Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health , - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project.

An ethics reflection group is one of a range of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the implementation process of interdisciplinary ERGs in psychiatric and general hospital departments in Denmark. To our knowledge, this is the first study of ERG implementation to include both psychiatric and general hospital departments. The implementation and evaluation strategies are inspired by action research, using a qualitative approach and (...) systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. The implementation process was influenced by both structural factors and factors related to clinicians having different values, interests and experiences. Structural barriers and promotors in the process to implement ERG included the following sub-categories: Organizational factors, recruitment and training of ethics facilitators, the deliberation model, planning and recruitment of participants to the ERGs, the support of the ward managers and the project group. Barriers and promotors found among clinicians included the following sub-categories: Expectations and pre-understandings of ERGs, understandings of a physician’s job, challenges experienced by ethics facilitators. At the end of the study, when it was decided that the ERGs should be continued, the implementation strategies were remodeled by the participants to meet new challenges. The study of ERG implementation identified important structural and professional barriers and promotors that are likely to be relevant to anyone wanting to implement ethics support services across various types of healthcare services. (shrink)

Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. (...) Most participants report positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices. (shrink)

Background Research on the impact of ethics reflection groups (ERG) (also called moral case deliberations (MCD)) is complex and scarce. Within a larger study, two years of ERG sessions have been used as an intervention to stimulate ethical reflection about the use of coercive measures. We studied changes in: employees’ attitudes regarding the use of coercion, team competence, user involvement, team cooperation and the handling of disagreement in teams. Methods We used panel data in a longitudinal design (...) study to measure variation in survey scores from multidisciplinary employees from seven departments within three Norwegian mental health care institutions at three time points (T0–T1–T2). Mixed models were used to account for dependence of data in persons who participated more than once. Results In total, 1068 surveys (from 817 employees who did and did not participate in ERG) were included in the analyses. Of these, 7.6% (N = 62) responded at three points in time, 15.5% (N = 127) at two points, and 76.8% (N = 628) once. On average, over time, respondents who participated in ERG viewed coercion more strongly as offending (p < 0.05). Those who presented a case in the ERG sessions showed lower scores on User Involvement (p < 0.001), Team Cooperation (p < 0.01) and Constructive Disagreement (p < 0.01). We observed significant differences in outcomes between individuals from different departments, as well as between different professions. Initial significant changes due to frequency of participation in ERG and case presentation in ERG did not remain statistically significant after adjustment for Departments and Professions. Differences were generally small in absolute terms, possibly due to the low amount of longitudinal data. Conclusions This study measured specific intervention-related outcome parameters for describing the impact of clinical ethics support (CES). Structural implementation of ERGs or MCDs seems to contribute to employees reporting a more critical attitude towards coercion. Ethics support is a complex intervention and studying changes over time is complex in itself. Several recommendations for strengthening the outcomes of future CES evaluation studies are discussed. CES evaluation studies are important, since—despite the intrinsic value of participating in ERG or MCD—CES inherently aims, and should aim, at improving clinical practices. (shrink)

Background:Healthcare personnel in the municipal healthcare systems experience many ethical challenges in their everyday work. In Norway, 243 municipalities participated in a national ethics project, aimed to increase ethical competence in municipal healthcare services. In this study, we wanted to map out what participants in ethics reflection groups experienced as promoters or as barriers to successful reflection.Objectives:To examine what the staff experience as promoters or as barriers to successful ethics reflection.Research design:The study has a (...) qualitative design, where 56 participants in municipal healthcare participated in 10 different focus-group interviews.Ethical considerations:The data collection was based on the participants’ informed consent and approved by the Data Protection Official of the Norwegian Centre for Research Data.Results:The informants had different experiences from ethics reflection group. Nevertheless, we found that there were several factors that were consistently mentioned: competence, facilitator’s role, ethics reflection groups organizing, and organizational support were all experienced as promoters and as a significant effect on ethics reflection groups. The absence of such factors would constitute important barriers to successful ethics reflection.Discussion:The results are coincident with other studies, and indicate some conditions that may increase the possibility to succeed with ethics reflection groups. A systematic approach seems to be important, the systematics of the actual reflections, but also in the organization of ethics reflection group at the workplace. Community healthcare is characterized by organizational instabilities as many vacancies, high workloads, and lack of predictability. This can be a hinder for ethics reflection group.Conclusion:Both internal and external factors seem to influence the organization of ethics reflection group. The municipalities’ instabilities challenging this work, and perceived as a clear inhibitor for the development. The participants experienced that the facilitator is the most important success factor for establishing, carrying out, and to succeed with ethics reflection groups. (shrink)

