This paper provides a systematic literature review, analysis and discussion of methods that are proposed to practise ethics in research and innovation. Ethical considerations concerning the impacts of R&I are increasingly important, due to the quickening pace of technological innovation and the ubiquitous use of the outcomes of R&I processes in society. For this reason, several methods for practising ethics have been developed in different fields of R&I. The paper first of all presents a systematic search of academic sources that (...) present and discuss such methods. Secondly, it provides a categorisation of these methods according to three main kinds: ex ante methods, dealing with emerging technologies, intra methods, dealing with technology design, and ex post methods, dealing with ethical analysis of existing technologies. Thirdly, it discusses the methods by considering problems in the way they deal with the uncertainty of technological change, ethical technology design, the identification, analysis and resolving of ethical impacts of technologies and stakeholder participation. The results and discussion of our literature review are valuable for gaining an overview of the state of the art and serve as an outline of a future research agenda of methods for practising ethics in R&I. (shrink)

This paper proposes a framework for an ethical impact assessment which can be performed in regard to any policy, service, project or programme involving information technology. The framework is structured on the four principles posited by Beauchamp and Childress together with a separate section on privacy and data protection. The framework identifies key social values and ethical issues, provides some brief explanatory contextual information which is then followed by a set of questions aimed at the technology developer or policy-maker to (...) facilitate consideration of ethical issues, in consultation with stakeholders, which may arise in their undertaking. In addition, the framework includes a set of ethical tools and procedural practices which can be employed as part of the ethical impact assessment. Although the framework has been developed within a European context, it could be applied equally well beyond European borders. (shrink)

We are reporting on how involved the mentor was in promoting responsible research in cases of research misconduct. We reviewed the USPHS misconduct files of the Office of Research Integrity. These files are created by Institutions who prosecute a case of possible research misconduct; ORI has oversight review of these investigations. We explored the role of the mentor in the cases of trainee research misconduct on three specific behaviors that we believe mentors should perform with their trainee: (1) review source (...) data, (2) teach specific research standards and (3) minimize stressful work situations. We found that almost three quarters of the mentors had not reviewed the source data and two thirds had not set standards. These two behaviors are positively correlated. We did not see convincing evidence in the records that mentors were causing stress, but it was apparent in the convicted trainees’ confessions that over 50% experienced some kind of stress. Secondary data, while not created for this research purpose, allows us to look at concrete research behaviors that are otherwise not very researchable. We believe it is important for mentors and institutions to devote more attention to teaching mentors about the process of education and their responsibilities in educating the next generation of scientists. This becomes a critical issue for large research groups who need to determine who is in charge educating, supervising and assuring data integrity. (shrink)

Background: Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses’ experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses’ experiences of caring for people who request this option. Aim: To synthesize what has been learned about nurses’ experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who (...) undertake this type of care. Design: Qualitative meta-synthesis. Methods: Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis. Results: The moral experience of the nurse is defined by a profound sense of responsibility, shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and sustained by intra-team moral and emotional support. Discussion: The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses’ moral agency that operate in everyday end-of-life care. Ethical considerations: Research ethics board approval was not required for this synthesis of previously published literature. Conclusion: In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded. (shrink)

In this article we attempt to situate nursing within the interprofessional care team with respect to processes of ethical practice and ethical decision making. After briefly reviewing the concept of interprofessionalism, the idea of a nursing ethic as ‘unique’ within the context of an interprofessional team will be explored. We suggest that nursing’s distinct perspective on the moral matters of health care stem not from any privileged vantage point but rather from knowledge developed through the daily activities of nursing practice. (...) Because of their position vis-à-vis patients and families in everyday clinical care, nurses cultivate ethical knowledge of at least two forms: (1) relational knowledge; and (2) embodied knowledge. Through the integration of these forms of knowledge, nurses develop a unique moral perspective and can make a meaningful contribution to the realm of ethics in interprofessional care. (shrink)

The ageing society poses significant challenges to Europe’s economy and society. In coming to grips with these issues, we must be aware of their ethical dimensions. Values are the heart of the European Union, as Article 1a of the Lisbon Treaty makes clear: “The Union is founded on the values of respect for human dignity…”. The notion of Europe as a community of values has various important implications, including the development of inclusion policies. A special case of exclusion concerns the (...) gap between those people with effective access to digital and information technology and those without access to it, the “digital divide”, which in Europe is chiefly age-related. Policies to overcome the digital divide and, more generally speaking, e-inclusion policies addressing the ageing population raise some ethical problems. Among younger senior citizens, say those between 65 and 80 years old, the main issues are likely to be universal access to ICT and e-participation. Among the older senior citizens, say those more than 80 years old, the main issues are mental and physical deterioration and assistive technology. An approach geared towards the protection of human rights could match the different needs of senior citizens and provide concrete guidance to evaluate information technologies for them. (shrink)

