Stages of Ethical Reasoning and Moral Norms of Carib Youths

ERIC Educational Resources Information Center

Gorsuch, Richard L.; Barnes, M. Louise

1973-01-01

Ethical development was investigated in a cross-cultural context by examining both the cognitive structure of ethical reasoning and the content of perceived moral norms in black Carib boys of British Honduras in the framework of stage theory. (Author/JM)

Partial and impartial ethical reasoning in health care professionals.

PubMed

Kuhse, H; Singer, P; Rickard, M; Cannold, L; van Dyk, J

1997-08-01

To determine the relationship between ethical reasoning and gender and occupation among a group of male and female nurses and doctors. Partialist and impartialist forms of ethical reasoning were defined and singled out as being central to the difference between what is known as the "care" moral orientation (Gilligan) and the "justice" orientation (Kohlberg). A structured questionnaire based on four hypothetical moral dilemmas involving combinations of (health care) professional, non-professional, life-threatening and non-life-threatening situations, was piloted and then mailed to a randomly selected sample of doctors and nurses. 400 doctors from Victoria, and 200 doctors and 400 nurses from New South Wales. 178 doctors and 122 nurses returned completed questionnaires. 115 doctors were male, 61 female; 50 nurses were male and 72 were female. It was hypothesised that there would be an association between feminine subjects and partialist reasoning and masculine subjects and impartialist reasoning. It was also hypothesised that nurses would adopt a partialist approach to reasoning and doctors an impartialist approach. No relationship between any of these variables was observed.

Partial and impartial ethical reasoning in health care professionals.

PubMed Central

Kuhse, H; Singer, P; Rickard, M; Cannold, L; van Dyk, J

1997-01-01

OBJECTIVES: To determine the relationship between ethical reasoning and gender and occupation among a group of male and female nurses and doctors. DESIGN: Partialist and impartialist forms of ethical reasoning were defined and singled out as being central to the difference between what is known as the "care" moral orientation (Gilligan) and the "justice" orientation (Kohlberg). A structured questionnaire based on four hypothetical moral dilemmas involving combinations of (health care) professional, non-professional, life-threatening and non-life-threatening situations, was piloted and then mailed to a randomly selected sample of doctors and nurses. SETTING: 400 doctors from Victoria, and 200 doctors and 400 nurses from New South Wales. RESULTS: 178 doctors and 122 nurses returned completed questionnaires. 115 doctors were male, 61 female; 50 nurses were male and 72 were female. It was hypothesised that there would be an association between feminine subjects and partialist reasoning and masculine subjects and impartialist reasoning. It was also hypothesised that nurses would adopt a partialist approach to reasoning and doctors an impartialist approach. No relationship between any of these variables was observed. PMID:9279744

Mock Institutional Review Board: Promoting Analytical and Reasoning Skills in Research Ethics.

PubMed

Dols, Jean Dowling; Hoke, Mary M; Rauschhuber, Maureen L

Although it is critical that nurses possess ethical reasoning skills for research, there is limited information on effective strategies to develop these skills in graduate health care students. A research study analyzing educational interventions including the effect of online human subjects training followed by a mock institutional review board simulation demonstrated that knowledge acquisition is not enough to acquire the ethical reasoning skills needed to implement health care research. Situational context is also needed to envision the application of ethical principles.

Practical Reason in Practice: Reflections on a Business Ethics Course.

ERIC Educational Resources Information Center

Warren, Richard C.

1995-01-01

A business ethics course aiming to depict business as a system of relationships and responsibilities covers the following areas: consideration of the moral climate of society, character development, exercise of moral imagination, and moral reasoning. The course introduces ethical theory and argument in a business context. (SK)

Reasons Preventing Teachers from Acting within the Framework of Ethical Principles

ERIC Educational Resources Information Center

Dag, Nilgün; Arslantas, Halis Adnan

2015-01-01

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

Ethical Reasoning Instruction in Non-Ethics Business Courses: A Non-Intrusive Approach

ERIC Educational Resources Information Center

Wilhelm, William J.

2010-01-01

This article discusses four confirmatory studies designed to corroborate findings from prior developmental research which yielded statistically significant improvements in student moral reasoning when specific instructional strategies and content materials were utilized in non-ethics business courses by instructors not formally trained in business…

The role of professional knowledge in case-based reasoning in practical ethics.

PubMed

Pinkus, Rosa Lynn; Gloeckner, Claire; Fortunato, Angela

2015-06-01

The use of case-based reasoning in teaching professional ethics has come of age. The fields of medicine, engineering, and business all have incorporated ethics case studies into leading textbooks and journal articles, as well as undergraduate and graduate professional ethics courses. The most recent guidelines from the National Institutes of Health recognize case studies and face-to-face discussion as best practices to be included in training programs for the Responsible Conduct of Research. While there is a general consensus that case studies play a central role in the teaching of professional ethics, there is still much to be learned regarding how professionals learn ethics using case-based reasoning. Cases take many forms, and there are a variety of ways to write them and use them in teaching. This paper reports the results of a study designed to investigate one of the issues in teaching case-based ethics: the role of one's professional knowledge in learning methods of moral reasoning. Using a novel assessment instrument, we compared case studies written and analyzed by three groups of students whom we classified as: (1) Experts in a research domain in bioengineering. (2) Novices in a research domain in bioengineering. (3) The non-research group--students using an engineering domain in which they were interested but had no in-depth knowledge. This study demonstrates that a student's level of understanding of a professional knowledge domain plays a significant role in learning moral reasoning skills.

Promoting Ethical Reasoning, Affect and Behaviour Among High School Students: An Evaluation of Three Teaching Strategies.

ERIC Educational Resources Information Center

DeHaan, Robert; Hanford, Russell; Kinlaw, Kathleen; Philler, David; Snarey, John

1997-01-01

Compares the effectiveness of three classes teaching ethical reasoning to high school students. The three classes were an introductory ethics class, a blended economics-ethics class, and a role-model ethics class taught by graduate students. Tests measured the ways students reason, feel, and act with regard to ethical-normative issues. (MJP)

Defining, Teaching, and Assessing Ethical Reasoning in Action

ERIC Educational Resources Information Center

Sanchez, Elizabeth R. H.; Fulcher, Keston H.; Smith, Kristen L.; Ames, Allison; Hawk, William J.

2017-01-01

National events highlight a critical need for refined decision-making skills; tragic ethical shortcomings are all too common in our society (James Madison University, 2013; Smith, Fulcher, & Sanchez, 2015). While employers around the world seek professionals with developed reasoning abilities (Hart Research Associates, 2013; Lau, 2010), higher…

Ethical Reasoning: A Heuristic Approach for Business Educators.

ERIC Educational Resources Information Center

Molberg, Diane R.

For the teaching of business report writing, ethical reasoning can be used as a heuristic for thinking that will encourage a more effective communication pattern for business students. Writing processes can be applied to thinking processes to help students approach theoretical concepts, make decisions, and write more effective business reports. A…

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

NASA Astrophysics Data System (ADS)

Berne, Birgitta

2014-11-01

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

Examining Moral Reasoning and Ethical Decision Making among Mississippi's Community College Administrators

ERIC Educational Resources Information Center

Wilson, Vernesia Bracey

2010-01-01

As ethical dilemmas arise in community colleges, administrators make decisions that require sensitivity to the organizational, political, and environmental factors surrounding their particular institutional climates and locales. The moral reasoning and ethical decision-making of community college administrators were examined in this study. In…

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

PubMed

Blomberg, Karin; Bisholt, Birgitta

2016-11-01

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

REASONS AND CONSEQUENCES OF APPLIED LEADERSHIP STYLES IN ETHICAL DILEMMAS WHEN NURSE MANAGERS MAKE DECISIONS.

PubMed

Zydziunaite, V; Suominen, T

2014-09-21

Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. Purpose: To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. Methods: The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (n=278) were nurse managers. The data were analyzed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. Results: The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients', relatives' and nurse managers' needs. Conclusions: Nurse managers exhibited leadership styles oriented to maintenance, focusing more on the "doing the job" than on managing the decision-making in ethical dilemmas.

Amenable to reason: Aristotle's rhetoric and the moral psychology of practical ethics.

PubMed

London, A J

2000-12-01

An Aristotelian conception of practical ethics can be derived from the account of practical reasoning that Aristotle articulates in is Rhetoric and this has important implications for the way we understand the nature and limits of practical ethics. an important feature of this conception of practical ethics is its responsiveness to the complex ways in which agents form and maintain moral commitments, and this has important implications for the debate concerning methods of ethics in applied ethics. In particular, this feature enables us to understand casuistry, narrative, and principlism as mutually supportive modes of moral inquiry, rather than divergent and mutually exclusive methods of ethics. As a result, an Aristotelian conception of practical ethics clears the conceptual common ground upon which practical ethicists can forge a stable and realistic self-understanding.

The value of metaphorical reasoning in bioethics: An empirical-ethical study.

PubMed

Olsman, Erik; Veneberg, Bert; van Alfen, Claudia; Touwen, Dorothea

2017-01-01

Metaphors are often used within the context of ethics and healthcare but have hardly been explored in relation to moral reasoning. To describe a central set of metaphors in one case and to explore their contribution to moral reasoning. Semi-structured interviews were conducted with 16 parents of a child suffering from the neurodegenerative disease CLN3. The interviews were recorded, transcribed, and metaphors were analyzed. The researchers wrote memos and discussed about their analyses until they reached consensus. Ethical considerations: Participants gave oral and written consent and their confidentiality and anonymity were respected. A central set of metaphors referred to the semantic field of the hands and arms and consisted of two central metaphors that existed in a dialectical relationship: grasping versus letting go. Participants used these metaphors to describe their child's experiences, who had to "let go" of abilities, while "clinging" to structures and the relationship with their parent(s). They also used it to describe their own experiences: participants tried to "grab" the good moments with their child and had to "let go" of their child when (s)he approached death. Participants, in addition, "held" onto caring for their child while being confronted with the necessity to "let go" of this care, leaving it to professional caregivers. The ethical analysis of the findings shows that thinking in terms of the dialectical relationship between "grasping" and "letting go" helps professional caregivers to critically think about images of good care for children with CLN3. It also helps them to bear witness to the vulnerable, dependent, and embodied nature of the moral self of children with CLN3 and their parents. Metaphorical reasoning may support the inclusion of marginalized perspectives in moral reasoning. Future studies should further explore the contribution of metaphorical reasoning to moral reasoning in other cases.

[The structure of meta-ethical reasoning and "paradigmatic instability" of medicine].

PubMed

Maroszyńska-Jezowska, B

1998-01-01

Meta-ethics is such a philosophical discipline that it analyses meaning and logical status of moral conceptions and arguments. Its scope of interest is focused on such problems, among others, as to what extent are moral values the intrinsic part of our reality and, on the other hand, to what extent are they merely the expression or certain conventions, emotions or directives. Codes of medical ethics and other legal acts concerning ethical commitments, both domestic and international (as, for example, Declaration of Helsinki), are based on a certain hidden meta-ethical presumption that morality is a human creation, and thus it belongs to a certain so-called "social realm". As such, medical ethics undergoes continuous transformations with regard to technological progress, which creates new moral challenges. This frequently leads to conflicts between moral, legal and praxiological norms under the absence of consensual conformity of utilitarian and deontological ways of moral reasoning. It may be useful for medical ethics to differentiate between axiological and thetic norms that are present in codes of medical ethics and in various international bioethical declarations and conventions.

The Ethical Imperative of Reason: How Anti-Intellectualism, Denialism, and Apathy Threaten National Security

DTIC Science & Technology

2016-03-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited THE ETHICAL ...REPORT DATE March 2016 3. REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE THE ETHICAL IMPERATIVE OF REASON: HOW ANTI...intellectualism in the policy process and demonstrates that, in the intricate and dynamic matters of our nation’s security, there is an ethical

Ethical reasoning through simulation: a phenomenological analysis of student experience.

PubMed

Lewis, Gareth; McCullough, Melissa; Maxwell, Alexander P; Gormley, Gerard J

2016-01-01

Medical students transitioning into professional practice feel underprepared to deal with the emotional complexities of real-life ethical situations. Simulation-based learning (SBL) may provide a safe environment for students to probe the boundaries of ethical encounters. Published studies of ethics simulation have not generated sufficiently deep accounts of student experience to inform pedagogy. The aim of this study was to understand students' lived experiences as they engaged with the emotional challenges of managing clinical ethical dilemmas within a SBL environment. This qualitative study was underpinned by an interpretivist epistemology. Eight senior medical students participated in an interprofessional ward-based SBL activity incorporating a series of ethically challenging encounters. Each student wore digital video glasses to capture point-of-view (PoV) film footage. Students were interviewed immediately after the simulation and the PoV footage played back to them. Interviews were transcribed verbatim. An interpretative phenomenological approach, using an established template analysis approach, was used to iteratively analyse the data. Four main themes emerged from the analysis: (1) 'Authentic on all levels?', (2)'Letting the emotions flow', (3) 'Ethical alarm bells' and (4) 'Voices of children and ghosts'. Students recognised many explicit ethical dilemmas during the SBL activity but had difficulty navigating more subtle ethical and professional boundaries. In emotionally complex situations, instances of moral compromise were observed (such as telling an untruth). Some participants felt unable to raise concerns or challenge unethical behaviour within the scenarios due to prior negative undergraduate experiences. This study provided deep insights into medical students' immersive and embodied experiences of ethical reasoning during an authentic SBL activity. By layering on the human dimensions of ethical decision-making, students can understand their

Investigation of lifestyle choices of individuals following a vegan diet for health and ethical reasons.

PubMed

Radnitz, Cynthia; Beezhold, Bonnie; DiMatteo, Julie

2015-07-01

The proportion of individuals choosing to follow a vegan diet has increased in recent years. The choice is made for different reasons, primarily concern for animals (ethics) and health, which may impact both specific food choices and other lifestyle behaviors linked to health outcomes. To determine the extent to which the reason for following a vegan diet was associated with health behaviors, we conducted an online survey recruiting an international sample of 246 individuals who reported adhering to a vegan diet. We hypothesized that compared to those following the diet for ethical reasons, those doing so for health reasons would consume foods with higher nutritional value and engage in other healthier lifestyle behaviors. Our hypotheses were partially supported in that those citing health reasons (n = 45) reported eating more fruit (U = 3503.00, p = 0.02) and fewer sweets (U = 3347.00, p <0.01) than did those citing ethical reasons (n = 201). Individuals endorsing ethical reasons reported being on the diet longer (U = 3137.00, p <0.01), and more frequent consumption of soy (U = 2936.00, p <0.01), foods rich in vitamin D (U = 3441.00, p = 0.01), high-polyphenol beverages (U = 3124.50, p <0.01), and vitamin supplements (vitamin D: χ(2)=4.65, p = 0.04; vitamin B12: χ(2)=4.46, p = 0.03) than did those endorsing health reasons. As these factors may affect outcome in studies investigating the impact of vegan diets on health, they should be taken into account when studying persons following a vegan diet. Copyright © 2015 Elsevier Ltd. All rights reserved.

The relationship of ethics education to moral sensitivity and moral reasoning skills of nursing students.

PubMed

Park, Mihyun; Kjervik, Diane; Crandell, Jamie; Oermann, Marilyn H

2012-07-01

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students.

Participatory research, people with intellectual disabilities and ethical approval: making reasonable adjustments to enable participation.

PubMed

Northway, Ruth; Howarth, Joyce; Evans, Lynne

2015-02-01

The aim of this paper is to explore how making reasonable adjustments to the process of securing ethical approval for research can facilitate the meaningful involvement of people with intellectual disabilities as members of a research team. This is achieved through critical reflection upon the approach taken within one participatory research study whose objective was to explore how people with intellectual disabilities understand abuse. Internationally participatory research studies (in which active involvement of community members in all stages of the research process is sought) are becoming increasingly common in the context of health care and, more specifically, within research involving people with intellectual disabilities. However, whilst it is acknowledged that participatory research gives rise to specific ethical challenges, how (or if) involvement in securing ethical approval is facilitated, is not discussed in most research reports. The significance of this paper is that it seeks to address this gap by exploring how meaningful participation can be promoted by making reasonable adjustments. Within the study, the research team worked in collaboration with the ethics committee to identify potential barriers that could prevent the participation of members of the research team who had intellectual disabilities. Reasonable adjustments (such as redesigning forms) were made to the processes involved in securing ethical approval. This study demonstrated that it is possible to ensure that ethical standards are upheld and the requirements of ethics committees met whilst also facilitating the meaningful involvement of people with intellectual disabilities. The reasonable adjustments approach explored within this paper can be translated into the context of clinical practice: making changes to the way that services are delivered can promote greater involvement of people with intellectual disabilities in their own health care. © 2014 John Wiley & Sons Ltd.

Team reasoning and collective rationality: piercing the veil of obviousness.

PubMed

Colman, Andrew M; Pulford, Briony D; Rose, Jo

2008-06-01

The experiments reported in our target article provide strong evidence of collective utility maximization, and the findings suggest that team reasoning should now be included among the social value orientations used in cognitive and social psychology. Evidential decision theory offers a possible alternative explanation for our results but fails to predict intuitively compelling strategy choices in simple games with asymmetric team-reasoning outcomes. Although many of our experimental participants evidently used team reasoning, some appear to have ignored the other players' expected strategy choices and used lower-level, nonstrategic forms of reasoning. Standard payoff transformations cannot explain the experimental findings, nor team reasoning in general, without an unrealistic assumption that players invariably reason nonstrategically.

The Effect of Teaching Medical Ethics on Medical Students' Moral Reasoning.

ERIC Educational Resources Information Center

Self, Donnie J; And Others

1989-01-01

A study of the effect of incorporating medical ethics into the medical curriculum and comparing two teaching methods (lecture and case studies) found higher moral reasoning after instruction, but neither method was significantly more effective. (Author/MSE)

"In this scenario, I do this, for these reasons": narrative, genre and ethical reasoning in the clinic.

PubMed

Jordens, Christopher F C; Little, Miles

2004-05-01

Narrative analysis has been applied by health researchers to investigate (among other things) clinical reasoning, clinical ethics and human identity. The term 'narrative' is often used as a broad category that covers a variety of spoken genres, however, and it thereby lacks delicacy as an analytic tool. We introduce genre theory, which enables us to differentiate more clearly between story genres and other spoken genres. We then apply the theory to ten narrative-style interviews with clinicians involved in the treatment and management of colorectal cancer in Sydney, Australia. We characterise the narrative-style interview as a macro-genre, and draw attention to the occurrence of spoken genres other than stories. We focus our analysis on a policy genre that occurred naturally and frequently in the spoken discourse of the informants, but which has not been described before in either the literature of social linguistics or the health and medical literature. We analyse two examples of this genre in detail in order to characterise its main semantic features, and differentiate it from story genres. We then discuss the genre with reference to Aristotelian interpretations of ethical reasoning in the clinic. We conclude that the policy genre is both the unfolding of practical wisdom in speech, and the appropriate choice of genre where a display of ethical identity is called for. Finally, we discuss the implications of our findings for ongoing research, for ethics education, for bioethical theory, and for communication between some of the different stakeholder groups in clinical medicine.

Justice or Care? Ethical Reasoning of Preservice Social Studies Teachers

ERIC Educational Resources Information Center

Kohlmeier, Jada; Saye, John W.

2012-01-01

The authors explored the ethical reasoning of 27 preservice teachers in the first course of a 4-course social studies education program. The students discussed 2 historically analogous cases that focused on 1 of 4 value problem areas: consent of the governed, general welfare, property, and morality. The authors were interested in exploring whether…

Engineering ethics, individuals, and organizations.

PubMed

Davis, Michael

2006-04-01

This article evaluates a family of criticism of how engineering ethics is now generally taught. The short version of the criticism might be put this way: Teachers of engineering ethics devote too much time to individual decisions and not enough time to social context. There are at least six version of this criticism, each corresponding to a specific subject omitted. Teachers of engineering ethics do not (it is said) teach enough about: 1) the culture of organizations; 2) the organization of organizations; 3) the legal environment of organizations; 4) the role of professions in organizations; 5) the role of organizations in professions; or 6) the political environment of organizations. My conclusion is that, while all six are worthy subjects, there is neither much reason to believe that any of them are now absent from courses in engineering ethics nor an obvious way to decide whether they (individually or in combination) are (or are not) now being given their due. What we have here is a dispute about how much is enough. Such disputes are not to be settled without agreement concerning how we are to tell we have enough of this or that. Right now we seem to lack that agreement and not to have much reason to expect it any time soon.

The effect of teaching medical ethics on medical students' moral reasoning.

PubMed

Self, D J; Wolinsky, F D; Baldwin, D C

1989-12-01

A study assessed the effect of incorporating medical ethics into the medical curriculum and the relative effects of two methods of implementing that curriculum, namely, lecture and case-study discussions. Results indicate a statistically significant increase (p less than or equal to .0001) in the level of moral reasoning of students exposed to the medical ethics course, regardless of format. Moreover, the unadjusted posttest scores indicated that the case-study method was significantly (p less than or equal to .03) more effective than the lecture method in increasing students' level of moral reasoning. When adjustment were made for the pretest scores, however, this difference was not statistically significant (p less than or equal to .18). Regression analysis by linear panel techniques revealed that age, gender, undergraduate grade-point average, and scores on the Medical College Admission Test were not related to the changes in moral-reasoning scores. All of the variance that could be explained was due to the students' being in one of the two experimental groups. In comparison with the control group, the change associated with each experimental format was statistically significant (lecture, p less than or equal to .004; case study, p less than or equal to .0001). Various explanations for these findings and their implications are given.

Thai and American doctors on medical ethics: religion, regulation, and moral reasoning across borders.

PubMed

Grol-Prokopczyk, Hanna

2013-01-01

Recent scholarship argues that successful international medical collaboration depends crucially on improving cross-cultural understanding. To this end, this study analyzes recent writings on medical ethics by physicians in two countries actively participating in global medicine, Thailand and the United States. Articles (133; published 2004-2008) from JAMA, the New England Journal of Medicine, and the Journal of the Medical Association of Thailand are analyzed to inductively build a portrait of two discursive ethical cultures. Frameworks of moral reasoning are identified across and within the two groups, with a focus on what authority (religion, law, etc.) is invoked to define and evaluate ethical problems. How might similarities and differences in ethical paradigms reflect the countries' historical "semicolonial" relationship, shed light on debates about Eastern vs. Western bioethics, and facilitate or hinder contemporary cross-national communication? Findings demonstrate substantial overlap in Thai and American doctors' vocabulary, points of reference, and topics covered, though only Thai doctors emphasize national interests and identity. American authors display a striking homogeneity in styles of moral reasoning, embracing a secular, legalistic, deontological ethics that generally eschews discussion of religion, personal character, or national culture. Among Thai authors, there is a schism in ethical styles: while some hew closely to the secular, deontological model, others embrace a virtue ethics that liberally cites Buddhist principles and emphasizes the role of doctors' good character. These two approaches may represent opposing reactions-assimilation and resistance, respectively-to Western influence. The current findings undermine the stereotype of Western individualism versus Eastern collectivism. Implications for cross-national dialog are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

ERIC Educational Resources Information Center

Berne, Birgitta

2014-01-01

This article reports on the outcomes of an intervention in a Swedish school in which the author, a teacher-researcher, sought to develop students' (14-15 years old) ethical reasoning in science through the use of peer discussions about socio-scientific issues. Prior to the student discussions various prompts were used to highlight different…

Teaching practical wisdom in medicine through clinical judgement, goals of care, and ethical reasoning.

PubMed

Kaldjian, Lauris Christopher

2010-09-01

Clinical decision making is a challenging task that requires practical wisdom-the practised ability to help patients choose wisely among available diagnostic and treatment options. But practical wisdom is not a concept one typically hears mentioned in medical training and practice. Instead, emphasis is placed on clinical judgement. The author draws from Aristotle and Aquinas to describe the virtue of practical wisdom and compare it with clinical judgement. From this comparison, the author suggests that a more complete understanding of clinical judgement requires its explicit integration with goals of care and ethical values. Although clinicians may be justified in assuming that goals of care and ethical values are implicit in routine decision making, it remains important for training purposes to encourage habits of clinical judgement that are consciously goal-directed and ethically informed. By connecting clinical judgement to patients' goals and values, clinical decisions are more likely to stay focused on the particular interests of individual patients. To cultivate wise clinical judgement among trainees, educational efforts should aim at the integration of clinical judgement, communication with patients about goals of care, and ethical reasoning. But ultimately, training in wise clinical judgement will take years of practice in the company of experienced clinicians who are able to demonstrate practical wisdom by example. By helping trainees develop clinical judgement that incorporates patients' goals of care and ethical reasoning, we may help lessen the risk that 'clinical judgement' will merely express 'the clinician's judgement.'

Influence of Ethics Education on Moral Reasoning among Pre-Service Teacher Preparation and Social Work Students

ERIC Educational Resources Information Center

Salopek, Michelle M.

2013-01-01

This comparative case study examines the influence of ethics education on moral reasoning among pre-service teacher preparation and social work students. This study specifically investigates the ethical values of students enrolled in a teacher preparation and social work education program by their fourth year of study; the degree of ethical…

Ethics Education Seen through the Lens of Habermas's Conception of Practical Reason: The Quebec Education Program

ERIC Educational Resources Information Center

Bouchard, Nancy; Morris, Ronald W.

2012-01-01

This paper examines the Quebec Education Program (QEP), particularly the new course in ethics and religious culture (ERC), in the light of Habermas's conception of the moral and ethical uses of practical reason. Habermas's discursive theory of morality is used to assess the program's understanding of what it means to be competent in moral matters.…

Ethical Awareness and Ethical Orientation of Turkish Teachers

ERIC Educational Resources Information Center

Gökçe, Asiye Toker

2013-01-01

This study inquires ethical evaluation of teachers, investigating their moral reasoning to ethical decision making, in Turkey. Specifically three hypotheses were tested: Overall ethical awareness of teachers is high; Teachers will identify reasons for ethical evaluation related to philosophical values such as justice, deontology, utilitarianism,…

Between reason and coercion: ethically permissible influence in health care and health policy contexts.

PubMed

Blumenthal-Barby, J S

2012-12-01

In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats-or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the broad middle terrain-and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the "manipulation" label and relabeling this space "nonargumentative influence," with two subtypes: "reason-bypassing" and "reason-countering." Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to

Using Ethical Reasoning to Amplify the Reach and Resonance of Professional Codes of Conduct in Training Big Data Scientists.

PubMed

Tractenberg, Rochelle E; Russell, Andrew J; Morgan, Gregory J; FitzGerald, Kevin T; Collmann, Jeff; Vinsel, Lee; Steinmann, Michael; Dolling, Lisa M

2015-12-01

The use of Big Data--however the term is defined--involves a wide array of issues and stakeholders, thereby increasing numbers of complex decisions around issues including data acquisition, use, and sharing. Big Data is becoming a significant component of practice in an ever-increasing range of disciplines; however, since it is not a coherent "discipline" itself, specific codes of conduct for Big Data users and researchers do not exist. While many institutions have created, or will create, training opportunities (e.g., degree programs, workshops) to prepare people to work in and around Big Data, insufficient time, space, and thought have been dedicated to training these people to engage with the ethical, legal, and social issues in this new domain. Since Big Data practitioners come from, and work in, diverse contexts, neither a relevant professional code of conduct nor specific formal ethics training are likely to be readily available. This normative paper describes an approach to conceptualizing ethical reasoning and integrating it into training for Big Data use and research. Our approach is based on a published framework that emphasizes ethical reasoning rather than topical knowledge. We describe the formation of professional community norms from two key disciplines that contribute to the emergent field of Big Data: computer science and statistics. Historical analogies from these professions suggest strategies for introducing trainees and orienting practitioners both to ethical reasoning and to a code of professional conduct itself. We include two semester course syllabi to strengthen our thesis that codes of conduct (including and beyond those we describe) can be harnessed to support the development of ethical reasoning in, and a sense of professional identity among, Big Data practitioners.

Casuist BDI-Agent: A New Extended BDI Architecture with the Capability of Ethical Reasoning

NASA Astrophysics Data System (ADS)

Honarvar, Ali Reza; Ghasem-Aghaee, Nasser

Since the intelligent agent is developed to be cleverer, more complex, and yet uncontrollable, a number of problems have been recognized. The capability of agents to make moral decisions has become an important question, when intelligent agents have developed more autonomous and human-like. We propose Casuist BDI-Agent architecture which extends the power of BDI architecture. Casuist BDI-Agent architecture combines CBR method in AI and bottom up casuist approach in ethics in order to add capability of ethical reasoning to BDI-Agent.

Using Eight Key Questions as an Inquiry-Based Framework for Ethical Reasoning Issues in a General Education Earth Systems and Climate Change Course

NASA Astrophysics Data System (ADS)

Johnson, E. A.; Ball, T. C.

2014-12-01

An important objective in general education geoscience courses is to help students evaluate social and ethical issues based upon scientific knowledge. It can be difficult for instructors trained in the physical sciences to design effective ways of including ethical issues in large lecture courses where whole-class discussions are not practical. The Quality Enhancement Plan for James Madison University, "The Madison Collaborative: Ethical Reasoning in Action," (http://www.jmu.edu/mc/index.shtml) has identified eight key questions to be used as a framework for developing ethical reasoning exercises and evaluating student learning. These eight questions are represented by the acronym FOR CLEAR and are represented by the concepts of Fairness, Outcomes, Responsibilities, Character, Liberty, Empathy, Authority, and Rights. In this study, we use the eight key questions as an inquiry-based framework for addressing ethical issues in a 100-student general education Earth systems and climate change course. Ethical reasoning exercises are presented throughout the course and range from questions of personal behavior to issues regarding potential future generations and global natural resources. In the first few exercises, key questions are identified for the students and calibrated responses are provided as examples. By the end of the semester, students are expected to identify key questions themselves and justify their own ethical and scientific reasoning. Evaluation rubrics are customized to this scaffolding approach to the exercises. Student feedback and course data will be presented to encourage discussion of this and other approaches to explicitly incorporating ethical reasoning in general education geoscience courses.

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

PubMed

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

2015-04-04

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

Beware the "Obvious"

ERIC Educational Resources Information Center

Weinberg, Eugene D.; Fraser, Dean

1976-01-01

Discussed is the tendency in science to challenge obvious explanation for observed phenomenon. Ten examples are given where the initial obvious explanation was subsequently shown to be totally incorrect. Four examples that relate to biomedicine are presented in detail. (SL)

Using rhetorical theory in medical ethics cases.

PubMed

Heifferon, B

2000-01-01

In this paper I argue that rhetorical theory is a valuable tool in medical ethics cases. The case I use as an example is one in which traditional, philosophy-based medical ethics are applied. In this case the traditional ethical approach is not adequate to the task. Key issues and problems are not addressed, resulting in a problem that seems to be solved on the surface, but, when rhetorically analyzed, it's obvious that none of the issues have been resolved in any satisfactory way. By using rhetorical theory, such as that Michel Foucault uses in Power/Knowledge, we discover that the reason this case has not been solved is that the power issues have not been addressed. Using Foucault's concepts of "subjugated knowledge", "local knowledge", "situated knowledge", and "docile bodies", we can tease out the real issues that surface in this ethics case and solve them. Foucault also recommends we use theory as a "toolkit". I propose a model that is a further iteration of this idea. My model uses numerous rhetorical and literary theories, depending on the issues that need to be addressed in each individual medical ethics case. I briefly describe the various theories and include a handout of what the new model of using rhetorical theory in such cases would look like.

Imaginative ethics--bringing ethical praxis into sharper relief.

PubMed

Hansson, Mats G

2002-01-01

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

Integrating Ethics across the Curriculum: A Pilot Study to Assess Students' Ethical Reasoning

ERIC Educational Resources Information Center

Willey, Susan L.; Mansfield, Nancy Reeves; Sherman, Margaret B.

2012-01-01

At Georgia State University (GSU), undergraduate and graduate business students are introduced to ethical theory and decision making in the required legal environment of business course, but ethics instruction in the functional areas is sporadic and uncoordinated. After a broad overview of the history of ethics in the business curriculum in Part…

Identification of Bioethical Dilemmas, Ethical Reasoning, and Decision-Making in Military Emergency Medicine Departments

DTIC Science & Technology

2000-05-01

U.S. ARMY-BAYLOR UNIVERSITY GRADUATE PROGRAM IN HEALTH CARE ADMINISTRATION IDENTIFICATION OF BIOETHICAL DILEMMAS, ETHICAL REASONING, AND DECISION...of service members and their families. ABSTRACT ii Background. Little is known about (1) the range and frequency of bioethical dilemmas that military...making in resolving these complex issues. By identifying the type and frequency of bioethical dilemmas faced by military emergency medicine

Managed care's Achilles heel: ethical immaturity.

PubMed

Thompson, R E

2000-01-01

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

Lifting the veil: a typological survey of the methodological features of Islamic ethical reasoning on biomedical issues.

PubMed

Abdur-Rashid, Khalil; Furber, Steven Woodward; Abdul-Basser, Taha

2013-04-01

We survey the meta-ethical tools and institutional processes that traditional Islamic ethicists apply when deliberating on bioethical issues. We present a typology of these methodological elements, giving particular attention to the meta-ethical techniques and devices that traditional Islamic ethicists employ in the absence of decisive or univocal authoritative texts or in the absence of established transmitted cases. In describing how traditional Islamic ethicists work, we demonstrate that these experts possess a variety of discursive tools. We find that the ethical responsa-i.e., the products of the application of the tools that we describe-are generally characterized by internal consistency. We also conclude that Islamic ethical reasoning on bioethical issues, while clearly scripture-based, is also characterized by strong consequentialist elements and possesses clear principles-based characteristics. The paper contributes to the study of bioethics by familiarizing non-specialists in Islamic ethics with the role, scope, and applicability of key Islamic ethical concepts, such as "aims" (maqāṣid), "universals" (kulliyyāt), "interest" (maṣlaḥa), "maxims" (qawā`id), "controls" (ḍawābit), "differentiators" (furūq), "preponderization" (tarjīḥ), and "extension" (tafrī`).

Research ethics in the post-genomic era.

PubMed

Vähäkangas, Kirsi

2013-08-01

New high-throughput 'omics techniques are providing exciting opportunities in clinical medicine and toxicology, especially in the development of biomarkers. In health science research there are traditional ethical considerations that are reasonably obvious, like balancing health benefits and health risks, autonomy mainly pursued by informed consent, and protecting privacy. Epidemiological studies applying new large-scale approaches (e.g., high-throughput or high-content methods and global studies that utilize biobanking of samples and produce large-scale datasets) present new challenges that call for re-evaluation of standard ethical considerations. In this context, assessment of the ethics underlying study designs, bioinformatics, and statistics applied in the generation and clinical translation of research results should also be considered. Indeed, there are ethical considerations in the research process itself, in research objectives and how research is pursued (e.g., which methodologies are selected and how they are carried out). Maintaining research integrity is critical, as demonstrated by the relatively frequent retraction of scientific papers following violations of good scientific practice. Abiding by the laws is necessary but not sufficient for good research ethics, which is and remains in the hands of the scientific community at the level of both individual scientists and organizations. Senior scientists are responsible for the transfer of research tradition to the next generation of scientists through education, mentorship, and setting an example by their own behavior, as well as by creating systems in institutions that support good research ethics. Copyright © 2013 Wiley Periodicals, Inc.

The ethical desirability of moral bioenhancement: a review of reasons

PubMed Central

2014-01-01

Background The debate on the ethical aspects of moral bioenhancement focuses on the desirability of using biomedical as opposed to traditional means to achieve moral betterment. The aim of this paper is to systematically review the ethical reasons presented in the literature for and against moral bioenhancement. Discussion A review was performed and resulted in the inclusion of 85 articles. We classified the arguments used in those articles in the following six clusters: (1) why we (don’t) need moral bioenhancement, (2) it will (not) be possible to reach consensus on what moral bioenhancement should involve, (3) the feasibility of moral bioenhancement and the status of current scientific research, (4) means and processes of arriving at moral improvement matter ethically, (5) arguments related to the freedom, identity and autonomy of the individual, and (6) arguments related to social/group effects and dynamics. We discuss each argument separately, and assess the debate as a whole. First, there is little discussion on what distinguishes moral bioenhancement from treatment of pathological deficiencies in morality. Furthermore, remarkably little attention has been paid so far to the safety, risks and side-effects of moral enhancement, including the risk of identity changes. Finally, many authors overestimate the scientific as well as the practical feasibility of the interventions they discuss, rendering the debate too speculative. Summary Based on our discussion of the arguments used in the debate on moral enhancement, and our assessment of this debate, we advocate a shift in focus. Instead of speculating about non-realistic hypothetical scenarios such as the genetic engineering of morality, or morally enhancing ‘the whole of humanity’, we call for a more focused debate on realistic options of biomedical treatment of moral pathologies and the concrete moral questions these treatments raise. PMID:25227512

The ethical desirability of moral bioenhancement: a review of reasons.

PubMed

Specker, Jona; Focquaert, Farah; Raus, Kasper; Sterckx, Sigrid; Schermer, Maartje

2014-09-16

The debate on the ethical aspects of moral bioenhancement focuses on the desirability of using biomedical as opposed to traditional means to achieve moral betterment. The aim of this paper is to systematically review the ethical reasons presented in the literature for and against moral bioenhancement. A review was performed and resulted in the inclusion of 85 articles. We classified the arguments used in those articles in the following six clusters: (1) why we (don't) need moral bioenhancement, (2) it will (not) be possible to reach consensus on what moral bioenhancement should involve, (3) the feasibility of moral bioenhancement and the status of current scientific research, (4) means and processes of arriving at moral improvement matter ethically, (5) arguments related to the freedom, identity and autonomy of the individual, and (6) arguments related to social/group effects and dynamics. We discuss each argument separately, and assess the debate as a whole. First, there is little discussion on what distinguishes moral bioenhancement from treatment of pathological deficiencies in morality. Furthermore, remarkably little attention has been paid so far to the safety, risks and side-effects of moral enhancement, including the risk of identity changes. Finally, many authors overestimate the scientific as well as the practical feasibility of the interventions they discuss, rendering the debate too speculative. Based on our discussion of the arguments used in the debate on moral enhancement, and our assessment of this debate, we advocate a shift in focus. Instead of speculating about non-realistic hypothetical scenarios such as the genetic engineering of morality, or morally enhancing 'the whole of humanity', we call for a more focused debate on realistic options of biomedical treatment of moral pathologies and the concrete moral questions these treatments raise.

