This study sheds new light on why healthcare organisations are having difficulty responding to the growing pressure from stakeholders to proactively address their responsibility to deliver high-quality services without harming the environment. Basing our work on past research on stakeholder pressure and environmental barriers, we conceptualise and empirically test the effect of the interplay between stakeholder pressure and internal barriers on healthcare organisations’ adoption of proactive environmental strategies. To test the proposed hypotheses, a survey was carried out among (...) medical directors of Italian healthcare organisations in 2012. Our results show that the lack of commitment to environmental issues within the organisation represents the main barrier to healthcare organisations’ implementing PESs. Furthermore, the difficulties in evaluating the impacts of advanced environmental practices negatively moderate the influence of stakeholders on developing PESs. Our findings contribute to extending previous knowledge on PESs in two ways: focusing on the healthcare sector, our study investigates the phenomenon in a research context that has been largely overlooked in the sustainability literature; and cross-cutting previous research on stakeholder pressure and internal barriers, the study conceptualises and tests a more complete framework for understanding the adoption of PESs. (shrink)

Measuring outcomes using quantitative analytic methods is the hallmark of scientific research in healthcare. For clinical ethics support services (CESS), tangible outcome metrics are lacking and literature examining CESS quality is limited to evaluation of single cases or the influence on individual healthcare professional’s perceptions or behaviour. This represents an enormous barrier to implementing and evaluating ethics initiatives to improve quality. In this context, Kok _et al_ propose a theoretical framework for how moral case deliberation (MCD) can drive quality at (...) an organisational-level, termed _morisprudence_ 1. By offering mechanistic insights into how MCD can lead to organisational learning and quality improvement (QI), they provide a roadmap for actionable items to measure quality. As conceptualised, _morisprudence_ follows accumulation of organisational practical wisdom from a repertoire of ‘paradigmatic’ MCDs, aiding identification of patterns of morally important features. Here, there are parallels between healthcare professionals’ clinical judgement, where past experience... (shrink)

In this paper, we conceptually explore the role of empathy as a connectedness organising mechanism. We expand ideas underlying positive organisational scholarship and examine leading-edge studies from neuroscience and quantum physics that give support to our claims. The perspective we propose has profound implications regarding how we organise and how we manage. First, we argue that empathy enhances connectedness through the unconscious sharing of neuro-pathways that dissolves the barriers between self and other. This sharing encourages the integration of (...) affective and cognitive consciousness which facilitates the ability to find common ground for solution building. Second, empathy enhances connectedness through altruistic action. In giving to others, feelings of joy and harmony are activated. This in turn allows personal freedom to be enriched and transcendence from the rational ego-self is reduced to develop a more expansive, integrated and enlightened state underlying connectedness. Finally, empathy enhances connectedness which results in sharing the quantum field of coherence where there is little separation between self and other. This means living beyond self-interest in a coherent world based upon interdependent wholeness rather than atomization and separation. Empathy allows us to find that state of coherent connectedness. (shrink)

Les rencontres de Royaumont de 1998 ont donné naissance à un superbe volume, richement illustré, faisant le point sur l’histoire des femmes au sein de l’ordre cistercien, du Moyen Âge jusqu’à nos jours. Cet ouvrage vient à point nommé pour enrichir l’historiographie de cet ordre, largement dominée jusqu’ici par le masculin. Les communications, nombreuses et variées, se sont réparties en deux journées selon deux thèmes centraux. Le premier s’intéresse à l’architecture et à l’organisation de l’...

This article discusses which barriers hamper access to, and participation in, cultural life for members of vulnerable groups, in particular persons belonging to old and new minorities and persons with disabilities in the context of digitization. It then examines what role public authorities can play in addressing and dismantling these barriers. The article adopts a bottom-up approach, in that it is based on a qualitative study, which gives voice to vulnerable groups. The qualitative research involved interviews with different (...) organisations representing, or working with, vulnerable groups in 12 European Union Member States (Belgium, Croatia, Denmark, Estonia, Finland, France, Germany, Hungary, Ireland, Italy, Malta and Spain). In that regard, the article approaches vulnerability from a distinct conceptual standpoint, identifying vulnerability as a condition caused by structural barriers. On the whole, the article shows that, while digitization of cultural content, goods and services, offers increased opportunities for culture to be democratised and for its consumption by wider and more varied audiences to be enhanced, it also engenders structural barriers and creates additional challenges. Furthermore, while digitisation has ensured more diverse representation in cultural content, vulnerable groups still face stereotypical and negative portrayals within mainstream cultural content. The thematic analysis of the qualitative interviews also captures different dimensions of access to digital cultural and supports the identification of effective policy measures to bridge the ‘digital divide’ and assist in the fulfilment of cultural rights of vulnerable groups. (shrink)

