El artículo tiene como objetivo describir las competencias informacionales a desarrollar durante la formación profesional. Se presenta los referentes teóricos a partir del empleo de un enfoque de sistema que supone el análisis y la síntesis, la inducción y la deducción como métodos de investigación, con el propósito de dar conocer los hitos en las universidades y organizaciones internacionales relacionadas. La modelación fue empleada para la construcción de un nuevo proyecto de desarrollo de competencias informacionales desde la perspectiva de la (...) formación profesional universitaria ajustada a las necesidades de la educación superior en Cuba. El nuevo proyecto se configura en tres unidades básicas, con sus respectivos elementos de competencia, saberes esenciales e indicadores para la evaluación del desempeño. El artículo fundamenta la tesis de que el desarrollo de competencias informacionales debe ser sistemáticamente estructurado, planificado y ejecutado como parte integral de la formación curricular en interacción con los contenidos de las disciplinas docentes, bajo la dirección del profesor y la participación protagónica de los profesionales en formación. The article aims at describing the competence to be developed during professional training. It presents the theoretical referents by means of an approach system that includes synthesis and analysis, induction and deduction as research methods in order to reveal the milestones of information skills development in universities and related international organizations. Modeling was used for the construction of a new skills development project from the perspective of university professional training according to the needs of Higher Education in Cuba. The new project is composed of three basic units, with their respective competence elements, essential knowledge and indicators for the evaluation of the performance. The article supports the theory that information development skills must be systematically structured, planned and implemented as an integral part of the curricular training in interaction with the contents of subjects, under the teacher´s guidance and the active participation of profesionals in training. (shrink)

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

In addition to facing the known competitors in the formal economy, entrepreneurs must also be concerned with rivalry emanating from the informal economy. The informal economy is characterized by actions outside the normal scope of commerce, such as unsanctioned payments and gift-giving, as means of influencing competition. Scholars and policy makers alike have an interest in mitigating the impacts of such informal activity in that it might present an obstacle for legitimate commerce. Received theory suggests that country institutions can enable (...) and constrain productive activity, and, in doing so, influence competitive obstacles in a country. Leveraging 13,670 responses from entrepreneurs distributed across 59 countries, we provide evidence that two particular types of enabling institutions, countries’ property rights regulations and cooperative actions, are useful for lowering the obstacles presented by informal activity. We also find evidence that two constraining institutions, economic and financial regulations lead to more obstacles presented by informal activity. We describe implications for entrepreneurs, policy makers, and future researchers stemming from these findings. (shrink)

The notion of “cultural competency” in healthcare has gained currency in recent years. Health professionals are expected to be sensitive to the cultural backgrounds and language of their patients. Courses on cultural competency are now routinely offered to physicians, nurses, and others working in health fields. Although the rhetoric of cultural competency has been applied to clinical contexts, little attention has been given to its applicability in health research generally or, more specifically, in international health research. In this paper, I (...) briefly explore the relevance and limitations of cultural competency for informed consent to international health research, particularly in the context of low-resource settings. (shrink)

According to what we propose to call “the competence model,” competence is a necessary condition for valid informed consent. If a person is not competent to make a treatment decision, the decision must be made by a substitute decision-maker on her behalf. Recent reports of various United Nations human rights bodies claim that article 12 of the Convention on the Rights of Persons with Disabilities involves a wholesale rejection of this model, regardless of whether the model is based on a (...) status, outcome, or functional approach to competence. The alleged rationale of this rejection is that denying persons the right to make their own treatment decisions based on an assessment of competence necessarily discriminates against persons with mental disorders. Based on a philosophical account of the nature of discrimination, we argue that a version of the competence model that combines supported decision-making with a functional approach to competence does not discriminate against persons with mental disorders. Furthermore, we argue that status- and outcome-based versions of the competence model are discriminatory. (shrink)

Coevolution spreading dynamics on complex networks is a hot topic, which attracts much attention in network science. This paper proposes a mathematical model to describe the two competing complex information spreading dynamics on multiplex networks. An individual can only accept one of the two pieces of information. A heterogeneous mean-field theory is developed to describe the spreading dynamics. We reveal different regions through Monte Carlo simulations of the competing complex information spreading dynamics: no global information, one (...) information dominant, and two information coexistence. We finally find that the heterogeneity of the multiplex networks’ degree distributions does not qualitatively affect the results. (shrink)

