This chapter contains sections titled: Introduction Clearing Some Definitional Ground: Standards as Epistemic Objects What Counts as a Standard?: Orthodoxies and other Stories Travelling with Actor‐Network Theory: ‘It's Practice All theWay Down’6 The Project in Question: Data and Method Assemblage7 Teaching and Standards of Teaching: Performative Tales from the Field Assembling the Accomplished Teacher: Whose Assemblage Counts? The Critical Contribution of Actor‐Network Theory: Performative Politics Notes References.

Set within the socio-political context of standards-based education reform, this article explores the constitutive role of teaching standards in the production of the practice and identity of the ‘accomplished’ teacher. It contrasts two idioms for thinking about and studying these standards, the representational and the performative. Utilising the material-semiotic approach of actor-network theory, it addresses the issue of how the representational idiom of teaching standards has become so authoritative that it readily eclipses other ways to think and (...) ‘do’ them. In tracing the development of a specific set of teaching standards as part of a national research project, the argument is made that standards should be understood as performative knowledge and identity practices. And, accounting them should also be performative. Accordingly, attention is given to key locales in which this development is taking place. Teaching standards emerge as ontologically variable and it is struggles around this variability that can create conditions for a renewed practice and politics of education reform. (shrink)

Set within the socio‐political context of standards‐based education reform, this article explores the constitutive role of teaching standards in the production of the practice and identity of the ‘accomplished’ teacher. It contrasts two idioms for thinking about and studying these standards, the representational and the performative. Utilising the material‐semiotic approach of actor‐network theory, it addresses the issue of how the representational idiom of teaching standards has become so authoritative that it readily eclipses other ways to think and (...) ‘do’ them. In tracing the development of a specific set of teaching standards as part of a national research project, the argument is made that standards should be understood as performative knowledge and identity practices. And, accounting them should also be performative. Accordingly, attention is given to key locales in which this development is taking place. Teaching standards emerge as ontologically variable and it is struggles around this variability that can create conditions for a renewed practice and politics of education reform. (shrink)

This guide accompanies the following article(s): ‘Full Disclosure of the “Raw Data” of Research on Humans: Citizens’ Rights, Product Manufacturer’s Obligations and the Quality of the Scientific Database.’Philosophy Compass 6/2 (2011): 90–99. doi: 10.1111/j.1747‐9991.2010.00376.x Author’s Introduction Securing consent (and informed consent) from patients and research study participants is a key concern in patient care and research on humans. Yet, the legal doctrines of consent and informed consent differ in their applications. In patient care, the judicial doctrines of consent and informed (...) consent are disclosure doctrines based on the obligation of physicians to inform their patients of the following types of information: the nature of the procedure the physician is recommending in the patent’s care (P), the alternatives to the physician‐recommendation (A), and the risks of procedure and its alternatives (R). In addition, the physician must provide truthful answers to the patient’s questions (Q) to the best of the physician’s abilities. In research on humans, the onus of disclosure by study sponsors and principal investigators is much greater than in patient care precisely because the purpose of research is not patient care. The purpose of research is the identification and development of new generalizable knowledge. Thus, participation in a research study or trial may not benefit the study volunteer at all. In addition, the participant may carry a heavy risk burden in relationship to any testing of a newly designed drug or device as part of their experiences in the research study. Presently, despite the risks borne by the research study participant, the raw data collected from volunteers in research trials are treated by courts as if they were the private property of the study sponsor rather than generally owed to the public as would be expected by an effort like research participation aimed at contributing to the development of generalizable knowledge. This paper reviews the obligations that study sponsors owe to their study participants based on the very definition of research as a systematic activity whose purpose is to develop generalizable knowledge to help all humans. Author Recommends Court cases Canterbury v. Spence, United States Court of Appeals, District of Columbia Circuit 464 F.2d 772 (1972). (Federal appellate decision heard in the District of Columbia, USA) Reibl v. Hughes, 2 S.C.R. 880 (1980). (Supreme Court of Canada) Rogers v. Whitaker, 175 C.L. R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Canterbury v. Spence is the landmark Federal informed consent case in the United States heard in the District of Columbia. In this case, Judge Spottswood Robinson articulated the reasonable person standard of informed consent. This standard was subsequently adopted by the Supreme Court of Canada (Reibl v. Hughes, 2 S.C.R. 880 (1980)) and the High Court of Australia (Rogers v. Whitaker, 175 C.L. R. 479 (1992)). The House of Lords rejected the reasonable person standard in England in Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985). Book Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. This book is a detailed guide for the review of scientific and ethical aspects of research on humans contained in the research study protocols and research informed consent forms which need to be submitted by study sponsors and principal investigators to institutional review boards (IRBs) for IRB review before a research study can receive approval to be conducted within a human study population in those institutions over which the IRB has authority. It also presents basic definitions in the area of research on humans and basic approaches to help conduct a deep review of the underlying scientific and ethical issues that are present within a research study protocol and its accompanying research informed consent form. Report National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). This U.S. National Commission in the Belmont Report argued for the necessity of a reasonable volunteer standard in research on humans in the United States. Arguing that the professional standard and the reasonable person standard of consent and informed consent were insufficient to base a disclosure standard in research on humans, this National Commission developed the reasonable volunteer standard where a study participant is to be approached in research informed consent with that information that a reasonable volunteer would want to know. Online Materials Belmont Report: Syllabus Topics for Lecture and Discussion Week I: Introduction and Overview Readings: Rogers v. Whitaker, 175 C.L.R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week II: The Different Standards of Consent and Informed Consent Readings: Canterbury v. Spence, 464 F.2d 772 (1972). (Federal appellate opinion heard in the District of Columbia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week III: Definition of Research Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 2 and 3) Week IV: How to Review a Research Study Protocol and Research Informed Consent Form Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 4–6, 10, and 12–14) Week V: Obligations in Research of Humans Versus Patient Care Reading: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). Focus Questions • How do the judicial doctrines of consent in England and Australia compare to the judicial doctrines of informed consent in the United States and Canada? • How does a professional standard of disclosure differ from a reasonable person standard of disclosure? • What is the definition of research? • How is a research study (study proposal and research informed consent form) reviewed from scientific and ethical bases for considerations of approval by an IRB? • How do the obligations of a study sponsor, a principal investigator, and a research team conducting a research trial on human study participants differ from the obligations of a physician caring for a patient? • Should all raw data of research derived from humans be made available to the public for use in developing generalizable knowledge to help others, or should raw data be considered the private property of the study sponsors (for example, prescription drug manufacturers), who fund the research trials? Seminar/project Idea Draw a timeline of the development of the basic concepts of consent and informed consent in patient care and in patient research. On this timeline, first place the dates of the key court cases in England, the United States, Canada, and Australia on consent and informed consent. Then place the date of the development of the Belmont Report. Why do differences exist between these four countries in terms of the legal requirements of informedness of a patient (in medical care) and a study participant (in medical research)? What roles if any do the concepts of self‐determination and self‐decision have in consent and informed consent in patient care and in informed consent in research on humans among the four countries of interest? What are the realities of research on human participants that require a new standard of informed consent, the reasonable volunteer standard, to be developed beyond the two standards in patient care, the professional standard, and the reasonable person standard? Counterpoint Arguments The following are counterpoint arguments that need to be appreciated to more fully understand the concepts that impact the thesis that ‘raw data’ should be open to the public to allow the opportunity of checking of the results of its associated scientific paper and for further analysis. De‐Identified (Anonymized) Raw Data A current approach to identifying (anonymizinig) raw data is based on the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L.104‐191). HIPAA was enacted by the U.S. Congress in 1996 to keep a person’s medical information private. In a research study, a person’s private medical information can become research data. HIPAA’s Privacy Rule allows a covered entity to de‐identify data by removing all 18 elements that could be used to identify the individual or the individual’s relatives, employers, or household members; these elements are enumerated in the Privacy Rule. The covered entity must also have no actual knowledge that the remaining information could be used alone or in combination with other information to identify the individual who is the subject of the information. Under this method, the identifiers that must be removed are the following: 1 Names. 2 All geographic subdivisions smaller than a state, including street address, city, county, precinct, ZIP Code, and their equivalent geographical codes, except for the initial three digits of a ZIP Code if, according to the current publicly available data from the Bureau of the Census: 2a. The geographic unit formed by combining all ZIP Codes with the same three initial digits contains more than 20,000 people. 2b. The initial three digits of a ZIP Code for all such geographic units containing 20,000 or fewer people are changed to 000. 3 All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, and date of death, and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older. 4 Telephone numbers. 5 Facsimile numbers. 6 Electronic mail addresses. 7 Social security numbers. 8 Medical record numbers. 9 Health plan beneficiary numbers. 10 Account numbers. 11 Certificate/license numbers. 12 Vehicle identifiers and serial numbers, including license plate numbers. 13 Device identifiers and serial numbers. 14 Web universal resource locators (URLs). 15 Internet protocol (IP) address numbers. 16 Biometric identifiers, including fingerprints and voiceprints. 17 Full‐face photographic images and any comparable images. 18 Any other unique identifying number, characteristic, or code, unless otherwise permitted by the Privacy Rule for re‐identification. Even though ‘raw data’ can be de‐identified (anonymized) so that there is no way to trace back the data to the study participant from which it was drawn, there are still questions whether the ‘de‐identified raw data’ can be given to other researchers or made public without the original study participant’s approval. It may be the case that this approval could be done at the start of any research study where the individual considering study participation would be counseled on what the process of de‐identification consists of and would be asked whether the participant would allow use of the data by other researchers or made available to the public in a de‐identified state. However, there may be questions of the study participants as to whether the data are truly de‐identified and untraceable back to the study participant since the participant would not be able to see the process actually being carried out in detail in all relevant circumstances. Using Raw Data in Context Simply being in possession of raw data is never enough to build on that data from a research perspective. Researchers need to understand the context of the scientific research study in which the data were collected. This research context includes (but is not limited to): (i) the scientific hypothesis of the research study, (ii) the inclusion and exclusion criteria selected by the research designers of the study to determine which study participants were included and which were excluded from the study, (iii) the methods used to collect the data and possibilities of errors in the data collection processes, and (iv) answers to questions regarding whether any data were excluded from the study data and why these data were excluded. Ownership Rights Over Data There are ownership rights over data. Ownership rights include court decision making related to the question which parties are to be considered as the owners of the data. Possible owners here include (but are not limited to) (i) the study sponsor whose only role was to fund that study, (ii) the principal investigator(s) who developed the scientific hypothesis, and (iii) individual study participants through special contracts made by individual participants who negotiate such contracts with study sponsors and principal investigators to share in the ownership of data. Examples of such data are participant sources of unique gene lines or unique cell lines to be used in future research. Objections to Data Sharing Finally, individual researchers may simply object to sharing data. A researcher’s arguments here may be simply stating that he or she has a right to fully analyze the data since the collection of the data was the researchers’ idea in the first place. These researchers may argue that they have the right to mine the data as fully as they can before deciding to make the data open to the public for others to analyze. Works Cited 1 Kaiser, J. ‘Making Clinical Data Widely Available.’Science 322.5899 (10 Oct. 2008): 217–8. 2 de Lusignan, S., J.F. Metsemakers, P. Houwink, V. Gunnarsdottir, and J. van der Lei. ‘Routinely Collected General Practice Data: Goldmines for Research? A Report of the European Federation for Medical Informatics Primary Care Informatics Working Group (EFMI PCIWG) from MIE2006, Maastricht, The Netherlands.’Informatics in Primary Care 14.3 (2006): 203–9. 3 Sim, I. ‘Human Studies Database Project’, CTSA Data Repositories Symposium (17 Oct. 2008). 23 Nov. 2010. 4 Sim, I., C.G. Chute, H. Lehmann, R. Nagarajan, M. Nahm, and R.H. Scheuermann. ‘Keeping Raw Data in Context.’Science 323.5915 (6 Feb. 2009): 713. 5 U.S. Department of Health and Human Services, National Institutes of Health, HIPAA Privacy Rule, Information for Researchers. 13 Nov. 2010. 6 Wilczynski, N.L., R.B. Haynes, and Hedges Team. ‘EMBASE Search Strategies for Identifying Methodologically Sound Diagnostic Studies for Use by Clinicians and Researchers.’BMC Medicine 29.3 (March 2005): 7. (shrink)