Low-wage migrant workers in Singapore are legally entitled to healthcare provided by their employers and supported by private insurance, separate from the national UHC (universal health coverage) system. In practice, they face multiple barriers to access. In this article, we describe this policy-practice gap from the perspective of HealthServe, a non-profit organisation that assists low-wage migrant workers. We outline the healthcare financing system for migrant workers, describe commonly encountered barriers, and comment on their implications for the global UHC (...) movement’s key ethical concepts of fairness, equity, and solidarity. (shrink)

Zusammenfassung Verschiedene Studien zur Sportpartizipation zeigen auf, dass insbesondere Mädchen und Frauen mit Migrationshintergrund in Sportvereinen proportional untervertreten sind. Während die Ursachen für die geringe Teilhabe am organisierten Sport in zahlreichen Analysen auf Seiten der Mädchen und Frauen mit Migrationshintergrund verortet werden, wird hingegen die Integrationsfähigkeit von Sportvereinen bislang kaum differenziert betrachtet. Der vorliegende Beitrag nimmt darum den Sportverein in seinen spezifischen Organisationsstrukturen in den Blick. Auf der Grundlage eines organisationstheoretischen Zugangs werden die Strukturen von Sportvereinen dahingehend be­leuchtet, inwieweit diese (...) Integration überhaupt zulassen. Im Zuge dieser Analyse werden Barrieren identifiziert, die die Integration von Mädchen und Frauen mit Migrationshintergrund in den Verein stören, erschweren oder verhindern können. Gleichzeitig werden Möglichkeitsbedingungen für die Integration der Zielgruppe benannt und in der Organisationsstruktur von Sportvereinen verortet. (shrink)

Standardisation is increasingly seen as a means to insert ethics in innovation processes. We examine the institutionalisation of responsible innovation in de jure standardisation as this is an important but unexplored research area. In de jure standardisation, stakeholders collaborate in committees to develop standards. We adopt the anticipation, inclusion, reflexivity, and responsiveness responsible innovation framework as our theoretical lens. Our study suggests that responsible standardisation processes should embody forms of these four dimensions. We investigate the institutionalisation of these dimensions and (...) identify 96 factors that can motivate, hinder, or facilitate responsible standardisation. Factors were found through in-depth interviews with managers of a standard developing organisation. These are subsequently validated/rejected using surveys completed by committee representatives. The results suggest that the social desirability of standards is not self-evident. This study could pave the way for future research on responsible standardisation processes, complementing research on legitimacy, responsible innovation, and standardisation. (shrink)

BackgroundCervical cancer disproportionately burdens disadvantaged women. Organised cervical screening aims to make cancer prevention available to all women in a population, yet screening uptake and cancer incidence and mortality are strongly correlated with socioeconomic status. Reaching underscreened populations is a stated priority in many screening programs, usually with an emphasis on something like ‘equity’. Equity is a poorly defined and understood concept. We aimed to explain experts’ perspectives on how cervical screening programs might justifiably respond to ‘the underscreened’.MethodsThis paper reports (...) on a grounded theory study of cervical screening experts involved in program organisation. Participants were 23 experts from several countries and a range of backgrounds: gynecology; epidemiology; public health; pathology; general practice; policy making. Data were gathered via semi-structured interview and concepts developed through transcript coding and memo writing.ResultsMost experts expressed an intuitive commitment to reducing systematic differences in screening participation or cancer outcomes. They took three different implicit positions, however, on what made organised programs justifiable with respect to underscreened populations. These were: 1) accepting that population screening is likely to miss certain disenfranchised groups for practical and cultural reasons, and focusing on maximising mainstream reach; 2) identifying and removing barriers to screening; and 3) providing parallel tailored screening services that attended to different cultural needs. Positions tended to fall along country of practice lines.ConclusionsExperts emphasised the provision of opportunity for underscreened populations to take up screening. A focus on opportunity appeared to rely on tacit premises not supported by evidence: that provision of meaningful opportunity leads to increased uptake, and that increased uptake of an initial screening test by disadvantaged populations would decrease cervical cancer incidence and mortality. There was little attention to anything other than the point of testing, or the difficulties disadvantaged women can have in accessing follow up care. The different approaches to ‘improving equity’ taken by participants are differently justified, and differently justifiable, but none attend directly to the broader conditions of disadvantage. (shrink)

