Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support inspired by Habermas’ theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this (...) study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved. (shrink)

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

Health care often involves ethically difficult situations that may disquiet the conscience. The purpose of this study was to develop a questionnaire for identifying various perceptions of conscience within a framework based on the literature and on explorative interviews about perceptions of conscience (Perceptions of Conscience Questionnaire). The questionnaire was tested on a sample of 444 registered nurses, enrolled nurses, nurses’ assistants and physicians. The data were analysed using principal component analysis to explore possible dimensions of perceptions of conscience. The (...) results showed six dimensions, found also in theory and empirical health care studies. Conscience was perceived as authority, a warning signal, demanding sensitivity, an asset, a burden and depending on culture. We conclude that the Perceptions of Conscience Questionnaire is valid for assessing some perceptions of conscience relevant to health care providers. (shrink)

The purpose of this phenomenological-hermeneutic study was to illuminate the meaning of being in ethically difficult care situations. The participants were 20 enrolled nurses employed in six intensive care units in Sweden. The results reveal a complex human process manifested in relation to one’s inner self and the other person, which transforms desolation into consolation through becoming present to the suffering other when perceiving fragility rather than tragedy. The main point of significance here is for all health professionals to create (...) an ethical work environment and strive for praxis that fosters ‘athomeness’, which renders us free to transform desolation into consolation. Consolation is of significance in ethics because it makes us available and helps us to fulfil the demands of life, while desolation makes us unavailable to others. (shrink)

ABSTRACT Social media is becoming increasingly embedded in people’s daily lives. These virtual spaces are now regularly used as a tool for information dissemination. Drawing on the moral intensity literature combined with uses and gratifications theory, this research explores how using social media to consume information can affect the ethical decision-making process. This study compares the influence of two online media dissemination formats – an online news article and social media discussion thread – on individuals’ ethical perceptions and decisions. Results (...) indicate that social media usage has an effect on perceptions of social consensus, problem recognition, and ethical sensemaking. Overall, Social media is shown to inhibit ethical decision-making when used as an information dissemination tool. (shrink)

BackgroundThis study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection.The aim of this study was to illuminate the meanings of being in ethically difficult situations that led to the burden of a troubled conscience, as narrated by physicians working in dialysis care.MethodA phenomenological (...) hermeneutic method was used to analyze the transcribed narrative interviews with five physicians who had varying lengths of experience in nephrology.ResultsThe analysis shows that physicians working in hemodialysis care suffered from a troubled conscience when they felt torn by conflicting demands and trapped in irresolution. They faced ethical dilemmas where they were forced to make crucial decisions about life or death, or to prioritize when squeezed between time restraints and professional and personal demands. In these ethical dilemmas the physicians avoided arousing conflicts, were afraid of using their authority, were burdened by moral responsibility and felt devalued and questioned about their way of handling the situation. The findings point to another way of encountering ethical dilemmas, being guided by their conscience. This mean sharing the agony of deciding how to act, being brave enough to bring up the crucial problem, feeling certain that better ways of acting have not been overlooked, being respected and confirmed regarding decisions made.ConclusionThe meanings of being in ethically difficult situations that led to the burden of a troubled conscience in those working in hemodialysis care, indicate the importance of increasing the level of communication within and among various professional groups - to transform being burdened by a troubled conscience into using conscience as a guide - in situations where no way of solving the problem seems to be good. (shrink)

Drawing on early work on ethical leadership, we argue that when leaders engage in leader moral hypocrisy (i.e., ethical promotion without ethical demonstration), followers can experience psychological reactance—a negative response to a perceived restriction of freedom—which can have negative downstream consequences. In a survey of employee–manager dyads (study 1), we demonstrate that leader moral hypocrisy is positively associated with follower psychological reactance, which increases follower deviance. In two subsequent laboratory experiments, we find similar patterns of results (study 2) and explore (...) potential alternative mechanisms (study 3). We demonstrate in a final experiment with working adults that the relationship between leader moral hypocrisy and psychological reactance is partly explained by increased perceptions of a leader’s use of power (study 4). We discuss the implications of our findings and advocate for further understanding of the risks associated with psychological reactance in response to leaders and other workplace situations. (shrink)

While training design choices seem amoral, they interact to determine training (in)effectiveness, potentially harming/benefiting trainees and organizations. These moral implications intensify when training is administered at scale (e.g., e-training) and focuses on social issues like sexual harassment (hereafter, SH). In fact, research on SH training shows it can elicit trainees’ gender-based biases against content messengers. We suggest that one such bias, resulting from messenger gender-occupation incongruence and influencing training effectiveness, is lowered perceptions of the messenger’s integrity. We also investigate whether (...) rich media will increase or decrease this perceived integrity penalty. Using an excerpt from real SH e-training and a sample [_N_ = _210_] consistent with the targeted training audience, we conducted a 2 × 2 × 2 relative comparison experiment (messenger gender x messenger occupation x media richness) and tested a moderated mediation model of the interactive effects of messenger gender-occupation incongruence and media richness on trainees’ perceptions of messenger integrity and training outcomes. Results suggest that trainees’ perceptions of messenger integrity decrease when the messenger’s gender is incongruent with their occupation, leading to worse outcomes in text-based training. These effects, however, are mitigated by increased media richness, providing support for media richness theory. Implications for researchers and practitioners are discussed. (shrink)

