Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ETHICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,243 records · Page 69Linked to original sources
PubMed1992

A survey method for investigating ethical decision making in family practice.

BACKGROUND: The tension between respect for patient autonomy versus concern for patient welfare is a challenging ethical issue for physicians. The purpose of this research was to describe a method for analyzing ethical decisions and to report the results of a survey of ethical decision making among family physicians. METHODS: We developed a survey instrument that used simulated case scenarios, each of which posed an ethical dilemma. The ethical problems on the survey included the extent to which diagnostic information should be revealed to patients, the extent to which physicians should become involved in patients' life-style issues, and how to deal with patients' family problems. We mailed the questionnaire to 1,300 US family physicians. RESULTS: Six hundred seventy-four physicians responded. Respondents did not deal with the simulated ethical problems in a uniform manner and often tended to respond more to specific details of a case rather than the overall ethical dilemma posed. Physicians who chose a course of action giving patients more control were motivated by factors that showed respect for patient autonomy. On the other hand, physicians who chose a course of action giving patients less control were not motivated by factors suggesting a concern for patient welfare. CONCLUSIONS: Based on responses to simulated case scenarios, family physicians did not demonstrate a uniform approach but rather a more contextual one. Respect for patient autonomy was linked to family physicians' reported courses of action.

Adult↗
PubMed1993

Ethical considerations in podiatric care of the older patient.

Ethical issues are constantly changing. Today, there is a greater consideration of the social issues as they relate to medical care. The questions of comfort are of greater concern for as we deal with increasing numbers of aging patients and chronic disease, cure may not always be possible; thus, patient management is a key issue. There are greater concerns for the rights of patients, their privacy, and the relationships that need to be maintained between doctors and their patients. There is a greater focus on the quality of life and not just saving a life. There are new questions posed in relation to the termination of treatment, particularly in relation to aging and at what point is there harm and not good from treatment. There is also the issue of public rights and whether the system should be permitted to develop without a freedom of choice or restrictions on podiatric care that are not imposed on any other professional service. Ethics and bioethics in itself is more than a statutory issue, it is more than policy. It also must be an educational issue that considers societal issues in the changing delivery of health care. It must now deal with professional liability and cost containment because now there are mechanisms for the rationing of care based on costs alone. Ethics must be based on respect, obligation, professional responsibility, as well as care issues. It must be an issue of moral relevance. Ethics must continue to deal with conduct, professional relationships, and human dignity. It must deal with improved knowledge and skills. It must consider and maintain the highest possible level of professional judgement. Ethics must also consider professional responsibility and obligation beyond what might be required to meet the legal basis of practice. Simply being "this side of legal" is not adequate in both an ethical and moral sense. If we recognize that it is the public that ultimately will determine our future health care system, partly on a preconceived need, partly on cost, partly on opinion, and partly on political impression, then we in podiatric medicine must assume a greater responsibility in protecting and promoting quality care, ethical conduct, and serving as a moving force in the changes that will take place in our health care delivery system in the future. Foot care is both basic and needed. Our state practice acts and laws and regulations have established this fact and demonstrated a public need for podiatry. Our obligation is to protect that need with integrity.

Aged↗
PubMed2002

Research ethics review and the bureaucracy.

This paper suggests that the increasing bureaucracy of ethics review by committee is more about fulfilling institutional requirements than it is about ethics. It is suggested that ethics committees should not be instruments of bureaucratic regulation and control. They should be freed to play a critical role within the institution, to support and develop ethical research and researchers, and given time to discuss and explore the difficult ethical issues where they arise. To burden research ethics committees with trivial bureaucratic tasks is to miss an opportunity for healthy exchanges of views about ethics and to distort the nature and meaning of ethics.

Australia↗
PubMed2004

Ethics training: a genuine dilemma for engineering educators.

This is an examination of three main strategies used by engineering educators to integrate ethics into the engineering curriculum. They are: (1) the standalone course, (2) the ethics imperative mandating ethics content for all engineering courses, and (3) outsourcing ethics instruction to an external expert. The expectations from each approach are discussed and their main limitations described. These limitations include the insular status of the stand-alone course, the diffuse and uneven integration with the ethics imperative, and the orphaned status of ethics using the outside expert. A fourth option is proposed--a special modular option. This strategy avoids the limitations of earlier approaches and harmonizes well with curricular objectives and professional values. While some help is provided by a professional ethicist, the headliner for the series of seminars is a high-profile engineer who shares an ethics dilemma encountered in professional practice. Students discuss the case and propose solutions. The goal is to make ethics applicable to real-life problems facing working engineers and to help change behaviors.

Engineering↗
PubMed2005

The gap between law and ethics in human embryonic stem cell research: overcoming the effect of U.S. federal policy on research advances and public benefit.

