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PubMed1991

Principle-oriented ethics and the ethic of care: a creative tension.

Research to date in the field of nursing ethics has overlooked the nature of the guiding moral framework in nursing practice, while focusing primarily on the moral reasoning and moral behaviors among nurses. This research depicts two moral frameworks--a principle-oriented ethic and the ethic of care--as they are experienced by practicing critical care nurses. The interdependence of these two frameworks as they inform the moral experience of the nurse is demonstrated in the analysis of a complex nurse narrative that depicts the nurse's moral struggle.

Beneficence↗
PubMed1990

Psychiatric ethics and ethical psychiatry.

This paper critically examines the code of ethics that applies to practising psychiatrists. The code performs the functions for which it was designed admirably well. It does not, however, resolve moral dilemmas (i.e., complex situations in which any course of action compromises certain ethical principles). In these cases, the psychiatrist must turn to wider moral theory (i.e., psychiatric ethics) for guidance.

Codes of Ethics↗
PubMed2003

The American Nurses Association Code of Ethics: a reflection on the ethics of respect and human dignity with nurse as expert.

The American Nurses Association Code of Ethics for Nurses calls for the nurse to practice with compassion and respect for every individual. What are the ethics and challenges of practicing professional nursing with expertise and educating a new generation of nurses while incorporating the interpretive statements into practice? This column differentiates the traditional biomedical views on human dignity and respect while exploring the embedded ethics of respect and self-determination and what it truly means to be an expert of nursing from the theoretical perspective of the human becoming school of thought.

American Nurses' Association↗
PubMed1984

Ethics in dentistry: review and critique of Principles of Ethics and Code of Professional Conduct.

This paper has reviewed an ethic for the profession of dental medicine, such an ethic being grounded in the classical characteristics of a profession. The Principles and Code of the ADA have been reviewed and critiqued. The following conclusions are drawn: The dental profession and the individual dentist have a duty to recognize the reciprocity of the relationship that exists with society, and the duty of covenantal fidelity. The dentist has a duty to conduct his or her professional life in accordance with the ethical principles rooted in the moral rules. These are the principles of beneficence: autonomy and justice, in both individual and societal contexts. The dentist has a duty to maintain his or her level of knowledge and skill current. The dentist has an obligation to participate in the professional community to help ensure just distribution of society's resources and to share the burden of professional self-regulation to the extent that such a privilege is granted by society. The current Principles and Code are helpful expressions of dentistry's professional obligations, but are deficient in: not speaking to reciprocity of relationship, the principle of self-determination, and not providing for societal participation in the covenant agreement.(ABSTRACT TRUNCATED AT 250 WORDS)

American Dental Association↗
PubMed2000

Ethics in the classroom: a reflection on integrating ethical discussions in an introductory course in computer programming.

In this paper, we describe our recent approaches to introducing students in a beginning computer science class to the study of ethical issues related to computer science and technology. This consists of three components: lectures on ethics and technology, in-class discussion of ethical scenarios, and a reflective paper on a topic related to ethics or the impact of technology on society. We give both student reactions to these aspects, and instructor perspective on the difficulties and benefits in exposing students to these ideas.

California↗
PubMed2006

Yoga and the battlefield of ethics: highlighting an infusion model for ethics education.

This paper articulates an infusion model of ethics education for engineering students by illuminating the value of a religious studies course on yoga. This model is distinguished from four other possible approaches that have traditionally been used to prepare engineering students to face the challenges of the work place. The article is not claiming that this approach should be used to the exclusion of the other approaches, but rather that it adds strength to the other approaches. Specifically, the article claims that the infusion model provides an opportunity for students to reflect upon the foundational ethical positions emanating from the world's religions and thereby provides them with a vista from which they can not only ask what professional ethical code applies in a given situation, but also ponder the nature of character needed to follow that ethical code.

Curriculum↗
PubMed1997

Ethics in the intensive care unit. Creating an ethical environment.

This article discusses ethical issues that exist each and every day in interactions with patients, families, and fellow workers in the ICU, even in the absence of overt conflict or controversy. The creation of an ethical working environment in the ICU is a necessary precondition for dealing with the ethical issues raised by specific issues such as cardiopulmonary resuscitation, the limitation or withdrawal of life-sustaining treatment, the special care of children with disabilities, brain death, and organ procurement, and triage. The creation of an ethical working environment requires developing a collaborative relationship with patients, families, staff, and other health care professionals.

Adult↗
PubMedDate not supplied

Ethical challenges in emergency medical services. A special contribution of the Ethics Committee, National Association of Emergency Medical Services Physicians.

