classic vaccines. Contrary to expectations of simplicity and success, quitting smoking with a vaccine requires a complex supportive network. Social justice and public trust may become important ethical challenges when deciding whether to use further public funds for research or whether to implement these innovative vaccines in the future.

The President's Physician: An African Play : Emmanuel Babatunde Omobowale, 2004, All Saints' Publishers (Ibadan, 978-978-37727-3-1, 77 pp.).

PubMed

Mayaki, Joseph Ajagunmolu

2017-12-01

This review examines issues relating to biomedical ethics and literature in the African drama The President's Physician by Emmanuel Babatunde Omobowale. The play investigates the psychological dilemma of Doctor Bituki Warunga, a personal physician to General Kalunga Ntibantunganyah who brutally and inhumanely rules Wavaria, a fictional African country. The doctor is faced with deciding to uphold the ethics of his profession versus terminating the tyrant's life to set the nation free. The play aims to help budding medical doctors rightly inculcate the principles of medical ethics-autonomy, beneficence, competence, and power-by providing a fictional platform to investigate difficult issues that can arise in clinical practice. The play highlights Warunga's complex dilemma as he struggles to uphold the Hippocratic Oath and at the same time satisfy his conscience towards his contribution to his country's freedom. This review explores the difficulties in decision-making when professional duties not only clash with personal preferences but also with the well-being of an entire nation. This discussion is done alongside the ethical concept of utilitarianism and also highlights significant literary concepts such as satire, symbolism, intertextuality, utopian aesthetics, and authorial vision as conveyed in the text.

Ethical issues in the prevention of suicide in prison.

PubMed

Bell, D

1999-10-01

The aim of this paper is to discuss ethical issues that arise in the care of suicidal patients within a prison context. Such a discussion provides a suitable framework for exploration of the broader question of how coercion may be exercised by psychiatrists in a morally justifiable, as opposed to abusive, manner. Literature relevant to the abuse of psychiatric power is reviewed. The means for immediate containment of highly suicidal patients in certain prison contexts is described and the paucity of relevant empirical research literature relating to this is identified. A framework is proposed to assist clinicians in making an ethical evaluation of coercive interventions that is applicable not only in the prevention of prisoner suicide, but also in the practice of psychiatry as a whole. Due regard for the moral dimensions of the relationship between psychiatrist and prisoner has the potential to radically transform the way the exercise of power is subjectively experienced by each of them. Coercion can be exercised by psychiatrists within an ethical framework which is not abusive. There will always be a risk that coercion will become an unhealthy habit of life within which the psychiatrist feels too comfortable.

Philosophical and ethical perspectives on cardiovascular disease risk in low-wage workers.

PubMed

Hwang, Won Ju

2011-01-01

One of the overriding goals of Healthy People 2010 is to reduce the health disparities observed among Americans. Because workers in small businesses tend to have little or no access to health screening or preventive health education programs, they may be unaware of their unique risk factors and are thus more at risk of cardiovascular disease (CVD). Furthermore, occupational health nurses are more likely to be available in health programs to employees in large rather than small businesses. The purpose of this paper is to illustrate how nursing values and philosophy might influence public health nurses' thinking about nursing science and ethical issues relating to the risk of CVD among low-wage workers. The following questions will guide the exploration of health disparities among low-wage workers: (a) What are the health disparities observed among low-wage workers with CVD risk? (b) What are the philosophical and ethical perspectives on the issues presented? (c) Based on these findings, how should limited resources be allocated? and (d) How does this affect nursing? These approaches will provide the foundation for developing a culturally sensitive ethical and philosophical perspective to prevent CVD and promote cardiovascular health among low-wage workers. © 2011 Wiley Periodicals, Inc.

A comparison of ethical issues in nursing practice across nursing units.

PubMed

Park, Mihyun; Jeon, Sang Hee; Hong, Hyun-Ja; Cho, Sung-Hyun

2014-08-01

The complexity and variety of ethical issues in nursing is always increasing, and those issues lead to special concerns for nurses because they have critical impacts on nursing practice. The purpose of this study was to gather comprehensive information about ethical issues in nursing practice, comparing the issues in different types of nursing units including general units, oncology units, intensive care units, operating rooms, and outpatient departments. The study used a descriptive research design. Ethics/human rights issues encountered by nurses in their daily nursing practice were identified by using the Ethical Issues Scale. The study sample included 993 staff nurses working in a university hospital in South Korea. This study was approved by the University Institutional Review Board. Completed questionnaires were returned sealed with signed informed consent. The most frequently and disturbingly encountered issues across nursing units were "conflicts in the nurse-physician relationship," "providing care with a possible risk to your health," and "staffing patterns that limit patient access to nursing care." The findings of this study showed that nurses from different nursing units experienced differences in the types or frequency of ethical issues. In particular, intensive care units had the greatest means of all the units in all three component scales including end-of-life treatment issues, patient care issues, and human rights issues. Nurses experienced various ethical challenges in their daily practice. Of the ethical issues, some were distinctively and frequently experienced by nurses in a specific unit. This study suggested that identifying and understanding specific ethical issues faced by nurses in their own areas may be an effective educational approach to motivate nurses and to facilitate nurses' reflection on their experiences. © The Author(s) 2014.

Music Therapy and Spiritual Care in End-of-Life: A Qualitative Inquiry into Ethics and Training Issues Identified by Chaplains and Music Therapists.

PubMed

Masko, Meganne K

2016-01-01

Music therapists are increasingly employed by hospices. As such, they are often called upon to provide additional spiritual care to patients receiving end-of-life care. However, researchers have not yet examined the appropriateness of music therapists providing spiritual care as part of the hospice team, or ethics and training issues related to music therapist-led spiritual care. The purpose of this study was to explore the thoughts and attitudes of hospice chaplains and music therapists (MTs) about ethics and training issues related to music therapists providing spiritual care as part of the hospice interdisciplinary team. The study used semi-structured interviews with a purposive sample of music therapists and chaplains specializing in hospice care as part of a larger exploratory mixed methods study. Each interview was recorded, transcribed, and analyzed using a two-step process including both a modified phenomenological inductive approach and thematic analysis. Participants discussed ethics and training issues related to the provision of music therapist-led spiritual care as part of the hospice team. These issues included scope of practice, cultural competence and maintaining personal boundaries, and spiritual care training topics such as educational content and educational methods. While it was clear that both chaplains and music therapists felt it was appropriate for music therapists to provide spiritual care as part of the hospice team, there is a need for formal and informal spiritual care training for music therapists doing this type of work. Training should potentially include information about comparative religions, cultural competence, scope of practice, and maintaining personal boundaries. © the American Music Therapy Association 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

(The Ethics of) Teaching Science and Ethics: A Collaborative Proposal.

PubMed

Kabasenche, William P

2014-12-01

I offer a normative argument for a collaborative approach to teaching ethical issues in the sciences. Teaching science ethics requires expertise in at least two knowledge domains-the relevant science(s) and philosophical ethics. Accomplishing the aims of ethics education, while ensuring that science ethics discussions remain grounded in the best empirical science, can generally best be done through collaboration between a scientist and an ethicist. Ethics as a discipline is in danger of being misrepresented or distorted if presented by someone who lacks appropriate disciplinary training and experience. While there are exceptions, I take philosophy to be the most appropriate disciplinary domain in which to gain training in ethics teaching. Science students, who must be prepared to engage with many science ethics issues, are poorly served if their education includes a misrepresentation of ethics or specific issues. Students are less well prepared to engage specific issues in science ethics if they lack an appreciation of the resources the discipline of ethics provides. My collaborative proposal looks at a variety of ways scientists and ethicists might collaborate in the classroom to foster good science ethics education.

Ethical and Social Issues in Health Research Involving Incarcerated People.

PubMed

Coughlin, Steven S; Lewis, Sharon R; Smith, Selina A

2016-01-01

The use of inmates in research in the U.S. was restricted by the recommendations of the National Commission and by federal regulations and guidelines that followed. By the 1980s, many health care officials became concerned about the exclusion of inmates from experimental treatments for human immunodeficiency virus infection (HIV). These developments in ethics occurred in the context of racial/ethnic disparities in health. In this article, ethical considerations in clinical and public health research on HIV in prison and jail settings are considered. Ethical considerations in mental health research are summarized as well as issues pertaining to research involving female inmates. Issues related to oversight of research involving incarcerated people are considered along with the ethics of public health research. The ethics of research involving incarcerated people extends beyond traditional issues in human subjects ethics to include issues within the domains of bioethics and public health ethics.

Ethical and Social Issues in Health Research Involving Incarcerated People

PubMed Central

Coughlin, Steven S.; Lewis, Sharon R.; Smith, Selina A.

2016-01-01

The use of inmates in research in the U.S. was restricted by the recommendations of the National Commission and by federal regulations and guidelines that followed. By the 1980s, many health care officials became concerned about the exclusion of inmates from experimental treatments for human immunodeficiency virus infection (HIV). These developments in ethics occurred in the context of racial/ethnic disparities in health. In this article, ethical considerations in clinical and public health research on HIV in prison and jail settings are considered. Ethical considerations in mental health research are summarized as well as issues pertaining to research involving female inmates. Issues related to oversight of research involving incarcerated people are considered along with the ethics of public health research. The ethics of research involving incarcerated people extends beyond traditional issues in human subjects ethics to include issues within the domains of bioethics and public health ethics. PMID:27133509

Clinical Ethics in Gabon: The Spectrum of Clinical Ethical Issues Based on Findings from In-Depth Interviews at Three Public Hospitals.

PubMed

Sippel, Daniel; Marckmann, Georg; Ndzie Atangana, Etienne; Strech, Daniel

2015-01-01

Unlike issues in biomedical research ethics, ethical challenges arising in daily clinical care in Sub-Saharan African countries have not yet been studied in a systematic manner. However this has to be seen as a distinct entity as we argue in this paper. Our aim was to give an overview of the spectrum of clinical ethical issues and to understand what influences clinical ethics in the Sub-Saharan country of Gabon. In-depth interviews with 18 health care professionals were conducted at three hospital sites in Gabon. Interview transcripts were analyzed using a grounded theory approach (open and axial coding), giving a qualitative spectrum of categories for clinical ethical issues. Validity was checked at a meeting with study participants and other health care experts in Gabon after analysis of the data. Twelve main categories (with 28 further-specified subcategories) for clinical ethical issues were identified and grouped under three core categories: A) micro level: "confidentiality and information", "interpersonal, relational and behavioral issues", "psychological strain of individuals", and "scarce resources"; B) meso level: "structural issues of medical institutions", "issues with private clinics", "challenges connected to the family", and "issues of education, training and competence"; and C) macro level: "influence of society, culture, religion and superstition", "applicability of western medicine", "structural issues on the political level", and "legal issues". Interviewees reported a broad spectrum of clinical ethical issues that go beyond challenges related to scarce financial and human resources. Specific socio-cultural, historical and educational backgrounds also played an important role. In fact these influences are central to an understanding of clinical ethics in the studied local context. Further research in the region is necessary to put our study into perspective. As many participants reported a lack of awareness of ethical issues amongst other health care professionals in daily clinical practice, we suggest that international organizations and national medical schools should consider infrastructure and tools to improve context-sensitive capacity building in clinical ethics for Sub-Saharan African countries like Gabon.

Substance use disorder genetic research: investigators and participants grapple with the ethical issues.

PubMed

Coors, Marilyn E; Raymond, Kristen M

2009-04-01

This qualitative research examined the ethical concerns regarding the psychosocial issues, research design and implementation, and application of psychiatric genetic research on substance use disorders (SUD) from multiple perspectives. A literature review of the bioethics literature related to psychiatric genetics and focus groups explored the ethical implications of SUD genetic research. Twenty-six National Institute on Drug Abuse funded principal investigators in the field of psychiatric genetic research, nine adolescent patients in residential SUD treatment, and 10 relatives of patients participated in focus groups (held separately). The focus groups were recorded, transcribed, and the content was analyzed. The themes that emerged from the literature and the focus group transcripts were organized by using NVIVO7, a software package designed to manage, analyze, and compare narrative data. Investigators and the literature expressed similar concerns regarding the ethical concerns associated with psychiatric genetic research including violation of privacy, misunderstanding about psychiatric genetics, stigmatization, commercialization, discrimination, eugenics, consequences of research on illegal behavior, unforeseen consequences, altered notion of individual responsibility, and others. Patients and their relatives showed little familiarity with the ethical issues as identified by professionals and little concern regarding most of the potential risks. The exception was apprehension associated with potential criminal justice uses of stored genetic information, in particular enforced therapy and stigmatization, which elicited some concern from all perspectives. The challenge for further research is to identify risks and benefits of SUD research that are germane in a behaviorally disinhibited population and devise effective tools to communicate information to participants through an improved informed consent process.

Substance Use Disorder Genetic Research: Investigators and Participants Grapple with the Ethical Issues

PubMed Central

Raymond, Kristen M.

2009-01-01

Objective This qualitative research examined the ethical concerns regarding the psychosocial issues, research design and implementation, and application of psychiatric genetic research on substance use disorders (SUD) from multiple perspectives. Method A literature review of the bioethics literature related to psychiatric genetics and focus groups explored the ethical implications of SUD genetic research. Twenty-six National Institute on Drug Abuse (NIDA) funded principal investigators in the field of psychiatric genetic research, 9 adolescent patients in residential SUD treatment, and 10 relatives of patients participated in focus groups (held separately). The focus groups were recorded, transcribed, and the content was analyzed. The themes that emerged from the literature and the focus group transcripts were organized using NVIVO7, a software package designed to manage, analyze and compare narrative data. Results Investigators and the literature expressed similar concerns regarding the ethical concerns associated with psychiatric genetic research including violation of privacy, misunderstanding about psychiatric genetics, stigmatization, commercialization, discrimination, eugenics, consequences of research on illegal behavior, unforeseen consequences, altered notion of individual responsibility, and others. Patients and their relatives demonstrated little familiarity with the ethical issues as identified by professionals and little concern regarding most of the potential risks. The exception was apprehension associated with potential criminal justice uses of stored genetic information and enforced therapy, which elicited some concern from all perspectives. Conclusions The challenge for further research is to identify risks and benefits of SUD research that are germane in a behaviorally disinhibited population and devise effective tools to communicate information to participants through an improved informed consent process. PMID:19668113

Access to investigational medicinal products for minors in Europe: ethical and regulatory issues in negotiating children's access to investigational medicines.

PubMed

Pinxten, Wim; Nys, Herman; Dierickx, Kris

2010-12-01

Patients who search for a better treatment, an increased quality of life, or even a chance to preserve life itself may claim to have an interest in accessing investigational medicinal products (IMP), particularly when no validated treatment for their disease or condition exists. For many, awaiting the uncertain and time-consuming process of converting an IMP into an approved drug may not appear a realistic option, as prognoses may be grim and a dramatic outcome may seem hard to avert. Gaining access to an IMP, however, often proves to be a difficult enterprise with a highly uncertain outcome. In addition, the process of seeking access to IMP is surrounded by various ethical issues that will be explored in this article. This paper explores the ethical concerns in two potential tracks of seeking access to IMP for minors: on an individual basis, or collectively, as a patient organisation. In this discourse, several unique ethical and regulatory concerns related to the direct negotiation of access to IMP for minor patients are identified, with a focus on product safety, the recruitment of research subjects, the unnoticed entry of market mechanisms in the recruitment of research subjects, and the sidelining of third parties in the recruitment process. The paper concludes with a concise reflection on the way forward. The quest for access to investigational drugs is particularly relevant to paediatric practice, in which a significant share of the drugs prescribed has never been tested in children or labelled for use in the paediatric population.

Simple Gifts: Ethical Issues in the Conduct of Person-Based Composition Research.

ERIC Educational Resources Information Center

Anderson, Paul V.

1998-01-01

Discusses ethical issues involved with person-based research. Discusses the ethical discourse embodied in the "Nuremberg Code," federal regulations, and the "Belmont Report." Discusses several specific issues in research ethics to illustrate how this discourse provides new ways of thinking about what must be done to treat…

Ethics in the College-Level Business Classroom: A Tripartite Examination.

ERIC Educational Resources Information Center

DuFrene, Debbie D.; And Others

This paper discusses the need for Ethics instruction in college business curricula and presents study results in determining the issues to include in such instruction. Ratings of potential ethical issues were obtained from three cohorts (business faculty, business practitioners, and business students) using the Ethical Issues Rating Scale…

Modified Policy-Delphi study for exploring obesity prevention priorities.

