Ethics consultation has become an integral part of the fabric of U.S. health care delivery. This article summarizes the second edition of the Core Competencies for Health Care Ethics Consultation report of the American Society for Bioethics and Humanities. The core knowledge and skills competencies identified in the first edition of Core Competencies have been adopted by various ethics consultation services and education programs, providing evidence of their endorsement as health care ethics consultation (HCEC) standards. This revised report was prompted (...) by thinking in the field that has evolved since the original report. Patients, family members, and health care providers who encounter ethical questions or concerns that ethics consultants could help address deserve access to efficient, effective, and accountable HCEC services. All individuals providing such services should be held to the standards of competence and quality described in the revised report. (shrink)

Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about (...) the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy. (shrink)

Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about (...) the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy. (shrink)

We critically evaluate the ways in which competence in medical ethics has been evaluated. We report the initial stage in the development of a relevant, reliable and valid instrument to evaluate core critical thinking skills in medical ethics. This instrument can be used to evaluate the impact of medical ethics education programmes and to assess whether medical students have achieved a satisfactory level of performance of core skills and knowledge in medical ethics, within and across institutions.

DNR decisions are frequently made in oncology and hematology care and physicians and nurses may face related ethical dilemmas. Ethics is considered a basic competence in health care and can be understood as a capacity to handle a task that involves an ethical dilemma in an adequate, ethically responsible manner. One model of ethical competence for healthcare staff includes three main aspects: being, doing and knowing, suggesting that ethical competence requires abilities of character, action and knowledge. (...) Ethical competence can be developed through experience, communication and education, and a supportive environment is necessary for maintaining a high ethical competence. The aim of the present study was to investigate how nurses and physicians in oncology and hematology care understand the concept of ethical competence in order to make, or be involved in, DNR decisions and how such skills can be learned and developed. A further aim was to investigate the role of guidelines in relation to the development of ethical competence in DNR decisions. Individual interviews were conducted with fifteen nurses and sixteen physicians. The interviews were analyzed using thematic content analysis. Physicians and nurses in the study reflected on their ethical competence in relation to DNR decisions, on what it should comprise and how it could be developed. The ethical competence described by the respondents related to the concepts being, doing and knowing. In order to make ethically sound DNR decisions in oncology and hematology care, physicians and nurses need to develop appropriate virtues, improve their knowledge of ethical theories and relevant clinical guidelines. Ethical competence also includes the ability to act upon ethical judgements. Continued ethical education and discussions for further development of a common ethical language and a good ethical working climate can improve ethical competence and help nurses and physicians cooperate better with regard to patients in relation to DNR decisions, in their efforts to act in the best interest of the patient. (shrink)

In Education Sciences, the notion of ‘competence’ is widely used, both as an aim to be reached with students and as performance in teachers’ education. This article advances a type of competence that is highly relevant for teachers’ work, namely the ‘ethical competence.’ Ethical competence enables teachers to responsibly deal with the daily challenges arising from their professional roles. In this study, I put forward a definition of ethical competence and I propose a conceptual structure, both meant (...) to support the illustration, description, and development of ethical competence for teachers. (shrink)

BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics (...) education that promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

Ethical challenges are traditionally described in a negative light, even though moral conflict can express the individual ability to perceive when something is not working and promote change. The true question, therefore, is not to how to silence moral conflict but how to educate it. Although the need for ethical support of health- and social-care professionals in elderly care is clearly perceived, there is no universal method for providing effective interventions. The authors hypothesize that adequate training sessions can (...) help care professionals enhance this skill, once clear goals and specific educational techniques are set. This research tests the hypothesis on twenty care professionals working in acute and residential care settings for the elderly, building on the ethics round method. Mixed methods drawn from literature and the experience of educators were adapted to meet different educational goals. Moral issues can hardly be removed from a context characterized by increasing demand and decreasing resources, but they can be recognized and addressed with common efforts, a critical attitude, and a growth mindset. Enhancing these skills in qualified workers can help them accept the reality of work, release pressure, and identify common team goals. Introducing these skills before graduation can help future workers avoid unreal expectations and reduce frustration and early job quit rates. (shrink)

