An empirical investigation was conducted to determine whether management information systems (MIS) majors, on average, exhibit ethical decision-making processes that differ from students in other functional business areas. The research also examined whether the existence of a computer-based information system in an ethical dilemma influences ethical desision-making processes. Although student subjects were used, the research instrument has been highly correlated with educational levels attained by adult subjects in similar studies. Thus, we feel that our (...) results have a high likelihood of generalization to the MIS professional community. The results indicate that MIS majors exhibit more socially-oriented ethical decision-making processes than non-MIS majors measured by the Defining Issues Test. The results also indicate that the existence of a computer-based information system in an ethical dilemma may influence ethical decision-making processes. The study makes no statement regarding MIS majors making more (or less) ethical decisions. The business ethics literature is reviewed, details of the study are presented, implications for management are considered, and directions for future research are suggested. (shrink)

Our comments focus on the ACMCode of Ethics and situate the Code within ageneral ethical decision-making process tospecify the five steps which logically precedehuman action in ethical matters and determinethat action, and the individual differencetraits in these five steps which bear upon theresolution of an ethical problem and lead tomorally responsible action. Our main purpose isto present a cognitive moral processing modelwhich computing professionals can use to betterunderstand their professional rights andduties. It is clear (...) that the Code providessubstantial guidance in the areas ofintellectual property rights, unauthorizedentry into computing systems, and privacy. Inother areas, such as obscenity onbulletin-board systems, the Code is silent. Aninteractive software program which allows theuser to see the ways in which the Code isintegrated and instructive in the six-stepmoral decision-making process is accessible viathe internet. Our secondary purpose is toreformulate the Code as a set of questionswhich allow the computing professional to seepractices which diminish the human person asunethical and those which enhance the humanperson as ethical. (shrink)

There has been neglect of systematic conceptual development and empirical investigation within consumer ethics. Scenarios have been a long-standing tool yet their development has been haphazard with little theory guiding their development. This research answers four questions relative to this gap: Do different scenario decision frames encourage different moral reasoning styles? Does the way in which framing effects are measured make a difference in the measurement of the relationship between moral reasoning and judgment by gender? Are true framing effects (...) likely to vary with the situation? and Are true framing effects likely to vary by gender? The conclusions reached were that (1) different scenario frames encourage both types of reasoning, but rule based moral reasoning is dominant regardless of frame, (2) accounting for formal equivalency in the measurement of true framing effects is likely to enhance the interpretation of studies in moral reasoning and judgment, (3) True framing effects are more likely to occur in situations with low to moderate perceived ethicality, and (4) true framing effects are not likely to vary by gender. Explanations as to why these results occurred are discussed. (shrink)

In this comparative survey of 191 Egyptian and 92 U.S. executives, we explore the relationship between national culture and ethical decision-making within the context of business. Using Reidenbach and Robin’s (1988) multi-criteria ethics instrument, we examine how differences on two of Hofstede’s national culture dimensions, individualism/collectivism, and power distance, are related to the manner in which business practitioners make ethical decisions. Egypt and the U.S. provide an interesting comparison because of the extreme differences in their economies (...) and related business development. Our results indicate that respondents from the U.S, individualistic and low in power distance, were likely to view the decision making outcome in ethics scenarios as more unethical than the more collectivistic and high power distance Egyptians, when applying ethical criteria based on justice, utilitarianism, relativism, and (contrary to our predictions) egoism. However, we also found that both Egyptians and Americans rely on justice, utilitarianism, and relativism in predicting their intentions to behave ethically, and that Americans substitute egoism for justice, when the behavioral intentions of peers are examined. (shrink)

Focusing on millennials, individuals born between 1980 and 2000 and representing the largest generational population in our history, this research seeks to understand their ethical decision-making processes by exploring the distinctive, yet interconnected, theories of personal values and cognitive moral reasoning. Utilizing a decision-making framework introduced in the 1990s, we discover that there is a statistically supported relationship between a millennial’s personal value orientation and stage of cognitive moral reasoning. Moreover, we discover a strong relationship (...) between three of the four value orientations and a corresponding stage of cognitive moral reasoning. The theoretical and practical research implications of our discovery about millennials’ decision making are discussed. (shrink)

The aim of the present research is studying the relationship between the salespersons’ ethical philosophy and their ethical decision-making process and seeks to answer two fundamental questions: first, what is the ethical philosophy of salespersons? And second, how does the salespersons’ ethical philosophy affect their ethical decision-making process? Statistical population of this research is salespersons who have passed the sales training course at the Department of Commerce Research Centre. One (...) hundred thirty-seven questionnaires of total 300 accessible populations were analyzed through path analysis method. The findings indicate that most salespersons are idealists. Although this idealism affects the ethical judgment directly, but the effect of relativism on ethical intention is more considerable. (shrink)