American high schools have never been under more pressure to reform: student populations are more diverse than ever, resources are limited, and teachers are expected to teach to high standards for all students.

BackgroundIn the last 2 weeks of January 2021, Portugal was the worst country in the world in incidence of infections and deaths due to COVID-19. As a result, the pressure on the healthcare system increased exponentially, exceeding its capacities and leaving hospitals in near collapse. This scenario caused multiple constraints, particularly for hospital medical staff. Previous studies conducted at different moments during the pandemic reported that COVID-19 has had significant negative impacts on healthcare workers’ psychological health, including stress, anxiety, depression, (...) burnout, post-traumatic stress symptoms, and sleep disturbances. However, there are many uncertainties regarding the professional quality of life of hospital nurses and physicians. To address gaps in previous research on secondary traumatic stress, we focused on healthcare workers working in hospitals affected by a major traumatic event: the third wave of COVID-19.ObjectivesThe aim of the present study was to identify the contribution of personal and work-related contextual variables on professional quality of life of healthcare workers.MethodsCross-sectional study with a web-based questionnaire given to physicians and nurses working in a hospital setting. A total of 853 healthcare professionals participated in the survey assessing professional quality of life compassion satisfaction, secondary traumatic stress, and burnout. Factors of professional quality of life were assessed using regression analysis.ResultsMost of the participants showed moderate or high levels of compassion satisfaction, whereas the majority of them experienced moderate levels of burnout and secondary traumatic stress. The analyzed variables demonstrated no differences between professionals who were directly or not involved in the care of COVID-19 patients. Parental status was found to be a significant factor in compassion satisfaction. Female gender was significantly associated with more susceptibility to secondary traumatization. Factors that may potentially contribute to burnout include years of professional experience and the number of work hours per week.ConclusionThe COVID-19 pandemic has created a new challenge for the healthcare system. Burnout and secondary traumatic stress can lead to medical errors and impact standards of patient care, particularly compromising compassionate care. It is therefore recommended that hospitals develop psychoeducational initiatives to support professionals in dealing with barriers to compassion. (shrink)

A striking difference between those fields we classify as humanities and those we regard as sciences is the attitude within each field toward its history. Learning about literature, music, or the visual arts requires becoming knowledgeable about a significant amount of the history of those areas. And education in these fields, at whatever level, invariably involves some study of great accomplishments in the past. By contrast, scientific work and standard scientific textbooks make little reference to the history of the science (...) in question, and such reference is typically relegated to the appreciative mention in passing of important empirical discoveries or theoretical innovations. And professional training in the sciences, both graduate and undergraduate, involves no serious examination of the achievements or methodology of past scientific work, no matter how impressive and influential those achievements may have been. Progress dominates thinking in the sciences, and that emphasis may seem to explain such casual and occasionally condescending reference to the history of the sciences. But progress occurs in the humanities as well; even if some of the greatest artistic accomplishments are well in the past, there is remarkable innovation in style, technique, and methodology in the various arts. Some of the most monumental accomplishments in the sciences, moreover, are historical; nobody is likely to surpass the quality and importance of Newton's achievements, and few will ever equal those of Einstein. So it is unlikely that attitudes towards progress or past accomplishments can explain the divergent attitudes that fields in the sciences and humanities exhibit towards their own history. We can better understand this contrast by appeal to a characteristic feature of the arts. Nobody today writes in the manner of Milton, Racine, or Shakespeare, or composes in the manner of Bach or Beethoven, or paints in the style of Vermeer, Renoir, or Da Vinci. Even Picasso's early, somewhat ostentatious paintings in the styles of various past masters were more to show his prodigious abilities than they were original artistic endeavors.. (shrink)

Whether one's interests lie in psychological practice, counseling, research, or the classroom, psychologists today must deal with a broad range of ethical issues--from charging fees to maintaining a client's confidentiality, and from conducting research to respecting clients, colleagues, and students. Now in a new edition, Ethics in Psychology, the most widely read and cited ethics textbook in psychology, considers many of the ethical questions and dilemmas that psychologists encounter in their everyday practice, research, and teaching. The book has been (...) completely updated in response to evolving trends in psychological research and practice, as well as extensive changes in the American Psychological Association's ethics code. Taking a practical, common sense approach to ethics in modern-day psychological practice, this useful book offers constructive means for both preventing problems and resolving ethical predicaments. This new edition retains the key features which have contributed to its popularity, including extensive case studies that provide illustrative guidance on a wide variety of topics, such as fee setting, advertising for clients, research ethics, sexual attraction, classroom ethics, managed care issues, confidentiality, and much more. Highly readable, the book unites an accessible style with humorous anecdotes that highlight the human side of ethics and make the book a pleasure to read. Ethics in Psychology will be an indispensable guide to ethical decision-making for all psychologists and students in psychology. (shrink)

This article considers the issues of adaptation and organization of the educational process, barrier-free environment and readiness for professional activity of students with disabilities in inclusive education in conditions of inclusive education in a medical university. The relevance of this work is determined by one of the priority areas of state policy in the field of higher education – access to higher education for people with disabilities in inclusive education. Inclusive education at the university is designed to ensure not (...) only the realization of the right of students with disabilities in inclusive education to higher education, but also to solve the problems of socialization and professional demand for such people. In order to improve the process of introducing inclusive education at the Ryazan State Medical University named after Academician I.P. Pavlov, a study was conducted, the main problems and ways of solving them were identified, related to the organization of the educational process, the conditions of the barrier-free environment and the readiness for professional activity of students with disabilities in inclusive education. An increase in the proportion of university teachers who have undergone advanced training in inclusive education also contributes to solving problems. Adaptation of educational programs and educational and methodological support for persons with disabilities includes psychological, pedagogical and tutor support etc. The organization of the educational process using distance education technologies is one of the priority conditions for teaching students with disabilities and/or HIA. The use of this technology makes it possible to significant-ly expand and modify some educational standards for students with disabilities in inclusive education, namely, to create an individual way for each student with disabilities in inclusive education in a medical university. It is proposed to use training techniques such as: online consultation of teachers; VR technologies; availability of training materials 24/7; online webinars that facilitate the inclusion of such students in the educational and research activities of the university. The professionally organized educational space and educational process of the university provide not only a high level of mastery of professional competencies, but also contribute to the formation of personal qualities of students with disabilities in inclusive education, necessary for their successful socialization, life and activity in society. (shrink)