Background:Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty.Objectives:The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi.Methodology:A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample (...) of 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0.Ethical consideration:The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi.Results:The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings.Conclusion:The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

In spite of the growing interest in nursing ethics, few studies have focused on ethical dilemmas experienced by nurses working with clinical studies as ‘research nurses’. The aim of the present study was to describe and explore ethical dilemmas that Swedish research nurses experience in their day-to-day work. In a qualitative study a purposeful sample of six research nurses from five wards of differing disciplines in four Swedish hospitals was interviewed. The analysis displayed several examples of ethical (...) dilemmas, primarily tensions between the nurses’ obligations to the study and to the patients involved. A guiding moral principle for the nurses was patient-centeredness, where the interest of research must not override the interest of the patient. In situations where tensions between research and patient interests occurred, and doctors and nurses disagreed upon the judgement, the nurses sometimes chose to follow the doctors’ advice, and thus acted against their own moral judgment. Such situations seemed to create feelings of moral distress among the nurses. They described their profession as being ‘invisible’ and as lacking opportunities for ethical competence building. The conclusion is that research nurses frequently experience severe and difficult ethical dilemmas in their daily work. They need to be acknowledged as a particular profession in the health care organisation and encouraged to develop their specific ethical competence. (shrink)

Designed specifically for the educational needs of RN to BSN students This is a unique, innovative professional nursing ethics textbook designed specifically for the educational needs of RN to BSN students. Written by experts in the field, it discusses ethical concepts geared to the licensed nurse who has spent several years in practice but is learning high-level concepts and applications. The text addresses different areas of professional practice and is rich with case studies illustrating clinical scenarios involving ethical (...) awareness and decision-making. The book fulfills the necessary criteria for the AACN Essentials for Baccalaureate Education and the QSEN and ISOM competencies. Clear and concise, the text relates content to the nurse’s current practice and professional development without extraneous information typically included in other texts. Progressing from simple to complex, chapters build on previous practice experience to focus on ethical decision-making in a variety of practice environments. The book incorporates a “four boxes” decision-making model and addresses essential communication skills, how to recognize and resolve moral distress, and the role of an ethics committee. It discusses common ethical issues likely to be encountered and ethical practice as it relates to quality and safety. Case Study Dilemmas that include evidence-based research provide the opportunity to apply ethical decision-making principles. QSEN application principles are also featured in each chapter, and interactive exercises and questions and PowerPoints provide further opportunity for critical thinking. Key Features: Addresses the specific needs of students in the RN to BSN course Fulfills AACN Essentials, IOM Competencies, and QSEN KSAs Builds upon previous practice experience of RN to BSN students Discusses ethical decision-making in a variety of practice environments Includes Case Study Dilemmas to apply ethical decision-making principles. (shrink)

In order to participate effectively in international relations, this essay argues that international actors of all kinds, including states, international organizations, corporations, and individuals, have to acquire the skills necessary to protect freedom and diversity in the modern world.

Higher education institutions have a responsibility to promote the development of students' ethical and citizenship competencies, especially in contexts of major social inequality. Graduates, who constitute a very small percentage of the population in México, are the best qualified to conceive of creative alternatives to resolve its demanding social challenges. But this cannot be done if trained professionals and specialists remain indifferent to their communities and merely seek to satisfy their personal interests. Higher education institutions should have an active (...) role to play in the consolidation of democracy in México, providing society with technically and professionally well prepared individuals who are also ethical and competent citizens. This article sketches a 10-year program focusing on the development of the ethical and citizenship competencies of higher education students being implemented in a private university. Evidence from the first phase of assessment of ethical competencies is cited and discussed. (shrink)

