Climate change has substantial impacts on public health and safety, disease risks and the provision of health care, with the poor being particularly disadvantaged. Management of the associated health risks and changing health service requirements requires adequate responses at local levels. Health-care providers are central to these responses. While climate change raises ethical questions about its causes, impacts and social justice, medicine and bioethics typically focus on individual patients and research participants rather than these broader issues. We broaden this focus (...) by examining awareness among health-care providers in the Caribbean region, where geographic and socioeconomic features pose particular vulnerabilities to climate change. In focus groups, Caribbean providers described rises in mosquito-borne, flood-related, heat-related, respiratory and mental illnesses, and attributed these to local impacts of climate change. Their discussions showed that the significance of these impacts differs in different Caribbean nations, raising policy and social justice questions. Bioethics and public health ethics are situated to frame, inform and initiate public and policy dialog about values and scientific evidence associated with climate change. We urge readers to initiate such dialog within their own institutions about the context-dependent nature of the burdens of climate change, and values and policies that permit it to worsen. (shrink)

This article presents empirical data on the limited availability of hospice and palliative care to the 6 million people of the English-speaking Caribbean. Ten of the 13 nations therein responded to a survey and reported employing a total of 6 hospice or palliative specialists, and having a total of 15 related facilities. The evolving socioeconomic and cultural context in these nations bears on the availability of such care, and on the willingness to report, assess, and prioritize pain, and to prescribe (...) opiates for pain. Socioeconomics and culture also impinge on what medications and modalities of care are routinely available for pain or other conditions and can challenge professionalism, empathy, and responsiveness to patients’ unrelieved pain. Although all respondents report having a protocol for pain management, hospice, or end-of-life care, their annual medical use of opiates is well below the global mean. The International Narcotics Control Board , which monitors such use, encourages Caribbean and other low- and middle-income countries to increase their use of opiates to treat pain, and to overcome both unfounded fears of addiction and overly restrictive interpretation of related laws and regulations. Contextual considerations like those described here are important to the success of policies and capacity-building programs aiming to increase access to hospice and palliation, and perhaps to improving other aspects of health and healthcare. Exploring and responding to the realities of socioeconomic and cultural conditions will enhance public and policy dialogue and improve the design of interventions to increase access to palliative and hospice care. Improving access to palliative and hospice care in the Caribbean demonstrates beneficence and helps to fulfill human rights conventions. (shrink)

This empirical study investigates the effects of nine ethical climate types (self-interest, company profit, efficiency, friendship, team interest, social responsibility, personal morality, company rules and procedures, and lastly laws and professional codes) on employee work satisfaction. The ethical climate typology developed by Victor and Cullen (in W. C. Frederick (ed.) Research in Corporate Social Performance and Policy, 1987; Administrative Science Quarterly 33, 101–125, 1988) is tested on a sample of staff and managers from 62 different telecommunication firms in Turkey. The (...) results obtained from the 1174 usable questionnaires confirm the existence of nine different ethical climate types observed in western cultures in the present sample context, which is a developing Muslim country. Regarding the effects of ethical climatic factors on employee work satisfaction, self-interest climate type appears to negatively influence work satisfaction, whereas team interest, social responsibility and law and professional codes climate types are found to have positive impacts. Managerial and further research implications of the findings are discussed. (shrink)

Cognitive accounts of emotion agree that appraisal of situations or events with respect to their implications for one's well-being, goals, needs, and concerns, generate emotions (e.g., Frijda, 1986...

The purpose of this study was to determine the professional and personal values among midwifery students in Turkey and to identify whether the years of study affected these values. A total of 192 participants were asked to prioritize 16 professional and 36 personal values. The relationship between the year of study and value ranking was analyzed by Kruskal–Wallis test. The first three of the professional values were justice, equality, and human dignity. Equality ranked sixth among the personal terminal values, and (...) it increased with the years of study. Of personal instrumental values, responsibility and cleanliness ranked second and fifth, which are of central importance for the profession of midwifery. However, the other two important values, privacy and preventing unnecessary suffering, ranked lower when the years of study increased, in other words when the students confront clinics. Since these values are important for midwifery, ethics courses should be given throughout the midwifery education to prepare students for the challenges they face in the clinical environment. (shrink)