Publicity for (and laterly increased economic stringency which makes more likely), failures of care in the NHS engender concern for care quality while its assurance remains the subject of a fragmented and unhelpful literature. A selective attempt is made to examine some underlying principles by posing and answering three questions. What is the quality of care? What basic principles must be followed in defining `standards'? How then may quality be assured? Any definition of care must be multi-faceted and in common (...) use pervaded with the patients' pre-occupation with a search for cures. Nevertheless, it is argued that there are gains in restricting the technical use of the term `care' to those systematic processes of health services and their culture which impinge on the personal experience of patients and which fashion their response. In contemporary society care ought to be designed to restore and enhance the independence, dignity and choice of the patient. Although there is a contrary tendency to abandon problems of care to the professionals, standards for care should be judged ultimately not from the specialised professional but from the viewpoint of lay people whose behaviour in the outside world fashions those norms by which independence, dignity and choice are judged. A number of difficulties in identifying and securing improvements in care are discussed. In particular, it is argued that such is the interdependence of the style of management of an institution and the style of care it provides that enforcement of high quality care is likley to be a contradiction in terms. Only trained and sensitive staff can act intuitively and pre-emptively to prevent even incipient deterioration in care. They cannot carefully foster at all times the independence and dignity of their patients unless they are treated in a similar way as professional employees. As an initial step in improving the quality of care a simple start is urged upon implementing an inventory of checks. These are designed to establish the identification and operation of health care policies and practices which give appropriate recognition to the characteristics of care that patients and public expect, coming as they do from a lay rather than professional world. The article concludes with an appropriate inventory of questions to be put to professionals by those laymen who are increasingly imported into health care management through community representation (in CHCs) and staff participation (in joint consultation) and whose interest and concern should be harnessed appropriately. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Response to Randall Allsup, “Music Teacher Quality and Expertise”Bennett ReimerI am delighted to have this opportunity to reflect on Randall Allsup’s excellent, incisive, and wise paper. The issues he raises reach to the core of who we have been, where we are now, and how we must adapt ourselves to new challenges that deeply question both our ideals and our practices.Allsup’s opening questions relate directly to the most pressing (...) matters our profession is now facing—questions philosophical in essence. What kind of music teachers do our students deserve? What is the purpose of public education? And how do we get beyond our continuing and understandable desire for better-trained music teachers to ask the more pertinent question of what constitutes effective music teaching and learning in what the musical world is swiftly becoming. He has the courage to address this level of complexity seriously, and to make significant progress toward clarification. That deserves my respect and, I am quite sure, the respect of all of us.Allsup approaches his central premise on the significant changes needed in our professional identity by reminding us that we have “a long and distinguished [End Page 108] commitment to teaching and teachers.” That commitment, however, is based on the established assumption that music education is founded on excellence of performance as its ultimate goal and its greatest value. To achieve this musical end, he points out, requires mastery, attained through prolonged, careful apprenticeship. This “long running pedagogy of mastery and excellence appears closed to, or at least hostile to, innovation and popular input.”In addition, he argues, this belief system embroils all of us, teachers and their students, in the dichotomy of, on the one hand, replication of existing excellence as our goal, and, on the other, the need for emancipation from what was and what is, toward what might be; the need, that is, for transformation. The past, he recognizes, cannot simply be ignored: it is too precious for that. The future, however, also cannot be excluded. Within this antinomy we must find our way, honoring the past while not allowing it to constrict our future.At this point in his exposition Allsup approaches the proposition he is harboring, a proposition I want to explore for its potential in both clarity and complication. The basis of his key proposal is our need for teachers who are able “to think openly and less certainly about the design and implementation of musical instruction. Our pluralistic society,” he continues, “makes it imperative that we multiply the methods employed in the pursuit and construction of knowledge.”To accomplish this, Allsup presents a foundational dichotomy. There are “open forms of music” relating to “new and evolving ways of aesthetic participation that break with our traditional processes and our established codes and standards.” Contrasting with open forms are “closed forms,” representing the authoritative, the certain, and the canonic. “Closed forms,” he says, “represent culturally-structured and norm-driven literacies, where valuations of goodness pre-exist any aesthetic encounters.” Closed forms, he argues, are based on culturally agreed-upon modes of participation that are rigid in nature, such as in the prescribed and proscribed sequence of musical events proceeding inexorably in the order of composer-conductor-performer-audience.Such past (and present) rigidities, he points out, have become increasingly irrelevant. In every dimension of our lives significant and fast-occurring changes have become dominant, even expected, leaving us, as citizens and as educators, in confusion and uncertainty, and therefore in distress. We encounter aesthetic forms that are open-sourced and de-authored, unconnected to shared standards of practice. Technologies of music making and taking, he points out, have overthrown tradition to a startling degree, erasing distinctions among expert and amateur, between master and apprentice, between process and product, specialist and generalist, the classical and the vernacular.All this, and much more, is argued cogently and, I think, persuasively. It leads us to a central conception influencing how we must act as professionals. Our [End Page 109] obligation is to not only incorporate openness of musical engagements into our present culture of musical “closedness,” but to recognize the advent of openness as being a... (shrink)

The concept of professional autonomy has figured prominently in literature that addresses nursing's project of professionalization. Nursing's capacity to determine the nature and scope of its practice is related in important ways to the location of practice. Within highly structured environments such as acute‐care hospitals, nurses' professional autonomy has frequently been contested yet is often implicated by nursing's elite as a necessary condition in the construction of quality work environments. Professional concerns and management practices related to retaining (...) experienced nurses to support sustainability in healthcare delivery systems' impact on the ability of nurses to practice autonomously. Our paper focuses on the emerging field of practice of chronic disease management. We describe the complex relationships negotiated by a nurse in a theoretically autonomous practice setting as she seeks to fulfil both the requirements of a research protocol designed by physician experts representing the specialty of renal medicine, and her professional obligations to respond to the expressed needs of patients with early‐stage renal disease. We utilize a case study approach to explore particular contemporary concerns that nurses in practice confront as they attempt to accomplish professional relationships with patients central to achieving prescribed medical outcomes where nursing practice, as an element of the achievement of those outcomes, is constituted as absent or unacknowledged by the medical researchers leading the project. Implications for nursing's discourses on the professional project of autonomy will be discussed. (shrink)

Law wrangles with setting and applying standards for the practice of medicine in many different arenas. One of the most prominent is medical malpractice litigation in which the trial process examines a physician's performance and measures it against the standard of care. The profession's prevailing custom, with some substantial tolerance for “respectable minority” views, has been the gold standard for scrutinizing physician practice and treatment decisions in the malpractice context. Using the profession's custom as the measure against which a physician's (...) performance is judged defers to the expertise of medicine. Deference to the medical profession is attractive as a tool for reining in law. Reliance on customary practice is criticized, however, for driving physicians to the relative safety of the middle of the herd. Creating such a strong incentive for compliance with customary practice can dampen medical innovation and the diffusion of new clinical knowledge. The safety of the herd can also deprive individual patients of the best care in their particular circumstances.Several current trends are strengthening claims that professional practice patterns are an inappropriate tool for distinguishing between high‐quality and substandard care. In particular, advocacy for evidence‐based medicine aggressively asserts that the traditional way of making medical treatment decisions is largely untethered from scientific method or data, rendering professional judgment, even in the aggregate, suspect. (shrink)

Today, nurses are required to have knowledge and awareness concerning professional values as standards to provide safe and high-quality ethical care. Nurses’ perspective on professional values affects decision-making and patient care. Therefore, the present study aimed to investigate the importance of professional values from clinical nurses’ perspective. The present cross-sectional study was conducted in 2016 in four educational hospitals of Kerman University of Medical Sciences, Iran. Data were collected via the Persian version of Nursing Professional Values (...) Scale-Revised by Weis and Schank. Sampling was conducted through the use of stratified random sampling method and 250 clinical nurses participated in the study. Results indicated that the total score of the nurses’ professional values was high.. From nurses’ perspective items such as “Maintaining confidentiality of patients” and “Safeguarding patients’ right to privacy” had more importance; however, “Recognizing role of professional nursing associations in shaping healthcare policy” and “Participating in nursing research and/or implementing research findings appropriate to practice had less importance. A statistically significant relationship was observed between NPVS-R mean scores and nurses’ age, work experience as well as participation in professional ethical training. Although the total score related to the clinical nurses’ perspective on professional values was high, the importance of certain values was at a lower level. Owing to the emerging ethical challenges, it is indispensable to design educational programs in order to improve nurses’ awareness and understanding of the comprehensive importance of professional values. Furthermore, it is recommended that mixed methods studies should be conducted in order to design an instrument to evaluate the use of values in nursing practice. (shrink)

BackgroundMany authors choose to work with professional medical writers when reporting the results of clinical trials. We conducted a systematic review to examine the relationship between professional medical writing support (PMWS) and the quality, ethics and timeliness of publications reporting clinical trials.MethodsUsing terms related to ‘medical writer’ and ‘observational study’, we searched MEDLINE and Embase (no date limits), as well as abstracts and posters from meetings of the International Society for Medical Publication Professionals (ISMPP; 2014–2018). We also hand-searched (...) the journals Medical Writing and The Write Stuff (2014–2018) and the bibliographies of studies identified in the electronic searches. We screened the results to identify studies that compared the quality, ethics and timeliness of clinical trial publications written with and without declared PMWS.ResultsOur searches identified 97 potentially relevant studies, of which 89 were excluded during screening and full paper review. The remaining eight studies compared 849 publications with PMWS with 2073 articles developed without such support. In these eight studies, PMWS was shown to be associated with increased adherence to Consolidated Standards of Reporting Trials (CONSORT) guidelines (in 3/3 studies in which this was assessed), publication in journals with an impact factor (one study), a higher quality of written English (one study), and a lower likelihood of reporting non-pre-specified outcomes (one study). PMWS was not associated with increased adherence to CONSORT for Abstracts guidelines (one study) or with the impact of published articles (mean number of citations per year, mean number of article views per year and Altmetric score; one study). In studies that assessed timeliness of publication, PMWS was associated with a reduced time from last patient visit in clinical trials to primary publication (one study), whereas time from submission to acceptance showed inconsistent results (two studies).ConclusionsThis systematic review of eight observational studies suggests that PMWS is positively associated with measures of overall quality of reporting of clinical trials and may improve the timeliness of publication.Video abstract. (MP4 161000 kb). (shrink)