Teaching ethics in compulsory school regained urgency some years ago in Sweden when National Tests in ethics were introduced. Students were evaluated as having or not having the ethics knowledge required. The aim of this study is to investigate what aspects of ethical competence students express in texts from National Tests, and to investigate what cultural tools 12- and 15-year-old students use in their texts about a given ethical situation. A qualitative content analysis was performed in three steps. (...) In the first step, four aspects of ethical competence were identified: to verbalise, to take a stand, to take responsibility for one’s actions and an understanding of life. In the second step, the identified ethical competence was interpreted through four ethical voices building on the theories of Nussbaum, Løgstrup, Benhabib and Singer, showing that the students’ texts contain varying aspects of ethics. In the third step, cultural tools used by the students were identified. The conclusions were that some ethical perspectives, such as the societal and global perspectives, are disadvantaged in the analysed texts, and accordingly in the tasks;, ethics is a difficult subject to assess in a fair way; and since cultural tools are dependent on the social, cultural and historical context, the school has a responsibility to teach ethics in a way that gives all students the power and authority to live good lives. (shrink)

The objective of the present research was two-fold: to provide a new definition of ethical competence, and to clarify the influence of empathy, personal values, and the five-factor model of personality on ethical competence. The present research provides a comprehensive overview about recent approaches and empirically explores the interconnections of these constructs. 366 German undergraduate students were examined in a cross-sectional study that investigated the relationship of empathy, personal values, and the five-factor model of personality with moral judgment (...) competence and counterproductive work behavior as indicators of moral judgment and behavior. We found self-transcendence values to be related to both, high levels of empathy and ethical competence, in contrast to self-enhancement values. Multiple mediation analysis revealed unique effects of empathy on ethical competence through values as mediators. Affective empathy transmitted its effect on ethical competence through benevolence, conformity, tradition, power, and hedonism. Most importantly, perspective taking lost its predictive power when investigated alongside affective empathy dimensions. These results converge to an important role of affective empathy, in particular empathic concern, with regard to personal values and ethical competence. Furthermore, the five-factor model of personality explained variance in measures of ethical competence. Our research suggests that organizational decision makers should consider the role of empathy, personal values, and the five-factor model in their human resource management in order to select employees with high ethical competence. (shrink)

Die Anforderungen an das ethisch-professionelle Handeln Pflegender und somit auch die Forderungen an die professionelle Ethikkompetenz Pflegender im praktischen Berufsfeld wandeln sich sowohl qualitativ als auch quantitativ. Dies wird auch in den veränderten normativen Rahmungen der Pflegebildung deutlich. Der Lernort Praxis als ein zentraler Ort pflegebezogener (Aus‑)Bildungsprozesse rückt somit nochmals stärker in den Fokus der Ethikkompetenzentwicklung professionell Pflegender. Der Beitrag konturiert zentrale Anforderungen und veränderte Bezüglichkeiten für die Ethikbildung im beruflichen Handlungsfeld professioneller Pflege und formuliert davon ausgehend zentrale Prämissen an (...) organisationsethische Rahmenbedingungen mit dem Ziel, eine ethisch fundierte professionelle pflegerische Handlungspraxis zu unterstützen. (shrink)

Background Head nurses have duties in providing nursing care and ethical supervision to the nurses in the unit. Compliance with the ethical competence framework for head nurses is essential in fostering an ethical climate in the organization. Objective The objective of this research is to study the head nurses’ compliance with the ethical competence framework by the Thailand Nursing and Midwifery Council (TNMC). Methods The study is a qualitative research, using in-depth interviews conducted among 20 head (...) nurses practicing in a super tertiary hospital in Bangkok, Thailand. The sample was selected using a criterion sampling method. The head nurses’ ethical experience relating to work practice was analyzed by thematic analysis. Ethical considerations The ethical approval of this study was obtained from the Committee for Research Ethics (Social Sciences), Mahidol University, and from the Institutional Review Board of the hospital in which the study was conducted. Results From the thematic analysis of the ethical experience practiced by the head nurses, 8 themes and 16 sub-themes were categorized across 5 ethical competencies based on the ethical competence framework by the TNMC. It was found that all the identified themes and sub-themes conformed to the ethical competence framework, and demonstrated the head nurses’ compliance with the framework. Discussion Head nurses’ ethical experience in practice conforms to the ethical competence framework by the TNMC. The framework that is based on the Code of conduct and the nursing culture that places the importance of the seniority system may facilitate the compliance with the ethical competence framework. Conclusion Head nurses demonstrated compliance with the ethical competence framework by the TNMC. Nevertheless, improvements could be done to the framework by adding details such as more examples of ethical decision-making scenarios, personnel’s rights, and social media usage guidelines. (shrink)