Diagnosing dementia: Ethnography, interactional ethics and everyday moral reasoning.

PubMed

Hillman, Alexandra

2017-02-01

This article highlights the contribution of ethnography and qualitative sociology to the ethical challenges that frame the diagnosis of dementia. To illustrate this contribution, the paper draws on an ethnographic study of UK memory clinics carried out between 2012 and 2014. The ethnographic data, set alongside other studies and sociological theory, contest the promotion of a traditional view of autonomy; the limiting of the point of ethical interest to a distinct moment of diagnosis disclosure; and the failure to recognise risk and uncertainty in the building of clinical 'facts' and their communication. In addressing these specific concerns, this article contributes to the wider debate over the relationship between sociology and bioethics (medical ethics). At the heart of these debates lies more fundamental questions: how can we best understand and shape moral decision-making and ethics that guide behaviour in medical practice, and what should be the guiding ideas, concepts and methods to inform ethics in the clinic? Using the case of dementia diagnosis, this article illustrates the benefits of an ethnographic approach, not just for understanding this ethical problem but also for exploring if and how a more empirically informed ethics can help shape healthcare practices for the better.

Reasons for resubmission of research projects to the research ethics committee of a university hospital in São Paulo, Brazil.

PubMed

Bueno, Mariana; Brevidelli, Maria Meimei; Cocarelli, Thaís; Santos, Gianni Mara Silva dos; Ferraz, Maria Auxiliadora; Mion, Décio

2009-01-01

It is important to know the reasons for resubmitting research projects to the Research Ethics Committee in order to help researchers to prepare their research projects, informed consent forms and needed research documentation. To verify the reasons for resubmitting projects that were previously rejected by the Ethics Committee. This is a cross-sectional study that evaluated research projects involving human beings. Research projects were submitted in 2007 to the Research Ethics Committee of the Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. One thousand two hundred and fifty six research projects were submitted to the ethics committee and the average time for evaluating the research projects and related documents until a final decision was reached was 49.95 days. From the total, 399 projects were reviewed in 2 or more meetings until a final decision was reached. Of these, 392 research projects were included in the study; 35 projects were subsequently excluded for involving animals. Among the research projects included, 42.5% concerned research with new drugs, vaccines and diagnostic tests, 48.5% consisted of undergraduate students' research projects, 68.9% of the research had no sponsorship, and 97.5% were eventually approved. The main reasons for returning the projects to the researchers were the use of inadequate language and/or difficulty of understanding the informed consent form (32.2%), lack of information about the protocol at the informed consent form (25.8%), as well as doubts regarding methodological and statistical issues of the protocol (77.1%). Other reasons for returning the research projects involved lack of, inaccuracy on or incomplete documentation, need of clarification or approval for participation of external entities on the research, lack of information on financial support. Among the research projects that were returned to the researchers for additional clarification, the main reasons were inadequacies or doubts

Diagnosing dementia: Ethnography, interactional ethics and everyday moral reasoning

PubMed Central

Hillman, Alexandra

2016-01-01

This article highlights the contribution of ethnography and qualitative sociology to the ethical challenges that frame the diagnosis of dementia. To illustrate this contribution, the paper draws on an ethnographic study of UK memory clinics carried out between 2012 and 2014. The ethnographic data, set alongside other studies and sociological theory, contest the promotion of a traditional view of autonomy; the limiting of the point of ethical interest to a distinct moment of diagnosis disclosure; and the failure to recognise risk and uncertainty in the building of clinical ‘facts’ and their communication. In addressing these specific concerns, this article contributes to the wider debate over the relationship between sociology and bioethics (medical ethics). At the heart of these debates lies more fundamental questions: how can we best understand and shape moral decision-making and ethics that guide behaviour in medical practice, and what should be the guiding ideas, concepts and methods to inform ethics in the clinic? Using the case of dementia diagnosis, this article illustrates the benefits of an ethnographic approach, not just for understanding this ethical problem but also for exploring if and how a more empirically informed ethics can help shape healthcare practices for the better. PMID:28255279

The Need for Systematic Reviews of Reasons

PubMed Central

Sofaer, Neema; Strech, Daniel

2012-01-01

There are many ethical decisions in the practice of health research and care, and in the creation of policy and guidelines. We argue that those charged with making such decisions need a new genre of review. The new genre is an application of the systematic review, which was developed over decades to inform medical decision-makers about what the totality of studies that investigate links between smoking and cancer, for example, implies about whether smoking causes cancer. We argue that there is a need for similarly inclusive and rigorous reviews of reason-based bioethics, which uses reasoning to address ethical questions. After presenting a brief history of the systematic review, we reject the only existing model for writing a systematic review of reason-based bioethics, which holds that such a review should address an ethical question. We argue that such a systematic review may mislead decision-makers when a literature is incomplete, or when there are mutually incompatible but individually reasonable answers to the ethical question. Furthermore, such a review can be written without identifying all the reasons given when the ethical questions are discussed, their alleged implications for the ethical question, and the attitudes taken to the reasons. The reviews we propose address instead the empirical question of which reasons have been given when addressing a specified ethical question, and present such detailed information on the reasons. We argue that this information is likely to improve decision-making, both directly and indirectly, and also the academic literature. We explain the limitations of our alternative model for systematic reviews. PMID:21521251

The Relationship between Intuitive Action Choices and Moral Reasoning on Animal Ethics Issues in Students of Veterinary Medicine and Other Relevant Professions.

PubMed

Verrinder, Joy M; Phillips, Clive J C

2018-01-01

With growing understanding of animals' capabilities, and public and organizational pressures to improve animal welfare, moral action by veterinarians and other relevant professionals to address animal issues is increasingly important. Little is known about how their action choices relate to their moral reasoning on animal ethics issues. A moral judgment measure, the VetDIT, with three animal and three non-animal scenarios, was used to investigate the action choices of 619 students in five animal- and two non-animal-related professional programs in one Australian university, and how these related to their moral reasoning based on Personal Interest (PI), Maintaining Norms (MN), or Universal Principles (UP) schemas. Action choices showed significant relationships to PI, MN, and UP questions, and these varied across program groups. Having a previous degree or more experience with farm animals had a negative relationship, and experience with horses or companion animals a positive relationship, with intuitive action choices favoring life and bodily integrity of animals. This study helps to explain the complex relationship between intuitive moral action choices and moral reasoning on animal ethics issues. As a useful research and educational tool for understanding this relationship, the VetDIT can enhance ethical decision making.

[Medical ethics as professional ethics].

PubMed

Kwon, Ivo

2012-09-25

Contemporary medical ethics is far from the traditional concept of "In-Sul (benevolent art)" or "Yul-Li (倫, ethics), which emphasizes so much the personality or the character of a doctor. Nowadays, medical ethics should be considered as "professional ethics" which regulates the acts and medical practices of ordinary doctors in their daily practice. The key concepts of the professional ethics are "autonomy", "integrity", and "professional standard" established by medical organizations such as medical societies or associations. Most of Korean doctors have not been familiar with the concept of professional ethics or professionalism, which is due to the modern history of Korea. However, the concept of professional ethics is really critical to Korean doctors from the perspective of professional dignity and social respect to this profession. The current healthcare system of Korea is suffering from many problems of both private and public sector. Nonetheless, the professional ethics is urgently demanded for that very reason.

Clinical ethics and happiness.

PubMed

Devettere, R J

1993-02-01

Most contemporary accounts of clinical ethics do not explain why clinicians should be ethical. Those few that do attempt an explanation usually claim that clinicians should be ethical because ethical behavior provides an important good for the patient--better care. Both these approaches ignore the customary traditional reason for being ethical, namely, the good of the moral agent. This good was commonly called 'happiness'. The following article shows how the personal happiness of the moral agent provided a major reason for being ethical in the ancient philosophical and biblical traditions and how it continues to play a role in the more modern rights-based, Kantian and utilitarian theories. This history suggests that the personal happiness of the clinician, rightly understood, is a legitimate and important goal of clinical ethics.

Sensemaking Strategies for Ethical Decision-making.

PubMed

Caughron, Jay J; Antes, Alison L; Stenmark, Cheryl K; Thiel, Chaise E; Wang, Xiaoqian; Mumford, Michael D

2011-01-01

The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision-making. Using a sample of 163 undergraduates, a low fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision-making. A mediated model is presented which suggests that environmental factors influence reasoning strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision-making. Findings were mixed but generally supported the hypothesized model. Interestingly, framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies.

Can Ethics Be Taught? A Quasi-Experimental Study of the Impact of Class Size on the Cognitive Moral Reasoning of Freshmen Business Students

ERIC Educational Resources Information Center

Sullivan, Ethan A.

2011-01-01

The purpose of this study was to determine the impact of a business ethics course on the cognitive moral reasoning of freshmen business students. The sample consisted of 268 college students enrolled in a required business ethics course. The students took Rest's Defining Issues Test--Version 2 (DIT2) as a pre-test and then post-test (upon…

Ethical issues in sports medicine: a review and justification for ethical decision making and reasoning.

PubMed

Greenfield, Bruce H; West, Charles Robert

2012-11-01

Ethical issues present a challenge for health care professionals working with athletes of sports teams. Health care professionals-including the team physician, the physical therapist, and the athletic trainer-are faced with the challenge of returning an athlete to competition as quickly as possible but as safely as possible. Conflicts of interest arise due to conflicting obligations of the team physician to the athlete and other members of the sports organization, including coaches and the team owner. The multiple stakeholders involved in sports teams challenge the traditional notion of confidentiality and autonomy. The aims of this article are to explicate the ethics of sports medicine, highlight the ethical issues, and provide some strategies and suggestions for ethical decision making.

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.

Nonrational Processes in Ethical Decision Making

ERIC Educational Resources Information Center

Rogerson, Mark D.; Gottlieb, Michael C.; Handelsman, Mitchell M.; Knapp, Samuel; Younggren, Jeffrey

2011-01-01

Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasi-legal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior,…

Sensemaking Strategies for Ethical Decision-making

PubMed Central

Caughron, Jay J.; Antes, Alison L.; Stenmark, Cheryl K.; Thiel, Chaise E.; Wang, Xiaoqian; Mumford, Michael D.

2015-01-01

The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision-making. Using a sample of 163 undergraduates, a low fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision-making. A mediated model is presented which suggests that environmental factors influence reasoning strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision-making. Findings were mixed but generally supported the hypothesized model. Interestingly, framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies. PMID:26257505

Assessing the Effectiveness of Problem-Based Learning as a New Approach on Health Care Provider Ethical Reasoning Development in Shiraz University of Medical Sciences.

PubMed

Bazrafcan, Leila; Takmil, Farnaz; Shokrpour, Nasrin

2018-06-18

Problem-based learning (PBL) has become a distinct approach in learning. To assess the effectiveness of PBL in teaching ethics to medical students and the effect it has on their ethical reasoning, we decided to hold a PBL ethics workshop and then evaluate them based on pretest and posttest. This quasi-experimental comparative study in Shiraz University of Medical Sciences was designed based on pretest-posttest nonequivalent groups. After obtaining their consent, 120 health care providers were randomly selected and assigned in 4 groups and then asked to attend the ethics workshop. For measuring the participants' ethical reasoning through pretesting and posttesting, a case study consisting of 21 multiple-choice questions (cognitive domain-apply level) was performed. Data were then collected using a questionnaire, which was completed by the participants and analyzed using SPSS software (version 17). The comparison between the participants' attitude and knowledge toward ethics before and after the workshop revealed that all indices in the cognitive domain were changed (P < .001). The scores of pretest and posttest were significantly different. As to the results of our study, the PBL groups showed a more positive learning attitude and higher motivation in comparison with the control group who were subjected to traditional-based method of learning. The result of our study suggests that PBL can and should be used as an alternative method in teaching ethics in medical students because it is more effective and motivates the students.

A Worksheet for Ethics Instruction and Exercises in Reason.

ERIC Educational Resources Information Center

Bivins, Thomas H.

1993-01-01

Argues that teaching applied mass media ethics requires two vital components: a grounding in the relevant ethical theories, and a structured approach to analyzing the issues in case-study format. Presents a worksheet model that provides such an approach over a wide range of issues. (SR)

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

PubMed

Mertz, Marcel

2007-09-01

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

Comparison of ethical judgments exhibited by clients and ethics consultants in Japan.

PubMed

Nagao, Noriko; Kadooka, Yasuhiro; Asai, Atsushi

2014-03-04

Healthcare professionals must make decisions for patients based on ethical considerations. However, they rely on clinical ethics consultations (CEC) to review ethical justifications of their decisions. CEC consultants support the cases reviewed and guide medical care. When both healthcare professionals and CEC consultants face ethical problems in medical care, how is their judgment derived? How do medical judgments differ from the ethical considerations of CECs? This study examines CECs in Japan to identify differences in the ethical judgment of clients and CEC consultants. The CEC request and response documents of all 60 cases reviewed across Japan between October 2006 and the end of October 2011 were classified in terms of the presence of decisional capacity in the patient. We conducted a qualitative content analysis of the differences in reasoning between client and CEC consultants. Reasoned judgments were verified in individual cases to classify the similarities or differences of opinion between CEC clients and teams. As the result of classification of the decisional capacity and the difference of opinion regarding medical care, the most frequent category was 25 cases (41.7%) of "uncertain decisional capacity," and 23 cases (38.3%) of "withholding of decision-making." A chi-square analysis was performed on presence of decisional capacity and agreement in decision-making, yielding a statistically significant difference (p < 0.05). The CEC consultants' reasoning was based on "patient's preference was ambiguous," "validity of family as a surrogate," "estimation of patient preference," and "patient's best interest," whereas the CEC client's reasoning was based on "consistent family preference was shown/not shown" and "appropriate therapeutic methods to manage patient safety." Differences in opinions were found in cases classified according to decisional capacity. Furthermore, the reasoning behind judgments differed between CEC clients and CEC consultants. The

Lithuanian health care in transitional state: ethical problems

PubMed Central

Jakušovaitė, Irayda; Darulis, Žilvinas; Žekas, Romualdas

2005-01-01

Background Throughout the economic and political reforms in post-communist countries, significant changes have also occurred in public morality. One of the tasks of the Lithuanian health policy is to create mechanisms for strengthening the significance of ethical considerations in the decision-making processes concerning health care of individuals and groups of individuals, as well as considering the positions of physicians and the health care system itself in a general way. Thus, health care ethics could be analyzed at two levels: the micro level (the ethics of doctor-patient relationships) and the macro level (the ethics of health policy-making, which can be realized by applying the principles of equal access, reasonable quality, affordable care and shared responsibilities). To date, the first level remains dominant, but the need arises for our attention to refocus now from the micro level to the patterns of managing and delivering care, managing the health care resources, and conducting business practices. Discussion In attempting to increase the efficiency of health services in Lithuania, a common strategy has been in place for the last fifteen years. Decentralization and privatization have been implemented as part of its policy to achieve greater efficiency. Although decentralization in theory is supposed to improve efficiency, in practice the reform of decentralization has still to be completely implemented in Lithuania. Debates on health policy in Lithuania also include the issue of private versus public health care. Although the approach of private health care is changing in a positive way, it is obvious that reduced access to health services is the most vulnerable aspect. In the Lithuanian Health Program adopted in July 1998, the target of equity was stressed, stating that by 2010, differences in health and health care between various socio-economic groups should be reduced by 25%. Summary The restructuring of health care system in Lithuania should be

Lithuanian health care in transitional state: ethical problems.

PubMed

Jakusovaite, Irayda; Darulis, Zilvinas; Zekas, Romualdas

2005-11-09

Throughout the economic and political reforms in post-communist countries, significant changes have also occurred in public morality. One of the tasks of the Lithuanian health policy is to create mechanisms for strengthening the significance of ethical considerations in the decision-making processes concerning health care of individuals and groups of individuals, as well as considering the positions of physicians and the health care system itself in a general way. Thus, health care ethics could be analyzed at two levels: the micro level (the ethics of doctor-patient relationships) and the macro level (the ethics of health policy-making, which can be realized by applying the principles of equal access, reasonable quality, affordable care and shared responsibilities). To date, the first level remains dominant, but the need arises for our attention to refocus now from the micro level to the patterns of managing and delivering care, managing the health care resources, and conducting business practices. In attempting to increase the efficiency of health services in Lithuania, a common strategy has been in place for the last fifteen years. Decentralization and privatization have been implemented as part of its policy to achieve greater efficiency. Although decentralization in theory is supposed to improve efficiency, in practice the reform of decentralization has still to be completely implemented in Lithuania. Debates on health policy in Lithuania also include the issue of private versus public health care. Although the approach of private health care is changing in a positive way, it is obvious that reduced access to health services is the most vulnerable aspect. In the Lithuanian Health Program adopted in July 1998, the target of equity was stressed, stating that by 2010, differences in health and health care between various socio-economic groups should be reduced by 25%. The restructuring of health care system in Lithuania should be based on a balance between

The Ethics and Politics of Ethics Approval

ERIC Educational Resources Information Center

Battin, Tim; Riley, Dan; Avery, Alan

2014-01-01

The regulatory scope of Human Research Ethics Committees can be problematic for a variety of reasons. Some scholars have argued the ethics approval process, for example, is antithetical to certain disciplines in the humanities and social sciences, while others are willing to give it qualified support. This article uses a case study to cast the…

Methods of legitimation: how ethics committees decide which reasons count in public policy decision-making.

PubMed

Edwards, Kyle T

2014-07-01

In recent years, liberal democratic societies have struggled with the question of how best to balance expertise and democratic participation in the regulation of emerging technologies. This study aims to explain how national deliberative ethics committees handle the practical tension between scientific expertise, ethical expertise, expert patient input, and lay public input by explaining two institutions' processes for determining the legitimacy or illegitimacy of reasons in public policy decision-making: that of the United Kingdom's Human Fertilisation and Embryology Authority (HFEA) and the United States' American Society for Reproductive Medicine (ASRM). The articulation of these 'methods of legitimation' draws on 13 in-depth interviews with HFEA and ASRM members and staff conducted in January and February 2012 in London and over Skype, as well as observation of an HFEA deliberation. This study finds that these two institutions employ different methods in rendering certain arguments legitimate and others illegitimate: while the HFEA attempts to 'balance' competing reasons but ultimately legitimizes arguments based on health and welfare concerns, the ASRM seeks to 'filter' out arguments that challenge reproductive autonomy. The notably different structures and missions of each institution may explain these divergent approaches, as may what Sheila Jasanoff (2005) terms the distinctive 'civic epistemologies' of the US and the UK. Significantly for policy makers designing such deliberative committees, each method differs substantially from that explicitly or implicitly endorsed by the institution. Copyright © 2014 Elsevier Ltd. All rights reserved.

Institution animal care and use committees need greater ethical diversity.

PubMed

Hansen, Lawrence Arthur

2013-03-01

In response to public outrage stemming from exposés of animal abuse in research laboratories, the US Congress in 1985 mandated Institutional Animal Care and Use Committees (IACUCs) to oversee animal use at institutions receiving federal grants. IACUCs were enjoined to respect public concern about the treatment of animals in research, but they were not specifically instructed whether or not to perform ethical cost-benefit analyses of animal research protocols that IACUCs have chosen, with approval contingent upon a balancing of animal pain and suffering against a reasonable expectation of resultant human benefit. IACUCs have chosen not to make such ethical judgments but, rather, restrict themselves to an advisory role, often tweaking the details of animal-use protocols, but eventually approving all of them. This disinclination by IACUCs to take a broader ethical view of their authority and responsibilities may reflect a membership composition highly skewed towards animal researchers themselves (67%) and institutional veterinarians (15%), both with vested interests in continuing animal research. The resultant ethical monoculture may impair IACUC's ability to meet public concern for laboratory animal welfare. Psychological research has established that unconscious bias affects us all, that deliberations among the like-minded lead to adapting extremist positions, and that groupthink blinds organisations to alternatives that might be obvious to outsiders. Taken together, skewed IACUC membership composition and psychological research insights into unconscious bias and groupthink suggest that an infusion of ethical diversity by increasing the percentage of institutionally unaffiliated members on IACUCs would broaden their ethical perspectives and enable them to better address public concerns about laboratory animal welfare.

The harms of enhancement and the conclusive reasons view.

PubMed

Douglas, Thomas

2015-01-01

Many critics of bioenhancement go to considerable lengths to establish the existence of reasons against pursuing bioenhancements but do little to establish the absence of reasons in favor. This suggests that they accept what Allen Buchanan has called the conclusive reasons view (CRV). According to this view, our reasons against bioenhancement are obviously decisive, so there is no need to balance them against countervailing reasons. Buchanan criticizes the CRV by showing that the reasons most commonly adduced against bioenhancement are not decisive, or, at least, not obviously so. In this article, I suggest that both Buchanan and the authors to whom he is responding underestimate the strength of the case for the CRV. There are, I argue, harm-based reasons against bioenhancement that provide stronger support to the CRV than the reasons that have most often been adduced by critics of enhancement. However, I then argue that even these harm-based reasons are not obviously decisive. Thus, I ultimately agree with Buchanan about the falsity of the CRV, though I disagree with him about the reasons for its falsity.

Comparison of ethical judgments exhibited by clients and ethics consultants in Japan

PubMed Central

2014-01-01

Background Healthcare professionals must make decisions for patients based on ethical considerations. However, they rely on clinical ethics consultations (CEC) to review ethical justifications of their decisions. CEC consultants support the cases reviewed and guide medical care. When both healthcare professionals and CEC consultants face ethical problems in medical care, how is their judgment derived? How do medical judgments differ from the ethical considerations of CECs? This study examines CECs in Japan to identify differences in the ethical judgment of clients and CEC consultants. Methods The CEC request and response documents of all 60 cases reviewed across Japan between October 2006 and the end of October 2011 were classified in terms of the presence of decisional capacity in the patient. We conducted a qualitative content analysis of the differences in reasoning between client and CEC consultants. Reasoned judgments were verified in individual cases to classify the similarities or differences of opinion between CEC clients and teams. Results As the result of classification of the decisional capacity and the difference of opinion regarding medical care, the most frequent category was 25 cases (41.7%) of “uncertain decisional capacity,” and 23 cases (38.3%) of “withholding of decision-making.” A chi-square analysis was performed on presence of decisional capacity and agreement in decision-making, yielding a statistically significant difference (p < 0.05). The CEC consultants’ reasoning was based on “patient’s preference was ambiguous,” “validity of family as a surrogate,” “estimation of patient preference,” and “patient’s best interest,” whereas the CEC client’s reasoning was based on “consistent family preference was shown/not shown” and “appropriate therapeutic methods to manage patient safety.” Conclusion Differences in opinions were found in cases classified according to decisional capacity. Furthermore, the

Ethical reasoning and online social media.

PubMed

Englund, Heather; Chappy, Sharon; Jambunathan, Jaya; Gohdes, Erick

2012-01-01

Undergraduate nursing students are frequent users of social media sites; however, the ethical or professional implications surrounding the use of online social networking sites are ambiguous and understudied. Faculty guidance is needed if students are to gain the necessary skills and values to appropriately use social media while maintaining professional accountability. The authors discuss the outcomes of a study that assessed their students' sensitivity to posting clinical information on social media sites.

Beliefs, Values, Ethics and Moral Reasoning in Socio-Scientific Education

ERIC Educational Resources Information Center

Yap, Siew Fong

2014-01-01

The realisation to integrate science, ethics and morality is recognised with growing impetus in recent years (as noted with introducing the Australian Curriculum "Science as a Human Endeavour" strand), to develop sophisticated epistemologies of science, which includes an appreciation of the social context including ethical thinking. To…

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

ERIC Educational Resources Information Center

Knowlton, Steven; McKinley, J. Christopher

2016-01-01

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

Overview of psychiatric ethics IV: the method of casuistry.

PubMed

Robertson, Michael; Ryan, Christopher; Walter, Garry

2007-08-01

The aim of this paper is to describe the method of ethical analysis known as casuistry and consider its merits as a basis of ethical deliberation in psychiatry. Casuistry approximates the legal arguments of common law. It examines ethical dilemmas by adopting a taxonomic approach to 'paradigm' cases, using a technique akin to that of normative analogical reasoning. Casuistry offers a useful method in ethical reasoning through providing a practical means of evaluating the merits of a particular course of action in a particular clinical situation. As a method ethical moral reasoning in psychiatry, casuistry suffers from a paucity of paradigm cases and its failure to fully contextualize ethical dilemmas by relying on common morality theory as its basis.

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

ERIC Educational Resources Information Center

Taft, Susan H.; White, Judith

2007-01-01

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

The Ethics of School Administration.

ERIC Educational Resources Information Center

Strike, Kenneth A.; And Others

This is the first book in the Teachers College Press series, Professional Ethics in Education, which is devoted to the examination of ethical issues in all educational settings. The book's purpose is to teach a range of ethical concepts and the process of ethical reasoning to educational administrators. Organized around cases, each chapter begins…

Institution animal care and use committees need greater ethical diversity

PubMed Central

Hansen, Lawrence Arthur

2013-01-01

In response to public outrage stemming from exposés of animal abuse in research laboratories, the US Congress in 1985 mandated Institutional Animal Care and Use Committees (IACUCs) to oversee animal use at institutions receiving federal grants. IACUCs were enjoined to respect public concern about the treatment of animals in research, but they were not specifically instructed whether or not to perform ethical cost-benefit analyses of animal research protocols that IACUCs have chosen, with approval contingent upon a balancing of animal pain and suffering against a reasonable expectation of resultant human benefit. IACUCs have chosen not to make such ethical judgments but, rather, restrict themselves to an advisory role, often tweaking the details of animal-use protocols, but eventually approving all of them. This disinclination by IACUCs to take a broader ethical view of their authority and responsibilities may reflect a membership composition highly skewed towards animal researchers themselves (67%) and institutional veterinarians (15%), both with vested interests in continuing animal research. The resultant ethical monoculture may impair IACUC's ability to meet public concern for laboratory animal welfare. Psychological research has established that unconscious bias affects us all, that deliberations among the like-minded lead to adapting extremist positions, and that groupthink blinds organisations to alternatives that might be obvious to outsiders. Taken together, skewed IACUC membership composition and psychological research insights into unconscious bias and groupthink suggest that an infusion of ethical diversity by increasing the percentage of institutionally unaffiliated members on IACUCs would broaden their ethical perspectives and enable them to better address public concerns about laboratory animal welfare. PMID:23131895

[Ethical aspects of biological sample banks].

PubMed

Cambon-Thomsen, A; Rial-Sebbag, E

2003-02-01

Numerous activities in the domain of epidemiology require the constitution or the use of biological sample banks. Such biobanks raise ethical issues. A number of recommendations are applicable to this field, in France and elsewhere. Major principles applicable to biobanks include the respect of person's autonomy, the respect of human body, the respect of confidentiality. These principles are translated into practices through the following procedures: relevant information to the persons regarding their sample management prior to informed consent, opinion of an independent ethics committee, actual implementation of conditions for protecting samples and data. However, although those principles may appear quite simple and obvious, in the context of a largely international practice of research and given the large variety of biobanks, it is not always obvious for researchers to find their way. The attitudes vary between countries, there are numerous texts for various types of biobanks, the same texts raise different interpretations in different institutions, there are new ethical opinions expressed, and mainly the novelty of questions raised by the uses of samples that are possible today, especially in genetics, and were not foreseeable at the time of sampling make the field difficult in practice. This article reviews the types of biobanks, the relevant ethical issues. It also underlines the still unclear or ambiguous situations using some examples of practical situations.

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

PubMed

Mullen, Caroline

2008-12-01

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

Teaching Educational Leaders to Move from Moral Reasoning to Moral Action

ERIC Educational Resources Information Center

Pijanowski, John

2017-01-01

Ethical leadership is critical to effective schools. However, earlier research showed that ethics and moral reasoning were often not formally taught nor assessed in pre-service leadership programs. In this study I examined graduate programs' approaches to curriculum, instruction, and assessment of learning in ethics and moral reasoning. Rest's…

Ethics of justice vs the ethics of care in moral decision making.

PubMed

Botes, A

1998-03-01

The question to be addressed in this paper is: How can the ethics of justice and the ethics of care be used complementary to each other in ethical decision making within the health care team? Various arguments are presented that justify the reasons that the ethics of justice and the ethics of care should be used complementary to each other for effective ethical decision making within the health care team. The objective is to explore and describe the compatibility of the ethics of justice and the ethics of care from two perspectives: firstly an analysis of the characteristics of the two ethical theories, and secondly the scientific-philosophical viewpoints of these theories. The two theories are incompatible when viewed from these perspectives. For a probable solution to this incompatibility arguments are presented from the perspectives of reflection and virtue-based ethics.

Some not so obvious reasons to teach optical mineralogy

NASA Astrophysics Data System (ADS)

Gunter, M. E.

2004-12-01

Hands-on, interactive, critical thinking, interdisciplinary, spiral learning, and 3-D visualization are familiar words in pedagogy, while Becke lines, dispersion staining, grain mounts, sign of elongation, extinction angle, and optical indicatrix are words seldom used in today's geosciences curriculum. However, the teaching of these seemingly rather historical optical methods, and proper training in the use of the polarized (not petrographic) light microscope (PLM), will by themselves lead to improved learning of our students. And this, if for no other reason, might warrant the inclusion of a semester-long optical mineralogy course. However, another $70 billion per year concern in the U.S. also warrants inclusion of optical mineralogy in a geosciences curriculum. That dollar amount (which would be approximately 10% of annual petroleum sales in the U.S.) centers around the cost spent (wasted?) on asbestos litigation in the U.S. Unfortunately, because we no longer teach PLM skills in the geosciences curriculum, many of the microscopists, regulators, and "expert" witnesses involved in the asbestos issue have little or no formal training in mineralogy or optical mineralogy. This, in turn, often leads to formulation of regulations that make little sense (e.g., that quartz, the most abundant mineral species in the earth's crust is now listed as a human carcinogen) and unsolved mineralogical issues (e.g., OSHA deregulated high-aspect ratio amphibole cleavage fragments in 1994 but did not propose a method to distinguish them from amphibole fibers). The current asbestos issues often deal with tremolite contamination in chrysotile or talc. There are simple PLM methods that we could teach whereby thousands of particles could be screened in minutes to find these possible contaminates, whereas electron beam or X-ray diffraction methods require orders of magnitude more time and cost - and this is only one of many examples. Finally, one might also argue that since minerals

Introducing the Medical Ethics Bowl.

PubMed

Merrick, Allison; Green, Rochelle; Cunningham, Thomas V; Eisenberg, Leah R; Hester, D Micah

2016-01-01

Although ethics is an essential component of undergraduate medical education, research suggests that current medical ethics curricula face considerable challenges in improving students' ethical reasoning. This article discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised: the Medical Ethics Bowl (MEB). Finally, we suggest the pedagogical advantages of the MEB when compared to other ethics curricula.

On using ethical theories to teach engineering ethics.

PubMed

Bouville, Mathieu

2008-03-01

Many engineering ethics classes and textbooks introduce theories such as utilitarianism and Kantianism (and most others draw from these theories without mentioning them explicitly). Yet using ethical theories to teach engineering ethics is not devoid of difficulty. First, their status is unclear (should one pick a single theory or use them all? does it make a difference?) Also, textbooks generally assume or fallaciously 'prove' that egoism (or even simply accounting for one's interests) is wrong. Further, the drawbacks of ethical theories are underestimated and the theories are also otherwise misrepresented to make them more suitable for engineering ethics as the authors construe it, viz. the 'moral reasoning' process. Stating in what various theories disagree would allow the students to frame the problem more productively in terms of motive-consequence or society-individual dichotomies rather than in terms of Kant-utilitarian.

Rewind, review, reflect and fast forward: from Ethics to GeoEthics.

NASA Astrophysics Data System (ADS)

Marone, Eduardo

2017-04-01

Philosophy has as many definitions as philosophers but, at the end of the day, it is no more and no less than the science of thinking using the reason. It gives us tools for rationalizing, following logical paths and with a critical eye, to understand the material and immaterial substance of the universe. It has many branches, and a couple of them, Ethics and Epistemology, are central for the evolution of the human knowledge, among many others. Today, at the XXI Century, it seems that the lack of formal and adequate education on such important matters is making the act of "thinking" not so important when compared with the accumulation of "information", right or wrong, pasteurized or in disconnected pieces, with no much room/time for critical and logical analysis (Philosophy). If the tools to build the knowledge (Epistemology) are not usually familiar to the scientists and, worst, the need of taking the right actions with the generated new and existing knowledge (Ethics) is not a priority; the outputs cannot be the best ones. There have been several academic works and meetings looking into the causes of the scholarly illiteracy on Ethics and Epistemology in Earth Sciences. Among them, our sessions at EGU have endured showing important aspects that need to be tackled and, particularly, insisting in the fact that it is a continuous effort. However, we still need to go back (Rewind) to the main principles of Philosophy, Epistemology and Ethics, looking at them with care (Review), and think (Reflecting) returning to the present (Fast Forward) to make the world better for future generations. Geoethics consists of research and reflection on the values that underpin appropriate behaviours and practices, wherever human activities interact with the Earth system. Although more general ethical issues, which affect other/all sciences practices and behaviours, are included among the Geoethic concerns (as plagiarism, harassment, gender equity, etc.), the focus remains at the

The Uses of Reason in Times of Technical Mediation.

PubMed

Dorrestijn, Steven

2017-01-01

The art of living idiom suits well a practice-oriented approach in ethics of technology. But what remains or becomes of the functioning and use of reason in ethics? In reaction to the comments by Huijer this reply elaborates in more detail how Foucault's art of living can be adapted for a critical contemporary ethics of technology. And the aesthetic-political rationality in Foucault's ethics is compared with Wellner's suggestions of holding on to the notion of code but with a new meaning. Foucault's fourfold scheme of subjectivation and a distinction of "below and above reason" structure the argument.

Ethical Challenges of Military Social Workers Serving in a Combat Zone

ERIC Educational Resources Information Center

Simmons, Catherine A.; Rycraft, Joan R.

2010-01-01

Often faced with ethical challenges that may appear extraordinary, military social workers comprise a distinctive subgroup of the social work profession. From the unique paradigms in which they practice their craft, obvious questions about how military social workers address the ethical challenges inherent to their wartime mission arise. Using a…

Assessing Ethics in Secondary Science

ERIC Educational Resources Information Center

Reiss, Michael J.

2011-01-01

An increasing number of science courses now include consideration of the ethical implications of science. However, there is little agreement about how ethical reasoning in science should be assessed. This article highlights the conclusions of a seminar on the assessment of ethics in science that was organized by the Nuffield Foundation Curriculum…

Ethical Guidelines for Computer Security Researchers: "Be Reasonable"

NASA Astrophysics Data System (ADS)

Sassaman, Len

For most of its existence, the field of computer science has been lucky enough to avoid ethical dilemmas by virtue of its relatively benign nature. The subdisciplines of programming methodology research, microprocessor design, and so forth have little room for the greater questions of human harm. Other, more recently developed sub-disciplines, such as data mining, social network analysis, behavioral profiling, and general computer security, however, open the door to abuse of users by practitioners and researchers. It is therefore the duty of the men and women who chart the course of these fields to set rules for themselves regarding what sorts of actions on their part are to be considered acceptable and what should be avoided or handled with caution out of ethical concerns. This paper deals solely with the issues faced by computer security researchers, be they vulnerability analysts, privacy system designers, malware experts, or reverse engineers.

Learning Ethics through Virtual Fieldtrips: Teaching Ethical Theories through Virtual Experiences

ERIC Educational Resources Information Center

Houser, Rick; Thoma, Steve; Coppock, Amanda; Mazer, Matthew; Midkiff, Lewis; Younanian, Marisa; Young, Sarah

2011-01-01

Teaching ethical reasoning is considered an important component of the undergraduate learning experience. A recent approach to teaching using experiential learning is through virtual worlds such as Second Life. We discuss how ethics may be taught using experiential learning in the virtual world of Second Life. Participants in the class in this…

Overview of psychiatric ethics V: utilitarianism and the ethics of duty.

PubMed

Robertson, Michael; Morris, Kirsty; Walter, Garry

2007-10-01

The aim of this paper is to describe the ethical theories of utilitarianism and the ethics of duty (Kant's ethics) and to evaluate their value as theoretical bases of psychiatric ethics. Utilitarianism is a well-established moral philosophy and has significant instrumental value in dealing with common ethical problems faced by psychiatrists. Despite its capacity to generate solutions to ethical problems, utilitarianism requires a process of what Rawls described as 'reflective equilibrium' to avoid morally repugnant choices, based on utility. The criticisms of utilitarianism, such as the problems of quantifying utility and the responsibility for consequences, are very relevant for psychiatry. Singer's model of utilitarian thinking is particularly problematic for our profession. Kant's ethics provides the pretext for duty bound codes of ethics for psychiatrists, but suffers from problems of flawed claims to the universalizability prescribed by Kant's 'categorical imperative'. Kant's valorization of reason as the core of the autonomy of persons is a valuable insight in understanding psychiatrists' ethical obligations to their patients.

Ethics Assessment in a General Education Programme

ERIC Educational Resources Information Center

Quesenberry, Le Gene; Phillips, Jamie; Woodburne, Paul; Yang, Chin

2012-01-01

The purpose of this study was to assess whether flagged "values intensive" courses within a public university's general education curriculum impacted on students' abilities to reason ethically. The major research question to be explored was, "what effect does taking a values intensive course have on students' ethical reasoning ability, when…

Teaching Behavioral Ethics

ERIC Educational Resources Information Center

Prentice, Robert

2014-01-01

Many ethics courses are philosophy based, others focus on building character, and many are a combination of the two. Sharpening one's moral reasoning and reinforcing one's character are certainly beneficial courses of action for those who wish to be better people and those who wish to teach others how to act more ethically. Because the empirical…

What are applied ethics?

PubMed

Allhoff, Fritz

2011-03-01

This paper explores the relationships that various applied ethics bear to each other, both in particular disciplines and more generally. The introductory section lays out the challenge of coming up with such an account and, drawing a parallel with the philosophy of science, offers that applied ethics may either be unified or disunified. The second section develops one simple account through which applied ethics are unified, vis-à-vis ethical theory. However, this is not taken to be a satisfying answer, for reasons explained. In the third section, specific applied ethics are explored: biomedical ethics; business ethics; environmental ethics; and neuroethics. These are chosen not to be comprehensive, but rather for their traditions or other illustrative purposes. The final section draws together the results of the preceding analysis and defends a disunity conception of applied ethics.