Patient autonomy, beneficence, and justice are the fundamental ethical principles of an emergency medical service. Ethical conflicts are present in the daily practice of prehospital care. These conflicts surround issues of resuscitation, futile therapy, consent, and refusal of care, duty, and confidentiality. Emergency medical services must remain fair and equitable, equally available to those it is designed to serve, regardless of the patient's social or economic status. Establishing priorities for patient care is dictated by medical and operational concerns. Education and information regarding ethical issues are important for the providers of prehospital medical care as well as the medical director. Policies and protocols must continue to be developed to address requests to limit resuscitation, such as refusal of care and patient confidentiality. Policies should be developed in conjunction with experienced legal advice. Current training does not equip even the most advanced prehospital care provider to deal easily with every potential situation. Many learn by experience, some are guided by clear policy. Ideally, medical control personnel will be educated, interested, and available to address dilemmas which arise. Where possible, policies and procedures should be developed to address ethical issues which are likely to be faced by EMS personnel.

Confidentiality↗
PubMed1996

Ethical conflict resolution based on an ethics of relationships for brain injury rehabilitation.

An ethics of relationships for brain injury (BI) rehabilitation is described based on three principles; (1) human relationships are important; (2) human relationships are as important as individual survival; (3) human relationships are important enough to extend throughout the family of humankind. Within the context of this ethics of relationships, ethical conflict resolution (ECR) is offered as a process to address disagreements among those involved in BI rehabilitation. ECR provides a means to arrive at moral decisions in situations in which people disagree about the appropriate course of action because of differing values. ECR recognizes that, although disagreements in BI rehabilitation settings can be associated with multiple other factors, including disturbed self-awareness, emotions, communication, and interpersonal dynamics, such disagreements may also be value-based, either in whole or part. ECR invites the professional team to identify the value-based portion of these disagreements and provides a rational and supportive process to address disagreements. In this discussion of ECR, common and potentially universal areas of ethical concern in BI rehabilitation are identified, as well as potential risks. Specific examples of the application of ECR in cases of vegetative state, coma stimulation, and cognitive rehabilitation are described.

Brain Damage, Chronic↗
PubMed2004

Toward critical research ethics: transforming ethical conduct in qualitative health care research.

Based on research conducted with women injection drug users (WIDUs), I discuss the ethical conflicts that researchers and sub-contractors face in gaining access to the life narratives of WIDUs. Foremost among these is the potentially exploitative nature of the study participant-researcher relationship. I suggest that federal and institutional guidelines for human subject research must incorporate additional safeguards to protect study populations such as WIDUs. Moreover, the ethical concerns related to health care research should be addressed in guidelines for ethical conduct with human subjects, research ethics seminars, and required training programs for researchers and subcontractors separately.

Confidentiality↗
PubMed2002

The cultural specifity of research ethics--or why ethical debate in France is different.

In the search for a globally binding ethical minimal consensus in dealing with research on human beings the awareness of the cultural specificity of such questions will be of central importance. France provides a good example of such cultural specificities. Three basic structures of French discussion on research ethics can be enumerated: first the particular weight placed on therapeutic benefit, second a particular accentuation on freedom and voluntarism, and third its lesser attention to the aspect of ability to give consent. The weak emphasis on the ability to give consent is rooted as much in the traditionally paternalistically imbued physician-patient relationship as in the French legal system, in which the doctrine of consent is not given the fundamental position of importance found in the Anglo-Saxon countries. As an important Roman country, a different accentuation in the ethical discussion on research on humans can be recognised, a discussion in which for a long time the right of self determination was less of a criterion for decision than the teleology of medical action. It is precisely this aspect of latent cultural influence in ethical convictions which is of decisive importance for future discussion on research on humans.

Cultural Diversity↗
PubMed1981

Ethics rounds: a model for teaching ethics in the psychiatric setting.

Despite growing interest in ethical matters in psychiatry, little attention has been paid to means of teaching ethics to mental health professionals. In a monthly "ethics rounds" developed in a community mental health center, the co-leaders of the rounds visited one of the center's clinical services during a regularly scheduled staff conference to lead a discussion of a case selected by the staff and the underlying ethical problems. The rounds were attended by personnel at all levels and from a variety of disciplines. A survey of participants showed that the program was generally well received. Two cases selected for discussion at the rounds--one concerned with confidentiality and the other with court-ordered treatment--are presented, along with the discussion that each case stimulated. The advantages and disadvantages of the model are discussed, and suggestions for implementing a similar program are offered.

