In this paper i offer a detailed analysis of the dilemma of participation (parmenides, 130e-131e), in which plato considers the consequences of participation in the whole, and in a part of, a form. This analysis explains, in contrast to existing interpretations of the argument, plato's claim that participation in parts of a form is incompatible with the uniqueness of the form, and his modal claim that becoming equal by possessing part of the equal is absurd. In (...) the second part of the paper, i give the premisses and logical steps of the third man argument in the parmenides, and show the premisses to be committed to absurdity, even without the assumption that there is a unique form per character f. (shrink)

From the 1980s/90s, Brazilian foreign policy adopted a more assertive agenda regarding neighboring countries in northern South America. In this context, the celebration of the Framework Agreement between Brazil and France is inserted, an institutional framework that implemented cross-border cooperation between Amapá and French Guiana. At the time, France was interested in projecting itself politically and commercially in South America. On the other hand, Brazil has also achieved success with this new agenda. However, after twenty-four years in force, cross-border cooperation (...) does not show effectiveness regarding the results expected by the collectives on both sides of the Guyano-Amapá border. This article seeks to discuss that the lack of local participation has become a contender in the development of this cooperation, which has not resulted in a political project capable of promoting the aggregation of cultural matrices that stimulate an identity of objectives. To development the reflection, non-participant observation, interviews with residents in the city of Oiapoque were used, as well as the examination of some agreements concluded between Brazil and France and the minutes of the meetings of the Joint Cross-Border Commission-CTM. The specificities that make the Guyano-Amapá border interesting to the governments of Brazil and France are found in the temporal experiences of multiple actors, unrelated to chronologies, but rather to the length of life lived. (shrink)

The normal way to establish that a person has authority over another requires a rule-governed institutional setting. To have authority is to have power, in the juridical sense of the term, and power can only be conferred by norms constituting it. Power-conferring norms are essentially institutional, and the obligation to comply with a legitimate authority's decree is, first and foremost, institutional in nature. The main argument presented in this essay is that an explanation of practical authorities is a two-stage affair: (...) the special, practical import of an authority can only be explained against the background of an institutional setting which constitutes the authority's power and the corresponding obligation to comply. However, this obligation is not an all things considered obligation, it is conditioned on reasons to participate in the relevant institution or practice. (shrink)

This article analyzes the conditions that facilitate or hinder office-worker activism. Participant observations in Baltimore Working Women, a local affiliate of 9 to 5, and interviews with 72 members and nonmembers revealed the dilemmas of organizing women office workers. Early joiners recruited themselves and then brought in friends for whom the costs of activism were greater. Job security, supportive bosses, and experience in protesting inequities eased the difficulties associated with activism, and commitment to working women's issues sustained activism. Those who (...) feared reprisals from unsupportive bosses and coworkers but joined for friendship tended not to be active. Nonmembers' loyalty to employer and family demands limited their potential as recruits. (shrink)

A profound reading of the Narcissus tale and of the recovery of one's own soul.

This article presents an interpretive phenomenological study that explores how physicians experience dilemmas of conscience in their day-to-day practice. Eighteen physicians of various ages and professional backgrounds were interviewed and asked to identify and discuss three instances when they experienced a dilemma of conscience. Preliminary findings from narrative analyses of these physician interviews suggest that dilemmas of conscience are ubiquitous, temporal and context-dependent; they cannot be reduced and understood as a focal phenomenon. Moral development appears to parallel acquisition of (...) medical knowledge; participants' specific concerns and their clinical contexts evolved as they gained experience and insight. Participants learned how to negotiate dilemmas of conscience through time, mistakes, examples, actualization, rehearsals and struggles. Remaining engaged in care, developing partnerships and protecting spaces for dialogue can help create practices of accountability when dilemmas of conscience occur. (shrink)

Infertility Accepted treatment is replete with bioethical dilemmas regarding the limits of available medical therapies. Poland has no legal acts regulating the ethical problems associated with infertility treatment and work on such legislation has been in progress for a long time, arousing very intense emotions in Polish society. The purpose of the present study was to find out what Polish women undergoing infertility treatment think about the most disputable and controversial bioethical problems of assisted reproduction. An Attitudes towards Bioethical Problems (...) of Infertility Scale was constructed specifically for this study. Items were taken from the Bioethics Bills currently under discussion in Polish Parliament (Seym). 312 women were enrolled in the study. Women experiencing infertility favoured more liberal legislation. Participants disagreed, for example, with the following regulations: prohibition of embryo freezing, prohibition of preimplantation genetic diagnosis of embryos, age limits for women using in vitro fertilisation and prohibition of in vitro fertilisation for single women. The opinions of patients undergoing infertility treatment are an important voice in the Polish debate on the Bioethics Bills. (shrink)