The central theme in the discussion of how education about religion can, and should, be developed in pluralistic societies concerns challenges and opportunities involving intercultural religious education (RE). One example is Robert Jackson’s report Signposts, commissioned by the Council of Europe, in which various aspects of intercultural competence are captured and made visible regarding a religious didactic context. Here, different dimensions of what can be described as ‘ethical competence’ appear to be central. In this article, the interpretive approach, strongly (...) connected with Jackson, is considered to be in need of a development of a theoretical framing of forceful strategies for handling ethical challenges taking place in multicultural, multireligious and multi-confessional classrooms. It is argued that such strategies will depend on a careful analysis of the concept of ethical competence. A theoretical platform for the argument is presented with reference to James Rest’s analysis of ethical competence, which is shown to be relevant to an examination of how the concept of ethical competence can contribute to the development of strategies for teaching intercultural RE. As a basis for this examination, the Danish, Finnish and Norwegian syllabuses for compulsory school RE are analysed regarding how they express conceptions of ethical competence. This selection shaped the curricular arena of the investigation as being non-confessional, whilst simultaneously, more or less explicitly, resting on a shared historical Protestant anchorage. This twofold interpretation is shown to allow for an analysis of ethical competence, in relation to which an identification of certain prerequisites for developing strategies for teaching intercultural RE is possible. (shrink)

At the University of Newcastle, health law and ethics is taught and assessed in each year of the five-year curriculum. However, the critical question for assessment remains: 'Does teaching ethics have a measurable effect on the clinical activity of medical students who have had such courses?' Those responsible for teaching confront this question each year they sit down to construct their assessment tools. Should they assess what the student knows? Should they assess the student's moral reasoning, that is, what decisions (...) the student makes, and, how these decisions are justified, or should they assess what the student actually does when dealing with patients in the clinical setting, and how he or she does it? From 1982 to 1991, assessment at Newcastle was primarily aimed at determining the quality of the students' ethics knowledge base. This paper describes the strengths and limitations of a purely knowledge-based method of evaluation and why in 1992, we are now attempting to redefine and assess, what we call 'clinical ethical competence' in terms of how students actually apply this knowledge base in a controlled clinical context. (shrink)

BackgroundPatients have the right to equal, respectful treatment. Nowadays, one third of patient complaints concern health care staff’s behavior towards patients. Ethically safe care requires ethical competence, which has been addressed as a core competence in physiotherapy. It has been defined in terms of character strength, ethical awareness, moral judgment skills in decision-making, and willingness to do good. The purpose of this study was to analyze the ethical competence of practicing physiotherapists.MethodA self-evaluation instrument (Physiotherapist’s Ethical Competence (...) Evaluation Tool) based on an analysis of a concept “ethical competence” was constructed in 2016 and physiotherapists (n = 839), working in public health services or private practice responded to the questionnaire.ResultsBased on the results, most of the physiotherapists evaluated themselves highly ethically competent in all areas of ethical competence, subscales being Strength, Awareness, Skills and Will. Willingness to do good was evaluated as highest, while character strength, including the strength to support ethical processes and speak on behalf of the patient, was evaluated the lowest. Physiotherapists most commonly consult a colleague when encountering an ethical problem. Other methods for problem solving are not very familiar, neither are the international or national ethical codes of conduct.ConclusionsThis was the first attempt to assess all aspects of ethical competence empirically in a clinical environment in physiotherapy, using a novel self-evaluation instrument. Even if physiotherapists evaluate themselves as competent in ethics, further exploration is needed for ethical awareness. Also the patients’ viewpoints about ethically competent care should be considered, to better ensure ethical safety of the patient. (shrink)