Feminists have argued that oppressive socialization undermines the liberal model of autonomy. We contend that this argument can also be employed effectively as a challenge to the standard bioethical model of informed consent. We claim that the standard model is inadequate because it relies on presumptions of procedural autonomy and rational choice that overlook the problem of how agents are often socialized so that they adopt and internalize oppressive norms as part of their motivational structure. The argument that oppressive socialization (...) undermines liberalism’s view of autonomy is most relevant to what Beauchamp and Childress call the threshold elements of informed consent—competence and voluntariness. We show how these elements fail to account for morally relevant factors such as oppressive socialization. (shrink)

Feminists have argued that oppressive socialization undermines the liberal model of autonomy. We contend that this argument can also be employed effectively as a challenge to the standard bioethical model of informed consent. We claim that the standard model is inadequate because it relies on presumptions of procedural autonomy and rational choice that overlook the problem of how agents are often socialized so that they adopt and internalize oppressive norms as part of their motivational structure. The argument that oppressive socialization (...) undermines liberalism’s view of autonomy is most relevant to what Beauchamp and Childress call the threshold elements of informed consent—competence and voluntariness. We show how these elements fail to account for morally relevant factors such as oppressive socialization. (shrink)

As was mentioned by Nicolas Lori in his (Found Sci, 2010 ) commentary, the definition of Information in Physics is something about which not all authors agreed. According to physicists like me Information decreases when Entropy increases (so entropy would be a negative measure of information), while many physicists, seemingly the majority of them, are convinced of the contrary (even in the camp of Quantum Information Theoreticians). In this reply I reproduce, and make more precise, some (...) of my arguments, that appeared here and there in my ( 2010 ) paper, in order to clarify the presentation of my personal point of view on the subject. (shrink)

Information and communication technology has certain advantages that can contribute positively in business ethics education programmes. It is necessary, however, to identify first the factors critical for acquiring ethical competence and later to proceed to the construction and use of such tools, in order to ensure that these tools are indeed adapted to the process and the goals of business ethics education. Based on psychological theory and research, it is argued that one such crucial factor is the psychological construct (...) of ethical autonomy. The strengths and weaknesses of information and communication technology tools are discussed in accordance with this, and some suggestions are given on fruitful ways to incorporate these tools in business ethics education. (shrink)

The fourth industrial revolution will be ushered in by future high technology, and as a result, the world will face new difficulties relating to people, the environment, and profitability. Accordingly, the competitive edge and long-term viability of businesses would depend on the knowledge workers who could overcome these excruciatingly difficult obstacles and have the knowledge and competency to influence the overall performance of any type of company. But managing knowledge workers falls under the purview of human resources, and only effective (...) human resources tools, plans, and procedures can ensure the success of this task. One such tool, which has the capacity and capability to change the whole scenario in an organization's favor, is the human resource information system. The purpose of this structured review is to provide insight into a field of HRM that has largely been neglected by other reviews of the literature and has only been briefly discussed by a small number of publications published in reputable, top-tier journals. A customized HRIS framework is the result of this structured literature review for managing knowledge and competence. The study presents the content analysis of 48 articles, systematically and purposefully selected for this literature review, published during the past three decades. The study has several implications for policymakers and HR practitioners. (shrink)

Berger and Miller argue that cultural competency as an educational tool for physicians-in-training fails to address structural inequality and systemic oppression. Instead, it focuses on “cul...

The article recounts that against the background of globalization processes that swept the world in the late twentieth century and left an indelible mark on the further progress of mankind there was a need to adapt the educational and social systems of Ukraine to functioning in the new conditions of crucial transformations caused by the dynamic changes triggered by universal digitalization, which now penetrates all branches and spheres of public life. It has been noted that the educational sphere is in (...) a state of permanent change, trying to adapt to the new environment in order to ensure a decent level of training specialists of the relevant educational and qualification level capable of adapting to rapidly changing conditions, taking into account the competence acquired in the process of training. As a result, it is shown that in today’s globalized world, the need to master digital competence at an appropriate qualification level comes to the fore, taking into consideration the factors of stair stepping and succession, in response to requirements and challenges of today’s world, which even in a short period of time are able to significantly influence any sphere, transforming its further functioning. The content analysis of regulatory documents enabled to identify the main problematic aspects of the educational industry in the context of ensuring the compliance of the process of standardization of education at the relevant qualification levels, which is characterized by certain fragmentarity and inconsistency and requires further weighted and step-by-step transformative phases in the educational system of Ukraine ensuring its correlation with the European educational standards and guaranteeing its quality. (shrink)

