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PubMed2006

Kant's assessment of motivation in the fulfillment of social obligations.

This paper explores the motivations of physicians who promote the health of their communities through the fulfillment of social obligations beyond the boundaries of their own patients. Based on the assumption that physicians do not have social obligations, this paper looks at the normative, motivational question, namely "How should physicians be motivated to fulfill social obligations?" The paper traces the Kantian view of morality and motivation. The distinctions between required, merely permissible, and forbidden actions is drawn. Furthermore, Kant's view that required actions done in accordance with duty are of no moral worth is critiqued from three stand points. First, it is argued that just because motivations outside of Kantian-based duty are not as good, it does not follow that these motivations are of no moral worth. Second, it is argued that there are some motivations behind required actions that are clearly better than other motivations. Third, it is argued that required actions done in accordance with duty are clearly better than those actions done without relevance to duty. The paper concludes that many required actions done in accordance with duty are performed from motivations that do have moral worth.

Altruism↗
PubMed1998

Learning ethics the hard way: facing the ethics committee.

This article describes an approach to enhancing the value of case study material in teaching professional ethics in psychology. The mock committee approach involves a series of hearings convened by students who rotate membership on a class ethics committee. Members of the class participate randomly as psychologists accused of various ethical violations. While the class observes, formal complaint hearings occur that result in official rulings and the setting of appropriate penalties and remedial requirements. The larger class then joins in active feedback and exchange with the committee to highlight and discuss salient ethical issues. We present and discuss student evaluation data for this technique and comment on the potential advantages of this teaching approach.

Committee Membership↗
PubMed1984

Maryland hospitals get plan for creating ethics committees.

The Maryland Hospital Association's Advisory Committee on Medical Ethics, charged to assist member hospitals in forming ethics committees, focused on four concerns: study and development, physician support, patient/family participation, and potential issues. The committee recommended as a first step in establishing an ethics committee the creation of a study group. It warned hospitals not to expect a fully operational ethics committee immediately. A start-up period, according to the committee, should be used to develop a process for handling ethical questions and for educating the hospital community about the committee's role. To promote the best possible decision making, the hospital ethics committee should function as a support unit, for physicians as well as for patients, families, and hospital personnel. Clearly stated policies will provide a basis for appropriate intervention and help gain physician cooperation, the committee said. Such policies should encourage ethics committees to anticipate problems and to review decisions already made. While recognizing the need to involve patients' families in decision making, the advisory group agreed that the question of their presence at committee meetings should be addressed by each institution. In cases of controversial treatment or disagreement about the course of treatment, patient/family access to the committee should be clearly defined. The advisory committee suggested that each institution prepare its own list of topics that an ethics committee might consider. It also prepared a "model statement" of an ethics committee's purposes, membership, and procedures.

Ethics Committees, Clinical↗
PubMed1982

Institutional Radiation Safety Committee--Nuclear Regulatory Commission. Final rule.

The Nuclear Regulatory Commission (NRC) is amending its regulations regarding hospitals licensed to use radioactive byproduct material for human applications. Currently, such a license requires that the hospital have a Medical Isotopes Committee to review clinical aspects of the use of radioactive materials within the hospital. The amendment requires instead a Radiation Safety Committee with a simplified membership that will focus on the radiation safety of workers and the general public. The rule change acknowledges the Food and Drug Administration's role in regulating the safety and effectiveness of radioactive drugs with respect to the patient. The membership of the new Radiation Safety Committee will include the hospital management and the nursing staff in decisions affecting radiation safety at the hospital and will be easier for smaller hospitals to recruit.

Licensure↗
PubMed1992

Ethics committees in Japanese medical schools.

The present features and functions of ethics committees in 80 Japanese medical schools were surveyed by employing questionnaires. Seventy-nine schools had already established committees on each campus (however, the ethics committee at Kitasato Medical University was formally established after the completion of this survey). The major role of Japanese ethics committees may be said roughly to correspond to that of Institutional Review Boards (IRB) in the U.S., although ethics committees have other functions as well. Among the ethics committees' many problems, two significant weaknesses should be underscored. The first is the inappropriate composition of the membership of the committees: more non-campus members, younger professionals, and women should be invited to participate. The second concern is the committees' essentially closed review process: this process has not been adequately open to the public even in cases in which the issue of the patient's confidentiality does not arise. However, several schools are now preparing to open their meetings to non-members and this policy should improve the present situation. It is fortunate, however, that the ethics committees in Japan's medical schools were established by members from each campus and not as a response to national directives or legislation.

Community Participation↗
PubMed1989

Institutional ethics committees: a survey of children's hospitals.

