This chapter contains sections titled: Professional Issues Educational Issues Policy Issues Leadership Issues Specific Issues References.

Background:There have been a number of debates in the field of nursing ethics. Researchers have focused on various aspects of nursing ethics, such as professional ethics, professional, nursing and ethical values. Within this research, a variety of literature reviews have been conducted, but to the best of our knowledge, bibliometric mapping has not yet been used.Objective:This article aims to analyse the production of literature within nursing ethics research.Research design:In order to examine publishing (...) patterns, we focused on publishing dynamics, prolific research entities and the most-cited articles. We additionally visualised the content of the literature using a novel mixed-method approach, combining bibliometric analysis and mapping with thematic analysis.Ethical considerations:In our study, ethical review was not required.Findings:A total of 1416 information sources were found in the Scopus database. Overall, literature production has increased; however, in recent years, the quantity of published material has begun to decrease. The most prolific countries are the United States, the United Kingdom and Canada, and the most prolific source titles are Nursing Ethics, Journal of Advanced Nursing and Nursing Times. Lately, research in the field of nursing ethics has been focused more on life care (providing for the basic needs of older residents), moral distress and community nursing.Discussion:The dynamics of research literature production showed an exponential rise in the number of published information sources – a rise which started in the period between 1974 and 1998. Since that period, the trend has stabilised, which might indicate that nursing ethics research is starting a transition to a mature phase.Conclusion:The innovative use of bibliometric analysis and mapping, together with thematic analysis, is a useful tool for analysis of research production in the field of nursing ethics. The results presented can be an excellent starting point for literature reviews and more exhaustive data, information and knowledge seeking. (shrink)

Learn how to think beyond the theoretical in any environment. "Ethics & Issues in Contemporary Nursing, 1st Edition" examines the latest trends, principles, theories, and models in patient care to help you learn how to make ethically sound decisions in complex and often controversial situations. Written from a global perspective, examples throughout the text reflect current national and international issues inviting you to explore cases considering socio-cultural influences, personal values, and professional ethics. Historical examples demonstrate (...) how to think critically while upholding moral and professional standards, as well as the law. Key topics throughout explore advocacy and rights, diversity, nurse burnout, mass casualty events, social media, violence in the workplace, medication error prevention, opioid and other substance use, HIPAA, and healthcare reform. In addition, this new title contains supplemental case studies and review questions to further challenge and prepare you to make morally sound decisions in any healthcare setting. -- From product description. (shrink)

We recognize a paradox of power and promise in the context of legislative and organizational changes in nurse regulation which poses constraints on nursing's capacity to bring voice and influence to pressing matters of healthcare and public policy. The profession is at an important crossroads wherein leaders must be well informed in political, economic and legislative trends to harness the profession's power while also navigating forces that may put at risk its central mission to serve society. We present (...) a critical policy analysis of the impact of recent regulatory trends on what the International Council of Nurses considers nursing's three ‘pillars’ – the profession of nursing, socioeconomic welfare of nurses and nurse regulation. Themes surfacing from this analysis include regulatory discontinuity, a tightening of regulatory control, and an increasingly managerial governance culture. These themes illuminate insights and strategies required to renew and revitalize the social mandate of our profession amidst a climate of urgency in the questioning of nurse scholars with respect to the future of the profession. At this historic juncture, nurses must clearly understand the implications of legislative and organizational regulatory changes to ensure the profession contributes to full capacity in achieving health and health equity globally. (shrink)

_A portion of the revenue from this book’s sales will be donated to Doctors Without Borders to assist the humanitarian work of nurses, doctors, and other health care providers in the fight against COVID-19 and beyond._ _Concepts and Cases in Nursing Ethics_ is an introduction to contemporary ethical issues in health care, designed especially for Canadian audiences. The book is organized around six key concepts: beneficence, autonomy, truth-telling, confidentiality, justice, and integrity. Each of these concepts is explained and discussed (...) with reference to professional and legal norms. The discussion is then supplemented by case studies that exemplify the relevant concepts and show how each applies in health care and nursing practice. This new fourth edition includes an added chapter on end-of-life issues, and it is revised throughout to reflect the latest developments on topics such as global health ethics, cultural competence, social media, and palliative sedation, as well as ethical issues relating to COVID-19. (shrink)

Concepts and Cases in Nursing Ethics is an introduction to contemporary ethical issues in health care, designed especially for Canadian audiences. The book is organized around six key concepts: beneficence, autonomy, truth-telling, confidentiality, justice, and integrity. Each of these concepts is explained and discussed with reference to professional and legal norms. The discussion is then supplemented by case studies that exemplify the relevant concepts and show how each applies in health care and nursing practice. This new fourth (...) edition includes an added chapter on end-of-life issues, and it is revised throughout to reflect the latest developments on topics such as global health ethics, cultural competence, social media, and palliative sedation. (shrink)

Background: Nurses are expected to make and implement autonomous decisions to provide patients with excellent quality nursing while practicing complex, high-level care. However, studies have shown that nursing practice based on autonomous decision-making is difficult, and a gap exists between decision-making and implementation. Research question/aim/objectives: This study aims to clarify trends among nursing professionals who recognize they are practicing ethical behavior in their nursing practice. Research design/Participants and research context: We surveyed the basic attributes of (...) and used the Ode’s Ethical Behavior Scale for Nurses with 3467 nursing professionals working at 34 hospitals in suburban cities of Japan and investigated the relationships among these factors. Ethical considerations: This study was approved by the appropriate research ethics committee. The Ethical Behavior Scale for Nurses was used with the authors’ permission. Findings/results: Significant differences were found in the mean “ethical behavior” scores between nurses and licensed practical nurses and midwives and licensed practical nurses. Mean scores for the “justice” subscale differed significantly between the low experience group and mid-level experience group and between the high experience group and mid-level experience group. Significant differences were also found in the mean scores between those with ethics education experience and those without, those with ethics training experience and those without, and those with ethics conference experience and those without. Discussion: Midwives and nurses had higher ethical behaviors than licensed practical nurses. Nursing professionals with low and high experience had higher justice scores than those with mid-level experience. Finally, nursing professionals with ethics education, training, or conference experience had higher ethical behavior than those without such experience. Conclusion: Nursing professionals who recognize they are practicing ethical behavior tend to be midwives or nurses with low or high levels of experience who attended ethics education, training, or conferences. (shrink)