Informed consent is valid only if the person giving it is competent. Although allegedly informed consents are routinely tendered, there are nonetheless serious problems with the concept of competence as it stands. First, conceptual work upon competence is incomplete: the concept is unanalyzed and no logic of competence has been identified. It is thus virtually impossible to reliably discern who is competent. ;Traditional work on competence has explicated three dichotomies from which the necessary conditions for the possibility of competence will (...) be identified, viz., that competence is either a global or a specific notion; is present in varying degrees or in virtue of a threshold; and may or not include appeals to consequences. Past efforts have failed to notice a fourth dichotomy: competence as an affective or cognitive notion. Failure to designate the appropriate arms of these dichotomies is responsible for there being, at present, no reliable test for competence. The inadequacies of a highly regarded particular test for competence, the mental status examination, are examined in light of this failure. ;Competence is located within the rule-governed practice of informed consent. That practice and hence, competence, is justified through a Kantian analysis of respect for persons. This analysis reveals that the logic of competence requires assessment in terms of specific rather than global concerns; degrees of ability rather than a threshold; both cognitive and affective abilities; and no appeal to consequences. ;Based upon the analyses of consent as an example of decision making within the practice of informed consent and of respect for persons, the capacities which jointly comprise competence are identified. These are the capacities to receive, recognize, and retrieve information; to reason about, relate to oneself, and rank options; to choose among alternatives; and, under certain circumstances, to defend one's choice. ;Identification of the logic of competence and explication of and justification for the capacities that comprise competence to consent provide a conceptual foundation for the crucial concept of competence that the informed consent process currently lacks. It should facilitate construction of a test for competence. (shrink)

A competence model describes the abstract structure of a solution to some problem. or class of problems, facing the would-be intelligent system. Competence models can be quite derailed, specifying far more than merely the function to be computed. But for all that, they are pitched at some level of abstraction from the details of any particular algorithm or processing strategy which may be said to realize the competence. Indeed, it is the point and virtue of such models to specify some (...) equivalence class of algorithms/processing strategies so that the common properties highlighted by the chosen class may feature in psychologically interesting accounts. A question arises concerning the type of relation a theorist might expect to hold between such a competence model and a psychologically real processing strategy. Classical work in cognitive science expects the actual processing to depend on explicit or tacit knowledge of the competence theory. Connectionist work, for reasons to be explained, represents a departure from this norm. But the precise way in which a connectionist approach may disturb the satisfying classical symmetry of competence and processing has yet to be properly specified. A standard ?Newtonian? connectionist account, due to Paul Smolensky, is discussed and contrasted with a somewhat different ?rogue? account. A standard connectionist understanding has it that a classical competence theory describes an idealized subset of a network's behaviour. But the network's behaviour is not to be explained by its embodying explicit or tacit knowledge of the information laid out in the competence theory. A rogue model, by contrast, posits either two systems, or two aspects of a single system, such that one system does indeed embody the knowledge laid out in the competence theory. (shrink)

The present paper aims at addressing a crucial legal conflict in the information society: i.e., the conflict between security and civil rights, which calls for a “fine and ethical balance”. Our purpose is to understand, from the legal theory viewpoint, how a fine ethical balance can be conceived and what the conditions for this balance to be possible are. This requires us to enter in a four-stage examination, by asking: (1) What types of conflict may be dealt with by (...) means of balancing? (2) What is meant by balancing? Is it a metaphor that hides and dissimulates discretionary powers and subjective decisions or a rational instrument that helps us cope with conflicts between fundamental values and interests? (3) What models of balancing are available to us? Are these models irreducible to each other? What can provide us with a common understanding of different models of balancing? (4) How can the crucial issues of rational controllability, predictability, and homogeneity of legal decisions be dealt with? Our paper will try to answer those questions by trying to reconstruct the act of balancing in terms of a rational legal reasoning, which relies upon information. In fact, every judicial decision contains some information that is delivered to the legal system: that information may serve as the basis for future evaluations, decisions, and actions, and thus influence the way we recognize and hence we protect our values, interests, and rights. In this perspective, our examination will attempt to understand those questions in informational terms. This informational treatment can provide us with a more universalistic understanding of those issues and offer us a novel way to conceptually deal with them. To this aim, we will avail yourself of Luciano Floridi’s philosophy of information: notably, we believe his constructionist conception of epistemology is crucial, based on the Maker’s Knowledge approach and his solution of the upgrading problem (i.e., from information to knowledge) in terms of a network theory of account. The informational approach will help us having a better understanding of the balance between competing interests. (shrink)