Ethical Competence Questionnaire-Working Life and Business (ECQ-WLB) is an effort to build an instrument that measures ethical competence in business as a psychological problem-solving and decision-making skill. The questionnaire is constructed in a way that aims to avoid connection to any particular moral philosophical theory. Its theoretical base is the autonomy hypothesis of Piaget. Autonomous reasoning as measured by the questionnaire correlated positively to the level of organizational hierarchy. ECQ-WLB demonstrated satisfying psychometricproperties and reasonable reliability properties. A confirmatory (...) factor analysis showed that the measurement model is compatible with the data. (shrink)

Ethical Competence Questionnaire-Working Life and Business (ECQ-WLB) is an effort to build an instrument that measures ethical competence in business as a psychological problem-solving and decision-making skill. The questionnaire is constructed in a way that aims to avoid connection to any particular moral philosophical theory. Its theoretical base is the autonomy hypothesis of Piaget. Autonomous reasoning as measured by the questionnaire correlated positively to the level of organizational hierarchy. ECQ-WLB demonstrated satisfying psychometricproperties and reasonable reliability properties. A confirmatory (...) factor analysis showed that the measurement model is compatible with the data. (shrink)

Introduction The starting point is that ethical competence is the basis for ethical healthcare practices and quality of care. Simultaneously, there is a need for research and development from a holistic multi-professional perspective. Aim The aim is to create a proposed model for multi-professional ethical competence grounded in clarified meanings and dimensions of ethical competence studied from a multi-professional healthcare perspective. The research questions are, what is ethical competence from a multi-professional healthcare perspective and what (...) strengthens a multi-professional ethical healthcare practice? Research design The research has a qualitative approach and hermeneutic application research design. Two groups with six participants from clinical practice and two scientific researchers in each group met four times for dialogue. Thematic analysis was used as an analysis method. Ethical considerations The research is approved by the Declaration of Helsinki, the General Data Protection Regulations, and ethical permission was asked from the Norwegian Centre for Research Data (NSD). Results The proposed model for multi-professional ethical competence encompasses a three-dimensional ethical value base that is underpinned by: Ethical attitude – a personal desire to do good; Ethical basis – the best for the patient as a common goal and Ethical culture – common goals and values in the organization. Multi-professional ethical competence is strengthened by: Reflection – to see with new wondering eyes; Time for talk – interdisciplinary teamwork and Leadership – an ethical role model and support. Discussion Ethical competence has a strong link to the core of caring ethics and a deeper personal value base and attitude. Ethical competence involves the whole culture and is seen as a shared value base and a responsibility to do the best for the patient as a multi-professional team and organization. Ethical competence becomes active in healthcare practice by opening up for meaningful multi-professional talks and reflections. (shrink)

High-quality education has been considered important for social justice, although what good education means is contested. A project aimed at identifying varieties of conceptions of ethical competence was presented as well as another that focused on a fiction-based approach to ethics education. A multidimensional ethical competence mediated through a multitude of narratives was shown as a strong contribution to EE. The aim was to discuss as to what extent such a multidimensional ethical competence mediated through a multitude (...) of narratives could be understood as powerful knowledge. Sweden, where national tests lately have been understood as a tool to increase achievements, but where an unclear understanding of desired knowledge in EE exists, was the setting. Methodologically, the article drew on Michael Young’s definition of powerful knowledge, a hermeneutic meta-study on the findings of EthiCo concerning conceptions of ethical competence, as well as Mark Tappan’s sociocultural perspective on moral development. These perspectives were brought together to discuss powerful knowledge in EE as a contribution to education for social justice. Whether a multidimensional ethical competence mediated through a multitude of narratives could be understood as powerful knowledge was shown to be dependent on the definition. Whilst Young’s powerful knowledge is restricted to an academic language, Tappan stresses vernacular language as characteristic for a functional moral discourse. One conclusion was the centrality of fiction in EE for the development of moral discourses that transcend reality and shape ‘knowledge of possibilities’ – powerful in the shaping of societal justice. (shrink)