The purpose of this paper is to examine the various guidelines presented in the literature for instituting an ethics curriculum and to empirically study their effectiveness. Three questions are addressed concerning the trainability of ethics material and the proper integration and implementation of an ethics curriculum. An empirical study then tested the effect of ethics training on moral awareness and reasoning. The sample consisted of two business classes, one exposed to additional ethics curriculum (experimental), and one not exposed (control). For (...) the experimental group, ethics exercises and discussion relevant to each topic were completed. Findings suggested gender differences such that, relative to other groups, women in the experimental group showed significantly improved moral awareness and decision-making processes. An explanation of the underlying cognitive processes is presented to explain the gender effect. (shrink)

Abstract:This paper develops a framework for examining decision making about ethical issues and tests the applicability of a social contract perspective. Using two separate samples of students and salespeople, we determine that community members (salespeople) tend to judge a potentially unethical act to constitute a violation of an implicit social contract and non-community members (students) do not. Also, consistent with the emphasis on context specificity of integrative social contracts theory, situational variables influence perceptions of ethicality for the (...) community members, but do not affect the perceptions of individuals outside the community. The study finds considerable support for the use of a social contractarian perspective in the study of decision-making processes about ethical issues. (shrink)

Using professional accountants as respondents in Hong Kong, this study strives to develop a model to depict the effect of ethical reasoning on the relationships between guanxi and auditors; behaviour in an audit conflict situation. The results of the study found that (1) there is a significant relationship between an auditor's ethical judgement and one's moral cognitive development; (2) there is a relationship between an auditor's ethical judgement and the existence of guanxi; and (3) the impact of (...) guanxi on an auditor's judgement is depending on the level of ethical reasoning. (shrink)

ABSTRACT Social media is becoming increasingly embedded in people’s daily lives. These virtual spaces are now regularly used as a tool for information dissemination. Drawing on the moral intensity literature combined with uses and gratifications theory, this research explores how using social media to consume information can affect the ethical decision-making process. This study compares the influence of two online media dissemination formats – an online news article and social media discussion thread – on individuals’ (...) class='Hi'>ethical perceptions and decisions. Results indicate that social media usage has an effect on perceptions of social consensus, problem recognition, and ethical sensemaking. Overall, Social media is shown to inhibit ethical decision-making when used as an information dissemination tool. (shrink)

In this paper, we explore the impact of individualism and collectivism on three basic aspects of ethical decision making - the perception of moral problems, moral reasoning, and behavior. We argue that the inclusion of business practices within the moral domain by the individual depends partly upon individualism and collectivism. We also propose a pluralistic approach to post-conventional moral judgment that includes developmental paths appropriate for individualist and collectivist cultures. Finally, we argue that the link between moral (...) judgment and behavior is related to individualism and collectivism. (shrink)

We investigated the ethical decision-making processes and intentions of 151 military personnel responding to 1 of 2 ethical scenarios drawn from the deployment experiences of military commanders. For each scenario, option choice and perspective affected decision-making processes. Differences were also found between the 2 scenarios. Results add to the emerging literature concerning operational ethical conflicts and highlight the complexity and challenge that often accompanies operational ethics.

Using a nationwide survey, this study compared the ethical values and decision processes ofFortune executives and MBA students. Statistically significant differences in ethical values were found by class of respondent, gender, and professed decision approach. MBAs were also found to process ethical decisions differently than business professionals.

Ethical dilemmas require evaluation of alternatives in light of conflicting principles. Because of the difficulty of making and defending such complex decisions, we may compromise the quality of our ethical decisions and debates. We need a methodology that combines the weighted effects of multiple ethical guidelines on the issue at hand. This paper describes how the Analytic Hierarchy Process can help us improve ethical decision making.