The Catholic Church proscribes methods of birth control other than sexual abstinence. Although the U.S. Food and Drug Administration (FDA) recognizes abstinence as an acceptable method of birth control in research studies, some pharmaceutical companies mandate the use of artificial contraceptive techniques to avoid pregnancy as a condition for participation in their studies. These requirements are unacceptable at Catholic health care institutions, leading to conflicts among institutional review boards, clinical investigators, and sponsors. Subjects may feel coerced by such mandates (...) to adopt contraceptive techniques inconsistent with their personal situation and beliefs; women committed to celibacy or who engage exclusively in non-heterosexual activities are negatively impacted. We propose principles to insure informed consent to safeguard the rights of research subjects at Catholic institutions while mitigating this ethical conflict. At the same time, our proposal respects the interests of pharmaceutical research agencies and Catholic moral precepts, and fully abides by regulatory guidance. (shrink)

In this article we attempt to answer the question of how the ethical and conceptual framework (ECF) for a learning health‐care system (LHS) affects some of the main controversies in research ethics by addressing five key problems of research ethics: (a) What is the difference between practice and research? (b) What is the relationship between research ethics and clinical ethics? (c) What is the ethical relevance of the principle of clinical equipoise? (d) Does participation in research require a higher (...) standard of informed consent than the practice of medicine? and (e) What ethical principle should take precedence in medicine? These questions allow us to construct two opposite idealized positions on the distinction between research and practice: the integration model and the segregation model of research and practice. We then compare the ECF for an LHS with these two idealized positions. We argue that the ECF for a LHS does not, in fact, solve these problems, but that it is a third, separate position in the relationship between research ethics and clinical ethics. Moreover, we suggest that the ECF for a LHS raises new ethical problems that require additional ethical analysis and justification. Our article contributes to the discussion on the relationship between research ethics and clinical ethics, revealing that although a learning health‐care system may significantly change the landscape of health care, some ethical dilemmas still require resolving on both theoretical and policy‐making levels. (shrink)

This article considers the ethics of photojournalism from a television news perspective. The author, on the basis of his participant?observation study conducted at two major?market television stations, suggests that while most of the television news photographers he observed and interviewed expressed strong ethical beliefs and values, those same individuals admitted they often acted in contradiction to many of their personal ethical beliefs. Their actions in carrying out their work and their revelations on the structure of their ethical beliefs indicate they (...) face a dilemma in balancing values. They must deal with the often contradictory values of competition, careerism, journalistic norms, peer pressure, technology, and management and organizational expectations. (shrink)

As an instrument for participatory technology development, Scenario-Based Design offers significant potential for an early inclusion of future users. Over the course of a 3-year research project, this method was examined as a procedure for participatory technology development. Methods and instruments aimed at achieving a potential user’s participation, and the resulting cooperation of heterogeneous social groups can be seen as translation tools. Their purpose is to act as translators between different social fields and the specific knowledge associated with them. (...) These translation capabilities and participatory methods should result in the best possible convergence of different orientations and purposes. In this paper, attempting to achieve the best possible convergence is described as a dilemma of alignment. Several approaches will be used to describe the dynamic of the alignment dilemma within the above-mentioned project. The reconstruction follows one question that is proposed as a heuristic pattern to meet the requirements of an accurate analysis of holistic participatory methods: Who or what has to adjust to whom or what, why, when, and in which way? The main conclusions include the finding that the alignment dilemma is not equally balanced, that the agency of epistemic objects within the process has to be captured, and that it is easy for translation—provided primarily by core instruments of the participatory method used—to begin to overwrite the needs and purposes of one social group with the interests and orientations of another. (shrink)

ART and, in particular, IVF and ICSI, are essentially a laboratory experiment, but which, due to its specificity, goes beyond the disciplinary boundaries, explicitly acquiring an ethical-axiological dimension in the interaction zone of the members of a particular community involved in child-bearing. At the same time, it is noted that the activity and choice of a way to solve problems with childbirth has a characteristic severity, due to the traditions and level of civil and social maturity of a country, due, (...) among other things, to the level and achievements of technical equipment in this industry of knowledge and practice. According to foreign studies, about half of all subfertile people in developed countries are trying to overcome their infertility with the help of medicine, and research data indicate that the proportion of such individuals is growing. The most difficult problems of reproduction are associated with low quality of oocytes or low ovarian reserve ; aspermia and deep teratozoospermia, can not give hope to a couple to have genetically related offspring. However, donor programs create additional opportunities for social motherhood / paternity. Donation of oocytes is found in ART programs at least 3 times more often than donation of spermatozoa. At the moment, donation of gametes and embryos raises a number of ethical, legal, medical and socio-psychological issues that require competent support from experts of a wide range of specialists, as well as competent, non-commercial, primarily due to the interaction between donors and recipients. The analysis of possible modifications of family and kinship ties is based on the idea of transforming social relations, in which assisted reproductive technologies play a fundamental role, building a system of “new kinship and new family.” By entering into the intimate process of the birth of life and acting as a regulator of the composition of participants in this process through the stimulation of responsibility to present and future relatives, reproductive technologies affect the initial moral requirements in the community, redefining universal values based on the specific situation. Scenarios of childbearing through ART with the involvement of additional participants are possible in the context of the legal field, but legally fixed anonymity of the donor leaves many unresolved issues related to the problems of hereditary diseases, genetic abnormalities and epigenetic changes; in addition, there is a problem associated with the possibility of unintentional incest, as well as the difficulties of the child’s self-identification and the closeness of his genealogy. Solutions to these issues are postponed until later, thereby initiating future dramatic situations, ethical conflicts and dilemmas with a poorly predictable positive outcome. (shrink)