This article explains the main theoretical aspects of legal ethics, identifies the nature and intellectual structures of legal ethics research, and examines the occurrences, relationships, interconnections, developments and emerging trends of the topic of legal ethics in global legal research, using one of the methods of scientometrics – bibliometric analysis. The annual growth of legal research outputs indexed by Scopus was about 7% over the entire period of study (1991–2020). The most popular type of research (...) outputs in the field of legal ethics are research articles. A multidisciplinary scope of scholarly sources on legal ethics reveals the scholarly development of each field/scientific branch that is both unique and integrated with law and legal ethics, unfolds multifaceted perspectives of legal ethics research, and a contextual sociolegal approach to legal ethics as a social, societal, and political expression. Legal ethics is a much broader and more complex phenomenon than simply a set of codes/rules of ethics and requires integrated research: from an understanding of the particular impact and significance of legal education, ethical rules, and personal morality to ethical decision-making processes, cognitive and social factors. (shrink)

This article explains the main theoretical aspects of legal ethics, identifies the nature and intellectual structures of legal ethics research, and examines the occurrences, relationships, interconnections, developments and emerging trends of the topic of legal ethics in global legal research, using one of the methods of scientometrics – bibliometric analysis. The annual growth of legal research outputs indexed by Scopus was about 7% over the entire period of study (1991–2020). The most popular type of research (...) outputs in the field of legal ethics are research articles. A multidisciplinary scope of scholarly sources on legal ethics reveals the scholarly development of each field/scientific branch that is both unique and integrated with law and legal ethics, unfolds multifaceted perspectives of legal ethics research, and a contextual sociolegal approach to legal ethics as a social, societal, and political expression. Legal ethics is a much broader and more complex phenomenon than simply a set of codes/rules of ethics and requires integrated research: from an understanding of the particular impact and significance of legal education, ethical rules, and personal morality to ethical decision-making processes, cognitive and social factors. (shrink)

Although family business comprises the majority of global business, it is significantly under-researched. Yet it is considered to have unique ethical values compared to non-family corporations. This is attributable to its family orientation. Therefore, it is worthwhile to identify and define dominant family business ethics values. The authors compare a sample of the U.S. family business, U.S. corporate entities, and international family business mission statements for frequency of ethics values. The data reveals three primary findings: (1) generally, (...) the U.S. family business expressed a higher frequency of ethical values than its non-family corporate and international counterpart, (2) U.S. family business has a strong lead in “integrity” and “honesty” whereas international family business leads in “environmentalism,” “globalism,” and “social responsibility,” and (3) generally, the frequency of ethics values for all family business globally has increased over time. The family business mission statement continues to provide ethical direction for the majority of global business. The emerging family business values identified in our sample will further impact global business success and promote ethical sustainability world-wide. (shrink)

BackgroundDuring a disaster, nurses face complex ethical challenges because of risky situations. It is necessary to identify trends and ethical issues of nurses in disasters to improve the quality...

Background The global pandemic raised ethical issues for nurses about caring for all patients, not just those with COVID-19. Italy was the first European country to be seriously affected by the first wave, while Estonia’s infection and death rates were among the lowest in Europe. Did this raise different ethical issues for nurses in these two countries as well? Aim The aim was to describe and compare ethical issues between nurses working during the first wave of the COVID-19 pandemic (...) in Estonia and Italy. Research design A cross-sectional survey study with a self-administered questionnaire. The impact of COVID- 19 emergency on nursing care questionnaire was used. Participants and research context Convenience sampling was used to recruit 1098 nurses working during the first wave of the pandemic in 2020: 162 from Estonia and 936 from Italy. Ethical considerations Research ethics approvals were obtained, and the nurses provided informed consent. Results The most frequent ethical issues for Estonian nurses were professional communication and ensuring access to care for patients without COVID-19, and for Italian nurses, the end-of-life care and the risk of them getting the virus and transmitting it to their loved ones. There were no statistically significant differences in the frequency of ethical issues between Estonian nurses working with patients with and without COVID-19. Italian nurses caring for COVID-19 patients faced statistically significantly more (both p <.001) issues around prioritising patients and end-of-life. Nurses working with patients without COVID-19 in Italy faced more issues about access to care ( p <.001). Conclusions Estonian and Italian nurses, working in different clinical contexts during the first wave of the pandemic, faced different ethical issues. Local contextual aspects need to be considered to support nurses’ ethical decision-making in providing care during future crises and to ensure ethical care for patients. (shrink)

Research ethics is increasingly formally regulated, but little is known about how ethical considerations are reported in dissertations. The aim of this literature study was to describe the status and trends of ethical considerations in Swedish doctoral dissertations written by registered nurses. A total of 77 dissertations from 1987, 1997, and 2007 met the inclusion criteria and were analyzed by descriptive statistics. Ethical considerations were mostly overlooked in 1987, but almost ubiquitous by 2007. All dissertations in 2007, except (...) one, had a section on ethical considerations; however, these were short, lacking in references, and short on content. The most common topic was informed consent and approval from research ethics review boards, followed by confidentiality and ethical aspects of methodological issues. Our results imply that the quantity and quality of ethical considerations must be improved in order to assure ethical soundness for participants, patients, researchers, and society. (shrink)

