Background Encounters of moral distress have long-term consequences on healthcare workers’ physical and mental health, leading to job dissatisfaction, reduced patient care, and high levels of burnout, exhaustion, and intentions to quit. Yet, research on approaches to ameliorate moral distress across the health workforce is limited. Research Objective The aim of our study was to qualitatively explore multi-professional perspectives of healthcare social workers, chaplains, and patient liaisons on ways to reduce moral distress and heighten well-being at a southern (...) U.S. academic medical center. Participants & Research Context Purposive sampling and chain-referral methods assisted with recruitment through hospital listservs, staff meetings, and newsletters. Interested participants contacted the principal investigator and all interviews were conducted in-person. Consent was attained prior to interviews. All interviews were recorded and transcribed verbatim. Research Design Directed content analysis was used to deductively organize codes and to develop themes in conjunction with the National Academy of Medicine’s National Plan for Health Workforce Well-Being. Rigor was attained through peer-debriefing, data triangulation methods, and frequent research team meetings. Ethical Considerations Ethics approval was obtained from the university and medical center institutional review boards. Findings Themes demonstrate that rather than offering interventions in the aftermath of moral distress, multilevel daily practices ought to be considered that pre-emptively identify and reduce morally distressing encounters through (1) the care team, (2) management and leadership, and (3) the health care industry. Strategies include interdisciplinary decision-making, trusting managerial relationships, and organizational policies and practices that explicitly invest in mental health promotion and diverse leadership opportunities. Conclusion Moral distress interventions ought to target short-term stress reactions while also addressing the long-term impacts of moral residue. Health systems must financially commit to an ethical workplace culture that explicitly values mental health and well-being. (shrink)

Introduction The starting point is that ethical competence is the basis for ethical healthcare practices and quality of care. Simultaneously, there is a need for research and development from a holistic multi-professional perspective. Aim The aim is to create a proposed model for multi-professional ethical competence grounded in clarified meanings and dimensions of ethical competence studied from a multi-professional healthcare perspective. The research questions are, what is ethical competence from a multi-professional healthcare (...) perspective and what strengthens a multi-professional ethical healthcare practice? Research design The research has a qualitative approach and hermeneutic application research design. Two groups with six participants from clinical practice and two scientific researchers in each group met four times for dialogue. Thematic analysis was used as an analysis method. Ethical considerations The research is approved by the Declaration of Helsinki, the General Data Protection Regulations, and ethical permission was asked from the Norwegian Centre for Research Data (NSD). Results The proposed model for multi-professional ethical competence encompasses a three-dimensional ethical value base that is underpinned by: Ethical attitude – a personal desire to do good; Ethical basis – the best for the patient as a common goal and Ethical culture – common goals and values in the organization. Multi-professional ethical competence is strengthened by: Reflection – to see with new wondering eyes; Time for talk – interdisciplinary teamwork and Leadership – an ethical role model and support. Discussion Ethical competence has a strong link to the core of caring ethics and a deeper personal value base and attitude. Ethical competence involves the whole culture and is seen as a shared value base and a responsibility to do the best for the patient as a multi-professional team and organization. Ethical competence becomes active in healthcare practice by opening up for meaningful multi-professional talks and reflections. (shrink)

The ethics sections of Critical Care Societies have issued position statements and proposed a variety of position papers and policies describing the appropriate use of critical care services. These policies describe the goals of critical care provision — to support a patient through an acute, potentially reversible, life-threatening illness — and provide broad guidance on physiological and hemodynamic criteria that require the specialized care of an ICU environment. In recent years, many critical care professionals have, however, reported providing care they (...) felt was inappropriate or futile even though most felt they should not have done so. Futile care encompasses treatments that will not work or treatments that have no chance of providing any benefit. ICU teams define care as inappropriate when it fails to restore a person to an awareness of self, and an ability to interact with their environment particularly when a lot of critical care resources are required. When patients experience significant amounts of pain and suffering, such care seems even more inappropriate. (shrink)

Multiprofessional guidelines for fair access to and use of adult critical care services are desperately needed to define a consistent transparent standard of care: when such therapies have the potential to benefit and help a patient as they journey with illness and when they cannot.

Background Escalating levels of obesity place enormous and growing demands on Health care provision in the (U.K.) United Kingdom. Resources are limited with increasing and competing demands upon them. Ethical considerations underpin clinical decision making generally, but there is limited evidence regarding the relationship between these variables particularly in terms of treating individuals with obesity. Research aim To investigate the views of National Health Service (NHS) clinicians on navigating the ethical challenges and decision making associated with obesity management in adults (...) with chronic illness. Research design A cross-sectional, multi-site survey distributed electronically. Participants A consensus sample of nurses, doctors, dietitians and final year students in two NHS Trusts and two Universities. Ethical considerations Ethical and governance approvals obtained from a National Ethics Committee (11NIR035), two universities and two teaching hospitals. Results Of the total ( n = 395) participants, the majority were nurses (48%), female (79%) and qualified clinicians (59%). Participants strongly considered the individual to have primary responsibility for a healthy weight and an obligation to attempt to maintain that healthy weight if they wish to access NHS care. Yet two thirds would not withhold treatment for patients with obesity. Discussion While clinicians were clear about patient responsibility and obligations, the majority prioritised their duty of care and would not invoke a utilitarian approach to decision making. This may reflect awareness of obesity as a multi-faceted entity, with responsibility for support and management shared amongst society in general. Conclusions The attitudes of this sample of clinicians complemented the concept of the health service as being built on a principle of community, with each treated according to their need. However limited resources challenge the concept of needs-based decisions consequently societal engagement is necessary to agree a pragmatic way forward. (shrink)