Researchers appear to take unfair advantage of those who live in the developing world by using placebo-controlled trials to test the efficacy of drugs. This type of trial would not be permitted in developed countries, since in these countries treatment is available for the conditions that the drugs aim to treat. But if researchers are required to conduct active-controlled trials, the cost of doing research would increase, making research in developing countries inefficient and robbing these countries of the benefits of (...) participation. Contributors to Exploitation and Developing Countries, edited by Jennifer S. Hawkins and Ezekiel J. Emanuel, try to balance these concerns. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Underplayed Ethics and the Dilemmas of Psychiatric CareChong Siow Ann and Tamra LysaghtThe practice of psychiatry is fraught with uncertainty. The exact causes and the biological substrates underlying mental disorders remain to be elucidated; even the diagnosis of these disorders is descriptive and not based on an etiological understanding and no biological diagnostic markers have been validated. The manifestation of almost all mental disorders results from a complex interaction (...) of biological and environmental factors which encompasses the patient’s unique life history, experiences and relationship with others and the community. In the face of such uncertainties — at times extending to the types of treatment (psychiatry is generally acknowledged not be an exact science) — it has been argued that adopting a pragmatic approach is necessary.1 Accordingly, this approach necessitates high ethical standards among mental health practitioners.Some mental illnesses are associated with varying degrees and types of cognitive impairments. Others have certain symptoms like auditory hallucinations and delusions that might severely compromise the patients’ autonomy, distort their sense of reality, increase the risk of harm to themselves or others and render them incapable of making informed decisions in their treatment and participation in research.Consequently, there are issues that are particular to the provision of mental healthcare. These include the need for enforced involuntary treatment with the corollary of depriving a patient of his personal liberty even [End Page 173] though it is often justified on the grounds that it is in the patient’s best interests. However, at times, it is the legal and societal obligation of mental health practitioners to protect those who might be harmed from the patient’s action that might seem to be more pressing. In this situation of double agency, lies the tension of providing confidential care for patients and acting as “an agent of the state” where that patient’s confidentiality might be breached and his liberty infringed upon. This situation is further aggravated by the stigma that clings ever so tenaciously to those who suffer from mental disorders and where it is the norm to stereotype them as dangerous and unpredictable.Consideration of a patient’s autonomy is also challenged by characteristics that are unique to the practice of psychiatry. The prescription of certain psychotropic medications can alter how people think and feel, while psychotherapy works towards changing the patient’s views and values. The philosopher, Jennifer Radden, describes this process as “re-forming the patient’s whole self or character … akin to the responsibilities of raising children”.2 The psychotherapeutic relationship is thus particularly personal and intimate because patients are asked to provide information that often reveals their innermost feelings, fears and fantasies. This information is provided on the basis of trust and assurance of confidentiality, and with expectation of being helped.Jeremy Holmes and Gwen Adshead have elaborated on the vulnerability of patients seeking psychotherapy: they might be particularly susceptible to exploitation because their past experiences of being exploited have led to their distress and help seeking — their dependency and the extreme privacy of the therapeutic relationship make any transgression difficult to be uncovered.3 There is a calamitous combination of the “unconscious wish in the patient to be used” with the complicity of an unethical therapist seeking to fulfil his own interests.4As in any other doctor-patient relationship, the relationship between the mental healthcare practitioner and the patient is one of unequal power where the former is ascendant. While that power should be exercised to heal and to relieve suffering, it also gives the practitioner tremendous power “to harm, reject, misunderstand, or exploit patients who struggle with the experience of mental illness, which itself may generate helplessness, despair, distress, and exceptional dependence on the clinician”.5 Given the potential of doing good and harm coupled with the likelihood of being so significant in the life of the patient,6 providing care for those with mental disorders and distress is necessarily ethically exacting — arguably more so than in other medical practice settings. [End Page 174]This precariousness has led to the suggestion that ethics in psychiatry should have a special status and that the more general principles of biomedical ethics are too limited in scope to... (shrink)

BackgroundThis article is part of a study to gain insight into the decision-making process by looking at the views of the relatives of potential brain dead donors. Alongside a literature review, focus interviews were held with healthcare professionals about their role in the request and decision-making process when post-mortal donation is at stake. This article describes the perspectives of the relatives.MethodsA content-analysis of 22 semi-structured in-depth interviews with relatives involved in an organ donation decision.ResultsThree themes were identified: ‘conditions’, ‘ethical considerations’ (...) and ‘look back’. Conditions were: ‘sense of urgency’, ‘incompetence to decide’ and ‘agreement between relatives’. Ethical considerations result in a dilemma for non-donor families: aiding people or protecting the deceased’s body, especially when they do not know his/her preference. Donor families respect the deceased’s last will, generally confirmed in the National Donor Register. Looking back, the majority of non-donor families resolved their dilemma by justifying their decision with external arguments. Some non-donor families would like to be supported during decision-making.DiscussionThe discrepancy between general willingness to donate and the actual refusal of a donation request can be explained by multiple factors, with a cumulative effect. Firstly, half of the participants stated that they felt that they were not competent to decide in such a crisis and they seem to struggle with utilitarian considerations against their wish to protect the body. Secondly, non-donor families refused telling that they did not know the deceased’s wishes or contesting posthumous autonomy of the eligible. Thirdly, the findings emphasise the importance of Donor Registration, because it seems to prevent dilemmas in decision-making, at least for donor families.ConclusionDiscrepancies between willingness to consent to donate and refusal at the bedside can be attributed to an unresolved dilemma: aiding people or protect the body of the deceased. Non-donor families felt incompetent to decide. They refused consent for donation, since their deceased had not given any directive. When ethical considerations do not lead to an unambiguous answer, situational factors were pivotal. Relatives of unregistered eligible donors are more prone to unstable decisions. To overcome ambivalence, coaching during decision-making is worth investigation. (shrink)