Key ethical issues arise in association with the conduct of stem cell research by research institutions in the United States. These ethical issues, summarized in detail, receive no adequate translation into federal laws or regulations, also described in this article. U.S. Federal policy takes a passive approach to these ethical issues, translating them simply into limitations on taxpayer funding, and foregoes scientific and ethical leadership while protecting intellectual property interests through a laissez faire approach to stem cell patents and licenses. Those patents and licenses, far from being scientifically and ethically neutral in effect, virtually prohibit commercially sponsored research that could otherwise be a realistic alternative to the federal funding gap. The lack of federal funding and related data-sharing principles, combined with the effect of U.S. patent policy, the lack of key agency guidance, and the proliferation of divergent state laws arising from the lack of Federal leadership, significantly impede ethical stem cell research in the United States, without coherently supporting any consensus ethical vision. Research institutions must themselves implement steps, described in the article, to integrate addressing ethical review with the many legal compliance issues U.S. federal and state laws create.

Ethics, Medical↗
PubMed2006

Preventive ethics for including women of childbearing potential in clinical trials.

OBJECTIVE: We present a preventive ethics approach for including women of childbearing potential in clinical trials. STUDY DESIGN: We explain the concept of preventive ethics and identify its implications for study design, the informed consent process, and study management. RESULTS: We identify and address ethically significant questions for investigators and institutional review boards to address, to responsibly enroll women of childbearing potential in clinical trials. These questions concern preventive ethics for study design, for the informed consent process, and for study management. Distinctive components of this preventive ethics approach include the distinction between directive and nondirective counseling, the recognition of the concept of moral risk for women as research subjects, and the distinction between professional and individual conscience. We identify ethical considerations for physicians considering referral of their patients to clinical trials. CONCLUSION: A comprehensive, preventive ethics approach to the ethical challenges in clinical trials related to the prevention and occurrence of pregnancy is essential for responsibly enrolling women of childbearing potential.

Adolescent↗
PubMed2000

Rethinking maternal-fetal conflict: gender and equality in perinatal ethics.

Practitioners who care for pregnant women face dilemmas when their patients use illicit drugs, reject medical recommendations, or cause fetal harm. Many ethics scholars characterize those situations as maternal-fetal conflicts. In conflict-based models, maternal rights are considered to conflict with fetal rights, or moral obligations owed to pregnant women are considered to conflict with those owed to their fetuses. I offer an alternative model of pregnancy ethics by applying relational and equality-based moral theories to situations of fetal harm by pregnant women. In this model, clinicians faced with ethical dilemmas should attempt to understand pregnant women and their decisions within their broad social networks and communities, ask how the clinician's personal standpoint influences outcomes judged to be ethical, and determine whether the clinician's ethical formulations reduce or enhance existing gender, class, or racial inequality. This model focuses on the mutual needs of pregnant women and fetuses rather than on their mutually exclusive needs. It also avoids many pitfalls of traditional ethical formulations, specifically their tendency to neglect gender-specific modes of moral reasoning, their implicit assumptions that application of universal principles like autonomy and beneficence results in objective ethical solutions, and their failure to account for the ways that projecting fetal needs perpetuates social inequalities. This model provides the ethical foundations for moving law and policy away from criminalization and toward prevention of prenatal harm.

Conflict, Psychological↗
PubMed1999

New ethics guidelines for epidemiology: background and rationale.

In the past decade, at least four sets of ethics guidelines for epidemiologists have been prepared by various national and international organizations. None, however, have been officially adopted by the American College of Epidemiology (ACE). Recently, the ACE asked its Ethics and Standards of Practice (ESOP) Committee to produce ethics guidelines. In this paper, we explain the context and rationale for this effort, describe the purpose and content of ethics guidelines in epidemiology, and discuss their strengths and weaknesses. Three issues that are central to the mission of ACE-education, policy, and advocacy-are inadequately addressed in existing ethics guidelines. In addition, ethics guidelines are not static documents; they should reflect the changing role of epidemiologists in society, including issues arising in emerging subspecialty areas. New, more dynamic, guidelines that emphasize core values, obligations, and virtues, may help to further define and legitimize the profession of epidemiology and will provide a foundation for the discussion of specific ethical issues in the classroom and in professional practice. Guidelines however, do not provide the final word on ethical issues. Specific decisions in particular cases require judgments made upon reflection of the core values, obligations, and virtues described in the guidelines. From our review, we conclude that a new set of guidelines is reasonable and warranted.

Epidemiology↗
PubMed1997

Neither human nor natural: ethics and feral animals.