PubMed

Haynes, Emily; Palermo, Claire; Reidlinger, Dianne P

2016-09-06

Until now, industry and government stakeholders have dominated public discourse about policy options for obesity. While consumer involvement in health service delivery and research has been embraced, methods which engage consumers in health policy development are lacking. Conflicting priorities have generated ethical concern around obesity policy. The concept of 'intrusiveness' has been applied to policy decisions in the UK, whereby ethical implications are considered through level of intrusiveness to choice; however, the concept has also been used to avert government regulation to address obesity. The concept of intrusiveness has not been explored from a stakeholder's perspective. The aim is to investigate the relevance of intrusiveness and autonomy to health policy development, and to explore consensus on obesity policy priorities of under-represented stakeholders. The Policy-Delphi technique will be modified using the James Lind Alliance approach to collaborative priority setting. A total of 60 participants will be recruited to represent three stakeholder groups in the Australian context: consumers, public health practitioners and policymakers. A three-round online Policy-Delphi survey will be undertaken. Participants will prioritise options informed by submissions to the 2009 Australian Government Inquiry into Obesity, and rate the intrusiveness of those proposed. An additional round will use qualitative methods in a face-to-face discussion group to explore stakeholder perceptions of the intrusiveness of options. The novelty of this methodology will redress the balance by bringing the consumer voice forward to identify ethically acceptable obesity policy options. Ethical approval was granted by the Bond University Health Research Ethics Committee. The findings will inform development of a conceptual framework for analysing and prioritising obesity policy options, which will be relevant internationally and to ethical considerations of wider public health issues. The findings will be disseminated through peer-reviewed publications, conference presentations and collaborative platforms of policy and science. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

PubMed

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

2014-09-01

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

(ETHNO-)MEDICAL ETHICS IN GLOBALIZING CHINA: TRACING LOCAL KNOWLEDGE AND ADAPTATION OF BIOMEDICINE.

PubMed

Micollier, Evelyne

2015-12-01

Encounters between several bodies of therapeutic knowledge have led to a restructuring of the entire health system, including a transformation in medical ethics. Defining "new ethics" with both Chinese and international characteristics, is part of the ongoing knowledge production process: plural health ideas, practices and medical sciences develop within the broader framework of social and economic transition. Such transition simultaneously reveals and encourages China's influence and position in an era of globalization including in the technical and knowledge production domains. Re-alignments in medical ethics in Reform China (post-1979) highlight a rather under-explored aspect of medical plurality enabling these ethics to be used as an analytical lens to provide information about social and political issues. In this article, two sets of ethical principles, one from Late Imperial China (Late Ming Era), the other from post-Mao China (1980s), are detailed and analysed. They were selected as case-studies mainly because they reflected at the time of their emergence an on-going radical change in society in the realm of health and medicine. Therefore both sets unveil the process of legitimizing a "Chinese medicine" in a context of epistemological shift: such a process takes various conceptual and practicalforms framed along the lines of the current dominant ideological system and constrained by socio-economic and political factors. Finally, issues relative to research ethics, bioethics and the New Health Reform guidelines raised in the 2000s, which represents also a significant historical turn for China, are discussed. Drawn from the overall discussion throughout the text, several concluding remarks contribute to advocate for "win-win" encounters--from the East to the West and from the South to the South, and for more implementable transnational/global ethics designing.

The emergence of ethical issues in the provision of online sexual health outreach for gay, bisexual, two-spirit and other men who have sex with men: perspectives of online outreach workers.

PubMed

Fantus, Sophia; Souleymanov, Rusty; Lachowsky, Nathan J; Brennan, David J

2017-11-03

Mobile applications and socio-sexual networking websites are used by outreach workers to respond synchronously to questions and provide information, resources, and referrals on sexual health and STI/HIV prevention, testing, and care to gay, bisexual and other men who have sex with men (GB2M). This exploratory study examined ethical issues identified by online outreach workers who conduct online sexual health outreach for GB2M. Semi-structured individual interviews were conducted between November 2013 and April 2014 with online providers and managers (n = 22) to explore the benefits, challenges, and ethical implications of delivering online outreach services in Ontario, Canada. Interviews were digitally recorded and transcribed verbatim. Thematic analyses were conducted, and member-checking, analyses by multiple coders, and peer debriefing supported validity and reliability. Four themes emerged on the ethical queries of providing online sexual health outreach for GB2M: (a) managing personal and professional boundaries with clients; (b) disclosing personal or identifiable information to clients; (c) maintaining client confidentiality and anonymity; and (d) security and data storage measures of online information. Participants illustrated familiarity with potential ethical challenges, and discussed ways in which they seek to mitigate and prevent ethical conflict. Implications of this analysis for outreach workers, researchers, bioethicists, and policy-makers are to: (1) understand ethical complexities associated with online HIV prevention and outreach for GB2M; (2) foster dialogue to recognize and address potential ethical conflict; and (3) identify competencies and skills to mitigate risk and promote responsive and accessible online HIV outreach.

Ethics-sensitivity of the Ghana national integrated strategic response plan for pandemic influenza.

PubMed

Laar, Amos; DeBruin, Debra

2015-05-07

Many commentators call for a more ethical approach to planning for influenza pandemics. In the developed world, some pandemic preparedness plans have already been examined from an ethical viewpoint. This paper assesses the attention given to ethics issues by the Ghana National Integrated Strategic Plan for Pandemic Influenza (NISPPI). We critically analyzed the Ghana NISPPI's sensitivity to ethics issues to determine how well it reflects ethical commitments and principles identified in our review of global pandemic preparedness literature, existing pandemic plans, and relevant ethics frameworks. This paper reveals that important ethical issues have not been addressed in the Ghana NISPPI. Several important ethical issues are unanticipated, unacknowledged, and unplanned for. These include guidelines on allocation of scarce resources, the duties of healthcare workers, ethics-sensitive operational guidelines/protocols, and compensation programs. The NISPPI also pays scant attention to use of vaccines and antivirals, border issues and cooperation with neighboring countries, justification for delineated actions, and outbreak simulations. Feedback and communication plans are nebulous, while leadership, coordination, and budgeting are quite detailed. With respect to presentation, the NISPPI's text is organized around five thematic areas. While each area implicates ethical issues, NISPPI treatment of these areas consistently fails to address them. Our analysis reveals a lack of consideration of ethics by the NISPPI. We contend that, while the plan's content and fundamental assumptions provide support for implementation of the delineated public health actions, its consideration of ethical issues is poor. Deficiencies include a failure to incorporate guidelines that ensure fair distribution of scarce resources and a lack of justification for delineated procedures. Until these deficiencies are recognized and addressed, Ghana runs the risk of rolling out unjust and ethically indefensible actions with real negative effects in the event of a pandemic. Soliciting inputs from the public and consultation with ethicists during the next revision of the NISPPI will be useful in addressing these issues.

Roles and responsibilities: theoretical issues in the definition of consultation liaison psychiatry.

PubMed

Agich, G J

1985-05-01

Central to much medical ethical analysis is the concept of the role of the physician. While this concept plays an important role in medical ethics, its function is largely tacit. The present paper attempts to bring the concept of a social role to prominence by focusing on an historically recent and rather richly contextured role, namely, that of consultation liaison psychiatry. Since my intention is primarily theoretical, I largely ignore the empirical studies which purport to develop the detailed functioning of the role. My limited intent is to draw attention to the theoretical complexity of the consultation liaison role as an example of the general relevance of role concepts to medical ethics. For this reason, consultation liaison psychiatry will function as an illustration of fundamental concepts of medical ethics rather than as a subject of analysis in its own right. Similarly, the concept of the social role will be developed only as is necessary to explore the general relationship between the consultation liaison role and ethical analysis.

Exploring ethics in practice: creating moral community in healthcare one place at a time.

PubMed

Scott, Sandra L; Marck, Patricia; Barton, Sylvia

2011-01-01

Examining everyday ethical situations in clinical practice is a vital but often overlooked activity for nursing leaders and practitioners, as well as most other healthcare professionals. In this paper, we share how a series of practitioner-led Ethics in Practice sessions (EIPs), which originated within a busy urban teaching hospital, were adapted and translated, first into home care and more recently, into an EIP session for public health nurses. The success of EIP sessions rests with their focus on issues that are selected by practitioners. The aims of EIPs are to foster ethical leadership within communities of practice, create safe places to share concerns, use relevant research evidence and other literature to support informed discussion, and generate stories that deepen our understanding of the ethical situations we encounter in our work. We hope our experience inspires nursing leaders, nursing colleagues and fellow healthcare professionals to consider using the EIP approach to build moral community and the idea of moral imagination with their clinical colleagues, one place at a time.

Ethical aspects of malaria control and research.

PubMed

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

2015-12-22

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

Identification of shareholder ethics and responsibilities in online reverse auctions for construction projects.

PubMed

Hatipkarasulu, Yilmaz; Gill, James H

2004-04-01

The increasing number of companies providing internet services and auction tools helped popularize the online reverse auction trend for purchasing commodities and services in the last decade. As a result, a number of owners, both public and private, accepted the online reverse auctions as the bidding technique for their construction projects. Owners, while trying to minimize their costs for construction projects, are also required to address their ethical responsibilities to the shareholders. In the case of online reverse auctions for construction projects, the ethical issues involved in the bidding technique directly reflects on the owner's ethical and social responsibilities to their shareholders. The goal of this paper is to identify the shareholder ethics and responsibilities in online reverse auctions for construction projects by analyzing the ethical issues for the parties involved in the process. The identification of the ethical issues and responsibilities requires clear definition and understanding of professional ethics and the roles of the involved parties. In this paper, first, the concept of professional ethics and social responsibility is described in a general form. To illustrate the ethical issues and responsibilities, a sample case of bidding for a construction project using online reverse auction techniques is presented in which the shareholders were actively involved in questioning the ethical issues. The issues involved in the bidding process and their reflection on the shareholder responsibilities are described and analyzed for each stage of the process. A brief discussion of the overall process is also included to address the general ethical issues involved in online reverse auctions.

Clinical ethics issues in HIV care in Canada: an institutional ethnographic study.

PubMed

Kaposy, Chris; Greenspan, Nicole R; Marshall, Zack; Allison, Jill; Marshall, Shelley; Kitson, Cynthia

2017-02-06

This is a study involving three HIV clinics in the Canadian provinces of Newfoundland and Labrador, and Manitoba. We sought to identify ethical issues involving health care providers and clinic clients in these settings, and to gain an understanding of how different ethical issues are managed by these groups. We used an institutional ethnographic method to investigate ethical issues in HIV clinics. Our researcher conducted in-depth semi-structured interviews, compiled participant observation notes, and studied health records in order to document ethical issues in the clinics, and to understand how health care providers and clinic clients manage and resolve these issues. We found that health care providers and clinic clients have developed work processes for managing ethical issues of various types: conflicts between client-autonomy and public health priorities ("treatment as prevention"), difficulties associated with the criminalization of nondisclosure of HIV positive status, challenges with non-adherence to HIV treatment, the protection of confidentiality, barriers to treatment access, and negative social determinants of health and well-being. Some ethical issues resulted from structural disadvantages experienced by clinic clients. The most striking findings in our study were the negative social determinants of health and well-being experienced by some clinic clients - such as experiences of violence and trauma, poverty, racism, colonization, homelessness, and other factors affecting well-being such as problematic substance use. These negative determinants were at the root of other ethical issues, and are themselves of ethical concern.

Symbiotic empirical ethics: a practical methodology.

PubMed

Frith, Lucy

2012-05-01

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

[Moral problems in home health care--a descriptive ethical study].

PubMed

Lauxen, Oliver

2009-12-01

In Germany there is an increasing importance of home health care and nurses that are employed in the home care sector often have to face ethical issues. The purpose of this ethnographic study was to explore moral problems in the daily practice of these nurses. The method used was qualitative interviews with 20 nurses which have been analysed by content analysis. The results showed that the ethical principle of beneficence was the core concept for the participants. Moral problems arise when nurses cannot act in accordance to this principle or when they cannot determine the good in a situation. In particular, there were four types of moral problems: "beneficence vs. autonomy", "beneficence vs. justice", "beneficence vs. loyalty" and "The good cannot be determined". The way nurses in home health care address moral problems should be improved. Some participants lack ethical competencies. Furthermore, appropriate support services for dealing with moral problems have to be designed.

You got a problem with that? Exploring evaluators' disagreements about ethics.

PubMed

Morris, M; Jacobs, L R

2000-08-01

A random sample of American Evaluation Association (AEA) members were surveyed for their reactions to three case scenarios--informed consent, impartial reporting, and stakeholder involvement--in which an evaluator acts in a way that could be deemed ethically problematic. Significant disagreement among respondents was found for each of the scenarios, in terms of respondents' views of whether the evaluator had behaved unethically. Respondents' explanations of their judgments support the notion that general guidelines for professional behavior (such as AEA's Guiding Principles for Evaluators) can encompass sharply conflicting interpretations of how evaluators should behave in specific situations. Respondents employed in private business/consulting were less likely than those in other settings to believe that the scenarios portrayed unethical behavior by the evaluator, a finding that underscores the importance of taking contextual variables into account when analyzing evaluators' ethical perceptions. The need for increased dialogue among evaluators who represent varied perspectives on ethical issues is addressed.

New trends of short-term humanitarian medical volunteerism: professional and ethical considerations.

PubMed

Asgary, Ramin; Junck, Emily

2013-10-01

Short-term humanitarian medical volunteerism has grown significantly among both clinicians and trainees over the past several years. Increasingly, both volunteers and their respective institutions have faced important challenges in regard to medical ethics and professional codes that should not be overlooked. We explore these potential concerns and their risk factors in three categories: ethical responsibilities in patient care, professional responsibility to communities and populations, and institutional responsibilities towards trainees. We discuss factors increasing the risk of harm to patients and communities, including inadequate preparation, the use of advanced technology and the translation of Western medicine, issues with clinical epidemiology and test utility, difficulties with the principles of justice and clinical justice, the lack of population-based medicine, sociopolitical effects of foreign aid, volunteer stress management, and need for sufficient trainee supervision. We review existing resources and offer suggestions for future skill-based training, organisational responsibilities, and ethical preparation.

"Robin Hood" of techno-Turkey or organ trafficking in the state of ethical beings.

PubMed

Sanal, Aslihan

2004-09-01

Dr S. is a famous transplant surgeon in the Middle East. He operates "underground" on wealthy patients in different countries, from Israel to Turkey to Russia. The media refer to him as the "Organ Mafia doctor," and patients diagnosed with renal failure speak of him sardonically as "Robin Hood," acknowledging that he takes organs from the poor to give to the rich. But ethical issues of organ trafficking are not limited to marginal private clinics and "Mafia" doctors. All-living related organ transplants in Turkey involve similar ethical dilemmas: many related or nonrelated organ recipients pay their donors, and demand continues to rise. This paper explores practices in state and university hospitals and the ethical dilemmas doctors encounter to understand where and how judicial, cultural, and social categories of "human rights" and "crime" are constructed in our high-tech world.

Science and ethics: Some issues for education

NASA Astrophysics Data System (ADS)

Andrew, Jennifer; Robottom, Ian

2001-11-01

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.

HTA – Algorithm or Process?

PubMed Central

Culyer, Anthony J.

2016-01-01

Daniels, Porteny and Urrutia et al make a good case for the idea that that public decisions ought to be made not only "in the light of" evidence but also "on the basis of" budget impact, financial protection and equity. Health technology assessment (HTA) should, they say, be accordingly expanded to consider matters additional to safety and cost-effectiveness. They also complain that most HTA reports fail to develop ethical arguments and generally do not even mention ethical issues. This comment argues that some of these defects are more apparent than real and are not inherent in HTA – as distinct from being common characteristics found in poorly conducted HTAs. More generally, HTA does not need "extension" since (1) ethical issues are already embedded in HTA processes, not least in their scoping phases, and (2) HTA processes are already sufficiently flexible to accommodate evidence about a wide range of factors, and will not need fundamental change in order to accommodate the new forms of decision-relevant evidence about distributional impact and financial protection that are now starting to emerge. HTA and related techniques are there to support decision-makers who have authority to make decisions. Analysts like us are there to support and advise them (and not to assume the responsibilities for which they, and not we, are accountable). The required quality in HTA then becomes its effectiveness as a means of addressing the issues of concern to decision-makers. What is also required is adherence by competent analysts to a standard template of good analytical practice. The competencies include not merely those of the usual disciplines (particularly biostatistics, cognitive psychology, health economics, epidemiology, and ethics) but also the imaginative and interpersonal skills for exploring the "real" question behind the decision-maker’s brief (actual or postulated) and eliciting the social values that necessarily pervade the entire analysis. The product of such exploration defines the authoritative scope of an HTA. PMID:27694664

Identifying ethical issues of the Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists.

PubMed

Jenkins, Constance L; Elliott, Aaron R; Harris, Janet R

2006-08-01

The purposes of this study were to identify the ethical issues Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists (CRNAs) encountered in their anesthesia practice and how disturbed they were by these issues. This descriptive study used a secondary data analysis of a cross-sectional survey of Army Nurse Corps officers and Department of the Army civilian registered nurses (N = 5,293). The CRNA subset (n = 97) was obtained from questionnaires that indicated a primary practice setting as anesthesia. The most frequently occurring ethical issue identified was conflict in the nurse-physician relationship, whereas the most disturbing issue was working with incompetent/impaired colleagues. Unresolved ethical conflicts can negatively influence the nurses' morale, leading to avoidance of the issue and contributing to burnout. Identifying the ethical issues and disturbance level experienced by CRNAs should contribute to the development of an ethics education program that addresses issues encountered in CRNA practice.

Ethical Issues Associated with the Use of Interactive Technology in Learning Environments.

ERIC Educational Resources Information Center

Bork, Alfred

1988-01-01

Discusses general social, moral, and ethical issues connected with computers in education; considers ethical issues related to the development of computer-based learning materials; and examines the use of the computer as a medium for ethical and moral education. Highlights include equity of access, games and learning, and cultural bias. (seven…

The Ethical Issues Rating Scale: An Instrument for Measuring Ethical Orientation of College Students toward Various Business Practices.