This article examines the privacy of personal medical information in the health research context. Arguing that biomedical research in Canada has been caught up in the government's broader neoliberal policy agenda that has positioned biotechnology as a strategic driver of economic growth, the author discusses the tension between informational privacy and the need for medical information for research purposes. Consideration is given to the debate about whether privacy for medical information serves or hinders the “public good” in (...) respect of medical research and to discussions of informed consent as an element of “fair information practices” designed to safeguard the privacy of personal information, including attempts to subvert requirements for informed consent in the medical research context. (shrink)

This article examines the standard of disclosure, set by law, of risks of treatment and alternative procedures that should normally be disclosed to patients. Therapeutic privilege has been recognized by the courts as an exception to this standard of disclosure. It provides a justification for withholding such information from competent patients in the interests of patient welfare. The article explores whether this justification is either legally or ethically defensible. In assessing patient welfare, the health care professional is required to (...) consider the patient's overall best interests - but this is not limited to an assessment of medical best interests. It is contended that the health care professional is neither qualified nor justified in making such a judgement, as the law recognizes that a competent adult patient determines her own best interests. This is not possible without sufficient information of risks to inform the decision. (shrink)

Competence is central to informed consent and, therefore, to medical practice. In this context, competence is regarded as synonymous with decision-making capacity. There is wide consensus that competence should be approached conceptually by identifying the abilities needed for decision-making capacity. Incompetence, then, is understood as a condition in which certain abilities relevant to decision-making capacity are lacking. This approach has been helpful both in theory and practice. There is, however, another approach to incompetence, namely to relate it to mental disorder. (...) This approach has been followed in recent research that has shown, for instance, that in anorexia nervosa a person's values may be changed, resulting in ‘pathological’ values. We explore some advantages and disadvantages of both abilities-based and pathology-based approaches. We argue that both can be valuable for further clarification of the concept of competence and improving clinical practice. Given the current predominance of the abilities-based approach, we make a plea for a greater focus on pathology-based practice and research. (shrink)

German legislation demands that decisions about the treatment of mentally incompetent patients require an ‘informed consent’. If this was not given by the patient him-/herself before he/she became incompetent, it has to be sought by the physician from a guardian, who has to be formally legitimized before. Additionally this surrogate has to seek the permission of a Court of Guardianship (Vormundschaftsgericht), if he/she intends to consent to interventions, which pose significant risks to the health or the life of the person (...) under his/her care. This includes ‘end-of-life decisions’. Deviations from this procedure are only allowed in acute emergencies or cases of ‘medical futility’. On the basis of epidemiological and demographical data it can be shown that the vast majority of surrogate decisions on incompetent patients in Germany is not covered by legally valid consent. Moreover, the data suggests that if consent were to be requested according to the legal regulations, both the legal and medical system could realistically never cope with the practical consequences of this. Additionally, empiric research has revealed serious deficits concerning medical ‘end of life-decisions’ and practical performance in palliative care. As a consequence a multidisciplinary discussion has developed in Germany about the reform of present legislation with respect to key-issues like• the assessment of mental competence• the options for exercising patient self-determination via advance directives and durable powers of attorney• the improvement of palliative care facilities,• the clarification of formal procedures for surrogate decision-making in health care and towards the end of life• and the possibilities and their limitations of controlling these decision-making processes ‘externally’ (e.g., by Guardianship Courts or committees).The authors discuss those proposals, which clearly dominate the present debate: They all aim to comply with the scientific basis of German law, jurisdiction and the European traditions of philosophy of health care and bioethics. (shrink)

Dementia is highly prevalent and incurable. The participation of dementia patients in clinical research is indispensable if we want to find an effective treatment for dementia. However, one of the primary challenges in dementia research is the patients’ gradual loss of the capacity to consent. Patients with dementia are characterized by the fact that, at an earlier stage of their life, they were able to give their consent to participation in research. Therefore, the phase when patients are still competent to (...) decide offers a valuable opportunity to authorize research, by using an advance research directive. Yet, the use of ARDs as an authorization for research participation remains controversial. In this paper we discuss the role of autonomous decision-making and the protection of incompetent research subjects. We will show why ARDs are a morally defensible basis for the inclusion of this population in biomedical research and that the use of ARDs is compatible with the protection of incompetent research subjects. (shrink)