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

Providing a vibrant four-color design, market-leading BUSINESS ETHICS: ETHICAL DECISION MAKING AND CASES, Ninth Edition, thoroughly covers the complex environment in which managers confront ethical decision making. Using a proven managerial framework, this accessible, applied text addresses the overall concepts, processes, and best practices associated with successful business ethics programs--helping readers see how ethics can be integrated into key strategic business decisions. Thoroughly revised, the new ninth edition incorporates coverage of new legislation affecting business (...) ethics, the most up-to-date examples, and the best practices of high-profile organizations. It also includes 20 all-new or updated original case studies. (shrink)

In order to strengthen RI in the private sector, it is imperative to understand how companies organise this process, where it takes place, and what considerations and motivations are central in the innovation process. In this chapter, the questions of whether and where normative considerations play a role in the innovation process, and whether dimensions of RI are present in the innovation process, are addressed. In order answer these research questions, a theoretical framework is developed based (...) on Jones’s theory of ethical decision making and Cooper’s stagegate model of innovation management. In order to answer the research questions, a specific case of innovations that contribute to public health is explored, namely, that of food companies that participate in a Front-of-Pack logo for healthier food. As the use of healthy food logos does not necessarily have a positive impact on sales and profits, it is expected that in the decision-making process, as part of their innovation process, companies make several trade-offs between economic, technical and moral factors. As the social-ethical values at stake in corporate innovation processes have remained to a large extent unexplored in research on innovation management, the aim of this chapter is to identify the motivations and barriers for companies embracing and continuing a FoP logo for healthier food, and to assess whether ethical considerations play a role in this innovation process. From the findings in this research, it will become clear that although the studied companies participated in a programme for healthy food and thus are responsive to the needs of society, and although the companies feel responsible for public health, ethical considerations do not play a central role in the operational innovation process. Instead, technical and economic considerations seem to prevail in the operational innovation process. Furthermore, none of the procedural dimensions of RI seems to be present at this level in the innovation trajectory. It is argued that this may be an indication that the ethical decision-making process for RI is not located at the level of the operational innovation process itself, but is something that might be located on a higher strategic level in the company. It is at this level that the moral decision is taken to adopt the FoP logo and to engage in the RI process. The findings cast a new light on the discourse on RI in general, and in the private sector in particular. (shrink)

The resolution of ethical dilemmas often requires individuals to search for reasonable justifications to support their choices. Occasionally, such justifications must be made explicit to stakeholders inside or outside the organization. Other times, the justification for a decision will be known only by the decision-maker. In either case, the organizational code of conduct that governs the individual can play a vital role in providing guidelines about appropriate and inappropriate justifications. The present paper discusses the connections between organizational (...) codes and employee justifications. (shrink)

We develop a model of ethical decision making that integrates the decision-making process and the content variables considered by individuals facing ethical dilemmas. The process described in the model is drawn from Janis and Mann’s [1977, Decision Making: A Psychological Analysis of Conflict Choice and Commitment (The Free Press, New York)] work describing the decision process in an environment of conflict, choice and commitment. The model is enhanced by (...) the inclusion of content variables derived from the ethics literature. The resulting integrated model aids in understanding the complexity of the decision process used by individuals facing ethical dilemmas and suggests variable interactions that could be field-tested. A better understanding of the process will help managers develop policies that enhance the likelihood of ethical behavior in their organizations. (shrink)

This research on the ethics of meaningful work examined how types of job-related harm and their magnitude of consequences influenced components of ethical decision-making. The research also investigated the moderating effects of individual differences on the relation between the MOC and the ethical decision-making elements for each type of harm. Using a sample of 185 Chinese professionals, a between-subjects, fully crossed experimental scenario design revealed that physical and economic job-related harm were recognized as moral (...) issues to a greater extent than cognitive or emotional harm. Second, physical job-related harm stimulated a higher level of moral evaluations than economic and cognitive harm. Third, individuals intended to act ethically when MOC was high versus low. Finally, experience with layoffs and IMO helped explain the relations between MOC and moral evaluations for economic and cognitive job-related harm, respectively. Implications for research and management are discussed. (shrink)

Poor ethical decision–making costs industry billions of dollars a year and damages the images of corporations. Thus, by answering the question ‘Why do individuals behave as they do when confronted with ethical issues?’ ethical theory can provide businesses with a means to create a more ethical climate and a more successful operation. This study tested the Ethical Decision–Making Model with accountability (Beu & Buckley 2001), which uses theory that suggests that (...) class='Hi'>ethical behavior is influenced by the individual, the issue, social relationships (accountability), and the organization in which the employee is embedded (Brass, Butterfield & Skaggs 1988; Frink & Klimoski 1998). The results showed that individuals’ thought processes (cognitive moral development), personalities (locus of control, hostility and aggression, Machiavellianism), and gender influence how they respond to ethical dilemmas, as well as the salience of the moral issue (moral intensity) and the environmental context (work/school). (shrink)