By 2050, global livestock production is expected to double—growing faster than any other agricultural sub-sector—with most of this increase taking place in the developing world. As the United Nation’s four-hundred-page report, Livestock’s Long Shadow: Environmental Issues and Options , documents, livestock production is now one of three most significant contributors to environmental problems, leading to increased greenhouse gas emissions, land degradation, water pollution, and increased health problems. The paper draws on the UN report as well as a flurry of (...) other recently published studies in order to demonstrate the effect of intensive livestock production on global warming and on people’s health. The paper’s goal is to outline the problems caused by intensive livestock farming and analyze a number of possible solutions, including legislative changes and stricter regulations, community mobilizing, and consumers choosing to decrease their demand for animal products. (shrink)

Using philosophical guidelines--and applying these guidelines throughout a patient's lifespan--this text assists readers in making ethically sound choices in nursing. It explores both traditional and contemporary ethical theories and acknowledges changing trends in the health field, incorporating issues such as managed care. Includes clinical case studies within each chapter. Incorporates a new organization in Part Two, in three sections entitled "Developmental Highlights," "Issues and Problems," and "Morally Reasoned Nursing Interventions." Provides new "What if?" questions throughout to help (...) apply theory to real events. Offers extensive analysis of euthanasia and assisted suicide. Includes thorough coverage of the HIV/AIDS epidemic and its moral complexities. Discusses organ transplantation and experimental medical treatments in ethical context. Ideal for practicing nurses looking for a reference on professional ethics. (shrink)

The article discusses how theory and practice in global ethics affect each other. First, the author explores how the study of ethics has changed in the era of globalization and ponders what the role of the field of study of global ethics is in this context. Second, she wants to show how the logical fallacies in widening study field of ethics produce false polarizations between facts and value judgements in social ethics made in (...) various cultural contexts. She further elaborates how these false polarizations prevent constructive cross-cultural and transnational discussions on ethical guidelines and principles that are needed to produce joint action to deal with serious ethical issues globally and nationally. Finally, the paper argues that in order to find a way to solve our shared complex ethical problems in global context, we need to get back to basics by focusing on the method of ethics, that is, self-critical and logical analysis of sound argumentation and justification of our values and moral pr.. (shrink)

In Bulgaria, we are sharing a transition to a civic society and a market economy, which means transferring to new parameters of our culture. Many old customs based on coer cion, obedience and unacceptable interference are gradually dying out, and new princi ples tend to shape the way we live our collective lives. These include the ethics of partnership, which tend to create an assertion of individual rights and an affirmation of free will and autonomy, and within which the (...) individual is protected in the pursuit of personal judgements. It is remarkable, however, that we have so much difficulty in talk ing about and identifying the most beneficial approaches for the achievement of the new design of our society. In this paper, I propose to illustrate the current crisis in nursing ethics with informa tion mainly from Bulgaria. However, I think that the problems and trends in the other Eastern European countries are similar. (shrink)

Background:Palliative care is acknowledged as an appropriate approach to support older people in nursing homes. Ethical issues arise from many aspects of palliative care provision in nursing homes; however, they have not been investigated in this context.Aim:To explore the ethical issues associated with palliative care in nursing homes in the United Kingdom.Design:Exploratory, sequential, mixed-methods design.Methods:Semi-structured interviews with 13 registered nurses and 10 healthcare assistants (HCAs) working in 13 nursing homes in the United Kingdom were used to (...) explore ethical issues in palliative care. The ‘Ethical Issues in Palliative Care for Nursing Homes’ instrument was used to measure the frequency and level of distress arising from ethical issues through a cross-sectional survey with 69 registered nurses and 129 healthcare assistants. Data collection occurred between December 2014 and November 2015.Ethical considerations:Ethical approval was granted by Queen’s University’s School of Nursing and Midwifery Research Ethics Committee and governance sought from each nursing home’s manager.Findings:The interviews revealed three themes: ethical issues in practice; relational issues; and organisational issues. No significant differences between registered nurses and healthcare assistants were evident, confirming the patterns emerging from the interviews. Relational issues, primarily issues with residents and families, occurred most frequently and caused greater distress.Conclusion:The shared environment is key in the experience of ethical issues; therefore, multidisciplinary education is needed for ethical decision making in palliative care. Addressing staff knowledge and service organisation may reduce ethical issues locally and provide a benchmark for global change. (shrink)

By analysing the first, second, 10th and 11th years of publication (i.e. volumes 1, 2, 10, 11) of Nursing Ethics, I will show the significant visible trends in the articles and draw some conclusions. The trends are visible at various levels: from simple analysis of an issue, or a comment on a situation in the early years, to in-depth philosophical and research studies; and from short statements to much longer articles. The ethical approaches used go from (...) either none or unquestioned assumptions to several approaches used in any one study. This corresponds to the general postmodern trend in society. The interpretation made of these trends is of a kind of protest at nurses and nursing being devalued. Although this is expressed negatively, the positive message conveyed is that nurses are now taking their professional life into their own hands, vigorously and more daringly than a decade ago. (shrink)