“The Nature of Belief Systems” sets forth a Hobson's choice between rule by the politically ignorant masses and rule by the ideologically constrained—which is to say, the doctrinaire—elites. On the one hand, lacking comprehensive cognitive structures, such as ideological “belief systems,” with which to understand politics, most people learn distressingly little about it. On the other hand, a spiral of conviction seems to make it difficult for the highly informed few to see any aspects of politics but those that confirm (...) the cognitive structures that organize their political perceptions. This is a troubling situation for any consequentialist democratic political theory, according to which what is crucial is the electorate's (and subsidiary decision makers') ability to make informed policy judgments, not their possession of willful but uninformed political “attitudes.” Any political theorist who does not take democracy to be an end in itself (regardless of its consequences) should be concerned about Converse's findings. (shrink)

Competent patients who refuse life saving medical treatment present a dilemma for healthcare professionals. On one hand, respect for autonomy and liberty demand that physicians respect a patient’s decision to refuse treatment. However, it is often apparent that such patients are not fully competent. They may not adequately comprehend the benefits of medical care, be overly anxious about pain, or discount the value of their future state of health. Although most bioethicists are convinced that partial autonomy or marginal competence of (...) this kind demands the same respect as full autonomy, Israeli legislators created a mechanism to allow ethics committees to override patients’ informed refusal and treat them against their will. To do so, three conditions must be satisfied: physicians must make every effort to ensure the patient understands the risks of non-treatment, the treatment physicians propose must offer a realistic chance of significant improvement, and there are reasonable expectations that the patient will consent retroactively. Although not all of these conditions are equally cogent, they offer a way forward to assure care for certain classes of competent patients without abandoning the principle of autonomy altogether. These concerns reach past Israel and should engage healthcare professionals wary that respect for autonomy may sometimes cause avoidable harm. (shrink)

Designed specifically for the educational needs of RN to BSN students This is a unique, innovative professional nursing ethics textbook designed specifically for the educational needs of RN to BSN students. Written by experts in the field, it discusses ethical concepts geared to the licensed nurse who has spent several years in practice but is learning high-level concepts and applications. The text addresses different areas of professional practice and is rich with case studies illustrating clinical scenarios involving ethical awareness and (...) decision-making. The book fulfills the necessary criteria for the AACN Essentials for Baccalaureate Education and the QSEN and ISOM competencies. Clear and concise, the text relates content to the nurse’s current practice and professional development without extraneous information typically included in other texts. Progressing from simple to complex, chapters build on previous practice experience to focus on ethical decision-making in a variety of practice environments. The book incorporates a “four boxes” decision-making model and addresses essential communication skills, how to recognize and resolve moral distress, and the role of an ethics committee. It discusses common ethical issues likely to be encountered and ethical practice as it relates to quality and safety. Case Study Dilemmas that include evidence-based research provide the opportunity to apply ethical decision-making principles. QSEN application principles are also featured in each chapter, and interactive exercises and questions and PowerPoints provide further opportunity for critical thinking. Key Features: Addresses the specific needs of students in the RN to BSN course Fulfills AACN Essentials, IOM Competencies, and QSEN KSAs Builds upon previous practice experience of RN to BSN students Discusses ethical decision-making in a variety of practice environments Includes Case Study Dilemmas to apply ethical decision-making principles. (shrink)

The use of coercive measures in mental health care is an issue of ongoing concern (Cf. Fisher 1994; Janssen et al. 2008; Paterson and Duxbury 2007; Prinsen and Van Delden 2009; Widdershoven and Berghmans 2007; Wynn 2006). On the one hand, coercive interventions seem to infringe the patient’s right to self-determination (principle of autonomy). However, professionals are also committed to providing the care they deem necessary (principle of beneficence). In other words, professionals in mental health care are often caught between (...) the two (opposing) ideals of beneficence and autonomy. In medical practice, the right of self-determination is operationalized in the principle of informed consent. A medical physician is .. (shrink)

