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At least 109 records · Page 6Linked to original sources
PubMed2000

Rethinking technology, revitalizing ethics: overcoming barriers to ethical design.

This paper explores the role of ethics in design. Traditionally, ethical questions have been seen as marginal issues in the design of technology. Part of the reason for this stems from the widely held notion of technology being "out of control." This notion is a barrier to what I call "ethical design" because it implies that ethics has no role to play in the development of technology. This view, however, is challenged by recent work in the field of Science and Technology Studies (STS). Looking into the dynamics of technological change, STS scholars argue that human choices are present at every stage of a technology's development and, furthermore, that human values are reflected in the very design of artifacts. This alternative view suggests that ethics can and should be included in the design process. Drawing on examples from the privacy arena, I point to some of the potential advantages of addressing ethical concerns early on in the design of a technology. I conclude with some general strategies for bringing ethics back into design.

Ethics↗
PubMed1999

Psychiatric research ethics: an overview of evolving guidelines and current ethical dilemmas in the study of mental illness.

The field of psychiatry has an opportunity to construct a more refined, perhaps more enduring understanding of the ethical basis of mental illness research. The aim of this paper is to help advance this understanding by 1) tracing the evolution of the emerging ethic for biomedical experimentation, including recent recommendations of the President's National Bioethics Advisory Commission, and 2) reviewing data and concepts related to compelling ethical questions now faced in the study of mental disorders. Empirical findings on informed consent, the ethical safeguards of institutional review and surrogate decision making, and the relationship between scientific and ethical imperatives are outlined. Psychiatric researchers will increasingly be called upon to justify their scientific approaches and to seek ways of safeguarding the well-being of people with mental illness who participate in experiments. Most importantly, psychiatric investigators will need to demonstrate their appreciation and respect for ethical dimensions of investigation with special populations. Further empirical study and greater sophistication with respect to the distinct ethical issues in psychiatric research are needed. Although such measures present many challenges, they should not interfere with progress in neuropsychiatric science so long as researchers in our field seek to guide the process of reflection and implementation.

Bioethics↗
PubMed1996

Ethical considerations in resuscitation decisions: a nursing ethics perspective.

Resuscitation decisions present clear ethical issues that are examined through literature review and theoretical synthesis. Nursing ethics begins in the practice of presence, communication, and valuing the patient's uniqueness. Such an "ethic of care" responds to the medical decisions concerning resuscitation with clear values and concerns. The values of autonomy and beneficence are embodied in the ways the nurse relates to patients. An ethic of care also is expressed through establishing a caring environment. Also, the issues raised by advance directives and "medical futility" must be integrated into the ethical practice of caring for patients. Nurses who express such an ethic of care will have a profound impact on the ethical environment of their institutions and decision-making processes of their patients.

Advance Directives↗
PubMed1999

[The evolution of ethical standards in the practice of psychology: a reflection on the APA Code of Ethics].

After briefly describing the need for ethics in the development of professional regulation and analyzing the historical emergence of codes of ethics, the goal of this paper is to scrutinize the process by which the American Psychological Association developed its own Code of Ethics and proceeded to revise it periodically. Different lessons can be derived from these efforts and from the criticisms that were formulated. The need for international standards in professional and research ethics is then considered, and the results of a recent study on this subject are presented. Five major conclusions can be derived from the preceding analysis: (1) Codes of ethics can help professional recognition by stressing the importance given to the protection of the public, (2) the development of a code of ethics is usually related to the advancement of professional practice, (3) ethical standards should be in tune with the cultural values and the belief system of a given community, (4) a well-balanced code should incorporate both general aspirational principles and enforceable standards, and (5) the method used to define principles and standards should be empirically based.

Ethics, Professional↗
PubMed2001

[The development of ethics. Identifying what training in medical ethics is needed by family physicians].