There are three major ethical approaches to issues affecting nonhuman animals and the natural environment: an anthropocentric ethic, and ethic of concern for all sentient beings, and a biocentric approach. The ethic of concern for all sentient beings is the most defensible basis for resolving conflicts between the interests of humans and wild animals. There is no ethical basis for discounting the suffering of an animal simply because that being is a member of a different species. On the other hand, it is certainly true that human and nonhuman animals differ in their capacities, and this does make a difference to the ethics of what we may do to them, including rendering them infertile. Since ethics is not a matter of adhering to absolute rules, but rather of doing what will have best consequences, given the constraints under which we act, the ethics of using a specific method of fertility control for feral animals will depend on what other methods are being used, or will be used, if the given method is not available. It will also depend on the consequences of not using any method of controlling the population of the animals.

Animal Welfare↗
PubMed2002

Tobacco harm reduction: a call to address the ethical dilemmas.

The 2001 Institute of Medicine report Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction has helped to focus attention on the scientific basis for assessing tobacco harm reduction products. As the tobacco research and policy communities tackle the challenges of evaluating harm reduction, there are ethical issues that must also be addressed. There has, however, been very little writing on the ethics of this field. In an effort to spur research into answering these ethical questions, we present two complementary approaches. First we outline three overarching topics in tobacco harm reduction that would particularly lend themselves to study: (a) Is the pursuit of tobacco harm reduction an ethical goal? (b) What are the ethical considerations of tobacco harm reduction vis-à-vis pharmaceutical companies? and (c) What are the ethical considerations for harm reduction vis-à-vis tobacco companies? We then present one possible framework for analyzing the ethical issues that accompany particular tobacco harm reduction strategies. By considering the ethical dilemmas attendant to tobacco harm reduction in a prospective and thoughtful manner, we will be better prepared to handle the challenges that face us individually as researchers and collectively as a tobacco control community.

Drug Industry↗
PubMed2002

Ethics education in U.S. medical schools: a study of syllabi.

PURPOSE: Despite attempts to describe the "ideal" medical ethics curriculum, few data exist describing current practices in medical ethics education to guide curriculum directors. This study aimed to determine the scope and content of required, formal ethics components in the curricula of U.S. medical schools. METHOD: A questionnaire sent to all curriculum directors of four-year medical schools in the U.S. (n = 121) requested course syllabi for all required, formal ethics components in the four-year curriculum. Syllabi were coded and analyzed to produce a profile of course objectives, teaching methods, course contents, and methods for assessing students. RESULTS: Questionnaires were returned by 87 representatives of the schools (72%). A total of 69 (79%) required a formal ethics course, and 58 (84%) provided their ethics course syllabi. Analysis and codification of all syllabi identified ten course objectives, eight teaching methods, 39 content areas, and six methods of assessing students. The means for individual schools were three objectives, four teaching methods, 13 content areas, and two methods of assessment. The 58 syllabi either required or recommended 1,191 distinct readings, only eight of which were used by more than six schools. CONCLUSIONS: Ethics education is far from homogeneous among U.S. medical schools, in both content and extensiveness. While the study of syllabi demonstrates significant areas of overlap with recent efforts to identify an "ideal" ethics curriculum for medical students, several areas of weakness emerged that require attention from medical educators.

Bioethics↗
PubMed1995

Ethical issues in hospital-based nursing practice.

A professional nursing ethic is a living, dynamic set of standards for nurses' professional moral behavior. For a professional ethic to be adequate, it must address the ethical issues perceived as relevant to the profession. The purpose of this descriptive study was to identify the ethical issues hospital-based nurses face in their practice. The authors sought to determine whether there were any differences in these ethical issues over time or according to specialty practice, position, age, educational level, or years in practice. Different groups of nurses (N = 794) were surveyed on five separate occasions over 9 years. Data were analyzed using descriptive and chi 2 statistics. The most frequent ethical issue faced was pain relief and management. Over time, the percentage of nurses who reported being faced with ethical issues related to morphine drips increased. Implications for future research on development of a normative nursing ethic are discussed.

Adult↗
PubMed2005

An ethical attitude in the analytic relationship.

An ethical attitude in the analytic process is essential. This paper presents a brief overview of theories of moral development and the origins of an ethical attitude. Moral development and integrity are discussed as basic aspects of an ethical attitude. An analytic attitude encompasses an ethical attitude. Differences between these attitudes are noted. Ethical dilemmas are presented in the context of the complexities involved in maintaining an ethical attitude in relation to the proscriptions of legal and ethical codes in the profession. An ethical attitude involves struggling with an outer authority as well as inner authority.

Attitude↗
PubMed2000

Ethical issues in the ethnography of cyberspace.