In this paper, we propose a new hybrid neutrosophic multi criteria decision making (MCDM) framework that employs a collection of neutrosophic analytical network process (ANP), and order preference by similarity to ideal solution (TOPSIS) under bipolar neutrosophic numbers. The MCDM framework is applied for chief executive officer (CEO) selection in a case study at the Elsewedy Electric Group, Egypt. The proposed approach allows us to assemble individual evaluations of the decision makers and therefore perform accurate personnel selection. The outcomes (...) of the proposed method are compared with those of the related works such as weight sum model (WSM), weight product model (WPM), analytical hierarchy process (AHP), multiobjective optimization based on simple ratio analysis (MOORA) and ANP methods to prove and validate the results. (shrink)

This paper provides practitioner and academic insights into the importance of examining non-technical skills in a multiteam system emergency response. The case of public health professionals is highlighted, illustrated with unique qualitative field data which focused upon the use of non-technical skills at a meso level of analysis. Results reflected the importance of context upon the multiteam system and highlighted seven non-technical skills used by public health professionals to support an effective response. Recommendations for future research and implications for practice (...) are noted for this hard to access professional group, located within emerging advances in the scientific inquiry of complex and increasingly evident, multi-team systems. (shrink)

In recent years, much discussion has taken place regarding the social role of firms and their responsibilities to society. In this context, the role of universities is crucial, as it may shape management students’ attitudes and provide them with the necessary knowledge, skills and critical analysis to make decisions as consumers and future professionals. We emphasise that universities are multi-level learning environments, so there is a need to look beyond formal curricular content and pay more attention to implicit dimensions (...) of the learning process in order to create significant learning. With this in mind, we propose an integrative and holistic approach to guide the integration of ethics, corporate social responsibility and sustainability in management education that aims to improve students’ knowledge and attitudes. In this model, we consider three interdependent levels of analysis–the institutional level, the curricular level and the instrumental level–which together produce a leverage effect on student learning. For each level, we identify the main issues and aspects that need to be considered, based on an extensive literature review in this field. (shrink)

Artificial intelligence (AI) has garnered tremendous attention in health care, and many hope that AI can enhance our health system’s ability to care for people with chronic and degenerative conditions, including Parkinson’s Disease (PD). This paper reports the themes and lessons derived from a qualitative study with people living with PD, family caregivers, and health care providers regarding the ethical dimensions of using AI to monitor, assess, and predict PD symptoms and progression. Thematic analysis identified ethical concerns at four intersecting (...) levels: personal, interpersonal, professional/institutional, and societal levels. Reflecting on potential benefits of predictive algorithms that can continuously collect and process longitudinal data, participants expressed a desire for more timely, ongoing, and accurate information that could enhance management of day-to-day fluctuations and facilitate clinical and personal care as their disease progresses. Nonetheless, they voiced concerns about intersecting ethical questions around evolving illness identities, familial and professional care relationships, privacy, and data ownership/governance. The multi-layer analysis provides a helpful way to understand the ethics of using AI in monitoring and managing PD and other chronic/degenerative conditions. (shrink)

Appropriate and balanced decision-making is sentinel to goal setting and the provision of appropriate clinical care that are attuned to preserving the best interests of the patient. Current family-led decision-making in family-centric societies such as those in Singapore and other countries in East Asia are believed to compromise these objectives in favor of protecting familial interests. Redressing these skewed clinical practices employing autonomy-based patient-centric approaches however have been found wanting in their failure to contend with wider sociocultural considerations that impact (...) care determinations. Evaluation of a number of alternative decision-making frameworks set out to address the shortcomings of prevailing atomistic and family-centric decision-making models within the confines of end-of-life care prove these alternative frameworks to be little better at protecting the best interests of vulnerable patients. As a result, we propose the Welfare Model that we believe is attentive to the relevant socio-culturally significant considerations of a particular case and better meets the needs of end-of-life care goals of preserving the welfare of patients. Employing a multi-professional team evaluation guided by regnant psychosocial, legal, and clinical standards and the prevailing practical and clinical realities of the particular patient’s setting the Welfare Model provides a clinically relevant, culturally sensitive, transparent, and evidence-based approach to care determinations. (shrink)