Poor ethical decision–making costs industry billions of dollars a year and damages the images of corporations. Thus, by answering the question ‘Why do individuals behave as they do when confronted with ethical issues?’ ethical theory can provide businesses with a means to create a more ethical climate and a more successful operation. This study tested the Ethical Decision–Making Model with accountability (Beu & Buckley 2001), which uses theory that suggests that (...) class='Hi'>ethical behavior is influenced by the individual, the issue, social relationships (accountability), and the organization in which the employee is embedded (Brass, Butterfield & Skaggs 1988; Frink & Klimoski 1998). The results showed that individuals’ thought processes (cognitive moral development), personalities (locus of control, hostility and aggression, Machiavellianism), and gender influence how they respond to ethical dilemmas, as well as the salience of the moral issue (moral intensity) and the environmental context (work/school). (shrink)

This paper reports on a study of ethical decision-making in a fair trade company. This can be seen to be a crucial arena for investigation since fair trade firms not only have a specific ethical mission in terms of helping growers out of poverty, but they tend to be perceived as (and are often marketed on the basis of) having an "ethical" image. Eschewing a straightforward test of extant ethical decision models, we adopt (...) Thompson''s proposal for a more contextualist understanding rooted in ethnographic data. Our findings suggest that the fair trade mission of the firm is experienced as an over-riding ethical claim, which is often invoked to justify potentially ethically questionable decisions. Moreover, decision precedents emerge which can mean that the decision process is bypassed or hurried through. Finally we provide evidence that the significance of these precedents, and indeed, even moral intensity itself, could be actively shaped and constructed by organization members to support different, even shifting, conceptions of what is a morally acceptable decision for a fair trade company to make. (shrink)

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 describe the ethical decision-making processes employed by a select group of Filipino college deans in solving ethical dilemmas using the ethical paradigms proposed in the works of Starratt (...) (Educ Adm Q 27:185–202, 1991) and Shapiro and Stefkovich (Ethical leadership and decision-making in education: applying theoretical perspectives to complex dilemmas, 2005) as frameworks for the analysis. Data was gathered using semi-structured interviews and field text was analyzed using deductive thematic analysis. Findings of this study show that majority of the deans chose to share ethical dilemmas involving students and teachers. The findings also show the ethical frameworks of care, justice, and profession as the dominant paradigms utilized by Filipino deans and their preference for adopting multiple ethical frameworks when making their decisions. Most of the ethical dilemmas which the deans narrated relate to their tasks of academic administration such as monitoring student performance, faculty evaluation and maintaining school discipline. Interestingly, only a few dilemmas involving university administrators were expressed, and dilemmas that refer to broader societal issues usually associated with school administrators’ utilization of the ethic of critique were also significantly left out in the narratives of this study. This paper intends to contribute to current literature by expanding research to administrators working in the context of higher education in the Philippine setting. The findings of this study could serve as knowledge base in designing ethics courses to enhance educational leaders’ ethical decision-making skills. The study also provides useful insights of ethical decisions and reasoning processes employed by academic administrators in resolving real life ethical dilemmas that could be useful at the practical level for aspiring and practicing deans. (shrink)

Ethical decision-making descriptive theoretical models often conflict with each other and typically lack comprehensiveness. To address this deficiency, a revised EDM model is proposed that consolidates and attempts to bridge together the varying and sometimes directly conflicting propositions and perspectives that have been advanced. To do so, the paper is organized as follows. First, a review of the various theoretical models of EDM is provided. These models can generally be divided into rationalist-based ; and non-rationalist-based. Second, the (...) proposed model, called ‘Integrated Ethical Decision Making,’ is introduced in order to fill the gaps and bridge the current divide in EDM theory. The individual and situational factors as well as the process of the proposed model are then described. Third, the academic and managerial implications of the proposed model are discussed. Finally, the limitations of the proposed model are presented. (shrink)

Our research’s aim is to assess the effect of cultural factors on business ethical decision-making process in a Western cultural context and in a non-Western cultural context. Specifically, this study investigates ethical perceptions, religiosity, personal moral philosophies, corporate ethical values, gender, and ethical intentions of U.S. and Moroccan business managers. The findings demonstrate that significant differences do exist between the two countries in idealism and relativism. Moroccan managers tend to be more idealistic than (...) the U.S. managers. There is a strong positive relationship between religiosity and idealism. There were mixed findings in examining the correlates of religiosity and various components of ethical intentions. Moroccan managers were more homogenous in their corporate ethical values than were the U.S. managers. The results demonstrate that (in general) idealism is a good predictor of ethical intentions and behaviors. Additionally, managers from the two countries differed in the degree of relationship between perceptions and intentions in three of the four scenarios. This study’s results confirm other research findings that, in general, female business managers have higher ethical sensitivity in terms of their ethical judgment than their male counterparts. Managerial implications are also discussed. (shrink)