The aim of this study was to assess the opinions and role of intensive care unit (ICU) nurses regarding the distribution of ICU beds. We conducted this research among 30% of the attendees at two ICU congresses in Turkey. A self-administered questionnaire was used, which included 13 cases and allocation criteria. Of the total (136 nurses), 53.7% participated in admission/discharge decisions. The most important criterion was quality of life as viewed by the physician; the least important was the patient’s social (...) status. According to the findings, the nurses thought that medical benefit and avoiding discrimination were important. On the other hand their ignorance of patients’ autonomous preferences arouses suspicions about these nurses’ role in advocating for patients’ rights. For this reason, nurses’ role in allocation decisions should be clearly described and should also be the basis on which intensive care nurses’ duties in allocation decisions should be determined. (shrink)

When considering the principle of medical confidentiality, disclosure of genetic information constitutes a special case because of the impact that this information can have on the health and the lives of relatives. The aim of this study is to explore the attitudes of Turkish physicians and patients about sharing information obtained from genetic tests.

Background Undergraduate medical education is beginning to concern itself with educating students about professional attributes as well as about clinical knowledge and skills. Defining these characteristics, and in particular seeking the help of the students themselves to define them, can be a useful starting point when considering how to incorporate aspects of professional behaviour into the medical curricula. Method This study explores the views of first-year medical students at Kocaeli University Faculty of Medicine in the 2007–8 academic year. The students (...) were asked the open-ended question: ‘What, in your opinion, are the attributes a good physician should have?’ Four topics were defined by researchers based on the undergraduate and graduate education projects. The attributes expressed by the students were evaluated by the researchers according to these topics and compared with the topics covered in the undergraduate and graduate education projects. Results A total of 127 students responded, and between them suggested 756 attributes. The majority of these attributes (54.6%) were concerned with interpersonal relations and communication, whereas the category representing the fewest attributes (12.3%) was that involving scientific knowledge and medical practice. In general, students' perception corresponded to the concept of the ‘competent physician’ as described in the professionalism projects, but attributes reflecting their world-view were also expressed. Conclusion Experience suggests that the active participation of students in determining which attributes are necessary for a good physician is a positive way of ensuring they embrace the importance of such qualities and attributes in themselves. (shrink)

Background Several ethical issues are associated with providing living organ transplantation services, and there is limited information on these issues faced by the teams providing service to refugees or asylum seekers. Aim To determine the challenges healthcare professionals face in organ transplant centers providing services to Syrians under temporary protection status and discern whether these difficulties align with ethical issues in living organ transplantation. Research design This study employed a qualitative design and conducted individual semi-structured, in-depth interviews with 18 transplant (...) team members in Istanbul between September and November 2022. Data analysis was based on Braun and Clarke’s thematic analysis. Participants and research context The participants comprised 18 healthcare professionals, including 6 physicians and 12 nurses working in organ transplant teams in Istanbul. Ethical considerations The University’s Ethics Committee provided approval. Participants were informed regarding confidentiality and signed an informed consent form. Results Three themes emerged from the data on ethical issues faced by organ transplantation services to Syrians: (a) beneficence or double equipoise, (b) autonomy, and (c) justice. Transplant teams experience problems related to preserving double equipoise in the provision of living donor organ transplantation because of language barriers, poor socioeconomic conditions, and cultural factors, which increases transplant teams’ individual and indirect social burden. Although problems arise from the language barrier when obtaining informed consent in the autonomy theme, institutional and national policies in preventing donor abuse have a comforting effect. Health workers had the least problems with the justice theme, wherein national health policies are determined. Conclusion Fewer issues related to autonomy and justice were reported in providing organ transplantation services to Syrians, with the most intense reported issues being maintaining double equipoise. The results revealed the need to develop institutional, national, and international policies with individual solutions to prevent difficulties healthcare professionals face in this process. (shrink)

The present study aims to examine the mediator effect of organizational intelligence between quantum leadership and innovative behavior of employees in health organizations. It is aimed to examine the mediator effect of organizational intelligence between quantum leadership and innovative behavior of employees in health organizations. The data of the study were collected from 626 healthcare professionals working in hospitals and health centers in Istanbul, Turkey, by survey method. After the analysis of normality, validity and reliability, the hypotheses of the research (...) were tested on the LISREL program using the structural equal modelling. The findings have showed that the three hypotheses of the research were confirmed: quantum leadership and organizational intelligence affect the innovative behaviors of employees positively and significantly, and organizational intelligence has a mediator effect between quantum leadership and the innovative behavior of employees. It is imperative that healthcare organizations, which are likely to encounter chaos and crisis risks such as the Covid-19 pandemic, follow innovation in order to provide better quality services. Quantum leadership and organizational intelligence are necessities in terms of revealing innovative behavior for healthcare organizations operating in a dynamic and chaotic environment. Since the effects of quantum leadership have not been studied in health organizations adequately, this study makes a contribution to fill this gap. In addition, it is predicted that the findings of this research will be illuminating in terms of innovative behaviors and leadership styles for health organizations that have a vital importance in all societies and have recently experienced a fact like COVID-19. (shrink)