ERIC Educational Resources Information Center

Daniel, Larry G.; And Others

1997-01-01

Factor analysis of data from 213 college business students supported the existence of 5 constructs for the Ethical Issues Rating Scale, an instrument measuring respondents' assessment of the importance of various ethical issues. Suggestions about refining the instrument and using it are discussed. (SLD)

Ethical Issues Relating to Living Organ Donation in China.

PubMed

Wu, Y; Yang, T; Li, L; Ma, W

2016-01-01

Although great developments have been made in living organ donation, the ethical issues relating to living organ donation still face dilemmas in China. In this report, we discuss several ethical issues concerning living organ donation in China. It is argued that living organ donation in China could make further progress if the ethical issues proposed in this report are carefully considered. Copyright © 2016 Elsevier Inc. All rights reserved.

Crossing the Divide within Continental Philosophy: Reconstruction, Deconstruction, Dialogue and Education

ERIC Educational Resources Information Center

Papastephanou, Marianna

2012-01-01

In this article I explore some points of convergence between Habermas and Derrida that revolve around the intersection of ethical and epistemological issues in dialogue. After some preliminary remarks on how dialogue and language are viewed by Habermas and Derrida as standpoints for departing from the philosophy of consciousness and from…

The Human Genome Project and Eugenics: Identifying the Impact on Individuals with Mental Retardation.

ERIC Educational Resources Information Center

Kuna, Jason

2001-01-01

This article explores the impact of the mapping work of the Human Genome Project on individuals with mental retardation and the negative effects of genetic testing. The potential to identify disabilities and the concept of eugenics are discussed, along with ethical issues surrounding potential genetic therapies. (Contains references.) (CR)

Following Phaedrus: Alternate Choices in Surmounting the Reliability/Validity Dilemma

ERIC Educational Resources Information Center

Slomp, David H.; Fuite, Jim

2004-01-01

Specialists in the field of large-scale, high-stakes writing assessment have, over the last forty years alternately discussed the issue of maximizing either reliability or validity in test design. Factors complicating the debate--such as Messick's (1989) expanded definition of validity, and the ethical implications of testing--are explored. An…

Integrating Social Responsibility into an Entrepreneurship Education Program: A Case Study

ERIC Educational Resources Information Center

Maistry, Suriamurthee Moonsamy; Ramdhani, Jugathambal

2010-01-01

Entrepreneurship education in South Africa is often presented as a neutral discipline. Yet fundamental to any entrepreneurship education program should be the integration of key issues, such as ethics, values and social responsibility. This paper reports on a study that set out to explore student teachers experiences of engaging in an…

Personalizing the Scholarship of Teaching and Learning: A 2001-2002 Carnegie Scholars Project Report.

ERIC Educational Resources Information Center

Gayle, Barbara Mae

Societal acceptance of polarized discourse poses challenges for communication professors engaged in teaching ethical public speaking processes to undergraduates. This study explores how creating caring and safe environments for the discussion of difficult dialogues is paramount to creating civil and reasoned discourse that can address issues of…

Children's Film as an Instrument of Moral Education

ERIC Educational Resources Information Center

Wonderly, Monique

2009-01-01

This paper explores two philosophical treasures that we often neglect: the moral faculties of children and the pedagogic virtues of film. My thesis consists of three primary claims: (1) when properly educated, children are capable of thinking critically about ethical issues; (2) moral edification ought to have the dual aims of developing this…

Clinical Ethics in Gabon: The Spectrum of Clinical Ethical Issues Based on Findings from In-Depth Interviews at Three Public Hospitals

PubMed Central

Sippel, Daniel; Marckmann, Georg; Ndzie Atangana, Etienne; Strech, Daniel

2015-01-01

Introduction Unlike issues in biomedical research ethics, ethical challenges arising in daily clinical care in Sub-Saharan African countries have not yet been studied in a systematic manner. However this has to be seen as a distinct entity as we argue in this paper. Our aim was to give an overview of the spectrum of clinical ethical issues and to understand what influences clinical ethics in the Sub-Saharan country of Gabon. Materials and Methods In-depth interviews with 18 health care professionals were conducted at three hospital sites in Gabon. Interview transcripts were analyzed using a grounded theory approach (open and axial coding), giving a qualitative spectrum of categories for clinical ethical issues. Validity was checked at a meeting with study participants and other health care experts in Gabon after analysis of the data. Results Twelve main categories (with 28 further-specified subcategories) for clinical ethical issues were identified and grouped under three core categories: A) micro level: “confidentiality and information”, “interpersonal, relational and behavioral issues”, “psychological strain of individuals”, and “scarce resources”; B) meso level: “structural issues of medical institutions”, “issues with private clinics”, “challenges connected to the family”, and “issues of education, training and competence”; and C) macro level: “influence of society, culture, religion and superstition”, “applicability of western medicine”, “structural issues on the political level”, and “legal issues”. Discussion Interviewees reported a broad spectrum of clinical ethical issues that go beyond challenges related to scarce financial and human resources. Specific socio-cultural, historical and educational backgrounds also played an important role. In fact these influences are central to an understanding of clinical ethics in the studied local context. Further research in the region is necessary to put our study into perspective. As many participants reported a lack of awareness of ethical issues amongst other health care professionals in daily clinical practice, we suggest that international organizations and national medical schools should consider infrastructure and tools to improve context-sensitive capacity building in clinical ethics for Sub-Saharan African countries like Gabon. PMID:26161655

ENRICH Forum: Ethical aNd Regulatory Issues in Cancer ResearcH

Cancer.gov

ENRICH Forum: Ethical aNd Regulatory Issues in Cancer ResearcH, designed to stimulate dialogue on ethical and regulatory issues in cancer research and promote awareness of developing policies and best practices.

Conceptualizing boundaries for the professionalization of healthcare ethics practice: a call for empirical research.

PubMed

Brown, Nancy C; McGee, Summer Johnson

2014-12-01

One of the challenges of modern healthcare ethics practice is the navigation of boundaries. Practicing healthcare ethicists in the performance of their role must navigate meanings, choices, decisions and actions embedded in complex cultural and social relationships amongst diverse individuals. In light of the evolving state of modern healthcare ethics practice and the recent move toward professionalization via certification, understanding boundary navigation in healthcare ethics practice is critical. Because healthcare ethics is endowed with many boundaries which often delineate concerns about professional expertise and authority, epistemological reflection on the relationship between theory and practice points toward the social context as relevant to the conceptualization of boundaries. The skills of social scientists may prove helpful to provide data and insights into the conceptualization and navigation of clinical ethics qua profession. Empirical ethics research, which combines empirical description (usually social scientific) with normative-ethical analysis and reflection, is a way forward as we engage and reflect upon issues which have implications for practice standards and professionalization of the role. This requires cooperative engagement of the descriptive and normative disciplines to explore our understandings of boundaries in healthcare ethics practice. This will contribute to the ongoing reflection not only as we envision the professional role but to ensure that it is enacted in practice.

What Ethical Issues Really Arise in Practice at an Academic Medical Center? A Quantitative and Qualitative Analysis of Clinical Ethics Consultations from 2008 to 2013.

PubMed

Wasson, Katherine; Anderson, Emily; Hagstrom, Erika; McCarthy, Michael; Parsi, Kayhan; Kuczewski, Mark

2016-09-01

As the field of clinical ethics consultation sets standards and moves forward with the Quality Attestation process, questions should be raised about what ethical issues really do arise in practice. There is limited data on the type and number of ethics consultations conducted across different settings. At Loyola University Medical Center, we conducted a retrospective review of our ethics consultations from 2008 through 2013. One hundred fifty-six cases met the eligibility criteria. We analyzed demographic data on these patients and conducted a content analysis of the ethics consultation write-ups coding both the frequency of ethical issues and most significant, or key, ethical issue per case. Patients for whom ethics consultation was requested were typically male (55.8 %), white (57.1 %), between 50 and 69 years old (38.5 %), of non-Hispanic origin (85.9 %), and of Roman Catholic faith (43.6 %). Nearly half (47.4 %) were in the intensive care unit and 44.2 % died in the hospital. The most frequent broad ethical categories were decision-making (93.6 %), goals of care/treatment (80.8 %), and end-of-life (73.1 %). More specifically, capacity (57.1 %), patient's wishes/autonomy (54.5 %), and surrogate decision maker (51.3 %) were the most frequent particular ethical issues. The most common key ethical issues were withdrawing/withholding treatment (12.8 %), patient wishes/autonomy (12.2 %), and capacity (11.5 %). Our findings provide additional data to inform the training of clinical ethics consultants regarding the ethical issues that arise in practice. A wider research agenda should be formed to collect and compare data across institutions to improve education and training in our field.

Development of a moral judgment measure for veterinary education.

PubMed

Verrinder, Joy M; Phillips, Clive J C

2014-01-01

Veterinarians increasingly face animal ethics issues, conflicts, and dilemmas, both in practice and in policy, such as the tension between clients' and animals' interests. Little has been done to measure the capacity of veterinarians to make ethical judgments to prevent and address these issues or to identify the effectiveness of strategies to build this capacity. The objectives of this study were, first, to develop a test to identify the capacity of veterinarians to make ethical decisions in relation to animal ethics issues and, second, to assess students' perceptions of the usefulness of three methods for the development of ethical decision making. The Veterinary Defining Issues Test (VetDIT) was piloted with 88 first-year veterinary students at an Australian university. The veterinary students were at a variety of reasoning stages in their use of the Personal Interest (PI), Maintaining Norms (MN), and Universal Principles (UP) reasoning methods in relation to both human ethics and animal ethics issues and operated at a higher level of reasoning for animal than human ethics. Thirty-eight students assessed three methods for developing ethical decision-making skills and identified these as being helpful in clarifying their positions, clarifying others' positions, increasing awareness of the complexity of making ethical decisions, using ethical frameworks and principles, and improving moral reasoning skills, with two methods identified as most helpful. These methods and the VetDIT have the potential to be used as tools for development and assessment of moral judgment in veterinary education to address animal ethics issues.

"Let Me Keep My Dead Husband's Sperm": Ethical Issues in Posthumous Reproduction.

PubMed

Panagiotopoulou, Nikoletta; Karavolos, Stamatios

2015-01-01

The feasibility of posthumous reproduction when the surviving partner is female has brought to light many ethical, moral, social, and legal issues. This review aims to summarize these issues and to assist clinicians who may be faced with such requests. A question list, used for health technologies assessment, was utilized in a question-answer approach as the review methodology. Of the 1,208 publications identified through a comprehensive literature search in biomedical, psychological, and ethical databases, 31 articles included arguments related to one or more questions from the predefined question set. Key stakeholders identified include the deceased, the requesting party, the resultant child, the physician, and society. Key ethical issues relevant to posthumous reproduction include the four traditional pillars of medical ethics--autonomy, beneficence, nonmaleficence, justice--as well as the stakeholders' rights and sociocultural attitudes. The ethical framework formulated by these issues has been incorporated in a clinical ethics decision-making tool that could prove useful to clinicians and decision makers. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

The Ethics of Doing Ethics.

PubMed

Hansson, Sven Ove

2017-02-01

Ethicists have investigated ethical problems in other disciplines, but there has not been much discussion of the ethics of their own activities. Research in ethics has many ethical problems in common with other areas of research, and it also has problems of its own. The researcher's integrity is more precarious than in most other disciplines, and therefore even stronger procedural checks are needed to protect it. The promotion of some standpoints in ethical issues may be socially harmful, and even our decisions as to which issues we label as "ethical" may have unintended and potentially harmful social consequences. It can be argued that ethicists have an obligation to make positive contributions to society, but the practical implications of such an obligation are not easily identified. This article provides an overview of ethical issues that arise in research into ethics and in the application of such research. It ends with a list of ten practical proposals for how these issues should be dealt with.

Donor motivations, associated risks and ethical considerations of oocyte donation.

PubMed

Boutelle, Amy L

2014-01-01

Three decades after the first reported successful cases, oocyte donation continues to grow in popularity and regard as an established method to aid women in achieving their reproductive goals. As a result of the increased demand for donated oocytes, many young women in the U.S. volunteer to undergo complex medical procedures to donate their oocytes in return for financial compensation. To best care for these women before, during and after donation, it is important to explore donor characteristics and motivations, discuss the safety of the donation procedure and examine the ethical issues related to this process. © 2014 AWHONN.

Ethical questions regarding health insurance in India.

PubMed

Mathur, Vineesh

2011-01-01

Improved health and healthcare are of vital concern to the welfare of Indian society. The nascent health insurance system of the country is experiencing an explosive expansion and various models of health insurance provision are under trial by different agencies. Since the country has been relatively late in introducing health insurance, it can study the effects of different systems of healthcare and insurance and develop a system of health coverage which addresses the unique social character of our country as well as the ethical questions of comprehensiveness and inclusion. This article seeks to explore these issues in detail.

Politics and public health ethics in practice: right and left meet right and wrong.

PubMed

Gollust, Sarah E; Baum, Nancy M; Jacobson, Peter D

2008-01-01

As public health practitioners are no doubt aware, public health practice and politics are closely linked. Although theoretical discussion of the emerging field of public health ethics has been rich, scholars have paid little attention to the relationship between ethical issues and politics in public health practice. We conducted semistructured interviews with 45 public health practitioners across a range of occupations (eg, health officers, medical directors, sanitarians, nurses, educators, and commissioners) working at 12 local health departments across Michigan and the state health department. Practitioners were asked to describe the ethical issues they faced in their daily practice. Ethical issues that resulted from the political environment emerged as one major category of ethical issues our interviewees described. This article illustrates how political issues engender ethical challenges in 4 main areas: public health agenda-setting, political pressures, political conflicts with best practices, and the scope of public health practice. The findings suggest that politics and public health ethics intrinsically intersect, because political pressures and priorities often impose ethical challenges that practitioners negotiate in their daily work.

Intellectual Freedom and the National Laboratories : 2000 Sigma Xi Forum New Ethical Challenges in Science and Technology, November 9-10, 2000, Albuquerque, New Mexico"

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

Browne, John C.

2001-01-01

As we move toward the 21st century, I believe the importance of the ethical system on which the scientific establishment, including the national laboratories, can build its contributions to society is becoming increasingly more important. Issues include the impact of the research we do, the trust we have between ourselves and the general public and the federal government, and the complexity of the problems that we work on. One of the most important roles that I see for research management in large institutions, like the national laboratories, is to create the appropriate environment for ethical behavior for all of itsmore » employees. Ethics and modern science demands that we create and live a set of shared values. As Bob Dynes pointed out this morning, we're not just talking about rules. We really must have values upon which we build and create the kind of behaviors we want to see. The major issue that I see in developing these shared values is that management and employees must jointly develop, socialize and live those shared values. In this session today, as I said, we want to explore the issues of intellectual freedom and ethical environment in government and the contracts under which the national laboratories operate. One of the laboratories is run by a nonprofit, the University of California, and the other is a paid-for-profit corporation. I don't know if there are any differences, depending on who the overseeing contractor is. I don't think there are, but it would be interesting to explore any differences we might see between the two. We have chosen the title 'Intellectual Freedom.' It's not academic freedom. Although, clearly, there are a lot of shared attributes between academic freedom and intellectual freedom. In our case, intellectual freedom allows our researchers to challenge technical decisions that are made by the laboratory, by the government or by their peers in their area of expertise, not in policy making, but in the scientific realm. It really does not permit them the freedom to roam at will outside of their areas of technical expertise into the realm of policy without clearly stating that their remarks are those of a private citizen and must be handled, therefore, outside of the laboratory business. This is a major issue within our laboratories, and I think one that we try to nurture very carefully, because without it, we think that there would be a closing up of laboratories because of the type of classified work that we do. The issues that I hope we might explore in this session include, (1) how do you give technical advice to a policymaker? Where do you draw the line with respect to your judgment, your advice versus your opinion, which can change how government attacks very significant societal problems: (2) The issue of security and classification. How does that affect the intellectual freedom of our staff? (3) Dealing with the public on matters of risk. I am going to add to that, also, dealing with our employees on matters of risk, because one of the things that we're finding as we get better with our detection technology and our screening technologies, we now find out about how employees might be susceptible to illnesses, such as berylliosis, problems with beryllium sensitivity. What ethical issues arise when you now have the ability to learn more about impacts on, not only the public, but your employees as well? We share similar types of problems that Bob Dynes mentioned: conflict of interest, intellectual property questions. And we also have the conflict of interest as an institution. And I'll just mention one--perhaps it could come up in the discussion-is in the past year we had an issue with respect to how the Congress and the Administration handled the Comprehensive Test Ban Treaty. What kind of eihical issues arise in testing on our technical judgment regarding the CTBT versus institutional conflict of interest? Questions were raised. Were the laboratory directors simply protecting budgets or were they speaking out on technical matters in which they believe very strongly? So, I think we have many of these issues that come into play in our jobs every day. The security issues raised in the past year regarding Los Alamos were complicated, in my opinion, because of stories in the media that were not necessarily complete or accurate. They were also Complicated by the actions of the federal government in not allowing certain information to be made public because of ongoing litigation. So, it raised a lot of questions, and I think, in the next 5 to 10 years, the events of the past year or two will actually raise a lot of ethical questions about how people handle classified information, not just at the national laboratories, but in general. Not only the legal issues, but the ethical issues, the values associated with handling classified information.« less

A systematic review of ethical issues in vaccine studies involving pregnant women.