Savulescu J. Is current practice around late termination of pregnancy eugenic and discriminatory? Maternal interests and abortion. J Med Ethics 2001;27:165–71. Lachlan de Crespigny contributed in a major way to the conceptualisation, design, administration of surveys, ….

Dheensa S, Fenwick A, Lucassen A.‘Is this knowledge mine ….

Several studies have indicated that scientists are likely to have an outlook on both facts and values that are different to that of lay people in important ways. This is one significant reason it is currently believed that in order for scientists to exercise a reliable ethical reflection about their research it is necessary for them to engage in dialogue with other stakeholders. This paper reports on an exercise to encourage a group of scientists to reflect on ethical (...) issues without the presence of external stakeholders. It reports on the use of a reflection process with scientists working in the area of animal disease genomics (mainly drawn from the EADGENE EC Network of Excellence). This reflection process was facilitated by using an ethical engagement framework, a modified version of the Ethical Matrix. As judged by two criteria, a qualitative assessment of the outcomes and the participants’ own assessment of the process, this independent reflective exercise was deemed to be successful. The discussions demonstrated a high level of complexity and depth, with participants demonstrating a clear perception of uncertainties and the context in which their research operates. Reflection on stakeholder views and values appeared to be embedded within the discussions. The finding from this exercise seems to indicate that even without the involvement of the wider stakeholder community, valuable reflection and worthwhile discourse can be generated from ethical reflection processes involving only scienitific project partners. Hence, the previous assumption that direct stakeholder engagement is necessary for ethical reflection does not appear to hold true in all cases; however, other reasons for involving a broad group of stakeholders relating to governance and social accountability of science remain. (shrink)

Background Healthcare leader support and facilitation for ethics work are of great importance for healthcare professionals’ handling of ethical issues, moral distress, and quality care provision. A digital tool for ethical reflection in long-term care was developed in response to the demand for appropriate tools. Research aim This study aimed to explore healthcare leaders’ expectations of using a digital tool for ethical reflection among their home nursing care staff. Research design A qualitative research design with vignettes and (...) focus group interviews was used. The data were analyzed using reflexive thematic analysis. Participants and Research Context The sample comprised ten healthcare leaders from municipal long-term care in Norway. Ethical Considerations Participation was voluntary and based on informed consent. The Norwegian Agency for Shared Services in Education and Research approved this study. Findings The analysis resulted in the development of three themes representing leaders’ expectations of the tool: (i) giving staff a voice, (ii) revealing ethics in practice, and (iii) keeping the pot boiling. Discussion Leaders must be informed about the ethical issues experienced to engage in supportive measures for their staff. Digital channels can increase the democratization, safety, and efficiency of communication between employees and leaders and increase awareness of ethical aspects in daily care work. The leaders had positive expectations of employees’ activities and benefits from using the tool for ethical reflection. However, they admitted that realizing the tool’s potential to ensure continuity in ethics work requires considerable organizational and leader involvement. Conclusions This study shows that healthcare leaders are open to digital solutions for managing ethics work in home nursing care. Both opportunities and important prerequisites for successfully implementing the digital tool were identified. (shrink)

