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 1,297 records · Page 72Linked to original sources
PubMed2006

Ethical dilemmas and moral distress in oncology nursing practice.

Although ethical values and principles guide oncology nursing practice, nurses often are challenged to fulfill every professional core duty and responsibility in their everyday practice. Nurses commonly encounter clinical situations that have ethical conflicts, and they often have difficulty recognizing and articulating them. Unresolved conflicts can cause feelings of frustration and powerlessness, which can lead to compromises in patient care, job dissatisfaction, disagreements among those in the healthcare team, and burnout. This article reviews the ethical principles and values individual nurses bring to their practice as well as those basic to the profession of nursing. This article also discusses ethical conflicts in oncology practice and describes how nurses, especially students and novice nurses, may react to such situations with moral uncertainty or distress. In addition, a process for analyzing and resolving ethical problems in clinical situations is outlined. Increasing awareness and dialogue about ethical issues is an important first step in the process. Additional resources in the clinical setting may encourage nurses to actively participate in ethical decision making and take deliberate action as moral agents.

Adaptation, Psychological↗
PubMed2003

A comparative study of Chinese, American and Japanese nurses' perceptions of ethical role responsibilities.

This article reports a survey of nurses in different cultural settings to reveal their perceptions of ethical role responsibilities relevant to nursing practice. Drawing on the Confucian theory of ethics, the first section attempts to understand nursing ethics in the context of multiple role relationships. The second section reports the administration of the Role Responsibilities Questionnaire (RRQ) to a sample of nurses in China (n = 413), the USA (n = 163), and Japan (n = 667). Multidimensional preference analysis revealed the patterns of rankings given by the nurses to the statements they considered as important ethical responsibilities. The Chinese nurses were more virtue based in their perception of ethical responsibilities, the American nurses were more principle based, and the Japanese nurses were more care based. The findings indicate that the RRQ is a sensitive instrument for outlining the embedded sociocultural factors that influence nurses' perceptions of ethical responsibilities in the realities of nursing practice. This study could be important in the fostering of partnerships in international nursing ethics.

Adult↗
PubMed2005

A critical history of individual and collective ethics in the lineage of Lellouch and Schwartz.

The notions of individual and collective ethics were first explicitly defined in the biostatistical literature in 1971 to motivate a mathematical solution to a posed ethical dilemma. This paper reviews key antecedents to these concepts and traces explicit references to them over time, primarily in the biostatistical literature. Following a historical exposition of these texts, a critical thematic analysis shows the following: the normative force of these concepts has not been adequately argued. Individual and collective ethics do not solve the problem of how to use accumulating data to inform ethical action. The notions of the "individual" and the "collective" are too vague to prompt clear moral imperatives, especially in difficult cases. These concepts have not been successfully linked to a standard ethical framework. Finally, the paper concludes with the observation that a systematic, comprehensive ethical framework must be identified to fulfill the intuitions behind individual and collective ethics.

Bioethics↗
PubMed2000

Amenable to reason: Aristotle's rhetoric and the moral psychology of practical ethics.

An Aristotelian conception of practical ethics can be derived from the account of practical reasoning that Aristotle articulates in is Rhetoric and this has important implications for the way we understand the nature and limits of practical ethics. an important feature of this conception of practical ethics is its responsiveness to the complex ways in which agents form and maintain moral commitments, and this has important implications for the debate concerning methods of ethics in applied ethics. In particular, this feature enables us to understand casuistry, narrative, and principlism as mutually supportive modes of moral inquiry, rather than divergent and mutually exclusive methods of ethics. As a result, an Aristotelian conception of practical ethics clears the conceptual common ground upon which practical ethicists can forge a stable and realistic self-understanding.

Bioethics↗
PubMedDate not supplied

Louder than words. A multi-institutional system sets ethical standards for corporate action.

