Various types of health settings use clinical ethics committees (CEC) to deal with the ethical issues that confront both healthcare providers and their patients. Although these committees are now more common than ever, changes in the content of ethical dilemmas through the years is still a relatively unexplored area of research. The current study examines the major topics brought to the CEC of a psychiatric hospital in Israel and explores whether there were changes in their frequency across nearly three decades. (...) The present paper reports on a thematic analysis of the written verbatim transcripts from 466 ethical topics brought to the CEC between the years 1991 and 2016. The following major topics related to ethical dilemmas were identified: confidentiality (30%), patient autonomy (23%), health records (14%), dual relationship (12%), allocation of resources (11%), inappropriate professional and personal conduct (9%), and multicultural sensitivity (1%). Topics related to confidentiality increased significantly over the years, as did inappropriate professional and personal conduct. In addition, the analysis showed that the content of the ethical cases and the resolutions suggested by the CEC also varied over the years. In conclusion, although most ethical topics have remained relatively stable over time, the discourse around them has evolved, requiring a dynamic assessment and reflection by the mental health practitioners serving as members of a CEC. (shrink)

Objective To compare the coping patterns of physicians and clinical psychologists when confronted with clinical ethical dilemmas and to explore consistency across different dilemmas. Population 88 clinical psychologists and 149 family physicians in Israel. Method Six dilemmas representing different ethical domains were selected from the literature. Vignettes were composed for each dilemma, and seven possible behavioural responses for each were proposed, scaled from most to least ethical. The vignettes were presented to both family physicians and clinical psychologists. Results Psychologists’ aggregated (...) mean ethical intention score, as compared with the physicians, was found to be significantly higher =22.44, p<0.001, η2=0.37). Psychologists showed higher ethical intent for two dilemmas: issues of payment and dual relationships. In the other four vignettes, psychologists and physicians responded in much the same way. The highest ethical intent scores for both psychologists and physicians were for confidentiality and a colleague’s inappropriate practice due to personal problems. Conclusions Responses to the dilemmas by physicians and psychologists can be categorised into two groups: similar behaviours on the part of both professions when confronting dilemmas concerning confidentiality, inappropriate practice due to personal problems, improper professional conduct and academic issues and different behaviours when confronting either payment issues or dual relationships. (shrink)

The present study seeks to expand on research concerning the benefits of organizational citizenship behaviors (OCB) to work-family facilitation (WFF) by integrating the theoretical framework of the attachment personality perspective (Bowlby, 1982). We hypothesized that OCB would enhance WFF for employees having lower levels of avoidance and anxious orientations but reduce WFF for employees with higher levels of avoidance and anxiety orientations. Two studies were conducted to test these hypotheses. Study 1 adopted a cross-sectional design, and Study 2 implemented a (...) diary procedure. In Study 1, employees from a pharmaceutical company completed attachment orientations and WFF questionnaires, whereas their direct supervisors assessed the participants’ OCB. In Study 2, attachment orientations of 108 participants were assessed, with OCB and WFF measures collected over 10 days. Findings from both studies supported our hypotheses relating to avoidance orientations. Performing OCB can enhance WFF, with the effect stronger for employees having lower avoidance orientations. However, findings regarding anxiety orientations were non-significant. A better understanding of the role that attachment orientations play in the OCB - WFF association may facilitate implementing possible interventions that could benefit both the organization and the family. (shrink)