OBJECTIVE: To identify what training in medical ethics physician teachers need. DESIGN: Qualitative research study using a modified nominal group technique. SETTING: Family practice units affiliated with the Department of Family Medicine at Laval University in Quebec. PARTICIPANTS: Fifty-three physician teachers in six family practice units. METHOD: During seven meetings, the teachers shared information on clinical situations that had posed ethical problems. Data were analyzed using Strauss and Corbin's method. MAIN OUTCOME FINDINGS: The 277 clinical situations were classified under nine themes: ethics; confidentiality; consent, refusal of treatment, and the right to information; level of care and abstention from and cessation of treatment; relationships with pharmaceutical companies and the ethics of research; ethics of teaching; allocation of resources; influence of third parties; and euthanasia and assisted suicide. Learning objectives were developed. CONCLUSION: This research forms the basis of the ethics curriculum in the family medicine residency program at Laval University. It also offers a strategy for integrating ethics into daily teaching activities because the learning objectives derive directly from the concerns of the teaching faculty.

Adult↗
PubMed1994

The nurse's role on ethics committees and as an ethics consultant.

Nurses share in the moral responsibility of their institution to ensure that the best ethical decision-making process is in place to meet patient needs, uphold the philosophy of the institution, and preserve the integrity of the profession. With health care reform under way, clinical ethical decision making will be even more difficult and complex than it is now. As members of ethics committees, nurses have a role to share their unique perspective. Nursing's prolonged contact with the patient, therapeutic communication skills, and goal-oriented approach facilitate the ethical decision-making process and make nurses well-suited to participate on ethics committees. This article discusses the role of the nurse on an ethics committee and, briefly, the advanced practice nurse as an ethics consultant.

Communication↗
PubMed1998

Ethics summit I: assembling the ethical community.

Ethics Summit I was a unique gathering of organizations representing all of oral health care, convened by the American College of Dentists, for the purpose of seeking a common ethical ground. The background of the conference and its logistics are described here. Four themes were discussed: the role of ethics codes, conflicting values, responding to unethical behavior, and organizations as ethical agents. The conference was grounded in the unusual assumptions that the participants did not have to have a common profile of values to engage in ethical discussion and that individual behavior is not the only level at which ethical discussion must take place. Finally, we did not begin with an assumption that one group could define an ethical code that all others might subscribe to. One strong consensus that emerged was the desirability of creating an alliance of all concerned with oral health care to continue such conversations.

Dentistry↗
PubMed2006

Descriptive ethics: a qualitative study of local research ethics committees in Mexico.

OBJECTIVE: To describe how local research ethics committees (LRECs) consider and apply research ethics in the evaluation of biomedical research proposals. DESIGN: A qualitative study was conducted using purposeful sampling, focus groups and a grounded theory approach to generate data and to analyse the work of the LRECs. SETTING AND PARTICIPANTS: 11 LRECs of the Mexican Institute of Social Security (IMSS). RESULTS: LRECs considered ethics to be implicit in all types of research, but that ethics reviews were only necessary for projects that included the direct participation of human beings. The LRECs appeared to understand the importance of consent, as in the completion of a consent form, but did not emphasise the importance of the process of acquiring 'informed' consent. The committees considered their main roles or functions to be: (a) to improve the methodological quality of research and to verify - if applicable - the ethical aspects; (b) to encourage personnel to undergo research training; (c) to follow-up research to oversee the adherence to norms and compliance with a specified research timetable. CONCLUSIONS: This study provides a valuable insight into how these LRECs understand the ethical review process. The emphasis of the committees was on rules, regulations, improving research methodology and research training, rather than a focus on efforts to protect the rights and well being of research subjects. The results encourage further normative and descriptive lines of investigation concerning education and the development of LRECs.

Ethical Review↗
PubMed2005

Clinical ethics, information, and communication: review of 31 cases from a clinical ethics committee.

OBJECTIVES: To summarise the types of case brought to the Clinical Ethics Committee of the National Hospital of Norway from 1996 to 2002 and to describe and discuss to what extent issues of information/communication have been involved in the ethical problems. DESIGN: Systematic review of case reports. FINDINGS: Of the 31 case discussions, (20 prospective, 11 retrospective), 19 cases concerned treatment of children. Twenty cases concerned ethical problems related to withholding/withdrawing of treatment. In 25 cases aspects of information/communication were involved in the ethical problem, either explicitly (n = 3) or implicitly (n = 22). CONCLUSION: Problems related to information/communication may underlie a classic ethical problem. Identification of these "hidden" problems may be important for the analysis, and hence, the solution to the ethical dilemma.