Veterinary ethics is a coordination of ethical principles that apply morals, values and judgements to the practice of veterinary profession. Veterinary ethics cover its practical application in veterinary practices as well as on its history, philosophy, theology, and sociology. Veterinary ethics combine veterinary professional ethics and the focus of animal ethics. It can be inferred as a critical manifestation on the provision of veterinary services in hold of the profession’s responsibilities to animal kind and mankind. Many ethical issues (...) arise in a business unit in veterinary practice. Whenever such issues arise, it may lead to dilemmas, then proper and well-thought out ethical decision is to be made. Ethical decision making process in a business unit in veterinary practice is the use of ethical theories, principles, and rules by veterinary professionals and paraprofessionals in resolving ethical dilemmas in the veterinary practice. In order to resolve ethical dilemmas, being aware of and revelation to ethical theories is essential. Thoughtfulness of animal welfare and ethical issues is an essential component of a good ethical veterinary practice. This article reviews and discusses the ethics and major steps engaged in the ethical decision-making process in a business unit in veterinary practice. Strong commitment to the role, organization’s commitment to ethics and staff support could lower the levels of moral stress while facing ethical dilemma in a veterinary practice. Though using the ethical frameworks portrayed may not change the actual decisions finally reached by veterinary professionals, a good knowledge of ethical issues is imperative for client communication, better job satisfaction and preserving a positive public outline for both the individual and the veterinary practice. (shrink)

In response to the lack of empirical studies examining the internal disclosure behavior in the Chinese context, this study tested a whistleblowing -decision-making process among employees in the Chinese banking industry. For would-be whistleblowers, positive affect and organizational ethical culture were hypothesized to enhance the expected efficacy of their whistleblowing intention, by providing collective norms concerning legitimate, management-sanctioned behavior. Questionnaire surveys were collected from 364 employees in 10 banks in the Hangzhou City, China. By and large, (...) the findings supported the hypotheses. Issues of whistleblowing in the Chinese context and implications were discussed. (shrink)

As one approach to examining the way ethical decisions are made, we asked experts and novices to review a set of scenarios that depict some important ethical tensions in research. The method employed was “protocol analysis,” a talk-aloud technique pioneered by cognitive scientists for the analysis of expert performance. The participants were asked to verbalize their normally unexpressed thought processes as they responded to the scenarios, and to make recommendations for courses of action. We found that experts spent (...) more time working through the decision-making process than novices and also raised substantially more concerns than novices. Differences also exist among the three groups of experts. (shrink)

As one approach to examining the way ethical decisions are made, we asked experts and novices to review a set of scenarios that depict some important ethical tensions in research. The method employed was “protocol analysis,” a talk-aloud technique pioneered by cognitive scientists for the analysis of expert performance. The participants were asked to verbalize their normally unexpressed thought processes as they responded to the scenarios, and to make recommendations for courses of action. We found that experts spent (...) more time working through the decision-making process than novices and also raised substantially more concerns than novices. Differences also exist among the three groups of experts. (shrink)

Multinational corporations face a litany of challenges regarding ethical decision-making as they traverse new variables in each country they operate in. Presented here is a new approach to ethical decision-making research for multinational corporations with the inclusion of moral virtues, national culture, and a feedback mechanism. The new proposed model builds off of the existing work by Trevino’s Person-Situated Interactionist Model. Hofstede’s work on individual national culture characteristics is used to move the conversation forward (...) by explaining the relationships between individual moderators in Trevino’s model and the effect of national culture on them. The new proposed model recommends the inclusion of moral virtues, with honesty and integrity as examples, as individual moderators in the decision-making process based on previous work. It contributes to the literature by introducing moral virtues into traditional ethical decision-making process models and introduces a new variable with a feedback mechanism for future learning. The paper concludes with recommendations for the future direction of research for ethical decision-making models for multinational organizations. (shrink)

Information Technology is a new tool in education that continually changes and offers new opportunities for teaching and learning. In general, the effects of IT are complex and depend upon people’s decisions about development and use. This study investigates the ethical issues in education in terms of Information Systems students’ attitudes at Saudi universities towards digital piracy. The differences in the ethical decision-making process, ethical awareness, and intention to perform questionable acts is examined. The (...) authors tested for differences in attitudes toward eighteen different questionable actions by using three different factors. The measures of awareness capture the extent to which respondents felt that a particular action was unethical according to each of several ethical criteria. This work explored information technology ethics in several ways. The work analyzed whether information technology use is viewed by individuals as an ethical topic and demographic differences were explored. Significant differences were found in many cases between demographic groups based on ethical issues. These findings can be used to target and address ethical issues and enforcement in information systems curriculum. (shrink)