Automatized scalable healthcare support solutions allow real-time 24/7 health monitoring of patients, prioritizing medical treatment according to health conditions, reducing medical appointments in clinics and hospitals, and enabling easy exchange of information among healthcare professionals. With recent health safety guidelines due to the COVID-19 pandemic, protecting the elderly has become imperative. However, state-of-the-art health wearable device platforms present limitations in hardware, parameter estimation algorithms, and software architecture. This paper proposes a complete framework for health systems composed of multi-sensor wearable (...) health devices, high-resolution parameter estimation, and real-time monitoring applications. The framework is appropriate for real-time monitoring of elderly patients' health without physical contact with healthcare professionals, maintaining safety standards. The hardware includes sensors for monitoring steps, pulse oximetry, heart rate, and temperature using low-power wireless communication. In terms of parameter estimation, the embedded circuit uses high-resolution signal processing algorithms that result in an improved measure of the HR. The proposed high-resolution signal processing-based approach outperforms state-of-the-art HR estimation measurements using the photoplethysmography sensor. (shrink)

Responsibility and professionalism are increasingly issues of concern for professional associations, employers and educators alike. When bad things happen, professionals are often held personally accountable for complex situations. Professional Responsibility and Professionalism advances our approaches to professional responsibility from individual-centred, virtue-based prescriptions towards understanding and responding effectively to the multifaceted challenges encountered today by professionals working in dynamic complexity. The author applies a sociomaterial examination to specific examples drawn from different professional contexts of practice. She examines (...) important implications for what professional responsibility and accountability might mean individually and collectively, and what it might be becoming when demands increasingly conflict, and when we accept that capacities for action are performed into existence in emergent and precarious webs of both human and non-human forces. The chapters explore some of the most prominent questions in professional responsibility, including: What does professional responsibility, and accountability, mean in the escalating complexities and conflicts confronting today's professionals? How does professional responsibility become developed and enacted, and through what social and material entanglements? How should responsibility be determined in multi-agency and interprofessional practice? What happens when professional decisions are delegated to software algorithms and diagnostic instruments? How are new governing regimes of professional work, such as innovation imperatives, excessive audit and logics of blame and scapegoating, reconfiguring responsibility? How can professionals respond simultaneously to individuals in need, the obligations of their profession, the demands of their employer and an anxious society? A major concern addressed by each chapter, and the book as a whole, is educating professionals in and for responsibility. Specific dilemmas and strategies are offered for educators in universities, workplaces and professional development contexts who seek new approaches to helping professionals learn to critically understand and practise responsibility today. This book will appeal to a wide audience of education researchers and post-graduate students studying professional practice, professionalism and education across a wide range of disciplines. Health professionals, professionals working in private practices, such as law, architecture and engineering, newer professions such as social work and policing, and educational professionals at all levels will find stories and strategies reflecting key issues of their practice in this detailed exploration of professional responsibility and accountability. (shrink)

Teaching sustainability from the “inside-out” means starting at the level of individual students, progressing to organizational responsibilities, and lastly arriving at system-wide responsibilities.

Prior research has shown the importance of institutional pressures in investigating corporate environmental behaviour. To date, the literature has been lacking in survey-based reflective measures of institutional pressures. This paper focuses on the development of reflective measures of coercive, mimetic, and normative isomorphism.

Abstract Aim: The COVID-19 infection is transmitted either by human-to-human contact, social-physical contact, and respiratory droplets or by touching items touched by the infected. This has triggered some conflicted behaviors such as stigma, violence, and opposite behavior applause. The aim of this study is to explore several newspaper articles about stigma, violence, or insensitive behavior against healthcare professionals and to analyze the reason for these behaviors during these COVID-19 pandemics. Method: The website of the Turkish Medical Association "Press Releases News" (...) and online newspaper articles have been scanned using keywords and have been classified and analyzed according to the content of articles between the periods of March 11 to April 28, 2020. This is a qualitative study with content analysis. No official ethical permission was obtained as the study was conducted through open access internet news sites. Result: 16 reports were selected from online reports that matched the keywords of the study. 13 of these reports included desensitization, violence, lack of precaution, stigmatization, and applause, and 3 reports included doctors’ statements. After being categorized, content analyses were conducted. Conclusion: This study revealed the necessity of a multi-faceted evaluation of the problems faced by healthcare professionals who are at the forefront of the COVID-19 outbreak. This study has a primary role in the detection, diagnosis, and treatment of the pandemic and reveals that doctors are trying to fulfill their duties in an ethical framework despite stigmatized behavior. Authorities should provide various supports to protect healthcare professionals before, during, and after the epidemic for the success of the COVID-19 outbreak struggle. (shrink)

When heterogeneous players make strategic investment decisions in multi-stage contests, they might conserve resources in a current contest to spend more in a subsequent contest, if the degree of heterogeneity in the current contest is sufficiently large. We confirm these predictions using data from German professional soccer, in which players are subject to a one-match ban if they accumulate five yellow cards. Players with four yellow cards facing the risk of being suspended for the next match are less (...) likely to be fielded when the heterogeneity in the current match increases and more likely to receive a fifth yellow card in the current match when heterogeneity in the next match increases or heterogeneity in the next match but one decreases. (shrink)