Cet article examine la question de l’attention dans son rapport à l’admiration, dont le traitement fait apparaître de profondes divergences entre les Passions de l’âme et l’ Éthique. Dans Les Passions de l’âme, Descartes propose une genèse passionnelle de l’attention, dont la destination gnoséologique est assurée par un acte de la volonté qui transcende les perceptions de l’âme. À l’inverse, dans l’ Éthique, la connaissance ne dépend pas de l’exercice d’une faculté autonome, elle est immanente à l’ordre des idées, ce (...) à quoi l’admiration fait irréductiblement obstacle. La critique spinoziste de l’admiration s’accompagne alors d’une refonte du statut de l’attention et repose sur la critique de la partition cartésienne des facultés de l’âme. Nous montrerons néanmoins que l’attention a une fonction positive sous la forme d’une présence à soi de l’esprit qui veille à l’enchaînement en lui des idées vraies. (shrink)

Suivant le fil directeur du temps, cet ouvrage met au jour la manière dont l'admiration est devenue un problème philosophique central à l'âge classique et examine les différentes conceptions dont elle fait l'objet chez les principaux penseurs de la seconde moitié du XVIIe siècle.

The Bellum ciuile has been the subject of three major editions in the past thirty years, attributable to D.R. Shackleton Bailey, R. Badalì and G. Luck. The existence of these three works highlights the resurgence of sustained interest surrounding Lucan as of the 1970s, with the publication of two significant works, Lucan: An Introduction by F. Ahl and the collective volume of Entretiens à la fondation Hardt, yet it also demonstrates the difficulty in establishing the text of the Pharsalia.

Probing semantic relations Exploration and identification in specialized texts Alain Auger and Caroline Barrière In recent years, several scientific ...

In vitro fertilisation (IVF) daily practice reveals that couples are willing to take greater risks than doctors if there is a higher chance of pregnancy. Arising from this is a frequently addressed issue regarding the embryo transfer strategy: single or double embryo transfer? The dilemma is faced by patients, as well as physicians, who are caught between the possibility of no pregnancies at all and facing the prospect of iatrogenic twin gestation. How could the couple's preferences concerning how many children (...) they would like be taken into account in determining the number of embryos transferred? How should the physician exercise his medical responsibility towards his patients and the unborn child? An effective approach could be to enhance a couple’s autonomy by advocating a medical beneficence that incorporates patients’ values. This can be achieved through a case-by-case approach in a deliberative process of decision-making which includes real patient-centred communication. (shrink)

This paper explores the role of mentoring and networking in the career development of global female managers. The paper is based on data collected from interviews with 50 senior female managers. The voices of the female managers illustrate some of the difficulties associated with informal organisational processes, in particular mentoring and networking, which hinder their career development. The findings confirm that female managers can miss out on global appointments because they lack mentors, role models, sponsorship, or access to appropriate (...) networks – all of which are commonly available to their male counterparts. The interviewees suggest that men, as the dominant group, may want to maintain their dominance by excluding women from the informal interactions of mentoring and networking. The findings further suggest that if females had more access to networks and mentors they could be socialised in both the formal and informal norms of the organisation and gain career advantages from these. The managers reveal that they encounter additional barriers in ‹a man’s world’ and remind us that there is still much to be changed. (shrink)

In the current literature, institutional adoption of Corporate Social Responsibility (CSR) governance standards is mainly understood in a binary sense (adoption versus no adoption), and existing research has hitherto focused on inducements as well as on barriers of related organizational change. However, little is known about often invisible internal adoption patterns relating to institutional entrepreneurship in the field of CSR. At the same time, additional information about these processes is relevant in order to systematically assess the outcomes of institutional (...) entrepreneurship and to differentiate between substantive versus symbolic implementation. In this paper, we contribute a comparative intraorganizational differentiation of institutional adoption processes in the field of CSR, and we distinguish between broad and narrow organizational institutional adoption across different management functions relating to institutions of a similar type. Our study is based on a quantitative survey among members of the United Nations Global Compact Network Germany, as well as on qualitative interviews. We analyze different institutional adoption patterns and derive ten theoretical predictors of diverse institutional adoption choices and thereby inform the literatures on institutional entrepreneurship, CSR governance, and Multi-Stakeholder Initiatives. Besides our theoretical contributions, our findings serve as a source of information for practitioners engaged in CSR governance as they provide new insights into the managerial perception and assessment of different CSR standards and initiatives. (shrink)