PubMed

Beeler, Jennifer A; Lambach, Philipp; Fulton, T Roice; Narayanan, Divya; Ortiz, Justin R; Omer, Saad B

2016-08-02

Immunization during pregnancy can provide protection for mother and child. However, there have been only a limited number of studies documenting the efficacy and safety of this strategy. To determine the extent and nature of subject matter related to ethics in maternal immunization by systematically documenting the spectrum of ethical issues in vaccine studies involving pregnant women. We conducted a systematic literature review of published works pertaining to vaccine and therapeutic studies involving pregnant women through searches of PubMed, EMBASE, Web of Science, the Cochrane Database, and ClinicalTrials.gov. We selected literature meeting the inclusion criteria published between 1988 and June 2014. We systematically abstracted subject matter pertaining to ethical issues in immunization studies during pregnancy. Immunization-specific ethical issues were matched and grouped into major categories and subcategories. Seventy-seven published articles met the inclusion criteria. Published articles reported findings on data that had been collected in 26 countries, the majority of which were classified as high-income or upper-middle-income nations according to World Bank criteria. Review of these publications produced 60 immunization-specific ethical issues, grouped into six major categories. Notably, many studies demonstrated limited acknowledgment of key ethical issues including the rights and welfare of participants. Additionally, there was no discussion pertaining to the ethics of program implementation, including integration of maternal immunization programs into existing routine immunization programs. This review of ethical issues in immunization studies of pregnant women can be used to help inform future vaccine trials in this important population. Consistent documentation of these ethical issues by investigators will facilitate a broader and more nuanced discussion of ethics in immunization of pregnant women - offering new and valuable insights for programs developed to prevent disease in newborn children in low- and middle-income countries.

Talking ethics with strangers: a view from Jewish tradition.

PubMed

Newman, L E

1993-12-01

The work of H. Tristram Engelhardt provides an important set of reflections for bioethics in a secular context. Taking Engelhardt's work as its point of departure this article explores the challenges that Jewish ethicists face in contributing to bioethics in a secular context. The article explores how the Jewish tradition can address issues in bioethics in ways that are true to its tradition and at the same time accessible and relevant to "moral strangers" in a secular society.

Ethical and legal issues in non-heart-beating organ donation.

PubMed

Bos, Michael A

2005-05-15

Procurement of kidneys and livers from non-heart-beating donors (NHBD) raises ethical and legal issues that need to be considered before wider use of these donors is undertaken. Although NHBDs were used in kidney transplantation as early as the 1960s, retrieval of these organs is not universally accepted today. From a medical point of view, these organs were considered "marginal" because the majority showed delayed or impaired function early after implantation. Legal problems relate to determination of death on cardiopulmonary criteria, the issue of valid consent, and the use of preservation measures. Among ethical issues involved are observance of the dead-donor rule, decisions with respect to resuscitation and withdrawal of life-sustaining treatment, respect for the dying patient and the dead body, and proper guidance of the family. In The Netherlands NHB donation was pioneered by the Maastricht Centre as early as 1981. Today, all seven transplant centers procure and transplant these organs, and NHBDs have become an important source of transplantable kidneys and livers. Recent legislation in The Netherlands also supports NHB donation by allowing the use of organ-preserving measures, even in the absence of family consent. As a result, one of every three kidneys transplanted in The Netherlands in 2004 derives from a NHBD. This article explores Dutch NHBD practice, protocols, and results and compares these data internationally.

Ethical & Legal Issues in School Counseling. Chapter 5: Ethical Issues in Group Work.

ERIC Educational Resources Information Center

Kottler, Jeffrey A.; And Others

This document contains chapter 6 (5 articles) of a collection of 35 articles primarily from American Association for Counseling and Development (AACD) publications on the most important legal and ethical topics about which all school counselors need to be informed. "Ethics Comes of Age: Introduction to the Special Issue" (Jeffrey A. Kottler)…

Legal and Ethical Issues Involved When Counseling Minors in Nonschool Settings.

ERIC Educational Resources Information Center

Lawrence, Gabrielle; Kurpius, Sharon E. Robinson

2000-01-01

It is essential for counselors to understand the legal and ethical issues relevant to working with minors. Article reviews major court cases and legislation concerning these areas. Discusses four ethical issues: counselor competence, client's rights to confidentiality, informed consent, and duties related to child abuse. Considers issues for…

Nurses' perceptions of ethical issues related to patients' rights law.

PubMed

Yakov, Gila; Shilo, Yehudit; Shor, Tzippy

2010-07-01

August 2006 marked the 10th anniversary of landmark legislation when Israel's parliament passed the unique Patient's Rights Law. This law underscores the importance of medical ethics in Israeli society. During a seminar at the Shaare Zedek School of Nursing, third-year students performed a qualitative research study investigating ethical issues arising in the field of nursing, and how nursing staff dealt with these issues in relation to the law. The research was conducted using semistructured questionnaires. The results showed that the staff participants knew the law, but did not differentiate between legal and ethical problems. The establishment of a framework for dealing with these issues would help to promote professional ethics, encourage broad-based agreements related to ethical decisions, reduce ethical conflict, and increase implementation of the law on patients' rights.

Assessment and accountability: part 3 - sign-off mentors.

PubMed

Houghton, Trish

2016-08-03

Assessment in clinical practice is a complex role undertaken by mentors and practice teachers. This article is the third of three articles about assessment in practice. Part one focused on the importance of assessment and identified assessment methods used in clinical practice, while part two discussed the importance of feedback and managing failing students. This article examines the concepts of responsibility and accountability as well as ethical issues for mentors and practice teachers in relation to the assessment process. The role of the sign-off mentor, the issue of due regard, and ethical principles are discussed. The meaning of competence and partnership working when making assessment decisions are explored. This article relates to the third domain and outcomes of the Nursing and Midwifery Council's Standards to Support Learning and Assessment in Practice on assessment and accountability.

Faith healing and faith in healing.

PubMed

Gopichandran, Vijayaprasad

2015-01-01

Sarkar and Seshadri have presented an interesting paper in this issue on the ethical approach that a physician should take when faced with requests for faith healing (1). The paper describes four approaches that the physician can take. These are rejecting the request, keeping oneself detached from the issue, endorsing the request and trying to understand the practices concerned so as to make a reasoned decision. This commentary attempts to explore the issue of faith healing further, from the point of view of clinical care. It shall discuss five important dimensions which can supplement the arguments by Sarkar and Seshadri. These are the concepts of faith, spirituality and religion and faith healing; the difference between cure and healing; patient-centred care; the various factors influencing a doctor's response to requests for faith healing; and finally, the ethical issues to be considered while making a decision. Before launching into the discussion, it should be made clear that this commentary refers mainly to those faith healing practices which are not overtly harmful, such as prayers, and wearing rings and amulets.

Cinemeducation: A pilot student project using movies to help students learn medical professionalism.

PubMed

Lumlertgul, Nuttha; Kijpaisalratana, Naruchorn; Pityaratstian, Nuttorn; Wangsaturaka, Danai

2009-07-01

Using movies has been accepted worldwide as a tool to help students learn medical professionalism. In the second year, a group of medical students conducted the "Cinemeducation" project to promote professionalism in the "Medical Ethics and Critical Thinking" course. Five movies with professionalism issues were screened with 20-30 students attending each session. After the show, participants then were asked to reflect on what they had learned in terms of professionalism. Two students led group discussion emphasizing questioning and argumentation for 60 min. Additional learning issues emerging from each session were also explored in more depth and arranged into a report. In the Cinemeducation Project, medical students have learned five main ethical issues in each film, which were the doctor-patient relationship, informed consent and clinical trials in patients, management of genetic disorders, patient management, and brain death and organ transplantation. In addition to issues of professionalism, they also developed critical thinking and moral reasoning skills. Using a case-based scenario in movies has proven to be an effective and entertaining method of facilitating students with learning on professionalism.

Teaching ethics to engineers: ethical decision making parallels the engineering design process.

PubMed

Bero, Bridget; Kuhlman, Alana

2011-09-01

In order to fulfill ABET requirements, Northern Arizona University's Civil and Environmental engineering programs incorporate professional ethics in several of its engineering courses. This paper discusses an ethics module in a 3rd year engineering design course that focuses on the design process and technical writing. Engineering students early in their student careers generally possess good black/white critical thinking skills on technical issues. Engineering design is the first time students are exposed to "grey" or multiple possible solution technical problems. To identify and solve these problems, the engineering design process is used. Ethical problems are also "grey" problems and present similar challenges to students. Students need a practical tool for solving these ethical problems. The step-wise engineering design process was used as a model to demonstrate a similar process for ethical situations. The ethical decision making process of Martin and Schinzinger was adapted for parallelism to the design process and presented to students as a step-wise technique for identification of the pertinent ethical issues, relevant moral theories, possible outcomes and a final decision. Students had greatest difficulty identifying the broader, global issues presented in an ethical situation, but by the end of the module, were better able to not only identify the broader issues, but also to more comprehensively assess specific issues, generate solutions and a desired response to the issue.

Everyday Ethics: Ethical Issues and Stress in Nursing Practice

PubMed Central

Ulrich, Connie M.; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-01-01

Aim This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Background Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. Methods A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analyzed using descriptive statistics, cross-tabulations and Pearson correlations. Results A total of 422 questionnaires were used in the analysis. The five most frequently-occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Conclusion Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. PMID:20735502

Everyday ethics: ethical issues and stress in nursing practice.

PubMed

Ulrich, Connie M; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-11-01

This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. © 2010 Blackwell Publishing Ltd.

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

PubMed

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

2016-09-01

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

The role of ethics in information technology decisions: a case-based approach to biomedical informatics education.

PubMed

Anderson, James G

2004-03-18

The purpose of this paper is to propose a case-based approach to instruction regarding ethical issues raised by the use of information technology (IT) in healthcare. These issues are rarely addressed in graduate degree and continuing professional education programs in health informatics. There are important reasons why ethical issues need to be addressed in informatics training. Ethical issues raised by the introduction of information technology affect practice and are ubiquitous. These issues are frequently among the most challenging to young practitioners who are ill prepared to deal with them in practice. First, the paper provides an overview of methods of moral reasoning that can be used to identify and analyze ethical problems in health informatics. Second, we provide a framework for defining cases that involve ethical issues and outline major issues raised by the use of information technology. Specific cases are used as examples of new dilemmas that are posed by the introduction of information technology in healthcare. These cases are used to illustrate how ethics can be integrated with the other elements of informatics training. The cases discussed here reflect day-to-day situations that arise in health settings that require decisions. Third, an approach that can be used to teach ethics in health informatics programs is outlined and illustrated.

Canadian residents teaching and learning psychiatry in Ethiopia: a grounded theory analysis focusing on their experiences.

PubMed

Brook, Shelley; Robertson, David; Makuwaza, Tutsirai; Hodges, Brian D

2010-01-01

The Toronto Addis Ababa Psychiatry Project (TAAPP) is an international collaboration between University of Toronto and Addis Ababa University. University of Toronto psychiatric residents may participate in TAAPP as an elective. The authors explored the Canadian resident experience in a qualitative study of the project. Eleven residents were interviewed using a semistructured questionnaire. Grounded theory was employed to organize participants' experiences and highlight emerging themes. The computer software NVivo7 was used to facilitate data analysis. Participants described gaining competency as health advocates, collaborators, scholars, and teachers. They endorsed increased sensitivity to cross-cultural issues and greater awareness of global health issues, including practical and ethical ramifications of working at an intersection of cultures. Residents gained international perspective psychiatric practice. The elective provided unique opportunities for acquiring clinical, teaching, collaborative, leadership and advocacy skills. It prompted participants to consider ethical and cross-cultural issues and allowed them to be mentored intensively by Ethiopian and Canadian teachers and peers.

Minors or suspects? A discussion of the legal and ethical issues surrounding the indefinite storage of DNA collected from children aged 10-18 years on the National DNA Database in England and Wales.

PubMed

Mansel, Charlotte; Davies, Sharon

2012-10-01

There are currently over 250,000 children between the ages of 10 and 18 years who have their genetic information stored on the National DNA Database. This paper explores the legal and ethical issues surrounding this controversial subject, with particular focus on juvenile capacity and the potential results of criminalizing young children and adolescents. The implications of the adverse legal judgement of the European Court of Human Rights in S and Marper v UK (2008) and the violation of Article 8 of the Convention are discussed. The authors have considered the requirement to balance the rights of the individual, particularly those of minors, against the need to protect the public and have compared the position in Scotland to that of the rest of the UK. The authors conclude that a more ethically acceptable alternative could be the creation of a separate forensic database for children aged 10-18 years, set up to safeguard the interests of those who have not been convicted of any crime.

Communication strategies and intensive interaction therapy meet the theology of the body: bioethics in dialogue with people with profound disabilities.

PubMed

Matthews, Pia

2013-01-01

Academic bioethics does not appear to be interested in communication and its ethical concerns unless communication is to do with issues such as capacity, consent, truth telling and confidentiality. In contrast practitioners are interested in actually communicating with their patients and they are often particularly perplexed when it comes to people with profound disabilities where communication appears disrupted. Although some new and not so new communication strategies, and especially intensive interaction, are available, little has been written on either the ethical concerns these may present or the deeper concepts that underpin them. This article explores the practical applications of some of these communication strategies. By engaging these strategies with theology, and specifically Pope John Paul's Theology of the Body, this article identifies and addresses some significant ethical issues that may arise, notably the risk of dualism and of objectifying the human person. Moreover it provides communication strategies with a rationale that goes beyond practicalities to one based on respect for human dignity, justice and solidarity.

Public participation in genetic databases: crossing the boundaries between biobanks and forensic DNA databases through the principle of solidarity.

PubMed

Machado, Helena; Silva, Susana

2015-10-01

The ethical aspects of biobanks and forensic DNA databases are often treated as separate issues. As a reflection of this, public participation, or the involvement of citizens in genetic databases, has been approached differently in the fields of forensics and medicine. This paper aims to cross the boundaries between medicine and forensics by exploring the flows between the ethical issues presented in the two domains and the subsequent conceptualisation of public trust and legitimisation. We propose to introduce the concept of 'solidarity', traditionally applied only to medical and research biobanks, into a consideration of public engagement in medicine and forensics. Inclusion of a solidarity-based framework, in both medical biobanks and forensic DNA databases, raises new questions that should be included in the ethical debate, in relation to both health services/medical research and activities associated with the criminal justice system. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The challenge of raising ethical awareness: a case-based aiding system for use by computing and ICT students.

PubMed

Sherratt, Don; Rogerson, Simon; Ben Fairweather, N

2005-04-01

Students, the future Information and Communication Technology (ICT) professionals, are often perceived to have little understanding of the ethical issues associated with the use of ICTs. There is a growing recognition that the moral issues associated with the use of the new technologies should be brought to the attention of students. Furthermore, they should be encouraged to explore and think more deeply about the social and legal consequences of the use of ICTs. This paper describes the development of a tool designed to raise students' awareness of the social impact of ICTs. The tool offers guidance to students undertaking computing and computer-related courses when considering the social, legal and professional implications of the actions of participants in situations of ethical conflict. However, unlike previous work in this field, this tool is not based on an artificial intelligence paradigm. Aspects of the theoretical basis for the design of the tool and the tool's practical development are discussed. Preliminary results from the testing of the tool are also discussed.

Do we have the training? The ethics of workplace drug testing and the GP.

PubMed

Evans, Alan; Thornett, Andrew

2003-08-01

Workplace drug testing has been in place in Australia since the early 1990s. In some industries it is required by legislation, while in others, employers have introduced it as an apparent cost effective way of improving productivity, safety and the health of its workforce while reducing absenteeism, accident rates and even deaths. There are national standards in place for workplace drug testing regarding specimen collection and testing, and well documented processes to follow in establishing a drug screening program within a workforce. This article explores the ethics of workplace drug testing and questions the assumed rights and obligations of employer, employee and the clinician involved in occupational medicine. It is questionable whether most general practitioners have the appropriate training to deal with these ethical issues comprehensively.

Views of academic and community partners regarding participant protections and research integrity: a pilot focus group study.

PubMed

Anderson, Emily E

2013-02-01

When community partners have direct interaction with human research participants, it is important to consider potential threats to participant protections and research integrity. Few studies have directly compared the views of academic and community partners. This pilot focus group study explores the views of academic partners (APs) and community partners (CPs) regarding challenges to the protection of research participants and research integrity in community-engaged research (CEnR). Data are analyzed to understand how APs and CPs define and think about ethical problems and how meaning and analysis may differ between the two groups. Findings have implications for the development of research ethics training materials for academic-community research partnerships and IRBs; best practices for CEnR; and future research on ethical issues in CEnR.

An ecological compass for planetary engineering.

PubMed

Haqq-Misra, Jacob

2012-10-01

Proposals to address present-day global warming through the large-scale application of technology to the climate system, known as geoengineering, raise questions of environmental ethics relevant to the broader issue of planetary engineering. These questions have also arisen in the scientific literature as discussions of how to terraform a planet such as Mars or Venus in order to make it more Earth-like and habitable. Here we draw on insights from terraforming and environmental ethics to develop a two-axis comparative tool for ethical frameworks that considers the intrinsic or instrumental value placed upon organisms, environments, planetary systems, or space. We apply this analysis to the realm of planetary engineering, such as terraforming on Mars or geoengineering on present-day Earth, as well as to questions of planetary protection and space exploration.