IntroductionRheumatologists are the primary healthcare professionals responsible for patients with rheumatic diseases and should acquire medical ethical competencies, such as the informed consent process. The objective clinical structured examination is a valuable tool for assessing clinical competencies. We report the performance of 90 rheumatologist trainees participating in a station designed to evaluate the ICP during the 2018 and 2019 national accreditations.MethodsThe station was validated and represented a medical encounter in which the rheumatologist informed a patient with systemic lupus erythematosus (...) with clinically active nephritis about renal biopsy. A trained patient–actor and an evaluator were instructed to assess ICP skills in obtaining formal informed consent, delivering bad news and overall communication with patients. The evaluator used a tailored checklist and form.ResultsCandidate performance varied with ICP content and was superior for potential benefit information but significantly reduced for potential complications and biopsy description. Only 17.8% of the candidates mentioned the legal perspective of ICP. Death was omitted by the majority of the candidates ; after the patient–actor challenged candidates, only 57.1% of them gave a clear and positive answer. Evaluators frequently rated candidate communications skills as superior, but ≥1 negative aspect was identified in 69% of the candidates.ConclusionsEthical competencies are mandatory for professional rheumatologists. It seems necessary to include an ethics competency framework in the curriculum throughout the rheumatology residency. (shrink)

The Commission on Public Relations Education (CPRE) found that early-career professionals are not meeting their supervisors’ expectations in ethics knowledge. The purpose of this study was to identify what ethics competencies public relations practitioners perceive are essential and how they evaluate themselves and their colleagues regarding mastery of these competencies. The study surveyed 314 U.S. public relations and communication practitioners and revealed they perceive the most important ethics competencies to be integrity, leadership and critical thinking. Other valued competencies included a (...) personal code of ethics or values system and ability to identify ethical issues. Early-career professionals were overconfident regarding their mastery of these skills and abilities, while mid-career and senior professionals were modest in their self-assessments. Practitioners who have obtained accreditation/certifications had more confidence in their preparedness to provide ethics counsel and engaged in ethics counseling more frequently. Recommendations for enhancing personal ethics competencies are provided. (shrink)

The article reveals a study of the ethical competence formation of students at medical universities. This competence includes theoretical knowledge of professional ethics, professional and ethical value orientations, moral and personal qualities and practical skills of a doctor in the professional activity. Formation of ethical competence provides for the doctor’s conscious ethical behavior in accordance with professional and ethical standards, as well as the need for professional and ethical self-improvement throughout life. The results of (...) the study allowed to establish the availability of reserves to improve the quality of future doctors’ training and formation of their ethical competence. Taking into account the trends of globalization of the educational sphere, the impact of postmodernism on the formation and development of value orientations of student youth, the emergence of new forms of ethical values, etc., it is assumed that the this competence formation will be effective if at different stages of students’ training at medical universities there will be introduced pedagogical conditions that enhance functioning of the main subsystems of the educational process. These stages correspond to the peculiarities of students’ professional and personal development during different years of study and in view of their cognitive abilities. Experimental verification of the effectiveness of pedagogical conditions for the formation of future doctors’ ethical competence at medical universities confirmed the validity of the research hypothesis. At the same time summarizing of the research results revealed certain influence of the tendencies of traditionalism, universalism and pragmatic motives on the future doctors’ value-motivational sphere. (shrink)

Background As more people are living longer, they become frail and are affected by multi-morbidity, resulting in increased demands from the ambulance service. Being vulnerable, older patients may have reduced decision-making capacity, despite still wanting to be involved in decision-making about their care. Their needs may be complex and difficult to assess, and do not always correspond with ambulance assessment protocols. When needing an ambulance, older patients encounter ambulance clinicians who are under high workloads and primarily consider themselves as emergency (...) medical care providers. This situates them in the struggle between differing expectations, and ethical conflicts may arise. To resolve these, providing ethical care, focussing on interpersonal relationships and using ethical competence is needed. However, it is not known whether ambulance clinicians possess the ethical competence required to provide ethical care. Thus, the aim of this study was to deductively explore their ethical competence when caring for older patients with reduced decision-making ability. Methods A qualitative deductive and exploratory design was used to analyse dyadic interviews with ambulance clinicians. A literature review, defining ethical competence as comprising ethical sensitivity, ethical knowledge, ethical reflection, ethical decision-making, ethical action and ethical behaviour, was used as a structured categorization matrix for the analysis. Results Ambulance clinicians possess ethical competence in terms of their ethical knowledge, highlighting the need for establishing an interpersonal relationship with the older patients. To establish this, they use ethical sensitivity to interpret the patients’ needs. Doing this, they are aware of their ethical behaviour, signifying how they must act respectfully and provide the necessary time for listening and interacting. Conclusions Ambulance clinicians fail to see their gut feeling as a professional ethical competence, which might hinder them from reacting to unethical ways of working. Further, they lack ethical reflection regarding the benefits and disadvantages of paternalism, which reduces their ability to perform ethical decision-making. Moreover, their ethical knowledge is hampered by an ageist approach to older patients, which also has consequences for their ethical action. Finally, ambulance clinicians show deficiencies regarding their ethical reflections, as they reflect merely on their own actions, rather than on their values. (shrink)

