This analysis examines the practice of care providers in residential aged care lying to residents with dementia. Qualitative data were collected through multiple methods. Data here represents perceptions from registered and enrolled nurses, personal care assistants, and allied health professionals from five residential aged care facilities located in Queensland, Australia. Care providers in residential aged care facilities lie to residents with dementia. Lying is conceptualized as therapeutic whereby the care provider’s intent is to eliminate harm and also control behaviour. Care (...) providers of residents with dementia in RACFs need guidance around lying. An ethical framework cognisant of an ethical theory of good and ethical theory of right supplemented by a theory of virtue is proposed. A complimentary four stage communication strategy that promotes truth telling as a first option while also recommending the lie as a suitable strategy is also promoted. (shrink)

Moral distress has been widely reviewed across many care contexts and among a range of disciplines. Interest in this area has produced a plethora of studies, commentary and critique. An overview of the literature around moral distress reveals a commonality about factors contributing to moral distress, the attendant outcomes of this distress and a core set of interventions recommended to address these. Interventions at both personal and organizational levels have been proposed. The relevance of this overview resides in the implications (...) moral distress has on the nurse and the nursing workforce: particularly in regard to quality of care, diminished workplace satisfaction and physical health of staff and increased problems with staff retention. (shrink)

An ethic of the fitting: a conceptual framework for nursing practiceNurses are expected to act within an ethos of care cognisant of duty, the right, and the good. Concepts of virtue theory, utilitarianism and deontology are used to outline a conceptual ethical framework for nurses in practice. This ‘Moebius’ framework aims to locate the virtues in a symbiotic relationship with the principles of utilitarianism and deontology. Under this framework, fitting ethical responses are sought. Within an ethic of the fitting, rules (...) and principles do not guarantee the most ethically justifiable outcomes. Within the Moebius approach, the nurse ought to respond with a sense of compassion that befits the moment rather than adhere to a rule at all costs. (shrink)

Conviction Narrative Theory (CNT) is a theory of choice underradical uncertainty– situations where outcomes cannot be enumerated and probabilities cannot be assigned. Whereas most theories of choice assume that people rely on (potentially biased) probabilistic judgments, such theories cannot account for adaptive decision-making when probabilities cannot be assigned. CNT proposes that people usenarratives– structured representations of causal, temporal, analogical, and valence relationships – rather than probabilities, as the currency of thought that unifies our sense-making and decision-making faculties. According to CNT, (...) narratives arise from the interplay between individual cognition and the social environment, with reasoners adopting a narrative that feels “right” to explain the available data; using that narrative to imagine plausible futures; and affectively evaluating those imagined futures to make a choice. Evidence from many areas of the cognitive, behavioral, and social sciences supports this basic model, including lab experiments, interview studies, and econometric analyses. We identify 12 propositions to explain how the mental representations (narratives) interact with four inter-related processes (explanation, simulation, affective evaluation, and communication), examining the theoretical and empirical basis for each. We conclude by discussing how CNT can provide a common vocabulary for researchers studying everyday choices across areas of the decision sciences. (shrink)

Turning a Blind Eye Is Unreasonable, Unprofessional, and Unethical Content Type Journal Article Category Case Studies Pages 115-116 DOI 10.1007/s11673-011-9340-0 Authors Anthony G. Tuckett, The University of Queensland / Blue Care Research and Practice Development Centre, Toowong, Brisbane, Queensland, Australia Journal Journal of Bioethical Inquiry Online ISSN 1872-4353 Print ISSN 1176-7529 Journal Volume Volume 9 Journal Issue Volume 9, Number 1.

In general, most, but not necessarily all, patients want truthfulness about their health. Available evidence indicates that truth-telling practices and preferences are, to an extent, a cultural artefact. It is the case that practices among nurses and doctors have moved towards more honest and truthful disclosure to their patients. It is interesting that arguments both for and against truth-telling are established in terms of autonomy and physical and psychological harm. In the literature reviewed here, there is also the view that (...) truth-telling is essential because it is an intrinsic good, while it is argued against on the grounds of the uncertainty principle. Based on this review, it is recommended that practitioners ought to ask patients and patients' families what informational requirements are preferred, and research should continue into truth-telling in clinical practice, particularly to discover its very nature as a cultural artefact, and the other conditions and contexts in which truth-telling may not be preferred. (shrink)

Why is it that despite having many of the same concerns on how ethics may be included in undergraduate medical curriculums, I write to state my concerns on Cowley’s formulation and conclusions.1I think my main problem is with an argument that starts from a position of criticising “universalising”, but offers as a substitute the idealising of another universality—“their own healthy intuitions and vocabulary”. What is it that can help in promoting an appreciation of what may be a “healthy”, as opposed (...) to an “unhealthy”, intuition? At the risk of immediately undermining my argument by indulging in psychoanalytical …. (shrink)

Based on the proceedings of a 1985 conference held in the U.K., this volume embraces most of the important concerns in AI today, emphasizing common techniques and methodologies rather than applications. Topics covered include building efficient computational logic, planning and design, the representation of uncertain knowledge, user modelling, and psychological and philosophical issues. Papers on perception, theorem proving, expert systems, robotics, and data bases are also included. Each section is preceded by an introduction which draws comparisons between various papers.