A Consideration to Two Main Ethical Issues in Educational Research, and How May These Be Addressed

ERIC Educational Resources Information Center

Abed, Mohaned Ghazi

2015-01-01

This paper has firstly discussed the topic of Ethical Issues in Education, and has accordingly highlighted the fact that ethics are not something to deem at the commencement of a research project or fieldwork, but rather throughout the entire research process. Furthermore, two of the most important ethical issues have been given…

Ethics in Educational Technology: Towards a Framework for Ethical Decision Making in and for the Discipline

ERIC Educational Resources Information Center

Spector, J. Michael

2016-01-01

This special issue of "ETR&D" is devoted to ethics in the broad domain of educational technology. Many ethical issues arise involving the study and use of educational technologies. A well-known issue involves the digital divide and the degree to which the introduction of new technologies is increasing the digital divide and…

Ethics and Privacy.

ERIC Educational Resources Information Center

Brewer, Erin; Eastmond, Nick; Geertsen, Reed; Johnson, Doug; Lewandowski, Judith; Yeaman, Andrew R. J.

2003-01-01

Contains four articles covering trends and issues on ethics and privacy in instructional technology, including: considerations for assessing ethical issues; what schools must do to develop ethical behaviors in students; a privacy primer for educators; and manufacturing technophopia. Each article contains references. (MES)

What ethics for case managers? Literature review and discussion.

PubMed

Corvol, Aline; Moutel, Grégoire; Somme, Dominique

2016-11-01

Little is known about case managers' ethical issues and professional values. This article presents an overview of ethical issues in case managers' current practice. Findings are examined in the light of nursing ethics, social work ethics and principle-based biomedical ethics. A systematic literature review was performed to identify and analyse empirical studies concerning ethical issues in case management programmes. It was completed by systematic content analysis of case managers' national codes of ethics. Only nine empirical studies were identified, eight of them from North America. The main dilemmas were how to balance system goals against the client's interest and client protection against autonomy. Professional codes of ethics shared important similarities, but offered different responses to these two dilemmas. We discuss the respective roles of professional and organizational ethics. Further lines of research are suggested. © The Author(s) 2015.

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

PubMed

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

2016-01-01

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

Ethical, legal, and social issues in health technology assessment for prenatal/preconceptional and newborn screening: a workshop report.

PubMed

Potter, B K; Avard, D; Entwistle, V; Kennedy, C; Chakraborty, P; McGuire, M; Wilson, B J

2009-01-01

Prenatal/preconceptional and newborn screening programs have been a focus of recent policy debates that have included attention to ethical, legal, and social issues (ELSIs). In parallel, there has been an ongoing discussion about whether and how ELSIs may be addressed in health technology assessment (HTA). We conducted a knowledge synthesis study to explore both guidance and current practice regarding the consideration of ELSIs in HTA for prenatal/preconceptional and newborn screening. As the concluding activity for this project, we held a Canadian workshop to discuss the issues with a diverse group of stakeholders. Based on key workshop themes integrated with our study results, we suggest that population-based genetic screening programs may present particular types of ELSIs and that a public health ethics perspective is potentially highly relevant when considering them. We also suggest that approaches to addressing ELSIs in HTA for prenatal/preconceptional and newborn screening may need to be flexible enough to respond to diversity in HTA organizations, cultural values, stakeholder communities, and contextual factors. Finally, we highlight a need for transparency in the way that HTA producers move from evidence to conclusions and the ways in which screening policy decisions are made. Copyright © 2008 S. Karger AG, Basel.

Ethical, Legal, and Social Issues in Health Technology Assessment for Prenatal/Preconceptional and Newborn Screening: A Workshop Report

PubMed Central

Potter, B.K.; Avard, D.; Entwistle, V.; Kennedy, C.; Chakraborty, P.; McGuire, M.; Wilson, B.J.

2008-01-01

Prenatal/preconceptional and newborn screening programs have been a focus of recent policy debates that have included attention to ethical, legal, and social issues (ELSIs). In parallel, there has been an ongoing discussion about whether and how ELSIs may be addressed in health technology assessment (HTA). We conducted a knowledge synthesis study to explore both guidance and current practice regarding the consideration of ELSIs in HTA for prenatal/preconceptional and newborn screening. As the concluding activity for this project, we held a Canadian workshop to discuss the issues with a diverse group of stakeholders. Based on key workshop themes integrated with our study results, we suggest that population-based genetic screening programs may present particular types of ELSIs and that a public health ethics perspective is potentially highly relevant when considering them. We also suggest that approaches to addressing ELSIs in HTA for prenatal/preconceptional and newborn screening may need to be flexible enough to respond to diversity in HTA organizations, cultural values, stakeholder communities, and contextual factors. Finally, we highlight a need for transparency in the way that HTA producers move from evidence to conclusions and the ways in which screening policy decisions are made. PMID:19023190

Human rights, cultural pluralism, and international health research.

PubMed

Marshall, Patricia A

2005-01-01

In the field of bioethics, scholars have begun to consider carefully the impact of structural issues on global population health, including socioeconomic and political factors influencing the disproportionate burden of disease throughout the world. Human rights and social justice are key considerations for both population health and biomedical research. In this paper, I will briefly explore approaches to human rights in bioethics and review guidelines for ethical conduct in international health research, focusing specifically on health research conducted in resource-poor settings. I will demonstrate the potential for addressing human rights considerations in international health research with special attention to the importance of collaborative partnerships, capacity building, and respect for cultural traditions. Strengthening professional knowledge about international research ethics increases awareness of ethical concerns associated with study design and informed consent among researchers working in resource-poor settings. But this is not enough. Technological and financial resources are also necessary to build capacity for local communities to ensure that research results are integrated into existing health systems. Problematic issues surrounding the application of ethical guidelines in resource-poor settings are embedded in social history, cultural context, and the global political economy. Resolving the moral complexities requires a commitment to engaged dialogue and action among investigators, funding agencies, policy makers, governmental institutions, and private industry.

Student participation in health professions education research: in pursuit of the Aristotelian mean.

PubMed

Chen, Ruth P

2011-05-01

In research ethics reviews, traditional approaches of research ethics boards (REBs) balance the risks with the potential for benefit of proposed studies, and this review process has been similar for health professions education research (HPER) as it has been for clinically based studies. Health professions students are the primary population from which most education researchers draw their participants although relatively little discussion has taken place in the literature regarding student participation in HPER. The majority of HPER studies could be considered minimal risk and therefore many have suggested that such studies be exempted from REB review. However, there are not only risks to student participants which require consideration, but I argue that when this issue is viewed through the lens of Aristotle's virtue ethics, there are also potential benefits to the student, for which REB oversight can be helpful, that have not factored strongly into discussions. This paper seeks to highlight the key factors involved in student participation in HPER; to explore Aristotle's doctrine of the mean and to evaluate how this ethical framework can add value to the discussion; and to propose possible applications of the Aristotelian mean to this issue and address some of the challenges that would arise with its application.

Ethical issues evolving from patients’ perspectives on compulsory screening for syphilis and voluntary screening for cervical cancer in Kenya

PubMed Central

2014-01-01

Background Public health aims to provide universal safety and progressive opportunities to populations to realise their highest level of health through prevention of disease, its progression or transmission. Screening asymptomatic individuals to detect early unapparent conditions is an important public health intervention strategy. It may be designed to be compulsory or voluntary depending on the epidemiological characteristics of the disease. Integrated screening, including for both syphilis and cancer of the cervix, is a core component of the national reproductive health program in Kenya. Screening for syphilis is compulsory while it is voluntary for cervical cancer. Participants’ perspectives of either form of screening approach provide the necessary contextual information that clarifies mundane community concerns. Methods Focus group discussions with female clients screened for syphilis and cancer of the cervix were conducted to elicit their perspectives of compulsory and voluntary screening. The discussions were audiotaped, transcribed and thematic content analysis performed manually to explore emerging ethics issues. Results The results indicate that real ethical challenges exist in either of the approaches. Also, participants were more concerned about the benefits of the procedure and whether their dignity is respected than the compulsoriness of screening per se. The implication is for the policy makers to clarify in the guidelines how to manage ethical challenges, while at the operational level, providers need to be judicious to minimize potential harms participants and families when screening for disease in women. Conclusions The context for mounting screening as a public health intervention and attendant ethical issues may be more complex than hitherto perceived. Interpreting emerging ethics issues in screening requires more nuanced considerations of individuals’ contextual experiences since these may be contradictory to the policy position. In considering mounting screening for Syphilis and cervical cancer as a public heal intervention, the community interests and perspectives should be inculcated into the program. Population lack of information on procedures may influence adversely the demand for screening services by the individuals at risk or the community as a collective agent. PMID:24678613

Preceptorship: using an ethical lens to reflect on the unsafe student.

PubMed

Earle-Foley, Vicki; Myrick, Florence; Luhanga, Florence; Yonge, Olive

2012-01-01

Patient safety has become a worldwide health concern, and health care professionals have a moral and ethical responsibility to promote patient safety. The clinical education of many health care professionals often involves a preceptorship or field experience wherein students are assigned to work one-to-one with a preceptor or field educator so that they can be socialized into the profession and receive a reality-oriented experience. Health care professionals who accept the responsibility of being a preceptor face additional workload and stress, especially when the students to whom they are assigned are not meeting the expectations of safe, professional practice. Taking a stand against unsafe students is an important way for preceptors to promote patient safety. Given the nature of the stress and the inherent ethical issues associated with precepting an unsafe student, it is useful to examine this experience through an ethical lens. Included in this article is a brief overview of preceptorship as a model of clinical education, together with a discussion of the nature of the ethical decisions that preceptors face when precepting an unsafe student. Ethical theories, namely, virtue ethics and utilitarianism, are also explored and serve to provide the ethical lens through which preceptors can reflect upon their experiences with unsafe students. Copyright © 2012 Elsevier Inc. All rights reserved.

The Marketing Ethics Course: Current State and Future Directions

ERIC Educational Resources Information Center

Ferrell, O. C.; Keig, Dawn L.

2013-01-01

Many of the critical issues facing modern businesses can be considered marketing ethics issues. It follows that as the field of business ethics has evolved, marketing has played a key role in the development of business ethics education. Despite a general trend of increasingly larger amounts of ethical content included in business curricula, prior…

Nursing management and organizational ethics in the intensive care unit.

PubMed

Wlody, Ginger Schafer

2007-02-01

This article describes organizational ethics issues involved in nursing management of an intensive care unit. The intensive care team and medical center management have the dual responsibility to create an ethical environment in which to provide optimum patient care. Addressing organizational ethics is key to creating that ethical environment in the intensive care unit. During the past 15-20 yrs, increasing costs in health care, competitive markets, the effect of high technology, and global business changes have set the stage for business and healthcare organizational conflicts that affect the ethical environment. Studies show that critical care nurses experience moral distress and are affected by the ethical climate of both the intensive care unit and the larger organization. Thus, nursing moral distress may result in problems related to recruitment and retention of staff. Other issues with organizational ethics ramifications that may occur in the intensive care unit include patient safety issues (including those related to disruptive behavior), intensive care unit leadership style, research ethics, allocation of resources, triage, and other economic issues. Current organizational ethics conflicts are discussed, a professional practice model is described, and multidisciplinary recommendations are put forth.

Socially Just Research for Social Justice: Negotiating Consent and Safety in a Participatory Action Research Project

ERIC Educational Resources Information Center

DePalma, Renee

2010-01-01

This contribution explores what it means to pursue equality and social justice through equitable and just collaborative research methodologies, with a particular focus on two issues: the creation of safe spaces for research participants in the context of a "dangerous" research topic, and the generation of ethically viable research…

Faculty Consulting in Natural Sciences and Engineering: Between Formal and Informal Knowledge Transfer

ERIC Educational Resources Information Center

Amara, Nabil; Landry, Rejean; Halilem, Norrin

2013-01-01

Academic consulting is a form of knowledge and technology transfer largely under-documented and under-studied that raises ethical and resources allocation issues. Based on a survey of 2,590 Canadian researchers in engineering and natural sciences, this paper explores three forms of academic consulting: (1) paid consulting; (2) unpaid consulting…

Between Ideals and Practice: Journalism Students Facing Ethical Dilemmas in Online Newsroom Teaching--Lessons From Denmark

ERIC Educational Resources Information Center

Eberholst, Mads Kaemsgaard; Hartley, Jannie Møller; Olsen, Maria Bendix

2016-01-01

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…

Locating the "I" in the Teaching of Death and Dying: Challenges of the Open Distance Learning Model

ERIC Educational Resources Information Center

Watts, Jacqueline H.

2007-01-01

The UK Open University's second-level undergraduate course "Death and Dying" (K260) draws on personal and professional experience to explore the issues of loss, care, ethical practice, communication and grief. Students come from diverse occupational backgrounds (nurses, social workers, medical practitioners) but many study K260 for…

A Delphi Study to Understand Relational Bonds in Supervision and Their Effect on Rehabilitation Counselor Disclosure in the Public Rehabilitation Program

ERIC Educational Resources Information Center

Magnuson, Lori Anne

2012-01-01

The scholarly literature surrounding counselor supervision suggests that relational bonds built on liking, trusting, and caring between supervisors and counselors positively impact counselor willingness to disclose practice errors and ethical issues in supervision. This Delphi study explored the opinions of expert public rehabilitation supervisors…

Problem-Based Learning in an Online Course: A Case Study

ERIC Educational Resources Information Center

Cheaney, James D.; Ingebritsen, Thomas S.

2005-01-01

Problem-based learning (PBL) is the use of a "real world" problem or situation as a context for learning. The present study explores the use of PBL in an online biotechnology course. In the PBL unit, student groups dealt with the ethical, legal, social, and human issues surrounding pre-symptomatic DNA testing for a genetic disease. Issues…

Nursing students' experiences of ethical issues in clinical practice: A New Zealand study.

PubMed

Sinclair, J; Papps, E; Marshall, B

2016-03-01

Nursing students experience ethical problems in clinical practice in a different way from registered nurses. In order to develop ethical reasoning and competence in nursing students, nurse educators must recognise the unique issues students face. This research described the occurrence of ethical issues in clinical practice for 373 undergraduate nursing students who responded to a national questionnaire investigating the frequency of pre-determined ethical issues and the corresponding level of distress. Over two thirds of respondents experienced breaches of a patient's right to confidentiality, privacy, dignity or respect and 87% experienced unsafe working conditions. The most distressing issues were those that compromised patient safety, including unsafe healthcare practices, working conditions and suspected abuse or neglect. Themes that emerged from an open-ended question included lack of support and supervision, bullying and end of life issues. This research found the frequency at which ethical issues are experienced was highest in year three participants. However, the overall distress levels were lower for the majority of issues for those participants in the later part of their degree. Recommendations from this research include developing ethics education around the main concerns that students face in order to enhance students' understanding, resilience and ability to respond appropriately. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ethical, legal, and social issues: our children's future.

PubMed

Gilbert, Steven G

2005-08-01

A convergence of issues suggests that protecting child health is not so much a matter of research, but rather a matter of policy and advocacy. First, we have well-articulated views of a vision for child health. Second, we have experience and toxicological research findings demonstrating the adverse health effects of hazardous chemicals on children and recognize that children are more sensitive than adults to chemical exposures. Results from toxicology research have motivated many regulatory and legal actions, and public policy decisions, including the banning of some pesticides, reducing exposures in the workplace, and lowering of acceptable blood lead levels in children. We also know that childhood disabilities from chemical exposure during developmental are often not treatable and therefore must be prevented. Finally, we have an increasingly well-defined framework for discussing social and ethical responsibility to our children. New discoveries in the basic biological and toxicological sciences have challenged our bioethical thinking and societal decision-making. This paper will explore the ethical, legal, and social issues raised by the toxicological sciences first by examining some hard lesson learned about childhood effects of chemicals and then by examining the difficult policy and research decisions that must be made as we address our need for additional information about the health effects of chemicals on adults and children and the impact of having this information. The precautionary principle will be considered as an alternative decision-making approach as well as exploring the concept of the citizen toxicologist (CT). As Garrett Hardin pointed out many years ago, the problems we face often have no technical solutions, but rather require a policy-based approach. This paper will be of interest to the public and health professionals concerned about the broader impact of toxicological research on bioethical and societal decision-making.

The 'Magic Light': A Discussion on Laser Ethics.

PubMed

Stylianou, Andreas; Talias, Michael A

2015-08-01

Innovations in technology and science form novel fields that, although beneficial, introduce new bio-ethical issues. In their short history, lasers have greatly influenced our everyday lives, especially in medicine. This paper focuses particularly on medical and para-medical laser ethics and their origins, and presents the complex relationships within laser ethics through a three-dimensional matrix model. The term 'laser' and the myth of the 'magic light' can be identified as landmarks for laser related ethical issues. These ethical issues are divided into five major groups: (1) media, marketing, and advertising; (2) economic outcomes; (3) user training; (4) the user-patient/client relationship; and (5) other issues. In addition, issues arising from two of the most common applications of lasers, laser eye surgery and laser tattoo removal, are discussed. The aim of this paper is to demonstrate that the use of medical and para-medical lasers has so greatly influenced our lives that the scientific community must initiate an earnest discussion of medical laser ethics.