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia. Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of (...) 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation. (shrink)

In this response article, we challenge a core assumption that lies at the centre of a round table discussion regarding the Pharmacogenetics to Avoid Loss of Hearing trial. The round table regards a genetic test for a variant that increases the risk of deafness if a carrier is given the antibiotic gentamicin. The idea is that rapid testing can identify neonates at risk, providing an opportunity to prevent giving an antibiotic that might cause deafness. We challenge the assumption that a (...) positive test unequivocally guides antibiotic choice because, aside from the risk of deafness, all antibiotics for neonatal sepsis are equivalent. We argue that this assumption is faulty and has particularly troubling moral consequences. We claim that giving an alternative to gentamicin is potentially providing inferior treatment and thereby may increase the risk of death. Parents and doctors are faced with a terrible choice as a result of positive point-of-care testing : give gold-standard treatment and risk deafness or give second line care and risk death. While we do not indicate an answer to this choice, what we do argue is that such a deep and difficult choice is one that may make parents wish genetic testing was never undertaken, and therefore, contra some authors in the round table, provides a reason to gain specific consent for POCT. (shrink)

The ageing society poses significant challenges to Europe’s economy and society. In coming to grips with these issues, we must be aware of their ethical dimensions. Values are the heart of the European Union, as Article 1a of the Lisbon Treaty makes clear: “The Union is founded on the values of respect for human dignity…”. The notion of Europe as a community of values has various important implications, including the development of inclusion policies. A special case of exclusion concerns the (...) gap between those people with effective access to digital and information technology and those without access to it, the “digital divide”, which in Europe is chiefly age-related. Policies to overcome the digital divide and, more generally speaking, e-inclusion policies addressing the ageing population raise some ethical problems. Among younger senior citizens, say those between 65 and 80 years old, the main issues are likely to be universal access to ICT and e-participation. Among the older senior citizens, say those more than 80 years old, the main issues are mental and physical deterioration and assistive technology. An approach geared towards the protection of human rights could match the different needs of senior citizens and provide concrete guidance to evaluate information technologies for them. (shrink)

Background: In the last two decades, nursing authors have published ethical analyses of palliative sedation—an end-of-life care practice that also receives significant attention in the broader medical and bioethics literature. This nursing literature is important, because it contributes to disciplinary understandings about nursing values and responsibilities in end-of-life care. Research aim: The purpose of this project is to review existing nursing ethics literature about palliative sedation, and to analyze how nurses’ moral identities are portrayed within this literature. Research design: We (...) reviewed discussion papers, written by nurses about the ethics of palliative sedation, which were cited in MEDLINE, CINAHL, Nursing and Allied Health, or Philosopher’s Index (search date March 2018). Twenty-one papers met selection criteria. We performed a comprehensive review and analysis (using the Qualitative Analysis Guide of Leuven), of the values, responsibilities, and relationships reflected in authors’ portrayal of the nursing role. Findings: Two different tones are apparent in the extant nursing ethics literature. One is educational, while the other is critically reflective. Irrespective of tone, all authors agree on the alleviation of suffering as a fundamental nursing responsibility. However, they differ in their analysis of this responsibility in relation to other values in end-of-life care, including those that depend on consciousness. Finally, authors emphasize the importance of subjective and experience-based understandings of palliative sedation, which they argue as depending on nurses’ proximity to patients and families in end-of-life care. Discussion and conclusion: Based on our findings, we develop three recommendations for future writing by nurses about palliative sedation. These relate to the responsibility of recognizing how consciousness might matter in (some) peoples’ moral experiences of death and dying, to the importance of moral reflectiveness in nursing practice, and to the value of a relational approach in conceptualizing the nursing ethics of palliative sedation. (shrink)