The number of online courses in business schools is growing dramatically, but little has been published about teaching business ethics courses online. This article addresses key pedagogical design, delivery, student engagement, and assessment issues that should be considered when creating a high-quality, asynchronous online business ethics course for either undergraduate or graduate business student populations. Best practices are discussed within an integrative case study approach based on the experiences of a director of online faculty development and two accomplished (...) online business ethics instructors, one teaching at a small college and the other at a research-oriented university—their successes, learning opportunities, and recommendations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Rembrandt’s Art: A Paradigm for Critical Thinking and AestheticsMark S. Conn (bio)IntroductionThe purpose of art is to lay bare the questions, which have been hidden by the answers.—James BaldwinPhilosophers have asked, How do we know the world? Over centuries, many visual artists have responded to this question by provoking us to see the world differently—through their own eyes. Rembrandt, by no small measure, is one of those artists. While (...) many people have attempted to understand and interpret the art of this quintessential master, few have used his art as a tool to teach critical thinking. The challenge, then, is to set forth a paradigm, using Rembrandt’s art as the vehicle, to teach critical thinking skills. These skills can be applied across the curriculum without losing an appreciation for the aesthetic characteristics of his art.Several sections in this article begin with a foundational discussion of the connection between art and the general curriculum, including how the effectiveness of that curriculum may then be measured. Continuing with a working definition of critical thinking, I demonstrate how Rembrandt’s work relates particularly well to the social studies curriculum. Definitions of critical thinking skills are discussed just prior to introducing the paradigm. A discussion of the paradigm’s relationship to aesthetics and necessary concepts is followed by the conclusion, which contains the graphic illustration of the paradigm. [End Page 68]Foundational DiscussionIn order to create a paradigm that encompasses Rembrandt’s art, critical thinking, and aesthetics, it is important to understand the connection that art has to the curriculum. By examining the way in which this relationship has evolved and is measured, we discover its foundation. It also produces a rationale for the paradigm.For decades the educational community has debated the validity of including arts in the curriculum. There are those who believe that in order to justify inclusion in the curriculum, there needs to be evidence that art has a quantifiable impact upon learning. Others believe that there is a need to teach art for art’s sake.1 Elliot Eisner stated, “More often than we would like, arts educators receive requests to justify their professional existence or existence of the arts in our schools on the basis of their contribution to non-art outcomes.”2 According to Eisner’s research, there have been no studies that show a statistically significant relationship between the arts and academic success.3 Additionally, in their final report evaluators from Transforming Education Through the Arts Challenge (TETAC) concluded that “Analysis of site-specific data found no significant relationship between program implementation and performance on reading and math tests.”4 There are many sources that can be cited that report the same findings. In assessing these kinds of findings we find the conclusions to be approximately the same.If we look at the U.S. Department of Education’s National Assessment of Educational Progress, which each year releases “The Nation’s Report Card,” we find a tremendous amount of data.5 However, most of what we find is data that is analyzed scientifically, with a long but incomplete list of incomplete variables. Therefore, it is difficult to come to any consensus about which programs, in which states, are successful and why. All we actually see is who is supposedly doing better in various curriculum areas based upon standardized tests that vary from state to state. Consider an example of current thinking regarding curriculum and testing from an article by Diane Ravitch, former assistant U.S. secretary of education, and Deborah Meir, senior scholar at New York University’s Steinhardt School of Education:Both of us acknowledged that our choices involve risks. A national curriculum might be unwieldy and superficial (“a mile wide and an inch deep—ironically the charge directed at our current incoherent and fragmented curriculum”) as well as politically compromised, while a local one might reflect the low expectations of the local community as local foolishness and local biases (some schools, for example, might teach intelligent design). We agreed that the measurement of “results”—what constitutes intellectual achievement—has been badly distorted by current local and state tests, which undermine high-quality tasks and make... (shrink)

The expressions ‘high quality care’ and ‘low quality care’ are cognitive and linguistic artefacts that help to structure people’s lives and thinking; for example, moves are now afoot internationally to pay bonuses to health professionals for delivering high quality care. United States programmes, most conspicuously, are assuming that high quality care can be validly distinguished from low quality care, and incentivised through bonuses. This distinction is always at least implicit, for high quality care has no meaning without low quality care. (...) Through a ‘deconstructionist reading,’ this article discusses limitations of categorising the quality of care as either high or low. The limitations of this ‘binary opposition’ can include a lack of defining attributes; vagueness and fuzziness at the ‘boundaries’ between high quality care and low quality care; concealment of quality as a continuum; and use of the binary opposition to effect social order and control. Health policy implications of our analysis are discussed. Drawing upon the general medical services contract in the United Kingdom, we suggest an approach to overcoming the oversimplification and imprecision that categorisation tends to produce. (shrink)

Psychologists today must deal with a broad range of ethical issues--from charging fees to maintaining a client's confidentiality, and from conducting research to respecting clients, colleagues, and students. As the field of psychology has grown in size and scope, the role of ethics has become more important and complex whether the psychologist is involved in teaching, counseling, research, or practice. Now this most widely read and cited ethics text in psychology has been revised to reflect the ethics questions and (...) dilemmas that psychologists encounter in their everyday work. Ethics in Psychology has been completely updated in response to evolving trends in psychological research and practice, as well as extensive changes in the American Psychological Association's ethics code. Gerald P. Koocher and Patricia Keith-Spiegel take a practical, commonsense approach to ethics in modern-day psychological practice, and offer constructive suggestions for both preventing problems and resolving ethical predicaments. In this book, their main intent is to present the full range of contemporary ethical issues in psychology as not only relevant and intriguing, but also as integral and unavoidable aspects of the profession. The authors make extensive use of actual case studies in order to illustrate how the APA guidelines apply to specific situations, such as fee setting, advertising for clients, research ethics, sexual attraction, classroom ethics, managed care issues, confidentiality, and much more. The most recent ethics code of the American Psychological Association (1992) is used here only as a starting point. The authors go well beyond the APA code and incorporate the input of many experts. In addition to the analysis of a wide variety of general situations, new problematic areas are identified and explored. The book includes two appendixes - Ethical Principles of Psychologists and Code of Conduct, adopted by American Psychological Association, Rules and Procedures of the Ethics Committee of the American Psychological Association - both in an easy-to-use format. In addition, each chapter lists summary guidelines along with current and valuable references. Highly readable, the book unites a straightforward, lively writing style with humorous anecdotes that highlight the human side of ethics and make the book a pleasure to read. Ethics in Psychology will be an indispensable guide to ethical decision-making for all psychologists and students in psychology. (shrink)

Before we can resolve or avoid an ethical dilemma, we need to understand what makes something ethical. Practical and Professional Ethics : Key Concepts introduces us to a series of real cases where the stakes can be high, the situations complex, and the ethical issues often difficult to see. Drawing on examples from medicine, law and science, it offers a practical approach to thinking critically about the ethical problems that occur in our professions, teaching us how to: focus (...) on the ethical aspects of any situation distinguish between different kinds of ethical problems tailor our response to the kind of problem we face construct arguments we can plausibly attribute to those involved identify the role of power, discretion and moral blindness By guiding us through the concepts, issues and skills at play when we face an ethical problem, we learn how to find a solution. Ideal for students or professionals, this book provides the grounding required to become a more complex moral thinker, a quality that can be applied in a number of fields and jobs. (shrink)

Medical necessity (claiming that a medical intervention or care is – at minimum – reasonable, appropriate and acceptable) depends on empirical evidence and on the interpretation of that evidence. Evidence and its interpretation define the standard of care. This commentary argues that both the evidence base and its interpretation are currently weak gatekeepers. Empirical meta-research suggests that very few medical interventions have high quality evidence in support of their effectiveness and very few of them also have relatively thorough assessments of (...) their potential harms. Therefore, evidence on the risk-benefit ratios carries almost always very large uncertainty. Arbitration about medical necessity is thus left to the interpretation process. Professional guidelines are notoriously unreliable and biased in this regard. Regulatory approval ends up being the key arbitrator, but over the years the regulatory process has been subverted. Regulatory approval currently does not mean that an intervention has a favourable risk-benefit ratio, but simply that it can be marketed, sold and made profit from. The process leads to a tragedy of commons where the final victim is society at large: medical necessity is invoked as an alibi for medicine to absorb societal resources. (shrink)

This study examines the social impacts of labor-related corporate social responsibility policies or corporate codes of conduct on upholding labor standards through a case study of CSR discourses and codes implementation of Reebok - a leading branded company enjoying a high-profiled image for its human rights achievement - in a large Taiwanese-invested athletic footwear factory located in South China. I find although implementation of Reebok labor-related codes has resulted in a "race to ethical and legal minimum" labor standards when notoriously (...) inhumane and seriously illegal labor rights abuses were curbed, Chinese workers were forced to work harder and faster but, earned less payment and the employee-elected trade union installed through codes implementation operated more like a "company union" rather than an autonomous workers' organization representing worker' interests. In order to explain the paradoxical effects of Reebok labor-related codes on labor standards, I argue the result is determined by both structural forces and agency-related factors embedded in industrial, national and local contexts. To put it shortly, I find the effectiveness of Reebok labor-related codes is constrained not only by unsolved tension between Reebok's impetus for profit maximization and commitment to workers' human rights, but also by hard-nosed competition realities at marketplace, and Chinese government's insufficient protection of labor rights. Despite drawing merely from a single case study, these findings illuminate key determinants inhibiting the effectiveness of labor-related CSR policies or codes in upholding labor standards, and hence two possible way-outs of the deadlock: sharing cost for improving labor standards among key players in global supply chain; and combining regulatory power of voluntary codes and compulsory state legislations. (shrink)

This essay describes trends in the organization of work that have laid the groundwork for the adoption of interactive AI-driven instruction tools, and the technological innovations that will make intelligent tutoring systems truly competitive with human teachers. Since the origin of occupational specialization, the collection and transmission of knowledge have been tied to individual careers and job roles, specifically doctors, teachers, clergy, and lawyers, the paradigmatic knowledge professionals. But these roles have also been tied to texts and organizations that can (...) disseminate knowledge independently from professionals. Professionals and organizations turn knowledge into texts and tools that enable lay people to access knowledge without the intermediation of professionals or organizations. In the 21st century, one emerging tool for transmitting knowledge is the intelligent tutoring system. This paper examines how technological, epistemic, and economic trends in education are supporting the routinization, proletarianization, and automation of the occupation of teaching, leading to the increasing substitution of intelligent tutoring systems for human instruction. Some trends, such as standardized curricula and testing, both restrict teachers’ professional autonomy and facilitate the creation of pedagogical tools. Other trends reduce teachers’ ability to resist automation. The growth of adjunct teaching and paraprofessional roles in higher education allows organizations to take over and rationalize parts of the traditional teacher role. Faculty evaluations and learning outcomes assessment weaken professional claims to be the sole arbiters of instructional quality and student learning. The widespread use of intelligent tutoring systems also depends on the sophistication of software capable of performing the social-emotional and cognitive roles that educators perform. Eventually, pedagogical software will be able to interactively individualize curricula to the needs and interests of every learner, more cheaply, quickly, and accurately than any human teacher. Assessment of learning will be continuous, and certification of learning will be for specific skills instead of broad area competencies. Intelligent tutoring systems will help transition education from its medieval and industrial-era model to more accessible and flexible continuing education for employment and life enrichment. (shrink)

European quality assurance has a complicated history that must be viewed as taking place on two levels: first, in a national effort to deregulate the public sector and to make universities accountable for their teaching performance; and second, a supranational endeavor to accomplish European integration in the field of higher education. Similarly, the web of institutional constraints and opportunity structures in which accreditation agencies are embedded spans two policy levels, the national and the European. In this paper, we examine (...) how German accreditation agencies achieve some level of autonomy in a highly entrenched institutional environment. The paper is based on a qualitative study comprising archival data and over 70 semi-structured interviews. Drawing on the insights of neo-institutional theory, we argue that quality assurance agencies seek political leverage at the European level in order to strengthen their standing in the higher education systems of their own countries. (shrink)

