The social worker's view. An interview by Stephen O'Neill.
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The Bangladesh Medical Research Council is implementing a training program on research bioethics under International Bioethics Education and Career Development Award of Fogarty International Center of National Institutes of Health (NIH), USA. The ultimate goal of the program is to improve ethical practice in implementation of health research through capacity strengthening of the professionals involved in health research in Bangladesh. The duration of the program is 4 years and it has started from the year 2002. The first year (2002-2003) was assigned for curriculum development. Several workshops, focus group discussions and consultative meetings were organized during 2002-2003 and curriculum was developed. Under this training program every year 2 Certificate Courses on Research Bioethics (CCRB) with a duration of 10 weeks will be conducted for 40 participants (20 participants in each batch). Each year one Advance Course on Research Bioethics (ACRB) will be organized for 10 participants with a duration of 6 days. The courses are to be conducted during 2nd, 3rd and 4th year. The Certificate Course on Research Bioethics is intended for multidisciplinary participants having previous experience in research methodology while the Advance Course on Research Bioethics will target for training the members of Ethics Review Committees of the country. Through this program one hundred fifty Bangladeshi professionals will get adequate training on research bioethics. The training program will be implemented by national experts with technical assistance from distinguished international scientists in the field.
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The purpose of this paper is to present rather than resolve some new ethical problems which are likely to become the subject of public discussion in the near future. Some problems likely to be the subjects of extensive debate are: the foetal patient, 'home abortifacients' and abortifacient vaccines, the withdrawal of life-sustaining treatment, experimentation on 'spare' human embryos, the legalization of heroin abuse and the use of anencephalics and the persistently comatose as organ donors.
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Medicine has developed rapidly during the last decades. Transplantation, sex-change surgery in transsexual or heterosexual persons, interference in the process of reproduction of human species and procedures like lobotomy have remarkably expanded the possibilities of contemporary medicine. This, at the same time gives rise to unprecedented legal problems. A number of them have not yet been solved in many countries, though legislative solutions are sought. The road to their solution, however, is full of blind curves: no sooner does the law offer an answer to one problem than medicine demands the answer to another, brand new one. This is why knowledge of these problems' regulation in different countries might be of use. That article gives an outline of their regulation in Czechoslovakia.
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While most health care is provided at the primary care level, little research has been done to document the ethical issues of such care. A stratified random sample of 702 physicians, nurses, physical therapist, and physician assistants within one southeastern state was surveyed to determine the frequency of ethical issues in primary care. The most frequently occurring issue concerned moral decisions about the amount of time to spend with each patient. A comparison of physician and nonphysician professional groups revealed significant differences in frequencies of the issues. Age had a slight impact on the responses, while gender, religion, and region of practice had none. The study showed that the most frequently occurring issues are pragmatic, not dramatic, and center on patient self-determination, adequacy of care and professional responsibility, and distribution of resources.
PURPOSE/OBJECTIVES: To describe ethical issues determined to be highly important to oncology nurses and to discuss strategies by which the Oncology Nursing Society (ONS) can address these priority concerns. DATA SOURCES: Survey on oncology nurses regarding ethical issues; nursing literature. DATA SYNTHESIS: Nine priority ethical issues of oncology nurses are identified. Past, current, and future ONS activities that address these priority issues are discussed. IMPLICATIONS FOR NURSING PRACTICE: ONS must support activities to increase the knowledge, confidence, and involvement of oncology nurses in discussions and decision making related to the ethical issues. CONCLUSIONS: The top three priority ethical issues for oncology nurses are assisted suicide, end-of-life decisions, and pain management. Efforts should be made to increase ethics expertise among the ONS membership.
This essay focuses on how casuistry can become a useful technique of practical reasoning for the clinical ethicist or ethics consultant. Casuistry is defined, its relationship to rhetorical reasoning and its interpretation of cases, by employing three terms that, while they are not employed by the classical rhetoricians and casuists, conform, in a general way, to the features of their work. Those terms are (1) morphology, (2) taxonomy, (3) kinetics. The morphology of a case reveals the invariant structure of the particular case whatever its contingent features, and also the invariant forms of argument relevant to any case of the same sort: these invariant features can be called topics. Taxonomy situates the instant case in a series of similar cases, allowing the similarities and differences between an instant case and a paradigm case to dictate the moral judgment about the instant case. This judgment is based, not merely on application of an ethical theory or principle, but upon the way in which circumstances and maxims appear in the morphology of the case itself and in comparison with other cases. Kinetics is an understanding of the way in which one case imparts a kind of moral movement to other cases, that is, different and sometimes unprecedented circumstances may move certain marginal or exceptional cases to the level of paradigm cases. In conclusion, casuistry is the exercise of prudential or practical reasoning in recognition of the relationship between maxims, circumstances and topics, as well as the relationship of paradigms to analogous cases.
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The place of scholarly research in nursing has not been well studied. Ethical inquiry, as scholarly research, has been included in this neglect. The concept of ethics research is defended and new research approaches to ethics are outlined. Forms of ethics research identified are scholarly, empirical, and dual mode. Questions considered are: Is ethics research research? What are the forms of ethics research? What is the role of empiricism in ethics research? And what is the relationship of ethics research to the moral concerns of nursing? Ethics research explores the basic moral norms undergirding nursing research, practice, and education.
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