The Malaysian society, one of the successful and managed multi-ethnic societies, is replete of imbalances and there still underlie the racial and ethnic disproportions in geographical dwellings, educational and professional fields, and economic and political roles. The modern racial relation in Malaysia is the legacy of pre-colonial and colonial period of history dating back to fifteenth and sixteenth centuries. The unstable demographic balance, the unrestricted immigration policy or the policy of divide and rule by the colonial masters contributed (...) besides other reasons toward the troubled relations between ethnic communities of Malaysia- Malays, Chinese, Indians, and others. But the way the respective Malaysian governments have managed such sour relationship in their socio-economic and political spheres is the lesson that all multiethnic states can learn from. (shrink)

Freedom of Conscience and Freedom of Religion should be taken to protect two distinct sets of moral considerations. The former protects the ability of the agent to reflect critically upon the moral and political issues that arise in her society generally, and in her professional life more specifically. The latter protects the individual's ability to achieve secure membership in a set of practices and rituals that have as a moral function to inscribe her life in a temporally extended narrative. (...) Once these grounds are distinguished, it becomes more difficult to grant healthcare professionals' claims to religious exemptions on the basis of the latter than it is on the basis of the former. While both sets of considerations generate ‘internal reasons’ for rights to accommodation, the relevant ‘external’ reasons present in the case of claims of moral conscience do not possess analogues in the case of claims of religious conscience. However, the argument applies only to ‘irreducibly religious’ claims, that is to claims that cannot be translated into moral vocabulary. What's more, there may be reasons to grant the claims of religious persons to exemptions that have to do not with the nature of the claims, but with the beneficial effects that the presence of religious persons may have in the context of the healthcare institutions of multi-faith societies. (shrink)

In a globalizing world, governments are not always able or willing to regulate the social and environmental externalities of global business activities. Multi-stakeholder initiatives (MSI), defined as global institutions involving mainly corporations and civil society organizations, are one type of regulatory mechanism that tries to fill this gap by issuing soft law regulation. This conceptual paper examines the conditions of a legitimate transfer of regulatory power from traditional democratic nation-state processes to private regulatory schemes, such as MSIs. Democratic legitimacy (...) is typically concerned with input legitimacy (rule credibility, or the extent to which the regulations are perceived as justified) and output legitimacy (rule effectiveness, or the extent to which the rules effectively solve the issues). In this study, we identify MSI input legitimacy criteria (inclusion, procedural fairness, consensual orientation, and transparency) and those of MSI output legitimacy (rule coverage, efficacy, and enforcement), and discuss their implications for MSI democratic legitimacy. (shrink)

In a globalizing world, governments are not always able or willing to regulate the social and environmental externalities of global business activities. Multi-stakeholder initiatives (MSI), defined as global institutions involving mainly corporations and civil society organizations, are one type of regulatory mechanism that tries to fill this gap by issuing soft law regulation. This conceptual paper examines the conditions of a legitimate transfer of regulatory power from traditional democratic nation-state processes to private regulatory schemes, such as MSIs. Democratic legitimacy (...) is typically concerned with input legitimacy (rule credibility, or the extent to which the regulations are perceived as justified) and output legitimacy (rule effectiveness, or the extent to which the rules effectively solve the issues). In this study, we identify MSI input legitimacy criteria (inclusion, procedural fairness, consensual orientation, and transparency) and those of MSI output legitimacy (rule coverage, efficacy, and enforcement), and discuss their implications for MSI democratic legitimacy. (shrink)

This article reports the findings of a qualitative study that explored the organizational influences on moral distress for health professionals working in pediatric intensive care units across Canada. Participants were recruited to the study from PICUs across Canada. The PICU is a high-tech, fast-paced, high-pressure environment where caregivers frequently face conflict and ethical tension in the care of critically ill children. A number of themes including relationships with management, organizational structure and processes, workload and resources, and team dynamics were identified. (...) This study provides a rare and important multi-disciplinary perspective on this topic and the findings have implications for administrators and leaders who seek to improve the moral climate of healthcare delivery. (shrink)

This encyclopedia, edited by the past editors and founder of the Journal of Business Ethics, is the only reference work dedicated entirely to business and professional ethics. Containing over 2000 entries, this multi-volume, major research reference work provides a broad-based disciplinary and interdisciplinary approach to all of the key topics in the field. The encyclopedia draws on three interdisciplinary and over-lapping fields: business ethics, professional ethics and applied ethics although the main focus is on business ethics. The (...) breadth of scope of this work draws upon the expertise of human and social scientists, as well as that of professionals and scientists in varying fields. This work has come to fruition by making use of the expert academic input from the extraordinarily rich population of current and past editorial board members and section editors of and contributors to the Journal of Business Ethics. (shrink)