After establishing its Resource Center for Ethical concerns, Wheaton Franciscan Services, Inc. (WFSI), Wheaton, IL, set out to develop corporate ethics standards. The standards were to manifest a vision that acknowledged the mutuality of relationships among providers and those they serve, and among local and global communities. To establish "ownership" of the standards, WFSI wanted to involve as many people as possible in the planning process. Center staff established a 25-member working task force with broad representation of disciplines and system institutions, then prepared a position paper to serve as a basis for the formulation of the standards. The paper examined current issues in corporate ethics, the theoretical basis of corporate ethics, the appropriateness of corporate ethics for Catholic-sponsored institutions, and the role ethics standards play in an institutional setting. Staff then prepared the first draft of corporate standards. At the first workshop in October 1988, task force members critiqued the draft and modified the proposed corporate standards. Staff sent the draft for critique to a total of 157 persons throughout the system and encouraged them to pass it around to get the advice of others. From the feedback, staff compiled a third draft, which was ultimately approved. WFSI's Corporate Ethics Standards addresses provision of services, relationship with employees, social responsibility, confidentiality, and conflict of interest.

Catholicism↗
PubMed1986

Five key players shape institution's ethical character.

Various individuals or groups play important roles in achieving moral insight and direction in a health care facility. The administration, medical and nursing staffs, the professional theologian, and the bishop all contribute unique perspectives to the complex process of developing an institution's ethical character. An institutional ethics committee's (IEC's) effectiveness depends largely on the administrator's ability to support educational programming in ethics for the entire staff, coordinate ethical reflection throughout the organization, and shape ethically informed policy based on an IEC's practical experience. The medical staff brings its scientific background and practical experience to ethical issues under a committee's consideration, and nurses offer valuable insights based on their close contact with patients and family. The theologian provides resources and background on Catholic tradition as well as information on current theological developments. The IEC also should maintain a relationship with the local bishop whose duty is to articulate the Church's positions in health care ethics. Forthright dialogue among all parties is central to the IEC's task.

Catholicism↗
PubMed2000

A multidisciplinary forum for ethics in medicine: our seven years experience.

The Rappaport Faculty of Medicine of the Technion established an Ethics in Medicine Forum in March 1993. The main objective of the forum was to increase awareness of the philosophical principles of ethics in medicine, as defined and developed in the western world during the last three decades. The multidisciplinary forum meets once a month during the academic year. Our 7 years experience is documented. Of the 45 meetings, 30 were clinically oriented and of these more than half were based on cases. Only 15 meetings were purely theoretical. Our principal assumption was that any and every topic could be discussed, including those covered by the law. We explored how well western philosophical principles and rules fit the Israeli picture. Many of the forum discussions related to the draft of the Patient's Bill of Rights, which came into effect on 12 May 1996. The role of the "legal" hospital ethics committees was compared to that of the "advisory" ethics committees whose members constituted a large share of our forum. The multicultural Israeli population and the practice of medicine therein raised many lively discussions. The principle of autonomy in the ultraorthodox and in the family setting was a highly controversial issue. The forum served as a workshop for examining traditional medical ethical principles, which we strongly feel needs to be amended in light of the 1996 Patient's Bill of Rights. From our 7 years experience with an Ethics in Medicine Forum we recommend that medical ethical deliberations focus on genuine medical cases.

Clinical Medicine↗
PubMed2002

Medical-ethics teaching in Canadian physical medicine and rehabilitation residency training programs.