Globalization, an outgrowth of technology, while informing us about people throughout the world, also raises our awareness of the extreme economic and social disparities that exist among nations. As part of a global discipline, nurses are vitally interested in reducing and eliminating disparities so that better health is achieved for all people. Recent literature in nursing encourages our discipline to engage more actively with social justice issues. Justice in health care is a major commitment of nursing; thus (...) questions in the larger sphere of globalization, justice and ethics, are our discipline's questions also. Global justice, or fairness, is not an issue for some groups or institutions, but a deeper human rights issue that is a responsibility for everyone. What can we do to help reduce or eliminate the social and economic disparities that are so evident? What kind of ethical milieu is needed to address the threat that globalization imposes on justice and fairness? This article enriches the conceptualization of globalization by investigating recent work by Schweiker and Twiss. In addition, I discuss five qualities or characteristics that will facilitate the development of a viable and just global ethic. A global ethic guides all people in their response to human rights and poverty. Technology and business, two major forces in globalization that are generally considered beneficial, are critiqued as barriers to social justice and the common good. To turn human nature into humanity and righteousness is like turning the willow into cups and bowls.The book of Mencius. (shrink)

Traditional methods of teaching professional nursing ethics in the classroom have translated into limited success in clinical practice. Students don’t perceive an integration of ethics education in practical clinical settings, while educators grapple with a lack of perceived ‘excellence of moral character’ in their students when they are taught intellectual virtues and theoretical wisdom in the classroom that they do not see demonstrated in the clinical setting. Also traditionally, emphasis in ethics teaching has tended to focus (...) on the nurse-patient relationship, while less attention has been paid to nursing in a more inter/intra professional or global context. The purpose of using constructivist theory and concept-based learning strategies to teach junior level nursing students ethics was to present implications for nurse educators that will help them foster/improve their student’s critical thinking, and increase their mastery and global integration of the complex abstract concepts associated with professional nursing ethics. (shrink)

This paper examines the increasing trend by nursing scholars such as Patricia Benner to conceptualize ethics as a contextual and embodied ‘way of knowing’, embedded in nursing expertise. The intellectual origins of this development and its debt to neo‐Aristotelian thinkers such as philosopher Charles Taylor are discussed. It will be argued that rather than revealing a truth about ethical expertise, the emergence of the ‘expert’ nurse as a moral and ethical category is the result of the elaboration (...) of neo‐Thomist discourses in the educational and professional shaping of nurses. These discourses act on and are enacted by the individual nurse through his or her participation in specific ethical exercises that result in the constitution of the desired subjectivity – or ‘expertise’. Central to this shaping are particular notions of ‘the good’ and its relationship to knowledge, skill and practice. Critiques of these neo‐Aristotelian perspectives are discussed and applied to the notion of moral expertise in nursing, and the claims made by its proponents concerning the ‘ethical’ distinction between experienced and expert nurses. Finally, a call is made for a more pluralistic approach to ethics. (shrink)

Using 15 years of data (1995–2009) from literature reviews, survey questionnaires, personal interviews, and desktop research, the authors examine North American (Canada, Mexico, and the United States of America) regional trends in business ethics research, teaching and training. The patterns indicate that business ethics continues to flourish in North America with high levels of productivity in both quantity and quality of teaching, training and research publication outputs. Topics/themes that have been covered during the time period are treated (...) with an acknowledgement of the concomitant marginal impact on improving ethical business behavior and contexts—as recurring domestic and global scandals attest. Major North American business ethics challenges/issues to be addressed in the future are identified. (shrink)

This short article reflects the author’s engagement with nursing ethics. The experience of the global market is used to highlight the current practice of working to guidelines and laws rather than professional experience. The need for personal and professional responsibility is stressed as a significant counterbalance to instability in people and societies.

Background:The concept of conscientious objection is well described; however, because of its nature, little is known about real experiences of nursing professionals who apply objections in their practice. Extended roles in nursing indicate that clinical and value-based dilemmas are becoming increasingly common. In addition, the migration trends of the nursing workforce have increased the need for the mutual understanding of culturally based assumptions on aspects of health care delivery.Aim:To present (a) the arguments for and against conscientious (...) objection in nursing practice, (b) a description of current regulations and practice regarding conscientious objection in nursing in Poland and the United Kingdom, and (c) to offer a balanced view regarding the application of conscientious objection in clinical nursing practice.Design:Discussion paper.Ethical considerations:Ethical guidelines has been followed at each stage of this study.Findings:Strong arguments exist both for and against conscientious objection in nursing which are underpinned by empirical research from across Europe. Arguments against conscientious objection relate less to it as a concept, but rather in regard to organisational aspects of its application and different mechanisms which could be introduced in order to reach the balance between professional and patient’s rights.Discussion and conclusion:Debate regarding conscientious objection is vivid, and there is consensus that the right to objection among nurses is an important, acknowledged part of nursing practice. Regulation in the United Kingdom is limited to reproductive health, while in Poland, there are no specific procedures to which nurses can apply an objection. The same obligations of those who express conscientious objection apply in both countries, including the requirement to share information with a line manager, the patient, documentation of the objection and necessity to indicate the possibility of receiving care from other nurses. Using Poland and the United Kingdom as case study countries, this article offers a balanced view regarding the application of conscientious objection in clinical nursing practice. (shrink)