In this article we report findings from a qualitative study that explored how doctors and nurses in nursing homes describe professional collaboration around dying patients. The study also examined the consequences this can have for the life-prolonging treatment of patients and the care of them and their relatives. Nine doctors and 10 nurses from 10 Norwegian nursing homes were interviewed about their experience of decision-making processes on life-prolonging treatment and care. The findings reveal that the frameworks for the (...) professional collaboration and organization of physicians and nurses prevent patient treatment and care complying with ethical considerations and the law. These conditions have a challenging impact on the care of dying patients and their relatives. (shrink)

The ethical behavior prevalent in an organization often determines business success or failure. Much research in the business context has scrutinized ethical behavior, but there are still few insights into its roots; this study furthers this line of inquiry. In line with identity work theory, we examine how employees’ identification with a family business shapes internal ethical decision-making processes. Because it is individuals who engage in decision-making—be it ethical or not—our research perspective (...) centers on the individual level. We followed an inductive, qualitative approach and conducted interviews with 19 employees in seven family businesses. We found that individuals engage in identity work when they identify as individual family firm employees and when they identify with the perceived characteristics of the family firm. These processes of identification, in turn, influence how employees cope with ethical situations. Our findings contribute to ethics and family business research, as well as to identity theory. (shrink)

The ethics sections of Critical Care Societies have issued position statements and proposed a variety of position papers and policies describing the appropriate use of critical care services. These policies describe the goals of critical care provision — to support a patient through an acute, potentially reversible, life-threatening illness — and provide broad guidance on physiological and hemodynamic criteria that require the specialized care of an ICU environment. In recent years, many critical care professionals have, however, reported providing care they (...) felt was inappropriate or futile even though most felt they should not have done so. Futile care encompasses treatments that will not work or treatments that have no chance of providing any benefit. ICU teams define care as inappropriate when it fails to restore a person to an awareness of self, and an ability to interact with their environment particularly when a lot of critical care resources are required. When patients experience significant amounts of pain and suffering, such care seems even more inappropriate. (shrink)

Objectives—To investigate the factors considered by staff, and the practicalities involved in the decision making process regarding the withdrawal or withholding of potential life-sustaining treatment in a children's hospital. To compare our current practice with that recommended by the Royal College of Paediatrics and Child Health guidelines, published in 1997.Design—A prospective, observational study using self-reported questionnaires.Setting—Tertiary paediatric hospital.Patients and participants—Consecutive patients identified during a six-month period, about whom a formal discussion took place between medical staff, nursing staff (...) and family regarding the withholding or withdrawal of potentially life-sustaining treatments. The primary physician and primary nurse involved in the discussion were identified.Method—Two questionnaires completed independently by the primary physician and nurse.Results—Twenty-two patients were identified . In 20 cases treatment was withdrawn or withheld, in two cases treatment was continued. Nursing staff considered family wishes and family perceptions of patient suffering as significantly more important factors in decision making than medical staff, who considered prognostic factors as most important. In only two cases were the patient's expressed wishes apparently available. In most cases staff considered the patient's best interests were served and the process would not be enhanced by the involvement of an independent ethics committee. The exceptions were those cases in which treatment was continued following disagreement between parties.Conclusions—Our current practice is consistent with that recommended by the RCPCH. The contribution of the patient, provision of staff counselling and general practitioner involvement were identified as areas for improvement. (shrink)

The relationship between mental models and ethical decision making, along with the mechanisms through which mental models affect EDM, are not well understood. Using the sensemaking approach to EDM, we empirically tested the relationship of mental models to EDM. Participants were asked to depict their mental models in response to an ethics case to reveal their understanding of the ethical dilemma, and then provide a response, along with a rationale, to a different ethical problem. Findings (...) indicated that complexity of respondents’ mental models was related to EDM, and that this relationship was mediated by sensemaking processes. The implications of these findings for improving integrity training in organizations, as well as ultimately understanding the role of mental models in EDM, are discussed. (shrink)