Background Nurse leaders increasingly need effective tools that facilitate the prioritisation of ethics and help staff navigate ethical challenges and prevent moral distress. This study examined experiences with a new digital tool for ethical reflection, tailored to improve the capabilities of both leaders and employees in the context of municipal long-term care. Aim The aim was to explore the experiences of nurse leaders and nurses in using Digital Ethical Reflection as a tool for ethics work in (...) home nursing care. Research design The study employed a qualitative design, incorporating individual and focus group interviews for data collection. Qualitative content analysis was used to analyse the data. Participants and research context The participants comprised six nurse leaders and 13 nurses, representing six home care zones across two Norwegian municipalities. Ethical considerations The study involved informed, voluntary participation and was approved by the Norwegian Agency for Shared Services in Education and Research. Findings Four themes were developed: a constant walk on the edge between engagement and discouragement and lost in translation describe the process, while tuning in to the ethical dimension and navigating ethical uncertainties illuminate the experienced significance of Digital Ethical Reflection. Conclusion Success with Digital Ethical Reflection in home nursing care depends on clear leadership planning, nurses’ understanding of the tool’s purpose, and active use of digital registrations. Support from ethically interested nurses enhances overall engagement. Further research is needed to explore the potential of Digital Ethical Reflection as an additional tool in long-term care ethics work. (shrink)

Artificial Intelligence technology presents a multitude of ethical concerns, many of which are being actively considered by organizations ranging from small groups in civil society to large corporations and governments. However, it also presents ethical concerns which are not being actively considered. This paper presents a broad overview of twelve topics in ethics in AI, including function, transparency, evil use, good use, bias, unemployment, socio-economic inequality, moral automation and human de-skilling, robot consciousness and rights, dependency, social-psychological effects, and spiritual (...) effects. Each of these topics will be given a brief discussion, though each deserves much deeper consideration. (shrink)

Monrad JT. Ethical considerations for epidemic vaccine trials. J Med Ethics 2020;46:465–9. doi:10.1136/medethics-2020-106235 This ….

Ost S. Drs Bramhall and Bawa-Garba and the rightful domain of the criminal ….

Sheldon S, Lord J. Guest editorial: Care not criminalisation; reform of British abortion law is ….

Dubin S, Lane M, Morrison S, et al. Medically assisted gender affirmation: when children and parents disagree. ….

Douglas T. Going above and beneath the call ….

Wilkinson D. What has philosophy got to do with it? ….

Malm and colleagues (2008) consider (and reject) five arguments putatively justifying the idea that healthcare workers (HCWs) have a duty to treat (DTT) during a pandemic. We do not have sufficient...

Chinese health authorities have not set up a very clear legal framework or ethical guideline on genetic research involving a huge number of human genetic samples. A nationwide mail survey was conducted to identify whether Chinese research communities identified the fundamental ethical issues. This paper provides in-depth analysis about the attitudes of target groups towards ownership, commercial conflict of interest, international cooperation and ethical review mechanism that may be used to inform national guidelines related to genetic databases in China.

We concur with Baum and colleagues (2009) on the importance of pandemic planners taking explicit steps to employ public engagement methodologies. Thus far, as Baum and colleagues note, there have b...