Josh is a typical 27-year-old in a career that he enjoys and a successful marriage. Josh begins to exhibit the symptoms of a manic episode. He is soon diagnosed with bipolar disorder. While non-manic, Josh’s preferences are typical. While manic, his preferences change dramatically. He quits his job, cheats on his partner, and squanders his savings. These are behaviors that Josh, when non-manic (euthymic), would never agree to. When Josh returns to a euthymic state, he regrets these decisions. Should those (...) close to Josh have prevented him from making these decisions, or does his competence to decide persist despite his acute mania? In this paper, I examine the connections be-tween bipolar disorder and consent. I defend the view that many (although far from all) individuals with bipolar disorder are competent to consent to a wide variety of things when they are in a manic state. This means that mania should not be presumed to undermine competence in clinical settings. -/- I have several goals in this paper. I want to bring philosophy to bear on the connection between consent and bipolar disorder. Additionally, I intend this paper to contribute to the general debate about the conditions of informed consent. Bipolar disorder presents novel challenges to existing conceptions of competence to consent which require stable core of values for an agent to be competent. For example, Buchanan and Brock endorse such a view. In showing that shifting values do not undermine the competence of a person experiencing acute mania, I show that the aforementioned views of competence are false. Overall, this paper makes substantive contributions to the debate about competence to consent and presents the first sustained philosophical treatment of consent among people with bipolar disorder. (shrink)

BackgroundCultural competence is considered as one of the main skills of nurses enabling them to provide nursing care for those with different cultures. One of the cases related to nurses’ cultural competence is observance of ethical codes, but it has not been investigated sufficiently in studies.AimThis study has been conducted to determine the relationship between nurses’ cultural competence and observance of ethical codes in practice.Research designThis descriptive-correlational study was conducted in 2020. Sampling was done at several stages. The data were (...) collected using questionnaires of demographic information, cultural competence, and observance of ethical codes as self-report. The questionnaires were provided to the subjects by the corresponding researcher and the data were analyzed using Pearson correlation test.Participants and research contextThis study was done with participation of 267 nurses working in four training hospitals located in northwestern Iran and 16 head nurses of selected wards.Ethical considerationsThe study was approved by Human Ethics Committee of Hamadan University of Medical Sciences. Participation was voluntary. Consent was obtained and confidentiality kept.FindingsThe results of Pearson correlation coefficient test showed a positive and statistically significant relationship between cultural competence and observance of ethical codes (r = 0.524, p = 0.001). In addition, cultural competence and observance of ethical codes by most nurses were at a moderate level.ConclusionsThe results of the present study showed a significant relationship between nurses’ cultural competence and observance of ethical codes. Therefore, it can be concluded that by strengthening the level of nurses, the level of observing ethical codes by them can be increased. Cultural competency and observance of ethical codes are important components of nursing care, and their development can improve nursing care delivery to clients through academic training, hidden curriculum and in-service education. (shrink)

Recent developments in children's rights have led to increased criticism of the presumption of total incompetency until adulthood, a concept inconsistently defined by state law. Citing proposals from several disciplines, this article calls for increasing actual competency in decision-making through systematic education in conjunction with developmental levels and experience. The elements of informed consent are suggested as one mechanism for learning to make educated decisions in a variety of settings. The treatment of hyperkinetic children is discussed as a case example.

This paper discusses the Saudi Arabian case by Abdallah Adlan and Henk ten Have, published in a 2012 issue of the Journal of Bioethical Inquiry, regarding a congenitally disabled child enrolled in a research project examining the genetics of her condition. During the course of the study, her father was found not to be genetically related, and the case discussed the dilemma between disclosing to the family all findings as promised in consent documents or withholding paternity information because of (...) the likely severe social repercussions. Using Adlan and ten Have’s example, this paper proposes a framework to consider cases outside of the conventional bioethics frame of reference, splitting the bioethical task into three elements: understanding the problem from the patient’s and the clinician’s perspective and then engaging in dialogue to decide what to do next. The process of dialogue between affected parties is vital. Presuming that there is a common morality undermines the effectiveness of the dialogue needed to find a resolution. (shrink)