This study looks at how the corporate governance of family-owned business groups, the most dominant form of private sector organising in Asia, deals with different forms of corruption during the course of common business transactions. As a part of an ethnographic study conducted in 2007 to look at the impact of corporate governance reforms in the Philippines, one of the emergent themes from the study was the presence of significant corruption in the business environment of the country. A total of (...) 40 semi-structured interviews were conducted with board members from business groups and senior public sector officials supplemented by document analysis of media articles and other text and participant observation. Using Rose-Ackerman’s typology of petty and grand corruption, results show the dilemmas faced when trying to operate within the precepts of corporate governance whilst dealing with the practical reality of corruption in public sector institutions. The results of the study provide empirical evidence into corruption’s impact on Asian business groups and contribute to knowledge on the links between strong institutions and the efficacy of corporate governance. (shrink)

Ackelsberg investigates women’s activist participation in the National Congress of Neighborhood Women, a Brooklyn association established in 1974–75, which she treats as a model of democratic civic engagement that incorporated differences while avoiding the exclusions of the past. The NCNW assisted poor and working class women in organizing to better meet their needs and those of their communities. It arose in response to the ways women were either ignored or belittled when they attempted to engage in political work both (...) in their communities and beyond. In working with each other, the women found that they needed to address issues of diversity. The programs they created to help build bridges across differences that helped facilitate their successful activism while, simultaneously, broadening their understanding of what constitutes “politics.”. (shrink)

This article explores the challenge of developing a feminist law reform proposal to decertify sex and gender based on research conducted for the ‘Future of Legal Gender' project. Locating the proposal to decertify within a do-it-yourself, prefigurative approach to law reform, the article asks: Can a law reform proposal be both instrumental and radical? Can a proposal take shape as a viable legislative text and as a more subversive intervention to unsettle and reimagine gender’s relationship to law? This article explores (...) this at two levels. First, it considers the ontological challenges of developing a controversial law reform proposal in terms of its realness (or fictiveness), contours, and temporality, turning to ‘slow law' as a credible way of approaching radical reform. Second, it explores the design-based challenges of legal prototyping—foregrounding questions of legitimacy, participation, and purpose, which arise in designing a decertification law. At the heart of this discussion is the relationship between representation and enactment—between what a proposal presents and what its presentation does and does not accomplish. (shrink)

This timely and topical look at the role of ethics in fieldwork takes into account some of the major issues confronting qualitative researchers. The main purposes of this book are twofold: to promote an understanding of the harmful possibilities of fieldwork; and to provide ways of dealing with ethical problems and dilemmas. To these ends, examples of actual fieldwork are provided that address ethical problems and dilemmas, and posit ways of dealing with them.

The Gamer’s Dilemma is based on the intuitions that in single-player video games fictional acts of murder are seen as morally acceptable whereas fictional acts of sexual assault are seen as morally unacceptable. Recently, it has been suggested that these intuitions may apply across different forms of media as part of a broader Paradox of Fictionally Going Too Far. This study aims to empirically explore this issue by determining whether fictional murder is seen as more morally acceptable than fictional (...) sexual assault across different media types, and whether audio-visuality and the degree of agency afforded by the medium influences these judgments. An experimental survey study was developed where participants responded to imaginary fictional scenarios as part of a 2 (engages with fictional murder or fictional sexual assault) X 2 (in a high or low agency) X 2 (audio-visual or non-audio-visual medium) factorial design. It was found that fictional murder was seen to be more morally acceptable than fictional sexual assault across all media types, providing empirical support for the Paradox of Fictionally Going Too Far. It was also found that the audio-visuality and degree of agency influenced judgments of moral acceptability. (shrink)

Among the many interesting problems considered in this book, I will center my commentary on two issues: on the role of narrative reconstructions as an alternative to objectivist accounts of culture; on the implications of her proposed reformulation of discourse ethics as interactive universalism for the dilemmas of multiculturalism. On the question of the dialogical-narrative reconstructions of identity, a combination of perspectives of participants as well as of external observers is suggested, instead of a shift from the latter to the (...) former. On the more difficult question of the political, legal and moral implications for democratic theory of forms of rational accommodation of cultural differences, I will consider the problem of justification of morality under conditions not only of radical cultural differences but of asymmetries in power and resources among the participants, which seem to present a problem for a model that presupposes a cooperative engagement and free uncoerced consent from all involved. (shrink)