The EDPS Ethics Advisory Group (EAG) has carried out its work against the backdrop of two significant social-political moments: a growing interest in ethical issues, both in the public and in the private spheres and the imminent entry into force of the General Data Protection Regulation (GDPR) in May 2018. For some, this may nourish a perception that the work of the EAG represents a challenge to data protection professionals, particularly to lawyers in the field, as well as (...) to companies struggling to adapt their processes and routines to the requirements of the GDPR. What is the purpose of a report on digital ethics, if the GDPR already provides all regulatory requirements to protect European citizens with regard to the processing of their personal data? Does the existence of this EAG mean that a new normative ethics of data protection will be expected to fill regulatory gaps in data protection law with more flexible, and thus less easily enforceable ethical rules? Does the work of the EAG signal a weakening of the foundation of legal doctrine, such as the rule of law, the theory of justice, or the fundamental values supporting human rights, and a strengthening of a more cultural approach to data protection? Not at all. The reflections of the EAG contained in this report are not intended as the continuation of policy by other means. It neither supersedes nor supplements the law or the work of legal practitioners. Its aims and means are different. On the one hand, the report seeks to map and analyse current and future paradigm shifts which are characterised by a general shift from analogue experience of human life to a digital one. On the other hand, and in light of this shift, it seeks to re-evaluate our understanding of the fundamental values most crucial to the well-being of people, those taken for granted in a data-driven society and those most at risk. The objective of this report is thus not to generate definitive answers, nor to articulate new norms for present and future digital societies but to identify and describe the most crucial questions for the urgent conversation to come. This requires a conversation between legislators and data protection experts, but also society at large - because the issues identified in this report concern us all, not only as citizens but also as individuals. They concern us in our daily lives, whether at home or at work and there isn’t a place we could travel to where they would cease to concern us as members of the human species. (shrink)

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 20 Heft: 1 Seiten: 293-302.

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 20 Heft: 1 Seiten: 237-240.

The idea of the Internet as Gutenberg 2.0—a true revolution in disseminating information—is now a routine part of how bioethics education works. The Internet has become indispensable as a channel for sharing teaching materials and connecting learners with a central platform that houses materials to support an online or hybrid curriculum or a traditional course. A newer idea in bioethics education reflects developments in web-based medical education more broadly and draws on design principles developed for the Internet. This approach to (...) online bioethics education requires thinking about web-based learning as an engaging, potentially immersive experience, about learners' expectations concerning web-based learning, and about differences between self-directed learning and teaching to support group learning. In clinician education in bioethics, the interrelated goals of ethical reflection and practice for professionals and of continuous quality improvement in health care are supported by a focus on real-world challenges and by encouraging the habits of self-directed learning. In this paper, we describe how an international, interdisciplinary team used a web-based framework to develop a health care ethics casebook whose content, design, and pedagogy were tailored to the needs and expectations of health care professionals and other audiences in Singapore; we also explain how they used this framework to make the casebook accessible nationwide and to support cross-cultural learning. (shrink)

Adolescence is a valuable phase of life, not just because it is the phase of learning in school and preparing for a working life. During the COVID-19 pandemic it became clear that the rights, experiences, and lifeworlds of adolescents are considered less important than the needs of school, work, and productivity. However, there is an ethical claim for people to have a good adolescence, and this means that the losses of social contact, experiences, time, and space demanded of adolescents, in (...) order to protect older and vulnerable groups during the COVID-19 pandemic, should be taken seriously. A distinctive quality of adolescence is that it cannot be repeated, nor can these experiences be replicated as adults. First experiences of independence, friendship, love, informality, recklessness, and youthful exuberance are intrinsically valuable and cannot be substituted for later in life. It is therefore not surprising that adolescents have sought and found their own spaces during the pandemic, some of them forbidden, because lock downs and closed social spaces have relegated them to the confines of their childhood bedrooms. In this paper, I explore an ethic of a good adolescence, which was impacted on by the COVID-19 pandemic, and consider what can be learned from this situation. Adolescents are to be taken seriously, their experiences are no less valuable than those of adults, and the losses they have suffered for the benefit of others should be honored. As far as possible, young people should be supported to have a voice in public discourse and in finding spaces to be adolescents. (shrink)

In this essay, we address an important problem in the ethics of cultural engagement: the problem of giving a systematic account of when and why outsider use of insider cultural material is permissible or impermissible. We argue that many scholars rely on a problematic notion of collective ownership even when they claim to be disavowing it. After making this case, we motivate an alternative framework for thinking about cultural exchange, which we call the core interests framework. We conclude with (...) some reflections on how this framework helps to raise interesting questions about the most promising accounts of wrongful cultural appropriation. (shrink)

A twenty‐person working group convened to discuss the ethical and policy considerations of the controversial intervention called “growth attenuation,” and if possible to develop practical guidance for health professionals. A consensus proved elusive, but most of the members did reach a compromise.