When the state buys and then provides to the citizens goods and services, the state may certainly choose to audit, independently and comprehensively, the quality of the goods and services so provided, particularly when citizens are reporting back that the goods or services are causing unwanted, deleterious effects. This principle applies to intellectual property -- information -- education -- as well as to other goods and services. In particular, it applies to the theory of evolution as taught by the state (...) in its schools, colleges, and universities. A substantial public has long expressed concern; and the state may properly respond to that concern. Naturally, the state would never allow the vendor of goods and services to dictate that only its employees, or others whom it effectively controls, may be allowed to conduct audits. Indeed, persons substantially subject to the control of the vendor are the last possible choices to serve as independent auditors. The conflict-of-interest is well-recognized regarding information and opinion services: a huge problem arose with the big national auditing firms when they also established management consulting divisions -- the auditors tended to report favorably about companies and projects on which their own management consultants were involved. Yet the science community quite bluntly and openly proclaims that only its members -- persons it controls -- may function as auditors of the quality of scientific statements and propositions. They do this by asserting that only scientists may declare what is, or is not, scientific. Now it may be true that within any company, only employees of that company may properly develop the products that the company sells, and only they may deliver the company's statements regarding the quality of its own products. But when a company sells its products outside of itself, to others, such as the government, it may not impose as a condition of sale that only its employees may continue to render opinions about the quality of the product. When the science community actively urges the government to take-up and re-distribute its product, it necessarily surrenders any claim to a monopoly over auditing the product. A difficulty of conducting truly independent audits of science product vended to the government for delivery to the people lies in the fact that to-date, there is no systematic program of developing and training people to serve as such independent auditors. The closest group of people to rely on for this would be lawyers who, in litigation, have developed the ability to cross-examine expert witnesses in cases such as patent cases, or product-liability cases, or other litigations that involve expert testimony in advanced academic fields. This paper outlines a program by which states can conduct appropriate independent audits of evolution as vended to the state by the science community. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Particularity, Presence, Art Teaching, and LearningJulia Kellman (bio)The Awful, the Particular, and the TranscendentYears ago in a life drawing class during graduate school, for who knows what reason, I chose to focus my drawing on the model's head and not on her entire form. She was wearing an enormous and elaborate black velvet hat with yards of veiling and several large red silk roses. The combination of textures, (...) shadows, colors, forms, and the suggestion of a story, of meaning beyond the exercise itself, drew me in I think. Using an entire large sheet of tan-colored drawing paper, soft vine charcoal, and a kneaded rubber eraser I began to draw, moving from the impossible hat to the model's high cheekbones, deep-set shadowed eyes, soft cheeks, and curved neck. Somewhere between the top of the paper (the crown of her hat) and the woman's face, however, my hand, my self, the drawing, the young woman, and the hat merged by some means outside my control. I was the act of drawing. I was the charcoal, the curved cheek, the dark eyes, the wonderful hat. There were no boundaries among us. No distances. The drawing, it seemed, drew me at the same time that it revealed an image of the model and her black velvet hat on the paper and tied me to the woman seated before me. I was exalted, transported, amazed.Now, as I think back to that drawing, I understand it as my first clear art experience of doing, not thinking, being, not observing that all artists encounter on their best days. It was, in another way of considering, my initial encounter with the fact that "the imaginative faculty, especially as engaged in the art process is one of the strongest and clearest ways in which we can learn within the qualitative, immediate present, within kairotic as opposed to chronic time, or within the eternal present,"1 as the art educator Kenneth [End Page 51] Beittel explains. Or, put another way, it was my experience with the fact that, as the writer Lawrence Weschler suggests in his biography of the artist Robert Irwin, "Seeing is forgetting the name of the thing one sees."2 Or, as the sculptor Anne Truitt explains, drawing can be "a direct channel between one's [my] experience and one's [my] hand."3This transformation from a distinct see-er and seen to a single entity sharing both time and space, from a distant relationship to intimacy, from a world of the generalized to the place of the particular brings us to the intertwined themes of this article: the importance of the awesome transcendent particularity of the singular—person, creature, place, object, plant, or moment in art and, similarly, religious contemplation and the likeness and/or overlap of artistic engagement with spiritual experience.In order for us to examine the artist in the midst of creating, and to explore our theme of art's relationship to the awful (think of the older usage meaning "full of awe" here) particularity of thisness as John Dun Sotus4 describes the perfection of the particular and specific, as well as to explore the relationship of art making, art learning, art teaching, and spiritual experience, exemplars are necessary. Our first exemplar is Gordie, a member of the art class I teach at a local hospital. He, as much as anyone, exemplifies artistic engagement with the current moment, its thisness in fact, and he illustrates the art maker's/learner's engagement with pure doing in the act of creating an image. Our second exemplar, the filmmaker, writer, and painter Derek Jarman,5 exemplifies by his lifetime of creative accomplishment an artist in the most literal manner. And even in the last years of his life—as sculptor, gardener, landscape designer, writer, and creator of a place of great beauty—he illuminates in both his words and in his garden his engagement with the present moment, with particularity, and with the spiritual quality that permeates his world.Gordie's Tale: Art and FlowersGordie accompanied his friend Roger to the first art class to be held at the hospital for people with... (shrink)

Some philosophers consider that some of their colleagues deny that consciousness exists. We shall call the latter ‘deniers’, adopting a term that was initially meant pejoratively. What do the deniers deny? In order to answer this question, we shall examine arguments, both of some deniers and of their critics, and present denialism as a systematic highly non-trivial position that has had some interesting achievements. We will show that the denialist project concerns the epistemology of the mind and specifically of consciousness: (...) what can be known about it, and how it can be known. The main argument of denialism is that first-person reports about the mental realm are not always the best source of information about that realm, and are certainly not reliable. This leads the deniers to realize that the reference and meaning of mental terms as used in standard philosophical literature are vague and call for clarification, and that what many take to be empirical data in the study of the mind are actually heavily laden with theory. Denialism thus makes scientific and philosophical research clearer and more fruitful. (shrink)

Background:Organ donation and transplantation have made it possible to both save life and to improve the quality of life for a large number of patients. In the last years there has been an increasing gap between the number of patients who need organs and organs available for transplantation, and the focus worldwide has been on how to meet the organ shortage. This also rises some ethical challenges.Objective:The objective of this study was to explore healthcare professionals' experience of ethics related to (...) care and interaction with critically ill patients with severe brain injuries and their families.Research design:A hermeneutic phenomenological approach was used to explore the participants' experiences. Methods for collecting data were a combination of participant observations and in-depth interviews.Participants and research context:Two ICUs in a Norwegian university hospital were recruited for data collection. A total of 12 cases were observed, and 32 of the healthcare professionals involved were interviewed.Ethical considerations:The study was approved by the Regional Committee for Research Ethics. Permission to the study in the ICUs was obtained from the Chief Physician in the two ICUs respectively. The right of the participants was ensured by written, voluntary, and informed consent.Findings:From the thematic analysis, a structure of the participants' experiences emerged as a process. While the patients' condition was clarified through phases of prognostic ambiguity, gradual clarification and prognostic certainty, interaction with the families was characterized by ambiguity that involved withholding. The prognostic process had a great impact on how the healthcare professionals interacted with the family. The interaction challenged the participants' caring values in various ways and captured an important structure in their experiences of the ethical interaction with the patients' families. These challenges distinguish caring for families in donation situations from caring for relatives of critically ill patients in general.Discussion:In the discussion we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act.Conclusion:Ethical questions should be discussed more both in educations of healthcare professionals and in clinical practice. (shrink)

Maxwell’s Demon is a thought experiment devised by J. C. Maxwell in 1867 in order to show that the Second Law of thermodynamics is not universal, since it has a counter-example. Since the Second Law is taken by many to provide an arrow of time, the threat to its universality threatens the account of temporal directionality as well. Various attempts to “exorcise” the Demon, by proving that it is impossible for one reason or another, have been made throughout the years, (...) but none of them were successful. We have shown (in a number of publications) by a general state-space argument that Maxwell’s Demon is compatible with classical mechanics, and that the most recent solutions, based on Landauer’s thesis, are not general. In this paper we demonstrate that Maxwell’s Demon is also compatible with quantum mechanics. We do so by analyzing a particular (but highly idealized) experimental setup and proving that it violates the Second Law. Our discussion is in the framework of standard quantum mechanics; we give two separate arguments in the framework of quantum mechanics with and without the projection postulate. We address in our analysis the connection between measurement and erasure interactions and we show how these notions are applicable in the microscopic quantum mechanical structure. We discuss what might be the quantum mechanical counterpart of the classical notion of “macrostates”, thus explaining why our Quantum Demon setup works not only at the micro level but also at the macro level, properly understood. One implication of our analysis is that the Second Law cannot provide a universal lawlike basis for an account of the arrow of time; this account has to be sought elsewhere. (shrink)

A novel method of teaching military medical ethics, medical ethics and military ethics in the Israel Defense Force (IDF) Medical Corps, essential topics for all military medical personnel, is discussed. Very little time is devoted to medical ethics in medical curricula, and even less to military medical ethics. Ninety-five per cent of American students in eight medical schools had less than 1 h of military medical ethics teaching and few knew the basic tenets of the Geneva Convention. Medical (...) ethics differs from military medical ethics: the former deals with the relationship between medical professional and patient, while in the latter military physicians have to balance between military necessity and their traditional priorities to their patients. The underlying principles, however, are the same in both: the right to life, autonomy, dignity and utility. The IDF maintains high moral and ethical standards. This stems from the preciousness of human life in Jewish history, tradition and religious law. Emphasis is placed on these qualities within the Israeli education system; the IDF teaches and enforces moral and ethical standards in all of its training programmes and units. One such programme is ‘Witnesses in Uniform’ in which the IDF takes groups of officers to visit Holocaust memorial sites and Nazi death camps. During these visits daily discussions touch on intricate medical and military ethical issues, and contemporary ethical dilemmas relevant to IDF officers during active missions. (shrink)