The article investigates how users in the Czech wireless network community invented a technology for sending data over visible, red light. For five years, this was the most affordable method for connecting computers. The development of this technology was guided by the idea that it should be controlled by its users. With reference to this experiment, it is argued that a shared ethical and/or political vision can contribute to the establishment of norms within user communities encouraging their members to share (...) information with each other. Thus, it is suggested that ethical and political convictions can be crucial for enabling collective innovation processes. This highlighting of normativity is intended as a complement to the common premise in Innovation Studies that users innovate to satisfy unfulfilled needs. In opposition to this view, it is argued that the needs of users are not a constant but something which emerge together with the transformation of the user community and the technology in question. Particular focus is placed on the tension between, on one hand, the norms and ethical— political motives of the user community, and, on the other hand, the needs satisfied through product development, both stemming from the same innovation process. (shrink)

The surge of post-truth calls for a reassessment of psychoanalytic and ideology critique-approaches in the social sciences. Both traditions are dismissed by the principal antagonists in the post-truth debate, the “positivist” defenders of science and the “post-modern” critics of science. The antagonists share a predisposition towards anti-humanism, refusal to distinguish between the latent and the manifest, and adherence to descriptive methods. In order to substantiate these claims, the article investigates commonalities between B.F. Skinner and Michel Foucault and Jacques Derrida. The (...) article concludes that the allegedly “pseudo-scientific” or “metaphysical” concepts of Subject and Truth, pivotal to both psychoanalysis and ideology critique-approaches, need to be rehabilitated in response to the challenge of post-truth. (shrink)

Taking an abductive, mixed-methods approach, we explore the content of people’s moral deliberations. In Study 1, we gather qualitative data from small groups of graduate business students discussing moral dilemmas. We analyze their conversations with a focus on how participants perceive others’ thoughts, opinions, and evaluations about the dilemmas and incorporate them into their reasoning. Ascribing such capacities to think and feel to others—i.e., mind perception—is central to morality. We use the conversations in Study 1 to identify whose minds participants (...) perceive. Study 1 also identifies how particular elements of deliberation—including the exploration of consequences, acknowledging ambivalence, seeking alternative options, the development of deep feelings, and the search for a moral compass—are linked to these perceptions of others’ minds. In Study 2 (an exploratory, online experiment with 378 participants), we find that priming individuals with specific forms of mind perception can influence the elements of moral reasoning they employ, and we find evidence that the presence of elements of reasoning are linked to participants’ final choices in a business-related ethical dilemma. (shrink)

The aim of this study was to illuminate nurses’ reflections on obstacles to and possibilities for providing care as desired by people with malodorous exuding ulcers. Six nurses who took part in a previous study were interviewed. The participants were shown an illustration with findings from a study that elucidated the meaning of living with malodorous exuding ulcers. They were asked to reflect on the obstacles to and possibilities of providing the care desired by the patients. Twelve audio-recorded transcribed interviews (...) were analysed using qualitative content analysis. Our interpretations of participants’ reflections on the obstacles and possibilities while caring for such patients revealed one theme: striving to ‘do good’ and ‘be good’. The obstacles were formulated as subthemes: experiencing clinical competence constraints, experiencing organizational constraints, experiencing ineffective communication, fearing failure, and experiencing powerlessness. The possibilities were formulated by the subthemes: spreading knowledge about ulcer treatments, considering wholeness, and creating clear channels of communication. A multiprofessional team could overcome the identified obstacles and provide structure, competencies, commitment and support to ‘do good’ for patients and ‘be good’ nurses. (shrink)

BackgroundThe experience sampling method is an increasingly popular data collection method to assess interpersonal dynamics in everyday life and emotions contextualized in real-world settings. As primary advantages of ESM sampling strategies include minimization of memory biases, maximization of ecological validity, and hypothesis testing at the between- and within-person levels, ESM is suggested to be appropriate for studying the daily lives of educational actors. However, ESM appears to be underutilized in education research. We, thus, aimed to systematically evaluate the methodological characteristics (...) and quality of published ESM studies of social interactions among children and adolescents in school settings, as well as to explore how much variance in social interaction variables could be attributed to the within-person level.MethodUsing Academic Search Complete, APA PsycINFO, APA PsycArticles, ProQuest, Web of Science, Wiley Online Library, and SAGE Journals, and in accordance with PRISMA guidelines and pre-defined eligibility criteria, we conducted a systematic literature search of experience sampling studies up to November 2020. To assess methodological quality, we used a modified checklist for reporting of ESM studies.ResultsOf the originally 2 413 identified studies, a final 52 experience sampling studies were included in the present review. Findings on sample and study design characteristics generally revealed wide variability. Even if high-quality studies were associated with higher scores on the training of participants in using the ESM procedure, and use of incentives, these design strategies did not reveal a statistically significant impact on compliance. The intraclass correlation coefficient was reported in nine studies and on average 58% of the variance in social interaction variables could be attributed to within-person fluctuation between timepoints.ConclusionThe current study is the first to systematically review ESM-based studies on social interactions among children and adolescents in the school context. These observations suggest that ESM is a potentially favorable technique for extracting complex social phenomena in real-world settings. We hope that this review will contribute to improving the quality assessment of ESM studies as well as to inform and guide future experience sampling studies, particularly regarding social phenomena with children and adolescents in educational settings. (shrink)