Many questions concerning health involve values. How well is a health system performing? How should resources be allocated between the health system and other uses or among competing healthrelated uses? How should the costs of health services be distributed among members of a population? Who among those in need of transplants should receive scarce organs? What is the best way to treat particular patients? Although many kinds of expertise bear on these questions, values play a large role in answering them. (...) These values are of many kinds – judgments about how health states contribute to the well-being of individuals depend on views about what is good for a person, whereas judgments about how to share the costs of health care or about how to distribute scarce organs among those in need of transplants depend on theories of fairness. The value judgments that need to be made are not only multifaceted and heterogeneous; they are also controversial. Both the understanding of the questions and the substance of the answers may vary widely from individual to individual and among different groups within countries and across national boundaries. How are these many complicated, difficult and controversial evaluative questions to be answered? This could be a question about who should answer them as well as a question about how they should be answered. There are various possible mechanisms, and there is no reason why the same method should be employed to answer every question. Among the possible methods are (1) moral argument, (2) political deliberation and (3) eliciting preferences or judgments from some group. Included in the third method lie many different techniques of elicitation. For example, one could study attitudes by the use of deliberative (focus) groups, by permitting individual choice in some sort of market or quasi-market, by polling or by voting. These methods of answering evaluative questions are not always incompatible with one another. Moral argument can play a role within political deliberation, deliberation by focus groups, individual market choice, or voting.. (shrink)

Little is known about how health care professionals deal with ethical challenges in mental health care, especially when not making use of a formal ethics support service. Understanding this is important in order to be able to support the professionals, to improve the quality of care, and to know in which way future ethics support services might be helpful.

Since the 1970s and more rigorously since the 1990s, many countries have regulated data protection and privacy laws in order to ensure the safety and privacy of personal data. First, a comparison is made of different acts regarding genetic information that are in force in the EU, the USA, and China. In Turkey, changes were adopted only recently following intense debates. This study aims to explore the experts’ opinions on the regulations of the health information systems, data security, privacy, and (...) confidentiality in Turkey, with a particular focus on genetic data, which is more sensitive than other health data as it is a permanent identifier that is inherited to next of kin and shared with other family members. Two focus groups with 18 experts and stakeholders were conducted, discussing topics such as central data collection, legalized data sharing, and the management of genetic information in health information systems. The article concludes that the new Turkish personal data protection law is problematic as the frame of collectible data is wide-ranging, and the exceptions are extensive. Specific laws or articles dedicated to genetic data that also overlook the dimension of discrimination based on genetic differences in Turkey should be taken into consideration. In broader terms, it is intended to put up for discussion that in addition to ethical aspects, economic aspects and legal aspects of health should be included in the discussion to be carried out within the framework of socio-political analyses with culture-specific approaches and cross-culture boundaries simultaneously. (shrink)

American Academy of Pediatrics (AAP) and American College of Medical Genetics (ACMG) recently provided two recommendations about predictive genetic testing of children. The Clinical Sequencing Exploratory Research Consortium's Pediatrics Working Group compared these recommendations, focusing on operational and ethical issues specific to decision making for children. Content analysis of the statements addresses two issues: (1) how these recommendations characterize and analyze locus of decision making, as well as the risks and benefits of testing, and (2) whether the guidelines conflict (...) or come to different but compatible conclusions because they consider different testing scenarios. These statements differ in ethically significant ways. AAP/ACMG analyzes risks and benefits using best interests of the child and recommends that, absent ameliorative interventions available during childhood, clinicians should generally decline to order testing. Parents authorize focused tests. ACMG analyzes risks and benefits using the interests of the child and other family members and recommends that sequencing results be examined for additional variants that can lead to ameliorative interventions, regardless of age, which laboratories should report to clinicians who should contextualize the results. Parents must accept additional analysis. The ethical arguments in these statements appear to be in tension with each other. (shrink)