How Many Principles for Public Health Ethics?

PubMed Central

Coughlin, Steven S.

2009-01-01

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

Nonrational processes in ethical decision making.

PubMed

Rogerson, Mark D; Gottlieb, Michael C; Handelsman, Mitchell M; Knapp, Samuel; Younggren, Jeffrey

2011-10-01

Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasilegal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior, including context, perceptions, relationships, emotions, and heuristics. For example, a large body of behavioral research has demonstrated the importance of automatic intuitive and affective processes in decision making and judgment. These processes profoundly affect human behavior and lead to systematic biases and departures from normative theories of rationality. Their influence represents an important but largely unrecognized component of ethical decision making. We selectively review this work; provide various illustrations; and make recommendations for scientists, trainers, and practitioners to aid them in integrating the understanding of nonrational processes with ethical decision making.

Competition and Sensemaking in Ethical Situations.

PubMed

Caughron, Jay J; Antes, Alison L; Stenmark, Cheryl K; Thiel, Chaise E; Wang, Xiaoqian; Mumford, Michael D

2013-07-01

Intra-organizational competition was examined in relation to ethicality. The effect of a competitor being an in-group versus and out-group member, competitor offering uncorroborated or corroborated information, and the impact of the competitor expressing selfish, pro-group, or pro-organizational level goals were examined. Findings suggest that the way competition is presented has an important influence on how well individuals are able to make sense of an ethically ambiguous situation and render an ethical decision. A main effect for information sharing was found, such that when a competitor offers uncorroborated information participants made less ethical decisions and used pro-ethical reasoning strategies less often. An additional main effect was found suggesting that participants made more ethical decisions when working with an in-group competitor rather than an out-group competitor. Complex interactive effects were also found and discussed suggesting that pro-ethical reasoning strategies may be used less often depending on information corroboration, the competitor's relative group membership status, and the motives expressed by the competitor.

Competition and Sensemaking in Ethical Situations

PubMed Central

Caughron, Jay J.; Antes, Alison L.; Stenmark, Cheryl K.; Thiel, Chaise E.; Wang, Xiaoqian; Mumford, Michael D.

2015-01-01

Intra-organizational competition was examined in relation to ethicality. The effect of a competitor being an in-group versus and out-group member, competitor offering uncorroborated or corroborated information, and the impact of the competitor expressing selfish, pro-group, or pro-organizational level goals were examined. Findings suggest that the way competition is presented has an important influence on how well individuals are able to make sense of an ethically ambiguous situation and render an ethical decision. A main effect for information sharing was found, such that when a competitor offers uncorroborated information participants made less ethical decisions and used pro-ethical reasoning strategies less often. An additional main effect was found suggesting that participants made more ethical decisions when working with an in-group competitor rather than an out-group competitor. Complex interactive effects were also found and discussed suggesting that pro-ethical reasoning strategies may be used less often depending on information corroboration, the competitor’s relative group membership status, and the motives expressed by the competitor. PMID:26778850

Do Ethics Classes Teach Ethics?

ERIC Educational Resources Information Center

Curzer, Howard J.; Sattler, Sabrina; DuPree, Devin G.; Smith-Genthôs, K. Rachelle

2014-01-01

The ethics assessment industry is currently dominated by the second version of the Defining Issues Test (DIT2). In this article, we describe an alternative assessment instrument called the Sphere-Specific Moral Reasoning and Theory Survey (SMARTS), which measures the respondent's level of moral development in several respects. We describe eight…

ESHRE Task Force on ethics and Law 20: sex selection for non-medical reasons.

PubMed

Dondorp, W; De Wert, G; Pennings, G; Shenfield, F; Devroey, P; Tarlatzis, B; Barri, P; Diedrich, K

2013-06-01

This Task Force document revisits the debate about the ethics of sex selection for non-medical reasons in the light of relevant new technological developments. First, as a result of improvement of the Microsort® flow cytometry method, there is now a proven technique for preconception sex selection that can be combined both with IVF and IUI. Secondly, the scenario where new approaches that are currently being developed for preimplantation genetic screening (PGS) may lead to such screening becoming a routine part of all IVF treatment. In that scenario professionals will more often be confronted with parental requests for transfer of an embryo of a specific sex. Thirdly, the recent development of non-invasive prenatal testing based on cell-free fetal DNA in maternal plasma allows for easy and safe sex determination in the early stages of pregnancy. While stressing the new urgency that these developments give to the debate, the Task Force did not come to a unanimous position with regard to the acceptability of sex selection for non-medical reasons in the context of assisted reproduction. Whereas some think maintaining the current ban is the best approach, others are in favour of allowing sex selection for non-medical reasons under conditions that take account of societal concerns about the possible impact of the practice. By presenting these positions, the document reflects the different views about this issue that also exist in the field. Specific recommendations include the need for a wider delineation of accepted 'medical reasons' than in terms of avoiding a serious sex-linked disorder, and for a clarification of the legal position with regard to answering parental requests for 'additional sex selection' in the context of medically indicated preimplantation genetic diagnosis, or routine PGS.

Ethical Decision-Making in Academic Administration: A Qualitative Study of College Deans' Ethical Frameworks

ERIC Educational Resources Information Center

Catacutan, Maria Rosario G.; de Guzman, Allan B.

2015-01-01

Ethical decision-making in school administration has received considerable attention in educational leadership literature. However, most research has focused on principals working in secondary school settings while studies that explore ethical reasoning processes of academic deans have been significantly few. This qualitative study aims to…

Facilitating ethical reflection among scientists using the ethical matrix.

PubMed

Jensen, Karsten Klint; Forsberg, Ellen-Marie; Gamborg, Christian; Millar, Kate; Sandøe, Peter

2011-09-01

Several studies have indicated that scientists are likely to have an outlook on both facts and values that are different to that of lay people in important ways. This is one significant reason it is currently believed that in order for scientists to exercise a reliable ethical reflection about their research it is necessary for them to engage in dialogue with other stakeholders. This paper reports on an exercise to encourage a group of scientists to reflect on ethical issues without the presence of external stakeholders. It reports on the use of a reflection process with scientists working in the area of animal disease genomics (mainly drawn from the EADGENE EC Network of Excellence). This reflection process was facilitated by using an ethical engagement framework, a modified version of the Ethical Matrix. As judged by two criteria, a qualitative assessment of the outcomes and the participants' own assessment of the process, this independent reflective exercise was deemed to be successful. The discussions demonstrated a high level of complexity and depth, with participants demonstrating a clear perception of uncertainties and the context in which their research operates. Reflection on stakeholder views and values appeared to be embedded within the discussions. The finding from this exercise seems to indicate that even without the involvement of the wider stakeholder community, valuable reflection and worthwhile discourse can be generated from ethical reflection processes involving only scienitific project partners. Hence, the previous assumption that direct stakeholder engagement is necessary for ethical reflection does not appear to hold true in all cases; however, other reasons for involving a broad group of stakeholders relating to governance and social accountability of science remain.

Democracies restricting democratic rights: some classical sources and implications for ethics of biometrics.

PubMed

Leavitt, Frank J

2011-03-01

Ancient Greek and 17th century English philosophy are not usually discussed along with the ethics of biometrics and data sharing. Academic ethics today, however, suffers from a lack of background in classical texts. We may discuss whether biometrics and data sharing are consistent with democracy, but if we do not know what democracy is, then we cannot know what actions are consistent with it. I shall discuss how and why democracies have restricted the rights of their citizens. I will give the most attention to two paradigms that have most influenced modern democratic thinking: 17th century English democracy and ancient Athens. I do not accept the dogma that the Athenians were obviously wrong to try and then to condemn Socrates. His death-loving doctrine could not but have weakened the will of the youth to work and fight for the good of Athens. I will try to understand the Athenians' point of view and their need to defend their security. At the end, I will apply these lessons to biometrics and data sharing for security reasons.

Democracies Restricting Democratic Rights: Some Classical Sources and Implications for Ethics of Biometrics

PubMed Central

Leavitt, Frank J.

2011-01-01

Ancient Greek and 17 century English philosophy are not usually discussed along with the ethics of biometrics and data sharing. Academic ethics today, however, suffers from a lack of background in classical texts. We may discuss whether biometrics and data sharing are consistent with democracy, but if we do not know what democracy is, then we cannot know what actions are consistent with it. I shall discuss how and why democracies have restricted the rights of their citizens. I will give the most attention to two paradigms that have most influenced modern democratic thinking: 17 century English democracy and ancient Athens. I do not accept the dogma that the Athenians were obviously wrong to try and then to condemn Socrates. His death-loving doctrine could not but have weakened the will of the youth to work and fight for the good of Athens. I will try to understand the Athenians' point of view and their need to defend their security. At the end, I will apply these lessons to biometrics and data sharing for security reasons. PMID:21380481

Professional ethics in nursing: an integrative review.

PubMed

Kangasniemi, Mari; Pakkanen, Piiku; Korhonen, Anne

2015-08-01

To conduct an integrative review and synthesize current primary studies of professional ethics in nursing. Professional ethics is a familiar concept in nursing and provides an ethical code for nursing practice. However, little is known about how professional ethics has been defined and studied in nursing science. Systematic literature searches from 1948-February 2013, using the CINAHL, PubMed and Scopus electronic databases to look at previously published peer-reviewed studies. A modified version of Cooper's five-stage integrative review was used to review and synthesize current knowledge. Fourteen papers were included in this research. According to our synthesis, professional ethics is described as an intra-professional approach to care ethics and professionals commit to it voluntarily. Professional ethics consist of values, duties, rights and responsibilities, regulated by national legislation and international agreements and detailed in professional codes. Professional ethics is well established in nursing, but is constantly changing due to internal and external factors affecting the profession. Despite the obvious importance of professional ethics, it has not been studied much in nursing science. Greater knowledge of professional ethics is needed to understand and support nurses' moral decision-making and to respond to the challenges of current changes in health care and society. © 2015 John Wiley & Sons Ltd.

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

PubMed

Ebbesen, Mette; Pedersen, Birthe D

2007-10-25

This study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups. This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. In this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology physicians and molecular

Keeping it Ethically Real

PubMed Central

Ho, Dien

2016-01-01

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

The relationship between education and ethical behavior of nursing students.

PubMed

Dierckx de Casterlé, B; Janssen, P J; Grypdonck, M

1996-06-01

Based on the cognitive theory of moral development of Kohlberg, refined by the addition of the dimension "ethics of care" and the educational theory of Janssen, the relationship of education and ethical behavior of nursing students was examined. Ethical behavior referred not only to the ethical reasoning of students but also to the relationship between this reasoning and their behavior. This study examined the responses of 2,624 nursing students to five ethical nursing dilemmas included in the Ethical Behavior Test by relating them to four educational variables: students' level of education, level of enrollment, school, and students' perceptions of the educational process. A significant relationship between education and ethical behavior was found.

Ethical Dilemmas in Protecting Susceptible Subpopulations From Environmental Health Risks: Liberty, Utility, Fairness, and Accountability for Reasonableness

PubMed Central

Resnik, David B.; MacDougall, D. Robert; Smith, Elise M.

2018-01-01

Various U.S. laws, such as the Clean Air Act and the Food Quality Protection Act, require additional protections for susceptible subpopulations who face greater environmental health risks. The main ethical rationale for providing these protections is to ensure that environmental health risks are distributed fairly. In this article, we (1) consider how several influential theories of justice deal with issues related to the distribution of environmental health risks; (2) show that these theories often fail to provide specific guidance concerning policy choices; and (3) argue that an approach to public decision making known as accountability for reasonableness can complement theories of justice in establishing acceptable environmental health risks for the general population and susceptible subpopulations. Since accountability for reasonableness focuses on the fairness of the decision-making process, not the outcome, it does not guarantee that susceptible subpopulations will receive a maximum level of protection, regardless of costs or other morally relevant considerations. PMID:29466133

Active Ethical Leadership, Giftedness, and Creativity

ERIC Educational Resources Information Center

Runco, Mark A.

2017-01-01

This commentary is focused on Robert Sternberg's new Active Concerned Citizenship and Ethical Leadership (ACCEL) model. The new model is well conceived and goes far beyond existing models. It is especially attractive in that the emphasis is on ethics. Now more than ever before there is a clear need for education to support ethical reasoning and…

A Model of Comparative Ethics Education for Social Workers

ERIC Educational Resources Information Center

Pugh, Greg L.

2017-01-01

Social work ethics education models have not effectively engaged social workers in practice in formal ethical reasoning processes, potentially allowing personal bias to affect ethical decisions. Using two of the primary ethical models from medicine, a new social work ethics model for education and practical application is proposed. The strengths…

The Principle-Based Method of Practical Ethics.

PubMed

Spielthenner, Georg

2017-09-01

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

[Animals and environmentalist ethics].

PubMed

Guichet, Jean-Luc

2013-01-01

While environmental ethics and animal ethics have a common source of inspiration, they do not agree on the question of the status of animals. Environmental ethicists criticise the narrowness of the reason, focused on pain, given by animal ethicists and their strictly individual point of view; they maintain that their ethical concept is less emotional and more informed by science, with a broad point of view taking natural networks into account. Animal ethicists respond critically, accusing the environmental ethicists of not having any ethical foundation. There are, however, prospects for reconciling the two approaches, provided that they recognise two different ethical stances for animals: one based on the integrity of wild animals and the other based on a model contract for tame animals.

Teaching moral reasoning to student nurses.

PubMed

Weber, J R

1992-09-01

Teaching moral reasoning to students is a challenge for all nursing educators. The National League for Nursing and American Nurses' Association emphasize the importance of ethical content within the curriculum. Review of the literature indicates that ethics has been part of the nursing curriculum since the early 1900s. However, the focus of nursing ethics has changed to more critical reflective thinking versus duties and etiquette. Educators have used a variety of methods for teaching ethics and integrating it into the curriculum. Yet nursing graduates still lack adequate skills to be morally accountable practitioners. This creates a dilemma for the educator to find ways to integrate more ethics content into an already crowded curriculum. The code of ethics of holistic nurses may serve as a basis to guide nurse educators in resolving some of the problems encountered in promoting moral education.

Ethics in Higher Education Research

ERIC Educational Resources Information Center

Parsell, Mitch; Ambler, Trudy; Jacenyik-Trawoger, Christa

2014-01-01

Many educational researchers have experienced challenges in obtaining ethics approval. This article explores some of the reasons why this is the case, looking specifically at the participatory action research methodology. The authors' experience of seeking ethics approval for a project intended to introduce peer review as an enhancement process is…

When the severely ill elderly patient refuses food. Ethical reasoning among nurses.

PubMed

Jansson, L; Norberg, A; Sandman, P O; Aström, G

1995-02-01

Forty registered nurses (RNs) regarded as "good and experienced" in either cancer or dementia care, were asked about their decision to feed or not feed a severely ill elderly woman (a hypothetical case). In order to compare ethical reasoning in the two groups of nurses and to illuminate what it means to RNs to face a situation where the patients can/cannot decide for themselves, a phenomenological hermeneutic approach was used for the analysis. Both groups saw themselves as the advocate for their patients but in different ways. The RNs who talked about a mentally alert patient emphasized that they encouraged their patient to speak up for herself, while the RNs who talked about a severely demented patient emphasized that they tried very hard to interpret their patient's vague and unclear communicative cues and to act as her advocate, especially in relation to physicians. Transcending experiences of dying relatives and patients as well as role models helped them to achieve their ambition of putting themselves in the patient's shoes in order to respect and understand her or his wish and/or what was best for them. The majority of RNs strongly rejected active euthanasia.

Virtue Ethics in School Counseling: A Framework for Decision Making

ERIC Educational Resources Information Center

Wilczenski, Felicia L.; Cook, Amy L.

2011-01-01

Virtue ethics focus on the motives that guide ethical decision making and action, and as such, are critical to the competent application of the counseling profession's ethical codes. Knowledge of virtue ethics deepens understanding of moral responsibilities and ethical reasoning in professional practice. This paper is an overview of virtue ethics…

Impacts of Socratic questioning on moral reasoning of nursing students.

PubMed

Torabizadeh, Camellia; Homayuni, Leyla; Moattari, Marzieh

2018-03-01

Nurses are often faced with complex situations that made them to make ethical decisions; and to make such decisions, they need to possess the power of moral reasoning. Studies in Iran show that the majority of nursing students lack proper ethical development. Socratic teaching is a student-centered method which is strongly opposed to the lecturing method. This study was conducted to evaluate the impacts of Socratic questioning on the moral reasoning of the nursing students. In a quasi-experimental study, Crisham's Nursing Dilemma Test was used to evaluate the results of three groups before, immediately after, and 2 months after intervention. The data were analyzed using the SPSS statistical software (v 15). Participants and research context: Through random allocation, 103 nursing students were divided into three groups. In experiment group 1 (37 students), intervention consisted of Socratic questioning-based sessions on ethics and how to deal with moral dilemmas; experiment group 2 (33 students) attended a 4-h workshop; and the control group (33 students) was not subject to any interventions. Signed informed consent forms: This research was approved by the Ethics Committee of the University. All the participants signed written informed consents. There were significant differences between experiment group 1 and experiment group 2's pre-test and post-test scores on moral reasoning (p ≤ 0.001, p ≤ 0.001), nursing principled thinking (p ≤ 0.001, p ≤ 0.001), and practical considerations (p ≤ 0.001, p ≤ 0.031). Both the teaching approaches improved the subjects' moral reasoning; however, Socratic questioning proved more effective than lecturing. Compared to other similar studies in Iran and other countries, the students had inadequate moral reasoning competence. This study confirms the need for the development of an efficient course on ethics in the nursing curriculum. Also, it appears that Socratic questioning is an effective method to teach nursing ethics

The Press, the Government, and the Ethics Vacuum.

ERIC Educational Resources Information Center

Merrill, John C.

Immanuel Kant's idea of a will to do the right thing--to be ethical--is essentially a dead concept with both press and government. The reasons for this "ethics vacuum" are two-fold: the foundations of ethics in both circles are vague, confusing, and beset by relativism and pragmatism so that no system of ethics ever really coalesces; and neither…

Ethical aspects of clinical chemistry.

PubMed Central

BenGershôm, E

1983-01-01

The work performed by the clinical chemist may deeply affect the decisions of the doctor and the well-being of the patient. Yet in contrast to the doctor and to the nurse the clinical chemist usually has no personal relationship with the patient. Being encumbered by much technology and anonymity is itself a reason for scrutinising his involvement in issues of health care ethics. This is an attempt at clarifying some major aspects: the relationship of his professional ethics to medical ethics as a whole, his ethical obligations to the patient and to society, and other aspects. PMID:6199500

Ethics and prevention of overweight and obesity: an inventory.

PubMed

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

2011-09-01

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

A BRIEF HISTORY OF BIOMEDICAL RESEARCH ETHICS IN IRAN: CONFLICT OF PARADIGMS

PubMed Central

ARAMESH, KIARASH

2014-01-01

During the past two decades, Iran has experienced a noteworthy growth in its biomedical research sector. At the same time, ethical concerns and debates resulting from this burgeoning enterprise has led to increasing attention paid to biomedical ethics. In Iran, Biomedical research ethics and research oversight passed through major periods during the past decades, separated by a paradigm shift. Period 1, starting from the early 1970s, is characterized by research paternalism and complete reliance on researchers as virtuous and caring physicians. This approach was in concordance with the paternalistic clinical practice of physicians outside of research settings during the same period. Period 2, starting from the late 1990s, was partly due to revealing of ethical flaws that occurred in biomedical research in Iran. The regulatory and funding bodies concluded that it was not sufficient to rely solely on the personal and professional virtues of researchers to safeguard human subjects’ rights and welfare. The necessity for independent oversight, emphasized by international declarations, became obvious and undeniable. This paradigm shift led to the establishment of research ethics committees throughout the country, the establishment of academic research centers focusing on medical ethics (MEHR) and the compilation of the first set of national ethical guidelines on biomedical research–one of the first and most important projects conducted by and in the MEHR. Although not yet arrived, ‘period 3’ is on its way. It is predictable from the obvious trends toward performance of high-quality clinical research and the appearance of a highly educated new generation, especially among women. PMID:24720443

Making Pedagogical Adaptability Less Obvious

ERIC Educational Resources Information Center

Vagle, Mark D.

2016-01-01

In this article, I try to make pedagogical adaptability a bit less obvious. In particular, I use some post-structural philosophical ideas and some concepts at the intersections of social class and race to re-interpret Dylan Wiliam's conception of formative assessment. I suggest that this interpretation can provide opportunities to resist the urge…

Ethics fundamentals.

PubMed

Chambers, David W

2011-01-01

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

Inspiring and Equipping Students to Be Ethical Leaders.

PubMed

Schwartz, Arthur J

2015-01-01

This chapter describes the behaviors of the ethical leader and explores the reasons why leaders do not always act ethically. The chapter also offers five recommendations to help educators integrate the practices of ethical leadership into their work with student leaders. © 2015 Wiley Periodicals, Inc., A Wiley Company.

Care Reasoning in Real-Life Moral Conflicts

ERIC Educational Resources Information Center

Juujarvi, Soile

2006-01-01

This article examines real-life moral conflicts from the perspective of the ethic of care. Fifty-six (Time 1) and 57 (Time 2) real-life dilemmas provided by students representing different fields of study were analysed in terms of level of care reasoning according to Skoe's Ethic of Care Interview. The results showed that antisocial temptation and…

Evaluating the Effectiveness of a Mass Media Ethics Course.

ERIC Educational Resources Information Center

Lee, Byung; Padgett, George

2000-01-01

Examines the effectiveness of an ethics education component in a media law and ethics course. Suggests that a short-term mass media ethics study could not develop values considered essential for ethical behavior. Argues that students developed more complexity in their reasoning not measurable by the scale. Suggests a course or module on ethics…

Personalized Medicine: Ethical Aspects.

PubMed

Sharrer, G Terry

2017-01-01

In our time of genome-based personalized medicine, clinical research and clinical medicine are accelerating at a quick pace. Faster and cheaper DNA sequencing and protein profiling, microfluidic devices for capturing blood biomarkers, nanoparticles for precise drug delivery and enhanced imaging, rapid computational analysis of massive data inputs, and other technological wonders coalesce to create a kind of Moore's Law for medicine. Needs are obvious, knowledge grows, capital becomes available, but these factors are not entirely sufficient to make health more achievable. Personalized medicine also requires social acceptability, not only for accuracy and efficacy but also because medicine is a moral domain. This chapter deals with medical ethics that determine the choices a society makes regarding healthcare; and it has not always been a steady, morally correct course of progress. Indeed, medical ethics has largely derived from socio-scientific calamities in the past. Personalized medicine, with its enhanced capacity to access the individuality of illness, must have a continuously evolving feedback mechanism-the most important element being the physician-patient relationship-which is its ethical footing.

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.

The ethics of placebo-controlled trials: methodological justifications.

PubMed

Millum, Joseph; Grady, Christine

2013-11-01

The use of placebo controls in clinical trials remains controversial. Ethical analysis and international ethical guidance permit the use of placebo controls in randomized trials when scientifically indicated in four cases: (1) when there is no proven effective treatment for the condition under study; (2) when withholding treatment poses negligible risks to participants; (3) when there are compelling methodological reasons for using placebo, and withholding treatment does not pose a risk of serious harm to participants; and, more controversially, (4) when there are compelling methodological reasons for using placebo, and the research is intended to develop interventions that can be implemented in the population from which trial participants are drawn, and the trial does not require participants to forgo treatment they would otherwise receive. The concept of methodological reasons is essential to assessing the ethics of placebo controls in these controversial last two cases. This article sets out key considerations relevant to considering whether methodological reasons for a placebo control are compelling. © 2013.

Clinical reasoning and critical thinking.

PubMed

da Silva Bastos Cerullo, Josinete Aparecida; de Almeida Lopes Monteiro da Cruz, Diná

2010-01-01

This study identifies and analyzes nursing literature on clinical reasoning and critical thinking. A bibliographical search was performed in LILACS, SCIELO, PUBMED and CINAHL databases, followed by selection of abstracts and the reading of full texts. Through the review we verified that clinical reasoning develops from scientific and professional knowledge, is permeated by ethical decisions and nurses values and also that there are different personal and institutional strategies that might improve the critical thinking and clinical reasoning of nurses. Further research and evaluation of educational programs on clinical reasoning that integrate psychosocial responses to physiological responses of people cared by nurses is needed.

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

PubMed

Charlesworth, Max

2005-01-01

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

Turkish Preservice Science Teachers' Informal Reasoning Regarding Socioscientific Issues and the Factors Influencing Their Informal Reasoning

NASA Astrophysics Data System (ADS)

Topçu, Mustafa Sami; Yılmaz-Tüzün, Özgül; Sadler, Troy D.

2011-06-01

The purpose of the study is to explore Turkish preservice science teachers' informal reasoning regarding socioscientific issues and the factors influencing their informal reasoning. The researchers engaged 39 preservice science teachers in informal reasoning interview and moral decision-making interview protocols. Of the seven socioscientific issues, three issues were related to gene therapy, another three were related to human cloning, and one was related to global warming. The data were analyzed using an interpretive qualitative research approach. The characteristic of informal reasoning was determined as multidimensional, and the patterns of informal reasoning emerged as rationalistic, emotive, and intuitive reasoning. The factors influencing informal reasoning were: personal experiences, social considerations, moral-ethical considerations, and technological concerns.

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

Dual loyalties: Everyday ethical problems of registered nurses and physicians in combat zones.

PubMed

Lundberg, Kristina; Kjellström, Sofia; Sandman, Lars

2017-01-01

When healthcare personnel take part in military operations in combat zones, they experience ethical problems related to dual loyalties, that is, when they find themselves torn between expectations of doing caring and military tasks, respectively. This article aims to describe how Swedish healthcare personnel reason concerning everyday ethical problems related to dual loyalties between care and military tasks when undertaking healthcare in combat zones. Abductive qualitative design. Participants and research context: Individual interviews with 15 registered nurses and physicians assigned for a military operation in Mali. Ethical considerations: The participants signed up voluntarily, and requirements for informed consent and confidentiality were met. The research was approved by the Regional Ethics Review Board in Gothenburg (D no. 816-14; 24 November 2014). Three main categories emerged: reasons for not undertaking combat duties, reasons for undertaking combat duties and restricted loyalty to military duties, and 14 subcategories. Reasons for not undertaking combat duties were that it was not in their role, not according to ethical codes or humanitarian law or a breach towards patients. Reasons for undertaking combat duties were that humanitarian law does not apply or has to be treated pragmatically or that it is a case of force protection. Shortage of resources and competence were reasons for both doing and not doing military tasks. Under some circumstances, they could imagine undertaking military tasks: when under threat, if unseen or if not needed for healthcare duties. These discrepant views suggest a lack of a common view on what is ethically acceptable or not, and therefore we suggest further normative discussion on how these everyday ethical problems should be interpreted in the light of humanitarian law and ethical codes of healthcare personnel and following this, further training in ethical reflection before going on military operations.

An Extension of the Theory of Reasoned Action in Ethical Decision Contexts: The Role of Normative Influence and Ethical Judgment

ERIC Educational Resources Information Center

Celuch, Kevin; Dill, Andy

2011-01-01

The moral conduct of organizations is ultimately dependent on the discrete actions of individuals. The authors address the scholarly and managerial imperative of how individuals combine various cognitions in their ethical decision making. The study extends the understanding of ethical decision making by exploring relationships among Theory of…

Ethical objections against including life-extension costs in cost-effectiveness analysis: a consistent approach.

PubMed

Gandjour, Afschin; Müller, Dirk

2014-10-01

One of the major ethical concerns regarding cost-effectiveness analysis in health care has been the inclusion of life-extension costs ("it is cheaper to let people die"). For this reason, many analysts have opted to rule out life-extension costs from the analysis. However, surprisingly little has been written in the health economics literature regarding this ethical concern and the resulting practice. The purpose of this work was to present a framework and potential solution for ethical objections against life-extension costs. This work found three levels of ethical concern: (i) with respect to all life-extension costs (disease-related and -unrelated); (ii) with respect to disease-unrelated costs only; and (iii) regarding disease-unrelated costs plus disease-related costs not influenced by the intervention. Excluding all life-extension costs for ethical reasons would require-for reasons of consistency-a simultaneous exclusion of savings from reducing morbidity. At the other extreme, excluding only disease-unrelated life-extension costs for ethical reasons would require-again for reasons of consistency-the exclusion of health gains due to treatment of unrelated diseases. Therefore, addressing ethical concerns regarding the inclusion of life-extension costs necessitates fundamental changes in the calculation of cost effectiveness.

The ethical dimensions of wildlife disease management in an evolutionary context

PubMed Central

Crozier, GKD; Schulte-Hostedde, Albrecht I

2014-01-01

Best practices in wildlife disease management require robust evolutionary ecological research (EER). This means not only basing management decisions on evolutionarily sound reasoning, but also conducting management in a way that actively contributes to the on-going development of that research. Because good management requires good science, and good science is ‘good’ science (i.e., effective science is often science conducted ethically), good management therefore also requires practices that accord with sound ethical reasoning. To that end, we propose a two-part framework to assist decision makers to identify ethical pitfalls of wildlife disease management. The first part consists of six values – freedom, fairness, well-being, replacement, reduction, and refinement; these values, developed for the ethical evaluation of EER practices, are also well suited for evaluating the ethics of wildlife disease management. The second part consists of a decision tree to help identify the ethically salient dimensions of wildlife disease management and to guide managers toward ethically responsible practices in complex situations. While ethical reasoning cannot be used to deduce from first principles what practices should be undertaken in every given set of circumstances, it can establish parameters that bound what sorts of practices will be acceptable or unacceptable in certain types of scenarios. PMID:25469160

The ethical dimensions of wildlife disease management in an evolutionary context.

PubMed

Crozier, Gkd; Schulte-Hostedde, Albrecht I

2014-08-01

Best practices in wildlife disease management require robust evolutionary ecological research (EER). This means not only basing management decisions on evolutionarily sound reasoning, but also conducting management in a way that actively contributes to the on-going development of that research. Because good management requires good science, and good science is 'good' science (i.e., effective science is often science conducted ethically), good management therefore also requires practices that accord with sound ethical reasoning. To that end, we propose a two-part framework to assist decision makers to identify ethical pitfalls of wildlife disease management. The first part consists of six values - freedom, fairness, well-being, replacement, reduction, and refinement; these values, developed for the ethical evaluation of EER practices, are also well suited for evaluating the ethics of wildlife disease management. The second part consists of a decision tree to help identify the ethically salient dimensions of wildlife disease management and to guide managers toward ethically responsible practices in complex situations. While ethical reasoning cannot be used to deduce from first principles what practices should be undertaken in every given set of circumstances, it can establish parameters that bound what sorts of practices will be acceptable or unacceptable in certain types of scenarios.

Nursing students' responses to ethical dilemmas in nursing practice.

PubMed

Dierckx de Casterlé, B; Grypdonck, M; Vuylsteke-Wauters, M; Janssen, P J

1997-01-01

In literature as well as in nursing practice a growing concern about nurses' ethical competence can be observed. Based on the cognitive theory of moral development by Kohlberg, this research examined nursing students' ethical behaviour in five nursing dilemmas. Ethical behaviour refers not only to the ethical reasoning of nursing students but also to the relationship between reasoning and behaviour. Kohlberg's definition of morality was refined by adding a care perspective. The results show that the majority of students can be located in the fourth moral stage according to Kohlberg's theory, that is, the conventional level of moral development. This finding implies that students are still guided by professional rules, norms and duties, and have not (yet) succeeded in making personal ethical decisions on the basis of their own principles and acting according to such decisions.

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

PubMed Central

Ebbesen, Mette; Pedersen, Birthe D

2007-01-01

Background This study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups. Method This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. Results In this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology

A Brief History of Biomedical Research Ethics in Iran: Conflict of Paradigms.

PubMed

Aramesh, Kiarash

2015-08-01

During the past two decades, Iran has experienced a noteworthy growth in its biomedical research sector. At the same time, ethical concerns and debates resulting from this burgeoning enterprise has led to increasing attention paid to biomedical ethics. In Iran, Biomedical research ethics and research oversight passed through major periods during the past decades, separated by a paradigm shift. Period 1, starting from the early 1970s, is characterized by research paternalism and complete reliance on researchers as virtuous and caring physicians. This approach was in concordance with the paternalistic clinical practice of physicians outside of research settings during the same period. Period 2, starting from the late 1990s, was partly due to revealing of ethical flaws that occurred in biomedical research in Iran. The regulatory and funding bodies concluded that it was not sufficient to rely solely on the personal and professional virtues of researchers to safeguard human subjects' rights and welfare. The necessity for independent oversight, emphasized by international declarations, became obvious and undeniable. This paradigm shift led to the establishment of research ethics committees throughout the country, the establishment of academic research centers focusing on medical ethics (MEHR) and the compilation of the first set of national ethical guidelines on biomedical research-one of the first and most important projects conducted by and in the MEHR. Although not yet arrived, 'period 3' is on its way. It is predictable from the obvious trends toward performance of high-quality clinical research and the appearance of a highly educated new generation, especially among women. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Can one do good medical ethics without principles?

PubMed

Macklin, Ruth

2015-01-01

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

Ethics of xenotransplantation: animal issues, consent, and likely transformation of transplant ethics.

PubMed

Daar, A S

1997-01-01

The shortage of organs, breakthroughs in research, involvement of biotechnology companies, absence of ethically more acceptable alternatives, and a vaguely perceived "time to put man on the moon" feeling have contributed to the current reawakening of interest in xenotransplantation. The focus of ethical attention has changed from the moral correctness of using animals for research/therapy to an increasingly appreciated danger of the establishment and spread of xenozoonoses in recipients, their contacts, and the general public. The United Kingdom has established an embargo on clinical trials and has set up a national regulatory authority to oversee and coordinate the development of research, establish guidelines, and decide on when trials can proceed. In the United States, on the other hand, the overall attitude is to "proceed with caution," and the Food and Drug Administration has approved a number of xenotransplant studies. The Public Health Service guidelines on reducing infection risk are still evolving and are likely to end up being more cautions than they are currently. There are a number of reasons for not using subhuman primates for xenotransplantation, including their closeness to humans, the likelihood of passing on infections, their depletability (gorillas, chimpanzees), their slow breeding, and the expense of breeding them under specified-pathogen free conditions. The pig, although domesticated and familiar, is too distant to evoke the same feelings we have for primates, has the correct-size organs, is probably less likely to pass on infections, breeds rapidly, and is not endangered; moreover, millions of them are eaten every year. Although drawing ethical conclusions is difficult, at this stage of knowledge and debate it seems acceptable to manipulate pigs genetically and to proceed to using their organs for xenotransplantation trials when infection control measures and the scientific base justify it. The question of informed consent is likely to be a

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

Can the study of ethics enhance nursing practice?

PubMed

Allmark, Peter

2005-09-01

The aim of this paper is to suggest that the study of ethics and ethical theories can enhance nursing practice. Knowledge of ethical theories can be of practical use to nurses in at least three ways. First, it can help nurses uncover to what extent a problem is an ethical one. The questions faced in practice can be empirical, formal or philosophical. Very often, a practical decision requires us to tackle all three types. In the example of a 'Do not attempt resuscitation' order, deciding on whether such an order is appropriate requires us to answer empirical questions such as how likely any attempt is to achieve success. It also requires us to answer formal questions such as whether the law permits such an order in the present circumstance. Finally, it requires us to answer ethical/philosophical questions, such as how we should weigh up quality of life against quantity. Second, it can enable practitioners to develop skills and tools to tackle ethical/philosophical questions. In this paper I describe two such tools: Socratic questioning and Aristotelian dialectic. Third, it can help practitioners to develop the soundness of their ethical values and beliefs. All ethical reasoning requires us to use our values and beliefs, and attending to them enhances the quality of our reasoning. The study of ethics can enhance nursing practice.

How psychotherapists handle treatment errors – an ethical analysis

PubMed Central

2013-01-01

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

Publication ethics from the ground up.

PubMed

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

2018-02-01

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

George Williams in Thailand: An Ethical Decision-Making Exercise

ERIC Educational Resources Information Center

James, Constance R.; Smith, J. Goosby

2007-01-01

This article presents a classroom ethical decision-making exercise designed to help students make reasoned ethical decisions while gaining insight into their own and others' ethical decision-making strategies. During the exercise, students individually analyze an original mini-case, then meet in small groups to reach consensus on the advice and…

Assessing the Growth of Ethical Banking: Some Evidence from Spanish Customers

PubMed Central

Callejas-Albiñana, Fernando E.; Martínez-Rodríguez, Isabel; Callejas-Albiñana, Ana I.; de Vidales-Carrasco, Irene M.

2017-01-01

Aristotle, who, having predated Adam Smith by 2000 years, deserves to be recognized as the world’s first economist (Solomon, 1995), distinguished between two different senses of what we call economics: oikonomikos, or household trading, which he approved of and considered essential to the working of any even slightly complex society, and chrematisike, or trade for profit, which he considered selfish and utterly devoid of virtue, calling those who engaged in such practices “parasites”. Of course, consumers do not purchase and invest for solely economic reasons (Polanyi, 1944). Interest in ethics in economics has been the subject of continuous study. In this regard, the recent financial crisis has had not only economic, but also social, psychological, political, and ethical consequences, which have impacted the financial and banking system. Consumers are no longer drawn only by the economic return but also by ethical factors. Ethical banking is on the rise. This paper aims to explain the reasons for the growth in ethical banking and to answer the following questions: can banking consumers-investors change the characterization of the banking system? Can ethical banking gain ground on traditional banking? And is ethical banking really effective? To this end, it will examine the Spanish case, using econometric causal regression models to identify the reasons why consumers decide to invest in ethical banking and determine its role in the Spanish economy. PMID:28596742

Assessing the Growth of Ethical Banking: Some Evidence from Spanish Customers.

PubMed

Callejas-Albiñana, Fernando E; Martínez-Rodríguez, Isabel; Callejas-Albiñana, Ana I; de Vidales-Carrasco, Irene M

2017-01-01

Aristotle, who, having predated Adam Smith by 2000 years, deserves to be recognized as the world's first economist (Solomon, 1995), distinguished between two different senses of what we call economics : oikonomikos , or household trading, which he approved of and considered essential to the working of any even slightly complex society, and chrematisike , or trade for profit, which he considered selfish and utterly devoid of virtue, calling those who engaged in such practices "parasites". Of course, consumers do not purchase and invest for solely economic reasons (Polanyi, 1944). Interest in ethics in economics has been the subject of continuous study. In this regard, the recent financial crisis has had not only economic, but also social, psychological, political, and ethical consequences, which have impacted the financial and banking system. Consumers are no longer drawn only by the economic return but also by ethical factors. Ethical banking is on the rise. This paper aims to explain the reasons for the growth in ethical banking and to answer the following questions: can banking consumers-investors change the characterization of the banking system? Can ethical banking gain ground on traditional banking? And is ethical banking really effective? To this end, it will examine the Spanish case, using econometric causal regression models to identify the reasons why consumers decide to invest in ethical banking and determine its role in the Spanish economy.