PurposeThis purpose of this paper is to identify principal stakeholders and needs in e‐inclusion, with particular reference to senior citizens, determining to what extent those needs are being met or could be met by other stakeholders. It considers inclusive stakeholder organisational structures that could address unmet needs.Design/methodology/approachAlthough the European Commission, Member States, local authorities, industry, and researchers have called for greater collaboration and partnerships among stakeholders to overcome the so‐called digital divides, little attention has been giv]en to the form of (...) collaboration. Reviewing various policy‐oriented documents, this paper compiles a list of principal stakeholders and their e‐inclusion needs, reviews existing multi‐stakeholder undertakings and partnership structures as candidates for addressing needs not already met.FindingsMany important e‐inclusion needs are not addressed by any multi‐stakeholder undertaking. Some structured collaboration or partnership should address those needs. A new structure should not merely represent all interested stakeholders, but involve them in decision‐making processes.Research limitations/implicationsThis is a conceptual paper, constrained by length from producing a detailed list of needs. Similarly, although the paper identifies 12 different stakeholder categories, some could be further segmented.Practical implicationsFurther research and analysis could be undertaken sourcing each identified need, perhaps adding others and further segmenting stakeholder categories.Originality/valueThe paper is of value to stakeholders involved or interested in e‐inclusion efforts. It uses a novel, straight‐forward, approach for identifying stakeholders and needs, who can meet those needs and who is addressing those needs. (shrink)

Many western industrialized countries are currently suffering from a crisis in health human resources, one that involves a debate over the recruitment and licensing of foreign-trained doctors and nurses. The intense public policy interest in foreign-trained medical personnel, however, is not new. During the 1960s, western countries revised their immigration policies to focus on highly-trained professionals. During the following decade, hundreds of thousands of health care practitioners migrated from poorer jurisdictions to western industrialized countries to solve what were then deemed (...) to be national doctor and nursing 'shortages' in the developed world. Migration plummeted in the 1980s and 1990s only to re-emerge in the last decade as an important debate in global health care policy and ethics. This paper will examine the historical antecedents to this ethical debate. It will trace the early articulation of the idea of a 'brain drain', one that emerged from the loss of NHS doctors to other western jurisdictions in the 1950s and 1960s. Only over time did the discussion turn to the 'manpower' losses of 'third world countries', but the inability to track physician migration, amongst other variables, muted any concerted ethical debate. By contrast, the last decade's literature has witnessed a dramatically different ethical framework, informed by globalization, the rise of South Africa as a source donor country, and the ongoing catastrophe of the AIDS epidemic. Unlike the literature of the early 1970s, recent scholarship has focussed on a new framework of global ethics. (shrink)

E-inclusion is getting a lot of attention in Europe these days. The European Commission and EU Member States have initiated e-inclusion strategies aimed at reaching out to the e-excluded and bringing them into the mainstream of society and the economy. The benefits of mainstreaming the excluded are numerous. Good practices play an important role in the strategies, and examples can be found in e-health, e-learning, e-government, e-inclusion and other e-domains. So laudable seems the rationale for e-inclusion, few have questioned the (...) benefits. In fact, e-inclusion does raise ethical issues, and this paper discusses a few of the key ones. The paper draws several conclusions, principally regarding the need for some empirical research on what happens to the e-excluded once they have access to information and communications technologies, notably the Internet. (shrink)

Aims The purpose of this literature review was to explore the psychosocial implications of long-term survival for people affected by cancer by systematically examining published research evidence. Key findings 283 abstracts of papers were retrieved and checked and 33 studies relating to the implications of long-term survival subjected to detailed scrutiny. This review suggests that the majority of long-term cancer survivors cope well and enjoy good QoL. However, there are areas of concern which warrant attention. Whilst this review did not (...) set out to review physical problems experienced in the long-term, long-term physical consequences of cancer and its treatment were associated with poorer QoL and more psychological distress and sexual problems. Other long term concerns included anxiety regarding recurrence, financial difficulties and reduced social and emotional support. Long term survivors of lung, head and neck cancers appear particularly vulnerable to long term problems although there were few studies involving people with these cancers in this review. A number of limitations in the current evidence base were highlighted. Little research was conducted in the UK and raises questions as to the relevance of the findings for a different environment or culture where patients may have different attitudes to cancer survival and receive different treatments. Also, when looking at practical issues for long-term survivors such as ability to obtain insurance, or employment matters, then country-specific factors will be important. (shrink)

Revised versions of papers presented at the 1994 Tyndale Fellowship jubilee conference held in Hayes Conference Centre, Swanwick.