In Brazil, the epicenter of the Zika crisis, brown, black, and indigenous poor women living in municipalities with scarce resources were disproportionally affected. The gendered consequences of the epidemic exposed how intersectional lenses are central to understand the impact of public health emergencies in the lives of women and girls. The demand for Zika-affected children and women to be research participants is relevant for an ethical analysis of participant protection procedures during a crisis. We investigated how women experienced research participation (...) by analyzing their narratives. Two-year-long longitudinal qualitative study in Brazilian sites located in the epidemic's epicenter was performed using mixed methods: ethnography with women from two distinct states and individual semi-structured interviews with five women in different Zika-affected states, four of which were community leaders. All women in the study were mothers or grandmothers of Zika-affected children. Thematic analysis was used for data evaluation. Women perceived being pressured to participate in research and a lack of benefit sharing. Structural determinants of gender inequality, such as its effect on power distribution, were found to impact research participant protection. Formal procedures for research protocols approvals were insufficient in protecting participants because these instruments were unable to account for structural aspects. Communitarian mobilization, through WhatsApp groups, was found to be an important mechanism to create conditions to challenge oppressive structures. Strengthening public health, effective community-based participation in research planning and implantation of ethical strategies that promotes gender equality can have transformative effect on unequal power structures and promote participant protection. (shrink)

The past few decades have seen a turn to the empirical in applied ethics. This article makes two contributions to debates on this turn: one with regard to methodology and the other with regard to scope. First, it considers empirical bioethics, which arose out of a protest against abstract theorizing in moral philosophy and a call for more sensitivity to lived experience. Though by now an established field, methodological discussions are still centred around the question of how empirical research (...) can inform normative analysis. This article proposes an answer to this question that is based on Iris Murdoch’s criticism of the fact/value distinction and Cora Diamond’s concept of reflective empiricism. Second, the discussion takes as a point of departure a study on genome-edited farmed salmon that uses qualitative research interviews and focus groups. Although there are several animal ethics studies based in empirical data, there are few works on the methodological challenges raised by empirical ethics in this area. The article contributes to these discussions by arguing that reflective empiricism can constitute a methodological approach to animal ethics. (shrink)

The COVID-19 pandemic raised not only overwhelming practical challenges but also deep ethical dilemmas for educators. There have been few efforts to connect these challenges to either ethical dilemmas teachers faced in pre-pandemic times or to philosophical analyses of complex normative terrain of teachers’ work. We facilitated eleven discussion groups with 101 educators from seven countries on the dilemmas they faced due to COVID-19. Analysis of these sessions reveals how the pandemic amplified, exacerbated and augmented pre-pandemic educational dilemmas in ways (...) that recalibrated teachers’ core values and beliefs, and highlights the importance of engaging teachers in ethical dialogue. (shrink)

The prospect of using genome technologies to modify the human germline has raised profound moral disagreement but also emphasizes the need for wide-ranging discussion and a well-informed policy response. The Hinxton Group brought together scientists, ethicists, policymakers, and journal editors for an international, interdisciplinary meeting on this subject. This consensus statement formulated by the group calls for support of genome editing research and the development of a scientific roadmap for safety and efficacy; recognizes the ethical challenges involved in (...) clinical reproductive applications of genome editing but, importantly, rejects the idea that human reproductive germline modification is necessarily morally unacceptable; and highlights the importance of meaningful engagement in discussions of genome editing and the development of regulation and oversight mechanisms to govern future uses of such technologies. (shrink)

Europe: The Space and Time of ReflectionOn the Complutense Research Group La Europa de la Escritura.