Ethical issues in palliative care for nursing homes: Development and testing of a survey instrument.

PubMed

Preshaw, Deborah Hl; McLaughlin, Dorry; Brazil, Kevin

2018-02-01

To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes. Registered nurses and healthcare assistants have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers. Cross-sectional survey of Registered nurses and healthcare assistants in nursing homes in one region of the UK. A survey instrument, "Ethical issues in Palliative Care for Nursing homes", was developed through the findings of qualitative interviews with Registered nurses and healthcare assistants in nursing homes and a literature review. It was reviewed by an expert panel and piloted prior to implementation in a survey in 2015 with a convenience sample of 596 Registered nurses and healthcare assistants. Descriptive and exploratory factor analyses were used to assess the underlying structure of the Frequency and Distress Scales within the instrument. Analysis of 201 responses (response rate = 33.7%) revealed four factors for the Frequency Scale and five factors for the Distress Scale that comprise the Ethical issues in Palliative Care for Nursing homes. Factors common to both scales included "Processes of care," "Resident autonomy" and "Burdensome treatment." Additionally, the Frequency Scale included "Competency," and the Distress Scale included "Quality of care" and "Communication." The Ethical issues in Palliative Care for Nursing homes instrument has added to the palliative care knowledge base by considering the ethical issues experienced specifically by Registered nurses and healthcare assistants within the nursing home. This research offers preliminary evidence of the psychometric properties of the Ethical issues in Palliative Care for Nursing homes survey instrument. The two largest factors highlight the need to address the organisational aspects of caring and provide training in negotiating conflicting ethical principles. © 2017 John Wiley & Sons Ltd.

Disease, communication, and the ethics of (in) visibility.

PubMed

Pietrzak-Franger, Monika Monika; Holmes, Martha Stoddard

2014-12-01

As the recent Ebola outbreak demonstrates, visibility is central to the shaping of political, medical, and socioeconomic decisions. The symposium in this issue of the Journal of Bioethical Inquiry explores the uneasy relationship between the necessity of making diseases visible, the mechanisms of legal and visual censorship, and the overall ethics of viewing and spectatorship, including the effects of media visibility on the perception of particular "marked" bodies. Scholarship across the disciplines of communication, anthropology, gender studies, and visual studies, as well as a photographer's visual essay and memorial reflection, throw light on various strategies of visualization and (de)legitimation and link these to broader socioeconomic concerns. Questions of the ethics of spectatorship, such as how to evoke empathy in the representation of individuals' suffering without perpetuating social and economic inequalities, are explored in individual, (trans-)national, and global contexts, demonstrating how disease (in)visibility intersects with a complex nexus of health, sexuality, and global/national politics. A sensible management of visibility--an "ecology of the visible"--can be productive of more viable ways of individual and collective engagement with those who suffer.

Ethical issues with colorectal cancer screening-a systematic review.

PubMed

Hofmann, Bjørn

2017-06-01

Colorectal cancer (CRC) screening is widely recommended and implemented. However, sometimes CRC screening is not implemented despite good evidence, and some types of CRC screening are implemented despite lack of evidence. The objective of this article is to expose and elucidate relevant ethical issues in the literature on CRC screening that are important for open and transparent deliberation on CRC screening. An axiological question-based method is used for exposing and elucidating ethical issues relevant in HTA. A literature search in MEDLINE, Embase, PsycINFO, PubMed Bioethics subset, ISI Web of Knowledge, Bioethics Literature Database (BELIT), Ethics in Medicine (ETHMED), SIBIL Base dati di bioetica, LEWI Bibliographic Database on Ethics in the Sciences and Humanities, and EUROETHICS identified 870 references of which 114 were found relevant according to title and abstract. The content of the included papers were subject to ethical analysis to highlight the ethical issues, concerns, and arguments. A wide range of important ethical issues were identified. The main benefits are reduced relative CRC mortality rate, and potentially incidence rate, but there is no evidence of reduced absolute mortality rate. Potential harms are bleeding, perforation, false test results, overdetection, overdiagnosis, overtreatment (including unnecessary removal of polyps), and (rarely) death. Other important issues are related to autonomy and informed choice equity, justice, medicalization, and expanding disease. A series of important ethical issues have been identified and need to be addressed in open and transparent deliberation on CRC screening. © 2016 John Wiley & Sons, Ltd.

Sexual Harassment as an Ethical Issue in Academic Life. Issues in Academic Ethics.

ERIC Educational Resources Information Center

Francis, Leslie Pickering

This book provides a full examination of sexual harassment as an ethical issue in education. It considers issues raised by the definition, understanding, and regulation of campus sexual harassment and addresses the arguments that regulation may conflict with academic freedom and choice in relationships. Part 1 contains these chapters: (1) "Sexual…

Ethical Issues in Volunteer Management and Accountability.

ERIC Educational Resources Information Center

Netting, F. Ellen

1987-01-01

Examines the ethical issues surrounding President Reagan's directive to "Go back to the voluntary sector." Discusses trends which currently affect ethical issues of managing volunteer agencies/programs. Recommends proactive steps to be taken in developing the potential of voluntary organizations, identifying organizations' bases of support,…

Ethical Considerations for Psychologists Taking a Public Stance on Controversial Issues: The Balance Between Personal and Professional Life

PubMed Central

Haeny, Angela M.

2014-01-01

Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association’s (APA’s) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present paper analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present paper examines ethical issues that a) should be taken into account before psychologists take a public position on a controversial issue, and b) are in conflict with APA’s Ethics Code or current research. PMID:25342876

Ethical Considerations for Psychologists Taking a Public Stance on Controversial Issues: The Balance Between Personal and Professional Life.

PubMed

Haeny, Angela M

2014-07-01

Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association's (APA's) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present paper analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present paper examines ethical issues that a) should be taken into account before psychologists take a public position on a controversial issue, and b) are in conflict with APA's Ethics Code or current research.

Incorporating ethical principles into clinical research protocols: a tool for protocol writers and ethics committees

PubMed Central

Li, Rebecca H; Wacholtz, Mary C; Barnes, Mark; Boggs, Liam; Callery-D'Amico, Susan; Davis, Amy; Digilova, Alla; Forster, David; Heffernan, Kate; Luthin, Maeve; Lynch, Holly Fernandez; McNair, Lindsay; Miller, Jennifer E; Murphy, Jacquelyn; Van Campen, Luann; Wilenzick, Mark; Wolf, Delia; Woolston, Cris; Aldinger, Carmen; Bierer, Barbara E

2016-01-01

A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. PMID:26811365

5 CFR 2634.1004 - General rule.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS EXECUTIVE BRANCH FINANCIAL DISCLOSURE...) The Director of the Office of Government Ethics may issue a Certificate of Divestiture for specific... Government Ethics cannot issue a Certificate of Divestiture for property that already has been sold. Example...

5 CFR 2634.1004 - General rule.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS EXECUTIVE BRANCH FINANCIAL DISCLOSURE...) The Director of the Office of Government Ethics may issue a Certificate of Divestiture for specific... Government Ethics cannot issue a Certificate of Divestiture for property that already has been sold. Example...

Changing opinions of Mexican geneticists on ethical issues.

PubMed

Lisker, Rubén; Carnevale, Alessandra

2006-08-01

The discussion of ethical issues in the practice of medical genetics is quite recent in Mexico. However, in the present report we were able to compare the results obtained with the same instrument in two surveys performed with a 12-year interval. A semistructured questionnaire including 52 questions that explore many different situations in the form of case vignettes related to ethical dilemmas was sent on two occasions to geneticists certified by the Mexican Board of Human Genetics. The first survey was performed in 1993, obtaining a response rate of 72% (64 individuals) and the second in 2005 with a 61% response rate (86 individuals). The areas explored were fairness of access to genetic services, full disclosure of all relevant information, respect for parental choices, protection of patients' privacy, use of prenatal diagnosis only for information about the health of the fetus, voluntary vs. mandatory screening and patients' confidentiality vs. the defense of third party interests. All questions analyzed in the paper were answered by at least 80% of the geneticists surveyed, although in many instances their experience with the situation explored was limited. The complete results of the 2005 survey are given in the text and tables, whereas the 1993 results are used mainly for comparison and given in full only when practical. There was a tendency to answer general questions one way and later change opinions when confronted with specific cases. There was a clear paternalistic attitude and a generalized opinion that one of the goals of medical genetics is to diminish the proportion of individuals with genetic diseases, not for eugenics reasons, but to avoid suffering of the patients and their families. Comparison of both surveys clearly shows a tendency towards increasing respect for privacy and autonomy of the patients.

A systematic review of ethical issues in vaccine studies involving pregnant women

PubMed Central

Beeler, Jennifer A.; Lambach, Philipp; Fulton, T. Roice; Narayanan, Divya; Ortiz, Justin R.; Omer, Saad B.

2016-01-01

ABSTRACT Background: Immunization during pregnancy can provide protection for mother and child. However, there have been only a limited number of studies documenting the efficacy and safety of this strategy. Aims: To determine the extent and nature of subject matter related to ethics in maternal immunization by systematically documenting the spectrum of ethical issues in vaccine studies involving pregnant women. Method: We conducted a systematic literature review of published works pertaining to vaccine and therapeutic studies involving pregnant women through searches of PubMed, EMBASE, Web of Science, the Cochrane Database, and ClinicalTrials.gov. We selected literature meeting the inclusion criteria published between 1988 and June 2014. We systematically abstracted subject matter pertaining to ethical issues in immunization studies during pregnancy. Immunization-specific ethical issues were matched and grouped into major categories and subcategories. Results: Seventy-seven published articles met the inclusion criteria. Published articles reported findings on data that had been collected in 26 countries, the majority of which were classified as high-income or upper-middle-income nations according to World Bank criteria. Review of these publications produced 60 immunization-specific ethical issues, grouped into six major categories. Notably, many studies demonstrated limited acknowledgment of key ethical issues including the rights and welfare of participants. Additionally, there was no discussion pertaining to the ethics of program implementation, including integration of maternal immunization programs into existing routine immunization programs. Conclusion: This review of ethical issues in immunization studies of pregnant women can be used to help inform future vaccine trials in this important population. Consistent documentation of these ethical issues by investigators will facilitate a broader and more nuanced discussion of ethics in immunization of pregnant women – offering new and valuable insights for programs developed to prevent disease in newborn children in low- and middle-income countries. PMID:27246403

Interns' perceptions on medical ethics education and ethical issues at the Dokuz Eylul University School of Medicine in Turkey.

PubMed

Ozan, S; Timbil, S; Semin, S; Musal, B

2010-11-01

In Turkey and its neighboring countries, few studies have investigated medical students' reactions to ethics education and ethical issues they encounter. The aim of this study was to investigate interns' perceptions of medical ethics education and ethical issues. In students' first three years at the Dokuz Eylul University School of Medicine, various teaching methods are used in ethics education, including problem-based learning, interactive lectures and movies. During the clinical years, the curriculum helps students consider the ethical dimension of their clinical work, and during the internship period a discussion on ethical issues is held. Data were collected through a questionnaire distributed to interns in the 2005-2006 academic year. Its questions asked about interns' perceived adequacy of their ethics education, any interpersonal ethical problems they had witnessed, their approaches to ethical problems, obstacles they believe prevented them from resolving ethical problems and whether they felt themselves ready to deal with ethical problems. 67.2 % of interns were reached and all of them responded. In the assessment of the adequacy of ethics education, the most favorable score was given to educators. Students' most often mentioned ethical problems encountered were between physicians and students and between physicians and patients. Interns believed that difficult personalities on the team and team hierarchy were important obstacles to resolving ethical problems. There were significant differences between the approaches students currently used in dealing with ethical problems and how they anticipated they would approach these problems in their future professional lives. We obtained information about students' perceptions about ethics education and ethical problems which helped us to plan other educational activities. This study may assist other medical schools in preparing an ethics curriculum or help evaluate an existing curriculum.

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

PubMed

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

2010-08-01

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

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

ERIC Educational Resources Information Center

Csikai, Ellen L.

2004-01-01

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

“Nobody tosses a dwarf!” The relation between the empirical and normative reexamined

PubMed Central

Leget, C.; Borry, P.; De Vries, R.

2009-01-01

This article discusses the relation between empirical and normative approaches in bioethics. The issue of dwarf tossing, while admittedly unusual, is chosen as point of departure because it challenges the reader to look upon several central bioethical themes – including human dignity, autonomy, and the protection of vulnerable people – with fresh eyes. After an overview of current approaches to the integration of empirical and normative ethics, we consider five ways that the empirical and normative can be brought together to speak to the problem of dwarf tossing: prescriptive applied ethics, theorist ethics, critical applied ethics, particularist ethics and integrated empirical ethics. We defend a position of critical applied ethics that allows for a two-way relation between empirical and normative theories. The approach we endorse acknowledges that a social practice can and should be judged by both the gathering of empirical data and by the normative ethics. Critical applied ethics uses a five stage process that includes: (a) determination of the problem, (b) description of the problem, (c) empirical study of effects and alternatives, (d) normative weighing and (e) evaluation of the effects of a decision. In each stage, we explore the perspective from both the empirical (sociological) and the normative ethical poles that, in our view, should operate as two independent focuses of the ellipse that is called bioethics. We conclude by applying our five stage critical applied ethics to the example of dwarf tossing. PMID:19338523

'Nobody tosses a dwarf!' The relation between the empirical and the normative reexamined.

PubMed

Leget, Carlo; Borry, Pascal; de Vries, Raymond

2009-05-01

This article discusses the relation between empirical and normative approaches in bioethics. The issue of dwarf tossing, while admittedly unusual, is chosen as a point of departure because it challenges the reader to look with fresh eyes upon several central bioethical themes, including human dignity, autonomy, and the protection of vulnerable people. After an overview of current approaches to the integration of empirical and normative ethics, we consider five ways that the empirical and normative can be brought together to speak to the problem of dwarf tossing: prescriptive applied ethics, theoretical ethics, critical applied ethics, particularist ethics and integrated empirical ethics. We defend a position of critical applied ethics that allows for a two-way relation between empirical and normative theories. Against efforts fully to integrate the normative and the empirical into one synthesis, we propose that the two should stand in tension and relation to one another. The approach we endorse acknowledges that a social practice can and should be judged both by the gathering of empirical data and by normative ethics. Critical applied ethics uses a five stage process that includes: (a) determination of the problem, (b) description of the problem, (c) empirical study of effects and alternatives, (d) normative weighing and (e) evaluation of the effects of a decision. In each stage, we explore the perspective from both the empirical (sociological) and the normative ethical point of view. We conclude by applying our five-stage critical applied ethics to the example of dwarf tossing.

Ethical Issues in Online Education

ERIC Educational Resources Information Center

Anderson, Bill; Simpson, Mary

2007-01-01

Teaching at a distance raises ethical issues particular to the distance context. When distance teaching is also online teaching, the situation is even more complex. Online teaching environments amplify the ethical issues faced by instructors and students. Online sites support complex discourses and multiple relationships; they cross physical,…

The Ethical Employee.

ERIC Educational Resources Information Center

2002

A study examined the extent to which the issues of business ethics and corporate social responsibility are becoming pertinent among the United Kingdom workforce. A self-completion questionnaire sought views on a range of issues relating to employment and asked about perceptions of individual companies/organizations on work and ethical issues.…

Localized past, globalized future: towards an effective bioethical framework using examples from population genetics and medical tourism.

PubMed

Widdows, Heather

2011-02-01

This paper suggests that many of the pressing dilemmas of bioethics are global and structural in nature. Accordingly, global ethical frameworks are required which recognize the ethically significant factors of all global actors. To this end, ethical frameworks must recognize the rights and interests of both individuals and groups (and the interrelation of these). The paper suggests that the current dominant bioethical framework is inadequate to this task as it is over-individualist and therefore unable to give significant weight to the ethical demands of groups (and by extension communal and public goods). It will explore this theme by considering the inadequacy of informed consent (the 'global standard' of bioethics) to address two pressing global bioethical issues: medical tourism and population genetics. Using these examples it will show why consent is inadequate to address all the significant features of these ethical dilemmas. Four key failures will be explored, namely, • That the rights and interests of those related (and therefore affected) are neglected; • That consent fails to take account of the context and commitments of individuals which may constitute inducement and coercion; • That consent alone does not have the ethical weight to negate exploitation or make an unjust action just ('the fallacy of sufficiency'); • That consent is a single one-off act which is inappropriate for the types of decision being made. It will conclude by suggesting that more appropriate models are emerging, particularly in population genetics, which can supplement consent. © 2010 Blackwell Publishing Ltd.

Why the history of nursing ethics matters.