Institutional ethics committees first gained national prominence after the 1976 Karen Ann Quinlin decision by the New Jersey Supreme Court. However, it wasn't until the Federal Government promulgated the Baby Doe regulations in 1983 that significant movement occurred toward implementing such committees. Currently, statistics show that the number of ethics committees are increasing in health care institutions across the country. However, the majority of studies have focused on adult institutions. The membership of ethics committees and the objectives under which the committees function are usually addressed by the studies. Very little attention has been given to the nursing representation on the institutional ethics committee and the unique role played by nurses in the deliberation of ethical decision-making. It is the intent of this research to shed some light on the availability and functions of ethics committees within children's hospitals. Attention has also been given to the nurses' involvement on such committees. Additionally, the study takes a separate look at nursing ethics committees, their function within an institution, and the availability of ethics education for nurses. The study offers information not previously acknowledged in past studies of ethics committees. The study also opens up to consideration the unique concerns of nurses and their roles in ethical decision-making.

Child↗
PubMed1997

Prevalence of use of infection control rituals and outdated practices: Education Committee survey results.

BACKGROUND: To better serve APIC membership, the National APIC Education Committee periodically conducts educational needs assessments. METHODS: In the July/August 1995 issue of APIC News, the committee published a survey on the prevalence of infection control "sacred cows," practices considered to be outdated and ritualistic. A response was requested only from ICPs working in inpatient facilities. We asked ICPs which of the listed practices were part of their facility's infection control program, and whether they were interested in changing those that were. We also asked about the certification status of the program's manager (CIC vs non-CIC). RESULTS: A total of 506 survey forms were completed and returned, with 74% from acute care only, 7% from long-term care only, 10% from acute and long-term care, and 8% from other types of facilities. Mean number of beds was 226. Infection control programs had existed for a mean of 15 years. Most respondents' facilities still engaged in infection control rituals. Fifty-eight percent of respondents were still doing total surveillance, 43% were still using reverse or protective isolation, and 11% were still subjecting employees with positive reactions to purified protein derivative of tuberculin testing to annual chest radiographs, to name a few. Certified respondents were significantly less likely to include outdated practices than were non-CICs for 11 of 15 practices (73%). CICs were no more likely than non-CICs, however, to be interested in changing any current rituals. CONCLUSION: The Education Committee will use this information to plan future educational offerings.

Chi-Square Distribution↗
PubMed2004

Advisory committee; Pediatric Advisory Committee; establishment. Final Rule.

The Food and Drug Administration (FDA) is announcing the establishment of a Pediatric Advisory Committee in the Office of the Commissioner. Elsewhere in this issue of the Federal Register, FDA is publishing a document requesting nominations for the membership on this committee. This document adds the Pediatric Advisory Committee to the agency's list of standing advisory committees in 21 CFR 14.100.

Advisory Committees↗
PubMed1991

Advisory committees; OTC Drugs Advisory Committee; establishment--FDA. Final rule.

The Food and Drug Administration (FDA) is announcing the establishment by the Commissioner of Food and Drugs of the OTC Drugs Advisory Committee in FDA's Center for Drug Evaluation and Research. Elsewhere in this issue of the Federal Register, FDA is publishing a notice requesting nominations for membership on this committee. This document adds to the agency's list of standing advisory committees.

Drug Evaluation↗
PubMedDate not supplied

Factors affecting membership in specialty nursing organizations.

A discouraging trend in many specialty nursing organizations is the stagnant or declining membership. The research committee of the Southeast Texas Chapter of the Association of Rehabilitation Nurses (ARN) collected data and studied this trend to determine what changes would be necessary to increase membership. Using Herzberg's motivational theory as a framework, a review of the literature was initiated. There were few current studies on this issue, but relevant information was found about nursing's emerging workforce, as well as implications of the growth of magnet hospitals, which affect whether nurses join specialty nursing organizations. A multifaceted data-collection approach using convenience samples was designed. First, relevant literature was reviewed. Second, a survey was sent by e-mail to other ARN chapters. Third, a telephone survey on other specialty organizations in the geographic region was completed. Finally, members of the local ARN chapter and four other specialty organizations, as well staff nurses in the geographic area, were given questionnaires to complete. Descriptive statistics and cross tabulations were used to determine why nurses do and do not join specialty organizations (N = 81). The most frequent reasons for joining an organization were to increase knowledge, benefit professionally, network, and earn continuing education units. Reasons for choosing not to participate were family responsibilities, lack of information about these organizations, and lack of time. Ways to reverse the decline in membership are discussed.

Adult↗
PubMed2004

Expertise in research ethics: is there any such thing?

In this paper, I consider the question of whether there is such a thing as 'expertise in research ethics'. I discuss first the issue of expertise in ethics more generally. There is quite a lot of resistance to the idea that there are ethics experts, for reasons which I will raise and respond to. I outline two different views of what might be counted as expertise in ethics, and argue that only one of these is defensible. But the defensible view is also a useful view. Ethics expertise in this sense does exist. It is a set of generic analytic skills and knowledge of ideas and logical processes. Expertise in research ethics is a particular type of ethics expertise, and I give a brief account of what it includes, and how it differs from ethics expertise in general. I end with the suggestion that people with such expertise would be useful members of Human Research Ethics Committees, and steps ought to be taken to increase the likelihood that they become members. This may or may not involve adding the category of 'ethicist' to the list of HREC membership categories.

Committee Membership↗