Critical congenital heart disease screening is rapidly becoming the standard of care in the United States after being added to the Recommended Uniform Screening Panel in 2011. Newborn screens typically do not require affirmative parental consent. In fact, most states allow parents to exempt their baby from receiving the required screen on the basis of religious or personally held beliefs. There are many ethical considerations implicated with allowing parents to exempt their child from newborn screening for CCHD. Considerations include the (...) treatment of religious exemptions in our current legal system, as well as medical and ethical principles in relation to the rights of infants. Although there are significant benefits to screening newborns for CCHD, when a parent refuses for religious or personal beliefs, in the case of CCHD screening, the parental decision should stand. (shrink)

A disconnect remains between theories about responsible management and application in real-life organizations. Part of the reason is due to the complexity and holistic nature of the field, and the fact that many of the benefits of aligning business objectives with changing societal conditions are of an intangible nature. Human resource management is an increasingly important part of the field with benefits including talent retention, higher levels of motivation, and improvements in organizational cohesion. This paper sets out an experiment run (...) at a large Spanish university to try to analyze the impact on worker productivity of a responsible management stance by an employer. Based on the Corporate Social Performance model, the paper examines the issue from the point of view of responsibilities, responsiveness, and outcomes, and considers the cost/benefit effect of incorporating a social responsibility variable into the wage structure to measure the impact on productivity. (shrink)

Older minority Americans experience worse health outcomes than their white counterparts, exhibiting the need for social justice in all areas of their health care. Justice, fairness, and equity are crucial to minimizing conditions that adversely affect the health of individuals and communities. In this paper, Alzheimer's disease (AD) is used as an example of a health care disparity among elderly Americans that requires social justice interventions. Cultural factors play a crucial role in AD screening, diagnosis, and access to care, and (...) are often a barrier to support and equality for minority communities. The “conundrum of health disparities” refers to the interplay between disparity, social justice, and cultural interpretation, and encourages researchers to understand both (1) disparity caused by economic and structural barriers to access, treatment, and diagnosis, and (2) disparity due to cultural interpretation of disease, in order to effectively address health care issues and concerns among elderly Americans. (shrink)

Background There is considerable variation in the functionality of bioethical services in different institutions and countries for children in hospital, despite new challenges due to increasing technology supports for children with serious illness and medical complexity. We aimed to understand how bioethics services address bioethical concerns that are increasingly encountered in paediatric intensive care. Methods A qualitative descriptive design was used to describe clinician’s perspectives on the functionality of clinical bioethics services for paediatric intensive care units. Clinicians who were members (...) of formal or informal clinical bioethics groups, or who were closely involved with the process of working through ethically challenging decisions, were interviewed. Interviews took place online. Resulting transcripts were analysed using thematic analysis. Results From 33 interviews, we identified four themes that described the functionality of bioethics services when a child requires technology to sustain life: striving for consensus; the importance of guidelines; a structure that facilitates a time-sensitive and relevant response; and strong leadership and teamwork. Conclusions Clinical bioethics services have the potential to expand their role due to the challenges brought by advancing medical technology and the increasing options it brings for treatment. Further work is needed to identify where and how bioethics services can evolve and adapt to fully address the needs of the decision-makers in PICU. (shrink)

The 2006 term of the United States Supreme Court is now well underway, and the results of the congressional mid-term elections are in. No doubt, decisions will be handed down and national legislation proposed – perhaps even enacted – that will directly or indirectly affect the physician-patient relationship as well as the profession of medicine itself. Of major concern to physicians, patients, and the lay public is the ongoing, rather contentious debate surrounding both patient access to adequate pain control and (...) what constitutes proper physician conduct in treating patients who are experiencing either chronic or end stage disease pain. Those knowledgeable in palliative medicine maintain that an “epidemic of undertreated pain” now exists, and probably has existed for more than a decade. A significant number of patients experience unnecessary pain and suffering, and this disturbing phenomenon is both an individual patient care problem and a public health concern. (shrink)

The U.S.Supreme Court's 6-decision in Gonzales v. Oregon is the latest defeat for the Bush administration in its sustained attack on Oregon's physician-assisted suicide law. Both the majority opinion and the major dissent in Oregon provide an opportunity to assess the dangers inherent in allowing a political agenda that emphasizes the sanctity of life and minimizes professional ethical obligations to overshadow quality patient care at the end of life.