In “Why Forgiving the Unrepentant is not Demeaning or Insulting: A Reply to Nicholas Wolterstorff,” David E. Wright argues against Wolterstorff’s view in Justice in Love that it is wrong or impossible to forgive the unrepentant wrongdoer. In response to Wolterstorff’s claim that it is impossible to forgive the unrepentant, Wright presents the case of Timothy and Hubert, which seems to show that one can forgive the unrepentant and take the wrong seriously. In response to Wolterstorff’s claim that it is (...) not morally permissible to forgive the unrepentant, Wright employs Trudy Govier and Colin Hirano’s invitational model of forgiveness, in which the act of forgiveness serves as the impetus or “invitation” for reconciliation. To illustrate this, Wright presents the case of Timothy and Jake, which seems to show that forgiving the unrepentant can be respectful of both the victim and the wrongdoer. (shrink)

Institutions receiving federal funding for research from the U.S.Public Health Service need to have policies and procedures to both prevent research misconduct and to adjudicate it when it occurs. The person who is designated to handle research misconduct is typically referred to as the research integrity officer (RIO). In this interview study we report on 79 RIOs who describe how they would handle allegations of research misconduct. Their responses were compared to two expert RIOs. The responses to the allegations in (...) the scenarios demonstrated that RIOs are not uniformly well prepared to handle activities associated with reported allegations of research misconduct. We recommend greater preparation through directed training, use of check lists of possible behaviors necessary to consider when situations arise, being involved in a network of RIOs so one can discuss options, and the possible need to certify RIOs. (shrink)

This review essay discusses three articles from the Palgrave Handbook of Critical Thinking in Higher Education concerned with outlining the connection between cognitive science and critical thinking. All of the authors explain how recent findings in cognitive science, such as research on heuristics and cognitive biases might be incorporated into the critical thinking curriculum. The authors also elaborate on how recent findings in metacognition can reshape critical thinking pedagogy. For instance, the essays articulate how critical thinking instructors would be wise (...) to broaden the scope of traditional critical thinking content by instructing students in the metacognitive strategies of self-regulation, cognitive monitoring, and evaluation in order to encourage better decision making both inside and outside the classroom. (shrink)

This thesis aims to provide the appropriate historical context for interpreting John Stuart Mill's Utilitarianism. The central question considered here concerns two views of Mill's intentions for Utilitarianism, and whether the work should be read as Mill arguing for his own version of utilitarianism, or as an ecumenical document expressing and defending the views of many utilitarians. The first view, labeled the orthodox view, as defended by Roger Crisp, is probably the most commonly held view as to how to interpret (...) the document. The second view, labeled the revisionist view, is defended by Daniel Jacobson in a recent article. By examining Mill's place in the history of utilitarianism, his journals, correspondence, and other writings leading up to and after the publication of Utilitarianism, this thesis argues in support of the revisionist position. Furthermore, it is argued that certain portions of the book deserve special consideration apart from other chapters, and this is taken to have implications for the future of research in Mill?s thought. This thesis has four chapters including the first introductory chapter, which outlines the motivations guiding the orthodox and revisionist views. The second chapter provides a general exposition of Utilitarianism, as well as an outline of the primary evidence supporting the orthodox and revisionist positions. The third chapter is a defense of the revisionist position, and it highlights the specific biographical context in which Utilitarianism was composed, as well as evidence from Mill's writings, correspondence, and journals suggesting that he saw the need to write a general defense of the principle of utility and elaborate his theory of justice. This chapter also includes a historiographical analysis of Mill's biographers, which suggests that Utilitarianism is not viewed by Mill's biographers as being especially central to his considered views on utilitarianism. Finally, the chapter includes a section on the early reception and criticisms offered against Utilitarianism, which partly explains why the book has come to be interpreted as it has. The final chapter reviews the evidence for the revisionist position and explains the implications for Mill scholarship in light of the findings of this study. (shrink)

Ethical questions about information and communications technologies have been debated since World War II. Western democracies have had more than 50 years of experience in addressing and organising the ethical, social and legal aspects of scientific and technological developments. However, this expertise, tradition and experience are not enough to manage the most urgent ethical and social issues and contemporary challenges involving ICT. A systematic and institutional organisation of social values in the context of modern ICT tools is needed.This paper focuses (...) on four major areas: developing a specific approach to ethical issues raised by ICT; describing in more detail the age-related digital divide in Europe; identifying technology trends and emerging challenges; and defining the legal framework for inclusion of senior citizens in the digital society. The paper then concludes with a summary of its key points on the basis of which it makes three proposals as a contribution to efforts aimed at overcoming the exclusion of senior citizens from today's Information Society. (shrink)