The treatment of life-threatening illnesses in childhood is replete with ethical issues and with clinical issues that have ethical implications. The central issues are those involved with a child's participation in the decision-making process and with communication of information about the illness and treatments to children. This article examines the questions of patient autonomy and of parental responsibility and prerogative in the context of pediatric oncology. Included in this examination of the ethical dimensions of pediatric life-threatening illness is a (...) discussion of the many related aspects involved, including medical, cultural, psychosocial, legal, and developmental. A multidimensional approach that considers the ways in which these multiple aspects interact with one another, and which focuses on establishing a strong working alliance between the health care team and the pediatric patient's family, can help to avoid or resolve potential ethical and clinical conflicts. (shrink)

The aim of this study was to describe specialist ambulance nurse students’ experiences of ethical conflicts and dilemmas in prehospital emergency care. In the autumn of 2015, after participating in a mandatory lecture on ethics, 24 specialist ambulance nurse students reported experiences and interpretations concerning conflicts and ethical dilemmas from prehospital emergency care. The text consisted of 24 written critical incidents which were interpreted using hermeneutic text interpretation. The text revealed three themes: Not safeguarding a patient’s body and identity; Not (...) agreeing on the care actions; and Not treating the patient with dignity. The SANs experiences ethical dilemmas and conflict of values when they witness how others violate a patient’s dignity. Discussion and reflection is based on ethical conflicts and dilemmas experienced when students see how caregivers do not safeguard the patient’s body or identity. When caregivers have a conflicting will, it results in patients not being treated in an ethical manner. Also, seeing how caregivers put themselves in a power position over patients is described as an ethical dilemma that students experience when they choose not to intervene. (shrink)

The ethical dilemma of whether autonomous vehicles should protect the passengers or pedestrians when harm is unavoidable has been widely researched and debated. Several behavioral scientists have sought public opinion on this issue, based on the premise that EDs are critical to resolve for AV adoption. However, many scholars and industry participants have downplayed the importance of these edge cases. Policy makers also advocate a focus on higher level ethical principles rather than on a specific solution to EDs. But (...) conspicuously absent from this debate is the view of the consumers or potential adopters, who will be instrumental to the success of AVs. The current research investigated this issue both from a theoretical standpoint and through empirical research. The literature on innovation adoption and risk perception suggests that EDs will be heavily weighted by potential adopters of AVs. Two studies conducted with a broad sample of consumers verified this assertion. The results from these studies showed that people associated EDs with the highest risk and considered EDs as the most important issue to address as compared to the other technical, legal and ethical issues facing AVs. As such, EDs need to be addressed to ensure robustness in the design of AVs and to assure consumers of the safety of this promising technology. Some preliminary evidence is provided about interventions to resolve the social dilemma in EDs and about the ethical preferences of prospective early adopters of AVs. (shrink)

This study looks at how the corporate governance of family-owned business groups, the most dominant form of private sector organising in Asia, deals with different forms of corruption during the course of common business transactions. As a part of an ethnographic study conducted in 2007 to look at the impact of corporate governance reforms in the Philippines, one of the emergent themes from the study was the presence of significant corruption in the business environment of the country. A total of (...) 40 semi-structured interviews were conducted with board members from business groups and senior public sector officials supplemented by document analysis of media articles and other text and participant observation. Using Rose-Ackerman’s typology of petty and grand corruption, results show the dilemmas faced when trying to operate within the precepts of corporate governance whilst dealing with the practical reality of corruption in public sector institutions. The results of the study provide empirical evidence into corruption’s impact on Asian business groups and contribute to knowledge on the links between strong institutions and the efficacy of corporate governance. (shrink)

Perioperative nurses assist in organ procurement surgery; however, there is a dearth of information of how they encounter making conscientious objection requests or refusals to participate in organ procurement surgery. Organ procurement surgical procedures can present to the operating room ad hoc and can catch a nurse who may not desire to participate by surprise with little opportunity to refuse as a result of staffing, skill mix or organizational work demands. This paper that stems from a larger doctoral research study (...) exploring the experiences of perioperative nurses participating in multi‐organ procurement surgery used a grounded theory method to develop a substantive theory of the nurses’ experiences. This current paper aimed to highlight the experiences of perioperative nurses when confronted with expressing a conscientious objection towards their participation in these procedures. A number of organizational and cultural barriers within the healthcare organization were seen to hamper their ability in expressing a conscience‐based refusal, which lead to their reluctant participation. Perioperative nurses must feel safe to express a conscientious objection towards these types of surgical procedures and feel supported in doing so by their respective hospital organizations and not be forced to participate unwillingly. (shrink)