BACKGROUND: Medical-ethics education is a required component of all Royal College residency training programs in Canada. There have been no studies to determine how and to what extent this teaching is done in physical medicine and rehabilitation training programs. OBJECTIVE: To assess the state of medical-ethics teaching in Canadian physical medicine and rehabilitation residency training programs. METHODS: A six-question survey was faxed to the program directors of the 10 physiatry residency training programs in Canada. We asked whether medical-ethics teaching is being done, who is doing the teaching, which pedagogic methods is used, how many hours are dedicated to the topic, which topics are taught, and what evaluation method is used. RESULTS: The response rate was 90 per cent. The study confirmed that medical-ethics teaching is done in all Canadian physiatry training programs. However, the person doing the teaching, the number of hours allocated to ethics education, the pedagogic method used, and the topics being taught vary from program to program. CONCLUSION: Although medical-ethics teaching is done in all programs, there is a need for more standardization in the curriculum and in evaluation. The curriculum should focus on ethical issues that are most likely to be encountered in daily physiatric practice. Small-group, case-based teaching should be used for maximum effectiveness. Whenever possible, teaching should be done by a physiatrist.

Bioethics↗
PubMed2005

Clinical ethics support services in Europe.

The paper presents the main debates that have taken place on clinical ethics committees within the European project entitled Ethical Function in Hospital Ethics Committees. It depicts the great variety of formula existing in Europe in terms of legal status, functions, accessibility, composition and training requirements and a the onset of clinical ethics concept itself. Moreover, in the interstices of the various institutionalised ethics systems we can find extremely innovative initiatives under development, spawned more by premises of a political nature than drawn from the specialised corps of medical ethics. Could clinical ethical committees play some role in the overall democratisation process in medicine?

Committee Membership↗
PubMedDate not supplied

Medical ethics in Russia before the October revolution (1917).

The evolution of medical ethics in Russia was determined by several factors. First, such Russian concepts as "obshina" (community" and "sobornost" (counciliarism) determined the supremacy of the collective body over the individual body, the state over a person etc. There is no analogue for "privacy" in the Russian language. Second, Russian medical doctors with university degrees appeared only in the 18th century after the politics of westernization by Peter the Great (1672-1725). Medical ethics probably starts from Prof. Matvei Mudrov (1776-1831) of Moscow who followed the Hippocratic credo "to treat not a disease but a patient". Third, after serfdom had been abolished in 1861 medical care in many rural regions was provided by zemstva (local elected councils). Zemskie medical doctors had idealistic views of self-sacrificing for the service to society and to the people. On the other hand, while dealing with illiterate peasants paternalism was a necessity. Ethical problems of healthcare and medicine were a subject of intense discussions both in professional and popular literature. A weekly periodical "Vrach" edited by V. Manassein played an important role in this discourse. Local medical societies adopted their own ethical codes but an All-Russian code of medical ethics was never formulated because the country lacked a national medical society. "Confessions of a physician" by Vikenty Veresaev published in 1901 put problems of doctor-patient relationship and human experimentation in the centre of public debates both nationally and internationally. Two Russian editions of "Aerztliche Ethik" by Albert Moll also contributed to the discourse on medical ethics in Russia. Medicine as a money-making activity was criticized and ridiculed in Russian literature (see, for example, Tolstoy's novels and Chekhov's stories). Medical morality was generally understood as moral life in action when deeds are much more important than words (e.g. formal codes of medical ethics).

Bioethical Issues↗
PubMedDate not supplied

Intravenous nursing code of ethics.

Preamble: A code of ethics acknowledges the acceptance by a profession of the responsibility and trust that society has conferred, and it recognizes the obligations inherent in that trust. The specialty practice of intravenous nursing involves ethical decision making. The Intravenous Nursing Code of Ethics is based on the premise that intravenous nurses, both individually and collectively, must be aware of ethical issues, and pursue the highest possible ethical standards. The principles in this Code of Ethics define the nursing profession's expectations and responsibilities for each member of the Intravenous Nurses Society. This code is a guide to ethical decision making to which all intravenous nurses should adhere.

Clinical Competence↗
PubMed1989

Perceptions of ethical problems by forensic psychiatrists.