12 CFR 1710.14 - Code of conduct and ethics.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Code of conduct and ethics. 1710.14 Section... Code of conduct and ethics. (a) General. An Enterprise shall establish and administer a written code of conduct and ethics that is reasonably designed to assure the ability of board members, executive officers...

12 CFR 1710.14 - Code of conduct and ethics.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Code of conduct and ethics. 1710.14 Section... Code of conduct and ethics. (a) General. An Enterprise shall establish and administer a written code of conduct and ethics that is reasonably designed to assure the ability of board members, executive officers...

12 CFR 1710.14 - Code of conduct and ethics.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Code of conduct and ethics. 1710.14 Section... Code of conduct and ethics. (a) General. An Enterprise shall establish and administer a written code of conduct and ethics that is reasonably designed to assure the ability of board members, executive officers...

12 CFR 1710.14 - Code of conduct and ethics.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Code of conduct and ethics. 1710.14 Section... Code of conduct and ethics. (a) General. An Enterprise shall establish and administer a written code of conduct and ethics that is reasonably designed to assure the ability of board members, executive officers...

12 CFR 1710.14 - Code of conduct and ethics.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Code of conduct and ethics. 1710.14 Section... Code of conduct and ethics. (a) General. An Enterprise shall establish and administer a written code of conduct and ethics that is reasonably designed to assure the ability of board members, executive officers...

Confessions of an Ethics Committee Chair

ERIC Educational Resources Information Center

Halse, Christine

2011-01-01

This essay examines the possibilities of being/becoming an ethical researcher in the academy. It tackles this task through the lens of an ethics application by Mary [pseudonym], a PhD student in sociology whose research thesis was investigating the reasons why married men with children use prostitutes. Two analyses are offered of Mary's story. The…

Ethics for pandemics beyond influenza: Ebola, drug-resistant tuberculosis, and anticipating future ethical challenges in pandemic preparedness and response.

PubMed

Smith, Maxwell J; Silva, Diego S

2015-01-01

The unprecedented outbreak of Ebola virus disease (EVD) in West Africa has raised several novel ethical issues for global outbreak preparedness. It has also illustrated that familiar ethical issues in infectious disease management endure despite considerable efforts to understand and mitigate such issues in the wake of past outbreaks. To improve future global outbreak preparedness and response, we must examine these shortcomings and reflect upon the current state of ethical preparedness. To this end, we focus our efforts in this article on the examination of one substantial area: ethical guidance in pandemic plans. We argue that, due in part to their focus on considerations arising specifically in relation to pandemics of influenza origin, pandemic plans and their existing ethical guidance are ill-equipped to anticipate and facilitate the navigation of unique ethical challenges that may arise in other infectious disease pandemics. We proceed by outlining three reasons why this is so, and situate our analysis in the context of the EVD outbreak and the threat posed by drug-resistant tuberculosis: (1) different infectious diseases have distinct characteristics that challenge anticipated or existing modes of pandemic prevention, preparedness, response, and recovery, (2) clear, transparent, context-specific ethical reasoning and justification within current influenza pandemic plans are lacking, and (3) current plans neglect the context of how other significant pandemics may manifest. We conclude the article with several options for reflecting upon and ultimately addressing ethical issues that may emerge with different infectious disease pandemics.

Moral orientation of elderly persons: considering ethical dilemmas in health care.

PubMed

Pinch, W J; Parsons, M E

1997-09-01

Knowledge about moral development and elderly persons is very limited. A hermeneutical interpretative study was conducted with healthy elderly persons (n = 20) in order to explore and describe their moral orientation based on the paradigms of justice (Kohlberg) and care (Gilligan). The types of moral reasoning, dominance, alignment and orientation were determined. All but one participant included both types of reasoning when discussing an ethical conflict. None of the men's moral reasoning was dominated by caring, but justice dominated the reasoning of four women. The implications for ethical decision-making and future research are discussed.

Ethics consultation on demand: concepts, practical experiences and a case study.

PubMed

Reiter-Theil, S

2000-06-01

Despite the increasing interest in clinical ethics, ethics consultation as a professional service is still rare in Europe. In this paper I refer to examples in the United States. In Germany, university hospitals and medical faculties are still hesitant about establishing yet another "committee". One of the reasons for this hesitation lies in the ignorance that exists here about how to provide medical ethics services; another reason is that medical ethics itself is not yet institutionalised at many German universities. The most important obstacle, however, may be that medical ethics has not yet demonstrated its relevance to the needs of those caring for patients. The Centre for Ethics and Law, Freiburg, has therefore taken a different approach from that offered elsewhere: clinical ethics consultation is offered on demand, the consultation being available to clinician(s) in different forms. This paper describes our experiences with this approach; practical issues are illustrated by a case study.

The role of ethics in pediatrics.

PubMed

Cooke, Robert E

1975-10-01

Medical ethics has increased in importance in medical education and practice as a consequence of advances in definitive treatment of patients. Most problems in ethics related to medicine have certain common denominators. Medical scientists and practitioners frequently disclaim any ethical absolutes or consider as important only nonmoral consequences rather than ethical principles such as justice, noninjury, truth-telling, etc. Failure to differentiate moral from nonmoral decisions as well as differences in level of moral reasoning also account for substantial differences in analyzing a given clinical problem. Finally, individual moral policy may be rendered ineffective because of institutional policies that result from purely pragmatic considerations.

In search of an ethic of medical librarianship.

PubMed Central

Crawford, H

1978-01-01

Why is the literature on the ethics of librarianship so sparse? Some of the codes of ethics proposed or officially adopted during this century are examined, with an informal commentary on the reasons why they seem to have aroused so little sustained interest and discussion. Attention is directed particularly to library--user relationships and to some of the unique ethical situations in medical libraries. PMID:678701

Examining why ethics is taught to veterinary students: a qualitative study of veterinary educators' perspectives.

PubMed

Magalhães-Sant'Ana, Manuel; Lassen, Jesper; Millar, Kate M; Sandøe, Peter; Olsson, I Anna S

2014-01-01

Although it is widely agreed that veterinary students need to be introduced to ethics, there is limited empirical research investigating the reasons why veterinary ethics is being taught. This study presents the first extensive investigation into the reasons for teaching veterinary ethics and reports data collected in semi-structured interviews with educators involved in teaching undergraduate veterinary ethics at three European schools: the University of Copenhagen, the University of Nottingham, and the Technical University of Lisbon (curricular year 2010-2011). The content of the interview transcripts were analyzed using Toulmin's argumentative model. Ten objectives in teaching veterinary ethics were identified, which can be grouped into four overarching themes: ethical awareness, ethical knowledge, ethical skills, and individual and professional qualities. These objectives include recognizing values and ethical viewpoints, identifying norms and regulations, developing skills of communication and decision making, and contributing to a professional identity. Whereas many of the objectives complement each other, there is tension between the view that ethics teaching should promote knowledge of professional rules and the view that ethics teaching should emphasize critical reasoning skills. The wide range of objectives and the possible tensions between them highlight the challenges faced by educators as they attempt to prioritize among these goals of ethics teaching within a crowded veterinary curriculum.

The importance of an ethics curriculum in surgical education.

PubMed

Keune, Jason D; Kodner, Ira J

2014-07-01

The nature of surgical work provides fertile ground in which ethical problems can grow. The concept of what it means to be a "good surgeon" includes the ability to reason and deliberate about how the surgeon's unique technical capabilities integrate with larger society. Ethics education at the resident level is important for several reasons. It can ensure that care is delivered in a socially and ethically responsible manner through global and emergent effects on institutions and traditions. It will prepare residents for leadership positions. It can allow residents to confront issues, such as the scientific underdetermination of surgical practice, the application of new technologies to trusting patients that have been developed by for-profit companies, and a surgical environment that is becoming increasingly institutionalized. Resident ethics education provides the opportunity for a model of collective deliberation to be developed that can be used to make sense of ethical problems as they arise.

Teaching Ethics in International Business Courses: The Impacts of Religions

ERIC Educational Resources Information Center

Ruhe, John; Lee, Monle

2008-01-01

Implicit in most comparative ethical studies is the assumption that cultural and religious differences between countries are the major reasons behind the variations in ethical beliefs and business practice across nations. This article examines research on the international ethical issues and the common moral concerns that permeate differing…

Nature and grace: the paradox of Catholic ethics.

PubMed

Smith, Russell E

1995-09-01

Roman Catholic bioethics seems to be caught in a paradox. On the one hand it is committed to the natural law tradition and the power of reason to understand the structures of creation and the moral law. On the other hand there is a greater and greater appeal to Scripture and revelation. The tradition maintains that reason is capable of understanding the rational structures of reality and that ethics is properly built on metaphysics. In this way ethics, bioethics, is non-sectarian. However, the tradition also recognizes the effects of Original Sin on the will and intellect and the broad cultural changes that have affected our understanding of metaphysics. The appeal to Revelation is a corrective to many contemporary trends in ethics and bioethics. This article will examine the interplay of reason and revelation in the Church's teaching on sexuality (particularly contraception and in vitro fertilization), suffering, and death. Catholic bioethics is in the end prophetic and ecumenical and not gnostic and non-ecumenical.

Learning for Oneself: A Confucian-Inspired Case for Moral Formation in Ethics Pedagogy

ERIC Educational Resources Information Center

Duperon, Matthew

2018-01-01

This article explores the disconnection between ethical theory and ethical practice in ethics courses at secular U.S. colleges and universities. In such contexts academic ethics focuses almost exclusively on "ethical reasoning" and leaves the business of practical moral formation of students in the realm of "student life." I…

Digital Photography--a Question of Ethics.

ERIC Educational Resources Information Center

Meltzer, Bonnie

1996-01-01

Discusses reasons for computer manipulation of photographs and the need to educate students about the ethics involving digital scanning. Focuses on ownership, copyrights, reasons for changing a photograph, reader-interpretation, and the context in which the photograph is used. Suggests a photo illustration project to teach students about these…

Ethical Issues in Social Media Research for Public Health.

PubMed

Hunter, Ruth F; Gough, Aisling; O'Kane, Niamh; McKeown, Gary; Fitzpatrick, Aine; Walker, Tom; McKinley, Michelle; Lee, Mandy; Kee, Frank

2018-03-01

Social media (SM) offer huge potential for public health research, serving as a vehicle for surveillance, delivery of health interventions, recruitment to trials, collection of data, and dissemination. However, the networked nature of the data means they are riddled with ethical challenges, and no clear consensus has emerged as to the ethical handling of such data. This article outlines the key ethical concerns for public health researchers using SM and discusses how these concerns might best be addressed. Key issues discussed include privacy; anonymity and confidentiality; authenticity; the rapidly changing SM environment; informed consent; recruitment, voluntary participation, and sampling; minimizing harm; and data security and management. Despite the obvious need, producing a set of prescriptive guidelines for researchers using SM is difficult because the field is evolving quickly. What is clear, however, is that the ethical issues connected to SM-related public health research are also growing. Most importantly, public health researchers must work within the ethical principles set out by the Declaration of Helsinki that protect individual users first and foremost.

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.

Ethics in a time of contagion: a relational perspective.

PubMed

Austin, Wendy

2008-12-01

In times of contagion, the key role of nurses brings fears, dangers, and unique demands. The ethics of such challenges need to be explored and understood. Using Callahan's framework for thinking ethically and Taylor's "worries" of modern life, the author elucidates some of the challenges and then argues that the current approach to pandemic ethics, with its reliance on moral reasoning, is insufficient to guide nurses' ethical actions. Relational ethics, which explicitly situates ethics within relationships and our commitment to one another, and which recognizes that context matters in ethical decision-making, is offered as a viable alternative for nurses in considering how to respond.

A preliminary investigation into the moral reasoning abilities of UK veterinarians.

PubMed

Batchelor, C E M; Creed, A; McKeegan, D E F

2015-08-01

Veterinary medicine is an ethically challenging profession, but the ethical reasoning abilities of practising veterinarians in the UK have never been formally assessed. This study investigated moral reasoning ability in 65 qualified veterinarians (38 practising and 27 academic) and 33 members of the public in the UK using the Defining Issues Test. Academic veterinarians had higher scores than members of the public but practising veterinarians did not. There was large variation in moral reasoning abilities among qualified veterinarians. Moral reasoning score in veterinarians did not improve with years of experience. These results show that despite having a professional degree moral reasoning skills of practising veterinarians may be insufficient to deal with the demands of their profession. This could have implications for animal welfare, client services and veterinarian wellbeing. The results highlight the need for more training in this area. British Veterinary Association.

[Ethical Evaluation of Non-Therapeutic Male Circumcision].

PubMed

İzgi, M Cumhur

2015-01-01

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

Ethics of caring and professional roles.

PubMed

Paulsen, Jens Erik

2011-03-01

Normative discussions about modern health care often revolve around principles stating what must not be done or how to ration scarce resources in the name of justice. These are important discussions. However, in order to have an impact on clinical roles, ethical reflection must be able to describe and address the complexities and challenges of modern nursing and doctoring, and maybe even the patient role. A multi-principled approach, such as the one suggested by Beauchamp and Childress, can obviously address almost any such issue, but a great deal of translation is often required in order to address role-related issues. I shall here argue that an ethics of caring is better suited to grasping the big picture when the question is how to create value-informed clinical roles in an era of rapid development.

Integrating ethics into technical courses: micro-insertion.

PubMed

Davis, Michael

2006-10-01

Perhaps the most common reason science and engineering faculty give for not including 'ethics' (that is, research ethics, engineering ethics, or some discussion of professional responsibility) in their technical classes is that 'there is no room'. This article 1) describes a technique ('micro-insertion') that introduces ethics (and related topics) into technical courses in small enough units not to push out technical material, 2) explains where this technique might fit into the larger undertaking of integrating ethics into the technical (scientific or engineering) curriculum, and 3) concludes with some quantified evidence (collected over more than a decade) suggesting success. Integrating ethics into science and engineering courses is largely a matter of providing context for what is already being taught, context that also makes the material already being taught seem 'more relevant'.

A student's perspective on medical ethics education.

PubMed

Terndrup, Christopher

2013-12-01

Despite many efforts to increase ethics education in US medical schools, barriers continue to arise that impede the production of morally driven physicians who practice medicine with ideal empathy. Research has shown that, particularly during the clinical years, medical students lose the ability both to recognize ethical dilemmas and to approach such situations with compassionate reasoning. This article summarizes the current status of ethics education in US medical schools, described through the eyes of and alongside the story of a graduating medical student.

[Assessing bioethics education: Teaching to be virtuous doctors or just doctors with practical ethical skills].

PubMed

Esquerda, Montse; Pifarré, Josep; Roig, Helena; Busquets, Ester; Yuguero, Oriol; Viñas, Joan

2018-04-04

In the last decades, bioethics has been incorporated into the academic training of the Medical Schools. Some studies analyze the ethical-moral development of medical students and the effect of ethical education in other countries. This evaluation is done by measuring Kohlberg's moral reasoning (virtuous doctors), or ethical sensitivity to resolve clinical cases (physicians with ethical skills). The following study is proposed to assess the impact of bioethics training on these two variables, in Spanish medical students. Observational cross-sectional study. SITE: Faculty of Medicine, University of Lleida. 175 students from third year of medicine (78 before bioethics and 97 after bioethics, in different courses) were conducted. Bioethics course. A socio-demographic questionnaire, the Rest Defining Issue test scale, and Problem Identification Test with clinical vignettes were administered. A consistent and significant correlation has been found between moral reasoning and ethical sensitivity. Women presented greater post-conventional reasoning. There were no changes in Kohlberg's stage of global moral reasoning with ethical training. There were changes in ethical sensitivity with bioethical training, with a significantly and globally improvement. In our study, training in bioethics does not improve moral development but rather the ethical problem solving skills. It is asked if this improvement is enough to train doctors prepared for the new challenges. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

Need for ethics support in healthcare institutions: views of Dutch board members and ethics support staff.

PubMed

Dauwerse, Linda; Abma, Tineke; Molewijk, Bert; Widdershoven, Guy

2011-08-01

The purpose of this article is to investigate the need for ethics support in Dutch healthcare institutions in order to understand why ethics support is often not used in practice and which factors are relevant in this context. This study had a mixed methods design integrating quantitative and qualitative research methods. Two survey questionnaires, two focus groups and 17 interviews were conducted among board members and ethics support staff in Dutch healthcare institutions. Most respondents see a need for ethics support. This need is related to the complexity of contemporary healthcare, the contribution of ethics support to the core business of the organisation and to the surplus value of paying structural attention to ethical issues. The need for ethics support is, however, not unconditional. Reasons for a lacking need include: aversion of innovations, negative associations with the notion of ethics support service, and organisational factors like resources and setting. There is a conditioned need for ethics support in Dutch healthcare institutions. The promotion of ethics support in healthcare can be fostered by focusing on formats which fit the needs of (practitioners in) healthcare institutions. The emphasis should be on creating a (culture of) dialogue about the complex situations which emerge daily in contemporary healthcare practice.

Money and morals: ending clinical trials for financial reasons.

PubMed

Eaton, Margaret L; Kwon, Brian K; Scott, Christopher Thomas

2015-01-01

Too often, biopharmaceutical companies stop their clinical trials solely for financial reasons. In this chapter, we discuss this phenomenon against the backdrop of a 2011 decision by Geron Corporation to abandon its stem cell clinical trial for spinal cord injury (SCI), the preliminary results of which were released in May 2014. We argue that the resultant harms are widespread and are different in nature from the consequences of stopping trials for scientific or medical reasons. We examine the ethical and social effects that arise from such decisions and discuss them in light of ethical frameworks, including duties of individual stakeholders and corporate sponsors. We offer ways that sponsors and clinical sites can ensure that trials are responsibly started, and once started adequately protect the interests of participants. We conclude with recommendations that industry sponsors of clinical trials should adopt in order to advance a collective and patient-centered research ethic.

Moral Reasoning of MSW Social Workers and the Influence of Education

ERIC Educational Resources Information Center

Kaplan, Laura E.

2006-01-01

This research examined the influence of undergraduate degree and ethics education on the moral reasoning of social workers. Statistical analyses found MSW social workers with liberal arts undergraduate degrees more likely to prefer postconventional levels of moral reasoning, defined as greater complexity of thought and principled reasoning. The…

Drug use and abuse: the ethical issues.

PubMed

Almond, B

1992-01-01

Drug abuse is both a personal and a public issue, raising questions about individual rights and the boundaries of law, as well as about national sovereignty and international control. Ethical issues that arise under these headings may be related to certain broad ethical positions. The implications of adopting utilitarian assumptions may be contrasted with basing ethics on a theory of individual rights, closely related to a theory of human nature. Neither position justifies a libertarian presumption against control, for, first, an individual decision to expose one's mind and personality to the control of drugs cannot be ethically justified and, second, there are no ethical reasons, nor any compelling arguments from social and political theory, for decriminalizing non-medical drug use.

An ethical framework for nursing service administration.

PubMed

Christensen, P J

1988-04-01

Nurses as administrators are responsible for creating an ethical work environment in which nurses' human welfare is promoted. Bureaucratic organizations can dehumanize people, wherein human welfare suffers in the midst of institutional constraints. Amid these conditions nurses' ethical competence cannot develop nor can nurses maintain a sense of personal integrity. Applying concepts from nursing and general ethics to administrative practice provides a basis for developing an ethical framework for management. The proposed framework involves ethical awareness, principled reasoning, moral commitment to the profession and to one another, and primary consideration for human welfare with strategies to promote it. Use of these components when making decisions in daily practice and on a policy level enhances the well-being of nurses working in organizations.

Virtue ethics as an alternative to deontological and consequential reasoning in the harm reduction debate.

PubMed

Christie, Timothy; Groarke, Louis; Sweet, William

2008-02-01

There is strong evidence that harm reduction interventions such as Supervised Injection Sites and Needle Exchange Programs prevent many of the negative consequences of problematic substance use. Yet many governments, including the United States and Canada, still do not endorse these interventions, claiming that they do not get people off of drugs and send a mixed message. This paper will analyze objections to harm reduction in light of the ethical theories of John Stuart Mill, Immanuel Kant and Aristotle. The most important ethical issue in the abstinence vs. harm reduction debate is whether harm reduction - because it does not require individuals to either reduce their consumption of illicit substances or to abstain from illicit substance use - can be ethically justified. Harm reduction interventions are clearly justified on Utilitarian grounds because, based on the evidence, such policies would produce the greatest good for the greatest number. However, Kant would not think that the values guiding harm reduction are ethical because the justification of harm reduction interventions focuses exclusively on examining consequences. Virtue Ethics seeks to find the proper balance between harm reduction and abstinence. We claim that the virtue of compassion would provide a defense of harm reduction.

Developing Abilities to Navigate Through the Grey Zones in Complex Environments: Nurses' Reasons for Applying to a Clinical Ethics Residency for Nurses.

PubMed

Jurchak, Martha; Grace, Pamela J; Lee, Susan M; Willis, Danny G; Zollfrank, Angelika A; Robinson, Ellen M

2017-07-01

Nurses face complex ethical issues in practice and have to determine appropriate actions. An inability to conceptualize or follow a preferred course of action can give rise to moral uncertainty or moral distress. Both moral uncertainty and moral distress are problematic for nurses and their patients. A program designed to increase nurse confidence in moral decision making, the clinical ethics residency for nurses (CERN), was offered selectively to nurses affiliated with two academic medical centers. This is a report of the analysis of their application essays. Over a 3-year period, 67 application essays were analyzed using conventional content analysis. Applicants comprised one third advanced practice nurses (APNs) and two thirds staff nurses. They were asked to describe their reasons for interest in the CERN and how they would apply the knowledge gained. For conventional content analyses, no theoretical presumptions are used; rather, codes are identified from the data in an iterative manner and eventually collapsed into themes. Initially, broad themes were identified by the CERN team. Subsequently, in-depth and recursive readings were completed by a subset of three members, resulting in refinement of themes and subthemes. The overarching theme identified was "developing abilities to navigate through the 'grey zones' in complex environments." Three subthemes were: (a) nurses encountering patients who are chronically critically ill, culturally diverse, and presenting with complex circumstances; (b) nurses desiring enhanced ethics knowledge and skills to improve quality of care, understand different perspectives, and act as a resource for others; and (c) nurses supporting and facilitating patient-centered ethical decision making. Findings are consistent with those appearing in the international literature but provide a more cohesive and comprehensive account than previously, and hold promise for the development of educational and policy strategies to address moral

Forthcoming ethical issues in biological psychiatry.

PubMed

Helmchen, Hanfried

2005-01-01

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

Health promotion: an ethical analysis.

PubMed

Carter, Stacy M

2014-04-01

Thinking and practising ethically requires reasoning systematically about the right thing to do. Health promotion ethics - a form of applied ethics - includes analysis of health promotion practice and how this can be ethically justified. Existing frameworks can assist in such evaluation. These acknowledge the moral value of delivering benefits. But benefits need to be weighed against burdens, harms or wrongs, and these should be minimised: they include invading privacy, breaking confidentiality, restraining liberty, undermining self-determination or people's own values, or perpetuating injustice. Thinking about the ethics of health promotion also means recognising health promotion as a normative ideal: a vision of the good society. This ideal society values health, sees citizens as active and includes them in decisions that affect them, and makes the state responsible for providing all of its citizens, no matter how advantaged or disadvantaged, with the conditions and resources they need to be healthy. Ethicists writing about health promotion have focused on this relationship between the citizen and the state. Comparing existing frameworks, theories and the expressed values of practitioners themselves, we can see common patterns. All oppose pursuing an instrumental, individualistic, health-at-all-costs vision of health promotion. And all defend the moral significance of just processes: those that engage with citizens in a transparent, inclusive and open way. In recent years, some Australian governments have sought to delegitimise health promotion, defining it as extraneous to the role of the state. Good evidence is not enough to counter this trend, because it is founded in competing visions of a good society. For this reason, the most pressing agenda for health promotion ethics is to engage with communities, in a procedurally just way, about the role and responsibilities of the citizen and the state in promoting and maintaining good health.

Improving Moral Reasoning among College Students: A Game-Based Learning Approach

ERIC Educational Resources Information Center

Huang, Wenyeh; Ho, Jonathan C.

2018-01-01

Considering a company's limited time and resources, an effective training method that improves employees' ability to make ethical decision is needed. Based on social cognitive theory, this study proposes that employing games in an ethics training program can help improve moral reasoning through actively engaging learners. The experimental design…

Cultural diversity and the case against ethical relativism.

PubMed

Brannigan, M

2000-01-01

The movement to respect cultural diversity, known as multiculturalism, poses a daunting challenge to healthcare ethics. Can we construct a defensible passage from the fact of cultural differences to any claims regarding morality? Or does multiculturalism lead to ethical relativism? Macklin argues that, in view of a leading distinction between universalism in ethics and moral absolutism, the only reasonable passage avoids both absolutism and relativism. She presents a strong case against ethical relativism and its pernicious consequences for cross-cultural issues in healthcare. She also provides sound criteria for the assessment of a culture's moral progress.

A longitudinal simulation-based ethical-legal curriculum for otolaryngology residents.

PubMed

Fanous, Amanda; Rappaport, Jamie; Young, Meredith; Park, Yoon Soo; Manoukian, John; Nguyen, Lily H P

2017-11-01

To develop, implement, and evaluate a longitudinal, simulation-based ethics and legal curriculum designed specifically for otolaryngology residents. Otolaryngology residents were recruited to participate in a yearly half-day ethical-legal module, the curriculum of which spanned 4 years. Each module included: three simulated scenarios, small-group multisource feedback, and large-group debriefings. Scenarios involved encounters with standardized patients. Residents' ethical-legal knowledge was assessed pre- and postmodule with multiple-choice questions, and ethical reasoning was assessed by a variety of evaluators during the simulated scenario using a locally developed assessment tool. Participants completed an exit survey at the end of each module. Eighteen residents completed four modules from the academic years of 2008 to 2009 to 2011 to 2012. The first year was considered a pilot module, and data were collected for the following 3 years. Knowledge of legal issues improved significantly among residents (mean at pre = 3.40 and post = 4.60, P < 0.05). Residents' ethical reasoning skills also improved across years (mean 3.60/5 in 2009-2010, 3.76/5 in 2010-2011, and 4.33 in 2011-2012, P < 0.05). Survey results revealed a statistically significant self-perceived improvement in ethics reasoning skills (mean pre = 3.62, post = 4.86, P < 0.05). Participants reported that the curriculum was relevant to their practice (85%), that the debriefings were of high quality (83%), and that they would recommend this module to others (88%). To our knowledge, this is the first study exploring a longitudinal simulation-based ethical-legal curriculum tailored to otolaryngology-head and neck surgery residents. This educational program resulted in a both objective and subjective improvement in legal and ethics knowledge and skills. NA. Laryngoscope, 127:2501-2509, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Cyberspace in the Curricula: New Legal and Ethical Issues.

ERIC Educational Resources Information Center

Smethers, J. Steven

1998-01-01

Finds that most journalism and mass communication programs integrate legal and ethical issues surrounding cyberspace and interactive media into existing courses, especially into ethics and communication law courses, but also into introductory survey courses, communication technology, and reporting classes. Details reasons why some programs do not…

Ethics and eplerenone.

PubMed

Gupta, Shruti; Fugh-Berman, Adriane J; Scialli, Anthony

2013-02-01

The use of a placebo arm in clinical trials is unethical if there is an active comparator that is acceptably safe and effective. We argue that reasonable evidence of effectiveness and safety of an inexpensive alternative to an expensive therapy is sufficient to require that the inexpensive therapy be included as a comparator when the expensive therapy is tested, and that use of an inactive placebo comparator only is not ethical. For example, studies of the expensive drug eplerenone for congestive heart failure have not included a spironolactone arm, although there is reasonable evidence that spironolactone would be safe and effective, and spironolactone is inexpensive. The requirement to study inexpensive therapies is based on avoidance of unnecessary cost in medical care as an example of non-maleficence. Several ethical actors in the design, conduct, and publication of clinical trials and their results bear responsibility for the appropriate conduct of clinical trials. That responsibility includes protecting study subjects from being asked to participate in clinical trials that serve primarily to promote the use of new and expensive therapies.

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

PubMed

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

2015-01-01

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

[Legal repercussions of Clinical Ethics Committees reports].

PubMed

Couceiro V, Azucena; Beca I, Juan Pablo

2006-04-01

Clinical Ethics Committees and Research Ethics Committees have their own specific roles. The Clinical Ethics Committee's pronouncements have an advisory function, whereas Research Ethics Committees' decisions are binding. This article analyzes the legal impact of the Clinical Ethics Committees' reports. Legal and medical reasoning share the same practical nature. Both can have several correct answers to the same situation. Clinical Ethics Committees deliberate about these alternatives and analyze the involved values. Their conclusions are non-compulsory recommendations. They do not replace nor diminish the doctor's personal responsibility. Even though the Clinical Ethics Committees' reports are not binding, they constitute a sort of "expert's opinion", expressed by qualified professionals, who assume their own professional responsibility as advisors. The members' behavior is necessarily subject to constitutional and legal regulations. When judges review the Clinical Ethics Committee's reports, they must realize that their nature is advisory, and also consider them an essential element to reduce the gap between the medical and legal fields. In this way, the problem of increasingly transforming medicine into a legal issue can be prevented.

Leader Perceptions of Ethical/Moral leadership in Community College Business School Curriculum

ERIC Educational Resources Information Center

England, David Lee

2014-01-01

The purpose of this qualitative phenomenological study was to identify the perceptions, beliefs, and attitudes of educational leadership toward implementation of ethical leadership in the taught curriculum. The need for skills in ethical/moral leadership has engendered renewed interest in development of ethical/moral reasoning. This movement has…

Ethical dilemmas in veterinary medicine.

PubMed

Morgan, Carol A; McDonald, Michael

2007-01-01

Veterinarians frequently encounter situations that are morally charged and potentially difficult to manage. Situation involving euthanasia, end-of-life care, economics, and inadequate provision of care create practical and moral dilemmas. Ethical tension may be attributable to differences in beliefs regarding the moral value of animals, client and veterinary responsibilities, and deciding what is best for an animal. Veterinarians can employ communication skills used in medical situations to explore the reasons underpinning ethical dilemmas and to search for solutions with clients, staff, and colleagues.

Lecture-based versus problem-based learning in ethics education among nursing students.

PubMed

Khatiban, Mahnaz; Falahan, Seyede Nayereh; Amini, Roya; Farahanchi, Afshin; Soltanian, Alireza

2018-01-01

Moral reasoning is a vital skill in the nursing profession. Teaching moral reasoning to students is necessary toward promoting nursing ethics. The aim of this study was to compare the effectiveness of problem-based learning and lecture-based methods in ethics education in improving (1) moral decision-making, (2) moral reasoning, (3) moral development, and (4) practical reasoning among nursing students. This is a repeated measurement quasi-experimental study. Participants and research context: The participants were nursing students in a University of Medical Sciences in west of Iran who were randomly assigned to the lecture-based (n = 33) or the problem-based learning (n = 33) groups. The subjects were provided nursing ethics education in four 2-h sessions. The educational content was similar, but the training methods were different. The subjects completed the Nursing Dilemma Test before, immediately after, and 1 month after the training. The data were analyzed and compared using the SPSS-16 software. Ethical considerations: The program was explained to the students, all of whom signed an informed consent form at the baseline. The two groups were similar in personal characteristics (p > 0.05). A significant improvement was observed in the mean scores on moral development in the problem-based learning compared with the lecture-based group (p < 0.05). Although the mean scores on moral reasoning improved in both the problem-based learning and the lecture-based groups immediately after the training and 1 month later, the change was significant only in the problem-based learning group (p < 0.05). The mean scores on moral decision-making, practical considerations, and familiarity with dilemmas were relatively similar for the two groups. The use of the problem-based learning method in ethics education enhances moral development among nursing students. However, further studies are needed to determine whether such method improves moral decision-making, moral reasoning

Understanding ill-structured engineering ethics problems through a collaborative learning and argument visualization approach.

PubMed

Hoffmann, Michael; Borenstein, Jason

2014-03-01

As a committee of the National Academy of Engineering recognized, ethics education should foster the ability of students to analyze complex decision situations and ill-structured problems. Building on the NAE's insights, we report about an innovative teaching approach that has two main features: first, it places the emphasis on deliberation and on self-directed, problem-based learning in small groups of students; and second, it focuses on understanding ill-structured problems. The first innovation is motivated by an abundance of scholarly research that supports the value of deliberative learning practices. The second results from a critique of the traditional case-study approach in engineering ethics. A key problem with standard cases is that they are usually described in such a fashion that renders the ethical problem as being too obvious and simplistic. The practitioner, by contrast, may face problems that are ill-structured. In the collaborative learning environment described here, groups of students use interactive and web-based argument visualization software called "AGORA-net: Participate - Deliberate!". The function of the software is to structure communication and problem solving in small groups. Students are confronted with the task of identifying possible stakeholder positions and reconstructing their legitimacy by constructing justifications for these positions in the form of graphically represented argument maps. The argument maps are then presented in class so that these stakeholder positions and their respective justifications become visible and can be brought into a reasoned dialogue. Argument mapping provides an opportunity for students to collaborate in teams and to develop critical thinking and argumentation skills.

Professional Commitment, Ethical Reasoning, and the Belief in Regulatory Compliance as Perceived by Safety Professionals

ERIC Educational Resources Information Center

Wells, John W., Jr.

2012-01-01

The awareness of ethical business practices is becoming a focal point in both the business world and academia. As cross-cultural growth expands due to globalization, the perception of ethical behavior invites increasing scrutiny as society witnesses the changing global community. This ever-changing environment of demographics and globalization of…

Aristotle, nursing and health care ethics.

PubMed

Scott, P A

1995-12-01

Even a brief consideration of the nature of nursing will indicate that an ethical dimension underlies much, if not all, of nursing practice. It is therefore important that students and practitioners are facilitated in developing an ethical awareness and sensitivity from early in their professional development. This paper argues that Aristotelian virtue theory provides a practice-based focus for health care ethics for a number of reasons. Also, because of his emphasis on the character of the moral agent, and on the importance of perception and emotion in moral decision-making, Aristotelian virtue theory provides a useful supplement to the traditional duty-based approaches to health care ethics analysis, which are increasingly being identified in the literature as having limits to their application within the health care context.

The ethics of sin taxes.

PubMed

Green, Rebecca

2011-01-01

ABSTRACT The current global economic crisis is forcing governments to consider a variety of methods to generate funds for infrastructure. In the United States, smoking-related illness and an obesity epidemic are forcing public health institutions to consider a variety of methods to influence health behaviors of entire target groups. In this paper, the author uses a public health nursing model, the Public Health Code of Ethics (Public Health Leadership Society, 2002), the American Nurses' Association (ANA) Code of Ethics (2001), and other relevant ethical theory to weigh and balance the arguments for and against the use of sin taxes. A position advocating the limited use of sin taxes is supported as a reasonable stance for the public health professional. © 2010 Wiley Periodicals, Inc.

The ethics of reviving long extinct species.

PubMed

Sandler, Ronald

2014-04-01

There now appears to be a plausible pathway for reviving species that have been extinct for several decades, centuries, or even millennia. I conducted an ethical analysis of de-extinction of long extinct species. I assessed several possible ethical considerations in favor of pursuing de-extinction: that it is a matter of justice; that it would reestablish lost value; that it would create new value; and that society needs it as a conservation last resort. I also assessed several possible ethical arguments against pursuing de-extinction: that it is unnatural; that it could cause animal suffering; that it could be ecologically problematic or detrimental to human health; and that it is hubristic. There are reasons in favor of reviving long extinct species, and it can be ethically acceptable to do so. However, the reasons in favor of pursuing de-extinction do not have to do with its usefulness in species conservation; rather, they concern the status of revived species as scientific and technological achievements, and it would be ethically problematic to promote de-extinction as a significant conservation strategy, because it does not prevent species extinctions, does not address the causes of extinction, and could be detrimental to some species conservation efforts. Moreover, humanity does not have a responsibility or obligation to pursue de-extinction of long extinct species, and reviving them does not address any urgent problem. Therefore, legitimate ecological, political, animal welfare, legal, or human health concerns associated with a de-extinction (and reintroduction) must be thoroughly addressed for it to be ethically acceptable. © 2013 Society for Conservation Biology.

Transformational leadership and moral reasoning.

PubMed

Turner, Nick; Barling, Julian; Epitropaki, Olga; Butcher, Vicky; Milner, Caroline

2002-04-01

Terms such as moral and ethical leadership are used widely in theory, yet little systematic research has related a sociomoral dimension to leadership in organizations. This study investigated whether managers' moral reasoning (n = 132) was associated with the transformational and transactional leadership behaviors they exhibited as perceived by their subordinates (n = 407). Managers completed the Defining Issues Test (J. R. Rest, 1990), whereas their subordinates completed the Multifactor Leadership Questionnaire (B. M. Bass & B. J. Avolio, 1995). Analysis of covariance indicated that managers scoring in the highest group of the moral-reasoning distribution exhibited more transformational leadership behaviors than leaders scoring in the lowest group. As expected, there was no relationship between moral-reasoning group and transactional leadership behaviors. Implications for leadership development are discussed.

Team reasoning: Solving the puzzle of coordination.

PubMed

Colman, Andrew M; Gold, Natalie

2017-11-03

In many everyday activities, individuals have a common interest in coordinating their actions. Orthodox game theory cannot explain such intuitively obvious forms of coordination as the selection of an outcome that is best for all in a common-interest game. Theories of team reasoning provide a convincing solution by proposing that people are sometimes motivated to maximize the collective payoff of a group and that they adopt a distinctive mode of reasoning from preferences to decisions. This also offers a compelling explanation of cooperation in social dilemmas. A review of team reasoning and related theories suggests how team reasoning could be incorporated into psychological theories of group identification and social value orientation theory to provide a deeper understanding of these phenomena.