Since 2013, mortgage advisory has become an independent profession in the Netherlands. Initially working for mortgage providers, the newly nonpartisan advisers now work for standard advisory fees, thereby reducing conflicts of interest. In this article, I provide an ethical analysis of the different types of ethos of mortgage advisers, that is, the ways they see and talk about, and relate to their work in a certain way. The central research question is: What different kinds of ethos do mortgage advisers have, (...) and which moral dilemmas do they experience in their advisory work? The existence of moral dilemmas is controversial in ethics but nonetheless experienced in real-world business practice. An “ethological” understanding of morality is developed in this paper to understand how these dilemmas are experienced. Twenty-nine mortgage advisers have participated in Q methodological research, a mixed qualitative–quantitative small-sample method. Three different types of ethos were found: Principled Advisers, Moral Advisers, and Minimal Morality Advisers. In considering these three types, I argue that many mortgage advisers should professionalize their ethical stance and learn to address situations in which moral values are neglected. Business ethicists, in turn, need to acknowledge that something may be considered morally inappropriate but is still defensible in some other sense. In this paper, I develop a “layered” conception of business ethics that broadens the perspective from universal notions, such as “rights” and “duties,” toward a concrete ethos that people have in a certain professional practice. (shrink)

Undergraduate social work students are exposed to ethical and legal dilemmas during their fieldwork training. This article presents a study that examined these ethical dilemmas in an Israeli sample of undergraduate social work students. 117 students who participated in a course in ethics submitted 31 written presentations of ethical-dilemma analysis. Their oral presentations were recorded and transcribed. Using a qualitative analysis, three major themes emerged: 1. The tension between the duty to maintain client's confidentiality and its violation under certain (...) conditions; 2. The students’ conflict of loyalty toward the client vs. the organization; 3. The question of the clients’ right to self-determination when, in the student's view, this is against their best interests.Our findings point to the vital role of an ethics course in the social work undergraduate curriculum that can enhance students’ knowledge of specific laws relevant to the limits of confidentiality in social work and their ability to analyze ethical dilemmas as future professionals. Furthermore, it is essential to raise awareness in educators and supervisors concerning moral distress that may afflict students coping with ethical dilemmas at this early professional developmental phase. (shrink)

BackgroundLarge-scale, centralized data repositories are playing a critical and unprecedented role in fostering innovative health research, leading to new opportunities as well as dilemmas for the medical sciences. Uncovering the reasons as to why citizens do or do not contribute to such repositories, for example, to population-based biobanks, is therefore crucial. We investigated and compared the views of existing participants and non-participants on contributing to large-scale, centralized health research data repositories with those of ex-participants regarding the decision to end their (...) participation. This comparison could yield new insights into motives of participation and non-participation, in particular the behavioural change of withdrawal.MethodsWe conducted 36 in-depth interviews with ex-participants, participants, and non-participants of a three-generation, population-based biobank in the Netherlands. The interviews focused on the respondents’ decision-making processes relating to their participation in a large-scale, centralized repository for health research data.ResultsThe decision of participants and non-participants to contribute to the biobank was motivated by a desire to help others. Whereas participants perceived only benefits relating to their participation and were unconcerned about potential risks, non-participants and ex-participants raised concerns about the threat of large-scale, centralized public data repositories and public institutes, such as social exclusion or commercialization. Our analysis of ex-participants’ perceptions suggests that intrapersonal characteristics, such as levels of trust in society, participation conceived as a social norm, and basic societal values account for differences between participants and non-participants.ConclusionsOur findings indicate the fluidity of motives centring on helping others in decisions to participate in large-scale, centralized health research data repositories. Efforts to improve participation should focus on enhancing the trustworthiness of such data repositories and developing layered strategies for communication with participants and with the public. Accordingly, personalized approaches for recruiting participants and transmitting information along with appropriate regulatory frameworks are required, which have important implications for current data management and informed consent procedures. (shrink)

Gaining ethical approval for qualitative health research and implementing all the planned research processes in a proposed study are not straightforward endeavours. The situation becomes more complex when qualitative research is conducted in a cross-national healthcare and academic context. Also, it is even exhausting when the study is student-based, as student researchers may be considered novices and inexperienced researchers, especially for field-based research. Our aim in this reflective paper is to present, reflect, and discuss the experiences of a doctoral researcher (...) in dealing with two independent institutional review boards in Canada and Ghana during an interdisciplinary Ph.D. project and the ethical dilemmas encountered while collecting data in Ghana. Based on the researcher’s experiences, it became apparent that consent and its documentation can have cultural implications in different settings; hence, institutional review boards must exercise reflexivity in their protocol review practice. Also, sharing research data with participants and institutional leaders while maintaining participant confidentiality and privacy in institutional ethnographic research requires sensitivity to bi-lateral ethical values. With the experiences shared in this paper, we advocate for a dialogic ethical review process in qualitative research where researchers and research ethics boards engage in ongoing dialogue rather than the usual prescriptive format research ethics reviews often assume. (shrink)

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia. Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of (...) 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation. (shrink)

Background Payment of research participants helps to increase recruitment for research studies, but can pose ethical dilemmas. Research ethics committees (RECs) have a centrally important role in guiding this practice, but standardisation of the ethical approval process in Ireland is lacking. Aim Our aim was to examine REC policies, experiences and concerns with respect to the payment of participants in research projects in Ireland. Method Postal survey of all RECs in Ireland. Results Response rate was 62.5% (n=50). 80% of RECs (...) reported not to have any established policy on the payment of research subjects while 20% had refused ethics approval to studies because the investigators proposed to pay research participants. The most commonly cited concerns were the potential for inducement and undermining of voluntary consent. Conclusions There is considerable variability among RECs on the payment of research participants and a lack of clear consensus guidelines on the subject. The development of standardised guidelines on the payment of research subjects may enhance recruitment of research participants. (shrink)