Background Nurses have an essential role in caring for end-of-life patients. Nevertheless, the nurse’s involvement in the passive euthanasia decision-making process is insufficient and lower than expected. Objectives To explore factors associated with nurses’ intention to be involved in non-treatment decisions (NTD) regarding passive euthanasia decision-making versus their involvement in the palliative care of patients requesting euthanasia, using the Theory of Planned Behavior (TPB) framework. Design A cross-sectional study utilizing a random sample. Participants and research (...) context The study was conducted in one of the largest hospitals in Israel among 125 nurses employed in internal and surgical care wards. Data was collected through face-to-face interviews between March and April 2019. Method A closed structured questionnaire was developed according to TPB instructions. A paired sample t test and two multiple hierarchical regressions were conducted. Variance explained (R2) and the significance of F change were calculated for each regression. The study used the STROBE statement guideline. Ethical considerations The study was approved by the hospital’s Helsinki Committee (#20.11.2017). Findings A paired sample t test revealed that nurses’ involvement in the palliative care of patients requesting passive euthanasia was significantly higher than in NTD regarding euthanasia. Regression analyses revealed that nurses’ position and attitudes explain their intention to be involved in decision-making; attitudes and perceived behavioral control explain nurses’ intention to be involved in the care of patients requesting euthanasia. Conclusions According to the TPB, nurses’ attitudes explained their intention to participate in decision-making regarding passive euthanasia. It is recommended to enhance open discussion of this complex issue to encourage nurses’ willingness to participate in NTD decision-making regarding euthanasia. (shrink)

This study compares computer-supported groups, i.e., groups using group support systems (GSS), and face-to-face groups using ethical decision-making tasks. A laboratory experiment was conducted using five-person groups of information systems professionals. Face-to-face (FTF) and GSS groups were compared in terms of their decision outcomes and group members' reactions. The results revealed that computer-supported and face-to-face groups showed no significant difference in terms of the decision outcomes of choice shift and decision polarity. However, FTF groups (...) reached their decisions more quickly and they were more successful in attaining group consensus than GSS groups. Subjects evaluated face-to-face communication more favorably than GSS interaction on most post-group measures related to perceived group processes and satisfaction. Despite these outcomes, some possibilities for using GSS technology in an ethical decision making context are examined. (shrink)

Multiprofessional guidelines for fair access to and use of adult critical care services are desperately needed to define a consistent transparent standard of care: when such therapies have the potential to benefit and help a patient as they journey with illness and when they cannot.

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. (shrink)

This paper attempts to build on the contribution to moral imagination theory by Patricia Werhane by further integrating moral imagination with new theoretical developments that have taken place in the business ethics field. To accomplish this objective, part one will review the concept of moral imagination, from its definitional origins to its full theoretical conceptualization. Part two will provide a brief literature review of how moral imagination has been applied in empirical research. Part three will analyze and apply the construct (...) of moral imagination as it relates to the key process stages of ethical decision making including awareness, judgment, intention, and behavior. Immoral imagination is then discussed, along with other behavioral ethics concepts as they relate to moral imagination. The paper concludes with potential future research directions, as well as teaching and managerial implications for the moral imagination construct. (shrink)

Background: Increasing interest in empirical ethics has enhanced understanding of healthcare professionals’ ethical problems and attendant decision-making. A four-stage decision-making model involving ethical attention, reasoning, intention and action offers further insights into how more than reasoning alone may contribute to decision-making.Aims: To explore how the four-stage model can increase understanding of decision-making in healthcare and describe the decision-making of an under-researched professional group.Methods: 23 purposively sampled UK community pharmacists (...) were asked, in semi-structured interviews, to describe ethical problems in their work and how they were resolved. Framework analysis of transcribed interviews utilised the four decision-making stages, together with constant comparative methods and deviant-case analysis.Results: Pharmacists were often inattentive and constructed problems in legal terms. Ethical reasoning was limited, but examples of appeals to consequences, the golden rule, religious faith and common-sense experience emerged. Ethical intention was compromised by frequent concern about legal prosecution. Ethical inaction was common, typified by pharmacists’ failure to report healthcare professionals’ bad practices, and ethical passivity emerged to describe these negative examples of the four decision-making stages. Pharmacists occasionally described more ethically active decision-making, but this often involved ethical uncertainty.Discussion: The four decision-making stages are a useful tool in considering how healthcare professionals try to resolve ethical problems in practice. They reveal processes often ignored in normative theories, and their recognition and the emergence of ethical passivity indicates the complexity of decision-making in practice. Ethical passivity may be deleterious to patients’ welfare, and concerns emerge about improving pharmacists’ ethical training and promoting ethical awareness and responsibility. (shrink)