_‘For geographers across the globe this book provides the arguments for a return to the teaching of geography and why they should reject the politicisation of the subject by education policy makers and politicians. Standish’s careful critique shows the necessity of a depoliticised geography curriculum the irony of which would be that it would ensure that every child could point to Iraq, Iran and Afghanistan on a map.’_ Prof. Dennis Hayes – Oxford Brookes University, UK _'A prescient and critical analysis (...) of the changing face of geography teaching. This book deserves to be widely read and debated. Alex Standish's book puts current trends in geography teaching in historical and critical context. It comprises a forthright and timely defence of geographical education for its own sake.'_ Dr Jim Butcher, FRSA, Department of Sport Science, Tourism and Leisure, Canterbury Christ Church University. Since the early 1990s, educational policy makers and some subject leaders have been seeking to fundamentally change the teaching of geography in UK and US schools, from a subject which encourages students to explore spatial concepts, ideas and skills, to a more ethics based subject concerned with the promotion of environmentalism, cultural diversity and social justice. In this book the new approach is critically examined, within a historical and ideological context, addressing a number of fundamental questions: Should geography be used as a tool for the delivery of citizenship ideals? How does this affect the intellectual and moral value of geographical education for young people? If the state and teachers are taking more responsibility for the values, attitudes and emotional responses of students, how will they learn to develop these qualities for themselves? If global perspectives shift the focus of education from learning about the outside world to learning about the self, what is its vision of social progress and conception of social change? This book advocates a return to liberal models of education, arguing that the new approach to geography currently being promoted for schools fundamentally undermines the educational value of the subject, and the freedom of young people to shape the world in which they live. A vital resource for teachers and student teachers alike, Global Perspectives in the Geography Curriculum makes a significant contribution to the growing debate about the future direction of the discipline itself. (shrink)

This article raises some questions about the global influence of nursing in the USA and describes some problems that may come about because of it. Selected American values that are embedded in nursing and ethics are found in American nursing education, practice and research. These can then be exported to countries with very different cultural definitions and values. One such country is Japan. The discrepancy between national cultural norms and imported ideals of nursing practices (...) can create ethical problems for nurses in these countries. (shrink)

The concept of moral distress can be extended from clinical settings to larger environmental concerns affecting health care. Moral distress—a common experience in complex societies—arises when individuals have clear moral judgments about societal practices, but have difficulty in finding a venue in which to express concerns. Since health care is large in scale and climate change is proving to be a major environmental problem, scaling down health care is inevitably a necessary element for mitigating climate change. Because it is extremely (...) challenging to discuss these concerns in health care settings, those concerned about climate change and health care experience distress. This article outlines some philosophical concepts and perspectives that may be useful in mitigating this distress. (shrink)

There is an emergency to inform people about the biotechnological revolution and its multidirectional consequences in every day's life. Bioethical issues should be methodically analysed, since the definition of the term depends upon the educational background and the speciality of each scientist involved.An increasing international awareness is gradually expressed by the various bodies, (political authorities, educational Institutions etc), materialized through a series of declarations and legislative regulations or by establishing various assemblies responsible for bioethical issues. However the economic dimension interfering (...) in the field causes a strong pressure for acceleration of the relevant research and its applications. Thus, the role of the assemblies is deteriorated mainly to consultative recommendations hardly efficient for the acceptance of protective for the consumers countermeasures. The mean citizen is unprotected against the consequences concerning him and his environment. Therefore there is a demand for stregthening the educational initiatives addresed either to the students of particular disciplines or to the wide public which will hopefully increase the level of the respective knowledge. (shrink)

The UN Cartagena Protocol onBiosafety adopted in Montreal, 29 January, 2000and opened for signature in Nairobi, 15–26 May,2000 will exert a profound effect oninternational trade in genetically modifiedorganisms (GMOs) and their products. In thispaper, the potential effects of variousarticles of the Protocol on international tradein GMOs are analyzed. Based on the presentstatus of imports of GMOs and domestic researchand development of biotechnology in China,likely trends in imports of foreign GM food andrelated products after China accedes to WTO isexplored. Also, (...) China's potentialcountermeasures to control and regulate importsof GMOs in line with implementation of theProtocol are discussed. China, in recent times,has increased its food and agricultural importssubstantially from USA and Canada. Chinaimported soybean 10.42 mill. tons in 2000 andabout 15 mill tons in 2001, of which majorityare from USA where GM soybean accounts for60%. The plantation of US Monsanto'stransgenic Bt cotton was increased to more than1 million ha in China in 2001. Though China haspaid great attention to develop biotechnology,it appears to have little scope to export GMOsand GM products. So China may consider a rangeof administrative measures to implement theCartagena Protocol and to regulate its importof GMOs and GM agricultural products.Consequently, the Regulation on Safety ofAgri-GMOs was issued on June, 2001 and followedthree detailed rules issued in Jan. of 2002,with a priority to limit foreign GMOs importingby safety certification and labeling system.These were outlined taking into accountpolicies adopted in Western countries such asgreen barriers to international trade. (shrink)

The contemporary confluence of globalization and ethical pluralism is at the origin of many ethical challenges that confront business nowadays, both in practice and in theory. One of the challenges arising from the development of globalization has to do with respect for cultural diversity. It is often said that the success of economic globalization tends towards social and cultural homogeneity. To the extent that cultural diversity is usually seen as a valuable reality, that global trend seems to contradict our (...) efforts to respect ethical pluralism, both personal and cultural, within society. In this paper I argue that (a) ethical minimalism, despite its emphasis on tolerance and justice, does not take pluralism seriously into account in present-day society, and (b) ethical minimalism is not suited to balancing the homogenizing trend of globalization. Certainly ethical norms are necessary, but by no means are they sufficient in themselves to encourage either justice or tolerance; nor are they sufficient to inspire and encourage good practices and sound regulations. Instead, virtue-based ethics has the capacity of inspiring and encouraging good practices. Particularly, virtue-based ethics is able to inspire a serious dialogue about ethical and legal issues both in the public arena and within organizations. (shrink)