While there is much extant literature on “case method” pedagogy as practiced in law and business education, there is little written on its use in teaching practical (i.e. professional or applied) ethics. After relating the history and nature of the case method in law, business, and philosophy, the author offers guidance on how to develop and use philosophy cases, focusing on lesson plans for their presentation, their purpose within the practical ethics curriculum, and how to write and grade (...) course requirements involving them. Much more than the examples philosophers typically invent (designed to illustrate a point or bring discussion to a close), philosophy cases are highly varied, promoting discussion and sensitivity to complex ethical situations. The author argues that since the goal of a practical ethics course is to most often to familiarize people with the special standards of conduct that apply to members of a certain group (e.g. doctors, lawyers, academics), philosophy cases should encourage the expression of ethical opinions, encourage students to identify issues within cases and to make decisions that account for ethical complexities, promote students’ ability to justify those decisions convincingly, and develop in students a sense of how to incorporate feasibility into the moral decision-making process. (shrink)

This guide accompanies the following article(s): ‘Full Disclosure of the “Raw Data” of Research on Humans: Citizens’ Rights, Product Manufacturer’s Obligations and the Quality of the Scientific Database.’Philosophy Compass 6/2 (2011): 90–99. doi: 10.1111/j.1747‐9991.2010.00376.x Author’s Introduction Securing consent (and informed consent) from patients and research study participants is a key concern in patient care and research on humans. Yet, the legal doctrines of consent and informed consent differ in their applications. In patient care, the judicial doctrines of consent and informed (...) consent are disclosure doctrines based on the obligation of physicians to inform their patients of the following types of information: the nature of the procedure the physician is recommending in the patent’s care (P), the alternatives to the physician‐recommendation (A), and the risks of procedure and its alternatives (R). In addition, the physician must provide truthful answers to the patient’s questions (Q) to the best of the physician’s abilities. In research on humans, the onus of disclosure by study sponsors and principal investigators is much greater than in patient care precisely because the purpose of research is not patient care. The purpose of research is the identification and development of new generalizable knowledge. Thus, participation in a research study or trial may not benefit the study volunteer at all. In addition, the participant may carry a heavy risk burden in relationship to any testing of a newly designed drug or device as part of their experiences in the research study. Presently, despite the risks borne by the research study participant, the raw data collected from volunteers in research trials are treated by courts as if they were the private property of the study sponsor rather than generally owed to the public as would be expected by an effort like research participation aimed at contributing to the development of generalizable knowledge. This paper reviews the obligations that study sponsors owe to their study participants based on the very definition of research as a systematic activity whose purpose is to develop generalizable knowledge to help all humans. Author Recommends Court cases Canterbury v. Spence, United States Court of Appeals, District of Columbia Circuit 464 F.2d 772 (1972). (Federal appellate decision heard in the District of Columbia, USA) Reibl v. Hughes, 2 S.C.R. 880 (1980). (Supreme Court of Canada) Rogers v. Whitaker, 175 C.L. R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Canterbury v. Spence is the landmark Federal informed consent case in the United States heard in the District of Columbia. In this case, Judge Spottswood Robinson articulated the reasonable person standard of informed consent. This standard was subsequently adopted by the Supreme Court of Canada (Reibl v. Hughes, 2 S.C.R. 880 (1980)) and the High Court of Australia (Rogers v. Whitaker, 175 C.L. R. 479 (1992)). The House of Lords rejected the reasonable person standard in England in Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985). Book Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. This book is a detailed guide for the review of scientific and ethical aspects of research on humans contained in the research study protocols and research informed consent forms which need to be submitted by study sponsors and principal investigators to institutional review boards (IRBs) for IRB review before a research study can receive approval to be conducted within a human study population in those institutions over which the IRB has authority. It also presents basic definitions in the area of research on humans and basic approaches to help conduct a deep review of the underlying scientific and ethical issues that are present within a research study protocol and its accompanying research informed consent form. Report National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). This U.S. National Commission in the Belmont Report argued for the necessity of a reasonable volunteer standard in research on humans in the United States. Arguing that the professional standard and the reasonable person standard of consent and informed consent were insufficient to base a disclosure standard in research on humans, this National Commission developed the reasonable volunteer standard where a study participant is to be approached in research informed consent with that information that a reasonable volunteer would want to know. Online Materials Belmont Report: Syllabus Topics for Lecture and Discussion Week I: Introduction and Overview Readings: Rogers v. Whitaker, 175 C.L.R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week II: The Different Standards of Consent and Informed Consent Readings: Canterbury v. Spence, 464 F.2d 772 (1972). (Federal appellate opinion heard in the District of Columbia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week III: Definition of Research Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 2 and 3) Week IV: How to Review a Research Study Protocol and Research Informed Consent Form Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 4–6, 10, and 12–14) Week V: Obligations in Research of Humans Versus Patient Care Reading: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). Focus Questions • How do the judicial doctrines of consent in England and Australia compare to the judicial doctrines of informed consent in the United States and Canada? • How does a professional standard of disclosure differ from a reasonable person standard of disclosure? • What is the definition of research? • How is a research study (study proposal and research informed consent form) reviewed from scientific and ethical bases for considerations of approval by an IRB? • How do the obligations of a study sponsor, a principal investigator, and a research team conducting a research trial on human study participants differ from the obligations of a physician caring for a patient? • Should all raw data of research derived from humans be made available to the public for use in developing generalizable knowledge to help others, or should raw data be considered the private property of the study sponsors (for example, prescription drug manufacturers), who fund the research trials? Seminar/project Idea Draw a timeline of the development of the basic concepts of consent and informed consent in patient care and in patient research. On this timeline, first place the dates of the key court cases in England, the United States, Canada, and Australia on consent and informed consent. Then place the date of the development of the Belmont Report. Why do differences exist between these four countries in terms of the legal requirements of informedness of a patient (in medical care) and a study participant (in medical research)? What roles if any do the concepts of self‐determination and self‐decision have in consent and informed consent in patient care and in informed consent in research on humans among the four countries of interest? What are the realities of research on human participants that require a new standard of informed consent, the reasonable volunteer standard, to be developed beyond the two standards in patient care, the professional standard, and the reasonable person standard? Counterpoint Arguments The following are counterpoint arguments that need to be appreciated to more fully understand the concepts that impact the thesis that ‘raw data’ should be open to the public to allow the opportunity of checking of the results of its associated scientific paper and for further analysis. De‐Identified (Anonymized) Raw Data A current approach to identifying (anonymizinig) raw data is based on the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L.104‐191). HIPAA was enacted by the U.S. Congress in 1996 to keep a person’s medical information private. In a research study, a person’s private medical information can become research data. HIPAA’s Privacy Rule allows a covered entity to de‐identify data by removing all 18 elements that could be used to identify the individual or the individual’s relatives, employers, or household members; these elements are enumerated in the Privacy Rule. The covered entity must also have no actual knowledge that the remaining information could be used alone or in combination with other information to identify the individual who is the subject of the information. Under this method, the identifiers that must be removed are the following: 1 Names. 2 All geographic subdivisions smaller than a state, including street address, city, county, precinct, ZIP Code, and their equivalent geographical codes, except for the initial three digits of a ZIP Code if, according to the current publicly available data from the Bureau of the Census: 2a. The geographic unit formed by combining all ZIP Codes with the same three initial digits contains more than 20,000 people. 2b. The initial three digits of a ZIP Code for all such geographic units containing 20,000 or fewer people are changed to 000. 3 All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, and date of death, and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older. 4 Telephone numbers. 5 Facsimile numbers. 6 Electronic mail addresses. 7 Social security numbers. 8 Medical record numbers. 9 Health plan beneficiary numbers. 10 Account numbers. 11 Certificate/license numbers. 12 Vehicle identifiers and serial numbers, including license plate numbers. 13 Device identifiers and serial numbers. 14 Web universal resource locators (URLs). 15 Internet protocol (IP) address numbers. 16 Biometric identifiers, including fingerprints and voiceprints. 17 Full‐face photographic images and any comparable images. 18 Any other unique identifying number, characteristic, or code, unless otherwise permitted by the Privacy Rule for re‐identification. Even though ‘raw data’ can be de‐identified (anonymized) so that there is no way to trace back the data to the study participant from which it was drawn, there are still questions whether the ‘de‐identified raw data’ can be given to other researchers or made public without the original study participant’s approval. It may be the case that this approval could be done at the start of any research study where the individual considering study participation would be counseled on what the process of de‐identification consists of and would be asked whether the participant would allow use of the data by other researchers or made available to the public in a de‐identified state. However, there may be questions of the study participants as to whether the data are truly de‐identified and untraceable back to the study participant since the participant would not be able to see the process actually being carried out in detail in all relevant circumstances. Using Raw Data in Context Simply being in possession of raw data is never enough to build on that data from a research perspective. Researchers need to understand the context of the scientific research study in which the data were collected. This research context includes (but is not limited to): (i) the scientific hypothesis of the research study, (ii) the inclusion and exclusion criteria selected by the research designers of the study to determine which study participants were included and which were excluded from the study, (iii) the methods used to collect the data and possibilities of errors in the data collection processes, and (iv) answers to questions regarding whether any data were excluded from the study data and why these data were excluded. Ownership Rights Over Data There are ownership rights over data. Ownership rights include court decision making related to the question which parties are to be considered as the owners of the data. Possible owners here include (but are not limited to) (i) the study sponsor whose only role was to fund that study, (ii) the principal investigator(s) who developed the scientific hypothesis, and (iii) individual study participants through special contracts made by individual participants who negotiate such contracts with study sponsors and principal investigators to share in the ownership of data. Examples of such data are participant sources of unique gene lines or unique cell lines to be used in future research. Objections to Data Sharing Finally, individual researchers may simply object to sharing data. A researcher’s arguments here may be simply stating that he or she has a right to fully analyze the data since the collection of the data was the researchers’ idea in the first place. These researchers may argue that they have the right to mine the data as fully as they can before deciding to make the data open to the public for others to analyze. Works Cited 1 Kaiser, J. ‘Making Clinical Data Widely Available.’Science 322.5899 (10 Oct. 2008): 217–8. 2 de Lusignan, S., J.F. Metsemakers, P. Houwink, V. Gunnarsdottir, and J. van der Lei. ‘Routinely Collected General Practice Data: Goldmines for Research? A Report of the European Federation for Medical Informatics Primary Care Informatics Working Group (EFMI PCIWG) from MIE2006, Maastricht, The Netherlands.’Informatics in Primary Care 14.3 (2006): 203–9. 3 Sim, I. ‘Human Studies Database Project’, CTSA Data Repositories Symposium (17 Oct. 2008). 23 Nov. 2010. 4 Sim, I., C.G. Chute, H. Lehmann, R. Nagarajan, M. Nahm, and R.H. Scheuermann. ‘Keeping Raw Data in Context.’Science 323.5915 (6 Feb. 2009): 713. 5 U.S. Department of Health and Human Services, National Institutes of Health, HIPAA Privacy Rule, Information for Researchers. 13 Nov. 2010. 6 Wilczynski, N.L., R.B. Haynes, and Hedges Team. ‘EMBASE Search Strategies for Identifying Methodologically Sound Diagnostic Studies for Use by Clinicians and Researchers.’BMC Medicine 29.3 (March 2005): 7. (shrink)