Objective Moral distress is a complex phenomenon experienced by healthcare professionals. This study examined the relationships between key dimensions of Organizational Culture in Healthcare (OCHC)—perceived psychological safety, ethical climate, patient safety—and healthcare professionals’ perception of moral distress.Design Cross-sectional surveySetting Pediatric and adult critical care medicine, and adult hospital medicine healthcare professionals in the United States.Participants Physicians (n = 260), nurses (n = 256), and advanced practice providers (n = 110) participated in the study.Main outcome measures Three dimensions of OCHC were (...) measured using validated questionnaires: Olson’s Hospital Ethical Climate Survey, Agency for Healthcare Research and Quality’s Patient Safety Culture Survey, and Edmondson’s Team Psychological Safety Survey. The perception of moral distress was measured using the Moral Distress Amidst a Pandemic Survey. The hypothesized relationships between various dimensions were tested with structural equation modeling (SEM).Results Adequate model fit was achieved in the SEM: a root-mean-square error of approximation =0.072 (90% CI 0.069 to 0.075), standardized root mean square residual = 0.056, and comparative fit index =0.926. Perceived psychological safety (β= −0.357, p <.001) and patient safety culture (β = −0.428, p<.001) were negatively related to moral distress experience. There was no significant association between ethical climate and moral distress (β = 0.106, p = 0.319). Ethical Climate, however, was highly correlated with Patient Safety Culture (factor correlation= 0.82).Conclusions We used structural equation model to test a theoretical model of multi-dimensional organizational culture and healthcare climate (OCHC) and moral distress.Significant associations were found, supporting mitigating strategies to optimize psychological safety and patient safety culture to address moral distress among healthcare professionals. Future initiatives and studies should account for key dimensions of OCHC with multi-pronged targets to preserve the moral well-being of individuals, teams, and organizations. (shrink)

Principles of autonomy and self-determination have been upheld as vital to modern-day medical and ethical practice. However, the complexities of current health care and changes in the expectation of some patients and their families justify a review of such concepts. Their limitations and relativities may suggest that other descriptions of partnership and negotiated goal-setting, while based on respect for autonomy, reflect more modern and ideal multi-disciplinary practices. Discussion should extend beyond the 'classic' participants of patient and doctor to a (...) more realistic picture where other health carers are included. It is therefore apposite that other professional relationships are considered as they affect areas of doctors' and patients' responsibilities. Such partnership between members of the team may not be without problems and conflict, but the principle of negotiated agreements could result in more long-term harmony, and greater patient welfare. (shrink)

Within the context of structural theories this paper examines what health professionals say about their clinical service structures. We firstly trace various conceptual perspectives on clinical service structures, discussing multiple theoretical axes. These theories question whether clinical service structures represent either superficial or more profound changes in hospitals. We secondly explore which view is supported though a content analysis of the free text responses of 111 health professionals (44 doctors, 45 nurses and 22 allied health practitioners) about their clinical service (...) structures in a questionnaire survey in two large hospitals that had implemented clinical service structures three years previously. Commentaries unfavourable toward clinical service structures were made by 47.7% of staff, favourable by 24.3%, mixed (both favourable and unfavourable) by 17.1% and non-evaluative statements were made by 10.8%. The most frequent criticisms were inefficient organisation of change (27%), poor management (24.3%), lack of cooperation between staff (15.9%) and failure to empower health practitioners (13.5%). All professions made more negative than positive evaluations of their clinical service structures but the ratio was highest for doctors and lowest for allied health. Ranking of nurses' and allied health staffs' specific evaluations were similar but both differed significantly from doctors.' Unfavourable or negative comments predominated, and change appears more superficial and less profound than advocates of structural contributions hope. Four types of belief systems about clinical service structures are apparent. Some study participants are disposed toward the status quo; others toward restructuring; yet others are team oriented; and a final group is tribally oriented. The implication of this paper for managers is that more work is needed if clinical service structures are to realise the promise of more multi-disciplinarity and less fragmentation across professional groups. For scholars, the implication is that marrying different theoretical frames with empirical data can serve to produce fresh perspectives and perhaps new insights. (shrink)

The professional training of pastoral therapists has been a topic of controversy for many years in South Africa. Up to date, the training of pastoral workers has been limited to the study of ministry and as such is limited by the primary aims and outcomes of this curriculum. In a post-apartheid, post-colonial South Africa, the need for pastoral workers is intensified by the needs of community- and faith-based organisations for trained and registered therapists to alleviate the counselling needs of (...) their beneficiaries on all social levels. This article discusses the current state of affairs of the training and curriculum related to the profession of pastoral therapy in the context of South Africa, the various sociopolitical and religious needs that are still left unanswered in the field, and makes recommendations for the registration and accreditation of the profession with a specific curriculum focused on multicultural, multi-spiritual and post-modern nuances. The author argues that such a curriculum, accredited by a statutory body, can operate as a national health resource, will be more cost-effective than other related health services and may transform the social justice landscape related to both the providers and beneficiaries of this type of care. (shrink)