Science, engineering and technology are still male-dominated fields, and thus all over Europe much effort is expended on activities which, it is hoped, will lead to a sustainable gender balance. Scholarly work has frequently focused on the topic of how to motivate women to enter SET fields or to choose a corresponding education. In contrast to this one-sided approach, recent scholarly contributions have begun to emphasize the vital role of gendered structures and indirect exclusion mechanisms of technological institutions and their (...) professional self-understandings which discourage women from entering or staying in SET organizations. In particular, taken-for-granted knowledge as a mechanism for maintaining specific norms and values is considered a primary hindrance towards more inclusive and less oppressive organizational cultures. Since this taken-for-granted knowledge is often implicit, a primary goal of research can be said to make the invisible visible. Thus this article presents selected empirical results of a research project which makes use of an investigative tool called mind-scripting. Here the aim is to identify the main barriers, in terms of unquestioned taken-for granted knowledge, currently hindering an open and critical review of gendered structures and gender codes in the SET field, or in organizations in general, particularly with respect to professional norms. (shrink)

For over half a century there have been concerns about increases in the occurrence of academic misconduct by higher education students and this is now claimed to have reached crisis proportions (e.g. Mostrous & Kenber, 2016a ). This study explores the extent to which multi-national faculty judge the effectiveness of higher education institutions in dealing with such misconduct. A survey of multi-national higher education faculty was conducted to explore the perceived barriers to the implementation of academic integrity processes. It (...) asked faculty how likely some hypothetical scenarios of failures of such processes were to occur in the real world of higher education institutions. 63% of our participants perceived there to be institutional and/or faculty barriers to effectively dealing with academic misconduct. Mostly, they blamed the higher education model for this which, in the interests of mass education, has come to prioritise the need for institutions to focus more on their quantity of output as corporate business enterprises than on the integrity of their output as educators. In discussing participants’ comments, about the relationship of faculty to their employing institutions, Schein and Scheins’ ( 2016 ) theory of three levels of organisational culture was used. Participants’ comments suggested that, at the deepest level of organisational culture i.e. basic underlying taken-for-granted assumptions about beliefs and values, inadequate integrity measures have tended to become normalised. Despite the often considerable, efforts of the institutions, organisational barriers were noted which mitigate against faculty behaving professionally i.e. from doing a ‘good job’ in respect of student academic misconduct. Some blame was also placed on faculty. We argue that apparent institutional inability to effectively manage the integrity process, has potentially significant consequences for wider society. We discuss ways in which this situation might be improved including a recommendation that governments regulate this aspect of the corporate social responsibility of higher education institutions as they do other aspects, requiring that it be managed effectively. (shrink)

Negative gender-role stereotypes continue to pervade the careers of many women. The current study examines the careers of female National Health Service (NHS) nurses in the United Kingdom. The study identifies organizational mindsets which militate against women's career advancement. These mindsets form the basis of the "ethic of discrimination" which both maintains and perpetuates unequal outcomes for women in NHS nursing. We examine the implications for management in promoting non-discriminatory decision making, and the barriers that are faced in overcoming (...) the "ethic of discrimination". (shrink)

This paper presents an in-depth literature review on the driving forces and barriers for achieving operational excellence through artificial intelligence. Artificial intelligence is a technological concept spanning operational management, philosophy, humanities, statistics, mathematics, computer sciences, and social sciences. AI refers to machines mimicking human behavior in terms of cognitive functions. The evolution of new technological procedures and advancements in producing intelligence for machines creates a positive impact on decisions, operations, strategies, and management incorporated in the production process of goods (...) and services. Businesses develop various methods and solutions to extract meaningful information, such as big data, automatic production capabilities, and systematization for business improvement. The progress in organizational competitiveness is apparent through improvements in firm’s decisions, resulting in increased operational efficiencies. Innovation with AI has enabled small businesses to reduce operating expenses and increase revenues. The focused literature review reveals the driving forces for achieving operational excellence through AI are improvement in computing abilities of machines, development of data-based AI, advancements in deep learning, cloud computing, data management, and integration of AI in operations. The barriers are mainly cultural constraints, fear of the unknown, lack of employee skills, and strategic planning for adopting AI. The current paper presents an analysis of articles focused on AI adoption in production and operations. We selected articles published between 2015 and 2020. Our study contributes to the literature reviews on operational excellence, artificial intelligence, driving forces for AI, and AI barriers in achieving operational excellence. (shrink)