People have a powerful interest in geneticprivacy and its associated claim to ignorance,and some equally powerful desires to beshielded from disturbing information are oftenvoiced. We argue, however, that there is nosuch thing as a right to remain in ignorance,where a right is understood as an entitlementthat trumps competing claims. This doesnot of course mean that information must alwaysbe forced upon unwilling recipients, only thatthere is no prima facie entitlement to beprotected from true or honest information aboutoneself. Any (...) claims to be shielded frominformation about the self must compete onequal terms with claims based in the rights andinterests of others. In balancing the weightand importance of rival considerations aboutgiving or withholding information, if rightsclaims have any place, rights are more likelyto be defensible on the side of honestcommunication of information rather than indefence of ignorance. The right to free speechand the right to decline to acceptresponsibility to take decisions for othersimposed by those others seem to us moreplausible candidates for fully fledged rightsin this field than any purported right toignorance. Finally, and most importantly, ifthe right to autonomy is invoked, a properunderstanding of the distinction between claimsto liberty and claims to autonomy show that theprinciple of autonomy, as it is understood incontemporary social ethics and English law,supports the giving rather than the withholdingof information in most circumstances. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention, and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of legal preparedness: laws and legal authorities; competency in using those laws; and coordination of law-based public health actions; and information.This action agenda offers options for consideration by those responsible (...) for or interested in ensuring that public health professionals, their legal counsels, and relevant partners understand the legal framework in which they operate and are competent in applying legal authorities to public health emergency preparedness.Competencies are critical to an individual's ability to make effective legal response to all-hazards public emergencies. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention, and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of legal preparedness: laws and legal authorities; competency in using those laws; and coordination of law-based public health actions; and information.This action agenda offers options for consideration by those responsible (...) for or interested in ensuring that public health professionals, their legal counsels, and relevant partners understand the legal framework in which they operate and are competent in applying legal authorities to public health emergency preparedness.Competencies are critical to an individual's ability to make effective legal response to all-hazards public emergencies. (shrink)

The following description is based upon an actual case in which a patient initiated legal action after suffering a complication subsequent to an invasive diagnostic procedure performed by a senior fellow. Named as codefendants were the senior fellow, attending physician, and the hospital. Because any hospital with house staff is potentially vulnerable to similar litigation, Ethics Committees at Work is addressing the questions raised by this dilemma.

Background Researchers are required to determine whether a person has capacity to consent to a research study before they are able to participate. The Mental Capacity Act and accompanying Code of Practice for England and Wales provide some guidance on this process, but researchers have identified that it can be difficult to determine capacity to consent when a person has complex cognitive or communication needs. This study aimed to understand the experiences and opinions of researchers who recruit people with dementia (...) to research projects, to inform the future development of training resources. Methods A mixed method, cross-sectional, electronic survey was circulated via social media and research networks in England and Wales. The survey remained open for ten weeks and included open and closed questions exploring respondents’ confidence in determining capacity in the context of recruiting people with dementia to consent, their views on training and support they have experienced and their suggestions for future training and support needs. Results 60 respondents completed the survey from across England and Wales. Although 75% of respondents had experience of determining capacity to consent with people with dementia to research, only 13% rated themselves as feeling ‘very confident’ in this. Qualitative content analysis of open responses led to the generation of six themes, explaining researchers’ confidence, competence and future training needs in this area: (1) Researcher uncertainties, (2) Lack of time, (3) Balancing information complexity with accessibility, (4) Gatekeepers, (5) Existing enablers and (6) Envisioning future training. Conclusions Researchers would benefit from specific training in undertaking conversations around consent with people with dementia. People with dementia may have fluctuating capacity, and despite support from caregivers, researchers have little practical guidance on methods of determining a person’s ability to understand or appreciate the information they have provided during the consent process. Given the development of large complex trials within dementia research, there is an urgency to develop specific and practical guidance and training for researchers working with people with dementia and their families. (shrink)

Tracing graduates has become an imperative for higher education institutions much more during the pandemic. This tracer determined the employment and employability status of the 2019 BSE graduates and identified the competencies they adequately acquired and deemed vital for work. It used descriptive design, and data were collected from the 103 graduates through a google form with open and closed-ended questions administered between November and December 2020. Results revealed that most of the graduates had been employed in teaching and (...) teaching-related jobs but mostly in contractual arrangements within the first and second six months after graduation. Many had their first jobs with meager salaries from the private sector. Communication, pedagogy, information communication technology, time management, and flexibility were the top competencies they adequately acquired and were beneficial in work. The study concluded that these graduates had acquired 21st-century skills in their respective degree programs. These results have corresponding implications for future research in confirming the most employable skills in secondary teaching. As recommended, classroom instruction might emphasize the development of these skills. Eventually, these become the competitive advantage and employability capitals of future graduates. Administering the licensure examination and the release of its results can be done within the first three months after graduation to lessen the cost of waiting. (shrink)