The aim of the present study was to describe and explore the perception of ethical guidelines and their role in ethical competence-building among Swedish physicians and research nurses. Twelve informants were interviewed in depth. The results demonstrated that the informants had a critical attitude towards ethical guidelines and claimed to make little use of them in practical moral judgements. Ethical competence was seen primarily as character-building, related to virtues such as being empathic, honest and loyal to (...) patients. Ethical competence was assumed to be learned through good examples, role models and practical experience, while ethical guidelines were not perceived as valuable in this process. In order to improve the staff's familiarity with and the usability of ethical guidelines, the workplace needs to provide opportunities for ethical dialogues. In such discussions, argumentation can improve, virtues can be developed and guidelines can be usefully invoked. (shrink)

BackgroundA combination of theoretical and practical approaches is required to learn and acquire ethical competencies in caring. Occasionally, reflection on practical action differs from theoretica...

My university recently established a business ethics competency exam for graduate business students. The exam is designed to test whether students can demonstrate several abilities that are indicative of competency in business ethics. They are the abilities to speak the language of business ethics, identify business ethics issues, apply theories and concepts to issues, identify connections among theories and concepts as they relate to different issues, and construct and critically evaluate arguments for various positions on business ethics issues. (...) Through this paper, I hope to begin a discussion among business ethicists about both the merits of a competency exam and what the format of such an exam should be. I attempt to do this by explaining the reasons why my institution adopted a competency exam, the goals and purposes of the exam, the format of the exam, and why I believe the exam has merit. (shrink)

Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision-making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real-life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we attempt (...) to capture a comprehensive overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement-based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)

During the education of scientists at the university level the students become more and more specialized. The specialization of the students is a consequence of the scientific research becoming specialized as well. In the interdisciplinary field of nanoscience the importance of specialization is also emphasized throughout the education. Being an interdisciplinary field of study the specialization in this area is not focused on scientific disciplines, but on the different branches of the research. Historically ethics has not been a priority in (...) science education, however, in recent years the importance of such teachings has been highly recognize especially in medicine, biotechnology and engineering. The rapid development, the many new and unknown areas and the highly specialized focus of nanotechnology suggest the importance of having ethically competent researchers. In this article the importance of ethical competence in nanoscience research is argued for by an example of a dilemma that could occur in a research project. The dilemma is analyzed using two different ethical views, generating two different choices for action. It is seen that the dilemma can have more than one solution and that ethical competence can help in justifying the choice of solution in a specific situation. Furthermore it is suggested that a way to reach this competence is through education in ethics incorporated into the nanoscience education curriculum. (shrink)

Information and communication technology has certain advantages that can contribute positively in business ethics education programmes. It is necessary, however, to identify first the factors critical for acquiring ethical competence and later to proceed to the construction and use of such tools, in order to ensure that these tools are indeed adapted to the process and the goals of business ethics education. Based on psychological theory and research, it is argued that one such crucial factor is the psychological construct (...) of ethical autonomy. The strengths and weaknesses of information and communication technology tools are discussed in accordance with this, and some suggestions are given on fruitful ways to incorporate these tools in business ethics education. (shrink)

Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision‐making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real‐life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we attempt (...) to capture a comprehensive overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement‐based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)