Ethical decision-making is inherent in nursing practice. Although a definite portion of the nursing literature is devoted to ethics and ethical decision-making, the profession is just beginning to ground its ethics research in the actual experience of nurses. Therefore, the purpose of this phenomenological study was to examine the experience of staff nurses as they engage in ethical decision-making. Interview data were collected from 19 staff nurses in a large, midwestern American (...) metropolitan hospital. Interviews were subse quently transcribed and Giorgi's method of data analysis applied. The emerging descrip tion revealed four common aspects of ethical decision-making among staff nurses: context, trigger, ethical decision-making process (i.e. deliberation and integration), and outcomes. This description provides a foundation for future research regarding a descrip tive theory of ethical decision-making in nursing. (shrink)

It is now common in health care for a diverse range of professions and disciplines to work together in regular and close contact. Thus, there are now calls in the literature for research that documents insights on the ethical dimension of multidisciplinary relationships. Recent Australian research has responded to this call by examining how a multidisciplinary team of health professionals define and operationalize the notion of ethics in an acute ward hospital setting. This article provides findings from the research (...) study that indicate that, although there is a shared conceptualization of ethics as "patient-centered care", there can be times of conflict and tension in determining what is best for the patient. The discussion begins to build an understanding of how a multidisciplinary mix of health professionals responds to ethical conflict and tension. The authors' hope and expectation is that, by keeping the research focus on what health professionals in a multidisciplinary team (MDT) actually do, rather than exclusively on how they philosophically think about ethical dilemmas, the insights can be translated into practical strategies that can be utilized to strengthen the process of ethical decision making within the health care system. (shrink)

The COVID-19 pandemic has strained healthcare resources the world over, requiring healthcare providers to make resource allocation decisions under extraordinary pressures. A year later, our understanding of COVID-19 has advanced, but our process for making ethical decisions surrounding resource allocation has not. During the first wave of the pandemic, our institution uniformly ramped-down clinical activity to accommodate the anticipated demands of COVID-19, resulting in resource waste and inefficiency. In preparation for the second wave, we sought to make (...) such ramp down decisions more prudently and ethically. We report the development of a tool that can be used to make fair and ethical decisions in times of resource scarcity. We formed an interprofessional team to develop and use this tool to ensure that a diverse range of stakeholder perspectives were represented in this development process. This team, called the clinical activity recovery team, established institutional objectives that were combined with well-established procedural values, substantive ethical principles and decision-making criteria by using a variation on the well-known accountability for reasonableness ethical framework. The result of this is a stepwise, semiquantitative, ethical decision tool that can be applied to resource allocation challenges in order to reach fair and ethically defensible decisions. This ethical decision tool can be applied in various contexts and may prove useful at both the institutional and the departmental level; indeed this is how it is applied at our centre. As the second wave of COVID-19 strains healthcare resources, this tool can help clinical leaders to make fair decisions. There are no data in this work. (shrink)

While the influence of emotion on individuals'' ethical decisions has been identified by numerous researchers, little is known about how emotions influence individuals'' ethical decision process. Thus, it is not clear whether different emotions promote and/or discourage ethical decision-making in the workplace. To address this gap, this paper develops a model that illustrates how emotion affects the components of individuals'' ethical decision-making process. The model is developed by integrating research (...) findings that consider the two dimensions of emotion, arousal and feeling state, into an applied cognitive-developmental perspective on the process of ethical decision-making. The model demonstrates that certain emotional states influence the individual''s propensity to identify ethical dilemmas, facilitate the formation of the individual''s prescriptive judgments at sophisticated levels of moral development, lead to ethical decision choices that are consistent with the individual''s prescriptive judgements, and promote the individual''s compliance with his or her ethical decision choices. In particular, the model suggests that individuals experiencing arousal and positive affect resolve ethical dilemmas in a manner consistent with more sophisticated cognitive moral structures. Implications for theory and practice are discussed. (shrink)

Locked-in syndrome (LIS) is one of the most dramatic neurological outcomes and has a profound impact on patients and their families. Most patients have intact cognition and intellectual ability and perception. Communication is possible with eyelid and/or eyeball movement. According to the literature, the wish to die is not an important issue in acute and chronic LIS. This study describes and analyses the ethical decision-making process in two opposite cases of LIS in the intensive care unit. (...) One patient expressed the wish to prolong her life for as long as possible; the other patient asked for deliberate termination of life. Both wishes were honoured. In conclusion, most patients with LIS are competent and intellectually intact. In The Netherlands the autonomy of the patient is respected by law. In respecting this autonomy, medical choices can be different in comparable patients. (shrink)