The project of developing an anticipatory anthropology of the future reveals unique ethical opportunities. For example, the increased importance of performance means there is a substantial potential for a substantive "resocialing" of work in organizations, just as the decline of Modernism opens space for collective, situated ethics as opposed to individualized categorical imperatives. An anthropology of the future should address the question of the future of ethics in general. The very possibility of human agency, of informed individual moral action, is brought into question in new ways. The profound flexibility of the computer as a medium carries with it the dangers of hyper-abstraction, while the consolidation of capital reproduction on a global level increases the scope for apparently permanent mystification. Also important are the new ethical challenges raised for those engaged in knowledge "production" or science broadly conceived. These include the necessary effort to acknowledge fully the role of non-human agency, and the potentially profound possibilities in a transformation in the character of knowledge, a correlate, at least in part, of the commodification of knowledge associated with distance learning. These challenges accompany the more overt threats of transgenic entities and ecological degradation. How can one be an ethical intellectual or academic under these circumstances, let alone teach others to be? There are also some specific challenges facing anthropology in particular. Some derive from the increasing "privatization" of ethnography, both in its growing popularity in modes of social reproduction more directly implicated in the reproduction of capital and in the declining academic support for anthropology. In a very specific sense, anthropology has grounded its ethics on an appreciation of and support for the reproduction of "really existing" culture. This ethical compass is not available to the ethnographer who studies the future. How do we participate ethically in the construction of a future in whose character we are inevitably implicated?

Anthropology, Cultural↗
PubMed2006

Attention deficit hyperactivity disorder: legal and ethical aspects.

Attention deficit-hyperactivity disorder (ADHD) remains a controversial disorder, despite it now being a well validated clinical diagnosis. Ethical and legal issues are important in determining how doctors should behave in offering a diagnosis or treatment that may generate strong and unpredictable reactions from children, their families, or other agencies. A model for routine ethical practice was proposed, based on three sets of assumptions. Firstly, that ethical practice is consistent with the four principles of beneficence, non-maleficence, justice, and respect for autonomy. Secondly, ethical concerns lead to legal processes, whose task is to ensure ethical practice. Thirdly, that we are working in the interests of our patients. Current relevant literature was organised in terms of this model, and recommendations for practice derived from it. Though there is no general ethical problem regarding either the routine diagnosis or treatment of ADHD, ethical difficulties surround some special cases, especially when doctors are working in conjunction with other agencies or coping with non-medical frameworks. Particular care needs to be taken with confidentiality and consent, the limits of which are currently confused. The model worked well with everyday ethical problems, though more difficult cases required careful individual scrutiny.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

Ethics education for clinical pharmacy practice.

A review of the literature on pharmacy ethics found little concern for ethical issues that arise from pharmacist involvement in clinical practice. This lack of recognition and concern for ethical dilemmas that arise from new pharmacist roles has serious implications for clinical practitioners because of their close involvement in patient care and with other professionals. Also, implications for the profession are serious since a lack of internal control invites external control. Pharmacy educators must provide a leadership role in addressing this lack of concern by systematic evaluation and improvement of ethics education. A model of ethics education is presented that is based on a science education model--both a theoretical and a practical component leading to skill development in recognizing and resolving ethical dilemmas. In other words, pharmacy students will be trained to become their own ethics experts through the application of critical ethical thinking.

Education, Pharmacy↗
PubMed2001

Selected ethical issues in research and publication: perceptions of health education faculty.

A national random sample of 195 university health education faculty at graduate degree-granting programs completed a 31-item survey with regard to their perceptions of ethical issues in research and publishing. Most respondents were male (57%), tenured (75%), had graduate faculty status (92%), had presented original research at conferences (85%), and had published articles in health education journals (89%). Faculty members were requested to assess whether 21 scenarios dealing with ethical issues in research and publishing were ethical, unethical, questionable, or not an ethical issue. Of the scenarios, 3 were considered ethical and 7 unethical by the majority of respondents. The perceptions of how ethical the remaining 11 scenarios were varied considerably. Perceptions of the ethical scenarios did not differ among respondents by sex, academic rank, years taught as a faculty member, whether the department taught units/classes on research ethics, or whether the respondents were from doctoral-level versus master's-level programs.

Analysis of Variance↗
PubMed2005

Toward a vulnerable ethics of research practice.

This article considers ethical dilemmas concerning the protection of confidentiality that often arise in carrying out ethnographic research. A number of problematic assumptions are highlighted that generally (implicitly or explicitly) guide the practice of contemporary research ethics review committees: (1) ethical rules are context free; (2) there is always an ethical 'right answer'; (3) there is an objective position from which to judge what one ought ethically to do. Notably, this is a position of emotional detachment from the situation; (4) this objectively identified ethical position can be articulated in explicit and unambiguous public language. The troublesome character of these assumptions is raised in the context of fifteen years of ethnographic research among African American families in clinical settings within the urban United States, with special attention to an ongoing relationship with one research participant the author has known for eight years. Finally the article suggests an alternative ethical framework drawn from recent philosophical work in an Aristotelian-inspired 'virtue ethics'.

Black or African American↗