Adult↗
PubMed1996

What ethical issues are Japanese epidemiologists facing? Results of a questionnaire study for members of the Monbusho Research Committee on evaluation of risk factors for cancer by large-scale cohort study. Subcommittee of Ethical Issues.

In 1993 questionnaires concerning ethical issues were mailed to 34 committee members of the Monbusho research committee of a large-scale cohort study which started in 1988 including 32 rural communities and 4 occupational groups. The questionnaire survey revealed the following results. 1. In all cohorts, "informed consent" for health questionnaires was carried out, though the methods varied. 2. Although the method varied, informed consent for collection of blood was obtained in 28 (77.8%) of the 34 cohorts. The committee decided that the collected specimens without consent is not used for study. 3. The protection of privacy was deliberately planned and has been carefully carried out in the cohort study. 4. The committee members' concerns for ethical issues has increased after joining the cohort study. 5. The attitudes of informed consent for collection of blood at mass screenings showed wide differences among research objects and researchers. These results suggested that the research members had a considerably high concern for ethical issues and that ethical considerations in epidemiological studies should be continued in Japan.

Adult↗
PubMed1996

Bad ethics, good ethics and the genetic engineering of animals in agriculture.

Genetic engineers have been remiss in addressing ethical and social issues emerging from this powerful new technology, a technology whose, implications for agriculture are profound. As a consequence of this failure, society has been uneasy about genetic engineering of animals and has had difficulty distinguishing between genuine and spurious ethical issues the technology occasions. Many of the most prominent concerns do not require a serious response. On the other hand, concerns about a variety of possible risks arising from genetic engineering of animals require careful consideration and dialogue with the public. Such concerns are an admixture of ethics and prudence. A purely ethical challenge, however, hitherto not addressed, is represented by problems of animal welfare that arise out of genetically engineering agricultural animals. A principle of "conservation of welfare" is suggested as a plausible moral rule to guide such genetic engineering.

Animal Experimentation↗
PubMed2001

[Ethical problems in randomized clinical trials from the aspect of statistics. Part I. Is patient randomization acceptable from the ethical viewpoint?].

Randomized clinical trial is currently thought to be the most reliable method for comparing therapeutic effects. The article tries to answer the question whether chance allocation of patients into various therapeutic arms is acceptable from the ethical point of view. It deals with the conflict between two concepts: of individual ethics mostly defending interests of individual participants of each trial, and collective ethics based on well-designed experiments that are the sole source of reliable estimation of therapeutic effect and their conclusions can change clinical practice and help patients in the future. The article suggests this possible solution: providing there is no prevailing consensus as for superiority of one of the compared therapies, the offer to participate in randomized clinical trial is not only acceptable but necessary in view of individual patients' right and respect of their autonomy. If an informed consent is obtained the principles of medical ethics have not been violated. Finally, a few alternative trial designs are presented.

Ethics, Medical↗
PubMed2001

Law, ethical codes, and the report of the CSSP survey on ethics policies. Council of Scientific Society Presidents.

Recently, the Council of Scientific Society Presidents (CSSP) collected data from its member organizations regarding codes of ethics. To better understand why such a survey would be undertaken, this paper begins by examining what is meant by ethics and highlights some distinctions between law and ethics. It then discusses codes of ethics, stressing their purposes and functions. Finally, it looks at the results of the CSSP survey and evaluates how various organizations formulate and implement their codes.

Data Collection↗
PubMed2002

[Right and ethics in reproductive medicine--medical and ethical aspects].

Legality and ethics in reproductive medicine are interdependent. Whether ethics degenerates into an ethics of convenience and adaptation, or into an ethics that always comes too late, depends on each doctor and researcher. Our medical care requires legal guidelines. There is not only a responsibility for research, but also one for engaging in research. This position is presented in four sections: on reproductive medicine, the moral status of the embryo, the research on spare embryos and in a section on reproductive medicine in Europe.

Ethics, Medical↗
PubMed1992

[Ethics versus ethos: current ethical problems in palliative oncology].

Difficult moral concerns and choices are a characteristic of palliative cancer medicine. Problems in patient information, palliative chemotherapy, treatment with unconventional remedies and clinical drug development are given as examples. The physician-scientist as member of a clinical cancer research institution particularly faces ethically troublesome situations. It is argued that next to the acquisition of bioethical competence by 'doing' staff, members working in scientific and medical frontiers should specifically be trained to identify, analyse and resolve ethical dilemmas. In conclusion, a biomedical ethics programme is presented which will be instituted at a new cancer center, comprising the establishment of a humanities research group, ethical liaison, consultation and information services as well as a system of inhouse bioethical quality control.

Bioethics↗