Each Local Research Ethics Committee (LREC) is expected to produce an annual report for its establishing authority. Reports from 145 LRECs were examined with regard to (a) whether the committees were working within the terms of the most recent guidelines from the Department of Health and (b) observations on the role of LRECs with particular reference to accountability. Most LRECs had produced a report, although their length varied greatly. Most reports showed how seriously the committee took its task. Most committees (...) met many of the guidelines; for example, almost all had two or more lay-members. The guideline most frequently not met was that committees should have no more than 12 members. Many committees review very large numbers of projects (maximum 351). Approximately two-thirds provide details in the annual report of individual project titles, their author and the committee decision; all reports should contain this information. Although it may in fact happen more generally, only 23 per cent of the reports referred to any form of monitoring of the eventual outcome of the research. A significant issue to arise from the reports is the extent to which the framework for the operation of LRECs has been confused by the development of the purchaser-provider split. The paper concludes with suggestions for remedying the situation. (shrink)

Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient’s interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians (...) have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. (shrink)

Research has demonstrated that employee reactions to monitoring systems depend on both the characteristics of the monitoring system and how it is implemented. However, little is known about the role individual differences may play in this process. This study proposes that individuals have generalized attitudes toward organizational control and monitoring activities. We examined this argument by assessing the relationship between employees’ baseline attitudes toward a set of monitoring and control techniques that span the employment relationship. We further explore the effects (...) of employees’ generalized attitudes toward monitoring and their individual ethical orientations on their attitudinal reactions to an Internet monitoring system implemented in their workplace. Results of a longitudinal study indicate that as expected, prior beliefs and ethical orientation interact to affect employees’ reactions to monitoring systems. Implications for research and practice are discussed. (shrink)

In recent years, the practices of work organizations have raised increasing concerns regarding individual privacy at work. It is clear that people expect and value privacy in their personal lives. However, the extent to which privacy perceptions influence individuals’ work attitudes is less clear. Research has explored the extent to which employee perceptions of privacy derive from characteristics of the programs themselves. However, there is a paucity of research that examines how the characteristics of the individual employee may influence perceptions (...) of these programs. In this study we seek to shed light on this issue, as we examine how the individual ethical orientation of employees influences perceptions of a variety of human resource programs that have the potential to be perceived as invasive. Results indicate that ethical orientation exerts direct effects on perceived invasiveness of programs and exerts both direct and indirect effects on perceived appropriateness of programs. Implications for research and for managers adopting privacy-related programs are discussed. (shrink)

Corporate psychopathy thrives perhaps as the most significant threat to ethical corporate behaviour around the world. We argue that Human Resources Management professionals should formulate strategic solutions metaphorically by balancing what strategic military planners famously call ‘Search and Destroy’ and ‘Hearts and Minds’ counter-terrorist strategy. We argue that these military metaphors offer creative inspiration to help academics and practitioners theorise CP in richer, more reflective and more balanced and complementary ways. An appreciation of both metaphors is likely to favour the (...) use of hybrid strategies comprising SD and HM elements, which may provide the best HRM solutions to CP for the same reasons as the military now considers parallel hybrid solutions optimal for combating terrorist and guerrilla insurgency. (shrink)

Background: Healthcare providers who are accountable for patient care safety and quality but who are not empowered to actualize them experience moral distress. Interventions to mitigate moral distress in the healthcare organization are needed. Objective: To evaluate the effect on moral distress and clinician empowerment of an established, health-system-wide intervention, Moral Distress Consultation. Methods: A quasi-experimental, mixed methods study using pre/post surveys, structured interviews, and evaluation of consult themes was used. Consults were requested by staff when moral distress was present. (...) The purpose of consultation is to identify the causes of moral distress, barriers to action, and strategies to improve the situation. Intervention participants were those who attended a moral distress consult. Control participants were staff surveyed prior to the consult. Interviews were conducted after the consult with willing participants and unit managers. Moral distress was measured using the Moral Distress Thermometer. Empowerment was measured using the Global Empowerment Scale. Results: Twenty-one consults were conducted. Analysis included 116 intervention and 30 control surveys, and 11 interviews. A small but significant decrease was found among intervention participants, especially intensive care staff. Empowerment was unchanged. Interview themes support the consult service as an effective mode for open discussion of difficult circumstances and an important aspect of a healthy work environment. Conclusions: Moral distress consultation is an organization-wide mechanism for addressing moral distress. Consultation does not resolve moral distress but helps staff identify strategies to improve the situation. Further studies including follow up may elucidate consultation effectiveness. (shrink)