PurposeThe purpose of this paper is to discuss whether existing organisations that seek to integrate a range of stakeholders in the field of information and communication technology and ageing are adequately meeting the needs of each of these stakeholder groups, and to determine whether a new, or re‐organised, mechanism is needed to better meet the needs of stakeholders.Design/methodology/approachThe authors identify, describe, assess and compare the adequacy of various candidate multi‐stakeholder mechanisms in order to improve stakeholder co‐operation.FindingsThe authors' principal finding is (...) that the stakeholder co‐ordination mechanisms discussed in this paper are not adequate to foster e‐inclusion co‐operation, co‐ordination and collaboration among all different types of stakeholders.Practical implicationsThis analysis offers direction in how a new organisation, or the expansion of an existing mechanism, could ensure that currently un‐met needs are addressed. The strengths and weaknesses of the stakeholder co‐ordination mechanisms discussed here demonstrate that some organisational types are better for performing certain tasks and for integrating particular types of stakeholder. Thus, a federated, multi‐dimensional organisation offers one possibility for addressing the needs of all different types of stakeholders.Originality/valueThis paper provides an avenue of response to various calls for closer stakeholder collaboration by the European Commission and other stakeholders, in order to improve the quality of life for older persons and to meet European social objectives. (shrink)

ABSTRACTThis article examines right-leaning press representations of people living in the UK who can’t speak English, or at least speak English well, following the 2011 Census, which was the first to ask respondents about their main language and proficiency in English. The analysis takes a corpus-assisted approach to critical discourse analysis, based on a 1.8 million-word corpus of right-leaning newspaper articles about ‘speak English’ in the years following this historic Census. The analysis reveals the tendency for the press to focus (...) on immigrants – particularly in the contexts of education and health – who are represented with recourse to a series of argumentation strategies, or ‘topoi’. Over the course of this paper, we argue that these topoi are problematic, as they present paradoxes, obscure the role of the Government in ensuring integration, overlook the difficulties of language learning and cultural assimilation, and generally contribute to a broader anti-immigrant UK media narrative which serves to legitimise exclusionary and discriminatory practices against people from minority linguistic and ethnic backgrounds. (shrink)

This is a response essay to Donald Hatcher’s, “Critical Thinking Instruction: A Realistic Evaluation: The Dream vs. Reality.” Hatcher argues that critical thinking instruction seriously falls short of the ideal of honestly evaluating alternative evidence and arguments. This failure is apparent, he argues, when one surveys student performance on a variety of CT assessment tests. Hatcher reviews the current CT assessment data, which includes an extensive pool of results collected from Baker University where Hatcher oversaw a sophisticated and well-funded CT (...) program for about two decades. Hatcher also argues that evidence from the philosophical and psychological literatures on disagreement and judgment suggests even CT experts fail to model the ideal and that CT has suffered from an unrealistic conception of rationality and human decision-making. I reply by arguing that, by putting the CT assessment data in a different context and asking an alternative set of questions, one can justifiably derive a more positive evaluation of the future of CT instruction in light of the CT ideal. Instead of focusing on whether students are achieving the CT ideal by the time of the post-test, instructors should ask whether they are making the kind of progress that there is good reason to expect. I close by challenging the soundness of the proposed implications of Hatcher’s arguments. (shrink)

The introduction of modern Western science into late imperial China naturally involved the creation of new linguistic spaces through the translation of science textbooks and the formation of a modern scientific lexicon, but it also required translation in another, physical, sense through the creation of institutions whereby the new system of practices and ideas could be transmitted. The Shanghai Polytechnic, opened in 1876 under the direction of John Fryer, was promoted as an academy for the ‘extension of learning’; this paper (...) explores the role John Fryer and his Polytechnic played in making space for science in late nineteenth-century China. (shrink)

Delirium, a common syndrome in terminally ill people, presents specific challenges to a good death in end‐of‐life care. This paper examines the relational engagement between hospice nurses and their patients in a context of end‐of‐life delirium. Ethnographic fieldwork spanning 15 months was conducted at a freestanding residential hospice in eastern Canada. A shared value system was apparent within the nursing community of hospice; patients’ comfort and dignity were deemed most at stake and therefore commanded nurses’ primary attention. This overarching commitment (...) to comfort and dignity shaped all of nursing practice in this hospice, including practices related to end‐of‐life delirium. The findings of this study elaborate the ways in which hospice nurses interpreted and responded to the discomfort of their patients in delirium, as well as the efforts they made to understand their patients’ subjective experiences and to connect with them in supportive ways. In addition to what is already known about clinical assessment and treatment of delirium in palliative care settings, the findings of this study offer points of reflection for nurses anywhere who are contending with the relational challenges that delirium presents in end‐of‐life care. (shrink)