The aim of this article is to reveal how care workers in the home-help services handle the process when older people’s relocation to a residential home is under consideration. Since the care workers are engaged daily in defining care receivers’ needs and yet have no formal influence on care decisions in Sweden, the focus is on how they solve this dilemma. In this inductive study, the theoretical framework is based on occupational alliances, relationship-based practice, and discretion. Thirty-three care workers in (...) home-help services are included in open semi-structured interviews. Prominent features in the findings are that the care workers take their stand at the borderland of care management, when they know or try to find out what is right. The conclusions drawn are that care workers find ways to informally influence the decision-making process, quite contrary to the idea of approaches referred to as purchaser/provider models. The implications for social work policy and practice are that a distinction between assessment and intervention may not benefit the field of eldercare and should therefore be regarded as an area in need of thorough reconsideration. (shrink)

This article sets out to compare reconstructivism and critical theory as two possible avenues for a normative science and technology studies discipline “after constructivism”. This investigation is pursued through a case study of a wireless network community in the Czech Republic. The case study focuses on a schism that erupted after some users attempted to commercialise an invention for sending data with visible light. Their enterprise was partly motivated by a larger, political aspiration of creating a decentralised communication infrastructure. Other (...) members in the Czech wireless network community opposed this attempt as they perceived commercialisation as more of a threat than an aid for their politics. I will argue that these conflicting viewpoints over the role of markets can also clarify the different, theoretical assumptions behind reconstructivism and critical theory, and give some direction for a future, normative STS discipline. (shrink)

This article sets out to compare reconstructivism and critical theory as two possible avenues for a normative science and technology studies discipline “after constructivism”. This investigation is pursued through a case study of a wireless network community in the Czech Republic. The case study focuses on a schism that erupted after some users attempted to commercialise an invention for sending data with visible light. Their enterprise was partly motivated by a larger, political aspiration of creating a decentralised communication infrastructure. Other (...) members in the Czech wireless network community opposed this attempt as they perceived commercialisation as more of a threat than an aid for their politics. I will argue that these conflicting viewpoints over the role of markets can also clarify the different, theoretical assumptions behind reconstructivism and critical theory, and give some direction for a future, normative STS discipline. (shrink)

We propose a conceptual framework for analysing the relationship between social emancipation and alternative technology development. Key is the “functional autonomy” of the collective of users and developers of the technology vis-a-vis state and capital. We draw on previous empirical work about three hacker projects to substantiate the claim that the functional autonomy of hackers rests on three “pillars of autonomy”: technical skill, shared values, and collective memory. These three pillars sustain the autonomy of a community of hackers so that (...) it may successfully resist recuperation attempts by capital. We make this claim in contradistinction to looser constellations of users, citizen scientists, DIY hobbyists, etc., where the functional autonomy tends to be much weaker. Hence, in the latter case, we should expect the actors to be recuperated in short time. The emancipatory promises that they make in regard to their practices, and are often mirrored in the academic literature about user innovation, citizen science, etc., will then turn sour. From this observation, we develop a second-order reflection on the role of the scholar studying purportedly emancipatory technology projects. As against the popular “follow-the-actors” approach, we defend the continued need for scholarly critique. We do so with the caveat that critique must in part be conducted as self-critique. (shrink)

This research examines the trust and expectations people have for individuals with varying levels of status. Specifically, we predicted that people will have a greater amount of trust for individuals whom they perceive to have high (vs. low) status. Furthermore, we predicted that this positive effect of status on trust occurs because high-status individuals are viewed as less likely to engage in unethical behavior. We found evidence in two experimental laboratory studies and one survey study for some of our hypotheses. (...) An agenda for future research is suggested, including a discussion of the practical and theoretical implications of these findings. (shrink)

Various philosophers have used the image of a game as a metaphor to better interpret and deal with the world. In The Game of Philosophy, William C. Soderberg introduces the reader to the search for fairness in this game; a search that has been one of the main goals of moral and political philosophy. Soderberg examines the debate over the definition of a "fair social game" from various traditions and perspectives such as European, Anglo-American, African-American, multi-cultural, and feminist. The debate (...) between liberals and communitarians is a central theme of the moral and political philosophy section, and Soderberg explores the roots of this debate in the sections on metaphysics, epistemology, and philosophy of religion. In metaphysics and philosophy of religion, Soderberg presents both practical and speculative approaches; and he traces the emergence of anti-foundationalism in various epistemological traditions. A marvelous foundation text, this book will be of great value to beginning philosophers. (shrink)