Numerous studies have revealed that health care transitions for chronically ill older adults are frequently poorly managed, often with devastating human and economic consequences. And poorly managed transitions and their consequences also occur among younger, relatively healthy individuals who have adequate resources and are prepared to advocate on their own behalf. Despite the rich base of research confirming that evidence‐based transitional care enhances patients’ experiences, improves health and quality of life, and reduces costs, organizational, regulatory, financial, and cultural barriers (...) have, until recently, prevented widespread adoption of these proven approaches. Provisions of the Affordable Care Act, such as reductions in Medicare payments to hospitals with very high thirty‐day rehospitalization rates, have reduced barriers, but uptake of evidence‐based transitional care beyond demonstration projects continues to be sporadic and far too slow. With a rich understanding about how to better anticipate and respond to the compelling problems experienced by patients, family caregivers, and health care professionals throughout episodes of acute illness, the time has come to frame transitional care as a system's ethical responsibility in an aging society. Embedding transitional care within the ethical obligations of a health care system requires the perspectives and involvement of nurses and nursing because of this profession's integral role in every aspect of care transitions. (shrink)

The current emphasis that organisations are placing upon knowledge and the corresponding attention that workplace epistemological values are receiving within the educational community has resulted in an interesting convergence of discourses—school-based and work-based. Even as workplaces are tending toward abstraction over practice—based knowing, schools are being nudged into doing the reverse. The result of this ferment is that traditional barriers between these kinds of knowledge are being removed. As can be seen from workplace examples, it is possible for liberal (...) learning to be in the service of instrumental ends. So too schools may come to see more clearly the value of situatedness and team-work in the transaction of liberal learning. More generally, we see also new possibilities for retreat from received views about the worth of practical knowledge. (shrink)

First the ‘Weismann barrier’ and later on Francis Crick’s ‘central dogma’ of molecular biology nourished the gene-centric paradigm of life, i.e., the conception of the gene/genome as a ‘central source’ from which hereditary specificity unidirectionally flows or radiates into cellular biochemistry and development. Today, due to advances in molecular genetics and epigenetics, such as the discovery of complex post-genomic and epigenetic processes in which genes are causally integrated, many theorists argue that a gene-centric conception of the organism has become problematic. (...) Here, we first explore the causal implications of the following two central dogma-related issues: (1) widespread reverse transcription—arguing for an extension from ‘DNA-genome’ to RNA-encompassing ‘NA-genome’ and, thus, from traditional DNA-centrism to a broader ‘NA-centrism’; and (2) the absence of a mechanism of reverse translation—arguing for the ‘structural primacy’ of NA-sequence over protein in cellular biochemistry. Secondly, we explore whether this latter conclusion can be extended to a ‘functional primacy’ of NA-sequence over protein in cellular biochemistry, which would imply a limited kind of ‘gene/NA-centrism’ confined to the subcellular level of NA/protein-based biochemistry. Finally, we explore the conditions—and their (non)fulfilment—for a more generalised form of gene-centrism extendable to higher levels of biological organisation. We conclude that the higher we go in the biological hierarchy, the more dubious gene-centric claims become. (shrink)

ABSTRACTAs a result of intensive mobility and migration over the last twenty-five years, multiculturalism and multilingualism have become a reality in European prisons. This “superdiversity” poses a serious challenge to the various stakeholders who need efficient and reliable communication. Yet this topic has been underresearched. According to statistics for the year 2014 issued by the Council of Europe, Belgium has a high rate of foreign inmates. Against this background, the aim of this exploratory research is to describe how the Flemish (...) penitentiary system tackles this linguistic challenge. Data were gathered through qualitative research methods such as desktop research and in-depth interviews with 8 stakeholders. Due to the scarcity of financial resources and the presence of organizational hurdles, the Ministry of Justice rarely assigns jobs in prison to interpreters; instead, they are replaced by cheaper and immediately available... (shrink)