Purpose Computing ethics represents a long established, yet rapidly evolving, discipline that grows in complexity and scope on a near-daily basis. Therefore, to help understand some of that scope it is essential to incorporate a range of perspectives, from a range of stakeholders, on current and emerging ethical challenges associated with computer technology. This study aims to achieve this by using, a three-pronged, stakeholder analysis of Computer Science academics, ICT industry professionals, and citizen groups was undertaken to explore what they (...) consider to be crucial computing ethics concerns. The overlap between these stakeholder groups are explored, as well as whether their concerns are reflected in the existing literature. Design/methodology/approach Data collection was performed using focus groups, and the data was analysed using a thematic analysis. The data was also analysed to determine if there were overlaps between the literature and the stakeholders’ concerns and attitudes towards computing ethics. Findings The results of the focus group analysis show a mixture of overlapping concerns between the different groups, as well as some concerns that are unique to each of the specific groups. All groups stressed the importance of data as a key topic in computing ethics. This includes concerns around the accuracy, completeness and representativeness of data sets used to develop computing applications. Academics were concerned with the best ways to teach computing ethics to university students. Industry professionals believed that a lack of diversity in software teams resulted in important questions not being asked during design and development. Citizens discussed at length the negative and unexpected impacts of social media applications. These are all topics that have gained broad coverage in the literature. Social implications In recent years, the impact of ICT on society and the environment at large has grown tremendously. From this fast-paced growth, a myriad of ethical concerns have arisen. The analysis aims to shed light on what a diverse group of stakeholders consider the most important social impacts of technology and whether these concerns are reflected in the literature on computing ethics. The outcomes of this analysis will form the basis for new teaching content that will be developed in future to help illuminate and address these concerns. Originality/value The multi-stakeholder analysis provides individual and differing perspectives on the issues related to the rapidly evolving discipline of computing ethics. (shrink)

The aquatic, the virtual and the zero-gravity medium share some similarities in the way they are experienced by human beings. Present-day realities are uncertain and fluid. As the term ‘Aquaponics’ refers to agriculture and suggest a very static process, I would advance that the metaphors of travel and movement should be more appropriate to describe today’s challenges regarding the exploration and understanding of those medium. I have included in this article a personal interview with Dr Sarah Jane Pell, a researcher, (...) Artist and professional diver, in order to gain some perspectives on the testimonies of Kitsou Dubois, a French Choreographer who conducted zero-gravity performances. Based on their statements, I give further in the text an insight on my personal practice of Aikido, a Japanese martial art and mind–body harmonization technique. Using references from popular Culture, my own experiences and the testimonies of Kitsou Dubois and Dr Sarah Jane Pell, as well as examples taken from ancestral spiritual traditions from around the world, I try to draw a map of contemporary and multi-scalar realities with a critical approach to the concept of aquaponics. (shrink)

This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support (...) the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy. (shrink)

In exploring his concept of interactional expertise in the context of managers of big science projects, Collins identifies the development and deployment tacit knowledge as central, but acknowledges that sociologically, he cannot probe the concept further in developmental or pedagogical directions. In using the term tacit knowledge, Collins relies on the concept as articulated by Michael Polanyi. In coining the term, Polanyi acknowledges his reliance on Heidegger’s concept of being-in-the-world. This paper explores how Polanyi, and so Collins, fails to adequately (...) ground the idea of the tacit in Heidegger’s hermeneutic phenomenology. In so doing, it employs a rereading of Being and Time to phenomenologically resituate the tacit. This resituating of the tacit allows us to go further than Collins in providing developmental and pedagogical approaches to the tacit in the context of the kind of interactional expertise that may be employed to enhance the effectiveness of collaborative, multi-and interdisciplinary teams like those found in team science and in professional settings like healthcare management. As illustrative, the paper provides an example of this resituated understanding of the tacit in the author’s work teaching in a multidisciplinary healthcare management program. (shrink)

All around the world in March, due to COVID-19, competitive sport calendars were suddenly canceled, jeopardizing the training programs of athletes. Moreover, in Italy, the government banned all non-essential travel across the entire country from the beginning of March. Consequently, Italian cyclists were banned from leaving their homes and therefore unable to perform their ordinary training activities. The Italian Association of Professional Cyclists early on during that period noticed that several cyclists were experiencing a worrying decrease in their mental (...) well-being and asked the authors to set up an online Sport Psychology Intervention during lockdown to enhance the athletes' mental health. Through a number of unprecedented events and considerations, the aim of the current investigation was to assess the Italian cyclists' mental health during the lockdown and its changes after the SPI. We validated the Italian version of the Sport Mental Health Continuum Short Form —presented in Study 1—and then applied it to a sample of Italian professional cyclists—presented in Study 2—prior to and after the SPI. To achieve these objectives, the reliability and construct validity of the Italian version of the Sport MHC-SF were tested in Study 1. RM-MANOVA tests were run to evaluate the effect of SPI on cyclists in Study 2. A total of 185 Italian athletes were involved in the validation of the MHC in Study 1 and 38 professional cyclists in Study 2. Results from Study 1 suggested a three-factor higher order model of Sport MHC-SF [Model fit: χ2 = 471.252, p < 0.000; CFI = 0.951; RMSEA = 0.049; RMR= 0.048]. MCFA showed that the default model kept invariance among groups of athletes. Results from Study 2 highlighted that professional cyclists who followed the SPI were able to cope better with psychological stressors, showing improved well-being compared to the athletes that did not. No significant differences were found for emotional and social well-being. The present multi-study paper contributes to the theoretical field with a validated measure of Sport MHC-SF translated in the Italian language and culture. It also provides practical implications related to cases of reduced mental health due to injury, illness, or similar situations of home confinement in the future. (shrink)