The Congress on Information and Communication during the 2000 World Engineers’ Convention in Hannover, Germany, passed a document on trends, challenges, and tasks of information and communication technologies as a set of proposals and guidelines for engineers and society which assumes validity worldwide. In 2002, the Executive Board of the Association of Engineers VDI (Germany) passed the new document Fundamentals of Engineering Ethics, which also claims universal validity, on how to deal with conflicting professional responsibilities. Thus the (...) class='Hi'>global validity of ethics, under the impact of new technologies, has become visible as an issue widely discussed within engineering, philosophy, and society. It increasingly requires the awareness of our own responsibility towards all humans, as well as towards the natural environment and future generations. Thus the questions of how to decide and how to act challenge the interdisciplinary research field of ethics more than ever. In this paper, these elements of decisions and ethics are discussed in some detail. Subsequently they are illustrated by selected examples of ethical rules. (shrink)

The aim of this thematic literature review is to explore nurses' perceptions of ethical issues in the care of older people. Electronic databases were searched from September 1997 to September 2007 using specific key words with tight inclusion criteria, which revealed 17 primary research reports. The data analysis involved repeated reading of the findings and sorting of those findings into four themes. These themes are: sources of ethical issues for nurses; differences in perceptions between nurses and patients/relatives; nurses' personal responses (...) to ethical issues; and the patient—nurse relationship. The findings reveal that ageism is one of the major sources of the ethical issues that arise for nurses caring for older people. Education and organizational change can combat ageist attitudes. Wider training is required in the care of older people, workplace skills, palliative care and pain management for older people. The demands of a changing global demography will necessitate further research in this field. (shrink)

The concern for ethical principles and values is not limited to health professionals alone. However, ethical principles in nursing act as safety valves for social control to prevent professional misconduct and abuse of the rights of clients. As a result of colonial experience, developing countries like Botswana usually follow the European lead, especially examples from the UK. This article examines the ethical problems and dilemmas associated with rural nursing practice in Botswana, a developing country in sub-Saharan Africa. The (...) major ethical problems identified are related to the distribution of and access to health resources in rural communities. It is proposed that nurses must assume responsibility in the field of access and allocation by working collaboratively with governments and other professional bodies, and that nurses as a global community must work together as a team to support each other. (shrink)

This paper investigates how deans and directors at the top 50 global MBA programs (as rated by the "Financial Times" in their 2006 Global MBA rankings) respond to questions about the inclusion and coverage of the topics of ethics, corporate social responsibility, and sustainability at their respective institutions. This work purposely investigates each of the three topics separately. Our findings reveal that: (1) a majority of the schools require that one or more of these topics be covered (...) in their MBA curriculum and one-third of the schools require coverage of all three topics as part of the MBA curriculum, (2) there is a trend toward the inclusion of sustainability-related courses, (3) there is a higher percentage of student interest in these topics (as measured by the presence of a Net Impact club) in the top 10 schools, and (4) several schools are teaching these topics using experiential learning and immersion techniques. We note a fivefold increase in the number of stand-alone ethics courses since a 1988 investigation on ethics, and we include other findings about institutional support of centers or special programs; as well as a discussion of integration, teaching techniques, and notable practices in relation to all three topics. (shrink)

Scabies is a global problem and is of such concern that in 2013 it was added to the World Health Organization list of neglected tropical diseases.1 Due to its highly contagious nature, it is easily spread where humans are in close living environments, and is therefore of particular concern in nursing homes where it may affect both residents and staff. Hence, prompt diagnosis and appropriate treatment of cases are important to control the spread; however, this is hindered by (...) current difficulties in rapid diagnosis. Conducting research with vulnerable populations involves careful attention to the interest of the individual. It is indisputable that all potential research subjects must have provided consent to participate in research, and it is less clear how to proceed when potential research subjects lack the capacity to provide consent. (shrink)

Nurses are experiencing new ethical issues as a result of global developments and changes in health care. With health care becoming increasingly sophisticated, and countries facing challenges of graying population, ethical issues involved in health care are bound to expand in quantity and in depth. Blended learning rather as a combination of multiple delivery media designed to promote meaningful learning. Specifically, this study was focused on two questions: (1) the students’ satisfaction and attitudes as members of a scenario-based learning (...) process in a blended learning environment; (2) the relationship between students’ satisfaction ratings of nursing ethics course and their attitudes in the blended learning environment. In total, 99 senior undergraduate nursing students currently studying at a public nursing college in Taiwan were invited to participate in this study. A cross-sectional survey design was adopted in this study. The participants were asked to fill out two Likert-scale questionnaire surveys: CAAS (Case Analysis Attitude Scale), and BLSS (Blended Learning Satisfaction Scale). The results showed what students felt about their blended learning experiences — mostly items ranged from 3.27—3.76 (the highest score is 5). Another self-assessment of scenario analysis instrument revealed the mean scores ranged from 2.87—4.19. Nearly 57.8% of the participants rated the course ‘extremely helpful’ or ‘very helpful.’ This study showed statistically significant correlations (r = 0.43) between students’ satisfaction with blended learning and case analysis attitudes. In addition, results testified to a potential of the blended learning model proposed in this study to bridge the gap between students and instructors and the one between students and their peers, which are typical of blended learning, and to create meaningful learning by employing blended pedagogical consideration in the course design. The use of scenario instruction enables students to develop critical analysis and problem solving skills through active learning and social exchange of ideas. (shrink)