Ethical considerations in the orthopaedic relationship with industry.

PubMed

Sarmiento, A

2007-06-01

Members of the medical profession spend a long time and financial resources acquiring the knowledge necessary for the discharge of their responsibilities; therefore, they should be appropriately compensated for the services they provide. However, it has become obvious, at least in the United States, that excessive emphasis on profit making is fostering the transformation of the medical profession into strictly a business. This transformation is spawning ethical infractions, which are becoming increasingly apparent.

What is good medical ethics? A clinician's perspective.

PubMed

Kong, Wing May

2015-01-01

Speaking from the perspective of a clinician and teacher, good medical ethics needs to make medicine better. Over the past 50 years medical ethics has helped shape the culture in medicine and medical practice for the better. However, recent healthcare scandals in the UK suggest more needs to be done to translate ethical reasoning into ethical practice. Focusing on clinical practice and individual patient care, I will argue that, to be good, medical ethics needs to become integral to the activities of health professionals and healthcare organisations. Ethics is like a language which brings a way of thinking and responding to the world. For ethics to become embedded in clinical practice, health professionals need to progress from classroom learners to fluent social speakers through ethical dialogue, ethical reflection and ethical actions. I will end by discussing three areas that need to be addressed to enable medical ethics to flourish and bring about change in everyday clinical care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Ethics in American Health 2: An Ethical Framework for Health System Reform

PubMed Central

2008-01-01

I argue that an ethical vision resting on explicitly articulated values and norms is critical to ensuring comprehensive health reform. Reform requires a consensus on the public good transcending self-interest and narrow agendas and underpinning collective action for universal coverage. In what I call shared health governance, individuals, providers, and institutions all have essential roles in achieving health goals and work together to create a positive environment for health. This ethical paradigm provides (1) reasoned consensus through a joint scientific and deliberative approach to judge the value of a health care intervention; (2) a method for achieving consensus that differs from aggregate tools such as a strict majority vote; (3) combined technical and ethical rationality for collective choice; (4) a joint clinical and economic approach combining efficiency with equity, but with economic solutions following and complementing clinical progress; and (5) protection for disabled individuals from discrimination. PMID:18703448

Ethics in American health 2: an ethical framework for health system reform.

PubMed

Ruger, Jennifer Prah

2008-10-01

I argue that an ethical vision resting on explicitly articulated values and norms is critical to ensuring comprehensive health reform. Reform requires a consensus on the public good transcending self-interest and narrow agendas and underpinning collective action for universal coverage. In what I call shared health governance, individuals, providers, and institutions all have essential roles in achieving health goals and work together to create a positive environment for health. This ethical paradigm provides (1) reasoned consensus through a joint scientific and deliberative approach to judge the value of a health care intervention; (2) a method for achieving consensus that differs from aggregate tools such as a strict majority vote; (3) combined technical and ethical rationality for collective choice; (4) a joint clinical and economic approach combining efficiency with equity, but with economic solutions following and complementing clinical progress; and (5) protection for disabled individuals from discrimination.

The organizational costs of ethical conflicts.

PubMed

Nelson, William A; Weeks, William B; Campfield, Justin M

2008-01-01

Ethical conflicts are a common phenomenon in today's healthcare settings. As healthcare executives focus on balancing quality care and cost containment, recognizing the costs associated with ethical conflicts is only logical. In this article, we present five case vignettes to identify several general cost categories related to ethical conflicts, including operational costs, legal costs, and marketing and public relations costs. In each of these cost categories, the associated direct, indirect, and long-term costs of the ethical conflict are explored as well. Our analysis suggests that organizations have, in addition to philosophical reasons, financial incentives to focus on decreasing the occurrence of ethical conflicts. The cost categories affected by ethical conflicts are not insignificant. Such conflicts can affect staff morale and lower the organization's overall culture and profit margin. Therefore, organizations should develop mechanisms and strategies for decreasing and possibly preventing ethical conflicts. The strategies suggested in this article seek to shift the organization's focus when dealing with conflicts, from just reacting to moving upstream-that is, understanding the root causes of ethical conflicts and employing approaches designed to reduce their occurrence and associated costs. Such an effort has the potential to enhance the organization's overall culture and ultimately lead to organizational success.

Ethical challenges in surgery as narrated by practicing surgeons

PubMed Central

Torjuul, Kirsti; Nordam, Ann; Sørlie, Venke

2005-01-01

Background The aim of this study was to explore the ethical challenges in surgery from the surgeons' point of view and their experience of being in ethically difficult situations. Methods Five male and five female surgeons at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in such situations. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. Results No differences in ethical reasoning between male and female surgeons were found. They reasoned in both action and relational ethical perspectives. Surgeons focused on their relationships with patients and colleagues and their moral self in descriptions of the ethical challenges in their work. Dialogue and personal involvement were important in their relationships with patients. The surgeons emphasized the importance of open dialogue, professional recognition, and an inclusive and accepting environment between colleagues. Conclusion The surgeons are personally challenged by the existential realities of human life in their relationships with patients. They realized that ethical challenges are an inherent part of performing surgery and of life itself, and say that they have to learn to "live with" these challenges in a way that is confirmed both socially and by their inner moral self. This means accepting their personal and professional limitations, being uncertain, being fallible, and being humble. Living with the ethical challenges of surgery seems to contribute to the surgeons' confidence and vulnerability in their professional identity. PMID:15737235

Universality and Cultural Diversity in Professional Ethical Development: From Kohlberg to Dynamic Systems Theory

ERIC Educational Resources Information Center

Kim, Minkang

2012-01-01

Upholding ethical standards is part of what it means to be a professional and therefore part of professional education, but to what extent is the development of ethical reasoning universal across cultures, or is it highly dependent on culture? If universal, how can we explain the unique patterns of moral reasoning and behaviour in Asia, which…

Ethics and images of suffering bodies in humanitarian medicine.

PubMed

Calain, Philippe

2013-12-01

Media representations of suffering bodies from medical humanitarian organisations raise ethical questions, which deserve critical attention for at least three reasons. Firstly, there is a normative vacuum at the intersection of medical ethics, humanitarian ethics and the ethics of photojournalism. Secondly, the perpetuation of stereotypes of illness, famine or disasters, and their political derivations are a source of moral criticism, to which humanitarian medicine is not immune. Thirdly, accidental encounters between members of the health professions and members of the press in the humanitarian arena can result in misunderstandings and moral tension. From an ethics perspective the problem can be specified and better understood through two successive stages of reasoning. Firstly, by applying criteria of medical ethics to the concrete example of an advertising poster from a medical humanitarian organisation, I observe that media representations of suffering bodies would generally not meet ethical standards commonly applied in medical practice. Secondly, I try to identify what overriding humanitarian imperatives could outweigh such reservations. The possibility of action and the expression of moral outrage are two relevant humanitarian values which can further be spelt out through a semantic analysis of 'témoignage' (testimony). While the exact balance between the opposing sets of considerations (medical ethics and humanitarian perspectives) is difficult to appraise, awareness of all values at stake is an important initial standpoint for ethical deliberations of media representations of suffering bodies. Future pragmatic approaches to the issue should include: exploring ethical values endorsed by photojournalism, questioning current social norms about the display of suffering, collecting empirical data from past or potential victims of disasters in diverse cultural settings, and developing new canons with more creative or less problematic representations of

Scientific Integrity and Professional Ethics at AGU - The Establishment and Evolution of an Ethics Program at a Large Scientific Society

NASA Astrophysics Data System (ADS)

McPhaden, Michael; Leinen, Margaret; McEntee, Christine; Townsend, Randy; Williams, Billy

2016-04-01

The American Geophysical Union, a scientific society of 62,000 members worldwide, has established a set of scientific integrity and professional ethics guidelines for the actions of its members, for the governance of the union in its internal activities, and for the operations and participation in its publications and scientific meetings. This presentation will provide an overview of the Ethics program at AGU, highlighting the reasons for its establishment, the process of dealing ethical breaches, the number and types of cases considered, how AGU helps educate its members on Ethics issues, and the rapidly evolving efforts at AGU to address issues related to the emerging field of GeoEthics. The presentation will also cover the most recent AGU Ethics program focus on the role for AGU and other scientific societies in addressing sexual harassment, and AGU's work to provide additional program strength in this area.

Preparing for Ethical Leadership: A Longitudinal Study

ERIC Educational Resources Information Center

Myers, Lewis A., Jr.

2015-01-01

According to Johnson (2001) and Rest (1979) a leader who has developed a high level of moral reasoning will tend to make decisions that are better from an ethical/moral perspective than a leader who has achieved a lower level of moral reasoning. The mission statement at this university states that graduates will be prepared through training in…

Educational Context: Preparing Accounting Students to Identify Ethical Dilemmas

ERIC Educational Resources Information Center

Billiot, Mary Jo; Daniel, David; Glandon, Sid; Glandon, TerryAnn

2012-01-01

We examine the effect of different contexts in an educational process on measures of ethical sensitivity and levels of moral reasoning of accounting majors in the first Intermediate Accounting course. The educational process compared a context that centers on ethical issues with one that focuses on technical accounting issues. At the end of the…

Field and Experience Influences on Ethical Decision-Making in the Sciences

PubMed Central

Mumford, Michael D.; Connelly, Shane; Murphy, Stephen T.; Devenport, Lynn D.; Antes, Alison L.; Brown, Ryan P.; Hill, Jason H.; Waples, Ethan P.

2009-01-01

Differences across fields and experience levels are frequently considered in discussions of ethical decision-making and ethical behavior. In the present study, doctoral students in the health, biological, and social sciences completed measures of ethical decision-making. The effects of field and level of experience with respect to ethical decision-making, metacognitive reasoning strategies, social-behavioral responses, and exposure to unethical events were examined. Social and biological scientists performed better than health scientists with respect to ethical decision-making. Furthermore, the ethical decision-making of health science students decreased as experience increased. Moreover, these effects appeared to be linked to the specific strategies underlying participants' ethical decision-making. The implications of these findings for ethical decision-making are discussed. PMID:19750129

Reexamining the Ethics of Nuclear Technology.

PubMed

Andrianov, Andrei; Kanke, Victor; Kuptsov, Ilya; Murogov, Viktor

2015-08-01

This article analyzes the present status, development trends, and problems in the ethics of nuclear technology in light of a possible revision of its conceptual foundations. First, to better recognize the current state of nuclear technology ethics and related problems, this article focuses on presenting a picture of the evolution of the concepts and recent achievements related to technoethics, based on the ethics of responsibility. The term 'ethics of nuclear technology' describes a multidisciplinary endeavor to examine the problems associated with nuclear technology through ethical frameworks and paradigms. Second, to identify the reasons for the intensification of efforts to develop ethics in relation to nuclear technology, this article presents an analysis of the recent situation and future prospects of nuclear technology deployment. This includes contradictions that have aggravated nuclear dilemmas and debates stimulated by the shortcomings of nuclear technology, as well as the need for the further development of a nuclear culture paradigm that is able to provide a conceptual framework to overcome nuclear challenges. Third, efforts in the field of nuclear technology ethics are presented as a short overview of particular examples, and the major findings regarding obstacles to the development of nuclear technology ethics are also summarized. Finally, a potential methodological course is proposed to overcome inaction in this field; the proposed course provides for the further development of nuclear technology ethics, assuming the axiological multidisciplinary problematization of the main concepts in nuclear engineering through the basic ethical paradigms: analytical, hermeneutical, and poststructuralist.

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

PubMed

Guo-Ping, Wang

2007-06-01

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

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.

American College of Emergency Physicians Ethics Manual.

PubMed

1991-10-01

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

Nurse ethical awareness: Understanding the nature of everyday practice.

PubMed

Milliken, Aimee; Grace, Pamela

2017-08-01

Much attention has been paid to the role of the nurse in recognizing and addressing ethical dilemmas. There has been less emphasis, however, on the issue of whether or not nurses understand the ethical nature of everyday practice. Awareness of the inherently ethical nature of practice is a component of nurse ethical sensitivity, which has been identified as a component of ethical decision-making. Ethical sensitivity is generally accepted as a necessary precursor to moral agency, in that recognition of the ethical content of practice is necessary before consistent action on behalf of patient interests can take place. This awareness is also compulsory in ensuring patient good by recognizing the unique interests and wishes of individuals, in line with an ethic of care. Scholarly and research literature are used to argue that bolstering ethical awareness and ensuring that nurses understand the ethical nature of the role are an obligation of the profession. Based on this line of reasoning, recommendations for education and practice, along with directions for future research, are suggested.

Considering virtue: public health and clinical ethics.

PubMed

Meagher, Karen M

2011-10-01

As bioethicists increasingly turn their attention to the profession of public health, many candidate frameworks have been proposed, often with an eye toward articulating the values and foundational concepts that distinguish this practice from curative clinical medicine. First, I will argue that while these suggestions for a distinct ethics of public health are promising, they arise from problems within contemporary bioethics that must be taken into account. Without such cognizance of the impetus for public health ethics, we risk developing a set of ethical resources meant exclusively for public health professionals, thereby neglecting implications for curative medical ethics and the practice of bioethics more broadly. Second, I will present reasons for thinking some of the critiques of dominant contemporary bioethics can be met by a virtue ethics approach. I present a virtue ethics response to criticisms that concern (1) increased rigor in bioethics discourse; (2) the ability of normative theory to accommodate context; and (3) explicit attention to the nature of ethical conflict. I conclude that a virtue ethics approach is a viable avenue for further inquiry, one that leads us away from developing ethics of public health in a vacuum and has the potential for overcoming certain pitfalls of contemporary bioethics discourse. © 2011 Blackwell Publishing Ltd.

Intensive care unit research ethics and trials on unconscious patients.

PubMed

Gillett, G R

2015-05-01

There are widely acknowledged ethical issues in enrolling unconscious patients in research trials, particularly in intensive care unit (ICU) settings. An analysis of those issues shows that, by and large, patients are better served in units where research is actively taking place for several reasons: i) they do not fall prey to therapeutic prejudices without clear evidential support, ii) they get a chance of accessing new and potentially beneficial treatments, iii) a climate of careful monitoring of patients and their clinical progress is necessary for good clinical research and affects the care of all patients and iv) even those not in the treatment arm of a trial of a new intervention must receive best current standard care (according to international evidence-based treatment guidelines). Given that we have discovered a number of 'best practice' regimens of care that do not optimise outcomes in ICU settings, it is of great benefit to all patients (including those participating in research) that we are constantly updating and evaluating what we do. Therefore, the practice of ICU-based clinical research on patients, many of whom cannot give prospective informed consent, ticks all the ethical boxes and ought to be encouraged in our health system. It is very important that the evaluation of protocols for ICU research should not overlook obvious (albeit probabilistic) benefits to patients and the acceptability of responsible clinicians entering patients into well-designed trials, even though the ICU setting does not and cannot conform to typical informed consent procedures and requirements.

Ethics instruction in the dental hygiene curriculum.

PubMed

Kacerik, Mark G; Prajer, Renee G; Conrad, Cynthia

2006-01-01

Dental hygiene ethics is an essential component of the dental hygiene curriculum. The accreditation standards for dental hygiene education state that graduates must be competent in applying ethical concepts to the provision and/or support of oral health care services. Although the standards for entry into the profession of dental hygiene emphasize the importance of ethical reasoning, there is little published research specific to ethics instruction in dental hygiene programs. The purpose of this study was to assess how ethics is taught in the dental hygiene curriculum. A 17-item survey was designed and distributed to 261 accredited dental hygiene programs in the United States for a response rate of 56% (N=147). The survey requested that participants provide information on teaching and evaluation methodologies, didactic and clinical hours of instruction, individuals responsible for providing instruction, and the degree of emphasis placed on ethics and integration of ethical reasoning within the dental hygiene curriculum. Results of the survey reflect that dental hygiene programs devote a mean of 20. hours to teaching dental hygiene ethics in the didactic component of the curriculum. With regard to the clinical component of the curriculum, 63% of respondents indicated that 10 or less hours are devoted to ethics instruction. These results show an increase in didactic hours of instruction from previous studies where the mean hours of instruction ranged from 7 to 11.7 hours. Results showed 64% of respondents offered a separate course in ethics; however, 82% of programs surveyed indicated that ethics was incorporated into one or more dental hygiene courses with 98% utilizing dental hygiene faculty to provide instruction. Most programs utilized a variety of instructional methods to teach ethics with the majority employing class discussion and lecture (99% and 97% respectively). The type of institution-technical college, community college, four-year university with a

Taxing Times: An Educational Intervention to Enhance Moral Reasoning in Tax

ERIC Educational Resources Information Center

Doyle, Elaine

2015-01-01

This paper outlines the development and implementation of an online educational intervention designed to enhance moral reasoning in higher level tax students. Before decisions are made about how to behave ethically, cognitive moral reasoning takes place. The importance of education in developing morally sensitive individuals who use principled…

The ethics of 'public understanding of ethics'--why and how bioethics expertise should include public and patients' voices.

PubMed

Schicktanz, Silke; Schweda, Mark; Wynne, Brian

2012-05-01

"Ethics" is used as a label for a new kind of expertise in the field of science and technology. At the same time, it is not clear what ethical expertise consists in and what its political status in modern democracies can be. Starting from the "participatory turn" in recent social research and policy, we will argue that bioethical reasoning has to include public views of and attitudes towards biomedicine. We will sketch the outlines of a bioethical conception of "public understanding of ethics," addressing three different issues: (a) the methodological relevance of moral questions and problems raised by lay persons in everyday life regarding biomedicine and technology, (b) the normative relevance of such lay moralities for the justification of ethical decisions, and (c) the necessity of public deliberation in this context. Finally, we draw conclusions in view of the concepts and methods such a conception of "public understanding of ethics" should employ.

Mental models: an alternative evaluation of a sensemaking approach to ethics instruction.

PubMed

Brock, Meagan E; Vert, Andrew; Kligyte, Vykinta; Waples, Ethan P; Sevier, Sydney T; Mumford, Michael D

2008-09-01

In spite of the wide variety of approaches to ethics training it is still debatable which approach has the highest potential to enhance professionals' integrity. The current effort assesses a novel curriculum that focuses on metacognitive reasoning strategies researchers use when making sense of day-to-day professional practices that have ethical implications. The evaluated trainings effectiveness was assessed by examining five key sensemaking processes, such as framing, emotion regulation, forecasting, self-reflection, and information integration that experts and novices apply in ethical decision-making. Mental models of trained and untrained graduate students, as well as faculty, working in the field of physical sciences were compared using a think-aloud protocol 6 months following the ethics training. Evaluation and comparison of the mental models of participants provided further validation evidence for sensemaking training. Specifically, it was found that trained students applied metacognitive reasoning strategies learned during training in their ethical decision-making that resulted in complex mental models focused on the objective assessment of the situation. Mental models of faculty and untrained students were externally-driven with a heavy focus on autobiographical processes. The study shows that sensemaking training has a potential to induce shifts in researchers' mental models by making them more cognitively complex via the use of metacognitive reasoning strategies. Furthermore, field experts may benefit from sensemaking training to improve their ethical decision-making framework in highly complex, novel, and ambiguous situations.

Using Short Videos to Teach Research Ethics

NASA Astrophysics Data System (ADS)

Loui, M. C.

2014-12-01

Created with support from the National Science Foundation, EthicsCORE (www.natonalethicscenter.org) is an online resource center for ethics in science and engineering. Among the resources, EthicsCORE hosts short video vignettes produced at the University of Nebraska - Lincoln that dramatize problems in the responsible conduct of research, such as peer review of journal submissions, and mentoring relationships between faculty and graduate students. I will use one of the video vignettes in an interactive pedagogical demonstration. After showing the video, I will ask participants to engage in a think-pair-share activity on the professional obligations of researchers. During the sharing phase, participants will supply the reasons for these obligations.

A Pragmatic Approach to Ethical Decision-Making in Engineering Practice: Characteristics, Evaluation Criteria, and Implications for Instruction and Assessment.

PubMed

Zhu, Qin; Jesiek, Brent K

2017-06-01

This paper begins by reviewing dominant themes in current teaching of professional ethics in engineering education. In contrast to more traditional approaches that simulate ethical practice by using ethical theories to reason through micro-level ethical dilemmas, this paper proposes a pragmatic approach to ethics that places more emphasis on the practical plausibility of ethical decision-making. In addition to the quality of ethical justification, the value of a moral action also depends on its effectiveness in solving an ethical dilemma, cultivating healthy working relationships, negotiating existing organizational cultures, and achieving contextual plausibility in everyday professional practice. This paper uses a cross-cultural ethics scenario to further elaborate how a pragmatic approach can help us rethink ethical reasoning, as well as ethics instruction and assessment. This paper is expected to be of interest to educators eager to improve the ability of engineers and other professional students to effectively and appropriately deal with the kinds of everyday ethical issues they will likely face in their careers.

Ethics in writing: Learning to stay away from plagiarism and scientific misconduct

PubMed Central

Sharma, Bharat Bhushan; Singh, Virendra

2011-01-01

Fraudulent data and plagiarized text may corrupt scientific medical literature and ultimately harm patients. By prescribing erroneous treatment to an individual, only single patient is affected; but by presenting incorrect data or transcripts, the whole scientific medical universe is affected. Although both scenarios are highly undesirable, one can assume the magnitude of the effect of latter. Writers of scientific medical literature have been found to be involved in plagiarism and other publication misconducts from time to time irrespective of social, economic and geographic structure. The reason of such behavior is not usually obvious. Easy availability of personal computers has led to widespread dissemination of medical literature. As a result, young scientists are now publishing their research more frequently and efficiently. At the same time, this has increased the tendency to submit hurriedly prepared, poorly drafted and even illegitimate publications. Use of some amount of copy–paste followed by modifications during preparation of a manuscript seems to be common. Therefore, the researchers, especially postgraduate students, should be educated continuously about ethical medical writing. PMID:21712931

Evidence, Ethics, and Values: A Framework for Health Promotion

PubMed Central

Rychetnik, Lucie; Dietetics, PGradDip; Lloyd, Beverley; Kerridge, Ian H.; Baur, Louise; Bauman, Adrian; Hooker, Claire; Zask, Avigdor

2011-01-01

We propose a new approach to guide health promotion practice. Health promotion should draw on 2 related systems of reasoning: an evidential system and an ethical system. Further, there are concepts, values, and procedures inherent in both health promotion evidence and ethics, and these should be made explicit. We illustrate our approach with the exemplar of intervention in weight, and use a specific mass-media campaign to show the real-world dangers of intervening with insufficient attention to ethics and evidence. Both researchers and health promotion practitioners should work to build the capacities required for evidential and ethical deliberation in the health promotion profession. PMID:21233436

Esssential ethics--embedding ethics into an engineering curriculum.

PubMed

Fleischmann, Shirley T

2004-04-01

Ethical decision-making is essential to professionalism in engineering. For that reason, ethics is a required topic in an ABET approved engineering curriculum and it must be a foundational strand that runs throughout the entire curriculum. In this paper the curriculum approach that is under development at the Padnos School of Engineering (PSE) at Grand Valley State University will be described. The design of this program draws heavily from the successful approach used at the service academies--in particular West Point and the United States Naval Academy. As is the case for the service academies, all students are introduced to the "Honor Concept" (which includes an Honor Code) as freshmen. As an element of professionalism the PSE program requires 1500 hours of co-op experience which is normally divided into three semesters of full-time work alternated with academic semesters during the last two years of the program. This offers the faculty an opportunity to teach ethics as a natural aspect of professionalism through the academic requirements for co-op. In addition to required elements throughout the program, the students are offered opportunities to participate in service projects which highlight responsible citizenship. These elements and other parts of the approach will be described.

Avoiding bias in medical ethical decision-making. Lessons to be learnt from psychology research.

PubMed

Albisser Schleger, Heidi; Oehninger, Nicole R; Reiter-Theil, Stella

2011-05-01

When ethical decisions have to be taken in critical, complex medical situations, they often involve decisions that set the course for or against life-sustaining treatments. Therefore the decisions have far-reaching consequences for the patients, their relatives, and often for the clinical staff. Although the rich psychology literature provides evidence that reasoning may be affected by undesired influences that may undermine the quality of the decision outcome, not much attention has been given to this phenomenon in health care or ethics consultation. In this paper, we aim to contribute to the sensitization of the problem of systematic reasoning biases by showing how exemplary individual and group biases can affect the quality of decision-making on an individual and group level. We are addressing clinical ethicists as well as clinicians who guide complex decision-making processes of ethical significance. Knowledge regarding exemplary group psychological biases (e.g. conformity bias), and individual biases (e.g. stereotypes), will be taken from the disciplines of social psychology and cognitive decision science and considered in the field of ethical decision-making. Finally we discuss the influence of intuitive versus analytical (systematical) reasoning on the validity of ethical decision-making.

The ethics of research using biobanks: reason to question the importance attributed to informed consent.

PubMed

Hoeyer, Klaus; Olofsson, Bert-Ove; Mjörndal, Tom; Lynöe, Niels

2005-01-10

During the past decade, the use of stored tissue has become an object of increased ethical query. A Swedish biobank and a biotech company have been praised for solving the ethical problems with explicit informed consent procedures, and we decided to investigate donors' perceptions of the system. A questionnaire was sent to a randomized sample of 1200 donors who had donated blood and signed informed consent forms. The response rate was 80.9%. Of the respondents, 64.5% were aware that they had consented to donate a blood sample, 55.4% thought that they had consented to donate phenotypic information, and 31.6% believed that they could withdraw their consent. Among respondents, 3.9% considered informing donors about the research objective as the most important ethical issue in relation to biobanks, and 5.6% were unsatisfied with the information they had been given. There was 85.9% acceptance of surrogate decision making by regional research ethics committees. Considering that the donors in this study were not always aware of their donation but generally were not unsatisfied with the information they had received, and that they did not rate being informed about the research objective as an important issue, informed consent seems to be an inadequate measure of public acceptance of biobank-based research.

Examining Moral Judgment and Ethical Decision-Making in Information Technology Managers and Their Relationship

ERIC Educational Resources Information Center

Shahand, Assadullah

2010-01-01

Growing incidences of corporate ethical misconducts have revived the debate over ethical reasoning and moral development of corporate managers. The role of information technology (IT) in the ethical dilemmas is becoming more evident as virtual environments become increasingly popular, organizations adopt digital form of record keeping, and the…

The Stakes Are High: Ethics Education at U.S. War Colleges

DTIC Science & Technology

2016-02-13

keeping with the long-held belief among 3 American military leaders that “ ethics , the study of reasoning about moral right and wrong, nurtures the... moral consciousness and establishes the basis for right actions by military leaders.”6 Military ethics , as a subset of professional ethics , serves...It shares similarities with other professions, but is uniquely focused on those inherent moral issues of military service, namely the authority to

Cognitive Maps and the Structure of Observed Learning Outcome Assessment of Physiotherapy Students' Ethical Reasoning Knowledge

ERIC Educational Resources Information Center

Jones, Mark; van Kessel, Gisela; Swisher, Laura; Beckstead, Jason; Edwards, Ian

2014-01-01

Assessment of student learning in complex areas is challenging, particularly when there is interest in students' deeper understanding and connectivity of concepts. Assessment of ethics learning has been limited by lack of consensus regarding what is effective and an overfocus on quantification at the expense of clinical or ethical relevance.…

Measurement of ethical food choice motives.

PubMed

Lindeman, M; Väänänen, M

2000-02-01

The two studies describe the development of three complementary scales to the Food Choice Questionnaire developed by Steptoe, Pollard & Wardle (1995). The new items address various ethical food choice motives and were derived from previous studies on vegetarianism and ethical food choice. The items were factor analysed in Study 1 (N=281) and the factor solution was confirmed in Study 2 (N=125), in which simple validity criteria were also included. Furthermore, test-retest reliability was assessed with a separate sample of subjects (N=36). The results indicated that the three new scales, Ecological Welfare (including subscales for Animal Welfare and Environment Protection), Political Values and Religion, are reliable and valid instruments for a brief screening of ethical food choice reasons. Copyright 2000 Academic Press.

Is it possible to assess the "ethics" of medical school applicants?

PubMed Central

Lowe, M.; Kerridge, I.; Bore, M.; Munro, D.; Powis, D.

2001-01-01

Questions surrounding the assessment of medical school applicants' morality are difficult but they are nevertheless important for medical schools to consider. It is probably inappropriate to attempt to assess medical school applicants' ethical knowledge, moral reasoning, or beliefs about ethical issues as these all may be developed during the process of education. Attitudes towards ethical issues and ethical sensitivity, however, might be tested in the context of testing for personality attributes. Before any "ethics" testing is introduced as part of screening for admission to medical school it would require validation. We suggest a number of ways in which this might be achieved. Key Words: Ethics • medical school selection • personality PMID:11731605

[Considering body ethics in the healthcare profession].

PubMed

Wang, Shin-Yun

2014-10-01

This article uses the theory of body phenomenology and Watson's caring theory to develop and apply body ethics to the clinical healthcare profession. This attempt is meant to facilitate deep, humanistic experiences for healthcare personnel. The analysis of body phenomenology reveals that the soul is banished from her familiar and comfortable "at-home" status when illness and pain invade the body. In such situations, the body becomes an external object that is self-alienated. This experience induces experiences such as solitude and violence. However, it also holds the potential to expose the original morality of the body. Additionally, this article discusses popular tools used in clinical ethics such as principalism and virtual-based ethics, which are based on moral reasoning and moral feeling. In contrast to these, body ethics seek a more profound and humble level of sensibility that is able to implant authenticity into the ethics. Finally, we offer some suggestions related to Watson's caring theory.

Wisdom in clinical reasoning and medical practice.

PubMed

Edmondson, Ricca; Pearce, Jane; Woerner, Markus H

2009-01-01

Exploring informal components of clinical reasoning, we argue that they need to be understood via the analysis of professional wisdom. Wise decisions are needed where action or insight is vital, but neither everyday nor expert knowledge provides solutions. Wisdom combines experiential, intellectual, ethical, emotional and practical capacities; we contend that it is also more strongly social than is usually appreciated. But many accounts of reasoning specifically rule out such features as irrational. Seeking to illuminate how wisdom operates, we therefore build on Aristotle's work on informal reasoning. His account of rhetorical communication shows how non-formal components can play active parts in reasoning, retaining, or even enhancing its reasonableness. We extend this account, applying it to forms of healthcare-related reasoning which are characterised by the need for wise decision-making. We then go on to explore some of what clinical wise reasoning may mean, concluding with a case taken from psychotherapeutic practice.

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

PubMed

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

2018-04-20

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

Using Insights from Applied Moral Psychology to Promote Ethical Behavior Among Engineering Students and Professional Engineers.

PubMed

Gelfand, Scott D

2016-10-01

In this essay I discuss a novel engineering ethics class that has the potential to significantly decrease the likelihood that students (and professionals) will inadvertently or unintentionally act unethically in the future. This class is different from standard engineering ethics classes in that it focuses on the issue of why people act unethically and how students (and professionals) can avoid a variety of hurdles to ethical behavior. I do not deny that it is important for students to develop cogent moral reasoning and ethical decision-making as taught in traditional college-level ethics classes, but as an educator, I aim to help students apply moral reasoning in specific, real-life situations so they are able to make ethical decisions and act ethically in their academic careers and after they graduate. Research in moral psychology provides evidence that many seemingly irrelevant situational factors affect the moral judgment of most moral agents and frequently lead agents to unintentionally or inadvertently act wrongly. I argue that, in addition to teaching college students moral reasoning and ethical decision-making, it is important to: 1. Teach students about psychological and situational factors that affect people's ethical judgments/behaviors in the sometimes stressful, emotion-laden environment of the workplace; 2. Guide students to engage in critical reflection about the sorts of situations they personally might find ethically challenging before they encounter those situations; and 3. Provide students with strategies to help them avoid future unethical behavior when they encounter these situations in school and in the workplace.

Are there reasons to challenge a symbolic computationalist approach in explaining deductive reasoning?

PubMed

Faiciuc, Lucia E

2008-06-01

The majority of the existing theories explaining deductive reasoning could be included in a classic computationalist approach of the cognitive processes. In fact, deductive reasoning could be seen to be the pinnacle of the symbolic computationalism, its last fortress to be defended in the face of new, dynamic, and ecological perspectives over cognition. But are there weak points in that position regarding deductive reasoning? What would be the reasons for which new perspectives could gain in credibility? What could be their most important tenets? The answers given to those questions in the paper include two main points. The first one is that the present empirical data could not sustain unambiguously one view over the other, that they are obtained in artificial experimental conditions, and that there are data that are not easily explainable using the traditional computationalist paradigm. The second one is that approaching the deductive reasoning from dynamic and ecological perspectives could have significant advantages. The most obvious one is the possibility to integrate more easily the research regarding the deductive reasoning with the results obtained in other domains of the psychology (especially in what respects the lower cognitive processes), in artificial intelligence or in neurophysiology. The reasons for that would be that such perspectives, as they are sketched in the paper, would imply, essentially, processes of second-order pattern formation and recognition (as it is the case for perception), embodied cognition, and dynamic processes as the brain ones are.

Practical ethical theory for nurses responding to complexity in care.

PubMed

Fairchild, Roseanne Moody

2010-05-01

In the context of health care system complexity, nurses need responsive leadership and organizational support to maintain intrinsic motivation, moral sensitivity and a caring stance in the delivery of patient care. The current complexity of nurses' work environment promotes decreases in work motivation and moral satisfaction, thus creating motivational and ethical dissonance in practice. These and other work-related factors increase emotional stress and burnout for nurses, prompting both new and seasoned nurse professionals to leave their current position, or even the profession. This article presents a theoretical conceptual model for professional nurses to review and make sense of the ethical reasoning skills needed to maintain a caring stance in relation to the competing values that must coexist among nurses, health care administrators, patients and families in the context of the complex health care work environments in which nurses are expected to practice. A model, Nurses' Ethical Reasoning Skills, is presented as a framework for nurses' thinking through and problem solving ethical issues in clinical practice in the context of complexity in health care.

Teaching Business Ethics--A Conceptual Approach.

ERIC Educational Resources Information Center

Nappi, Andrew T.

1990-01-01

The study of ethics has much to offer secondary school students. As students search to define their moral values and responsibilities, business educators can help them to develop their ability to reason carefully about complicated issues and problems. (Includes learning activities.) (Author)

Ethical problems in clinical psychopharmacology.

PubMed

Müller-Oerlinghausen, B

1978-10-01

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

Teaching Ethics in Communication Courses: An Investigation of Instructional Methods, Course Foci, and Student Outcomes

ERIC Educational Resources Information Center

Canary, Heather E.

2007-01-01

This study investigates the impact of ethics instruction in communication courses on students' moral reasoning competence. Using a quasi-experiment, participants in interpersonal conflict courses and communication ethics courses were exposed to different levels of ethics instruction through a variety of instructional methods. Results indicate that…

The place of the ideal observer in medical ethics.

PubMed

Churchill, L R

1983-01-01

The idea of an ideal observer is frequently employed in ethical reasoning and has recently been introduced into medical ethics. The contemporary use of this idea, however, is deeply flawed. It ignores important social and personal dimensions of ethics. By espousing a perspective of observation removed from history and community, the ideal observer notion encourages a pretense of objectivity and overlooks the distortions of distance. If taken seriously as a model for choice, the ideal observer is incoherent, as it dispenses with the concrete moral agent and the locus of choice. Adam Smith's 'impartial spectator' is examined as a more adequate statement of the need for appreciating diverse perspectives in ethical choices.

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

PubMed

Hanson, Mark J

2015-01-01

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

Comparison of Ontology Reasoners: Racer, Pellet, Fact++

NASA Astrophysics Data System (ADS)

Huang, T.; Li, W.; Yang, C.

2008-12-01

In this paper, we examine some key aspects of three of the most popular and effective Semantic reasoning engines that have been developed: Pellet, RACER, and Fact++. While these reasonably advanced reasoners share some notable similarities, it is ultimately the creativity and unique nature of these reasoning engines that have resulted in the successes of each of these reasoners. Of the numerous dissimilarities, the most obvious example might be that while Pellet is written in Java, RACER employs the Lisp programming language and Fact++ was developed using C++. From this and many other distinctions in the system architecture, we can understand the benefits of each reasoner and potentially discover certain properties that may contribute to development of an optimal reasoner in the future. The objective of this paper is to establish a solid comparison of the reasoning engines based on their system architectures, features, and overall performances in real world application. In the end, we expect to produce a valid conclusion about the advantages and problems in each reasoner. While there may not be a decisive first place among the three reasoners, the evaluation will also provide some answers as to which of these current reasoning tools will be most effective in common, practical situations.

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.

Protection as care: moral reasoning and moral orientation among ethnically and socioeconomically diverse older women.

PubMed

Dakin, Emily

2014-01-01

This study examined moral reasoning among ethnically and socioeconomically diverse older women based on the care and justice moral orientations reflecting theoretical frameworks developed by Carol Gilligan and Lawrence Kohlberg, respectively. A major gap in this area of research and theory development has been the lack of examination of moral reasoning in later life. This study addressed this gap by assessing socioeconomically and ethnically diverse older women's reasoning in response to ethical dilemmas showing conflict between autonomy, representative of Kohlberg's justice orientation, and protection, representative of Gilligan's care orientation. The dilemmas used in this study came from adult protective services (APS), the U.S. system that investigates and intervenes in cases of elder abuse and neglect. Subjects were 88 African American, Latina, and Caucasian women age 60 or over from varying socioeconomic status backgrounds who participated in eight focus groups. Overall, participants favored protection over autonomy in responding to the case scenarios. Their reasoning in responding to these dilemmas reflected an ethic of care and responsibility and a recognition of the limitations of autonomy. This reasoning is highly consistent with the care orientation. Variations in the overall ethic of care and responsibility based on ethnicity and SES also are discussed. Copyright © 2013. Published by Elsevier Inc.

[Applying Ethics, Placating Ethics, or Applying ourselves to Ethics? A Critical View of Environmental Ethics as Applied Ethics].

PubMed

Serani Merlo, Alejandro

2016-01-01

There is actually a pervasive tendency to consider environmental ethics and bioethics as specific cases pertaining to a supposed kind of ″applied ethics″. Application can be understood in two different meanings: a concrete sense, as in technical applications, and a psychological meaning, as when we mentally apply ourselves to a task. Ethics has been always thought as a practical knowledge, in a ″praxical″ sense and not in a ″poietic″ one. Ethics has to do with ″ends″ not with ″means″; in this sense ethics is ″useless″. Since ethics has to do with the ultimate meaning of things, ethical choices give meaning to all practical activities. In that sense ethics instead of being useless must be considered as ″over-useful″ (Maritain). Nowadays politics tend to instrumentalize ethics in order to political objectives. The consequence has been the reconceptualization of specific ethics as applied ethics. Environmental ethics and bioethics are then submitted to politics following the logic of technical applications. Environmental ethics and bioethics considered as applied ethics are at risk to becoming not only useless, but also meaningless.

