COVID-19 vaccine research success and emergency use authorizations have shown the life sciences’ potential for positive health impact. But they also underscore potentially divergent and conf...

Background Few studies have been conducted to assess the quality of orientation practices for ethics advisory committees that conduct ethics consultation. This survey study focused on several Harvard teaching hospitals, exploring orientation quality and committee members’ self-evaluation in the American Society of Bioethics and Humanities ethics consultation competencies. Methods We conducted a survey study that involved 116 members and 16 chairs of ethics advisory committees, respectively. Predictor variables included professional demographics, duration on committees and level of training. Outcome variables included (...) familiarity with and preparedness in the ASBH competencies and satisfaction with orientations. We hypothesised that responses would be associated with both the aforementioned predictors and whether or not participants had encountered the ASBH competencies in training. Results A majority of respondents found their orientation curricula to be helpful, although a significant portion of respondents did not receive any orientation or were unsatisfied with their orientation. Familiarity with ASBH competencies was a statistically significant predictor of respondents’ self-evaluation in particular categories. Standard educational materials were reported as offered during orientation, such as readings and case studies ; different medium resources were less evidenced such as videos on ethics consultation. Conclusions Institutions should re-evaluate orientation practices for ethics committee members that perform ethics consultation. Integrating ASBH competencies and useful methods into a resourceful pedagogy will help improve both member satisfaction with orientation and preparation in consultation. (shrink)

Three ethical conflicts in particular are paradigmatic of what we define as “clerkship ethics.” First, a distinction that differentiates the clerkship student from the practicing physician involves the student’s principal role as a learner. The clerkship student must skillfully balance her commitment to her own education against her commitment to patient care in a fashion that may compromise patient care. While the practicing physician can often resolve the tension between these two goods when they come into conflict, the clerkship student (...) is left with a more ambiguous set of choices. Second, evaluative scrutiny during clinical clerkships often forces medical students to balance doing what is morally fitting against the perceived expectations of the medical teams in which they work. Third and finally, a deeply entrenched culture of medical hierarchy presents a particular challenge to innovation and improvement in ethics education during the clerkship years. Students regard faculty as exemplars, but are not provided with the tools to assess when technical medical competence is not matched by moral competence; moreover, these faculty are unlikely to have experienced the ethics education in which students are asked to demonstrate mastery. (shrink)

In February 2016, the Cleveland Clinic initiated the first attempt at cadaveric uterine transplantation (UTx) in the United States. The transplantation was ultimately unsuccessful, but it opened doors for further research on both live and cadaveric UTx. While initial strides toward successful transplantation have been made, questions persist on the ethics of UTx: whether the uterus is a vital organ, whether we should prioritize live or cadaveric options, and how the procedure should be covered by health insurance. If we agree (...) that the goal of the medical profession is both to treat and improve quality of life, then the question of whether or not infertility is considered a disease becomes inconsequential in the discussion. As such, the medical enterprise should move forward with research in UTx. In doing so, considering the ethical implications of UTx remains essential—and we must remember to pair innovation with regulation. (shrink)

As face shields are dusted off and conferences go virtual again, Omicron reminds us how the once-novel coronavirus ruptured our collective idea of medical training. For nearly 2 years, social media...

In 2012, Loyola University Chicago's Stritch School of Medicine became the first medical school in the United States to actively recruit and accept undocumented immigrants who received protections granted under the Deferred Action for Childhood Arrivals program that was established by presidential memorandum. By 2016, sixty-one medical schools were considering applications from DACA recipients for admission, and more than 110 students applied. According to the Association of American Medical Colleges, sixty-five DACA recipients matriculated in U.S. medical schools in the 2016–2017 (...) school year. These students contribute both diversity and talent to our medical community; they could also have a significant impact on the care of underserved and immigrant populations. The recent decision by the Trump administration to rescind DACA therefore comes with serious pragmatic and ethical ramifications, impeding our medical community's efforts to develop a diverse and representative workforce committed to improving access to quality care for all patients. (shrink)