There is a way of talking that would appear to involve ascriptions of purpose, goal directed activity, and intentional states to groups. Cases are familiar enough: classmates intend to vacation in Switzerland, the department is searching for a metaphysician, the Democrats want to minimize losses in the upcoming elections, and the US intends to improve relations with such and such country. But is this talk to be understood just in terms of the attitudes and actions of the individuals involved? Is (...) the talk, to take an overly simple proposal as an example, a mere summary of familiar individual attitudes of the group members? Or is the ascription of attitudes and actions to groups to be taken more literally, as suggesting that the group for example believes that P, or intends to A, over and above what the members individually think and do? In short, are there groups with minds of their own? Philip Pettit has deployed the “discursive dilemma” to defend the thesis that there are such group minds. In what follows, I explore the relationship between the group allegedly with a mind of its own and the individuals it comprises, and I consider just how this relationship must be understood in order to give Pettit’s argument for group minds its best chance for success. As I understand it, the discursive dilemma has to be used in conjunction with what might be called an indispensability argument for group minds. It is useful to distinguish two forms of this argument. The explanatory version of the indispensability argument is, very schematically, as follows: there is a compelling explanatory theory T concerning the social, certain indispensable elements of T entail the group mind thesis, so the group mind thesis is true. Several questions immediately arise: What sort of theory is T? In what sense is it indispensable? Are there other forms of indispensability? I don’t have definitive answers to these questions. But how we settle them will have implications for the interaction and support the discursive dilemma provides the indispensability argument. In particular, using the discursive dilemma to defend what I characterize below as a practical version of the indispensability argument commits us to the rationality of individual participants in a way that the explanatory version of the indispensability argument does not. My point in the first part of the paper is that if Pettit wants to avoid the weaknesses of the explanatory indispensability argument and pursue the practical version, then he owes us a story about the rationality of individual participation in groups. Pettit also owes us a story about the agency an individual exercises as part of a group. If it takes the actions of individuals to execute the intentions of the group, how are we to understand those actions in order for the group to count as having a mind of its own? How must group intentions figure in the practical or deliberative perspective of individuals who execute those intentions? I will argue that the proponent of the group mind thesis must proceed with some care here, because some natural ways of answering these questions will undermine the thesis. But in the end, I think that these questions are interesting independently of whether Pettit is right to think that groups do have minds of their own. That’s because investigating Pettit’s arguments might lead to new ideas about how the rationality and agency of individuals can be exercised, and suggests new ways of understanding how individuals can act together, irrespective of whether the groups they compose ever have minds of their own. (shrink)

Recent theories have argued that emotions play a central role in moral decision-making and suggested that emotion regulation may be crucial in reducing emotion-linked biases. The present studies focused on the influence of emotional experience and individual differences in emotion regulation on moral choice in dilemmas that pit harming another person against social welfare. During these “harm to save” moral dilemmas, participants experienced mostly fear and sadness but also other emotions such as compassion, guilt, anger, disgust, regret and contempt (Study (...) 1). Fear and disgust were more frequently reported when participants made deontological choices, whereas regret was more frequently reported when participants made utilitarian choices. In addition, habitual reappraisal negatively predicted deontological choices, and this effect was significantly carried through emotional arousal (Study 2). Individual differences in the habitual use of other emotion regulation strategies (i.e., acceptance, rumination and catastrophising) did not influence moral choice. The results of the present studies indicate that negative emotions are commonly experienced during “harm to save” moral dilemmas, and they are associated with a deontological bias. By efficiently reducing emotional arousal, reappraisal can attenuate the emotion-linked deontological bias in moral choice. (shrink)

Therapists treating adolescent gang members face unique ethical dilemmas. These dilemmas arise directly from clinical issues that inevitably emerge in the treatment of this population. Clinical issues related to the adolescent gang member having great difficulty trusting, having experienced and observed much violence, and usually having participated in criminal activities are central to the treatment process. In this article I discuss the ethical problems that subsequently emerge: maintaining confidentiality, discharging one's duty to warn or protect, and imposing one's personal values. (...) Suggestions for future research are offered. (shrink)

This article describes a qualitative investigation of 20 student activists' resolutions to environmental dilemmas. Participants responded to an oral interview asking them to resolve 6 dilemmas involving the natural environment and to give justifications for their resolutions. Several major themes emerged. First, participants tended to be concerned with maintaining human self-determination and tolerating human diversity. They also resolved dilemmas by reference to 3rd parties, and attributions of responsibility and sacrifice were made according to several patterns. Both humans and nonhumans were (...) considered in resolutions, and resolutions reflected concerns with procedural justice and fairness and context-based value hierarchies. These themes are discussed in terms of the difficulty of resolving such dilemmas and implications for studying values and moral choices in the environmental context. (shrink)