Adult↗
PubMed1994

Professional nurses should have their own ethics: the current status of nursing ethics in the Dutch curriculum.

Should nurses have their own ethics to match specific problems met in their daily routines? How do nurses act in a society that is changing from a 'monocultural' to an 'intercultural' structure? What are the ethical consequences of these changes for their many tasks? How can the ethical aspects be taught to nurses? This article describes the current status of nursing ethics in the curriculum taught in schools of higher education for nurses in The Netherlands. Aspects of the debate on nursing ethics are outlined and ideas about its future as a subject and discipline in nurse education are offered.

Bioethical Issues↗
PubMed2005

Ethical intensive care research: development of an ethics handbook.

Conduct of research involving humans in the intensive care unit (ICU) setting is complex and challenging. The vulnerable nature of critically ill patients raises issues of patient safety, and informed consent is difficult. With an increasing global interest in human research ethics, broadened government mandates have targeted improvements in research participant protection and research governance. A parallel rise in health consumerism and advocacy for privacy and protection of personal health information requires a clear understanding of the research participant role and importance of risk disclosure. In addition, the potential for conflicts of interest in a climate of increasingly competitive research funding, requires caution and transparency in related financial and contractual arrangements. The Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) fosters collaborative ICU research activity. We have developed An Ethics Handbook for Researchers (EH) for the ANZICS CTG for intended use by researchers in Australian and New Zealand ICUs. The purpose of the EH is to act as a practical advisory guide/supplement; to add clarification regarding ethical issues specific to intensive care research, to assist in the expedition of ethics committee research submission and to summarise available useful resources. This article introduces a précis of key issues from the EH including specific ethical difficulties pertaining to ICU research, a summary of the process by which ethics committee decisions in Australia and New Zealand are informed, and the use of ethical checklists to assist researchers.

Journal Article↗
PubMed2006

Private-sector research ethics: marketing or good conflicts management? The 2005 John J. Conley Lecture on Medical Ethics.

Pharmaceutical companies are major sponsors of biomedical research. Most scholars and policymakers focus their attention on government and academic oversight activities, however. In this article, I consider the role of pharmaceutical companies' internal ethics statements in guiding decisions about corporate research and development (R&D). I review materials from drug company websites and contributions from the business and medical ethics literature that address ethical responsibilities of businesses in general and pharmaceutical companies in particular. I discuss positive and negative uses of pharmaceutical companies' ethics materials and describe shortcomings in the companies' existing ethics programs. To guide employees and reassure outsiders, companies must add rigor, independence, and transparency to their R&D ethics programs.

Biomedical Research↗
PubMed2001

Ethics and communication: does students' comfort addressing: ethical issues vary by specialty team?

Ethics education aims to train physicians to identify and resolve ethical issues. To address ethical concerns, physicians may need to confront each other. We surveyed medical students to determine if their comfort challenging members of their ward teams about ethical issues varies by specialty and what attributes of students and their teams contributed to that comfort. Compared to other specialties, students felt significantly less comfortable challenging team members about ethical issues on surgery and obstetrics/gynecology. We suggest that ethics education must address the atmosphere on ward teams and give students skills to help them speak out despite their discomfort.

Adult↗
PubMed2004

Exploring the heart of ethical nursing practice: implications for ethics education.

The limitations of rational models of ethical decision making and the importance of nurses' human involvement as moral agents is increasingly being emphasized in the nursing literature. However, little is known about how nurses involve themselves in ethical decision making and action or about educational processes that support such practice. A recent study that examined the meaning and enactment of ethical nursing practice for three groups of nurses (nurses in direct care positions, student nurses, and nurses in advanced practice positions) highlighted that humanly involved ethical nursing practice is also simultaneously a personal process and a socially mediated one. Of particular significance was the way in which differing role expectations and contexts shaped the nurses' ethical practice. The study findings pointed to types of educative experiences that may help nurses to develop the knowledge and ability to live in and navigate their way through the complex, ambiguous and shifting terrain of ethical nursing practice.