The aim of this study was to assess attitudes of intensive care nurses to selected ethical issues related to end-of-life decisions in paediatric intensive care units. A self-administered questionnaire was distributed in 2005 to intensive care nurses at two different scientific occasions in Turkey. Of the 155 intensive care nurse participants, 98% were women. Fifty-three percent of these had intensive care experience of more than four years. Most of the nurses failed to agree about withholding (65%) or withdrawing (60%) futile (...) treatment. In addition, 68% agreed that intravenous nutrition must continue at all costs. In futile treatment cases, the nurses tended to leave the decision to parents or act maternalistically. The results showed that intensive care nurses could ignore essential ethical duties in end-of-life care. We suggest that it is necessary to educate Turkish intensive care nurses about ethical issues at the end of life. (shrink)

During the last decade, the interaction based models have received increased attention in economics, mainly with the recognition that modeling aggregate patterns of behavior requires viewing individuals in their social environments continuously in interaction with each other. The existing literature suggests that statistical mechanics tools can be useful to model interactions among economic agents. In addition to statistical mechanics, the network approach has also gained popularity, as is evident in the rising attention attributed to small world models and scale free (...) network topologies. These developments point to the fact that interdisciplinary research in economics, mainly using the tools of physics has accelerated to a great extent. In this paper, we review the analogies made between molecules and economic agents in statistical mechanics models, as they are utilized in economics literature. We perform a simulation study by using the small world model and statistical mechanics, to demonstrate the influence of network structure in the spreading of organizational forms, in particular the research collaboration decisions of firms. (shrink)

The review of literature on stakeholders reveals that there is need to understand more about firm-stakeholder relationships especially from stakeholders’ point of view. Market integration in the European Union (EU) provides an excellent context for increasing such understanding since it is creating opportunities and threats for firms and their stakeholders. This research aims to make a contribution in this direction by analyzing strategic responses of primary stakeholders to selected threat events in the history of Volkswagen (VW) since 1960.

The dynamics and fusion of multiple media into one space has been thoroughly studied by Frederick J. Kiesler. His investigations into a multi-dimensional, space are in fact the beginnings of what would become a radically new concept of form and content appropriately called ‘Endless Space’. In the 1930s entitled the ‘Correalist Theory’ believes that the essence of reality is not in the ‘thing’ itself, but in the way it correlates and orders itself to its environment, to its spatial dynamics and (...) to its atmosphere. Kiesler also deemed that it was essential to disregard the boundaries that separate the different arts and media. These boundaries needed to be dissolved and proclaimed that painters, sculptors and designers, driven away by functionalism, would return from exile to be welcomed by architecture. Since his death in 1965, his notion of Endless Space and his studies ‘On correalism and biotechnique’ in particular, have resurfaced in recent art discourse. New technologies have emerged that are now provoking different questions regarding the techno-ethics of integrated biotech and post-digital tectonic potentials that withhold the concept of an ubiquitous and synaesthetic space. (shrink)

In developing countries, the patriarchal social construct, unsatisfactory legal protection, and underlying cultural bias against women have resulted in increasing intimate partner violence, which largely goes unaddressed, undocumented, and unreported in healthcare settings. This case study presents a common scenario of intimate partner violence and carefully analyzes its ethical implications in an emergency case at a tertiary care hospital in Karachi, Pakistan. In this study, basic ethical principles are used to discuss important ethical challenges faced daily by healthcare workers in (...) the medical, social, and legal context. It further highlights the dire need of patient education, safety, and a solid framework for addressing, documenting, and reporting intimate partner violence for healthcare workers. (shrink)

Evidence proves that physician involvement in torture is widely practiced in society. Despite its status as an illegal act as established by multiple international organizations, mandates are routinely unheeded and feebly enforced. Philosophies condemning and condoning torture are examined as well as physicians’ professional responsibilities and the manner in which such varying allegiances can be persuasive. Physician involvement in torture has proven detrimental to the core values of medicine and has tainted the field’s commitment to individuals’ health and well-being. Only (...) when this complex issue is addressed using a multilevel approach will the moral rehabilitation of medicine begin. (shrink)