Dilemma discussions have been proven to be one of the most effective methods to enhance students’ moral reasoning in ethics education. Dilemma discussions are increasingly arranged online, but research on the topic has remained sparse, especially in the context of continuing professional education. The aim of the present paper was to develop a method of dilemma discussions for professional ethics. The method was based on asynchronous discussions in small groups. Health and social care students raised work-related dilemmas (...) from their experiences and discussed them in terms of professional values, ethical guidelines and theories. Participants in this quasi-experimental study were 87 first-term graduate students at a Finnish university of applied sciences. Health and social care students in two consecutive ethics courses constituted two experiment groups, whereas health and social care students and business students in other programmes served as control groups. Students filled in a Defining Issues Test (DIT2) at the beginning of their studies and three months apart. Statically significant increase in moral reasoning was evidenced for experiment group 2, when discussion groups were purportedly composed to maximise differences in initial levels of moral reasoning. Findings suggest that online dilemma discussions can advance students’ moral reasoning development, especially when students’ exposure to higher-level arguments is ensured through complementary means, such as instructions, examples and plenary discussions. Online real-life dilemma discussions may also serve other important goals of ethics education, especially acquiring ethical concepts, and they can promote other components of ethical decision making: ethical sensitivity and motivation, and acquisition of implementation skills. (shrink)

When conducting research in an international setting, in a country different than that of the researcher, unpredictable circumstances can arise. A study conducted by a novice North American researcher with a vulnerable population in northern Ghana highlights these happenings with an emphasis placed on the ethical challenges encountered. An illustration from the research is used to highlight an ethical dilemma while in the field, and how utilizing a moral decision-making framework can assist in making choices about a participant's right (...) to autonomy, privacy, and confidentiality during the research process. Moral frameworks, however, can never be enough to solve a dilemma since guidelines only describe what to aim for and not how to interpret or use them. Researchers must therefore strive to move beyond these frameworks to employ practical wisdom or phronesis so to combine the right thing to do with the skill required to figure out what the right choice is. The skill of practical wisdom must be acquired because without it international researchers indecisively fumble around with good intentions, often leaving a situation in worse shape than they found it. (shrink)

The Gamer’s Dilemma challenges us to justify the moral difference between enacting virtual murder and virtual child molestation in video games. The Dilemma relies for its argumentative force on the claim that there is an intuitive moral difference between these acts, with the former intuited as morally acceptable and the latter as morally unacceptable. However, there has been no empirical investigation of these claims. To explore these issues, we developed an experimental survey study in which participants were asked (...) to reflect on imaginary video game scenarios as part of a 2 (undertake virtual murder or molestation) X 2 (against an adult or child) X 2 (in a high or low realism virtual environment) factorial design. We found that there was a significant difference between people’s views about virtual murder and virtual molestation. Whether the virtual act was performed against an adult or child was non-significant in most conditions, whereas whether it was performed in a high or low realism virtual environment was significant in most conditions. Gender did not impact these results, whereas perceived gaming experience, hours of video game play per week, and integrity did. These results provide an empirical grounding for future discussions of the Gamer's Dilemma. (shrink)

Background:Caring for a partner with primary malignant brain tumour can be a dramatic life-changing event. Primary malignant brain tumour is known to give poor life expectancy and severe neurological and cognitive symptoms, such as changed behaviour and personality, which demand greater caring responsibilities from spouses.Aim:The aim of the study is to explore ethical dilemmas spouses experience in the everyday care of a partner in treatment for primary malignant brain tumour.Research design, participants and research context:A phenomenological and hermeneutic qualitative descriptive design (...) was adopted as a method for collecting and analysing data. Ten spouses were interviewed twice using an in-depth, semi-structured interview guide. The interviews took place at the spouses’ homes or at the hospital.Ethical consideration:Ethical matters were considered throughout the research process. Permission from The National Committee on Health Research Ethics and the Danish Data Protection Agency was obtained.Findings:The analysis showed that the spouses perceived daily ethical dilemmas in caring for a partner with primary malignant brain tumour. Their life as well as their partner’s life had changed considerably. The main theme that emerged therefore was ‘oscillating in a changing relationship’. This theme was further elaborated in three subthemes that in more detail demonstrated the dilemmas: ‘doing the right thing in unpredictable daily situations’; ‘torn between patience and guilt’; and ‘living in a time of uncertainty, hope and despair’.Conclusion:Caring for a partner with changed behaviour and personality due to primary malignant brain tumour may involve exhausting ethical caring dilemmas. Spouses’ married life may change to a semi-professional asymmetrical relationship, which is challenged by the oscillation between acting responsibly for their partners’ well-being and caring dilemmas with no answer for what the right thing to do is. Mixed feelings of right and wrong, patience and guilt, hope and despair seem to be spousal companions through their partners’ progressing illness. (shrink)

Previous studies have found that the proportions of people who endorsed utilitarian decisions varied across different variants of the trolley dilemma. In this paper, we explored whether moral choices were associated with beliefs about outcome probabilities in different moral dilemmas. Results of two experiments showed that participants’ perceptions of outcome probabilities were different between two dilemmas that were similar to the classical switch case and footbridge case. Participants’ judgments of the outcome probabilities were associated with their moral choices. The (...) results suggested that participants might not accept task instructions and thus did not perceive the outcomes in the dilemmas as certain. We argued that researchers who endorse descriptive tasks in moral reasoning research should be cautious about the findings and should take participants’ beliefs in the outcomes into account. (shrink)