PubMed

Fowler, Marsha D

2017-05-01

Modern American nursing has an extensive ethical heritage literature that extends from the 1870s to 1965 when the American Nurses Association issued a policy paper that called for moving nursing education out of hospital diploma programs and into colleges and universities. One consequence of this move was the dispersion of nursing libraries and the loss of nursing ethics textbooks, as they were largely not brought over into the college libraries. In addition to approximately 100 nursing ethics textbooks, the nursing ethics heritage literature also includes hundreds of journal articles that are often made less accessible in modern databases that concentrate on the past 20 or 30 years. A second consequence of nursing's movement into colleges and universities is that ethics was no longer taught by nursing faculty, but becomes separated and placed as a discrete ethics (later bioethics) course in departments of philosophy or theology. These courses were medically identified and rarely incorporated authentic nursing content. This shift in nursing education occurs contemporaneously with the rise of the field of bioethics. Bioethics is rapidly embraced by nursing, and as it develops within nursing, it fails to incorporate the rich ethical heritage, history, and literature of nursing prior to the development of the field of bioethics. This creates a radical disjunction in nursing's ethics; a failure to more adequately explore the moral identity of nursing; the development of an ethics with a lack of fit with nursing's ethical history, literature, and theory; a neglect of nursing's ideal of service; a diminution of the scope and richness of nursing ethics as social ethics; and a loss of nursing ethical heritage of social justice activism and education. We must reclaim nursing's rich and capacious ethics heritage literature; the history of nursing ethics matters profoundly.

From shame to shame resilience: narratives of counselor trainees with eating issues.

PubMed

Dayal, Helena; Weaver, Kathryn; Domene, José F

2015-02-01

Using narrative analysis, the experiences of 7 Canadian counselor trainees with eating issues were explored for meanings of shame and resilience. Shame was experienced as layers of discounting and disconnection from self and others, which served as barriers to help seeking and recovery. Trainees' attempts to overcome shame were characterized by a dialectic conflict of protecting shame vs. prioritizing recovery. Finding a culture of safety and belonging, invalidating perfection, and redefining ideals emerged as elements that fostered resilience from the layers of shame. Recommendations for future research include exploring the important features of social support and examining how safe disclosure contributes to overcoming shame. Potential implications for counselor education programs include introducing self-care initiatives, discussions about counselor wellness and ethical practice, and education on eating issues. © The Author(s) 2014.

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

PubMed Central

Newton, M J

1986-01-01

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

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

PubMed

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

2014-09-01

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

Virtue in Medical Practice: An Exploratory Study.

PubMed

Kotzee, Ben; Ignatowicz, Agnieszka; Thomas, Hywel

2017-03-01

Virtue ethics has long provided fruitful resources for the study of issues in medical ethics. In particular, study of the moral virtues of the good doctor-like kindness, fairness and good judgement-have provided insights into the nature of medical professionalism and the ethical demands on the medical practitioner as a moral person. Today, a substantial literature exists exploring the virtues in medical practice and many commentators advocate an emphasis on the inculcation of the virtues of good medical practice in medical education and throughout the medical career. However, until very recently, no empirical studies have attempted to investigate which virtues, in particular, medical doctors and medical students tend to have or not to have, nor how these virtues influence how they think about or practise medicine. The question of what virtuous medical practice is, is vast and, as we have written elsewhere, the question of how to study doctors' moral character is fraught with difficulty. In this paper, we report the results of a first-of-a-kind study that attempted to explore these issues at three medical schools (and associated practice regions) in the United Kingdom. We identify which character traits are important in the good doctor in the opinion of medical students and doctors and identify which virtues they say of themselves they possess and do not possess. Moreover, we identify how thinking about the virtues contributes to doctors' and medical students' thinking about common moral dilemmas in medicine. In ending, we remark on the implications for medical education.

Ethical issues in caring for patients with dementia.

PubMed

Hughes, Julian; Common, Jill

2015-08-05

This article discusses issues that might count as 'ethical' in the care of people with dementia and some of the dilemmas that occur. Ethical theories, such as virtue ethics, deontology and consequentialism are discussed, and ethical approaches that can be useful are outlined. Thinking about matters case-by-case is another approach, one that forms the first component of the Nuffield Council's ethical framework for dementia care, which is described. Case examples are provided, raising issues of autonomy, diagnosis, restraint and withholding treatment. The notion of personhood and the need to understand the person with dementia as broadly as possible are emphasised. Recommendations for nursing practice are included.

Ethics and maternity care: from principles to practice.

PubMed

Lothian, Judith A

2009-01-01

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

Schooling, work satisfaction and productivity: an examination of Jeremy Bentham.

PubMed

Lyons, R G

1998-01-01

This paper examines the ethical dimensions of work productivity and work satisfaction. This issue is explored by looking at the ethical theory of Jeremy Bentham. He argues that work satisfaction is so highly subjective and personal that we can school people to experience work satisfaction when in the most distasteful jobs. Bentham argues that, from the perspective of the principle of utility, there is nothing wrong with schooling some people to experience work satisfaction from what seems like distasteful work. This paper suggests that Bentham's theory justifies class relationship and flies in the face of the notion of equality of job opportunity.

Clinical social work practice and technology: personal, practical, regulatory, and ethical considerations for the twenty-first century.

PubMed

Dombo, Eileen A; Kays, Lisa; Weller, Katelyn

2014-10-01

The world that social work exists in is no longer defined by traditional physical settings and boundaries, such as schools, agencies, or even offices. With the advent of the Internet and digital communications, social work now exists in a far more complex reality, with clients and social workers engaging across multiple platforms, and sometimes even unintentionally and without one another's awareness. The implications of this can be ethical, practical, regulatory, and personal. This article explores these areas of concern and suggests strategies professionals can use to navigate these complex issues related to technology and clinical practice.

Nuclear Power as an Ethical Issue: Utilitarian Ethics and Egalitarian Responses.

ERIC Educational Resources Information Center

Hadjilambrinos, Constantine

1990-01-01

Described is the philosophical debate over the issue of nuclear power. Discussed are the utilitarian nature of the justification of nuclear power and the utilitarian approaches to the issue of nuclear power, the strengths and weaknesses of this approach, and utilitarian versus egalitarian ethics. (KR)

Neuroimaging Research with Children: Ethical Issues and Case Scenarios

ERIC Educational Resources Information Center

Coch, Donna

2007-01-01

There are few available resources for learning and teaching about ethical issues in neuroimaging research with children, who constitute a special and vulnerable population. Here, a brief review of ethical issues in developmental research, situated within the emerging field of neuroethics, highlights the increasingly interdisciplinary nature of…

Ethical and social issues facing obstetricians in low-income countries.

PubMed

Ogwuegbu, Chigbu Chibuike; Eze, Onah Hyacinth

2009-06-01

A review of publications on ethical and social issues from low-income countries was done with the aim of highlighting the major ethical and social issues facing obstetricians in these countries. Low-income countries were identified using the World Health Organization income group classification of member nations. Obstetricians in low-income countries face a wide range of special social and ethical issues that reflect the peculiarities of their practice environment characterized by poverty, low education, deep attachment to tradition and culture, low social status of women, and high levels of physician's paternalism.

The ethics of drug development and promotion: the need for a wider view.

PubMed

Brody, Howard

2012-11-01

Ethical issues at the interface between the medical profession and the pharmaceutical industry have generally been approached from the vantage point of medical professionalism, with a focus on conflict of interest as the key ethical concern. Although conflicts of interest remain important, other ethical issues may be obscured unless a wider perspective is adopted. Besides medical professionalism, the ethics of the clinical therapeutic relationship, ethics of public health, and business ethics all provide additional insights.

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

ERIC Educational Resources Information Center

Swann, Stephanie; Herbert, Sarah E.

1999-01-01

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

End-of-life ethics and disability: differing perspectives on case-based teaching.

PubMed

Kaufert, Joseph; Wiebe, Rhonda; Schwartz, Karen; Labine, Lisa; Lutfiyya, Zana Marie; Pearse, Catherine

2010-05-01

The way in which medical professionals engage in bioethical issues ultimately reflects the type of care such patients are likely to receive. It is therefore critical for doctors and other health care professionals to have a broad understanding of disability. Our purpose in this paper is to explore ways of teaching bioethical issues to first year medical students by integrating alternative approaches. Such approaches include (a) the use of the narrative format, (b) the inclusion of a disability perspective, and (c) the presentation and facilitation of classes by people with disabilities. We consider how these new kinds of presentations are evaluated by students, faculty, people with disabilities and professional ethicists. We hope new knowledge may provide health care professionals with a greater understanding of the perspectives of patients with disabilities, who are confronted by conflicting ethical values and frameworks for decision-making in their interaction with such professionals.

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

ERIC Educational Resources Information Center

Prock, Valencia N., Ed.; And Others

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

"Business Ethics Everywhere": An Experiential Exercise to Develop Students' Ability to Identify and Respond to Ethical Issues in Business

ERIC Educational Resources Information Center

Baker, Susan D.; Comer, Debra R.

2012-01-01

This article introduces an experiential exercise that enhances students' ability to identify ethical issues and to respond to them in ways that consider the relationship between organizational factors and ethical action. Students identify a required number of ethical incidents in their workplaces during a specified period. Students submit a…

The informal curriculum - general practitioner perceptions of ethics in clinical practice.

PubMed

Sturman, Nancy J; Parker, Malcolm; van Driel, Mieke L

2012-12-01

Australian medical students should graduate with an understanding of the principles of medical law and ethics, and their application to clinical settings. Although student perspectives have been studied previously, the teacher experience of ethical issues also needs to be understood, particularly in the general practice setting. Interviews were conducted with a convenience sample of 13 general practitioner teachers. They were asked to reflect on common and/or important ethical issues in their day-to-day practice. An inductive thematic analysis of the data was performed by two investigators, who reached a consensus on major themes using an iterative, dialogic process. Participants reported negotiating ethical issues frequently. Major themes included patient-doctor relationships, professional differences, truth-telling, ethically 'grey' areas and the personal demands of ethical decision making. General practitioners in this study describe sometimes needing to apply judgement and compromise in situations involving legal or ethical issues, in order to act in the best interests of patients and to successfully negotiate the patient-doctor relationship. Students learning in this clinical context may perceive mixed messages and ethical lapses in these challenging 'grey' areas. The ethical acumen and emotional resilience of both students and clinical teachers may be enhanced by ongoing reflective discussion with colleagues.

Pharmacists' Assessment of the Difficulty and Frequency of Ethical Issues Encountered in Community Pharmacy Settings.

PubMed

Crnjanski, Tatjana; Krajnovic, Dusanka; Savic, Mirko

2017-05-23

Researching ethical problems and their frequency could give us a complex picture and greater insight into the types of ethical issues that pharmacists face in providing health care. The overall aim of this study was to assess the pharmacist's perception of difficulty and frequency of selected ethical issues encountered by the community pharmacists in their everyday practice. A quantitative cross sectional multicenter study was performed using a validated survey instrument - Ethical Issue Scale for Community Pharmacy (EISP). The results of the analysis of 690 completely filled out instruments (response rate 78.49%) showed the difference between the ethical issues which always occurred ("A pharmacist is prevented from dispensing a medicine to the patient due to an administrative error in the prescription"), and the ones that pharmacists found most difficult ("A pharmacist dispenses a medicine he/she personally considers inadequate for the therapeutic treatment of the patient, in order to avoid any conflicts with the physician" and "A pharmacist is considering violating the rules and regulations in order to perform an act of humanity"). The majority of respondents (84.78%) were familiar with the Code of Ethics but the correlation between the familiarity and the perceived usefulness of the code in resolving problems in everyday practice was negative (ρ = -0.17, p < 0.001). Results showed that patients' well-being had a high influence on pharmacists' behavior. The results provided quantitative data by the examination of specific ethical issues and their occurrence. Further empirical research is recommended in order to systematically identify the ethical issues faced by community pharmacists.

Ethical issues in paleopathological and anthropological research experiences.

PubMed

Licata, Marta; Monza, Francesca

2017-10-23

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

Death with dignity from the Confucian perspective.

PubMed

Li, Yaming; Li, Jianhui

2017-02-01

Death with dignity is a significant issue in modern bioethics. In modern healthcare, the wide use of new technologies at the end of life has caused heated debate on how to protect human dignity. The key point of contention lies in the different understandings of human dignity and the dignity of death. Human dignity has never been a clear concept in Western ethical explorations, and the dignity of death has given rise to more confusions. Although there is no such term as "dignity" in Confucian ethics, there are discussions of a number of ideas related to human dignity and the dignity of death. Therefore, Confucian bioethics can offer a new perspective for understanding the theoretical difficulties associated with the dignity of death and new methods for solving them. In this article, we attempt to reconstruct Confucian views on human dignity and the dignity of death and, based on those views, to analyze the following issues: the relationship between the dignity of death and biological life, the relationship between the dignity of death and suffering, the relationship between the dignity of death and the autonomy of human beings, and the relationship between the dignity of death and social justice. This article will also compare the Confucian views on these issues with the views of Western philosophers. Confucian ethics can offer distinct answers to the above issues and help resolve some confusions concerning concepts and theories in Western research on the dignity of death.

[Equity in health? Health inequalities, ethics, and theories of distributive justice].

PubMed

Buyx, A M

2010-01-01

It is well-documented that the socio-economic status has an important influence on health. In all developed countries, health is closely correlated with income, education, and type of employment, as well as with several other social determinants. While data on this socio-economic health gradient have been available for decades, the moral questions surrounding social health inequalities have only recently been addressed within the field of public health ethics. The present article offers a brief overview of relevant data on social health inequalities and on some explanatory models from epidemiology, social medicine and related disciplines. The main part explores three influential normative accounts addressing the issue of health inequalities. Finally, an agenda for future work in the field of public health ethics and health inequalities is sketched, with particular attention to the German context.

Views of Academic and Community Partners Regarding Participant Protections and Research Integrity: A Pilot Focus Group Study

PubMed Central

Anderson, Emily E.

2013-01-01

When community partners have direct interaction with human research participants, it is important to consider potential threats to participant protections and research integrity. Few studies have directly compared the views of academic and community partners. This pilot focus group study explores the views of academic partners (APs) and community partners (CPs) regarding challenges to the protection of research participants and research integrity in community-engaged research (CEnR). Data are analyzed to understand how APs and CPs define and think about ethical problems and how meaning and analysis may differ between the two groups. Findings have implications for the development of research ethics training materials for academic-community research partnerships and IRBs; best practices for CEnR; and future research on ethical issues in CEnR. PMID:23485668

Public health equity in refugee situations

PubMed Central

2011-01-01

Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003. Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction. Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions. PMID:21575218

Taiwan Biobank: a project aiming to aid Taiwan's transition into a biomedical island.

PubMed

Fan, Chien-Te; Lin, Jui-Chu; Lee, Chung-His

2008-02-01

Essentially, the term 'biobank' can be defined in different ways. Taking the UK Biobank's experience as the main example, the Taiwan Biobank aims to collect the DNA of a large group of people on the population base and track their health and lifestyle for at least 10 years. It is hoped that the information collected, regarding the mechanisms underlying how genes and environmental factors interact with each other to make us ill, will benefit the society in various ways, including the exploration of a new generation of treatments, support to preventive medicine discovery and also the possible benefits for the promotion of evolving public health-related industries in Taiwan. However, the involvement of large-scale population base gene data collection also triggered serious ethical, legal and social issues. In Taiwan, the challenge is even more serious than for any other biobanking experiences that have occurred previously. Among all the ethical, legal and social issues, the convergence of aboriginal people protection provided under Taiwan's Constitution imposes on the research team an obligation to create an innovative Ethical & Legal Governance Framework adaptable to the unique social background of Taiwan, including a workable public consultation/communication mechanism. In early 2005, the creation of the 'Taiwan Biobank' has been included as a part of Taiwan's strategic development in promoting the country as an island of biomedicine. In this report, the ideology, the goals and special features, government strategy, visions and, in particular, the ethical, legal and social issue planning of the Taiwan Biobank will be briefly introduced and reviewed.

Public health equity in refugee situations.

PubMed

Leaning, Jennifer; Spiegel, Paul; Crisp, Jeff

2011-05-16

Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003.Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction.Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.

Exploring morally relevant issues facing families in their decisions to monitor the health-related behaviours of loved ones.

PubMed

Gammon, D; Christiansen, E K; Wynn, R

2009-07-01

Patient self-management of disease is increasingly supported by technologies that can monitor a wide range of behavioural and biomedical parameters. Incorporated into everyday devices such as cell phones and clothes, these technologies become integral to the psychosocial aspects of everyday life. Many technologies are likely to be marketed directly to families with ill members, and families may enlist the support of clinicians in shaping use. Current ethical frameworks are mainly conceptualised from the perspective of caregivers, researchers, developers and regulators in order to ensure the ethics of their own practices. This paper focuses on families as autonomous decision-makers outside the regulated context of healthcare. We discuss some morally relevant issues facing families in their decisions to monitor the health-related behaviours of loved ones. An example - remote parental monitoring of adolescent blood glucose - is presented and discussed through the lens of two contrasting accounts of ethics; one reflecting the predominant focus on health outcomes within the health technology assessment (HTA) framework and the other that attends to the broader sociocultural contexts shaping technologies and their implications. Issues discussed include the focus of assessments, informed consent and child assent, and family co-creation of system characteristics and implications. The parents' decisions to remotely monitor their child has relational implications that are likely to influence conflict levels and thus also health outcomes. Current efforts to better integrate outcome assessments with social and ethical assessments are particularly relevant for informed decision-making about health monitoring technologies in families.

Management of ethical issues related to care of seriously ill dialysis patients in free-standing facilities.