This paper examines contemporary Catholic higher education and its unique role in preparing graduates, who have been grounded in natural moral law, to respond to the bioethical questions of the day. The importance of the commitment by both administration and faculty to articulating and embracing the mission of Catholic higher education as they prepare graduates for a culture of relativism is presented. Curricular objectives, content, and teaching strategies are provided which address the most relevant bioethical dilemmas of the day. The (...) importance of an integrated approach to examining these dilemmas, as well as a grounding in core content in philosophy and theology for all graduates, regardless of discipline of concentration, are presented. The interjection of government mandates into the void of bioethical resolutions is examined in relationship to the rights of conscience. The paper concludes with examples of best practices, showing the role of Catholic higher education as uniquely suited to advance the common good. National Catholic Bioethics Quarterly 11.4 (Winter 2011): 705–734. (shrink)

Evidence suggests that the nurse’s role as an advocate for patients and for the professional right to conscience is being eroded because of a lack of conscience protections in the Patient Affordable Care Act and because of a faulty understanding in general of the separation of church and state. While the main task of the principle of separation of church and state is to secure religious liberty, the principle is increasingly interpreted in a secularist way to mean that religion must (...) be confined to the home and church and that people of conscience may not object to immoral practices in the workplace or public square. If nurses must risk their jobs to advocate for their patients, patient care will suffer. National Catholic Bioethics Quarterly 14.1 : 47–52. (shrink)

Over the past decade or so, no issue in medical ethics or bioethics law has raised more concerns about federal intervention in the practice of medicine, about judicial attempts to craft health policy, or about the wisdom of public mandates directing specific health care initiatives than the issue of physician-assisted suicide. State voter referenda, lower and federal court cases, proposed legislation in both houses of Congress, and orders and determinations from agencies within the executive branch of two administrations are representative (...) of the kinds of actions taken in the last ten years implicating medical care at the end of life. Whether the intent was to codify into law physician-assisted suicide, to deny a constitutional right of assisted suicide, or to make “easier” physicians' efforts to alleviate intractable suffering at the risk of hastening death, or to prohibit physician aid in dying altogether, the impact on the patient-doctor relationship and on our understanding of what constitutes dignified and humane care at the end of life is undeniable. (shrink)

Over the past decade or so, no issue in medical ethics or bioethics law has raised more concerns about federal intervention in the practice of medicine, about judicial attempts to craft health policy, or about the wisdom of public mandates directing specific health care initiatives than the issue of physician-assisted suicide. State voter referenda, lower and federal court cases, proposed legislation in both houses of Congress, and orders and determinations from agencies within the executive branch of two administrations are representative (...) of the kinds of actions taken in the last ten years implicating medical care at the end of life. Whether the intent was to codify into law physician-assisted suicide, to deny a constitutional right of assisted suicide, or to make “easier” physicians' efforts to alleviate intractable suffering at the risk of hastening death, or to prohibit physician aid in dying altogether, the impact on the patient-doctor relationship and on our understanding of what constitutes dignified and humane care at the end of life is undeniable. (shrink)

Recent years have seen rapid advancements in selection assessments, shifting away from human and toward algorithmic judgments of candidates. Indeed, algorithmic recruitment tools have been created to screen candidates’ resumes, assess psychometric characteristics through game-based assessments, and judge asynchronous video interviews, among other applications. While research into candidate reactions to these technologies is still in its infancy, early research in this regard has explored user experiences and fairness perceptions. In this article, we review applicants’ perceptions of the procedural fairness of (...) algorithmic recruitment tools based on key findings from seven key studies, sampling over 1,300 participants between them. We focus on the sub-facets of behavioral control, the extent to which individuals feel their behavior can influence an outcome, and social presence, whether there is the perceived opportunity for a social connection and empathy. While perceptions of overall procedural fairness are mixed, we find that fairness perceptions concerning behavioral control and social presence are mostly negative. Participants feel less confident that they are able to influence the outcome of algorithmic assessments compared to human assessments because they are more objective and less susceptible to manipulation. Participants also feel that the human element is lost when these tools are used since there is a lack of perceived empathy and interpersonal warmth. Since this field of research is relatively under-explored, we end by proposing a research agenda, recommending that future studies could examine the role of individual differences, demographics, and neurodiversity in influencing fairness perceptions of algorithmic recruitment. (shrink)