BackgroundIn Pakistan, drug promotion practices, ethical or unethical, have rarely been in the spotlight. We aimed to assess the perception and barriers of medical representatives (MRs) and doctors (MDs) regarding ethical promotion of pharmaceuticals in Pakistan.MethodsA cross sectional survey was conducted in seven major cities of Pakistan for 6-months period. Self-administered questionnaire was used for data collection. Logistic regression and five-point Likert scale scoring was used to estimate the perceptions and barriers.ResultsCompared to national companies (NCs), the medical representatives (MRs) of (...) multinational companies (MNCs) strongly believed that their companies follow World Health Organization (WHO) (OR; 5.31, p = 0.0005), International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) (OR; 6.45, p = 0.0005) and national codes of ethics (OR; 5.84, p = 0.0005). MNCs trained their MRs (OR; 6.68, p = 0.0005), provide accurate and valid scientific data (OR; 4.01, p = 0.007) with adequate system of accountability and controls on product samples (OR; 1.96, p = 0.047), while, NCs sponsor social or entertainment activities, seminars and conferences, and all sort of facilitation in form of gifts of their choice and clinic renovation for medical doctors (MDs). MDs perceptions were similar to MRs mentioned above, yet strongly agreed that companies offer cash payments or equivalents to MDs. The MRs of NCs/mncs and MDs agreed/strongly agreed that no external accountability, profiteering, pressure on sale targets, job insecurity, condoning unethical promotion by high-ups’ and business promotion by junior MDs were the predominant barriers.ConclusionIn conclusion, MRs of MNCs and MDs believed that MNCs follow certain codes of ethics in the promotion of pharmaceuticals, while NCs tend to be more profit oriented and even condone unethical promotion. All stakeholders, MRs, MDs and companies, might pose certain barriers, intentionally or unintentionally, in ethical promotion. (shrink)

While previous studies have examined the impact of informal institutions to determine entrepreneurial activities, this paper explores the different configurational paths of informal institutions to promote men’s and women’s entrepreneurial activities across factor-driven and efficiency-driven economies. We collected data from the Global Entrepreneurship Monitor for 56 countries for the years 2008-2013 and employed fuzzy-set qualitative comparative analysis to conduct the empirical analysis. The results confirm that a single antecedent condition is unable to produce an outcome while combination of different conditions (...) can produce an outcome. We find that cultural-cognitive institutional antecedents in combination with social-normative antecedents create configurations of conditions that lead to the higher levels of men’s and women’s entrepreneurial activities in factor-driven and efficiency-driven economies. Moreover, this study shows that these causal conditions configure differently to promote men’s and women’s entrepreneurial activities in factor-driven and efficiency-driven nations. This paper may create awareness in potential entrepreneurs regarding specific sets of institutional antecedents that can increase the emergence of entrepreneurship in different economic clusters. We show that institutional antecedents which are essential to promote entrepreneurship combine distinctly for men’s and women’s entrepreneurship and this combination varies in different stages of economic development. (shrink)

During periods of scarcity, or the fear of it, many health systems create or adopt triage protocols to determine how to best allocate limited resources. Interest in such protocols has become acute...

This is an account of a reading project that began in February 2020. Australia was burning, a pandemic was simmering, the two of us were early in our PhD journeys at the Melbourne Law School. Already, we felt exhausted by critical theory which seemed to amplify the affects we felt all too intensely. Our reading project began as an attempt to find and inhabit texts that might move beyond critique, that might allow us to find wonder and vitality in legal (...) theory. Taking up the literary critic Rita Felski’s invitation to craft a post-critical reading practice, our reading list evolved iteratively to encompass themes and concerns that we identified as possibly correlating with said practice. It evolved too, in conversation with Melbourne, as the city journeyed through different stages of the pandemic. Constantly changing restrictions changed the ways in which we met and conversed, influencing in turn the texts we chose to read and the manner in which we read them. In this account, we pay attention to the time and place of our encounters with these interlocutors, and to the feelings these encounters generated. As such, this article takes the form of a series of (revised) diary entries: first written in 2020, then revisited in the corresponding months of 2021. What we hope emerges from these entries is a sense of how these theoretical texts train us to live in a world undergoing a compounding series of crises – and, perhaps, to imagine that world otherwise. In a more jurisprudential register, we hope that our experiment will identify the methods these texts might give us for (re-)engaging with law in a spirit of wonder and vitality. (shrink)

Young academics have been facing a problem of high turnover rate due to missing links between the institutions’ policies and the performance. This study explores the effect of job embeddedness and community embeddedness on creative work performance and intentions to leave of young teaching staff in academic institutions in Pakistan. In this study, 300 qualified young academics from public and private universities were selected as subjects and asked to complete a questionnaire. Data were collected via mail-survey. A variance-based structural equation (...) model is employed to measure the path model. The results show that the fit-dimension of organizational- and community-embeddedness, along with the moderating effect of organization size and the availability of nearby alternative jobs have a significant impact on improving perceived creative performance and reducing staff turnover intentions. This study suggests that organizations should focus on organizational-fit and community-fit constructs in their nurturing strategies to embed young teachers in their academic institutions. This study also suggests that monetary rewards only are relatively ineffective to improve retention. Hence, public and private sector universities should facilitate meaningful contributions from young teachers in creative work and provide opportunities for social interactions and personal development. (shrink)