The high turnover of nurses has become a global problem. Several studies have proposed that nurses' perceptions of the ethical climate of their organization are related to higher job satisfaction and organizational commitment, and thus lead to lower turnover. However, there is limited empirical evidence supporting a relationship between different types of ethical climate within organizations and facets of job satisfaction. Furthermore, no published studies have investigated the impact of different types of ethical climate on the three components of (...) organizational commitment. This study attempts to explore the different types of ethical climate that exist in hospitals, and the degree of job satisfaction and organizational commitment of nurses in Taiwan. It uses path analysis to understand which types of ethical climate influence different facets of job satisfaction. The study also examines the impact of different types of ethical climate and facets of job satisfaction on the three components of organizational commitment. Questionnaires were distributed to 352 nurses. The relationships among variables were assessed by factor analysis, reliability, descriptive statistics, correlations, and regression. The important conclusion is that hospitals can increase job satisfaction and organizational commitment by influencing an organization's ethical climate. Hospital administrators can foster within organizations the climate types of caring, independent, and rules climate that increase satisfaction, while preventing organizations from developing the type of instrumental climate that decreases it. (shrink)

Die Wissensvermittlung in Gesundheitsethik ermöglicht es Auszubildenden der Pflege, sich in ihrer zukünftigen Tätigkeit bei Entscheidungsprozessen des Behandlungsteams hinsichtlich pflegeethischer Fragestellungen einzubringen. Vor diesem Hintergrund wurde anhand der vorliegenden Studie die Entwicklung moralischer Positionen sowie pflegeethischer Kenntnisse von Pflegeauszubildenden sichtbar gemacht. An zwei Krankenpflegeschulen (Berlin und Fürth) wurden im Rahmen einer Panelstudie von August 2010 bis März 2011 Daten einer ersten Querschnittserhebung von Auszubildenden in der Pflege erhoben. Für die Studie wurde ein strukturierter Fragebogen verwendet. Die Studienteilnahme erfolgte freiwillig. Alle (...) Auszubildenden hatten vor der Befragung in unterschiedlichem Umfang Unterricht in Gesundheitsethik erhalten. An beiden Standorten zeigten die Teilnehmenden einen Zuwachs an pflegeethischen Kenntnissen. Auszubildende, die bislang keine praktische Erfahrung mit Sterbehilfe gemacht hatten, zeigten Schwierigkeiten in der theoretischen Handhabung dieser Maßnahmen. Für alle Auszubildenden zeigte sich ein allgemeiner Trend zu einer Befürwortung des partizipativen Interaktionsmodells und damit zu einer Förderung der Patientenselbstbestimmung. Zugleich schätzten die Studienteilnehmenden die Fähigkeiten von Patienten, medizinisch richtige Therapieentscheidungen zu treffen, als gering ein. Die Ausbildung in Gesundheitsethik besitzt ein großes Potential, Kenntnisse zu vermitteln und dadurch die ethische Kompetenzentwicklung zu befördern. Unsere Ergebnisse werfen die Frage auf, inwieweit es einer Integration praktischer Erfahrungen mit Fragestellungen der Gesundheitsethik bedarf, um eine praxisrelevante und wissenschaftlich fundierte Wissensvermittlung zu gewährleisten. (shrink)

The large number of hungry people in a global economy based on industrialization, privatization, and free trade raises the question of the ethical dimensions of the worsening food crisis in the world in general and in developing countries in particular. Who bears the moral responsibility for the tragic situation in Africa and Asia where people are starving due to poverty? Who is morally responsible for their poverty - the hungry people themselves? the international community? any particular agency or institution? (...) In the context of Article 3 of the UN Declaration of Human Rights, which states that "Everyone has the right to life, liberty and security" (UNDHR, 1948), the ethical question of poverty and hunger becomes a major human concern that should be discussed publicly and resolved by whatever means available. But how can the poor and hungry realize their right to life and security if their very survival is at stake? This paper maintains that responsibility for global poverty at present lies in recent neo-liberal trends in the global economy and with those individuals and organizations who, though small in number, have acquired a disproportionate share of the world's assets and financial resources. That being the case, it is suggested that our monetary and financial policies are in need of drastic changes with regard to global responsibility towards the hungry and impoverished. (shrink)

The paper analyzes ethical codes in the health care profession in Slovakia while considering the four principle approach in medical ethics formulated by Beauchamp and Childress. For these purposes, the individual principles of this theory are identified and presented in light of performance in the health care profession. The second part introduces the main legal documents which represent the professional codes of ethics for physicians, nurses and midwives in Slovakia. In those, I have tried to identify the presence (...) of basic principles of medical ethics and the way they are formulated in the Slovak health care system. The aim is to show the capabilities of professional health care ethics in Slovakia to react to current trends of medical ethics and models within the health care system. (shrink)

Background:Collaboration between physicians and nurses is key to improving patient care. We know very little about collaboration and interdisciplinary practice in African healthcare settings.Research question/aim:The purpose of this study was to explore the ethical challenges of interdisciplinary collaboration in clinical practice and education in Botswana Participants and research context: This qualitative descriptive study was conducted with 39 participants (20 physicians and 19 nurses) who participated in semi-structured interviews at public hospitals purposely selected to represent the three levels of hospitals in (...) Botswana (referral, district, and primary).Ethical considerations:Following Institutional Review Board Approval at the University of Pennsylvania and the Ministry of Health in Botswana, participants’ written informed consent was obtained.Findings:Respondents’ ages ranged from 23 to 60 years, and their duration of work experience ranged from 0.5 to 32 years. Major qualitative themes that emerged from the data centered on the nature of the work environment, values regarding nurse–doctor collaboration, the nature of such collaboration, resources available for supporting collaboration and the smooth flow of work, and participants’ views about how their work experiences could be improved.Discussion:Participants expressed concerns that their work environment compromised their ability to provide high-quality and safe care to their patients. The physician staffing structure was described as consisting of a few specialists at the top, a vacuum in the middle that should be occupied by senior doctors, and junior doctors at the bottom—and not a sufficient number of nursing staff.Conclusion:Collaboration between physicians and nurses is critical to optimizing patients’ health outcomes. This is true not only in the United States but also in developing countries, such as Botswana, where health care professionals reported that their ethical challenges arose from resource shortages, differing professional attitudes, and a stressful work environment. (shrink)