This paper describes the results of several large empirical studies that investigated the impact of social product attributes on consumer purchase intentions. Our results show that some consumers are willing to pay for more socially acceptable products, but that most of those consumers do not think about the social product features of the products they purchase. Furthermore, our analyses demonstrate that consumers can be segmented based on their preferences for (or against) social product features and that these segments are not (...) country-specific. (shrink)

Moral distress is a well-documented phenomenon for health care providers (HCPs). Exploring HCPs’ perceptions of participation in moral distress interventions using qualitative and quantitative methods enhances understanding of intervention effectiveness. The purpose of this study was to measure and describe the impact of a two-phased intervention on participants’ moral distress. Using a cross-over design, the project aimed to determine if the intervention would decrease moral distress, enhance moral agency, and improve perceptions about the work environment. We used quantitative instruments and (...) explored participants’ perceptions of the intervention using semi-structured interviews. Participants were from inpatient settings, within three major hospitals of a large, urban healthcare system in the Midwest, United States. Participants included nurses (80.6%) and other clinical care providers. Using generalized linear mixed modeling we assessed the change in each of the outcome variables over time controlling for groups. Interviews were audiotaped and professionally transcribed. The written narratives were coded into themes. The change in scores on study instruments trended in the desired direction however did not meet statistical significance. Qualitative interviews revealed that intervention effectiveness was derived from a combination of learning benefits, psychological benefits, and building community that promoted moral agency. Findings demonstrate a clear link between moral distress and moral agency and suggest that Facilitated Ethics Conversations can enhance the work environment. Findings provide insight for developing evidenced-based approaches to address moral distress of hospital nurses. (shrink)

Multi-stakeholder initiatives for biodiversity conservation on working landscapes often necessitate strategies to facilitate learning in order to foster successful collaboration. To investigate the learning processes that both undergird and result from collaborative efforts, this case study employs the concept of boundary work as a lens to examine learning between rice growers and conservation professionals in California’s Central Valley, who were engaged in a collaborative research project focused on migratory bird conservation. Through analysis of workshop observations, project documents, and interviews (...) with rice growers and conservation professionals, we identified five distinct factors of the collaborative research process that influenced learning amongst these two groups: having mutually beneficial goals, sharing ownership of the collaborative research process, building trust, integrating knowledge, and institutional alignment. We also examined and identified learning outcomes for both rice growers and conservation professionals, which included new knowledge of the social-ecological system, new practices around farming and collaboration, and shifting identities. Our findings suggest that applying these factors and outcomes for learning when structuring collaborative research, and other multi-stakeholder initiatives, can foster learning amongst diverse stakeholder groups to support new approaches for balancing resource use and adaptive management. (shrink)

The impact of business ethics education on socially responsible practitioner behavior is not a new concern. A sizable extant literature base questions pedagogies used and outcomes achieved by the few early studies done in this area. Ensuing research has not produced definitive answers; measurement, methodological, and generalizability issues are prevalent due to the fragmented nature of most work. Given little pre-existing structure, an empirically-based model is needed which both sheds more awareness on the ethics education-business conduct relationship and quantifies the (...) degree of change that the education caused. This study operationalizes a multi-level ethical learning model. Using a survey administered at the start and end of an MBA ethics course,subsequent exploratory factor analysis, a matched t-test of pre and post-course mean scores, and an effect size calculation utilizing the Cohen’s d statistic, the existence of varying degrees of change in ethical outlook after formal ethics education is supported. Model enhancements and the potential for longitudinally following ethical learning from the classroom to the workplace are discussed. (shrink)

In this article, we examine patterns of negotiation in multi-party decision making in social work. We draw on Strauss’ theory of negotiated order and a discourse analytical approach, seeking to gain insight into the complex accomplishment of making a decision in an inter-professional and multi-party setting. Working with data from 97 team meetings in a social work setting, we identify two patterns of negotiation in talk: expanding and postponing. ‘Expanding’ covers a group of interactional actions involving turn-taking (...) and closure, while ‘postponing’ includes a group of actions whereby assessments or topics are avoided or made irrelevant. Both are examples of the complex ways in which team members negotiate both the institutional order and the decision to be made in the specific case in situ. (shrink)

This paper argues for the existence of two levels of stakeholder dialogue: a micro and a macro level. The first is the one companies have with their own stakeholder groups, the second is a broader social debate among different agents about the role of business in society. The paper argues why the macro level matters for CSR and why it can be called a dialogue. It also underlines the importance of mutual perceptions in the macro-dialogue. For this purpose we present (...) a research done in Spain about how different stakeholder groups perceive each other in relation to CSR and how they perceive the dialogue process. (shrink)

This paper describes the results of several large empirical studies that investigated the impact of social product attributes on consumer purchase intentions. Our results show that some consumers are willing to pay for more socially acceptable products, but that most of those consumers do not think about the social product features of the products they purchase. Furthermore, our analyses demonstrate that consumers can be segmented based on their preferences for social product features and that these segments are not country-specific.