Proper utilization of antenatal and postnatal care services plays an important role in reducing the maternal mortality ratio and infant mortality rate. This paper assesses the utilization of health care services during pregnancy, delivery and post-delivery among rural women in Uttar Pradesh and examines its determinants. Data from a baseline survey of UP Community Mobilization project was utilized. A cross-sectional sample of currently married women who delivered a baby 15 months prior to the survey was included. Information was collected from (...) 2208 women spread over five districts of UP. Information on socio-demography characteristics, utilization of antenatal care, delivery and postnatal care services was collected. To examine the determinants of utilization of maternal health services, the variables included were three ANC visits, institutional delivery and PNC within 42 days of delivery. Separate multilevel random intercept logistic regressions were used to account for clustering at a block and gram panchayat level after adjusting for covariates. Eighty-three percent of women had any ANC. Of them, 61% reported three or more ANC visits. Although 68% of women delivered in a health facility, 29% stayed for at least 48 h. Any PNC within 42 days after delivery was reported by 26% of women. In the adjusted analysis, women with increasing number of contacts with the health worker during the antenatal period, women exposed to mass-media and non-marginalized women were more likely to have at least three ANC visits during pregnancy. Non-marginalized women and women with at least three ANC visits were more likely than their counterparts to deliver in an institution. Contacts with health worker during pregnancy, marginalization, at least three ANC visits and institutional delivery were the strong determinants for utilization of PNC services. Self-help group membership had no association with the utilization of maternal health services. Utilization of maternal health services was low. Contact with the health worker and marginalization emerged as important factors for utilization of services. Although not associated with the utilization, SHGs can be used for delivering health care messages within and beyond the group. (shrink)

One of the goals of happiness research is to identify the key factors that influence it. Therefore, the present research is designed to examine the determining factors of subjective wellbeing in Pakistan. The present research is conducted by collecting the data of 1,566 households in Punjab, Pakistan, using the ordered logit and tobit model. The findings of this research confirm that income, education, government effectiveness, no perceived corruption, and perceived institutional quality improve wellbeing, while lower trust in family and friends, (...) poor health status, living on rent, and dissatisfaction with the services of hospitals lower the level of wellbeing. But individuals with more social ties, who face barriers in health services, live more happily satisfied with their lives. Crime victimization and worrisome terrorism also lower the level of SWB. Findings of research strongly emphasize policymakers and government institutions to improve their quality and take essential measures for improving the governance structure. (shrink)

Danish Modern explores the development of mid-century modernist design in Denmark from historical, analytical and theoretical perspectives. Mark Mussari explores the relationship between Danish design aesthetics and the theoretical and cultural impact of Modernism, particularly between 1930 and 1960. He considers how Danish designers responded to early Modernist currents: the Stockholm Exhibition of 1930, their rejection of Bauhaus aesthetic demands, their early fealty to wood and materials, and the tension between cabinetmaker craft and industrial production as it (...) challenged and altered their aesthetic approach. Tracing the theoretical foundations for these developments, Mussari discusses the writings and works of such figures as Poul Henningsen, Arne Jacobsen, Hans Wegner, Nanna Ditzel, and Finn Juhl. (shrink)

Abstract: Is Knud Eiler Løgstrup's conception of the ethical demand as deeply incompatible with the central theses of 20th century French Thomistic moral philosophy as it seems to be? Discussion of this question requires attention to both the Lutheran and the phenomenological background of Løgstrup's thought; a consideration of the Danish and French social contexts in which the claims of the two moral philosophies were developed; and an enquiry into how far aspects of each are complementary to rather than (...) in conflict with the other. An historical explanation for the genesis of the kind of normativity without norms defended by both Løgstrup and Levinas is proposed. (shrink)

Abstract:Is Knud Eiler Løgstrup's conception of the ethical demand as deeply incompatible with the central theses of 20th century French Thomistic moral philosophy as it seems to be? Discussion of this question requires attention to both the Lutheran and the phenomenological background of Løgstrup's thought; a consideration of the Danish and French social contexts in which the claims of the two moral philosophies were developed; and an enquiry into how far aspects of each are complementary to rather than in (...) conflict with the other. An historical explanation for the genesis of the kind of normativity without norms defended by both Løgstrup and Levinas is proposed. (shrink)