Standard methods for teaching Deliberative Democratic Theory (DDT) in the philosophy classroom include presenting theories in the historical order in which they originated, by theorist (or groups of theorists) or in various thematic categories, including criticisms of the theories. However, if Simone Chambers is correct and DDT has truly entered “a working theory stage,” whereby the theory and practice of deliberation receive equal consideration, then such approaches may no longer be appropriate for teaching DDT. I propose that DDT (...) be taught using the Critical Friends (CF) discussion protocol. This protocol enables high quality deliberation in the context of a supportive intellectual community. The key advantage of my proposal is that the CF pedagogical framework empowers students to conceive DDT through the lens of their own and others’ deliberative practices. By referring to a rather than the strategy, this proposal does not specify the single right way to teach DDT, but suggests one among a field of possibilities. (shrink)

BackgroundThere is increasing need for peer reviewers as the scientific literature grows. Formal education in biostatistics and research methodology during residency training is lacking. In this pilot study, we addressed these issues by evaluating a novel method of teaching residents about biostatistics and research methodology using peer review of standardized manuscripts. We hypothesized that mentored peer review would improve resident knowledge and perception of these concepts more than non-mentored peer review, while improving review quality.MethodsA partially blinded, randomized, controlled multi-center (...) study was performed. Seventy-eight neurology residents from nine US neurology programs were randomized to receive mentoring from a local faculty member or not. Within a year, residents reviewed a baseline manuscript and four subsequent manuscripts, all with introduced errors designed to teach fundamental review concepts. In the mentored group, mentors discussed completed reviews with residents. Primary outcome measure was change in knowledge score between pre- and post-tests, measuring epidemiology and biostatistics knowledge. Secondary outcome measures included level of confidence in the use and interpretation of statistical concepts before and after intervention, and RQI score for baseline and final manuscripts.ResultsSixty-four residents (82%) completed initial review with gradual decline in completion on subsequent reviews. Change in primary outcome, the difference between pre- and post-test knowledge scores, did not differ between mentored (−8.5%) and non-mentored (−13.9%) residents (p = 0.48). Significant differences in secondary outcomes (using 5-point Likert scale, 5 = strongly agree) included mentored residents reporting enhanced understanding of research methodology (3.69 vs 2.61; p = 0.001), understanding of manuscripts (3.73 vs 2.87; p = 0.006), and application of study results to clinical practice (3.65 vs 2.78; p = 0.005) compared to non-mentored residents. There was no difference between groups in level of interest in peer review (3.00 vs 3.09; p = 0.72) or the quality of manuscript review assessed by the Review Quality Instrument (RQI) (3.25 vs 3.06; p = 0.50).ConclusionsWe used mentored peer review of standardized manuscripts to teach biostatistics and research methodology and introduce the peer review process to residents. Though knowledge level did not change, mentored residents had enhanced perception in their abilities to understand research methodology and manuscripts and apply study results to clinical practice. (shrink)

The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration (...) -- Clients with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)

Since the 1990s, the essential function of teacher trainers in academic courses has gradually attained more attention from scholars. Also, the teacher trainers’ professional development has acquired worldwide attraction following the concept that teacher trainers are deeply liable for educator education quality. The present mini-review of literature indicates that while teacher trainers have several complicated functions, they obtain the least preparation or opportunities for professional development to perform such functions. Consequently, they require getting the related knowledge and skills (...) after accepting the role of teacher trainers. Besides numerous aspects affecting teacher trainers’ professional development, teaching skills, and knowledge have important functions that are at the center of attention in this mini-review of literature. In brief, several implications are presented for the instructional addressees. (shrink)

This paper makes a novel linkage between the multiple-computations theorem in philosophy of mind and Landauer’s principle in physics. The multiple-computations theorem implies that certain physical systems implement simultaneously more than one computation. Landauer’s principle implies that the physical implementation of “logically irreversible” functions is accompanied by minimal entropy increase. We show that the multiple-computations theorem is incompatible with, or at least challenges, the universal validity of Landauer’s principle. To this end we provide accounts of both ideas in terms of (...) low-level fundamental concepts in statistical mechanics, thus providing a deeper understanding of these ideas than their standard formulations given in the high-level terms of thermodynamics and cognitive science. Since Landauer’s principle is pivotal in the attempts to derive the universal validity of the second law of thermodynamics in statistical mechanics, our result entails that the multiple-computations theorem has crucial implications with respect to the second law. Finally, our analysis contributes to the understanding of notions, such as “logical irreversibility,” “entropy increase,” “implementing a computation,” in terms of fundamental physics, and to resolving open questions in the literature of both fields, such as: what could it possibly mean that a certain physical process implements a certain computation. (shrink)

Formal training in clinical ethics must become a central part of residency curricula to prepare practitioners to manage the ethical dimensions of patient care. Residency educators must ground their teaching in an understanding of the conceptual, biomedical, and psychosocial aspects of the important ethical issues that arise in that field of practice. Four aspects of professional competence in clinical ethics provide a useful framework for curricular planning. The physician should learn to: (1) recognize ethical issues as they arise (...) in clinical care and identify hidden values and unacknowledged conflicts; (2) think clearly and critically about these issues in ways that lead to ethically justifiable courses of action; (3) apply those practical skills needed to implement an ethically justifiably course of action; and (4) judge when the management of a clinical situation requires consultation with individuals or institutional bodies with additional expertise or authority. We argue that these practical goals can be accomplished with a relatively modest emphasis on the theoretical aspects of medical ethics. (shrink)

Intensive professional testing of children with disabilities is becoming increasingly prominent within the field of children’s rehabilitation. In this paper we question the high quality ascribed to standardized assessment procedures. We explore testing practices using a hermeneutic-phenomenological approach analyzing data from interviews and participant observations among 20 children with disabilities and their parents. All the participating children have extensive experience from being tested. This study reveals that the practices of testing have certain limitations when confronted with the lived experience (...) of those who are being tested. Testing seems to transmit the experts’ view of what is important, correct and admirable, and the way in which an individual child fulfills such requirements and fits in with the predetermined standard. Regular testing may result in insecurity on the part of the tested individual, and possibly to a lack of confidence in their body and the way it functions. For the individual being tested the meaning of testing is primarily related to passing or not passing the test requirements. Given the meaning of testing, children with disabilities may experience repeated testing as an ordeal that they are expected to put up with. By illuminating the experiences of the ones exposed to testing, this paper offers new insight for professionals to gauge more accurately the quality of contemporary testing practice. (shrink)

Introduction -- Ethics and research -- Twenty questions : ethical research dilemmas and PHD students -- Research pitfalls for new entrants to the academy -- Scientists behaving badly: insights from the fraud triangle -- Slicing and dicing : ex ante approaches -- Slicing and dicing : ex post approaches -- Retraction : mistake or misconduct? -- Double-blind review in the age of google and powerpoint -- Ethics in research scenarios : what would you do? -- Thought leader : Michael A. (...) Hitt on ethics in research -- Ethics and teaching -- Beyond course content : ethical dilemmas in teaching -- Teaching and ethics : a critical incident -- Peer pressure or, I thought i was out of high school -- Teaching versus preaching: conversational ethics in the classroom -- My students want to friend me! boundaries and relationships with social networks -- What do we do when students despair? : considering pedagogical caring -- From content to relationship -- It's not just rate my professor anymore! : ethics and student evaluations -- Student recommendations : to give, or not to give, that is the question -- Thought leader : Robert A. Giacalone on "broken when entering" -- Ethics in professional life -- Codes and conflicts of interest -- When is a job offer really a job offer in the academy? -- Attending professional meetings -- Peer reviewing -- Managing university service work -- Tribalism -- Outside appointments -- Consulting -- Media engagement -- Thought leader : Andrew H. van de Ven on ethics and professional life -- Conclusions -- Connecting the dots : themes, practices and considering what's next -- Index. (shrink)

Adherence to professional ethics in nursing is fundamental for high-quality ethical care. However, analysis of the use and impact of nurses’ codes of ethics as a part of professional ethics is limited. To fill this gap in knowledge, the aim of our review was to describe the use and impact of the Code of Ethics for Nurses with Interpretive Statements published by the American Nurses Association as an example of one of the earliest and most extensive codes of (...) ethics for nurses with their interpretative statements and constituting a strong basis for the International Council of Nurses’ Code of Ethics for Nurses. We based our review on previous literature using a scoping review method. We included both non-scientific and scientific publications to provide an analysis of codes of ethics which can be utilized in development and revision of other nurses’ codes of ethics. In the searches, we used CINAHL and PubMed databases limiting publications to texts with a connection to the Code of Ethics for Nurses published from January 2001 to November 2022 and written in English. Searches yielded 1739 references, from which 785 non-scientific and 71 scientific publications were included for analysis of the data. Although non-scientific and scientific publications addressed different number of categories, the results indicated that in the both groups the use and impact focused on professional ethics, nursing practice, and work environment and less on education, research, or social health issues. Nurses’ ethical standards were not addressed in non-scientific publications, and clinical issues and leadership were not in focus in scientific publications. To increase evidence-based knowledge of the impact of codes of ethics additional research is needed. Good scientific conduct was followed. (shrink)

This book takes a unique organizational approach towards understanding the concept of ethics in educational systems. It provides a global perspective and connects theory and praxis through team-based simulations, case studies and scenarios, thus presenting an integrative approach towards tackling teachers' withdrawal behaviors.