Team-Based Learning Instruction for Responsible Conduct of Research Positively Impacts Ethical Decision-Making

PubMed Central

McCormack, Wayne T.; Garvan, Cynthia W.

2013-01-01

Common practices for responsible conduct of research (RCR) instruction have recently been shown to have no positive impact on and possibly to undermine ethical decision-making (EDM). We show that a team-based learning (TBL) RCR curriculum results in some gains in decision ethicality, the use of more helpful meta-cognitive reasoning strategies in decision-making, and elimination of most negative effects of other forms of RCR instruction on social–behavioral responses. TBL supports the reasoning strategies and social mechanisms that underlie EDM and ethics instruction, and may provide a more effective method for RCR instruction than lectures and small group discussion. PMID:24073606

Clinical Ethics Consultation After God: Implications for Advocacy and Neutrality.

PubMed

Parker, J Clint

2018-06-01

In After God: Morality and Bioethics in a Secular Age, H. Tristram Engelhardt, Jr. explores the broad implications for moral reasoning once a culture has lost a God's-eye perspective. In this paper, I focus on the implications of Engelhardt's views for clinical ethics consultation. I begin by examining the question of whether clinical ethics consultants (CECs) should advocate a particular viewpoint and/or process during consultations or adopt a neutral stance. I then examine the implications of Engelhardt's views for this question. Finally, I discuss some of Engelhardt's foundational ontological, metaphysical, meta-ethical, and epistemological commitments and how these commitments connect to his views on clinical ethics consultation.

A Second Opinion: A Case Narrative on Clinical Ethics Mediation.

PubMed

Weinstein, Michael S

2015-01-01

Contrasting traditional and common forms of ethics consultation with bioethics mediation, I describe the case of a "second opinion" consultation in the care of a patient with advanced cancer for whom treatment was futile. While the initial ethics consultation, performed by a colleague, led to a recommendation that some may deem ethical, the process failed to involve key stakeholders and failed to explore the underlying values and reasons for the opinions voiced by various stakeholders. The process of mediation ultimately led to creative solutions in which all stakeholders could reach consensus on a plan of care. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

Reverence and ethics in science.

PubMed

Kovac, Jeffrey

2013-09-01

Codes of ethics abound in science, but the question of why such codes should be obeyed is rarely asked. Various reasons for obeying a professional code have been proposed, but all are unsatisfactory in that they do not really motivate behavior. This article suggests that the long forgotten virtue of reverence provides both a reason to obey a professional code and motivation to do so. In addition, it discusses the importance of reverence as a cardinal virtue for scientists drawing on the ideas of Paul Woodruff on the role of virtue in community.

An ethical exploration of barriers to research on controlled drugs

PubMed Central

ANDREAE, Michael H; RHODES, Evelyn; BOURGOISE, Tylor; CARTER, George; WHITE, Robert S.; INDYK, Debbie; SACKS, Henry; RHODES, Rosamond

2016-01-01

We examine the ethical, social and regulatory barriers that may hamper research on therapeutic potential of certain controversial controlled substances like marijuana, heroin or ketamine. Hazards for individuals and society, and their potential adverse effects on communities may be good reasons for limiting access and justify careful monitoring of certain substances. Overly strict regulations, fear of legal consequences, stigma associated with abuse and populations using illicit drugs, and lack of funding may hinder research on their considerable therapeutic potential. We review the surprisingly sparse literature and address the particular ethical concerns of undue inducement, informed consent, risk to participants, researchers and institutions, justice and liberty germane to the research with illicit and addictive substances. We debate the disparate research stakeholder perspectives and why they are likely to be infected with bias. We propose an empirical research agenda to provide a more evidentiary basis for ethical reasoning. PMID:26982922

Ethics Consultation in Pediatrics: Long-Term Experience from a Pediatric Oncology Center

PubMed Central

Johnson, Liza-Marie; Church, Christopher L.; Metzger, Monika; Baker, Justin N.

2015-01-01

There is little information about the content of ethics consultations (EC) in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records (2000–2011) at St. Jude Children’s Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician’s fiduciary responsibility to the patient. Non-patient consultations provided guidance in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision-making among multiple stakeholders and further prospective research is needed on the role of ethics consultation in pediatrics. PMID:25970382

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

PubMed

Lampe, Marc

2012-09-01

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

Ethical Issues in Editing Scholarly Journals.

ERIC Educational Resources Information Center

Stryker, Sheldon

1990-01-01

Discusses ethical issues that arise when serving as an editor of a scholarly journal. Suggests treating these issues using paradigm-based decisions; decisions based on personal sociological predilections and commitments; and reasonable referee-assignment policies. Notes how conflicts of interest inevitably accompanying such a position. (NL)

Clinical ethics and the role of clinical ethics committees: proposals for a revival. Commentary.

PubMed

Petrini, Carlo; Ricciardi, Walter

2017-01-01

The issue addressed in the paper published by the Italian National Bioethics Committee (NBC) entitled "Clinical ethics committees", is highly significant for many reasons. One of these is the fact that the ethics committees charged with assessing clinical trials have so much responsibility and such a heavy work-load that they have little time available for other tasks such as engaging directly with patients "at the bedside", as a result of which the role of committees responsible for assessing clinical cases is especially important. According to the NBC, the opinions of clinical ethics committees should be formulated jointly and are non-binding. The NBC offers practical proposals not only for the Italian context. While the Italian National Institute of Health (Istituto Superiore di Sanità - ISS) is not involved directly in treating patients, its role in providing guidance is crucial to the national health service and it has always paid special attention to these issues.

Reporting transparency: making the ethical mandate explicit.

PubMed

Nicholls, Stuart G; Langan, Sinéad M; Benchimol, Eric I; Moher, David

2016-03-16

Improving the transparency and quality of reporting in biomedical research is considered ethically important; yet, this is often based on practical reasons such as the facilitation of peer review. Surprisingly, there has been little explicit discussion regarding the ethical obligations that underpin reporting guidelines. In this commentary, we suggest a number of ethical drivers for the improved reporting of research. These ethical drivers relate to researcher integrity as well as to the benefits derived from improved reporting such as the fair use of resources, minimizing risk of harms, and maximizing benefits. Despite their undoubted benefit to reporting completeness, questions remain regarding the extent to which reporting guidelines can influence processes beyond publication, including researcher integrity or the uptake of scientific research findings into policy or practice. Thus, we consider investigation on the effects of reporting guidelines an important step in providing evidence of their benefits.

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

Researcher Perceptions of Ethical Guidelines and Codes of Conduct

PubMed Central

Giorgini, Vincent; Mecca, Jensen T.; Gibson, Carter; Medeiros, Kelsey; Mumford, Michael D.; Connelly, Shane; Devenport, Lynn D.

2014-01-01

Ethical codes of conduct exist in almost every profession. Field-specific codes of conduct have been around for decades, each articulating specific ethical and professional guidelines. However, there has been little empirical research on researchers’ perceptions of these codes of conduct. In the present study, we interviewed faculty members in six research disciplines and identified five themes bearing on the circumstances under which they use ethical guidelines and the underlying reasons for not adhering to such guidelines. We then identify problems with the manner in which codes of conduct in academia are constructed and offer solutions for overcoming these problems. PMID:25635845

ESHRE Task Force on Ethics and Law 10: surrogacy.

PubMed

Shenfield, F; Pennings, G; Cohen, J; Devroey, P; de Wert, G; Tarlatzis, B

2005-10-01

This 10th statement of the Task Force on Ethics and Law considers ethical questions specific to varied surrogacy arrangements. Surrogacy is especially complex as the interests of the intended parents, the surrogate, and the future child may differ. It is concluded that surrogacy is an acceptable method of assisted reproductive technology of the last resort for specific medical indications, for which only reimbursement of reasonable expenses is allowed.

What makes a problem an ethical problem? An empirical perspective on the nature of ethical problems in general practice

PubMed Central

Braunack-Mayer, A. J.

2001-01-01

Whilst there has been considerable debate about the fit between moral theory and moral reasoning in everyday life, the way in which moral problems are defined has rarely been questioned. This paper presents a qualitative analysis of interviews conducted with 15 general practitioners (GPs) in South Australia to argue that the way in which the bioethics literature defines an ethical dilemma captures only some of the range of lay views about the nature of ethical problems. The bioethics literature has defined ethical dilemmas in terms of conflict and choice between values, beliefs and options for action. While some of the views of some of the GPs in this study about the nature of their ethical dilemmas certainly accorded with this definition, other explanations of the ethical nature of their problems revolved around the publicity associated with the issues they were discussing, concern about their relationships with patients, and anxiety about threats to their integrity and reputation. The variety of views about what makes a problem a moral problem indicates that the moral domain is perhaps wider and richer than mainstream bioethics would generally allow. Key Words: Empirical ethics • general practice • qualitative research PMID:11314166

A Review of Contemporary Ethical Decision-Making Models for Mental Health Professionals

ERIC Educational Resources Information Center

Francis, Perry C.

2015-01-01

Mental health professionals are faced with increasingly complex ethical decisions that are impacted by culture, personal and professional values, and the contexts in which they and their clients inhabit. This article presents the reasons for developing and implementing multiple ethical decision making models and reviews four models that address…

From ethics of care to psychology of care: reconnecting ethics of care to contemporary moral psychology

PubMed Central

Govrin, Aner

2014-01-01

Moral psychology once regarded ethics of care as a promising theory. However, there is evidence to suggest that nowadays moral psychology completely ignores ethics of care’s various insights. Moreover, ethics of care’s core concepts – compassion, dependence, and the importance of early relations to moral development– are no longer considered to be relevant to the development of new theories in the field. In this paper, I will firstly discuss some of the reasons which, over recent years, have contributed to the marginalization of the role of ethics of care in moral psychology. Next, I will show that ethics of care’s most promising idea centered on the care given to an infant and the importance of that care to the development of moral thinking. In this context, I will be describing the implications of John Bowlby’s attachment theories, infant research, findings in moral psychology and neuroscience. I will argue that ethics of care needs to be radically re-thought and replaced by a psychology of care, an attachment approach to moral judgment, which would establish the centrality of the caregiver’s role in moral development. The philosophical implications of this approach to the understanding of the “rationalists” and “intuitionists” debate about the true nature of moral judgment is also discussed. PMID:25368588

Fostering Critical Thinking, Reasoning, and Argumentation Skills through Bioethics Education

PubMed Central

Chowning, Jeanne Ting; Griswold, Joan Carlton; Kovarik, Dina N.; Collins, Laura J.

2012-01-01

Developing a position on a socio-scientific issue and defending it using a well-reasoned justification involves complex cognitive skills that are challenging to both teach and assess. Our work centers on instructional strategies for fostering critical thinking skills in high school students using bioethical case studies, decision-making frameworks, and structured analysis tools to scaffold student argumentation. In this study, we examined the effects of our teacher professional development and curricular materials on the ability of high school students to analyze a bioethical case study and develop a strong position. We focused on student ability to identify an ethical question, consider stakeholders and their values, incorporate relevant scientific facts and content, address ethical principles, and consider the strengths and weaknesses of alternate solutions. 431 students and 12 teachers participated in a research study using teacher cohorts for comparison purposes. The first cohort received professional development and used the curriculum with their students; the second did not receive professional development until after their participation in the study and did not use the curriculum. In order to assess the acquisition of higher-order justification skills, students were asked to analyze a case study and develop a well-reasoned written position. We evaluated statements using a scoring rubric and found highly significant differences (p<0.001) between students exposed to the curriculum strategies and those who were not. Students also showed highly significant gains (p<0.001) in self-reported interest in science content, ability to analyze socio-scientific issues, awareness of ethical issues, ability to listen to and discuss viewpoints different from their own, and understanding of the relationship between science and society. Our results demonstrate that incorporating ethical dilemmas into the classroom is one strategy for increasing student motivation and

Fostering critical thinking, reasoning, and argumentation skills through bioethics education.

PubMed

Chowning, Jeanne Ting; Griswold, Joan Carlton; Kovarik, Dina N; Collins, Laura J

2012-01-01

Developing a position on a socio-scientific issue and defending it using a well-reasoned justification involves complex cognitive skills that are challenging to both teach and assess. Our work centers on instructional strategies for fostering critical thinking skills in high school students using bioethical case studies, decision-making frameworks, and structured analysis tools to scaffold student argumentation. In this study, we examined the effects of our teacher professional development and curricular materials on the ability of high school students to analyze a bioethical case study and develop a strong position. We focused on student ability to identify an ethical question, consider stakeholders and their values, incorporate relevant scientific facts and content, address ethical principles, and consider the strengths and weaknesses of alternate solutions. 431 students and 12 teachers participated in a research study using teacher cohorts for comparison purposes. The first cohort received professional development and used the curriculum with their students; the second did not receive professional development until after their participation in the study and did not use the curriculum. In order to assess the acquisition of higher-order justification skills, students were asked to analyze a case study and develop a well-reasoned written position. We evaluated statements using a scoring rubric and found highly significant differences (p<0.001) between students exposed to the curriculum strategies and those who were not. Students also showed highly significant gains (p<0.001) in self-reported interest in science content, ability to analyze socio-scientific issues, awareness of ethical issues, ability to listen to and discuss viewpoints different from their own, and understanding of the relationship between science and society. Our results demonstrate that incorporating ethical dilemmas into the classroom is one strategy for increasing student motivation and

Preconception sex selection for non-medical and intermediate reasons: ethical reflections.

PubMed

de Wert, G; Dondorp, W

2010-01-01

Sex selection for non-medical reasons is forbidden in many countries. Focusing on preconception sex selection, the authors first observe that it is unclear what should count as a 'medical reason' in this context and argue for the existence of 'intermediate reasons' that do not fit well within the rigid distinction between 'medical'and 'non-medical'. The article further provides a critical review of the arguments for the prohibition of sex selection for non-medical reasons and finds that none of these are conclusive. The authors conclude that the ban should be reconsidered, but also that existing-- societal concerns about possible harmful effects should be taken seriously. Measures to this effect may include limiting the practice to couples who already have at least one child of the sex opposite to that which they now want to select ('family balancing'). Finally, a difficult set of questions is raised by concerns about the reliability and unproven (long-term) safety of the only technology (flow cytometry) proven to work.

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

PubMed Central

Ypinazar, Valmae A; Margolis, Stephen A

2004-01-01

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

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

PubMed

Ypinazar, Valmae A; Margolis, Stephen A

2004-07-30

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

Why doctors should seek publicity: 15+ reasons to seek media attention.

PubMed

Baum, Neil

2014-01-01

Physicians have been shy about reaching out for free publicity, even though they are some of the most well-trained and accomplished professionals in our society. There's no reason for them not to seek out attention and to promote themselves in an ethical fashion. This article will review 15+ reasons for physicians to seek publicity and become a darling of the media.

Opinions of gynaecologists on prenatal diagnostics in first/second trimester and abortion--ethical aspect.

PubMed

Szymańska, M; Knapp, P

2007-01-01

The aim of the study was the assessment of the influence of ethics or the lack of medical ethics on everyday gynaecological practice, particularly the usefulness and purpose of detecting genetic irregularities in the first and second trimester and abortions. A sample of 164 gynaecological doctors was encompassed by the study. A questionnaire survey was applied as an independent empirical procedure on the basis of the theory of attitudes and the following questionnaires: WCQ (The Ways of Coping Questionnaire)--Folkman, Lazarus, Dukiel-Scheier & Weintraub, as the authors own adaptation of that instrument for the requirements of the study. In response to the question on the purpose of performing prenatal diagnostics in detecting genetic irregularities in the first and second trimester--35% of physicians were against such diagnostics if it served abortion, 60% supported the test even if in consequence an abortion was carried out, whereas 5% had no stance on the matter. The problem of physicians' approach to abortion for so-called "social reasons" was also studied. Over half, as many as 51% of physicians were against abortion in any form whatsoever, including pharmacological abortions; 45% agreed to abortion and 4% had no opinion. The veracity of ethical motivations was also measured: approx. 4%, refrained from expressing their support of either position; 29% stated that a physician, although they do not perform abortions themselves, should indicate other possibilities of performing the abortion and as many as 67% thought that the indication of a place or a person who performs abortions is obvious. The results of the survey indicate the differences in the attitudes of physicians towards the diagnosis of prenatal tests, especially the ones revealing genetic defects and lethal disease. There are two ambivalent patterns of behaviour: one group of physicians opt for delivering every child without any exceptions, but the other one is for destroying deformed foetuses.

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…

The obviously ill patient in need of treatment: a fourth standard for civil commitment.

PubMed

Treffert, D A

1985-03-01

The three relatively standard criteria currently contained in most state civil commitment laws (danger to self, danger to others, and gravely disabled) have forced many obviously ill patients to deteriorate to the point of dangerousness before receiving treatment, to become criminalized, or to wander the streets untreated. After discussing the origins of present civil commitment laws and the plight of obviously ill patients, the author details the cooperative effort of several groups in Wisconsin to codify a fourth standard for civil commitment that would ensure that obviously ill patients receive treatment with proper procedural and due process safeguards. Other statutory alternatives to remedy the plight of obviously ill patients are also discussed.

Reasons on the similarity of objections with regards to gambling and speculation in Islamic finance and conventional finance.

PubMed

Kunhibava, Sherin

2011-03-01

Gambling and speculation which leads to zero-sum outcomes are prohibited in Islamic finance and condemned in conventional finance. This article explores the reasons for the similarity of objections towards gambling and speculation. Three probable reasons are explored namely the concept of stewardship in conventional thought and the concept of khalifa in Islam, Christianity and morality's influence on conventional law and finance and the concept of ethics of sacrifice and ethics of tolerance.

A virtue ethics guide to best practices for community-based participatory research.

PubMed

Schaffer, Marjorie A

2009-01-01

Rule ethics, or principled thinking, is important in the analysis of risks and benefits of research and informed consent, but is not completely adequate for guiding ethical responses to communities as research participants and collaborators. Virtue ethics theory can be used to guide actions in relationships, which are foundational to the implementation of community-based participatory research (CBPR). Virtues are strengths of character that contribute to a life of flourishing or well-being for individuals and communities. This article provides an overview of virtue ethics theory, identifies common ethical problems in CBPR, and discusses how professional virtues can be used to guide ethical research practice. The virtues of compassion, courage, honesty, humility, justice, and practical reasoning are defined and applied to ethical practice in the development, implementation, and dissemination of CBPR. Best practices for CBPR that consider the well-being of communities are identified. The virtues of compassion and humility foster inclusiveness and integration of community perspectives in research collaboration. Courage requires researchers to step out of the research safety-net to listen to community member voices and wisdom and share power in research decisions. Honesty requires researchers to communicate realistic expectations for research outcomes, share all findings with the community, and consider community perspectives in research dissemination. Systematic involvement of the community in all steps of the research process represents the virtue of practical reasoning. From a justice perspective, CBPR aims to restore communities rather than take from them.

Ethical reasons for narrowing the scope of biotech patents.

PubMed

Andreassen, Tom

2015-11-01

Patents on biotech products have a scope that goes well beyond what is covered by the most widely applied ethical justifications of intellectual property. Neither natural rights theory from Locke, nor public interest theory of IP rights justifies the wide scope of legal protection. The article takes human genes as an example, focusing on the component that is not invented but persists as unaltered gene information even in the synthetically produced complementary DNA, the cDNA. It is argued that patent on cDNA holds this information captive, or illegitimately appropriates it in limiting other researchers and inventors' opportunity to explore new functions and uses based on this non-invented information. A tighter connection between legal IP protection and the use description stated in the patent claim is suggested. By binding protection to the product's foreseeable functions and use, instead of the product itself and all future uses of it, legitimacy of biotech product patents is restored.

Phronesis: Beyond the Research Ethics Committee-A Crucial Decision-Making Skill for Health Researchers During Community Research.

PubMed

Greeff, Minrie; Rennie, Stuart

2016-04-01

Health researchers conducting research in the community are often faced with unanticipated ethical issues that arise in the course of their research and that go beyond the scope of ethical approval by the research ethics committee. Eight expert researchers were selected through extreme intensity purposive sampling, because they are representative of unusual manifestations of the phenomenon related to their research in the community. They were selected to take part in a semi-structured focus group discussion on whether practical wisdom (phronesis) is used as a decision-making skill to solve unanticipated ethical issues during research in the community. Although the researchers were not familiar with the concept phronesis, it became obvious that it formed an integral part of their everyday existence and decision making during intervention research. They could balance research ethics with practical considerations. The capacity of practical wisdom as a crucial decision-making skill should be assimilated into a researcher's everyday reality, and also into the process of mentoring young researchers to become phronimos. Researchers should be taught this skill to handle unanticipated ethical issues. © The Author(s) 2016.

The Legal Ethical Backbone of Conscientious Refusal.

PubMed

Munthe, Christian; Nielsen, Morten Ebbe Juul

2017-01-01

This article analyzes the idea of a legal right to conscientious refusal for healthcare professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious refusal is distinguished from ideas regarding moral rights or reasons related to conscientious refusal, and none of the latter are found to support the notion of a legal right. Reasons for allowing some sort of room for conscientious refusal for healthcare professionals based on the importance of cultural identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply. One such factor is that a legal right to healthcare professionals' conscientious refusal must comply with basic legal ethical tenets regarding the rule of law and equal treatment, and this requirement is found to create serious problems for those wishing to defend the idea under consideration. We conclude that the notion of a legal right to conscientious refusal for any profession is either fundamentally incompatible with elementary legal ethical requirements, or implausible because it undermines the functioning of a related professional sector (healthcare) or even of society as a whole.

It's not all about moral reasoning: Understanding the content of Moral Case Deliberation.

PubMed

Svantesson, Mia; Silén, Marit; James, Inger

2018-03-01

Moral Case Deliberation is one form of clinical ethics support described as a facilitator-led collective moral reasoning by healthcare professionals on a concrete moral question connected to their practice. Evaluation research is needed, but, as human interaction is difficult to standardise, there is a need to capture the content beyond moral reasoning. This allows for a better understanding of Moral Case Deliberation, which may contribute to further development of valid outcome criteria and stimulate the normative discussion of what Moral Case Deliberation should contain. To explore and compare the content beyond moral reasoning in the dialogue in Moral Case Deliberation at Swedish workplaces. A mixed-methods approach was applied for analysing audio-recordings of 70 periodic Moral Case Deliberation meetings at 10 Swedish workplaces. Moral Case Deliberation facilitators and various healthcare professions participated, with registered nurses comprising the majority. Ethical considerations: No objection to the study was made by an Ethical Review Board. After oral and written information was provided, consent to be recorded was assumed by virtue of participation. Other than 'moral reasoning' (median (md): 45% of the spoken time), the Moral Case Deliberations consisted of 'reflections on the psychosocial work environment' to a varying extent (md: 29%). Additional content comprised 'assumptions about the patient's psychosocial situation' (md: 6%), 'facts about the patient's situation' (md: 5%), 'concrete problem-solving' (md: 6%) and 'process' (md: 3%). The findings suggest that a restorative function of staff's wellbeing in Moral Case Deliberation is needed, as this might contribute to good patient care. This supports outcome criteria of improved emotional support, which may include relief of moral distress. However, facilitators need a strategy for how to proceed from the participants' own emotional needs and to develop the use of their emotional knowing to focus on

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

PubMed

Grigorovich, Alisa; Kontos, Pia

2018-03-19

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

Can obviously intoxicated patrons still easily buy alcohol at on-premise establishments?

PubMed Central

Toomey, Traci L.; Lenk, Kathleen M.; Nederhoff, Dawn M.; Nelson, Toben F.; Ecklund, Alexandra M.; Horvath, Keith J.; Erickson, Darin J.

2015-01-01

Background Excessive alcohol consumption at licensed alcohol establishments (i.e., bars and restaurants) has been directly linked to alcohol-related problems such as traffic crashes and violence. Historically, alcohol establishments have had a high likelihood of selling alcohol to obviously intoxicated patrons (also referred to as “overservice”) despite laws prohibiting these sales. Given the risks associated with overservice and the need for up-to-date data, it is critical that we monitor the likelihood of sales to obviously intoxicated patrons. Methods To assess the current likelihood of a licensed alcohol establishment selling alcohol to an obviously intoxicated patron, we conducted pseudo-intoxicated purchase attempts (i.e., actors attempt to purchase alcohol while acting out obvious signs of intoxication) at 340 establishments in one Midwestern metropolitan area. We also measured characteristics of the establishments, the pseudo-intoxicated patrons, the servers, the managers, and the neighborhoods to assess whether these characteristics were associated with likelihood of sales of obviously intoxicated patrons. We assessed these associations with bivariate and multivariate regression models. Results Pseudo-intoxicated buyers were able to purchase alcohol at 82% of the establishments. In the fully adjusted multivariate regression model, only one of the characteristics we assessed was significantly associated with likelihood of selling to intoxicated patrons–establishments owned by a corporate entity had 3.6 greater odds of selling alcohol to a pseudo-intoxicated buyer compared to independently-owned establishments. Discussion Given the risks associated with overservice of alcohol, more resources should be devoted first to identify effective interventions for decreasing overservice of alcohol and then to educate practitioners who are working in their communities to address this public health problem. PMID:26891204

Failure to Apply for Ethical Approval for Health Studies in Low-Income Countries

PubMed Central

Simkhada, Padam

2015-01-01

On too many occasions researchers conduct public health and/or epidemiological studies in low-income countries without the appropriate in-country ethical approval. This article reflects on some of the underlying reasons for not applying for ethical approval. The piece concludes that we need to start by educating our (junior) researchers and research students about the importance of research ethics. We conclude with a number of recommendations for researchers, scientific journal editors and reviewers and ethical committees in high-income countries to bring the message home to researchers that ethical approval should be sought in low-income countries if and when required! PMID:26913212

A Second Opinion: A Case Narrative on Clinical Ethics Mediation.

PubMed

Weinstein, Michael S

2015-01-01

Contrasting traditional and common forms if ethics consultation with bioethics mediation. I describe the case of a "second opinion" consultation in the care of a patient with advanced cancer for whom treatment was futile. While the initial ethics consultation, performed by a colleague, let to a recommendation that some may deem ethical, the process failed to involve key stakeholders and failed to explore the underlying values and reasons for the opinions voiced by various stakeholders. The process of mediation ultimately led to creative solutions in which all stakeholders could reach consensus on a plan of care.

The Socio-Scientific Reasoning Model: Instruments for Evaluation.

ERIC Educational Resources Information Center

Cheu, Janey; And Others

The Environmental Issues Test (EIT) is an instrument designed to assess moral and ethical reasoning within a scientific or technological context. It is comprised of five dilemma stories each of which highlights an environmental issue and the moral conflicts inherent in that issue. Following each dilemma story is a series of 12 issues statements,…

A theoretical framework for human and veterinary medical ethics education.

PubMed

Magalhães-Sant'Ana, Manuel

2016-12-01

In their practice, physicians and veterinarians need to resort to an array of ethical competences. As a teaching topic, however, there is no accepted gold standard for human medical ethics, and veterinary medical ethics is not yet well established. This paper provides a reflection on the underlying aims of human and veterinary medical ethics education. Drawing from published literature on ethics education in the health professions a theoretical framework common to the teaching of human and veterinary medical ethics is proposed, based on three concepts: professional rules, moral virtues and ethical skills. The rules approach relies on the transmission of professional and social values by means of regulatory documents and depends intimately on the knowledge that students have of those documents. The virtues approach involves the inculcation of moral values and virtues that will stimulate students to develop desirable behaviours. The main focus of this approach to ethics is to develop students' attitudinal competences. Finally, the skills approach is focused on equipping the students with the necessary moral reasoning abilities to recognise and respect the plurality of ethical views that make part of contemporary society. This framework can inform future curriculum development in human and veterinary medical ethics as well as in other health care professions.

The original risk: overtheologizing ethics and undertheologizing sin.

PubMed

Müller, Denis

2007-01-01

The project of articulating a theological ethics on the basis of liturgical anthropology is bound to fail if the necessary consequence is that one has to quit the forum of critical modern rationality. The risk of Engelhardt's approach is to limit rationality to a narrow vision of reason. Sin is not to be understood as the negation of human holiness, but as the negation of divine holiness. The only way to renew theological ethics is to understand sin as the anthropological and ethical expression of the biblical message of the justification by faith only. Sin is therefore a secondary category, which can only by interpreted in light of the positive manifestation of liberation, justification, and grace. The central issue of Christian ethics is not ritual purity or morality, but experience, confession and recognition of our own injustice in our dealing with God and men.

[Care between ethics, work and political].

PubMed

Svandra, Philippe

2015-09-01

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

Reader's Response: Response to K. Hornsby's "Developing and Assessing Undergraduate Students' Moral Reasoning Skills"

ERIC Educational Resources Information Center

Payne, Carla

2008-01-01

In this brief response, Carla Payne comments on Karen Hornsby's "Developing and Assessing Undergraduate Students' Moral Reasoning Skills" (EJ1137006). Payne agrees with Hornsby's statement that the development of "moral reasoning skills" is a very desirable outcome for an ethics course, yet takes issue with Hornsby not sticking…

Care Reasoning Development and Family Socialisation Patterns in Later Adolescence: A Longitudinal Analysis

ERIC Educational Resources Information Center

Pratt, Michael W.; Skoe, Eva E.; Arnold, Mary Louise

2004-01-01

Over the past 20 years, care reasoning has been increasingly recognised as an important aspect of moral development. Skoe has developed an interview measure of levels of care reasoning about the needs of self and other in relationships, the Ethic of Care Interview or ECI. In the present longitudinal research, we investigated developmental changes…

Ethics consultants and ethics committees.

PubMed

La Puma, J; Toulmin, S E

1989-05-01

To address moral questions in patient care, hospitals and health care systems have enlisted the help of hospital ethicists, ethics committees, and ethics consultation services. Most physicians have not been trained in the concepts, skills, or language of clinical ethics, and few ethicists have been trained in clinical medicine, so neither group can fully identify, analyze, and resolve clinical ethical problems. Some ethics committees have undertaken clinical consultations themselves, but liability concerns and variable standards for membership hinder their efforts. An ethics consultation service comprising both physician-ethicists and nonphysician-ethicists brings complementary viewpoints to the management of particular cases. If they are to be effective consultants, however, nonphysician-ethicists need to be "clinicians": professionals who understand an individual patient's medical condition and personal situation well enough to help in managing the case. Ethics consultants and ethics committees may work together, but they have separate identities and distinct objectives: ethics consultants are responsible for patient care, while ethics committees are administrative bodies whose primary task is to advise in creating institutional policy.

The ethics of disclosing genetic diagnosis for Alzheimer's disease: do we need a new paradigm?

PubMed

Arribas-Ayllon, Michael

2011-01-01

Genetic testing for rare Mendelian disorders represents the dominant ethical paradigm in clinical and professional practice. Predictive testing for Huntington's disease is the model against which other kinds of genetic testing are evaluated, including testing for Alzheimer's disease. This paper retraces the historical development of ethical reasoning in relation to predictive genetic testing and reviews a range of ethical, sociological and psychological literature from the 1970s to the present. In the past, ethical reasoning has embodied a distinct style whereby normative principles are developed from a dominant disease exemplar. This reductionist approach to formulating ethical frameworks breaks down in the case of disease susceptibility. Recent developments in the genetics of Alzheimer's disease present a significant case for reconsidering the ethics of disclosing risk for common complex diseases. Disclosing the results of susceptibility testing for Alzheimer's disease has different social, psychological and behavioural consequences. Furthermore, what genetic susceptibility means to individuals and their families is diffuse and often mitigated by other factors and concerns. The ethics of disclosing a genetic diagnosis of susceptibility is contingent on whether professionals accept that probabilistic risk information is in fact 'diagnostic' and it will rely substantially on empirical evidence of how people actually perceive, recall and communicate complex risk information.

Ethical psychiatry in an uncertain world: conversations and parallel truths.

PubMed

Carson, Alexander M; Lepping, Peter

2009-06-25

Psychiatric practice is often faced with complex situations that seem to pose serious moral dilemmas for practitioners. Methods for solving these dilemmas have included the development of more objective rules to guide the practitioner such as utilitarianism and deontology. A more modern variant on this objective model has been 'Principlism' where 4 mid level rules are used to help solve these complex problems. In opposition to this, there has recently been a focus on more subjective criteria for resolving complex moral dilemmas. In particular, virtue ethics has been posited as a more sensitive method for helping doctors to reason their way through difficult ethical issues. Here the focus is on the character traits of the practitioner. Bloch and Green advocated another way whereby more objective methods such as Principlism and virtue ethics are combined to produce what they considered sound moral reasoning in psychiatrists. This paper points out some difficulties with this approach and instead suggests that a better model of ethical judgment could be developed through the use of narratives or stories. This idea puts equal prima facie value on the patient's and the psychiatrist's version of the dilemma they are faced with. It has the potential to lead to a more genuine empathy and reflective decision-making.

An in-depth analysis of ethics teaching in Canadian physiotherapy and occupational therapy programs.

PubMed

Laliberté, Maude; Hudon, Anne; Mazer, Barbara; Hunt, Matthew R; Ehrmann Feldman, Debbie; Williams-Jones, Bryn

2015-01-01

The purpose of this study was to examine current approaches and challenges to teaching ethics in entry-level Canadian physiotherapy (PT) and occupational therapy (OT) programs. Educators responsible for teaching ethics in the 28 Canadian PT and OT programs (n = 55) completed an online survey. The quantity of ethics teaching is highly variable, ranging from 5 to 65 h. Diverse obstacles to ethics teaching were reported, relating to the organization and structure of academic programs, student issues and the topic of ethics itself. Specific challenges included time constraints, large class sizes, a lack of pedagogical tools adapted to teaching this complex subject, a perceived lack of student interest for the subject and a preference for topics related to clinical skills. Of note, 65% of ethics educators who participated in the survey did not have any specialized training in ethics. Significant cross-program variation in the number of hours dedicated to ethics and the diversity of pedagogical methods used suggests that there is little consensus about how best to teach ethics. Further research on ethics pedagogy in PT and OT programs (i.e. teaching and evaluation approaches and effectiveness of current ethics teaching) would support the implementation of more evidence-based ethics education. Implications for Rehabilitation Ethics educators in Canadian PT and OT programs are experimenting with diverse educational approaches to teach ethical reasoning and decision-making to students, including lectures, problem-based learning, directed readings, videos, conceptual maps and clinical elective debriefing, but no particular method has been shown to be more effective for developing ethical decision-making/reasoning. Thus, research on the effectiveness of current methods is needed to support ethics educators and programs to implement evidence-based ethics education training. In our survey, 65% of ethics educators did not have any specialized training in ethics. Ensuring

75 FR 53643 - Examination Guidelines Update: Developments in the Obviousness Inquiry After KSR v.Teleflex

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-01

...The United States Patent and Trademark Office (USPTO or Office) is issuing an update (2010 KSR Guidelines Update) to its obviousness guidelines for its personnel to be used when applying the law of obviousness under 35 U.S.C. 103. This 2010 KSR Guidelines Update highlights case law developments on obviousness under 35 U.S.C. 103 since the 2007 decision by the United States Supreme Court (Supreme Court) in KSR Int'l Co. v. Teleflex Inc. These guidelines are intended to be used by Office personnel in conjunction with the guidance in the Manual of Patent Examining Procedure when applying the law of obviousness under 35 U.S.C. 103. Members of the public are invited to provide comments on the 2010 KSR Guidelines Update. The Office is especially interested in receiving suggestions of recent decisional law in the field of obviousness that would have particular value as teaching tools.

Overserving and Allowed Entry of Obviously Alcohol-Intoxicated Spectators at Sporting Events.

PubMed

Elgán, Tobias H; Durbeej, Natalie; Holder, Harold D; Gripenberg, Johanna

2018-02-01

Alcohol intoxication among spectators at sporting events and related problems, such as violence, are of great concern in many countries around the world. However, knowledge is scarce about whether or not alcohol is served to obviously intoxicated spectators at licensed premises inside and outside the sporting arenas, and if obviously intoxicated spectators are allowed entrance to these events. The objective of this study was therefore to examine the occurrences of overserving at licensed premises inside and outside arenas, and of allowed entry of obviously intoxicated spectators into arenas. An observational study assessing the rate of denied alcohol service and denied entry to arenas of trained professional actors portraying a standardized scene of obvious alcohol intoxication (i.e., pseudo-patrons) was conducted. The scene was developed by an expert panel, and each attempt was monitored by an observer. The settings were 2 arenas hosting matches in the Swedish Premier Football League in the largest city in Sweden and 1 arena in the second largest city, including entrances and licensed premises inside and outside the arenas. The rates of denied alcohol service were 66.9% at licensed premises outside the arenas (n = 151) and 24.9% at premises inside the arenas (n = 237). The rate of denied entry to the arenas (n = 102) was 10.8%. Overserving and allowed entry of obviously alcohol-intoxicated spectators are problematic at sporting events in Sweden and may contribute to high overall intoxication levels among spectators. The differences in server intervention rates indicate that serving staff at licensed premises inside the arenas and entrance staff are not likely to have been trained in responsible beverage service. This result underscores the need for server training among staff at the arenas. Copyright © 2017 by the Research Society on Alcoholism.

Some ethical issues regarding xenotransfusion.

PubMed

Roux, Françoise A; Saï, Pierre; Deschamps, Jack-Yves

2007-05-01

The use of porcine red blood cells has recently been proposed as a possible solution to the shortage of blood for human transfusion. The purpose of this paper is to compare some ethical issues regarding xenotransfusion (XTF) with those relating to xenotransplantation (XT) of organs, tissues and cells. Various ethical concerns and viewpoints relating to XTF are discussed. The main ethical obstacles to XT do not apply to XTF. It is much more ethically acceptable to raise pigs for regular blood collection as it doesn't damage the health of the animal. Porcine endogenous retrovirus infection, the major concern associated with XT, does not apply to XTF, since red blood cells have no DNA and have a very short lifespan. Clinical trials will be possible in humans once XTF has been demonstrated to be effective and harmless in non-human primates. Transgenesis is acceptable for pig blood donors because only a limited number of genes are involved, and these animals will never enter into the livestock gene pool or the food chain. Because the need for blood is less pressing than that for organs, tissues or cells, the use of animal blood for human transfusion is not an absolute necessity. However, it represents a real opportunity. The ability to gain access to an unlimited quantity of blood is a reasonable justification for XTF. Because its technical and ethical hurdles are less stringent, XTF could be the first large-scale clinical application of XT.