Laws, ordinances, regulations, and executive orders create the powers and duties of public health agencies and modify the complex community conditions that affect health. Appropriately trained legal counsel serving as legal advisors on the health officer's team facilitate clear understanding of the legal basis for public health interventions and access to legal tools for carrying them out.Legal counsel serve public health agencies via different organizational arrangements — e.g., internal staff counsel, external counsel from the state attorney general's office, state health (...) department, county or city, or private counsel under contract, or in combination. As of 2011, most state health departments employ their own counsel, and 56% use AG counsel, while 17% contract with independent attorneys; most local health departments work with attorneys and legal staff assigned by local government, by the state health agency, or contract with outside attorneys and legal staff. (shrink)

This paper provides a stagewise overview of the important issues that play a role in technology adoption and use in organizations. In the current literature, there is a lack of consistency and clarity about the different stages of the technology adoption process, the important issues at each stage, and the differentiation between antecedents, after-effects, enablers, and barriers to technology adoption. This paper collected the relevant issues in technology adoption and use, mentioned dispersedly and under various terminologies, in the recent (...) literature. The qualitative literature review was followed by thematic analysis of the data. The resulting themes were organized into a thematic map depicting three stages of the technology adoption process: pre-change, change, and post-change. The relevant themes and subthemes at each stage were identified and their significance discussed. The themes at each stage are antecedents to the next stage. All the themes of the pre-change and change stages are neutral, but the way they are managed and executed makes them enablers or barriers in effect. The thematic map is a continuous cycle where every round of technology adoption provides input for the subsequent rounds. Based on how themes have been addressed and executed in practice, they can either enhance or impair the subsequent technology adoption. This thematic map can be used as a qualitative framework by academics and practitioners in the field to evaluate technological changes. (shrink)

While women represent the vast majority of participants in religious organizations in the United States, their participation in top leadership positions within Christian congregations remains remarkably low. In this article, the author uses the National Congregations Study to examine the situations that lead to this “stained glass ceiling” effect, prohibiting women from attaining top congregational leadership positions. The author also investigates similar barriers that exist at other levels of congregational leadership. The results suggest that while a queue-like process appears, (...) the specifically religious nature of these organizations produces barriers that are quite different from the traditional glass ceiling conceptualization. (shrink)

The paper discusses the limitations of engineering ethics as implemented in practice, with a focus on the fact that engineering and other activities are carried out without any consideration of whether the activities are themselves ethical, and on the gap between legality and ethics. This leads to the following three central ideas of the paper. The first is the need for engineers to both be aware of and critique their own values and be able to widen their perspective to that (...) of the ‘other’, i.e., marginalised and minority groups and the environment. This understanding of the ‘other’ and values is also applied to the discussion of ethical issues relating to minority world (‘developed’) country engineers working in majority world (‘developing’) countries. The second central idea is the fact that structural and contextual factors in the form of barriers and enablers affect ethical values and practices. Individuals are not necessarily unethical in themselves, but the context and organisational ethos may present barriers to ethical behaviour and encourage the development of unethical values. These barriers and enablers are investigated through a pilot survey. The third central idea is the relationship between individual and collective responsibility and the need for support to enable engineers to think and behave ethically. (shrink)

Large organisations are especially advised to consider the possibility of an Ethics Helpdesk in which all employees and managers can report with all suspected cases of unethical conduct, critical comments, dilemmas and advice for which there is insufficient room within the organisational hierarchy. A helpdesk is a central contact point where it is decided who the most appropriate person is to dealing with a given case. The helpdesk model is characterised by low barriers in its easy accessibility, positive (...) approach and the simple procedures employees need to follow. It offers employees consistent support while relying on the responsibilities of the individual employee as much as possible and it facilitates adequate monitoring and reporting. A helpdesk increases the chances of detecting unethical conduct which enables management to take adequate and timely measures against improper conduct. This article formulates principles, discusses critical factors and considers three models for adopting a sound and integrated ethics safety net. It also presents a case study and shows why organisational openness needs to be institutionalised. (shrink)