The community has legislatively conferred on external auditors a special but lucrative responsibility to provide fair and independent opinions about management''s preparation of company financial statements. In return, auditors are obliged by professional standards to act with integrity, independently and in the public interest. This study examined 174 auditors'' predisposition to provide just and fair judgements, using Kohlberg''s theory of developmental moral reasoning, one of the most widely accepted theories in justice psychology. Respondents came from five international audit firms in (...) Copenhagen. Results indicated that auditors with pre-conventional or low level of just reasoning or comprised 64 respondents, the largest group in the sample. The pre-conventional level suggests that people will act in their own self-interest and do the right only to avoid punishment. Pre-conventional auditors have the ability to "do deals", advantageous for business. When faced with an ethical crisis, however, auditors as this level will tend to focus on their own needs at the expense of others. The post-conventional or mid level of just reasoning comprised 59 auditors, second largest group in the sample. This level indicates that these auditors have the predisposition to act fairly on principal, particularly when faced with an ethical crisis. The conventional level or mid-just reasoning consisted of 51 auditors. People with a conventional level of just reasoning believe in law and order, the maintenance of the status quo, however they tend not to be critical of laws, nor authority even if those laws and authority are unjust or evil. (shrink)

In 2014, the European Union Agency for Fundamental Rights ranked Denmark as the European Union country with the highest occurrence of male physical violence and sexual assault against women. This report was described as ‘grotesque’, ‘misguided’ and ‘untrustworthy’ in the Danish mainstream media, which cited a number of prominent political commentators and expert researchers who debunked these findings. Using this case of overt public rejection of violent and white masculinity as a central analytical thread, this article explores how the (...) invisiblization of Danish male violence, as well as the projection of sexual aggression onto minority communities, produces a peculiar politics of denial and denialism in Denmark. The authors argue that the nationalist myth of gender equality branded within the Danish mainstream media and society is a variety of gender exceptionalism; which in turn generates racist, reactionary and suppressive ideologies on violence, racial discrimination and social inequality. (shrink)

In this commentary on the recommendations of the Danish Council of Ethics (DCE) concerning criteria for death it is argued that whilst the DCE is correct in stressing the cultural aspects of death, its adoption of cardiac-oriented criteria raises several problems. There are problems with its notion of a 'death process', which purportedly begins with brain death and ends with cessation of cardiac function, and there are serious problems regarding its commitment to a cardiac-oriented definition whilst permitting transplantation when (...) the heart is still beating. (shrink)

There has been a great deal of discussion about the ethical implications of donating sperm and of the ways in which donated tissue is presented, selected, and sold for use in assisted reproduction. Debates have emerged within the academic sphere, from donor offspring and recipients, and in broader popular culture, including questions about the commodification of human tissue and the eugenic potential of selecting donors from particular demographic categories. However, the voices of donors themselves on this subject have been largely (...) silent. This paper draws on data from qualitative interviews with men who donated at a major Danish sperm bank between 2012 and 2013. It argues that many of them are indeed thinking through these complex issues. Donors’ approaches to ethical issues fell into two broad ‘types’: a pragmatic, individualistic approach which focused on more immediate personal consequences, and an ethically-driven approach in which donors considered the impact of donation on offspring and on a wider societal level. (shrink)

Danish agriculture is facing a turning point. Centuries of struggle to increase arable land area as well as its productivity is about to be reversed, due to overproduction and environmental problems. Some land will probably be turned back to nature, and the use of chemicals in agriculture in general will be reduced, perhaps with a lower productivity and a better environment as a consequence. This paper mainly describes some of the political actions taken in Denmark to influence environmental-agricultural issues. (...) First, however, some of the recently perceived environmental problems and over-production problems connected with Danish farming are outlined. (shrink)

This paper investigates the roles that Danish government has played in the development of corporate social responsibility (CSR). Denmark has emerged as a first mover among the Scandinavian countries when it comes to CSR. We argue that government has played a pivotal role in making this happen, and that this reflects strong traditions of regulation, corporatism and active state involvement. However, there is no unitary “Danish model of CSR” being promoted by government. Although Danish society is often (...) associated with a model of consensus, our claim is that Danish government policy on CSR is characterized by a lack of common direction and that we need to approach it on such terms. In order to provide a critical account of ‘the Danish model’ we apply a governmentality perspective that allows us to stress political difference. We argue that Danish government policy consists of three distinct regimes of practice and show how they subject CSR to different modes of rationalization and action. We conclude that the problem with public policy being split into three is not different as such, but the failure of each regime to recognize the value of the others. As a result, government tends to add to the confusion and opaqueness of CSR. (shrink)