Background Despite news reports of morally distressing situations resulting from complex and demanding community-care delivery in Canada, there has been little research on the topic of ethical conflicts experienced by community-based health care professionals. Research aim To identify ethical conflicts experienced by community nurses. Research design Data were collected using semi-structured interviews and then relevant text was extracted and condensed using qualitative content analysis. This research was part of a larger grounded theory project examining how community nurses manage ethical conflict. (...) Research context and participants Community nurses, including 13 public health nurses and 11 home care nurses from two Canadian provinces, were interviewed. Ethical considerations Study approval was granted by the Health Research Ethics Authority of Newfoundland and Labrador and by provincial health authorities. Findings Seven ethical conflicts were identified and assigned to one of two groups. In the grouping categorized as challenges with obligations or risks, the ethical conflicts were: (1) screening for child developmental issues knowing there is a lack of timely early intervention services; (2) encountering inequities in the health care system; (3) not fulfilling principles, goals, and initiatives of primary and secondary prevention; and (4) feeling powerless to advocate for clients. The remaining ethical conflicts were categorized as challenges with process, risks, and consequences, and were: (5) jeopardizing therapeutic relationships while reporting signs of a child at risk; (6) managing confidentiality when neighbors are clients; and (7) supporting client autonomy and decision-making but uncertain of the consequences. Conclusions Research investigation will continue to be important to raise awareness and mobilize ethics supports as health care services are steadily shifted from institutional to community settings. Moreover, with heightened potential for communicable disease outbreaks across international borders from global warming, community nurses around the world will continue to be required to address ethically-difficult care situations with competence and compassion. (shrink)

Recent technological advancements have deeply transformed society and the way people interact with each other. Instantaneous communication platforms have allowed connections with other people, forming global communities, and creating unprecedented opportunities in many sectors, making access to online resources more ubiquitous by reducing limitations imposed by geographical distance and temporal constrains. These technological developments bear ethically relevant consequences with their deployment, and legislations often lag behind such advancements. Because the appearance and deployment of these technologies happen much faster than (...) legislative procedures, the way these technologies affect social interactions have profound ethical effects before any legislative regulation can be built, in order to prevent and mitigate those effects. Ethics in Online AI-Based Systems: Risks and Opportunities in Current Technological Trends features a series of reflections from experts in different fields on potential ethically relevant outcomes that upcoming technological advances could bring about in our society. Creating a space to explore the ethical relevance that technologies currently still under development could have constitutes an opportunity to better understand how these technologies could or should not be used in the future in order to maximize their ethically beneficial outcomes, while avoiding potential detrimental effects. Stimulating reflection and considerations with respect to the design, deployment and use of technology will help guide current and future technological advancements from an ethically informed position in order to ensure that, tomorrow, such advancements could contribute towards solving current global and social challenges that we, as a society, have today. This will not only be useful for researchers and professional engineers, but also for educators, policy makers, and ethicists. (shrink)

Climate change, pollution, and deforestation have a negative impact on global mental health. There is an environmental justice dimension to this challenge as wealthy people and high-income countries are major contributors to climate change and pollution, while poor people and low-income countries are heavily affected by the consequences. Using state-of-the art data mining, we analyzed and visualized the global research landscape on mental health, climate change, pollution and deforestation over a 15-year period. Metadata of papers were exported from (...) PubMed®, and both relevance and relatedness of terms in different time frames were computed using VOSviewer. Co-occurrence graphs were used to visualize results. The development of exemplary terms over time was plotted separately. The number of research papers on mental health and environmental challenges is growing in a linear fashion. Major topics are climate change, chemical pollution, including psychiatric medication in wastewater, and neurobiological effects. Research on specific psychiatric syndromes and diseases, particularly on their ethical and social aspects is less prominent. There is a growing body of research literature on links between mental health, climate change, pollution, and deforestation. This research provides a graphic overview to mental healthcare professionals and political stakeholders. Social and ethical aspects of the climate change-mental health link have been neglected, and more research is needed. (shrink)

The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses (...) globally in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

This paper describes the first phase of an ongoing education and research project guided by three main intentions: (1) to create opportunities for phronesis in the classroom; (2) to develop new understandings about phronesis as it relates to nursing care generally and to caring for specific groups, like formerly incarcerated adults; and (3) to provide an opportunity for formerly incarcerated adults and graduate nursing students to participate in a dialectical conversation about ethical knowing. Gadamer's writings on practical philosophy, (...) phronesis, and the Socratic dialectic provide the philosophical foundation and framework for the project. The first phase in the project was a 4‐h class within a graduate‐level health promotion course during which 30 nursing students and three formerly incarcerated panelists engaged in a dialectic conversation about what it means to care for formerly incarcerated adults in a meaningful way. After the class, two focus groups were conducted, one with the students and one with the formerly incarcerated panelists. Findings articulated participants' prejudices and assumptions prior to the class, expanded sense of phronesis, and ability to consider nursing practice within a larger ethical framework. Panelists and students left the class with a deeper understanding of one another and expressed an openness towards continued dialectic conversations together. Use of the Socratic dialectic within nursing curricula reflects a current and critical trend in nursing education to bring non‐epistemologic forms of knowledge into the classroom. (shrink)