DUREY A, WYNADEN D, THOMPSON SC, DAVIDSON PM, BESSARAB D and KATZENELLENBOGEN JM. Nursing Inquiry 2012; 19: 144–152 [Epub ahead of print]Owning solutions: a collaborative model to improve quality in hospital care for Aboriginal AustraliansWell‐documented health disparities between Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) and non‐Aboriginal Australians are underpinned by complex historical and social factors. The effects of colonisation including racism continue to impact negatively on Aboriginal health outcomes, despite being under‐recognised and under‐reported. Many Aboriginal people (...) find hospitals unwelcoming and are reluctant to attend for diagnosis and treatment, particularly with few Aboriginal health professionals employed on these facilities. In this paper, scientific literature and reports on Aboriginal health‐care, methodology and cross‐cultural education are reviewed to inform a collaborative model of hospital‐based organisational change. The paper proposes a collaborative model of care to improve health service delivery by building capacity in Aboriginal and non‐Aboriginal personnel by recruiting more Aboriginal health professionals, increasing knowledge and skills to establish good relationships between non‐Aboriginal care providers and Aboriginal patients and their families, delivering quality care that is respectful of culture and improving Aboriginal health outcomes. A key element of model design, implementation and evaluation is critical reflection on barriers and facilitators to providing respectful and culturally safe quality care at systemic, interpersonal and patient/family‐centred levels. Nurses are central to addressing the current state of inequity and are pivotal change agents within the proposed model. (shrink)

The Modern Synthesis has dominated biology for 80 years. It was formulated in 1942, a decade before the major achievements of molecular biology, including the Double Helix and the Central Dogma. When first formulated in the 1950s these discoveries and concepts seemed initially to completely justify the central genetic assumptions of the Modern Synthesis. The Double Helix provided the basis for highly accurate DNA replication, while the Central Dogma was viewed as supporting the Weismann Barrier, so excluding the inheritance of (...) acquired characteristics. This article examines the language of the Modern Synthesis and reveals that it is based on four important misinterpretations of what molecular biology had shown, so forming the basis of the four Illusions: 1. Natural Selection; 2. The Weismann Barrier; 3. The Rejection of Darwin’s Gemmules; 4. The Central Dogma. A multi-level organisation view of biology avoids these illusions through the principle of biological relativity. Molecular biology does not therefore confirm the assumptions of the Modern Synthesis. (shrink)

Background Currently there is increasing recognition of the need for research in developing countries where disease burden is high. Understanding the role of local factors is important for undertaking ethical research in developing countries. We explored factors relating to information and communication during the process of informed consent, and the approach that should be followed for gaining consent. The study was conducted prior to a family-based genetic study among people with podoconiosis (non-filarial elephantiasis) in southern Ethiopia. Methodology/Principal Findings We adapted (...) a method of rapid assessment validated in The Gambia. The methodology was entirely qualitative, involving focus-group discussions and in-depth interviews. Discussions were conducted with podoconiosis patients and non-patients in the community, fieldworkers, researchers, staff of the local non-governmental organisation (NGO) working on prevention and treatment of podoconiosis, and community leaders. We found that the extent of use of everyday language, the degree to which expectations of potential participants were addressed, and the techniques of presentation of information had considerable impact on comprehension of information provided about research. Approaching podoconiosis patients via locally trusted individuals and preceding individual consent with community sensitization were considered the optimal means of communication. Prevailing poverty among podoconiosis patients, the absence of alternative treatment facilities, and participants' trust in the local NGO were identified as potential barriers for obtaining genuine informed consent. Conclusions Researchers should evaluate the effectiveness of consent processes in providing appropriate information in a comprehensible manner and in supporting voluntary decision-making on a study-by-study basis. (shrink)

As engineering applications require management of ever larger volumes of data, ontologies offer the potential to capture, manage, and augment data with the capability for automated reasoning and semantic querying. Unfortunately, considerable barriers hinder wider deployment of ontologies in engineering. Key among these is lack of a shared top-level ontology to unify and organise disparate aspects of the field and coordinate co-development of orthogonal ontologies. As a result, many engineering ontologies are limited to their scope, and functionally difficult to (...) extend or interoperate with other engineering ontologies. This paper demonstrates how the use of a top-level ontology, specifically the Basic Formal Ontology (BFO), greatly facilitates interoperability of multiple engineering-related ontologies. We constructed a system of formal linked ontologies by re-engineering legacy ontologies to be conformant with BFO and developing new BFO-conformant ontologies to capture knowledge in the engineering design, enterprise, human factors, manufacturing, and application domain of additive manufacturing. The resulting Integrated Framework for Additively Manufactured Products (IFAMP), including the body knowledge instantiated on its basis, serve as the basis for a proposed Design with Additive Manufacturing Method (DWAM), which we believe can support the design of innovative products with semantically enhanced ideation tools and enhanced access to application domain knowledge. The method and its facilitation through the ontological framework are demonstrated using a case study in medicine. (shrink)