The present study aims at analyzing the role of nativeness, the amount of input in L1 acquisition and the multilingual competence in the performance of Italian-German bilingual speakers. We compare novel data from the performance of adult L2 learners (L1: Italian; late L2: German) and that of heritage speakers (heritage language: Italian; majority language: German) to previous data from monolingual speakers of Italian. The comparison deals with the produced word order at the syntax-discourse interface in sentences containing New Information (...) Subjects in answers to questions that prompt the identification of the clausal subject. Overall, adult L2 speakers and heritage speakers perform alike but crucially differently from Italian monolinguals. These data reveal that multilingual proficiency determines an increased variety in the adopted answering strategies; in particular, the German-like strategy is active in Italian. Nativeness alone is thus no guarantee for a homogeneous performance across groups, nor do we find similar patterns of performance in speakers who grew up as monolinguals. Data also show heritage speakers’ sensitivity to verb classes, with answering strategies varying in accordance with the verb argument structure. Participants’ productions reveal an interesting relation in sentences with transitive verbs between subject position (pre-/postverbal) and object form (lexical DP/clitic pronoun). (shrink)

The topic of the democratic public's limited competence has preoccupied students of democracy for centuries. Anecdotal concerns about the problem reached their peak of sophistication in the writings of Walter Lippmann and Joseph Schumpeter. Not until Philip E. Converse's “The Nature of Belief Systems in Mass Publics” did statistical research overwhelmingly confirm the worst fears of such democratic skeptics. Subsequent work has tended to confirm Converse's picture of a tiny stratum of well‐informed ideological elites whose passionate political debates find little (...) echo, or even awareness, in the mass public. While a great deal of attention has been devoted to “saving” democratic legitimacy from such findings, the Converse‐inspired work of John Zaller (1992) shows how fruitful Converse's basic ideas can be not only in analyzing real‐world political events, but in pulling together and stimulating new lines of research into what moves the “creative synthesizers” of belief systems; into the factors that affect the small numbers of people who grasp such systems and attempt to transmit them to the public; and into the long‐term psychological or cultural sources of the predispositions with which members of the mass public confront the resulting political messages. (shrink)

When engaging in verbal communication, we do not simply use language to dispense information, but also to perform a plethora of actions, some of which depend on conventionalised, recurrent linguistic structures. Additionally, we must be skilled enough to arrive at the speaker’s intended meaning. However, speakers’ performance may deviate from certain habits and expectations concerning the way of speaking or accomplishing actions, while various factors may hinder comprehension, which may give rise to misappraisals of their respective abilities and capacities (...) as competent language users. This paper discusses whether such misappraisals may be subsumed by any of the already identified types of epistemic injustice and proposes a new label for them. It also describes the consequences of those misappraisals and approaches their origins from a cognitive perspective. (shrink)

Can heroin addicts give consent to research on trials in which heroin is prescribed to them? Analyses of addicts and informed consent have been objects of debate in several articles. Informed consent requires the agent not only to be competent but also to give consent voluntarily. This has been questioned because of alleged features of heroin addiction. Until recently the discussion has focused on heroin addicts' desires for heroin, whether these are irresistible and thus pose a problem for giving consent. (...) Still, in light of empirical evidence, there seems to be a consensus more or less that the problem is not whether the addicts can resist their desire for heroin. A recent article concentrates specifically on heroin addicts' false assumptions of options and voluntariness. We argue that the prevailing framing of the options in this discussion in terms of heroin and access to it is problematic. The way in which the options are typically laid out suggests an assumption that participation in the research is allegedly based on the addicts' views on using the drug. We argue that this way of presenting the options is, first, a mismatch to the studies carried out and, second, symptomatic of potential misconceptions about heroin addiction and addicts. Furthermore, we also suggest that the account of voluntariness needs to be realistic in order for subjects to be able to give consent voluntarily in actual situations, and for medical research to carry out studies on improving outcomes in addiction treatment in an ethical way. (shrink)

The aim of this article is to discuss and clarify the general framework of teachers’ competencies. The general framework regarding teacher competencies wereexplained in nine different dimensions as field competencies, research competencies, curriculum competencies, lifelong learning competencies, social-cultural competen cies, emotional competencies, communication competencies, information and communication technologies competencies (ICT) and environmental competencies. Teachers’ competencies affect their values, behaviors, communication, aims and practices in school and also they support (...) professional development and curricular studies. Thus, the discussion on teachers’ competencies to improve the teaching-learning process in school is of great importance. (shrink)