Recent discussions in the area of corporate social responsibility suggest that organizational size has complex meanings and thus requires more scholarly attention. This article explores organizational size in the context of relative power in inter-organizational networks. To shed light on the ways relative power interacts with size we studied social responsibility practices among cleaning subcontractors in three firms of different sizes. Our focus on the network differentiates these firms on the basis of their size and sector. Semi-structured interviews were used (...) to trace cleaning subcontractors' CSR-related practices. We analyzed subjective reports and discursive practices involved in subcontractors' self-presentations. While the economic and philanthropic dimensions of social responsibility were presented by the cleaning subcontractors as independent of network constraints, the findings show that the legal and ethical dimensions were subject to large client-firm pressures. What we learn from our data is that the four dimensions of Carroll's model, the economic, legal, ethical, and philanthropic, should all develop from and be evaluated against a fifth root dimension of inter-personal commitment. (shrink)

Today professionals have to deal with more uncertainties in their field than before. We live in complex and rapidly changing environments. The British philosopher Ronald Barnett adds the term ‘supercomplexity’ to highlight the fact that ‘we can no longer be sure how even to describe the world that faces us’ (Barnett, 2004). Uncertainty is, nevertheless, not a highly appreciated notion. An obvious response to uncertainty is to reduce it—or even better, to wipe it away. The assumption of this approach is (...) that uncertainty has no advantages. This assumption is, however, not correct as several contemporary authors have argued. Rather than problematising uncertainty, I will investigate the pros and cons of embedding uncertainty in educational practice of professional higher education. In order to thoroughly explore the probabilities and challenges that uncertainty poses in education, I will dwell on the radical ideas on uncertainty of the German philosopher Friedrich Nietzsche. In The Birth of Tragedy (1872) he recognises two forces: the Apollinian, that is the pursuit of order and coherence, and the Dionysian, that is the human tendency to nullify all systematisation and idealisation. Uncertainty is part of the Dionysian. I will argue that when educators take Nietzsche's plea to make room for the Dionysian to heart, they can better prepare students for an uncertain world. If, and only if, students are encouraged to deploy both tendencies—the Apollinian and the Dionysian—they can become professionals who are able to stand their ground in an uncertain and changing (professional) world. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Changing Theories of Undergraduate Theatre Studies, 1945–1980Anne Berkeley (bio)IntroductionThe history of theatre study in American undergraduate education is a story of prodigious quantitative success. Although it took two centuries to secure the right to perform plays at American colleges, it took only eighty years for the curriculum to grow from a few isolated courses at the turn of the twentieth century to well over 14,000 in the 1970s.1 By (...) far the steepest growth occurred during the unprecedented expansion of higher education between 1945 and 1979. But academic theatre's meteoric rise after the war years conceals more problematic qualitative achievements. Throughout its ascendancy, vexing questions persisted concerning the quality, standards, and evaluation of theatre programs. In academic journals and books, theorists explored with alacrity broad opportunities for educational theatre in the university. But they also bickered constantly about objectives and practices and their role in academe, ultimately providing a decidedly ambivalent assessment of accomplishment.According to Oscar G. Brockett, the fundamental questions are, What place, if any, should theatre have in a university? and, For what are students being educated?2 This study traces answers to these questions given by scholars and educators between 1945 and 1979.3 It explores the connections between the scholarship about theatre studies and the programs that developed, what scholars and educators wanted it to become, and what it became in the context of liberal arts education. These years are important because they are the golden age of higher education, a time of unprecedented expansion. Following World War II the G.I. Bill greatly increased student enrollment, and academic and research programs surged. At this time, the [End Page 57] university's governing interests were established by the politics of the Cold War, and the desire to surpass the Soviet Union at everything motivated the expansion of higher education.4 The National Defense Education Act of 1958 and the Higher Education Facilities Act of 1963 (legislation made possible by a prosperous economy) injected vast financial resources into program development, and federal programs such as the National Endowment for the Humanities (NEH) and the National Endowment for the Arts (NEA) were established.An earlier study of theatre curriculum between, roughly, the Civil War and the Second World War provides a useful background against which to interpret the data for this later period.5 From the earlier study we learn that academic theatre suffered from religious hostility for two centuries but that by the end of the nineteenth century there were extracurricular dramatic clubs and productions. The emergence of the modern research university brought with it the expansion and diversification of knowledge, the differentiation of the colonial college's general curriculum into discrete disciplines, and the departmentalization of the curriculum. As principles and aims for liberal arts education, and the bachelor of arts degree, began to take shape, reconstruction of the curriculum included the introduction of departments of speech and literature, which included dramatic curricula.6 Academic theatre first began in classical and later modern language departments as a way of teaching literature in another language; later speech and English departments added courses in oral interpretation and playwriting.After George Pierce Baker opened the theatre department at Yale in 1925, theatre became an autonomous field of study in increasing numbers of universities. During this early period several developments took place: curriculum for theatrical studies developed out of extra-curricular theatre, theatre was identified and justified as a humanistic study, the seeds were planted for the university's eventual role in nonprofit and professional regional theatres, and the study of theatre as a legitimate academic discipline was developed. During this period, too, most theorists argued that theatre was one of the liberal arts and should be taught as part of the humanities. Late in the period there developed a small but increasingly vocal group of scholars and teachers who began to argue that theatre departments should teach technical skills of theatrical performance as well as humanistic inquiry. Thus was born the so-called craft or culture dichotomy: should educational theatre emphasize the crafts of performance or the humanism that prevailed in general (unspecialized) liberal study?The Forties and Fifties: The Curriculum Diversifies... (shrink)

Business professions are increasingly faced with the question of how to best monitor the ethical behavior of their members. Conflicts could exist between a profession's desire to self-regulate and its accountability to the public at large. This study examines how members of one profession, public accounting, evaluate the relative effectiveness of various self-regulatory and externally imposed mechanisms for promoting a climate of high ethical behavior. Specifically, the roles of independent public accountants, regulatory and rule setting agencies, and undergraduate accounting education (...) are investigated. Of 461 possible respondents, 230 questionnaires (a 49.6% response rate) indicated that the profession's own rule setting body (The American Institute of Certified Public Accountants) and the use of peer review were perceived as the most effective mechanisms, while government regulation was ranked least. Respondents also evaluated the extent to which ethics should be covered in the accounting curriculum. For every course, the CPAs believed a greater emphasis on ethics is appropriate than presently exists. Suggestions for more effectively integrating ethics into accounting courses are made. Finally, respondents were also asked whether in answering the questionnaire they used a definition of ethics as either the Professional Code of Conduct or a moral and philosphical framework for guiding beliefs. Those who viewed ethics as abiding by a professional code had more confidence in the mechanisms addressed in this study to aid the public accounting profession's ability to ensure high ethical standards of conduct. Methodological implications of this distinction for future studies in business ethics are discussed. (shrink)

Bioethics education has remarkably grown across the globe in the last few decades. The data of the UNESCO Global Ethics Observatory proves that bioethics education is a global phenomenon with various bioethics institutions, teaching programs, and academicians. However, this situation does not mean that bioethics education has reached a stable and flawless level. Especially, the effectiveness of bioethics programs or their quality assessment is a major area that should be analyzed through more academic works. For filling that gap, this (...) article aims to formulate a general framework to address the quality standards and indicators in bioethics education. The article adapts Donabedian’s three approaches—structure, process, and outcome— as three levels to measure quality in bioethics education. The proposed model considers the indicators the ultimate quantifiable points by creating a sequential classification as the three levels, main categories, standards, and indicators, which means that it applies an inductive approach following a path from the indicators to the standards, from the standards to the main categories, and from the main categories to the levels in order to reach a conclusion about the effectiveness of each level. (shrink)

At first glance, the first informed consent case to be decided by the High Court of Australia appears to be little more than a clear and simple description of the substantive law accepted in most American jurisdictions - although that is no small accomplishment in and of itself. In Rogers v. Whitaker, the highest court in Australia succinctly and persuasively rejected informed consent as a species of battery law, accepted it as a form, of ordinary professional negligence law, and (...) adopted the “American” patient-oriented standard for measuring the breach of a healthcare professional's duty to her or his patients. On second look, however, the opinion is an even more significant one because it reveals that the law of informed consent is now based on principles broad enough to create a duty on the part of healthcare providers to offer adequate health education to all of their patients. In Implicitly recognizing the physician's duty to educate her or his patients, the High Court's judgment is consistent with a view increasingly held In the medical and ethical communities that teaching patients about how to maintain their health is just as much a part of the doctor's function as diagnosing and treating disease. It may have taken 2,500 years for medicine to progress from, the Hippocratic notion that physicians should apply treatment to patients who are kept in blissful Ignorance of their condition and Its remedy, but there Is little doubt that medicine finally has entered a post-Hippocratic era. (shrink)

In this article we wish to discuss different normative dilemmas that teachers and psychotherapists meet in their work with the student and the patient. We argue that crucial for a good practice is not the actual choice between normativity and freedom, between generalized or authorized standards and individual dialogue. Rather it is the professional’s continuous reflection on the form and quality of the interactions with the pupil and the patient, and the preservation of the balance between personal ethos and (...) professional responsibilities that best safeguard respect for the other's autonomy and self-determination. By illustrating psychotherapeutic malpractice and systematic mistreatment of children in the name of education, we wish to remind the reader that official governmental authorization of the professions pedagogy and psychology / psychotherapy is not automatically a guarantee for high professional standards or for the best possible teaching and psychotherapy. (shrink)

This paper depicts a case study of an organizational strategy for the promotion of ethical practice when introducing a new, high-risk, ethically-charged medical practice like Medical Assistance in Dying (MAiD). We describe the development of an interprofessional program that enables the delivery of high-quality, whole-person MAiD care that is values-based and sustainable. A “care ecology” strategy recognizes the interconnected web of relationships and structures necessary to support a quality experience of MAiD for patients, families, and clinicians. This program exemplifies a (...) care ecology approach that addresses common barriers to entry to MAiD practice, and also meets the needs of a variety of stakeholders through the creation of patient and family resources, team supports, standards of practice, professional development opportunities, organizational infrastructure, and community partnerships. We also describe how a thriving care ecology evolves to remain resilient, and to enable integration as the needs of the organization, team and program change over time. The design and development of this program may be adapted to other jurisdictions and organizations where MAiD is introduced, or where new patient populations become eligible for MAiD. This care ecology model may also be applicable to the creation of sustainable programs that provide other morally controversial or novel clinical services. (shrink)