Due to their understanding of self-management, healthcare team members responsible for depressed older persons can experience an ethical dilemma. Each team member contributes important knowledge and experience pertaining to the management of depression, which should be reflected in the management plan. The aim of this study was to explore healthcare team members’ reflections on the ethical dilemmas involved in promoting self-management among depressed older persons. A qualitative design was used and data were collected by means of focus group interviews. (...) The results revealed one main theme: ‘Lack of trust in the community health care system’s commitment to bringing about effectiveness and change, based on three themes; ‘Struggling to ensure the reliable transfer of information about depressed older persons to professionals and family members’, ‘Balancing autonomy, care and dignity’ and ‘Differences in the understanding of responsibility’. Lack of engagement on the part of and trust between the various professional categories who work in the community are extremely counterproductive and have serious implications for patient dignity as well as safety. In conclusion, ethical dilemmas occur when staff members are unable to act in accordance with their professional ethical stance and deliver an appropriate standard of care. (shrink)

This article summarizes a National Institute of Mental Health workshop that was convened to address the ethical and methodological issues that arise when conducting controlled psychosocial interventions research and introduces 6 thoughtful and inspiring papers prepared by workshop participants. These papers, on topics ranging from informed consent to ethnic minority issues, reflect the depth and breadth of expertise represented by the multidisciplinary group of scientists and ethicists present at the meeting. More extensive follow-up, particularly from federal research applications and (...) publications, of how investigators balance the need for strong research design with ethical considerations may help advance the science of psychosocial intervention research. (shrink)

Originally published between 1982 and 1991 the 3 volumes in this set Reflect the diversity in Hegelianism and every branch of philosophy which he contributed to. Examine Hegel's work in relation to Marx and Wittgenstein Discuss Hegel's social theory Examine British Hegelian thinking and the lines of its development Offer an interpretation of Hegelian theory that is relevant for the understanding of modern republican constitutions.

Reissuing works originally published between 1949 and ‘79, this set presents a rich selection of renowned scholarship across the subject, touching also on ethics, religion, and psychology and other behavioural science. Classic previously out-of-print works are brought back into print here in this set of important discourse and theory.

A set of basic static predicates, 'in itself, 'existing through itself, 'free', and others are taken to be (at least) extensionally equivalent, and some consequences are drawn in Parts A and? of the paper. Part C introduces adequate causation and adequate conceiving as extensionally equivalent. The dynamism or activism of Spinoza is reflected in the reconstruction by equating action with causing, passion (passive emotion) with being caused. The relation between conceiving (understanding) and causing is narrowed down by introducing grasping (λ (...) μβ?νω) as a basic epistemological term. Part D, 'The road to freedom through active emotion', introduces a system of grading with respect to the distinctions introduced in the foregoing, including 'being in itself, 'freedom', etc. Active emotions are seen to represent transitions to a higher degree of freedom, the stronger and more active ones being the more conducive to rapid increase in degree of freedom. Elementary parts of the calculus of predicates are used in order to facilitate the survey of conceptual relations and to prove some theorems. (shrink)

Each profession has its own code of ethics. The Merriam-Webster Online Dictionary (2008) defines professional ethics as "the principles of conduct governing an individual or a group." The Code of Ethics of the American Library Association (ALA Council 2008) has served librarians for seventy years and reflects the ideals toward which aII librarians strive. While they are not step by step directives, the statements in the Code provide a moral framework for school library media specialists in (...) their daily practice. School library professionals face ethical dilemmas every day. Although the situations vary, most affect students' access to information and their privacy while using library resources. The following real-life examples reflect contemporary situations. Think about them. (shrink)

IntroductionThis special issue brings together researchers from psychology and linguistics who apply the ethnomethodologically informed analytic technique of conversation analysis (henceforth CA) to examine a range of ethical issues as they emerge in transcribed recordings of interactions collected as part of routine research encounters. The data authors analyse are diverse, including naturalistic audio and video recordings of members’ everyday and professional practices (Mondada 2014), an ethnography of a gynaecology unit in a public hospital in Italy (Fatigante and Orletti 2014), focus (...) group interviews on domestic family life (Alby and Fatigante 2014), and semi-public meetings, recorded as part of an ethnography of ageing, poverty, and social exclusion (Paoletti 2014b). Noting that “ethical issues in research have seldom been the focus of ethnomethodological studies” (Paoletti 2014a: 174; see also Mondada 2014: 182–183), the primary aim of this special issue is to “open a debate on e. (shrink)