A survey was undertaken of the opinions of two groups of forensic psychiatrists to determine their views regarding forensic ethical issues. Although AAPL has made significant strides for our profession by adopting ethical guidelines, some important issues have not yet been addressed, as revealed by our survey. Included were items heretofore considered too "controversial" for incorporation into guidelines, as well as items from the APA ethical framework. All APA items were evaluated as addressing ethical problems. The majority of respondents also viewed most of the "controversial" items as confronting relevant ethical problems, thereby suggesting their inclusion, in some form, in the profession's guidelines. They also appeared to favor retention of many traditional medical ethical values when functioning as a forensic psychiatrist. Clear selective discrimination existed among differing death penalty facets. Since AAPL at present does not wish to conduct its own ethics hearings, the AAPL guidelines as well as the items supported in this paper's survey would best be translated into a form consistent with the APA framework. In this way, AAPL's guidelines and also the new suggested items could readily be coordinated within the APA framework and could play a role in the APA local district branch enforcement process.

Capital Punishment↗
PubMed1995

Medical ethics education: past, present, and future.

This paper examines undergraduate medical ethics education in the United States during its 25-year history. Included is a brief description of early efforts in medical ethics education and a discussion of the traditional model of ethics teaching, which emphasizes the knowledge and cognitive skills necessary for ethical decision making. The authors also discuss alternatives to the traditional model that focus more directly on students' personal values, attitudes, and behavior. Current areas of consensus in the field are then explored. Finally, the authors identify three incipient trends in medical ethics education--toward increased emphasis on everyday ethics, student ethics, and macroethics. Throughout the paper, examples of specific courses and curricula are used to illustrate the modes and trends described.

Curriculum↗
PubMed1993

Medical ethics in medical education: finding and keeping a place at the table.

Although almost three decades have passed from the early days of the modern medical ethics movement, both articles discussed here manifest variations of some old concerns. First, an acceptance of ethics is incorporated into general requirements and found in specific programs, but ethics is not given great attention by those who decide who will enter the medical profession. Second, in the clinical setting itself, practitioners are busy and the teaching process is placed amidst a multitude of other concerns. And third, the goals for resident and faculty education are remarkably similar to those proposed for undergraduates (awareness, development of analytical skills, involvement in patient care, and so forth). The evaluation of ethics instruction, which has been a concern since the 1960s, has a new face. Upon entering the medical-education setting, humanists found that there was a need for accountability that they had not generally experienced in their university teaching. Yet, they also knew that ethics was different from other medical courses, and that quantifying its special contribution was difficult. Today's general societal emphasis on cost and outcome as measures of the value of education gives consideration of evaluation a critical role. White and Zaner, and most of the other authors cited here, mention the need for systematic accounting of the results of teaching, as well as the difficulty of evaluation. The evaluation of the effectiveness of ethics instruction will remain problematic, yet it is necessary in the changing health-care market. To the degree to which it is possible to communicate knowledge about ethics, residency and other accrediting bodies can provide means to evaluate the results of teaching.(ABSTRACT TRUNCATED AT 250 WORDS)

Curriculum↗
PubMed1993

Classification and correlates of ethical dilemmas in hospital social work.

The authors used categories based on the NASW Code of Ethics to code hospital social workers' descriptions of ethical dilemmas according to the specific principles in conflict. They also developed codes to identify discharge destination and medical care issues involved in the ethical dilemma. Most ethical dilemmas were found to involve conflicts between client self-determination and client best interest. Ethical dilemmas were more likely when patient mental status was impaired and when decision making was problematic. Ethical dilemmas were related to delayed discharge, in-hospital mortality, and less-than-adequate postdischarge care. The study enhances understanding of ethical dilemmas and advances a methodology for studying their occurrence and consequences.

Aged↗
PubMed1996

Philosophy, literature, and ethics: let the engagement begin.