Written in the 1960s, TRUTH AND METHOD is Gadamer's magnum opus. Looking behind the self-consciousness of science, he discusses the tense relationship between truth and methodology. In examining the different experiences of truth, he aims to "present the hermeneutic phenomenon in its fullest extent.

ABSTRACT:Although prior work has shown that employees with ethical leaders are less likely to engage in deviant or unethical behaviors, it is unknown whetherallemployees respond this way or to the same extent. Drawing on social learning theory as a conceptual framework, this study develops and tests hypotheses suggesting that two follower characteristics—conscientiousness and core self-evaluation—moderate the negative relationship between ethical leadership and workplace incivility. Data from employees of a U.S. public school district supported our predictions. Implications and future research directions (...) are discussed. (shrink)

In their article “A Broader Understanding of Moral Distress,” Campbell, Ulrich, and Grady (2016) correctly assert that moral distress is well established in the nursing literature and is gaining at...

The US FDA currently encourages the addition of vitamin D to milk and cereals, with the aim of reducing rickets in children and osteoporosis in adults. However, vitamin D not only regulates the expression of genes associated with calcium homeostasis, but also genes associated with cancers, autoimmune disease, and infection. It does this by controlling the activation of the vitamin D receptor (VDR), a type 1 nuclear receptor and DNA transcription factor. Molecular biology is rapidly coming to an understanding of (...) the multiplicity of roles played by the VDR, but clinical medicine is having difficulty keeping up with the pace of change. For example, the FDA recently proposed a rule change that will encourage high levels of vitamin D to be added to even more foods, so that the manufacturers can claim those foods “reduce the risk of osteoporosis”. The FDA docket does not review one single paper detailing the transcriptional activity of vitamin D, even though, on average, one new paper a day is being published on that topic. Nor do they review whether widespread supplementation with vitamin D, an immunomodulatory secosteroid, might predispose the population to immune dysfunction. This BioEssay explores how lifelong supplementation of the food chain with vitamin D might well be contributing to the current epidemics of obesity and chronic disease. BioEssays 30:173–182, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

The emergence of new obstetrical and neonatal technologies, as well as more aggressive clinical management, has significantly improved the survival of extremely low birth weight infants. This development has heightened concerns about the limits of viability. ELBW infants, weighing less than 1,000 grams and no larger than the palm of one's hand, are often described as of late twentieth century technology. Improved survivability of ELBW infants has provided opportunities for long-term follow-up. Information on their physical and emotional development contributes to (...) developing standards of practice regarding their care. (shrink)

Kolbe and de Melo-Martin’s (2023) arguments draw attention to what is most useful about moral distress—identifying its causes is at least as important as measuring its severity. Jameton’s original...

In this paper, we compare one Nez Perce myth, namely lepuu ’Iceyeeye, or “Two Coyotes,” to some passages from Plato’s dialogues. Our point is to show how “Two Coyotes,” like Plato’s dialogues, serves as an instrument of philosophical reflection by engaging the listener/reader in aporia and paradox that motivate multiple reflections on the One, the Many, the nature and relation of kinds to instances, and thus the process and meaning of naming. If we are correct about the uses of “Two (...) Coyotes,” this might warrant a reevaluation of other first Nations’ myths. (shrink)

In this paper, we compare one Nez Perce myth, namely lepuu ’Iceyeeye, or “Two Coyotes,” to some passages from Plato’s dialogues. Our point is to show how “Two Coyotes,” like Plato’s dialogues, serves as an instrument of philosophical reflection by engaging the listener/reader in aporia and paradox that motivate multiple reflections on the One, the Many, the nature and relation of kinds to instances, and thus the process and meaning of naming. If we are correct about the uses of “Two (...) Coyotes,” this might warrant a reevaluation of other first Nations’ myths. (shrink)