Getting started: helping a new profession develop an ethics program.

PubMed

Davis, Michael; Keefer, Matthew W

2013-03-01

Both of us have been involved with helping professions, especially new scientific or technological professions, develop ethics programs-for undergraduates, graduates, and practitioners. By "ethics program", we mean any strategy for teaching ethics, including developing materials. Our purpose here is to generalize from that experience to identify the chief elements needed to get an ethics program started in a new profession. We are focusing on new professions for two reasons. First, all the older professions, both in the US and in most other countries, now have ethics programs of some sort. They do not need our advice to get started. Second, new professions face special problems just because they are new-everything from deciding who belongs to the profession to formalizing ethical standards so that they can be taught. Our purpose in this paper is to generalize from our experience and to identify some of the fundamentals for getting an ethics program started in a new profession. We present our recommendations in the form of response to 6 questions anyone designing an ethics program for a new profession should ask. We realize that our brief discussion does not provide a complete treatment of the subject. Our purpose has been to point in the right direction those considering an ethics program for new profession.

The use of ethical frameworks by students following a new science course for 16 18 year-olds

NASA Astrophysics Data System (ADS)

Reiss, Michael

2008-09-01

There has been a move in recent years towards the greater inclusion of social and ethical issues within science courses. This paper examines a new context-based course for 16 18 year-olds (Salters-Nuffield Advanced Biology) who are studying biology in England and Wales. The course is taught through contexts and has an emphasis on social issues and the development of ethical reasoning. Examination of a sample of reports written by students in 2005 as part of the course’s summative assessment shows that utilitarian ethical reasoning is used widely and that the other ethical frameworks to which students are introduced in the course—rights and duties, autonomy and virtue ethics—are used substantially less often. In addition, students mostly argue anthropocentrically though many of them argue ecocentrically and/or biocentrically too.

Ethics and forensic psychiatry: translating principles into practice.

PubMed

Appelbaum, Paul S

2008-01-01

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

Ethics committees, organ transplantation and public policy.

PubMed

Dickens, Bernard M

1992-01-01

It is clear that ethics committees face many dilemmas in developing sound public policy on organ transplantation through their roles in serving their institutions and their communities. With conscientiousnes and good faith, different committees may adopt different approaches to the same issue, and arrive at different solutions when subscribing to the same approach. It is valuable that committee members should be aware of other committees' approaches and disclose the reasons for their own in a frank, non-defensive way. It should also be remembered that a measure of legitimacy can attach to ethics committees' decisions because of the integrity with which their decisions are reached, even when they differ from other committees' decisions. Like courts of law, their decisions carry weight because of how they are reached, not simply because of how they comport with the judgments of others. This is not to say that every or any legally permissible policy is ethically sound, but only that ethics committees can contribute to public satisfaction that institutions are under reliable control through the demonstrable integrity and competence of their processes of policy making.

Craniometaphyseal dysplasia with obvious biochemical abnormality and rickets-like features.

PubMed

Wu, Bo; Jiang, Yan; Wang, Ou; Li, Mei; Xing, Xiao-Ping; Xia, Wei-Bo

2016-05-01

Craniometaphyseal dysplasia (CMD) is a rare genetic disorder that is characterized by progressive sclerosis of the craniofacial bones and metaphyseal widening of long bones, and biochemical indexes were mostly normal. To further the understanding of the disease from a biochemical perspective, we reported a CMD case with obviously abnormal biochemical indexes. A 1-year-old boy was referred to our clinic. Biochemical test showed obviously increased alkaline phosphatase (ALP) and parathyroid hormone (PTH), mild hypocalcemia and hypophosphatemia. Moreover, significant elevated receptor activator of nuclear factor kappa-B ligand (RANKL) level, but normal β-C-terminal telopeptide of type I collagen (β-CTX) concentration were revealed. He was initially suspected of rickets, because the radiological examination also showed broadened epiphysis in his long bones. Supplementation with calcium and calcitriol alleviated biochemical abnormality. However, the patient gradually developed osteosclerosis which was inconformity with rickets. Considering that he was also presented with facial paralysis and nasal obstruction symptom, the diagnosis of craniometaphyseal dysplasia was suspected, and then was confirmed by the mutation analysis of ANKH of the proband and his family, which showed a de novo heterozygous mutation (C1124-1126delCCT) on exon 9. Our study revealed that obvious biochemical abnormality and rickets-like features might present as uncommon characteristics in CMD patients, and the calcium and calcitriol supplementation could alleviate biochemical abnormalities. Furthermore, although early osteoclast differentiation factor was excited in CMD patient, activity of osteoclast was still inert. Copyright © 2016. Published by Elsevier B.V.

Validity and reliability of an instrument for assessing case analyses in bioengineering ethics education.

PubMed

Goldin, Ilya M; Pinkus, Rosa Lynn; Ashley, Kevin

2015-06-01

Assessment in ethics education faces a challenge. From the perspectives of teachers, students, and third-party evaluators like the Accreditation Board for Engineering and Technology and the National Institutes of Health, assessment of student performance is essential. Because of the complexity of ethical case analysis, however, it is difficult to formulate assessment criteria, and to recognize when students fulfill them. Improvement in students' moral reasoning skills can serve as the focus of assessment. In previous work, Rosa Lynn Pinkus and Claire Gloeckner developed a novel instrument for assessing moral reasoning skills in bioengineering ethics. In this paper, we compare that approach to existing assessment techniques, and evaluate its validity and reliability. We find that it is sensitive to knowledge gain and that independent coders agree on how to apply it.

Researching Street Children: Methodological and Ethical Issues.

ERIC Educational Resources Information Center

Hutz, Claudio S.; And Others

This paper describes the ethical and methodological problems associated with studying prosocial moral reasoning of street children and children of low and high SES living with their families, and problems associated with studying sexual attitudes and behavior of street children and their knowledge of sexually transmitted diseases, especially AIDS.…

Reasoning about truth-telling in end-of-life care of patients with acute stroke.

PubMed

Rejnö, Åsa; Silfverberg, Gunilla; Ternestedt, Britt-Marie

2017-02-01

Ethical problems are a universal phenomenon but rarely researched concerning patients dying from acute stroke. These patients often have a reduced consciousness from stroke onset and thereby lack ability to convey their needs and could be described as 'incompetent' decision makers regarding their own care. The aim of the study was to deepen the understanding of stroke team members' reasoning about truth-telling in end-of-life care due to acute stroke. Qualitative study based on individual interviews utilizing combined deductive and inductive content analysis. Participants and research context: A total of 15 stroke team members working in stroke units of two associated county hospitals in western Sweden participated. Ethical considerations: The study was approved by the Regional Ethics Review Board, Gothenburg, Sweden. The main findings were the team members' dynamic movement between the categories 'Truth above all' and 'Hide truth to protect'. Honesty was highly valued and considered as a reason for always telling the truth, with the argument of truth as common morality. However, the carers also argued for hiding the truth for different reasons such as not adding extra burden in the sorrow, awaiting a timely moment and not being a messenger of bad news. Withholding truth could both be seen as a way of protecting themselves from difficult conversations and to protect others. The results indicate that there are various barriers for truthfulness. Interpreted from a virtue of ethics perspective, withholding of truth might also be seen as an expression of sound judgement to put the patient's best interest first. The carers may need support in the form of supervision to be given space to reflect on their experience and thereby promote ethically justified care. Here, the multi-professional team can be of great value and contribute through inter-professional sharing of knowledge.

Medical ethics and ethical dilemmas.

PubMed

Iyalomhe, G B S

2009-01-01

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

Ethical Decision Making: A Teaching and Learning Model for Graduate Students and New Professionals

ERIC Educational Resources Information Center

McDonald, William M.; Ebelhar, Marcus Walker; Orehovec, Elizabeth R.; Sanderson, Robyn H.

2006-01-01

Student affairs practitioners are inundated with a variety of ethical considerations when making day-to-day decisions regarding the welfare of students and colleagues. There is every reason to believe that confronting ethical issues will be an increasingly difficult issue for student affairs professionals in the future. This article provides a…

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.

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.

Ethics and the University. Professional Ethics Series.

ERIC Educational Resources Information Center

Davis, Michael

This book brings together the closely related topics of the practice of ethics in the university, "academic ethics," and the teaching of practical, or applied, ethics in the university. The volume considers practical ethics, research ethics, the teaching of ethics, and sexual ethics as related to the university. The chapters are: (1) "The Ethics…

Practical virtue ethics: healthcare whistleblowing and portable digital technology

PubMed Central

Bolsin, S; Faunce, T; Oakley, J

2005-01-01

Virtue ethics, emphasising techniques promoting an agent's character and instructing their conscience, has become a significant mode of discourse in modern medical ethics. Healthcare whistleblowers, whose complaints are reasonable, made in good faith, in the public interest, and not vexatious, we argue, are practising those obligations of professional conscience foundational to virtue based medical ethics. Yet, little extant virtue ethics scholarship seriously considers the theoretical foundations of healthcare whistleblowing. The authors examine whether healthcare whistleblowing should be considered central to any medical ethics emphasising professional virtues and conscience. They consider possible causes for the paucity of professional or academic interest in this area and examine the counterinfluence of a continuing historical tradition of guild mentality professionalism that routinely places relationships with colleagues ahead of patient safety. Finally, it is proposed that a virtue based ethos of medical professionalism, exhibiting transparency and sincerity with regard to achieving uniform quality and safety of health care, may be facilitated by introducing a technological imperative using portable computing devices. Their use by trainees, focused on ethical competence, provides the practical face of virtue ethics in medical education and practice. Indeed, it assists in transforming the professional conscience of whistleblowing into a practical, virtue based culture of self reporting and personal development. PMID:16199607

[Continuing education in ethics: from clinical ethics to institutional ethics].

PubMed

Brazeau-Lamontagne, Lucie

2012-01-01

The mandate of the Ethics Committee of the Conseil de médecins, dentistes et pharmaciens (CMDP) at the Centre hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke, Quebec is three-fold: to guide the clinical decision; to address the institutional ethical function; to create the program for continuing education in ethics (Formation éthique continue or FEC). Might FEC be the means of bridging from individual ethics to institutional ethics at a hospital? To take the FEC perspectives considered appropriate for doctors and consider them for validation or disproving in the context of those of other professionals. Situate the proposed FEC mandate in a reference framework to evaluate (or triangulate) the clinical decision and the institutional ethic. CONVICTION: Sustainable professional development for doctors (DPD) includes ethics; it cannot be ignored. Without constant attention to upgrading one's abilities in professional ethics, these suffer the same fate as other professional aptitudes and competences (for example, techniques and scientific knowledge): decay.

The Primacy of Pity: Reconceiving Ethical Experience and Education in Rousseau

ERIC Educational Resources Information Center

Bojesen, Emile

2016-01-01

For Rousseau, there are only three things he does not reason away apart from reason itself: self-interest, the good and, at least until Emile, pity. This paper argues that it is Rousseau's original formulation of pity in the Second Discourse that is able to provide the extra-rational conception of ethics that his political and educational…

The effectiveness of ethics education: a quasi-experimental field study.

PubMed

May, Douglas R; Luth, Matthew T

2013-06-01

Ethical conduct is the hallmark of excellence in engineering and scientific research, design, and practice. While undergraduate and graduate programs in these areas routinely emphasize ethical conduct, few receive formal ethics training as part of their curricula. The first purpose of this research study was to assess the relative effectiveness of ethics education in enhancing individuals' general knowledge of the responsible conduct of research practices and their level of moral reasoning. Secondly, we examined the effects of ethics education on the positive psychological outcomes of perspective-taking, moral efficacy, moral courage, and moral meaningfulness. To examine our research hypotheses, we utilized a pretest-posttest quasi-experimental design consisting of three ethics education groups (control, embedded modules, and stand-alone courses). Findings revealed that both embedded and stand alone courses were effective in enhancing participants' perspective-taking, moral efficacy, and moral courage. Moral meaningfulness was marginally enhanced for the embedded module condition. Moral judgment and knowledge of responsible conduct of research practices were not influenced by either ethics education condition. Contrary to expectations, stand alone courses were not superior to embedded modules in influencing the positive psychological outcomes investigated. Implications of these findings for future research and practice are discussed.

Growing an ethics consultation service: A longitudinal study examining two decades of practice.

PubMed

Gorka, Christine; Craig, Jana M; Spielman, Bethany J

2017-01-01

Little is known about what factors may contribute to the growth of a consultation service or how a practice may change or evolve across time. This study examines data collected from a busy ethics consultation service over a period of more than two decades. We report a number of longitudinal findings that represent significant growth in the volume of ethics consultation requests from 19 in 1990 to 551 in 2013, as well as important changes in the patient population for which ethics help is requested. The findings include (1) a steady growth in requests from primary care providers (e.g., physicians and nurses), as well as increases in ancillary services (e.g., social workers); (2) a decrease in length of stay (days) before ethics help is requested; (3) an increase in the reasons that individuals ask for help from ethics; (4) an upsurge in consults requests from areas outside the intensive care unit (ICU); (5) a decrease in patients that died during hospitalization (e.g., live discharges); and (6) growth in the numbers of patients lacking decision-making capacity. We believe the increases in consult requests reflect appropriate and necessary growth because recent consultations have also been associated with consultations requiring (7) additional interventions and (8) reasonably high time intensity scores.

Ethical case deliberation and decision making.

PubMed

Gracia, Diego

2003-01-01

During the last thirty years different methods have been proposed in order to manage and resolve ethical quandaries, specially in the clinical setting. Some of these methodologies are based on the principles of Decision-making theory. Others looked to other philosophical traditions, like Principlism, Hermeneutics, Narrativism, Casuistry, Pragmatism, etc. This paper defends the view that deliberation is the cornerstone of any adequate methodology. This is due to the fact that moral decisions must take into account not only principles and ideas, but also emotions, values and beliefs. Deliberation is the process in which everyone concerned by the decision is considered a valid moral agent, obliged to give reasons for their own points of view, and to listen to the reasons of others. The goal of this process is not the reaching of a consensus but the enrichment of one's own point of view with that of the others, increasing in this way the maturity of one's own decision, in order to make it more wise or prudent. In many cases the members of a group of deliberation will differ in the final solution of the case, but the confrontation of their reasons will modify the perception of the problem of everyone. This is the profit of the process. Our moral decisions cannot be completely rational, due to the fact that they are influenced by feelings, values, beliefs, etc., but they must be reasonable, that is, wise and prudent. Deliberation is the main procedure to reach this goal. It obliges us to take others into account, respecting their different beliefs and values and prompting them to give reasons for their own points of view. This method has been traditional in Western clinical medicine all over its history, and it should be also the main procedure for clinical ethics.

Ethical Orientations for Understanding Business Ethics.

ERIC Educational Resources Information Center

Lewis, Phillip V.; Speck, Henry E., III

1990-01-01

Argues that history provides the necessary framework in which both to discuss and to seek answers to the three necessary and sequential questions about business ethics: (1) What is ethics and what does it mean to be ethical? (2) Why be ethical?; and (3) How can one be ethical? (SG)

A systematic format for resolving ethical issues in clinical periodontics.

PubMed

Schloss, Alexander J

2012-01-01

Ethical dilemmas are becoming increasingly common in dentistry and periodontics. Clinicians, challenged with such dilemmas, may not know how to apply the appropriate moral reasoning needed to resolve these situations especially when any of the five fundamental principles of ethics that form the foundation of the American Dental Association Principles of Ethics and Code of Professional Conduct--patient autonomy, nonmaleficence, beneficence, justice, and veracity--come into conflict with each other. The author describes one clinical case that presented with an ethical dilemma. An analytic framework, used in medicine, is introduced and used to solve the clinical case on whether to proceed with periodontal surgery on a patient who is not aware of his terminal prognosis from metastatic prostate cancer. Upon using the analytic framework, recommendations are made on the ethically appropriate path for the periodontist to follow in providing care for the patient's periodontal problem consistent with the principles of patient autonomy, respect for persons, and veracity.

Strategies for handling ethical problems in end of life care: obstacles and possibilities.

PubMed

Rejnö, Åsa; Berg, Linda

2015-11-01

In end of life care, ethical problems often come to the fore. Little research is performed on ways or strategies for handling those problems and even less on obstacles to and possibilities of using such strategies. A previous study illuminated stroke team members' experiences of ethical problems and how the teams managed the situation when caring for patients faced with sudden and unexpected death from stroke. These findings have been further explored in this study. The aim of the study was to illuminate obstacles and possibilities perceived by stroke team members in using strategies for handling ethical problems when caring for patients afflicted by sudden and unexpected death caused by stroke. A qualitative method with combined deductive and inductive content analysis was utilized. Data were collected through individual interviews with 15 stroke team members working in stroke units of two associated county hospitals in western Sweden. The study was approved by the Regional Ethics Review Board, Gothenburg, Sweden. Permission was also obtained from the director of each stroke unit. All the studied strategies for handling of ethical problems were found to have both obstacles and possibilities. Uncertainty is shown as a major obstacle and unanimity as a possibility in the use of the strategies. The findings also illuminate the value of the concept "the patient's best interests" as a starting point for the carers' ethical reasoning. The concept "the patient's best interests" used as a starting point for ethical reasoning among the carers is not explicitly defined yet, which might make this value difficult to use both as a universal concept and as an argument for decisions. Carers therefore need to strengthen their argumentation and reflect on and use ethically grounded arguments and defined ethical values like dignity in their clinical work and decisions. © The Author(s) 2014.

Ethics committees and the legality of research

PubMed Central

Douglas, T M

2007-01-01

One role of research ethics committees (RECs) is to assess the ethics of proposed health research. In some countries, RECs are also instructed to assess its legality. However, in other countries they are explicitly instructed not to do so. In this paper, I defend the claim that public policy should instruct RECs not to assess the legality of proposed research (“the Claim”). I initially defend a presumption in favour of the Claim, citing reasons for making research institutions solely responsible for assessing the legality of their own research. I then consider three arguments against the Claim which may over‐ride this presumption—namely, that policy should instruct RECs to assess the legality of research because (1) doing so would minimise the costs of assessing the legality of research, (2) whether research is legal may partly determine whether it is ethical and (3) whether research is legal may constitute evidence for whether it is ethical. I reject the first two arguments and note that whether the third succeeds depends on the answer to a more fundamental question about the appropriate nature of REC ethical deliberation. I end with a brief discussion of this question, tentatively concluding that the third argument also fails. PMID:18055906

Pediatricians' Experience with Clinical Ethics Consultation: A National Survey.

PubMed

Morrison, Wynne; Womer, James; Nathanson, Pamela; Kersun, Leslie; Hester, D Micah; Walsh, Corbett; Feudtner, Chris

2015-10-01

To conduct a national survey of pediatricians' access to and experience with clinical ethics consultation. We surveyed a randomly selected sample of 3687 physician members of the American Academy of Pediatrics. We asked about their experiences with ethics consultation, the helpfulness of and barriers to consultation, and ethics education. Using a discrete choice experiment with maximum difference scaling, we evaluated which traits of ethics consultants were most valuable. Of the total sample of 3687 physicians, 659 (18%) responded to the survey. One-third of the respondents had no experience with clinical ethics consultation, and 16% reported no access to consultation. General pediatricians were less likely to have access. The vast majority (90%) who had experience with consultation had found it helpful. Those with fewer years in practice were more likely to have training in ethics. The most frequently reported issues leading to consultation concerned end-of-life care and conflicts with patients/families or among the team. Intensive care unit physicians were more likely to have requested consultation. Mediation skills and ethics knowledge were the most highly valued consultant characteristics, and representing the official position of the hospital was the least-valued characteristic. There is variability in pediatricians' access to ethics consultation. Most respondents reported that consultation had been helpful in the past. Determining ethically appropriate end-of-life care and mediation of disagreements are common reasons that pediatricians request consultation. Copyright © 2015 Elsevier Inc. All rights reserved.

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

PubMed Central

Kluge, Eike-Henner W.

2008-01-01

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

German law on circumcision and its debate: how an ethical and legal issue turned political.

PubMed

Aurenque, Diana; Wiesing, Urban

2015-03-01

The article aims to illuminate the recent debate in Germany about the legitimacy of circumcision for religious reasons. The aim is both to evaluate the new German law allowing religious circumcision, and to outline the resulting conflict between the surrounding ethical and legal issues. We first elucidate the diversity of legal and medical views on religious circumcision in Germany. Next we examine to what extent invasive and irreversible physical interventions on infant boys unable to given their consent should be carried out for non-medical reasons. To this end, the potential benefits and harms of circumcision for non-medical reasons are compared. We argue that circumcision does not provide any benefits for the 'child as a child' and poses only risks to boys. We then set out to clarify and analyse political (rather than ethical) justifications of the new circumcision law. We demonstrate through this analysis how the circumcision debate in Germany has been transformed from a legal and ethical problem into a political issue, due at least in part to Germany's unique historical context. Although such a particular political sensibility is entirely comprehensible, it raises particular problems when it comes to framing and responding to medical ethical issues - as in the case of religious circumcision. © 2013 John Wiley & Sons Ltd.

Ethical analysis of non-medical fetal ultrasound.

PubMed

Leung, John Lai Yin; Pang, Samantha Mei Che

2009-09-01

Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as 'keepsake' ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding ultrasound safety issued by governments and professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed.

[Indication: scientific and ethical basis of medical practice].

PubMed

Neitzke, G

2014-02-01

The medical indication provides a rational foundation for treatment decisions. An indication can be defined as the reasonable professional judgement that a medical procedure is suitable and useful to reach a specific therapeutic goal with a certain probability. An indication includes empirical, causal and purposive considerations and justifications, and a scrutiny of the individual case. This ensures that medical aspects of the patient, therapeutic goals and evidence-based knowledge are integrated and represented in the indication. An indication justifies a treatment proposal to the patient, which may only be carried out after a procedure of informed consent. Indications can be considered as the ethical basis of treatment decisions and as the heart of professionalism: indications should be used as a professional tool to protect against irrational therapeutic expectations, while ensuring the patient's right for reasonable treatment. In health care that is increasingly shaped by economic constraints, conscientious indications ensure the professional and ethical basis of medical treatment decisions.

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.

Awareness and Ethical Orientation of Alternatively Certified Prospective Teachers to Intention for Whistle Blowing

ERIC Educational Resources Information Center

Toker Gokce, Asiye

2013-01-01

This study inquires whistle blowing intentions of alternatively certified prospective teachers, investigating their moral reasoning to blow the whistle. Specifically three hypotheses were tested: Overall ethical awareness of the alternatively certified prospective teachers is high; the participants will identify reasons related to philosophical…

"How Obvious": Personal Reflections on the Database of Educational Psychology and Effective Teaching Research

ERIC Educational Resources Information Center

Yates, Gregory C. R.

2005-01-01

From a personal perspective, the author reflects upon the notion that many research findings appear falsely to possess the quality of being "obvious". Specific attention is given to the topic of teacher effectiveness. The feeling that findings are obvious can be related to the following: the false consensus effect, selfserving cognition, hindsight…

Ethical issues in gastroenterology research.

PubMed

Eastwood, Gregory L

2015-03-01

Ethical issues have become increasingly important in gastroenterology research. This is for several reasons, including (i) an understanding of how conflicts of interest might affect research, (ii) the influence of the drug and device industries on research, (iii) ghostwriting (taking credit for something you did not write), (iv) the occurrence of ethically inappropriate research and scientific misconduct, and (v) respect for the rights of research subjects. These include the rights (i) to give informed consent to participate after understanding the purposes, risks, and benefits of the research; (ii) to ask questions; and (iii) to withdraw from participation at any time. Notions of doing good (beneficence), avoiding harm (non-maleficence), confidentiality, and, most important, the primacy of the welfare of the patient or research subject can be traced to antiquity. In the modern era, the Nuremburg Code (1947), the Declaration of Helsinki (1964), the Belmont report (1979), and other events and reports have led to the refinement of ethical practices in both clinical and research domains, have reinforced those long observed principles, and have given rise to the newer principles of autonomy and justice. The ethical conduct of research not only promotes good research but also is in the best interests of research subjects, investigators, sponsors, patients, and the public. © 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Why Are There So Few Ethics Consults in Children's Hospitals?

PubMed

Carter, Brian; Brockman, Manuel; Garrett, Jeremy; Knackstedt, Angie; Lantos, John

2018-06-01

In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children's hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are (1) ethics committee meetings, (2) Nursing Ethics Forum, (3) ethics Brown Bag workshops, (4) PICU ethics rounds, (5) Grand Rounds, (6) NICU Comprehensive Care Rounds, (7) Palliative Care Team (PaCT) case conferences, (8) multidisciplinary consults in Fetal Health Center, and (9) ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of "core competencies" than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple "moral spaces" in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set

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

Relationship between ethical ideology and moral judgment: Academic nurse educators' perception.

PubMed

Abou Hashish, Ebtsam Aly; Ali Awad, Nadia Hassan

2017-01-01

Ascertaining the relationship between ethical ideology, moral judgment, and ethical decision among academic nurse educators at work appears to be a challenge particularly in situations when they are faced with a need to solve an ethical problem and make a moral decision. This study aims to investigate the relationship between ethical ideology, moral judgment, and ethical decision as perceived by academic nurse educators. A descriptive correlational research design was conducted at Faculty of Nursing, Alexandria University. All academic nurse educators were included in the study (N = 220). Ethical Position Questionnaire and Questionnaire of Moral Judgment and Ethical Decisions were proved reliable to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects' informed consent. This study reveals a significant positive moderate correlation between idealism construct of ethical ideology and moral judgment in terms of recognition of the behavior as an ethical issue and the magnitude of emotional consequences of the ethical situation (p < 0.001; p = 0.031) respectively. Also, there is a positive significant moderate correlation between relativism construct of ethical ideology and overall moral judgment (p = 0.010). Approximately 3.5% of the explained variance of overall moral judgment is predicted by idealism together with relativism. The findings suggest that variations in ethical position and ideology are associated with moral judgment and ethical decision. Organizations of academic nursing education should provide a supportive work environment to help their academic staff to develop their self-awareness and knowledge of their ethical position and promoting their ethical ideologies and, in turn, enhance their moral judgment as well as develop ethical reasoning and decision-making capability of nursing

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

PubMed

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

2010-03-01

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

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

PubMed Central

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

2015-01-01

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

A Qualitative Analysis of Power Differentials in Ethical Situations in Academia

PubMed Central

Gibson, Carter; Medeiros, Kelsey E.; Giorgini, Vincent; Mecca, Jensen T.; Devenport, Lynn D.; Connelly, Shane; Mumford, Michael D.

2014-01-01

Power and organizational hierarchies are ubiquitous to social institutions that form the foundation of modern society. Power differentials may act to constrain or enhance people's ability to make good ethical decisions. However, little scholarly work has examined perceptions of this important topic. The present effort seeks to address this issue by interviewing academics about hypothetical ethical problems that involve power differences among those involved. Academics discussed what they would do in these scenarios, often drawing on their own experiences. Using a think-aloud protocol, participants were prompted to discuss their reasoning and thinking behind their ethical decisions. These interview data were content analyzed using a semantic analysis program that identified a number of distinct ways that academics think about power differences and abuses in ethical situations. Implications of these findings are discussed. PMID:25356066

Ethical issues regarding human cloning: a nursing perspective.

PubMed

Dinç, Leyla

2003-05-01

Advances in cloning technology and successful cloning experiments in animals raised concerns about the possibility of human cloning in recent years. Despite many objections, this is not only a possibility but also a reality. Human cloning is a scientific revolution. However, it also introduces the potential for physical and psychosocial harm to human beings. From this point of view, it raises profound ethical, social and health related concerns. Human cloning would have an impact on the practice of nursing because it could result in the creation of new physiological and psychosocial conditions that would require nursing care. The nursing profession must therefore evaluate the ethics of human cloning, in particular the potential role of nurses. This article reviews the ethical considerations of reproductive human cloning, discusses the main reasons for concern, and reflects a nursing perspective regarding this issue.

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

PubMed

Lundy, Courtnee

2006-01-01

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

Against Strong Ethical Parity: Situated Cognition Theses and Transcranial Brain Stimulation.

PubMed

Heinrichs, Jan-Hendrik

2017-01-01

According to a prominent suggestion in the ethics of transcranial neurostimulation the effects of such devices can be treated as ethically on par with established, pre-neurotechnological alterations of the mind. This parity allegedly is supported by situated cognition theories showing how external devices can be part of a cognitive system. This article will evaluate this suggestion. It will reject the claim, that situated cognition theories support ethical parity. It will however point out another reason, why external carriers or modifications of the mental might come to be considered ethically on par with internal carriers. Section "Why Could There Be Ethical Parity between Neural Tissue and External Tools?" presents the ethical parity theses between external and internal carriers of the mind as well as neurotechnological alterations and established alterations. Section "Extended, Embodied, Embedded: Situated Cognition as a Relational Thesis" will elaborate the different situated cognition approaches and their relevance for ethics. It will evaluate, whether transcranial stimulation technologies are plausible candidates for situated cognition theses. Section "On the Ethical Relevance of Situated Cognition Theses" will discuss criteria for evaluating whether a cognitive tool is deeply embedded with a cognitive system and apply these criteria to transcranial brain stimulation technologies. Finally it will discuss the role diverse versions of situated cognition theory can play in the ethics of altering mental states, especially the ethics of transcranial brain stimulation technologies.

Business ethics in ethics committees?

PubMed

Boyle, P

1990-01-01

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

Psychoanalysis and analytic psychotherapy in the NHS--a problem for medical ethics.

PubMed Central

Wilkinson, G

1986-01-01

I question the place of psychoanalysis and psychoanalytically oriented psychotherapy in the National Health Service (NHS), with reference to published material; and, particularly, in relation to primary care, health economics and medical ethics. I argue that there are pressing clinical, research, economic, and ethical reasons in support of the contention that an urgent review of the extent and impact of psychoanalytic practices in the health service is called for. PMID:3735363

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.

Medical Students' Development of Ethical Judgment - Exploring the Learners' Perspectives using a mixed methods approach.

PubMed

Langer, Thorsten; Jazmati, Danny; Jung, Ole; Schulz, Christian; Schnell, Martin W

2016-01-01

Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students' perspectives on their development in ethical judgment has received less attention. Better insights in the learners' experiences can help to improve educational interventions in medical ethics. Methods: A vignette featuring a challenging case with opposing views between a patient's parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5). The questionnaire included closed and open-ended questions addressing the participant's preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28%) over the study period. Participants' responses changed overtime. Accepting parents' autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%). On the contrary, not readily following the parents' decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%). Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor). Conclusions: Over the course of their medical training, the

Reasons Why Post-Trial Access to Trial Drugs Should, or Need not be Ensured to Research Participants: A Systematic Review

PubMed Central

Sofaer, Neema; Strech, Daniel

2011-01-01

Background: researchers and sponsors increasingly confront the issue of whether participants in a clinical trial should have post-trial access (PTA) to the trial drug. Legislation and guidelines are inconsistent, ambiguous or silent about many aspects of PTA. Recent research highlights the potential importance of systematic reviews (SRs) of reason-based literatures in informing decision-making in medicine, medical research and health policy. Purpose: to systematically review reasons why drug trial participants should, or need not be ensured PTA to the trial drug and the uses of such reasons. Data sources: databases in science/medicine, law and ethics, thesis databases, bibliographies, research ethics books and included publications’ notes/bibliographies. Publication selection: a publication was included if it included a reason as above. See article for detailed inclusion conditions. Data extraction and analysis: two reviewers extracted and analyzed data on publications and reasons. Results: of 2060 publications identified, 75 were included. These mentioned reasons based on morality, legality, interests/incentives, or practicality, comprising 36 broad (235 narrow) types of reason. None of the included publications, which included informal reviews and reports by official bodies, mentioned more than 22 broad (59 narrow) types. For many reasons, publications differed about the reason’s interpretation, implications and/or persuasiveness. Publications differed also regarding costs, feasibility and legality of PTA. Limitations: reason types could be applied differently. The quality of reasons was not measured. Conclusion: this review captured a greater variety of reasons and of their uses than any included publication. Decisions based on informal reviews or sub-sets of literature are likely to be biased. Research is needed on PTA ethics, costs, feasibility and legality and on assessing the quality of reason-based literature. PMID:21754950

Differences between health and ethical vegetarians. Strength of conviction, nutrition knowledge, dietary restriction, and duration of adherence.

PubMed

Hoffman, Sarah R; Stallings, Sarah F; Bessinger, Raymond C; Brooks, Gary T

2013-06-01

Little research has been published concerning the differences between health oriented and ethically oriented vegetarians. The present study compared differences in conviction, nutrition knowledge, dietary restriction, and duration of adherence to vegetarianism between the two groups. Subjects completed an online survey and were grouped by original reason for becoming vegetarian (n=292, 58 health, 234 ethical), and current reason for remaining vegetarian (n=281, 49 health, 232 ethical). Whether grouped by current or original motivation, ethical vegetarians scored higher on the conviction instrument than health vegetarians and exhibited somewhat greater dietary restriction (significant when grouped by current motivation) and had been vegetarian for longer (significant when grouped by original motivation). Nutrition knowledge did not differ between the two groups. The results suggest that ethical vegetarians could experience stronger feelings of conviction and consume fewer animal products than health vegetarians, and may remain vegetarian longer. More research is necessary to understand how vegetarians' eating behaviors are influenced by their motivational profiles. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Responsibility of Colleges and Universities for Building Ethical and Moral Character in Their Students.

ERIC Educational Resources Information Center

Perlman, Daniel H.

The role of the college or university in facilitating the ethical and moral development of college students is addressed. The views of Kohlberg, Perry, and others who have studied ethical and moral development are briefly reviewed. These psychologists suggest that there is a hierarchy or continuum for the development of moral reasoning. Colleges…

Practical virtue ethics: healthcare whistleblowing and portable digital technology.

PubMed

Bolsin, S; Faunce, T; Oakley, J

2005-10-01

Medical school curricula and postgraduate education programmes expend considerable resources teaching medical ethics. Simultaneously, whistleblowers' agitation continues, at great personal cost, to prompt major intrainstitutional and public inquiries that reveal problems with the application of medical ethics at particular clinical "coalfaces". Virtue ethics, emphasising techniques promoting an agent's character and instructing their conscience, has become a significant mode of discourse in modern medical ethics. Healthcare whistleblowers, whose complaints are reasonable, made in good faith, in the public interest, and not vexatious, we argue, are practising those obligations of professional conscience foundational to virtue based medical ethics. Yet, little extant virtue ethics scholarship seriously considers the theoretical foundations of healthcare whistleblowing. The authors examine whether healthcare whistleblowing should be considered central to any medical ethics emphasising professional virtues and conscience. They consider possible causes for the paucity of professional or academic interest in this area and examine the counterinfluence of a continuing historical tradition of guild mentality professionalism that routinely places relationships with colleagues ahead of patient safety.Finally, it is proposed that a virtue based ethos of medical professionalism, exhibiting transparency and sincerity with regard to achieving uniform quality and safety of health care, may be facilitated by introducing a technological imperative using portable computing devices. Their use by trainees, focused on ethical competence, provides the practical face of virtue ethics in medical education and practice. Indeed, it assists in transforming the professional conscience of whistleblowing into a practical, virtue based culture of self reporting and personal development.

Improving Ethical Attitudes or Simply Teaching Ethical Codes? The Reality of Accounting Ethics Education

ERIC Educational Resources Information Center

Cameron, Robyn Ann; O'Leary, Conor

2015-01-01

Ethical instruction is critical in accounting education. However, does accounting ethics teaching actually instil core ethical values or simply catalogue how students should act when confronted with typical accounting ethical dilemmas? This study extends current literature by distinguishing between moral/ethical and legal/ethical matters and then…

Ethical Design of Intelligent Assistive Technologies for Dementia: A Descriptive Review.

PubMed

Ienca, Marcello; Wangmo, Tenzin; Jotterand, Fabrice; Kressig, Reto W; Elger, Bernice

2017-09-22

The use of Intelligent Assistive Technology (IAT) in dementia care opens the prospects of reducing the global burden of dementia and enabling novel opportunities to improve the lives of dementia patients. However, with current adoption rates being reportedly low, the potential of IATs might remain under-expressed as long as the reasons for suboptimal adoption remain unaddressed. Among these, ethical and social considerations are critical. This article reviews the spectrum of IATs for dementia and investigates the prevalence of ethical considerations in the design of current IATs. Our screening shows that a significant portion of current IATs is designed in the absence of explicit ethical considerations. These results suggest that the lack of ethical consideration might be a codeterminant of current structural limitations in the translation of IATs from designing labs to bedside. Based on these data, we call for a coordinated effort to proactively incorporate ethical considerations early in the design and development of new products.

Rethinking maternal-fetal conflict: gender and equality in perinatal ethics.

PubMed

Harris, L H

2000-11-01

Practitioners who care for pregnant women face dilemmas when their patients use illicit drugs, reject medical recommendations, or cause fetal harm. Many ethics scholars characterize those situations as maternal-fetal conflicts. In conflict-based models, maternal rights are considered to conflict with fetal rights, or moral obligations owed to pregnant women are considered to conflict with those owed to their fetuses. I offer an alternative model of pregnancy ethics by applying relational and equality-based moral theories to situations of fetal harm by pregnant women. In this model, clinicians faced with ethical dilemmas should attempt to understand pregnant women and their decisions within their broad social networks and communities, ask how the clinician's personal standpoint influences outcomes judged to be ethical, and determine whether the clinician's ethical formulations reduce or enhance existing gender, class, or racial inequality. This model focuses on the mutual needs of pregnant women and fetuses rather than on their mutually exclusive needs. It also avoids many pitfalls of traditional ethical formulations, specifically their tendency to neglect gender-specific modes of moral reasoning, their implicit assumptions that application of universal principles like autonomy and beneficence results in objective ethical solutions, and their failure to account for the ways that projecting fetal needs perpetuates social inequalities. This model provides the ethical foundations for moving law and policy away from criminalization and toward prevention of prenatal harm.

Ethics rounds: An appreciated form of ethics support.