The impact of business ethics education on socially responsible practitioner behavior is not a new concern. A sizable extant literature base questions pedagogies used and outcomes achieved by the few early studies done in this area. Ensuing research has not produced definitive answers; measurement, methodological, and generalizability issues are prevalent due to the fragmented nature of most work. Given little pre-existing structure, an empirically-based model is needed which both sheds more awareness on the ethics education-business conduct relationship and quantifies the (...) degree of change that the education caused. This study operationalizes a multi-level ethical learning model. Using a survey administered at the start and end of an MBA ethics course,subsequent exploratory factor analysis, a matched t-test of pre and post-course mean scores, and an effect size calculation utilizing the Cohen’s d statistic, the existence of varying degrees of change in ethical outlook after formal ethics education is supported. Model enhancements and the potential for longitudinally following ethical learning from the classroom to the workplace are discussed. (shrink)

This paper presents and evaluates a methodological approach aiming at analysing some of the complex interaction between patients and different health care practitioners working together in teams. Qualitative health care research describes the values, perceptions and conceptions of patients and practitioners. In modern clinical work patients and professional practitioners often work together on complex cases involving different kinds of knowledge and values, each of them representing different perspectives. We need studies designed to capture this complexity. The methodological approach presented (...) here is exemplified with a study in rehabilitation medicine. In this part of the health care system the clinical work is organized in multi-professional clinical teams including patients, handling complex rehabilitation processes. In the presented approach data are collected in individual in-depth interviews to have thorough descriptions of each individual perspective. The interaction in the teams is analysed by comparing different descriptions of the same situations from the involved individuals. We may then discuss how these perceptions relate to each other and how the individuals in the team interact. Two examples from an empirical study are presented and discussed, illustrating how communication, differences in evaluations and the interpretation of incidents, arguments, emotions and interpersonal relations may be discussed. It is argued that this approach may give information which can supplement the methods commonly applied in qualitative health care research today. (shrink)

Background Advances in artificial intelligence, robotics and wearable computing are creating novel technological opportunities for mitigating the global burden of population ageing and improving the quality of care for older adults with dementia and/or age-related disability. Intelligent assistive technology is the umbrella term defining this ever-evolving spectrum of intelligent applications for the older and disabled population. However, the implementation of IATs has been observed to be sub-optimal due to a number of barriers in the translation of novel applications from the (...) designing labs to the bedside. Furthermore, since these technologies are designed to be used by vulnerable individuals with age- and multi-morbidity-related frailty and cognitive disability, they are perceived to raise important ethical challenges, especially when they involve machine intelligence, collect sensitive data or operate in close proximity to the human body. Thus, the goal of this paper is to explore and assess the ethical issues that professional stakeholders perceive in the development and use of IATs in elderly and dementia care. Methods We conducted a multi-site study involving semi-structured qualitative interviews with researchers and health professionals. We analyzed the interview data using a descriptive thematic analysis to inductively explore relevant ethical challenges. Results Our findings indicate that professional stakeholders find issues of patient autonomy and informed consent, quality of data management, distributive justice and human contact as ethical priorities. Divergences emerged in relation to how these ethical issues are interpreted, how conflicts between different ethical principles are resolved and what solutions should be implemented to overcome current challenges. Conclusions Our findings indicate a general agreement among professional stakeholders on the ethical promises and challenges raised by the use of IATs among older and disabled users. Yet, notable divergences persist regarding how these ethical challenges can be overcome and what strategies should be implemented for the safe and effective implementation of IATs. These findings provide technology developers with useful information about unmet ethical needs. Study results may guide policy makers with firsthand information from relevant stakeholders about possible solutions for ethically-aligned technology governance. (shrink)

In response to recent corporate ethical and financial disasters there has been increased pressure on business schools to improve their teaching of corporate ethics. Accreditation bodies, such as the Association to Advance Collegiate Schools of Business (AACSB), now require member institutions to develop the ethical awareness of business students, either through a dedicated subject or an integrated coverage of ethics across the curriculum. This paper describes an institutional approach to the incorporation of a comprehensive multi-disciplinary ethics framework into the (...) business curriculum. We discuss important implications for the assessment of ethics within institutional assurance practices, and address critical issues related to the support of academics whenrequired to incorporate new ethics material within their subject which may be outside their field of expertise. As an example, the successful application of the framework within the marketing discipline is presented and discussed. (shrink)