The goal is to isolate points of philosophical interest in the preceding articles on narrative medical ethics in order to focus subsequent dialogue between the two disciplines. Ethics is an enterprise that has over the centuries developed a somewhat malleable structure, comprising characteristics, methods, lines of reasoning, rules, principles, assumptions, and arguments. This structure provides the framework within which many disciplines contribute to ethics through the exercise of their particular interests, skills, and methods. Challenging or changing the structural components requires arguments of a traditional sort appropriate to the discipline of ethics. Three tenets are proposed as comprising the "received view" or credo of the literature and ethics movement. Each is examined. Then the individual articles in this issue are explored to the end of ferreting out points that would be fruitful points of discussion between philosophy and literature folks pursuing their mutual interest in ethics.

Ethical Analysis↗
PubMed2005

Ethics, transplantation, and the changing role of anatomists.

Anatomists are regarded as custodians of cadaveric material donated to science. Almost every facet of medical science has experienced explosive advances. This has impacted directly on anatomists and their role. Increasingly, anatomists are raising concerns with regard to the treatment of human tissue (Jones,2002, Clin. Anat. 15:436-440). The Korperwelten (Bodyworlds) of Gunther von Hagens et al. (1987, Anat. Embryol. 175:411-421) has evoked considerable debate about the treatment of human cadavers. Thus far clinical anatomists have had little role to play in policy formulation, legislation, and ethical imperatives as applied to cadaveric donation for organ transplantation. Anatomists play an even more negligible role in the raging ethical controversy around live related/unrelated organ transplantation. Due to the critical international shortage of cadaveric donors, boundaries are being pushed to meet the needs of potential recipients (Ohler,2001, Prog. Transplant. 11:160-161). Constant reappraisal of these ethical and moral issues is therefore appropriate. Issues that relate to cultural and economic imperialism and pronouncements of international transplant societies may also require re-evaluation. The legislature governing the donation of human tissue in various countries is usually governed by a Human Tissue Act or its equivalent. In general, such acts are congruent with the Human Tissue Act (South Africa: Government Gazette 9, November 2001; No. 22824) that states "It is an offense to charge a fee in relation to the donation of human organs." In many countries, however, various lay press report that "the sale of body parts is now coming of age." Terms such as "rewarded gifting" and "donors" being transformed into "vendors" are opening a Pandora's Box (Nelson et al.,1993, "Financial incentives for organ donation: a report on the UNOS ethics committee payment subcommittee"). Cameron and Hoffenberg (1999, Kidney Int. 55:724-732) feel strongly that arguments in favour of the sale of organs are sufficiently cogent to warrant further discussion. Equally disturbing is the use of executed prisoners as organ donors. In the developing world there are additional socio-economic, indigenous and cultural, religious, and ethical issues to consider. In addition, strategies that are ethically sound and morally acceptable to expand the pool of living donors must keep pace with recent advances in medicine. A paradigm shift is required for anatomists to contribute to the international ethical debate, not only as custodians of the dead but also as protectors of the living. Their voices should be heard in transplantation and other forums, and contribute to the ethical debate as well as relevant evolving legislature.

Anatomy↗
PubMed2005

Nanotechnology--a new field of ethical inquiry?

Parallel to the public discussion on the benefits and risks of nanotechnology, a debate on the ethics of nanotechnology has begun. It has been postulated that a new "nano-ethics" is necessary. In this debate, the--positive as well as negative--visionary and speculative innovations which are brought into connection with nanotechnology stand in the foreground. In this contribution, an attempt is made to discover new ethical aspects of nanotechnology in a more systematic manner than has been the case. It turns out that there are hardly any completely new ethical aspects raised by nanotechnology. It is much rather primarily a case of gradual shifts of emphasis and of relevance in questions which, in principle, are already known and which give reason for ethical discussions on nanotechnology. In a certain manner, structurally novel ethical aspects arise through the important role played by visions in the public discourse. New questions are also posed by the fact that previously separate lines of ethical reflection converge in the field of nanotechnology. The proposal of an independent "nano-ethics", however, seems exaggerated.

Humans↗