No discussion of when an individual is dead is meaningful in the absence of a definition of death. If human death is defined as the irreversible loss of the capacity for consciousness combined with the irreversible loss of the capacity to breathe spontaneously (and hence to maintain a spontaneous heart beat) the death of the brainstem will be seen to be the necessary and sufficient condition for the death of the individual. Such a definition of death is not something radically (...) new. It is merely the reformulation -- in the language of the neurophysiologist -- of much older concepts such as the 'departure of the (conscious) soul from the body' and the 'loss of the breath of life'. All death -- in this perspective -- is, and always has been, brainstem death... (shrink)

In a comparative context, Danish national identity and political culture combine features of what is often referred to as East European integral nationalism , typical of smaller, recently independent nation-states, and the patriotic concept of citizenship in the older West European state nations. The explanation of this apparent paradox is that Denmark belongs to both families. A former multinational, composite state in 1864 was cut down to a size that enabled a class of about 60,000 peasant-farmers to establish an (...) ideological hegemony in the diminished and nationalized, yet still fully legitimate, state. A libertarian ideology of social solidarity ended up dominating this rump nationstate. The net result in Denmark has been a political mentality stressing the importance of consensus among all the people, in Danish ‘folk’. This populism or ‘popular’ ideology ( folkelighed ) is shared by virtually all political parties. Thus Danish modernity was characterized by industrialized agrarian capitalism with a socially and nationally homogeneous face, i.e. a folkish democracy which I have elsewhere baptized ‘Peasants and Danes’ (Østergård, 1992). (shrink)

Background In the course of the last four decades, the profession of physiotherapy has progressively expanded its scope of responsibility and its focus on professional autonomy and evidence-based clinical practice. To preserve professional autonomy, it is crucial for the physiotherapy profession to meet society's expectations and demands of professional competence as well as ethical competence. Since it is becoming increasingly popular to choose a carrier in private practice in Denmark this context constitutes the frame of this study. Physiotherapy in private (...) practice involves mainly a meeting between two partners: the physiotherapist and the patient. In the meeting, power asymmetry between the two partners is a condition that the physiotherapist has to handle. The aim of this study was to explore whether ethical issues rise during the first physiotherapy session discussed from the perspective of the physiotherapists in private practice. Methods A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analysed by using a phenomenological framework. Results Four descriptive themes emerged: general reflections on ethics in physiotherapy; the importance of the first physiotherapy session; the influence of the clinical environment on the first session and; reflections and actions upon beneficence towards the patient within the first session. The results show that the first session and the clinical context in private practice are essential from an ethical perspective. Conclusions Ethical issues do occur within the first session, the consciousness about ethical issues differs in Danish physiotherapy private practice, and reflections and acts are to a lesser extent based on awareness of ethical theories, principles and ethical guidelines. Beneficence towards the patient is a fundamental aspect of the physiotherapists' understanding of the first session. However, if the physiotherapist lacks a deeper ethical awareness, the physiotherapist may reason and/or act ethically to a varying extent: only an ethically conscious physiotherapist will know when he or she reflects and acts ethically. Further exploration of ethical issues in private practice is recommendable, and as management policy is deeply embedded within the Danish public sector there are reasons to explore public contexts of physiotherapy as well. (shrink)

Should publishing decisions be influenced by the potential for violent reactions?

In this article,we address how the professionalization process is reflected in the way Danish nursing textbooks present ‘nursing’ to new members of the profession during the 20th century. The discussion is based on a discourse analysis of seven Danish textbooks on basic nursing published between 1904 and 1996. The analysis was inspired by the work of Michel Foucault, in particular the concepts of rupture and rules of formation. First, we explain how the dominating role of the human body (...) in nursing textbooks disappears in the mid‐20th century. This transformation can of course be attributed to changes in tasks and responsibilities for nurses or to the implementation of increasing amounts of knowledge and theories from other disciplines than medicine into the nurses’ knowledge base. However, inspired by Foucault, we consider these historical changes to be the conditions of possibilities and not causes. The second part of the analysis shows that along with ‘the disappearance of the body’, a second discursive change appears: the role of doctors and medicine changes fundamentally from about mid‐20th century. Finally, we argue that this discursive reorganization enabling new patterns of thought to emerge was driven by a professional interest in describing nursing as an independent profession. (shrink)

A new law has been passed by the Danish Parliament, establishing an ethical council. The law has caused considerable debate in Denmark, particularly because it states that 'the work of the council shall build on the basis that human life takes its beginning at the time of conception'.

The purpose of the paper is to examine trade boycott of Arab countries of Danish goods and role of WTO.