PubMed

Song, Mi-Kyung; Hanson, Laura C; Gilet, Constance A; Jo, Minjeong; Reed, Teresa J; Hladik, Gerald A

2014-09-01

There are few data on the frequency and current management of clinical ethical issues related to care of seriously ill dialysis patients in free-standing dialysis facilities. To examine the extent of clinical ethical challenges experienced by care providers in free-standing facilities and their perceptions about how those issues are managed. A total of 183 care providers recruited from 15 facilities in North Carolina completed a survey regarding the occurrence and management of ethical issues in the past year. Care plan meetings were observed at four of the facilities for three consecutive months. Also, current policies and procedures at each of the facilities were reviewed. The two most frequently experienced challenges involved dialyzing frail patients with multiple comorbidities and caring for disruptive/difficult patients. The most common ways of managing ethical issues were discussions in care plan meetings (n = 47) or discussions with the clinic manager (n = 47). Although policies were in place to guide management of some of the challenges, respondents were often not aware of those policies. Also, although participants reported that ethical issues related to dialyzing undocumented immigrants were fairly common, no facility had a policy for managing this challenge. Participants suggested that all staff obtain training in clinical ethics and communication skills, facilities develop ethics teams, and there be clear policies to guide management of ethical challenges. The scope of ethical challenges was extensive, how these challenges were managed varied widely, and there were limited resources for assistance. Multifaceted efforts, encompassing endeavors at the individual, facility, organization, and national levels, are needed to support staff in improving the management of ethical challenges in dialysis facilities. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Teaching ethics to engineers - a research-based perspective

NASA Astrophysics Data System (ADS)

Bowden, Peter

2010-10-01

This paper describes research underpinning a course, developed in Australia, on ethics for engineers. The methodology used, that of identifying the principal ethical issues facing the discipline and designing the course around these issues, would be applicable to other disciplines and in other countries. The course was based on the assumption that identifying the major ethical issues in the discipline, and subsequently presenting and analysing them in the classroom, would provide the future professional with knowledge of the ethical problems that they were likely to face on graduation. The student has then to be given the skills and knowledge to combat these concerns, should he/she wish to. These findings feed into several components of the course, such as the development of a code of ethics, the role of a professional society or industry association and the role of ethical theory The sources employed to identify the issues were surveys of the literature and about 30 case studies, in Australia and overseas. The issues thus identified were then put before a sample of engineering managers to assess the relevance to the profession.

5 CFR 2634.1007 - Cases in which Certificates of Divestiture will not be issued.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ETHICS GOVERNMENT ETHICS EXECUTIVE BRANCH FINANCIAL DISCLOSURE, QUALIFIED TRUSTS, AND CERTIFICATES OF... issued. The Director of the Office of Government Ethics, in his or her sole discretion, may deny a... a contract to renovate office space at his agency. The Department's designated agency ethics...

Ethical Issues in School Health: A Survey.

ERIC Educational Resources Information Center

Richardson, Glenn E.; Jose, Nancy

1983-01-01

The need for a code of ethics for health educators is discussed, and results of a survey of school health educators' opinions on curriculum-related ethical issses are reported. Ethical issues of concern include use of scare tactics, efforts to change behavior and attitudes, and appropriate subject matter. (PP)

78 FR 55171 - Removal of Standards of Ethical Conduct Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-10

... Ethical Conduct Regulations AGENCY: Special Inspector General for Iraq Reconstruction. ACTION: Final rule... concurrence of the Office of Government Ethics (OGE), issued a final rule for employees of the SIGIR that supplemented the executive-branch-wide Standards of Ethical Conduct (Standards) issued by OGE. With certain...

Ethical considerations of teaching spirituality in the academy.

PubMed

Becker, Annette L

2009-11-01

Despite evidence in college students indicating a hunger for spiritual insight and spirituality's application in health care, there continues to be guardedness within the academy towards inclusion of curricula that address spirituality. The purpose of this article is to examine the ethical considerations of teaching spirituality in the academy by describing current trends, issues relevant to nursing education and practice, legitimate concerns of the academy, and the importance of an ethical instructional response when teaching about spirituality. Data supporting the interest and desire by students to explore meaning and purpose in the context of spirituality will be presented. Challenges and barriers inherent in teaching this topic will be described, including the affective response, the lack of a universally accepted definition of spirituality, and spirituality's relationship to religion. Pedagogical strategies consistent with an ethical instructional response will be discussed as the key to eliciting trust within the academy. A model of teaching spirituality and health will be offered to illustrate these possibilities.

Protection of health research participants in the United States: a review of two cases.

PubMed

Douglass, Alison; Crampton, Peter

2004-06-01

Two research-related deaths and controversies in the United States during recent years have raised public concern over the safety of research participants. This paper explores the reasons why, in two studies, there was a failure of ethical oversight. The issues exposed by these failures have international relevance as they could possibly occur anywhere where human health research is carried out. Five factors that contributed to these failures are highlighted: 1. failure to support and resource research ethics committees; 2. failure of the research oversight process to adequately assess the risks and benefits of research, while giving undue emphasis to informed consent; 3. conflicts of interest arising from financial relationships and research ethics committee membership; 4. lack of consistent oversight of privately funded research; and 5. incompetent or intentional failure to adhere by ethical guidelines. There is considerable headway to be made in the United States, as in other countries, in the fostering and maintenance of robust systems of human research oversight.

The ethics of uterus transplantation.

PubMed

Catsanos, Ruby; Rogers, Wendy; Lotz, Mianna

2013-02-01

Human uterus transplantation (UTx) is currently under investigation as a treatment for uterine infertility. Without a uterus transplant, the options available to women with uterine infertility are adoption or surrogacy; only the latter has the potential for a genetically related child. UTx will offer recipients the chance of having their own pregnancy. This procedure occurs at the intersection of two ethically contentious areas: assisted reproductive technologies (ART) and organ transplantation. In relation to organ transplantation, UTx lies with composite tissue transplants such as face and limb grafts, and shares some of the ethical concerns raised by these non-life saving procedures. In relation to ART, UTx represents one more avenue by which a woman may seek to meet her reproductive goals, and as with other ART procedures, raises questions about the limits of reproductive autonomy. This paper explores the ethical issues raised by UTx with a focus on the potential gap between women's desires and aspirations about pregnancy and the likely functional outcomes of successful UTx. © 2011 Blackwell Publishing Ltd.

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

ERIC Educational Resources Information Center

Smith, Nick L.

2008-01-01

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

Contested Terrains: A Personal Journey through Image, (National) Identity and Ethics

ERIC Educational Resources Information Center

Gardner, Viv

2005-01-01

The essay deals with a Ugandan production of Brecht's Mother Courage and her Children and the issues raised when it travelled from Uganda to the United States, South Africa and back to Uganda. It explores the shift in perception and conception that happened/happens to both image and national identity when a production moved from one cultural…

Ethics, Vulnerability, and Speakers of Other Languages: How University IRBs (Do Not) Speak to Research Involving Refugee Participants

ERIC Educational Resources Information Center

Perry, Kristen H.

2011-01-01

In this study, the author analyzes the websites of 32 universities' Institutional Review Boards (IRBs) to explore two specific issues: (a) how individual IRBs define "vulnerable populations," and (b) the guidelines those IRBs offer with respect to participants who may have limited or no English language proficiency. Analysis indicates wide…

Moral Problems as Issues-Centered Social Studies Education: Discovering Dewey as a Guiding Foundation

ERIC Educational Resources Information Center

Jorgensen, C. Gregg

2013-01-01

By considering ethics and morals from a vantage point in which personal and political beliefs become part of our national debate, students could form the habit of political discussion in much the same way that representatives of social and political groups prepare and respond on a daily basis to an ever inquiring media. I will explore several…

Sustainability, the Arts and Big Numbers: the Challenge of Researching Children's Responses to Chris Jordan's Images

ERIC Educational Resources Information Center

O'Gorman, Lyndal

2017-01-01

Through the multiple languages of the arts, many ideas about sustainability can be explored with young children. This paper discusses the ethical issues involved in the implementation of a research study that uses artist Chris Jordan's confronting images about sustainability. Jordan's images typically depict tens of thousands of objects such as…

In Harm's Way: When Should We Risk American Lives in World Conflicts? A Study Circle Program.

ERIC Educational Resources Information Center

Lord, Mary, Ed.; McCoy, Martha L., Ed.

This four-session discussion guide, intended for use by teachers, students, and the community at large, explores the ethics of intervening or not intervening in conflicts abroad. Inserts provide current information on conflicts in Bosnia, Haiti, North Korea, and Somalia where U.S. military involvement is at issue, but the flexibility of the guide…

Working in America, Part I. Materials for Using American Issues Forum in the American History Classroom, Topic V.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of General Education Curriculum Development.

The learning module is the first in a three part series which examines American history in light of industrial development and expansion. Presented in field test condition to allow for feedback from students and teachers, the booklet explores the American work ethic through presentation of an extensive teacher background section, eight class…

Ethical issues confronted by medical students during clinical rotations.

PubMed

Fard, Nazila Nikravan; Asghari, Fariba; Mirzazadeh, Azim

2010-07-01

This study aimed to examine the most common and important ethical issues confronting medical students during clinical rotations so that ethics-related topics can be prioritised according to students' needs and this information used to develop a curriculum for the ethics course. In a cross-sectional approach, we reviewed the medical ethics-related cases recorded in the logbooks of all medical students (n=241) at Tehran University of Medical Sciences who attended the medical ethics course during October 2006 to July 2007. As part of a graded assignment, each student was required to record three encounters with ethics-related issues in his or her logbook. A total of 713 cases were assessed. Information related to the ethical issues and the conditions in which ethical issues arose was extracted and recorded by two experts, whose analysis showed agreement of kappa 0.77. In cases of discrepancy, both experts reviewed and discussed the record until they achieved agreement. A total of 713 cases were analysed. The most common issues reported by students related to ethics in medical education (20.1%, n=143), professionalism (18.8%, n=134), confidentiality (7.6%, n=54), the doctor-patient relationship (7.3%, n=52), informed consent (7.0%, n=50) and the doctor-peer relationship (7.0%, n=50). After adjusting for length of rotation, the highest numbers of ethics-related incidents were reported from urology, general surgery, orthopaedics, internal medicine, neurology, and obstetrics and gynaecology wards. The results of this study indicate that professionalism and related elements represent one of the most important areas of concern that need to be addressed when planning courses for medical students. The other significant area of concern is that of ethics in medical education, which, although the subject is not considered essential for medical practitioners, should be taught and respected so that student sensitivity to medical ethics is maintained and even increased.

Ethical, legal, and social issues in the translation of genomics into health care.

PubMed

Badzek, Laurie; Henaghan, Mark; Turner, Martha; Monsen, Rita

2013-03-01

The rapid continuous feed of new information from scientific discoveries related to the human genome makes translation and incorporation of information into the clinical setting difficult and creates ethical, legal, and social challenges for providers. This article overviews some of the legal and ethical foundations that guide our response to current complex issues in health care associated with the impact of scientific discoveries related to the human genome. Overlapping ethical, legal, and social implications impact nurses and other healthcare professionals as they seek to identify and translate into practice important information related to new genomic scientific knowledge. Ethical and legal foundations such as professional codes, human dignity, and human rights provide the framework for understanding highly complex genomic issues. Ethical, legal, and social concerns of the health provider in the translation of genomic knowledge into practice including minimizing harms, maximizing benefits, transparency, confidentiality, and informed consent are described. Additionally, nursing professional competencies related to ethical, legal, and social issues in the translation of genomics into health care are discussed. Ethical, legal, and social considerations in new genomic discovery necessitate that healthcare professionals have knowledge and competence to respond to complex genomic issues and provide appropriate information and care to patients, families, and communities. Understanding the ethical, legal, and social issues in the translation of genomic information into practice is essential to provide patients, families, and communities with competent, safe, effective health care. © 2013 Sigma Theta Tau International.

Ethics issues for HIV/AIDS researchers in international settings - perspectives from the Canadian experience.

PubMed

Gahagan, Jacqueline; Sweeney, Ellen; Worthington, Catherine; Perry, Darryl; Satzinger, Franziska; Rogers, Erin

2008-11-01

In recognition of the level of international HIV/AIDS research being conducted by Canadians, the Canadian Association for HIV Research (CAHR), along with its partners, has developed a resource document to assist researchers in identifying and preparing for the unique ethics issues and challenges that may arise during international HIV/AIDS research. Between 2004 and 2007, face-to-face consultations were undertaken with community and government stakeholders, and interviews were conducted with eight prominent HIV/AIDS researchers with international experience to identify key research ethics challenges and structural, cultural, political, social, and economic factors that may impact HIV/AIDS research ethics in resource-limited settings. These challenges and factors served as the basis for the hypothetical ethics issues case scenarios developed for each of the four research tracks. Ethics issues were identified at every stage of the research process. Key contextual issues included: (1) stigma and culturally-embedded conceptualizations of HIV; (2) local and global politics and economics; (3) gender inequities, power dynamics, and sexual roles; and (4) allocation and availability of resources for research and health services. The final document resulting from the consultation process provides a framework for open dialogue on the complex and interconnected ethics issues researchers may experience in the field of international HIV/AIDS research, and contributes to the HIV/AIDS research field by reinforcing the need for high quality and ethically sound research. This document can be found at http://ethics.cahr-acrv.ca/.

Moving life science ethics debates beyond national borders: some empirical observations.

PubMed

Bezuidenhout, Louise

2014-06-01

The life sciences are increasingly being called on to produce "socially robust" knowledge that honors the social contract between science and society. This has resulted in the emergence of a number of "broad social issues" that reflect the ethical tensions in these social contracts. These issues are framed in a variety of ways around the world, evidenced by differences in regulations addressing them. It is important to question whether these variations are simply regulatory variations or in fact reflect a contextual approach to ethics that brings into question the existence of a system of "global scientific ethics". Nonetheless, within ethics education for scientists these broad social issues are often presented using this scheme of global ethics due to legacies of science ethics pedagogy. This paper suggests this may present barriers to fostering international discourse between communities of scientists, and may cause difficulties in harmonizing (and transporting) national regulations for the governance of these issues. Reinterpreting these variations according to how the content of ethical principles is attributed by communities is proposed as crucial for developing a robust international discourse. To illustrate this, the paper offers some empirical fieldwork data that considers how the concept of dual-use (as a broad social issue) was discussed within African and UK laboratories. Demonstrating that African scientists reshaped the concept of dual-use according to their own research environmental pressures and ascribed alternative content to the principles that underpin it, suggests that the limitations of a "global scientific ethics" system for these issues cannot be ignored.

Ethics and human rights issues experienced by nurses in leadership roles.

PubMed

Redman, Barbara A; Fry, Sara T

2003-01-01

The aims of this study were to identify (1) the ethics and human rights issues experienced by nurses in leadership roles (NLs); (2) how frequently these issue occurred in the NLs'practices; and (3) how disturbed the NLs were by the issues. Dillman's Total Design Method (1978) for mailed surveys guided the study design. Data analysis was performed on 470 questionnaires from New England RNs in nursing leadership roles. The most frequently experienced ethics and human rights issues during the previous 12 months were (1) protecting patient right and human dignity; (2) respecting or not respecting informed consent to treatment; (3) use or nonuse of physical or chemical restraints; (4) providing care with possible risks to the RN's health; (5) following or not following advance directives; and (6) staffing patterns that limit patient access to nursing care. The most disturbing ethics and human rights issues experienced by the NLs were staffing patterns that limited patient access to nursing care, prolonging the dying process with inappropriate measures, working with unethical, incompetent, or impaired colleagues, implementing managed care policies that threaten quality of care, not considering quality of the patient's life, and caring for patients and families who are uninformed or misinformed about treatment, prognosis, or medical alternatives. Nearly 39% of the NLs reported experiencing ethics and human rights issues one to four times a week or more, and more than 90% handled their most recent ethics issue by discussing it with nursing peers. Study findings have implications for ethics education and resource support for nurses in leadership roles, and for further research on how NLs handle ethics and human rights issues in the workplace.

Incorporating ethical principles into clinical research protocols: a tool for protocol writers and ethics committees.

PubMed

Li, Rebecca H; Wacholtz, Mary C; Barnes, Mark; Boggs, Liam; Callery-D'Amico, Susan; Davis, Amy; Digilova, Alla; Forster, David; Heffernan, Kate; Luthin, Maeve; Lynch, Holly Fernandez; McNair, Lindsay; Miller, Jennifer E; Murphy, Jacquelyn; Van Campen, Luann; Wilenzick, Mark; Wolf, Delia; Woolston, Cris; Aldinger, Carmen; Bierer, Barbara E

2016-04-01

A novel Protocol Ethics Tool Kit ('Ethics Tool Kit') has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Current and Emerging Ethical Issues in Counseling: A Delphi Study of Expert Opinions

ERIC Educational Resources Information Center

Herlihy, Barbara; Dufrene, Roxane L.

2011-01-01

A Delphi study was conducted to ascertain the opinions of panel experts regarding the most important current and emerging ethical issues facing the counseling profession. Expert opinions on ethical issues in counselor preparation also were sought. Eighteen panelists responded to 3 rounds of data collection interspersed with feedback. Themes that…

Ethics: The Role of Adult and Vocational Education. Trends and Issues Alert No. 24.

ERIC Educational Resources Information Center

Wonacott, Michael E.

Ethics and social responsibility are the subject of both curriculum materials and research in adult and vocational education. State academic standards and curriculum frameworks address citizenship and personal and social responsibility. Ethical and legal issues for specific occupations are addressed in curricula issued by states, professional…