Canada↗
PubMed2002

Ethical orientation, functional linguistics, and the codes of ethics of the Canadian Nurses Association and the Canadian Medical Association.

The literature on codes of ethics suggests that grammatical and linguistic structures as well as the theoretical ethical orientation conveyed in codes of ethics have implications for the manner in which such codes are received by those bound by them. Certain grammatical and linguistic structures, for example, tend to have an authoritarian and disempowering impact while others can be empowering. The authors analyze and compare the codes of ethics of the Canadian Nurses Association (CNA) and the Canadian Medical Association (CMA) in terms of their ethical orientation and grammatical/linguistic structures. The results suggest that the two codes differ substantially along these two dimensions. The CNA code contains proportionally more statements that provide a rationale for ethical behaviour; the statements of the CMA code tend to be more dogmatic. Functional grammar analysis suggests that both codes convey a strong deontological tone that does not enhance the addressee's ability to engage in discretionary decision-making. The nurses' code nonetheless implies a collaborative relationship with the client, whereas the medical code implies that the patient is the recipient of medical wisdom. The implications of these findings are discussed.

Canada↗
PubMedDate not supplied

Integrating clinical and organizational ethics. A systems perspective can provide an antidote to the "silo" problem in clinical ethics consultations.

Traditionally, ethics consultations are conducted one case at a time. This typical approach addresses immediate needs pertinent to the case, but seldom looks toward preventing recurrences. The underlying problem is that clinical ethics and organizational ethics are still often regarded as separate areas with separate concerns. When it comes to ethics in health care, nothing helps clarify ideas like a case study. The autopsy case mentioned in this article demonstrates that clinical cases coming before an ethics committee are impeded in and influenced by a larger organizational context. The authors say that a "systems-oriented" perspective toward ethics consultation would help committee members view cases through the widest possible lens. This would enable committees to look at the larger system and thereby propose strategies for anticipated repeat problems.

Autopsy↗
PubMed1993

Experienced nurses' narratives of their being in ethically difficult care situations. The problem to act in accordance with one's ethical reasoning and feelings.

In previous interviews, experienced nurses have reported that their decisions in ethical matters depended "on the situation at hand." We interviewed 18 good, experienced cancer nurses to determine how they handled ethical decisions. They were asked to give an account of difficult situations that required ethical decisions to be made. The 60 narrated situations were interpreted step-by-step departing from the following two questions: What do nurses experience when being in ethically difficult care situations? What does the expression "it depends on the situation at hand how I act" mean? In complex situations, the nurses reported that the ethical situations that arose were regarded either as overwhelming or at the other end of the spectrum, as possible to grasp, and they expressed either loneliness or togetherness, respectively. When reporting overwhelming situations, the nurses mostly referred to themselves by using the word "one," i.e., "one would" and used "they" when referring to their coactors. When narrating situations possible to grasp, they used the terms "I" and "we." The most important situational factor that was revealed in these narratives was whether or not the nurses had a support group in which to share their thoughts. Without the support group, they reported difficulties acting in accordance with their ethical reasoning and feelings.

Adult↗
PubMed1994

Transcultural nursing ethics: a framework and model for transcultural ethical analysis.

Increased awareness of cultural diversity in contemporary society and nursing mandates the need for transcultural nursing ethics. The core of this ethics assumes that all discourse and interaction is transcultural because of strengths and differences in values and beliefs of individuals and groups within global society. Transcultural ethics addresses how people ought to live when subjectively sharing a common world. This article presents a framework and model with four parts: Transcultural Caring Dynamics, Principles, Transcultural Context, and Universal Source. These incorporate the ethics of virtue, principle, values, and belief, respectively. Interactive parts of the holistic process provide the foundation for assessing and analyzing transactions to facilitate understanding and direction toward culturally based ethical decision making.

Beneficence↗