PubMed

Silén, Marit; Ramklint, Mia; Hansson, Mats G; Haglund, Kristina

2016-03-01

Ethics rounds are one way to support healthcare personnel in handling ethically difficult situations. A previous study in the present project showed that ethics rounds did not result in significant changes in perceptions of how ethical issues were handled, that is, in the ethical climate. However, there was anecdotal evidence that the ethics rounds were viewed as a positive experience and that they stimulated ethical reflection. The aim of this study was to gain a deeper understanding of how the ethics rounds were experienced and why the intervention in the form of ethics rounds did not succeed in improving the ethical climate for the staff. An exploratory and descriptive design with a qualitative approach was adopted, using individual interviews. A total of 11 healthcare personnel, working in two different psychiatry outpatient clinics and with experience of participating in ethics rounds, were interviewed. The study was based on informed consent and was approved by one of the Swedish Regional Ethical Review Boards. The participants were generally positive about the ethics rounds. They had experienced changes by participating in the ethics rounds in the form of being able to see things from different perspectives as well as by gaining insight into ethical issues. However, these changes had not affected daily work. A crucial question is whether or not increased reflection ability among the participants is a good enough outcome of ethics rounds and whether this result could have been measured in patient-related outcomes. Ethics rounds might foster cooperation among the staff and this, in turn, could influence patient care. By listening to others during ethics rounds, a person can learn to see things from a new angle. Participation in ethics rounds can also lead to better insight concerning ethical issues. © The Author(s) 2014.

Application of a Sensemaking Approach to Ethics Training in the Physical Sciences and Engineering

NASA Astrophysics Data System (ADS)

Kligyte, Vykinta; Marcy, Richard T.; Waples, Ethan P.; Sevier, Sydney T.; Godfrey, Elaine S.; Mumford, Michael D.; Hougen, Dean F.

2008-06-01

Integrity is a critical determinant of the effectiveness of research organizations in terms of producing high quality research and educating the new generation of scientists. A number of responsible conduct of research (RCR) training programs have been developed to address this growing organizational concern. However, in spite of a significant body of research in ethics training, it is still unknown which approach has the highest potential to enhance researchers' integrity. One of the approaches showing some promise in improving researchers' integrity has focused on the development of ethical decision-making skills. The current effort proposes a novel curriculum that focuses on broad metacognitive reasoning strategies researchers use when making sense of day-to-day social and professional practices that have ethical implications for the physical sciences and engineering. This sensemaking training has been implemented in a professional sample of scientists conducting research in electrical engineering, atmospheric and computer sciences at a large multi-cultural, multi-disciplinary, and multi-university research center. A pre-post design was used to assess training effectiveness using scenario-based ethical decision-making measures. The training resulted in enhanced ethical decision-making of researchers in relation to four ethical conduct areas, namely data management, study conduct, professional practices, and business practices. In addition, sensemaking training led to researchers' preference for decisions involving the application of the broad metacognitive reasoning strategies. Individual trainee and training characteristics were used to explain the study findings. Broad implications of the findings for ethics training development, implementation, and evaluation in the sciences are discussed.

Application of a sensemaking approach to ethics training in the physical sciences and engineering.

PubMed

Kligyte, Vykinta; Marcy, Richard T; Waples, Ethan P; Sevier, Sydney T; Godfrey, Elaine S; Mumford, Michael D; Hougen, Dean F

2008-06-01

Integrity is a critical determinant of the effectiveness of research organizations in terms of producing high quality research and educating the new generation of scientists. A number of responsible conduct of research (RCR) training programs have been developed to address this growing organizational concern. However, in spite of a significant body of research in ethics training, it is still unknown which approach has the highest potential to enhance researchers' integrity. One of the approaches showing some promise in improving researchers' integrity has focused on the development of ethical decision-making skills. The current effort proposes a novel curriculum that focuses on broad metacognitive reasoning strategies researchers use when making sense of day-to-day social and professional practices that have ethical implications for the physical sciences and engineering. This sensemaking training has been implemented in a professional sample of scientists conducting research in electrical engineering, atmospheric and computer sciences at a large multi-cultural, multi-disciplinary, and multi-university research center. A pre-post design was used to assess training effectiveness using scenario-based ethical decision-making measures. The training resulted in enhanced ethical decision-making of researchers in relation to four ethical conduct areas, namely data management, study conduct, professional practices, and business practices. In addition, sensemaking training led to researchers' preference for decisions involving the application of the broad metacognitive reasoning strategies. Individual trainee and training characteristics were used to explain the study findings. Broad implications of the findings for ethics training development, implementation, and evaluation in the sciences are discussed.

Consent, ethics and genetic biobanks: the case of the Athlome project.

PubMed

Thompson, Rachel; McNamee, Michael J

2017-11-14

This article provides a critical overview of the ethics and governance of genetic biobank research, using the Athlome Consortium as a large scale instance of collaborative sports genetic biobanking. We present a traditional model of written informed consent for the acquisition, storage, sharing and analysis of genetic data and articulate the challenges to it from new research practices such as genetic biobanking. We then articulate six possible alternative consent models: verbal consent, blanket consent, broad consent, meta consent, dynamic consent and waived consent. We argue that these models or conceptions of consent must be articulated in the context of the complexities of international legislation and non legislative national and international biobank governance frameworks and policies, those which govern research in the field of sports genetics. We discuss the tensions between individual rights and public benefits of genomic research as a critical ethical issue, particularly where benefits are less obvious, as in sports genomics. The inherent complexities of international regulation and biobanking governance are challenging in a relatively young field. We argue that there is much nuanced ethical work still to be done with regard to governance of sports genetic biobanking and the issues contained therein.

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

PubMed

Small, Bruce H; Fisher, Mark W

2005-01-01

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

On the lingua franca of clinical ethics.

PubMed

Fins, Joseph J

2013-01-01

In this 25-year retrospective on the state of clinical ethics, and the anniversary of the founding of The Journal of Clinical Ethics, the author comments on the state of the field. He argues that the language of bioethics, as used in practice, seems dated and out of touch with a clinical reality marked by emerging technologies and the advent of new fields like palliative medicine. Reflecting on his experiences as a clinician and clinical ethicist, the author worries about the emergence of a shallow bioethics, which is the product of a lingua franca. This linguistic amalgam is a weak composite in which concepts are simplified and nuance is overlooked, leading to interpretative errors. The best of ethical reasoning or clinical decision making can be lost in translation. Instead of the well-worn arguments over the relative worth of modes of ethical analysis, like principlism or pragmatism, the author argues that the emphasis should be on the cultivation of the "linguistic" skills necessary for translating any critical method in order to replace the lingua franca of clinical ethics with a more substantial discourse worthy of the complexity of the clinic.Through the emergence of such a shared language, at the interface of the sciences and the humanities, this multidisciplinary field can evolve towards more authentic interdisciplinarity.

Factors influencing the effectiveness of research ethics committees.

PubMed

Schuppli, C A; Fraser, D

2007-05-01

Research ethics committees - animal ethics committees (AECs) for animal-based research and institutional research boards (IRBs) for human subjects - have a key role in research governance, but there has been little study of the factors influencing their effectiveness. The objectives of this study were to examine how the effectiveness of a research ethics committee is influenced by committee composition and dynamics, recruitment of members, workload, participation level and member turnover. As a model, 28 members of AECs at four universities in western Canada were interviewed. Committees were selected to represent variation in the number and type of protocols reviewed, and participants were selected to include different types of committee members. We found that a bias towards institutional or scientific interests may result from (1) a preponderance of institutional and scientist members, (2) an intimidating atmosphere for community members and other minority members, (3) recruitment of community members who are affiliated with the institution and (4) members joining for reasons other than to fulfil the committee mandate. Thoroughness of protocol review may be influenced by heavy workloads, type of review process and lack of full committee participation. These results, together with results from the literature on research ethics committees, suggested potential ways to improve the effectiveness of research ethics committees.

Nurses' contributions to the resolution of ethical dilemmas in practice.

PubMed

Barlow, Nichola Ann; Hargreaves, Janet; Gillibrand, Warren P

2018-03-01

Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification. Participants and context: Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis. Ethical considerations: Ethical approval was obtained from the local National Research Ethics Committee. Four major themes emerged: 'best for the patient', 'accountability', 'collaboration and conflict' and 'concern for others'. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas. Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing

State and local law enforcement agency efforts to prevent sales to obviously intoxicated patrons

PubMed Central

Lenk, Kathleen M.; Toomey, Traci L.; Nelson, Toben F.; Jones-Webb, Rhonda; Erickson, Darin J.

2013-01-01

Alcohol sales to intoxicated patrons are illegal and may lead to public health issues such as traffic crashes and violence. Over the past several decades, considerable effort has been made to reduce alcohol sales to underage persons but less attention has been given to the issue of sales to obviously intoxicated patrons. Studies have found a high likelihood of sales to obviously intoxicated patrons (i.e., overservice), but little is known about efforts by enforcement agencies to reduce these sales. We conducted a survey of statewide alcohol enforcement agencies and local law enforcement agencies across the U.S. to assess their strategies for enforcing laws prohibiting alcohol sales to intoxicated patrons at licensed alcohol establishments. We randomly sampled 1,631 local agencies (1082 participated), and surveyed all 49 statewide agencies that conduct alcohol enforcement. Sales to obviously intoxicated patrons were reported to be somewhat or very common in their jurisdiction by 55% of local agencies and 90% of state agencies. Twenty percent of local and 60% of state agencies reported conducting enforcement efforts to reduce sales to obviously intoxicated patrons in the past year. Among these agencies, fewer than half used specific enforcement strategies on at least a monthly basis to prevent overservice of alcohol. Among local agencies, enforcement efforts were more common among agencies that had a full-time officer specifically assigned to carry out alcohol enforcement efforts. Enforcement of laws prohibiting alcohol sales to obviously intoxicated patrons is an underutilized strategy to reduce alcohol-related problems, especially among local law enforcement agencies. PMID:24068596

State and local law enforcement agency efforts to prevent sales to obviously intoxicated patrons.

PubMed

Lenk, Kathleen M; Toomey, Traci L; Nelson, Toben F; Jones-Webb, Rhonda; Erickson, Darin J

2014-04-01

Alcohol sales to intoxicated patrons are illegal and may lead to public health issues such as traffic crashes and violence. Over the past several decades, considerable effort has been made to reduce alcohol sales to underage persons but less attention has been given to the issue of sales to obviously intoxicated patrons. Studies have found a high likelihood of sales to obviously intoxicated patrons (i.e., overservice), but little is known about efforts by enforcement agencies to reduce these sales. We conducted a survey of statewide alcohol enforcement agencies and local law enforcement agencies across the US to assess their strategies for enforcing laws prohibiting alcohol sales to intoxicated patrons at licensed alcohol establishments. We randomly sampled 1,631 local agencies (1,082 participated), and surveyed all 49 statewide agencies that conduct alcohol enforcement. Sales to obviously intoxicated patrons were reported to be somewhat or very common in their jurisdiction by 55 % of local agencies and 90 % of state agencies. Twenty percent of local and 60 % of state agencies reported conducting enforcement efforts to reduce sales to obviously intoxicated patrons in the past year. Among these agencies, fewer than half used specific enforcement strategies on at least a monthly basis to prevent overservice of alcohol. Among local agencies, enforcement efforts were more common among agencies that had a full-time officer specifically assigned to carry out alcohol enforcement efforts. Enforcement of laws prohibiting alcohol sales to obviously intoxicated patrons is an underutilized strategy to reduce alcohol-related problems, especially among local law enforcement agencies.

Mechanisms Linking Ethical Leadership to Ethical Sales Behavior.

PubMed

Wu, Yu-Chi

2017-06-01

This study investigated the relationship between ethical leadership and ethical sales behavior. A total of 248 matched surveys with participant responses from insurance agents and their customers were collected. The insurance agents were asked to rate the ethical leadership of their leaders, the ethical climate in their organization, and their individual moral identity. Customers were asked to rate the perceived ethical sales behavior of the insurance agents. This empirical study utilized moderated mediation techniques to analyze the data. Results indicated that ethical climate mediated the relationship between ethical leadership and ethical sales behavior when moral identity was high, however, did not when moral identity was low. The research framework including contextual effects (i.e., ethical climate) and individual differences in moral judgment (i.e., moral identity) can provide a comprehensive picture of how ethical leadership influences ethical sales behavior. Theoretical and practical implications of these findings are also discussed.

Mental disorder ethics: theory and empirical investigation

PubMed Central

Eastman, N; Starling, B

2006-01-01

Mental disorders and their care present unusual problems within biomedical ethics. The disorders themselves invite an ethical critique, as does society's attitude to them; researching the diagnosis and treatment of mental disorders also presents special ethical issues. The current high profile of mental disorder ethics, emphasised by recent political and legal developments, makes this a field of research that is not only important but also highly topical. For these reasons, the Wellcome Trust's biomedical ethics programme convened a meeting, “Investigating Ethics and Mental Disorders”, in order to review some current research, and to stimulate topics and methods of future research in the field. The meeting was attended by policy makers, regulators, research funders, and researchers, including social scientists, psychiatrists, psychologists, lawyers, philosophers, criminologists, and others. As well as aiming to inspire a stronger research endeavour, the meeting also sought to stimulate an improved understanding of the methods and interactions that can contribute to “empirical ethics” generally. This paper reports on the meeting by describing contributions from individual speakers and discussion sections of the meeting. At the end we describe and discuss the conclusions of the meeting. As a result, the text is referenced less than would normally be expected in a review. Also, in summarising contributions from named presenters at the meeting it is possible that we have created inaccuracies; however, the definitive version of each paper, as provided directly by the presenter, is available at http://www.wellcome.ac.uk/doc.WTX025116.html. PMID:16446414

An experiential, game-theoretic pedagogy for sustainability ethics.

PubMed

Sadowski, Jathan; Seager, Thomas P; Selinger, Evan; Spierre, Susan G; Whyte, Kyle P

2013-09-01

The wicked problems that constitute sustainability require students to learn a different set of ethical skills than is ordinarily required by professional ethics. The focus for sustainability ethics must be redirected towards: (1) reasoning rather than rules, and (2) groups rather than individuals. This need for a different skill set presents several pedagogical challenges to traditional programs of ethics education that emphasize abstraction and reflection at the expense of experimentation and experience. This paper describes a novel pedagogy of sustainability ethics that is based on noncooperative, game-theoretic problems that cause students to confront two salient questions: "What are my obligations to others?" and "What am I willing to risk in my own well-being to meet those obligations?" In comparison to traditional professional ethics education, the game-based pedagogy moves the learning experience from: passive to active, apathetic to emotionally invested, narratively closed to experimentally open, and from predictable to surprising. In the context of game play, where players must make decisions that can adversely impact classmates, students typically discover a significant gap between their moral aspirations and their moral actions. When the games are delivered sequentially as part of a full course in Sustainability Ethics, students may experience a moral identity crisis as they reflect upon the incongruity of their self-understanding and their behavior. Repeated play allows students to reconcile this discrepancy through group deliberation that coordinates individual decisions to achieve collective outcomes. It is our experience that students gradually progress through increased levels of group tacit knowledge as they encounter increasingly complex game situations.

A psychoanalytic approach to ethics.

PubMed

Breen, H J

1986-04-01

The paper addresses some of the problems of the relationship between ethics and psychology. Philosophical assumptions which are considered are shown to bear directly on the source of the conviction that one ought to behave in some particular way. The choice of an "empirical" ethic, i.e., an epistomology which rests on psychology, is perceived to be a confusing pseudo-scientific error, which has developed in response to increasing guilt. Guilt is seen to play a central role in the evolution of the superego and the self, considered from both an ontological and and phylogenetic basis. These problems, first presented in Civilization and Its Discontents (Freud, 1930), are considered from the standpoint of what is known about normal superego development, the influence of social and historical forces on such development, and pathological superego development. The Kantian assumption of a transcendent moral authority is shown to be related to the earliest symbiotic unity of mother and child, in the context of the first internalized constraints on the aggressive and libidinal drives. The burden of such constraints is seen to be guilt, increasingly less tolerable through the interaction of social, historical, and psychological influences. The response to this guilt is a major influence in the denial of a transcendent moral authority, and the shift toward fewer constraints on the drives. The more obvious social and political consequences are considered.

Medical Students’ Development of Ethical Judgment – Exploring the Learners’ Perspectives using a mixed methods approach

PubMed Central

Langer, Thorsten; Jazmati, Danny; Jung, Ole; Schulz, Christian; Schnell, Martin W.

2016-01-01

Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students’ perspectives on their development in ethical judgment has received less attention. Better insights in the learners’ experiences can help to improve educational interventions in medical ethics. Methods: A vignette featuring a challenging case with opposing views between a patient’s parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5). The questionnaire included closed and open-ended questions addressing the participant’s preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28%) over the study period. Participants’ responses changed overtime. Accepting parents’ autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%). On the contrary, not readily following the parents’ decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%). Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor). Conclusions: Over the course of their medical

Against Strong Ethical Parity: Situated Cognition Theses and Transcranial Brain Stimulation

PubMed Central

Heinrichs, Jan-Hendrik

2017-01-01

According to a prominent suggestion in the ethics of transcranial neurostimulation the effects of such devices can be treated as ethically on par with established, pre-neurotechnological alterations of the mind. This parity allegedly is supported by situated cognition theories showing how external devices can be part of a cognitive system. This article will evaluate this suggestion. It will reject the claim, that situated cognition theories support ethical parity. It will however point out another reason, why external carriers or modifications of the mental might come to be considered ethically on par with internal carriers. Section “Why Could There Be Ethical Parity between Neural Tissue and External Tools?” presents the ethical parity theses between external and internal carriers of the mind as well as neurotechnological alterations and established alterations. Section “Extended, Embodied, Embedded: Situated Cognition as a Relational Thesis” will elaborate the different situated cognition approaches and their relevance for ethics. It will evaluate, whether transcranial stimulation technologies are plausible candidates for situated cognition theses. Section “On the Ethical Relevance of Situated Cognition Theses” will discuss criteria for evaluating whether a cognitive tool is deeply embedded with a cognitive system and apply these criteria to transcranial brain stimulation technologies. Finally it will discuss the role diverse versions of situated cognition theory can play in the ethics of altering mental states, especially the ethics of transcranial brain stimulation technologies. PMID:28443008

Research ethics III: Publication practices and authorship, conflicts of interest, and research misconduct.

PubMed

Horner, Jennifer; Minifie, Fred D

2011-02-01

In this series of articles--Research Ethics I, Research Ethics II, and Research Ethics III--the authors provide a comprehensive review of the 9 core domains for the responsible conduct of research (RCR) as articulated by the Office of Research Integrity. In Research Ethics III, they review the RCR domains of publication practices and authorship, conflicts of interest, and research misconduct. Whereas the legal definition of research misconduct under federal law pertains mainly to intentional falsification, fabrication, and plagiarism, they discuss a host of research practices that raise ethical concerns. The integrity of the scientific record--its accuracy, completeness, and value--ultimately impacts the health and well-being of society. For this reason, scientists are both entrusted and obligated to use the highest standards possible when proposing, performing, reviewing, and reporting research or when educating and mentoring new investigators.

Professional Ethics of Software Engineers: An Ethical Framework.

PubMed

Lurie, Yotam; Mark, Shlomo

2016-04-01

The purpose of this article is to propose an ethical framework for software engineers that connects software developers' ethical responsibilities directly to their professional standards. The implementation of such an ethical framework can overcome the traditional dichotomy between professional skills and ethical skills, which plagues the engineering professions, by proposing an approach to the fundamental tasks of the practitioner, i.e., software development, in which the professional standards are intrinsically connected to the ethical responsibilities. In so doing, the ethical framework improves the practitioner's professionalism and ethics. We call this approach Ethical-Driven Software Development (EDSD), as an approach to software development. EDSD manifests the advantages of an ethical framework as an alternative to the all too familiar approach in professional ethics that advocates "stand-alone codes of ethics". We believe that one outcome of this synergy between professional and ethical skills is simply better engineers. Moreover, since there are often different software solutions, which the engineer can provide to an issue at stake, the ethical framework provides a guiding principle, within the process of software development, that helps the engineer evaluate the advantages and disadvantages of different software solutions. It does not and cannot affect the end-product in and of-itself. However, it can and should, make the software engineer more conscious and aware of the ethical ramifications of certain engineering decisions within the process.

Ethics and infectious disease.

PubMed

Selgelid, Michael J

2005-06-01

Bioethics apparently suffers from a misdistribution of research resources analogous to the '10/90' divide in medical research. Though infectious disease should be recognized as a topic of primary importance for bioethics, the general topic of infectious disease has received relatively little attention from the discipline of bioethics in comparison with things like abortion, euthanasia, genetics, cloning, stem cell research, and so on. The fact that the historical and potential future consequences of infectious diseases are almost unrivalled is one reason that the topic of infectious disease warrants more attention from bioethicists. The 'Black Death' eliminated one third of the European population during the 14th Century; the 1989 flu killed between 20 and 100 million people; and, in the 20th Century smallpox killed perhaps three times more people than all the wars of that period. In the contemporary world, epidemics (AIDS, multi-drug resistant turberculosis, and newly emerging infectious diseases such as SARS) continue to have dramatic consequences. A second reason why the topic of infectious disease deserves further attention is that it raises difficult ethical questions of its own. While infected individuals can threaten the health of other individuals and society as a whole, for example, public health care measures such as surveillance, isolation, and quarantine can require the infringement of widely accepted basic human rights and liberties. An important and difficult ethical question asks how to strike a balance between the utilitarian aim of promoting public health, on the one hand, and libertarian aims of protecting privacy and freedom of movement, on the other, in contexts involving diseases that are--to varying degrees--contagious, deadly, or otherwise dangerous. Third, since their burden is most heavily shouldered by the poor (in developing countries), infectious diseases involve issues of justice--which should be a central concern of ethics. I conclude

Wisdom of Generations: A Pilot Study of the Values Transmitted in Ethical Wills of Nursing Home Residents and Student Volunteers

ERIC Educational Resources Information Center

Cohen-Mansfield, Jiska; Regier, Natalie G.; Peyser, Hedy; Stanton, Joshua

2009-01-01

Purpose: This is a pilot study that provides a description of the values older persons report in ethical wills and their reasoning for the values they chose, and compares the values in ethical wills of seniors and students. Nursing home residents rarely get the opportunity or venue to discuss these topics and the ethical will enables them to have…

A Systematic Literature Review of US Engineering Ethics Interventions.

PubMed

Hess, Justin L; Fore, Grant

2018-04-01

Promoting the ethical formation of engineering students through the cultivation of their discipline-specific knowledge, sensitivity, imagination, and reasoning skills has become a goal for many engineering education programs throughout the United States. However, there is neither a consensus throughout the engineering education community regarding which strategies are most effective towards which ends, nor which ends are most important. This study provides an overview of engineering ethics interventions within the U.S. through the systematic analysis of articles that featured ethical interventions in engineering, published in select peer-reviewed journals, and published between 2000 and 2015. As a core criterion, each journal article reviewed must have provided an overview of the course as well as how the authors evaluated course-learning goals. In sum, 26 articles were analyzed with a coding scheme that included 56 binary items. The results indicate that the most common methods for integrating ethics into engineering involved exposing students to codes/standards, utilizing case studies, and discussion activities. Nearly half of the articles had students engage with ethical heuristics or philosophical ethics. Following the presentation of the results, this study describes in detail four articles to highlight less common but intriguing pedagogical methods and evaluation techniques. The findings indicate that there is limited empirical work on ethics education within engineering across the United States. Furthermore, due to the large variation in goals, approaches, and evaluation methods described across interventions, this study does not detail "best" practices for integrating ethics into engineering. The science and engineering education community should continue exploring the relative merits of different approaches to ethics education in engineering.

Improving global health: counting reasons why.

PubMed

Selgelid, Michael J

2008-08-01

This paper examines cumulative ethical and self-interested reasons why wealthy developed nations should be motivated to do more to improve health care in developing countries. Egalitarian and human rights reasons why wealthy nations should do more to improve global health are that doing so would (1) promote equality of opportunity (2) improve the situation of the worst-off, (3) promote respect of the human right to have one's most basic needs met, and (4) reduce undeserved inequalities in well-being. Utilitarian reasons for improving global health are that this would (5) promote the greater good of humankind, and (6) achieve enormous benefits while requiring only small sacrifices. Libertarian reasons are that this would (7) amend historical injustices and (8) meet the obligation to amend injustices that developed world countries have contributed to. Self-interested reasons why wealthy nations should do more to improve global health are that doing so would (9) reduce the threat of infectious diseases to developed countries, (10) promote developed countries' economic interests, and (11) promote global security. All of these reasons count, and together they add up to make an overwhelmingly powerful case for change. Those opposed to wealthy government funding of developing world health improvement would most likely appeal, implicitly or explicitly to the idea that coercive taxation for redistributive purposes would violate the right of an individual to keep his hard-earned income. The idea that this reason not to improve global health should outweigh the combination of rights and values embodied in the eleven reasons enumerated above, however is implausibly extreme, morally repugnant and perhaps imprudent.

The development of computer ethics: contributions from business ethics and medical ethics.

PubMed

Wong, K; Steinke, G

2000-04-01

In this essay, we demonstrate that the field of computer ethics shares many core similarities with two other areas of applied ethics. Academicians writing and teaching in the area of computer ethics, along with practitioners, must address ethical issues that are qualitatively similar in nature to those raised in medicine and business. In addition, as academic disciplines, these three fields also share some similar concerns. For example, all face the difficult challenge of maintaining a credible dialogue with diverse constituents such as academicians of various disciplines, professionals, policymakers, and the general public. Given these similarities, the fields of bioethics and business ethics can serve as useful models for the development of computer ethics.

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

PubMed

Attia, Peter

2013-09-01

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

Improving the Level and Quality of Ethics Review in Chinese Medicine and Integrative Medicine.

PubMed

Zhang, Cheng-Bin; Li, En-Chang

2018-04-01

Three features of ethics review in Chinese medicine (CM) and integrative medicine (IM) were put forward in this paper. It is consistent with the principles of ethical review in Western medicine; it has to be compliant with the laws of CM and IM; emphasis should be laid on the review of clinical practice facts and experience. Three problems were pointed out. The characteristics of CM and IM are not distinctive enough, operation procedures need to be refined and effectiveness remains to be improved. Based on the mentioned above, seven measures were proposed to improve the level and quality of ethics review in CM and IM, including better brand awareness, considerable tolerance, treatment based on disease differentiation and syndrome differentiation, scientific review and toxicity and side effects of CM, perfection of the ethics review system, reasonable procedures of ethics review and more specialized ethics review workers.

Autonomous Cars: In Favor of a Mandatory Ethics Setting.

PubMed

Gogoll, Jan; Müller, Julian F

2017-06-01

The recent progress in the development of autonomous cars has seen ethical questions come to the forefront. In particular, life and death decisions regarding the behavior of self-driving cars in trolley dilemma situations are attracting widespread interest in the recent debate. In this essay we want to ask whether we should implement a mandatory ethics setting (MES) for the whole of society or, whether every driver should have the choice to select his own personal ethics setting (PES). While the consensus view seems to be that people would not be willing to use an automated car that might sacrifice themselves in a dilemma situation, we will defend the somewhat contra-intuitive claim that this would be nevertheless in their best interest. The reason is, simply put, that a PES regime would most likely result in a prisoner's dilemma.

[Clinical trials: vulnerability and ethical relativism].

PubMed

Lima, Cristina

2005-01-01

Research in human beings is an important chapter of medical ethics. In recent years, investigation has been taken over by profit driven corporations that must guarantee the medical and commercial application of results. This new model of investigation has generated conflicts of interest in doctor-patient, researcher-subject relationship. The inevitable debate and media reaction has led. These trials of controversial design to regions of the globe where the vulnerability of the populations continues to allow their undertaking. This article includes a historical perspective on experimentation in human beings and the conditions that led to its regulation: the Nuremberg CODE, followed by the Helsinky Declaration in its different versions, and the Belmont Report, that defend the subject according to the ethic of principles used in western medicine. There is then a review of the attempts to change international regulation to reintroduce clinical trials with placebo--which since 1996 is only permitted where there are no therapeutic or diagnostic methods--on populations that would otherwise have no access to treatment. This then leads on to the issue of double standards in medical investigation defended by many investigators and some official entities. The article concludes that it may be prudent to allow local ethical commissions to approve deviation from the established norm if such is necessary to resolve urgent questions of health in the country, but it is unacceptable that any such emergency is used as a reason to reduce the ethical prerequisites, in clinical trials. It also concludes that true urgency is in making available to all who need it the effective products already in existence. Furthermore, that the acceptance of ethical relativism can result in the exploitation of vulnerable third world populations for research programmes that cannot be undertaken in their sponsoring countries due to the ethical restrictions in place.

Medical ethics, moral philosophy and moral tradition.

PubMed

Murray, T H

1987-01-01

Medical ethics is commonly assumed to be a form of 'applied moral philosophy' in which practical moral judgments are deduced from moral theories. This account of the relationship between moral theory and moral judgment is inadequate in several reports. The deductivist approach often results in inadequate attention being given to social, historical and developmental contexts. It also fails to explain some common phenomena in practical moral reasoning. In contrast to the emphasis in deductivism, a case-centered or casuistic practical ethics insists on immersion in the particularities of cases and on interpretation of details in light of moral maxims and other mid-level forms of moral reasoning. Two features of casuistics that ought to be distinguished but frequently are not, are: (1) the emphasis on immersion and interpretation, and (2) a claim about the relation between moral judgment and moral theory as sources of moral knowledge. Once we consider case-centered moral judgments as sources of moral knowledge, we must also begin to look critically but open-mindedly to moral traditions which, upon examination, appear to be more dynamic and to have more reformist potential than is commonly assumed.

Improving computer-aided detection assistance in breast cancer screening by removal of obviously false-positive findings.

PubMed

Mordang, Jan-Jurre; Gubern-Mérida, Albert; Bria, Alessandro; Tortorella, Francesco; den Heeten, Gerard; Karssemeijer, Nico

2017-04-01

Computer-aided detection (CADe) systems for mammography screening still mark many false positives. This can cause radiologists to lose confidence in CADe, especially when many false positives are obviously not suspicious to them. In this study, we focus on obvious false positives generated by microcalcification detection algorithms. We aim at reducing the number of obvious false-positive findings by adding an additional step in the detection method. In this step, a multiclass machine learning method is implemented in which dedicated classifiers learn to recognize the patterns of obvious false-positive subtypes that occur most frequently. The method is compared to a conventional two-class approach, where all false-positive subtypes are grouped together in one class, and to the baseline CADe system without the new false-positive removal step. The methods are evaluated on an independent dataset containing 1,542 screening examinations of which 80 examinations contain malignant microcalcifications. Analysis showed that the multiclass approach yielded a significantly higher sensitivity compared to the other two methods (P < 0.0002). At one obvious false positive per 100 images, the baseline CADe system detected 61% of the malignant examinations, while the systems with the two-class and multiclass false-positive reduction step detected 73% and 83%, respectively. Our study showed that by adding the proposed method to a CADe system, the number of obvious false positives can decrease significantly (P < 0.0002). © 2017 American Association of Physicists in Medicine.

Towards Best Practice in Ethics Education for Scholarly Practitioners of Leadership: An Undistorted View of Reality

ERIC Educational Resources Information Center

Reardon, R. Martin

2013-01-01

While it is reasonable to surmise that the vast majority of leaders, regardless of whether they are educators in the broad sense of that term, exercise their leadership in accord with sound ethical principles, the regular instances of exceptions to this rule highlight the importance of incorporating the study of ethics in leadership programs.…

[The ethical reflection approach in decision-making processes in health institutes].

PubMed

Gruat, Renaud

2015-12-01

Except in the specific case of end-of-life care, the law says nothing about the way in which health professionals must carry out ethical reflection regarding the treatment of their patients. A problem-solving methodology called the "ethical reflection approach" performed over several stages can be used. The decision-making process involves the whole team and draws on the ability of each caregiver to put forward a reasoned argument, in the interest of the patient. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Ethical challenges related to elder care. High level decision-makers' experiences.

PubMed

Mamhidir, Anna-Greta; Kihlgren, Mona; Sorlie, Venke

2007-04-10

care professionals concerning ways of dealing with ethical issues and the necessity of structures that facilitate dealing with them. Even if the high level decision-makers have learned to live with the ethical challenges that confronted them, it was obvious that they were not free from feelings of uncertainty, frustration and loneliness. Vulnerability was revealed regarding themselves and others. Their feelings of failure indicated that they felt something was at stake for the older adults in elder care and for themselves as well, in that there was the risk that important needs would go unmet.

Ethical challenges related to elder care. High level decision-makers' experiences

PubMed Central

Mamhidir, Anna-Greta; Kihlgren, Mona; Sorlie, Venke

2007-01-01

high level decision-makers and health care professionals concerning ways of dealing with ethical issues and the necessity of structures that facilitate dealing with them. Even if the high level decision-makers have learned to live with the ethical challenges that confronted them, it was obvious that they were not free from feelings of uncertainty, frustration and loneliness. Vulnerability was revealed regarding themselves and others. Their feelings of failure indicated that they felt something was at stake for the older adults in elder care and for themselves as well, in that there was the risk that important needs would go unmet. PMID:17419880

[Man and his fellow-creatures under ethical aspects].

PubMed

Teutsch, Gotthart M

2004-01-01

The repeated attempts to tighten up the literary report are finally showing effects. This not only as a result of shorter reports but also because of the fact that less is being written and published regarding our topic. The discussion seems exhausted which, for years, dealt with the controversial moral status of animals and the--finally--constitutionally sanctioned status of animal protection in Germany. The problem of animals in ethics is becoming a rarity. Correspondingly, bio-ethics is oriented towards human problems and related borderline cases in a rather one-sided manner. This radically altered situation corresponds to an equally profound shift in the direction of our thinking. In the 1970's it was the shock in reaction to brutality towards T.V.-reports. But soon questions asking about the guilty were being posed. To direct the question from a guilt-related "who" to the "what" of the underlying reasons was a more difficult task. Just like social ethics developed out of social criticism, modern animal ethics developed out of the criticism of cruelty to animals. And, to the degree that this criticism became a common public concern, it lost its importance in comparison to the ethical questions now moving into the centre of the interest. In view of book-production this means that animal protection-related literature appears in three major groups: Husbandry, Use and Abuse, Animal Protection Law, Animal (Protection) Ethics. To collect these three groups simultaneously is becoming increasingly difficult. The concentration on, and supposedly a limitation to the sectors morals and ethics of the man-animal relationship cannot be avoided in the literary report. Morals is stressed here in particular in order to limit the excessive dominance of theoretical ethics and to preserve the priority of action-guiding morals.

An integrated, ethically driven environmental model of clinical decision making in emergency settings.

PubMed

Wolf, Lisa

2013-02-01

To explore the relationship between multiple variables within a model of critical thinking and moral reasoning. A quantitative descriptive correlational design using a purposive sample of 200 emergency nurses. Measured variables were accuracy in clinical decision-making, moral reasoning, perceived care environment, and demographics. Analysis was by bivariate correlation using Pearson's product-moment correlation coefficients, chi square and multiple linear regression analysis. The elements as identified in the integrated ethically-driven environmental model of clinical decision-making (IEDEM-CD) corrected depict moral reasoning and environment of care as factors significantly affecting accuracy in decision-making. The integrated, ethically driven environmental model of clinical decision making is a framework useful for predicting clinical decision making accuracy for emergency nurses in practice, with further implications in education, research and policy. A diagnostic and therapeutic framework for identifying and remediating individual and environmental challenges to accurate clinical decision making. © 2012, The Author. International Journal of Nursing Knowledge © 2012, NANDA International.

Empirical ethics and its alleged meta-ethical fallacies.

PubMed

de Vries, Rob; Gordijn, Bert

2009-05-01

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

Chinese nurses' ethical concerns in a neurological ward.

PubMed

Tang, Ping Fen; Johansson, Camilla; Wadensten, Barbro; Wenneberg, Stig; Ahlström, Gerd

2007-11-01

Our aim was to describe Chinese nurses' experiences of workplace distress and ethical dilemmas on a neurological ward. Qualitative interviews were performed with 20 nurses. On using latent content analysis, themes emerged in four content areas: ethical dilemmas, workplace distress, quality of nursing and managing distress. The ethical dilemmas were: (1) conflicting views on optimal treatment and nursing; (2) treatment choice meeting with financial constraints; and (3) misalignment of nursing responsibilities, competence and available resources. The patients' relatives lacked respect for the nurses' skills. Other dilemmas could be traced to the transition from a planned to a market economy, resulting in an excessive workload and treatment withdrawal for financial reasons. Lack of resources was perceived as an obstacle to proper patient care in addition to hospital organization, decreasing the quality of nursing, and increasing moral and workplace distress. The nurses managed mainly by striving for competence, which gave them hope for the future.

Ethical issues across different fields of forensic science.

PubMed

Yadav, Praveen Kumar

2017-01-01

Many commentators have acknowledged the fact that the usual courtroom maxim to "tell the truth, the whole truth, and nothing but the truth" is not so easy to apply in practicality. In any given situation, what does the whole truth include? In case, the whole truth includes all the possible alternatives for a given situation, what should a forensic expert witness do when an important question is not asked by the prosecutor? Does the obligation to tell the whole truth mean that all possible, all probable, all reasonably probable, all highly probable, or only the most probable alternatives must be given in response to a question? In this paper, an attempt has been made to review the various ethical issues in different fields of forensic science, forensic psychology, and forensic DNA databases. Some of the ethical issues are common to all fields whereas some are field specific. These ethical issues are mandatory for ensuring high levels of reliability and credibility of forensic scientists.

Ethical and legal issues regarding consent in research with adult stroke patients: case study in the ethics of mental health research.

PubMed

Pope, Anne

2012-03-01

This case study describes research into interventions to enhance stroke patients' ability to communicate. Because patients' cognitive abilities are compromised, it is argued that they may lack the capacity to consent and that surrogate consent should be required. In South Africa, this would make conducting the research difficult because only court-appointed curators are "legally appropriate" substitutes for research enrolment. Here, the research ethics committee must balance legal requirements and ethical concerns. It must also balance protection and respect for autonomy, even for cognitively compromised participants. First, incapacity should not simply be assumed but should be individually assessed. However, stroke patients present a further complication for capacity assessment because they may retain the capacity to reason but have lost the ability to communicate effectively. Second, the research ethics committee must decide whether recruitment should be restricted or whether incapacitated participants may be enrolled. Given the low risk of harm, incapacitated persons could be enrolled by proxies.

Using an ecological ethics framework to make decisions about the relocation of wildlife.