Anonymized reflection was employed as an innovative way of teaching ethics in order to enhance students' ability in ethical decision making during a `Care of the Dying Patient and Family' module. Both qualitative and quantitative data were collected from the first two student cohorts who experienced anonymized reflection ( n = 24). The themes identified were the richness and relevance of scenarios, small-group work and a team approach to teaching. Students indicated that they preferred this style (...) of teaching. This finding was verified by a postal questionnaire conducted four months later. The conclusions drawn from this study suggest that using anonymized reflection is an effective method for teaching ethics to nurses and indicates that learning about ethical issues in this way reduces uncertainties. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.2 (2003) 80-98 [Access article in PDF] Musical Spirituality:Reflections on Identity and the Ethics of Embodied Aesthetic Experience in/and the Academy Deanne Bogdan Music in/and My Life Several years ago, I attended a Pontifical High Mass at St. Stephen's Cathedral in Vienna. It was the feast of the Epiphany, a public holiday in the predominantly Roman Catholic country of Austria. 1 A "lapsed" (...) Catholic myself, my intention as part of the congregation that day was not primarily one of worship as it was to listen to a performance of the Pauckenmesse of Joseph Haydn, complete with soloists, full choir, and orchestra (in overcoats), including, of course, timpani.As I stepped from the brilliant winter morning into the narthex of that gothic splendor, the pungency of the incense propelled me into Proustian recollections of growing up female, Catholic, and Italian-Canadian in the cathedral parish in Hamilton, Ontario, Canada's steel town. My mother and father, first generation Italian-Canadians, whose own parents had emigrated as teen-agers, had been partners in a corner grocery located in another part of the city that was largely professional and white-Anglo-Saxon Protestant. Eager to assimilate (they never spoke Italian to my sister or me, and we never learned the language), my parents realized early on that their most valuable legacy to their two daughters would be the advantages of a solid education, religious and secular. For them that meant enrolling us in the local co-educational Catholic elementary school. Later we attended a convent secondary school as day students, and were the only members of our extended family, male or female, to attend university.It was memories of those elementary school years that were conjured up for me that crisp January morning at St. Stephen's. (In hindsight, I am struck by the synchronicity 2 of the fact that my original surname is Di Stefano, or rather "Distefan," as it had become in its anglicized form). 3 For a [End Page 80] whole complex of reasons, I identified strongly with my parochial school and the church that sheltered/shadowed it — a soaring pseudo-gothic structure reputed to have been replicated, stone by stone, wood carving by hand wood carving, from some European cathedral. The romance of that basilica — The Cathedral of Christ the King — its "daughter" school, and the priests and nuns who were our guides and teachers became my second family for the whole of my grade school education. For me, being at school was like a recognition scene. As Italian-American literary theorist Marianna de Marco Torgovnick writes: When I was a child, school was...a light-filled, wide awake world in which fear did not erupt except on rare occasions. I saw school as a place where I was valued for my intelligence, even though I was female — and this probably had something to do with my absence of fear there. I quite naturally chose to stay in school through college and into graduate school. It's in these relatively late years that I first became fully conscious of how even within the world of school I was and always would be female. 4My identification with my church/school centered around my musical development, which began at age four when the piano I grew up on arrived like a beacon in our home. Coterminous with my eager entry into first grade, piano lessons were begun with Sister Cecile, a somewhat nervous, gentle nun predisposed to mystical experience, who shepherded me through exams and recitals until high school. Because I could sight-read fairly well, I was regularly pulled out of class to accompany soloists and dancing groups rehearsing for annual Christmas and St. Patrick's Day concerts. Something about this made me feel special; I both reveled in and felt isolated by my difference from my classmates. I had found a sense of community through my music, and enjoyed a feeling of security in the knowledge that my schoolwork was strong enough... (shrink)