Médecins Sans Frontières (MSF) is an independent medical humanitarian organisation working in over 70 countries. It has provided medical assistance for over 35 years to populations vulnerable through conflict, disease and inadequate health systems. Medical ethics define the starting point of the relationship between medical staff and patients. The ethics of humanitarian interventions and of research in conflict settings are much debated. However, less is known about the ethical dilemmas faced by medical humanitarian staff in their daily work. Ethical dilemmas (...) can be intensified in humanitarian contexts by insecure environments, lack of optimum care, language barriers, potentially heightened power discrepancies between care providers and patients, differing cultural values and perceptions of patients, communities and medical staff. Time constraints, stressful conditions and lack of familiarity with ethical frameworks can prevent reflection on these dilemmas, as can frustration that such reflection does not necessarily provide instant solutions. Lack of reflection, however, can be distressing for medical practitioners and can reduce the quality of care. Ethical reflection has a central role in MSF, and the organisation uses ethical frameworks to help with clinical and programmatic decisions as well as in deliberations over operational research. We illustrate and discuss some real ethical dilemmas facing MSF teams. Only by sharing and seeking guidance can MSF and similar actors make more thoughtful and appropriate decisions. Our aim in sharing these cases is to invite discussion and dialogue in the wider medical community working in crisis, conflict or with severe resource limitations. (shrink)

The urgent drive for vaccine development in the midst of the current COVID-19 pandemic has prompted public and private organisations to invest heavily in research and development of a COVID-19 vaccine. Organisations globally have affirmed the commitment of fair global access, but the means by which a successful vaccine can be mass produced and equitably distributed remains notably unanswered. Barriers for low-income countries include the inability to afford vaccines as well as inadequate resources to vaccinate, barriers that are (...) exacerbated during a pandemic. Fair distribution of a pandemic vaccine is unlikely without a solid ethical framework for allocation. This piece analyses four allocation paradigms: ability to develop or purchase; reciprocity; ability to implement; and distributive justice, and synthesises their ethical considerations to develop an allocation model to fit the COVID-19 pandemic. (shrink)

Global society is facing formidable current and future problems that threaten the prospects for justice and peace, sustainability, and the well-being of humanity both now and in the future. Many of these problems are related to science and technology and to how they function in the world. If the social responsibility of scientists and engineers implies a duty to safeguard or promote a peaceful, just and sustainable world society, then science and engineering education should empower students to fulfil this responsibility. (...) The contributions to this special issue present European examples of teaching social responsibility to students in science and engineering, and provide examples and discussion of how this teaching can be promoted, and of obstacles that are encountered. Speaking generally, education aimed at preparing future scientists and engineers for social responsibility is presently very limited and seemingly insufficient in view of the enormous ethical and social problems that are associated with current science and technology. Although many social, political and professional organisations have expressed the need for the provision of teaching for social responsibility, important and persistent barriers stand in the way of its sustained development. What is needed are both bottom-up teaching initiatives from individuals or groups of academic teachers, and top-down support to secure appropriate embedding in the university. Often the latter is lacking or inadequate. Educational policies at the national or international level, such as the Bologna agreements in Europe, can be an opportunity for introducing teaching for social responsibility. However, frequently no or only limited positive effect of such policies can be discerned. Existing accreditation and evaluation mechanisms do not guarantee appropriate attention to teaching for social responsibility, because, in their current form, they provide no guarantee that the curricula pay sufficient attention to teaching goals that are desirable for society as a whole. (shrink)

Attempts to use Big Data to transform car insurance pricing in France have failed. Why? Three possible explanations are discussed: organisational and cognitive inertia, normative preventions, and deliberate strategy. This article finds that moral or political reluctance has played only a secondary role in the failure of telematics devices. More important has been the deployment of an experimental strategy that has resulted in the conclusion that in the short and medium term at least, the use of big data to (...) rate car insurance is not profitable. There are too many organisational and cognitive barriers to the smooth adoption of innovation. All insurers note they all arrived at this conclusion. An implicit consensus therefore remains to retain the old business model. (shrink)