There is a growing interest in ethical competence-building within nursing and health care practising. This tendency is accompanied by a remarkable growth of ethical guidelines. Ethical demands have also been laid down in laws. Present-day practitioners and researchers in health care are thereby left in a virtual cross-fire of various legislations, codes, and recommendations, all intended to guide behaviour. The aim of this paper was to investigate the role of ethical guidelines in the process of (...) class='Hi'>ethical competence-building within health care practice and medical research. A conceptual and critical philosophical analysis of some paragraphs of the Helsinki Declaration and of relevant literature was performed. Three major problems related to ethical guidelines were identified, namely, the interpretation problem (there is always a gap between the rule and the practice, which implies that ethical competence is needed for those who are to implement the guidelines); the multiplicity problem (the great number of codes, declarations, and laws might pull in different directions, which may confuse the health care providers who are to follow them); and the legalisation problem (ethics concerns may take on a legal form, where ethical reflection is replaced by a procedure of legal interpretations). Virtue ethics might be an alternative to a rule based approach. This position, however, can turn ethics into a tacit knowledge, leading to poorly reflected and inconsistent ethical decisions. Ethical competence must consist of both being (virtues) and doing (rules and principles), but also of knowing (critical reflection), and therefore a communicative based model is suggested. (shrink)

The clinical clerkships in medical school are the first formal opportunity for trainees to apply bioethics concepts to clinical encounters. These clerkships are also typically trainees’ first sustained exposure to the “reality” of working in clinical teams and the full force of the challenges and ethical tensions of clinical care. We have developed a specialized, embedded ethics curriculum for Vanderbilt University medical students during their second year to address the unique experience of trainees’ first exposure to clinical care. Our (...) embedded curriculum is centered around core “ethics competencies” specific to the clerkship: for Medicine, advanced planning and end-of-life discussions; for Surgery, informed consent; for Pediatrics, the patient-family-provider triad; for Obstetrics and Gynecology, women’s autonomy, unborn child’s interests, and partner’s rights; and for Neurology/Psychiatry, decision-making capacity. In this paper, we present the rationale for these competencies, how we integrated them into the clerkships, and how we assessed these competencies. We also review the additional ethical issues that have been identified by rotating students in each clerkship and discuss our strategies for continued evolution of our ethics curriculum. (shrink)

Background: Midwifery students are confronted with several ethical dilemmas and challenging situations during clinical midwifery care practice. Since ethical competence of midwifery students is under development, it is important to support the students’ learning progress of ethical issues from diverse viewpoints. Objective: From the perspective of didactics of caring science and the context of midwifery students, to explore how midwifery students’ experience supports for ethical competence in midwifery education and investigate how ethically challenging situations have been (...) carried out during clinical midwifery care practice. Design: Qualitative, explorative and descriptive design with inductive nature. Methods: Focus group interviews with nine Swedish midwifery students. Hans-Georg Gadamer’s philosophical hermeneutics was applied to guide the interpretation. Ethical considerations: Ethical principles and scientific guidelines were followed. Informed consent was obtained from the participants. Confidentiality was respected and quotations anonymised. Results: Receiving support when ethically challenging situations occur in clinical midwifery practice is important and necessary. One main theme, such as support is a human and caring factor in the midwifery students’ Bildung process on ethical competence, and four subthemes, such as supporting through trust and responsibility; supporting through dignity and respect; supporting through truthfulness and justice; and supporting through dialogue and reflection, were created from the hermeneutical interpretation. Discussion: Teaching ethics should be carefully planned, consistent and continue throughout the midwifery education. There is dispersion in the pedagogy of ethical situations, the methods and perceptions associated with it, and in obtaining possible support for students. Developing well-experienced methods could benefit the support of midwifery students’ ethical competence when they experience ethically challenging situations in midwifery care practice. (shrink)

Kruger and Dunning (1999) presented evidence that metacognitive deficiencies in three “domains” (humour, logic, and grammar) are related to individuals’ perceptions that they are “above average” in terms of their competence in those domains. This paper documents a presentation and ensuing discussion concerning the possibility of extending the work of Kruger and Dunning to the domain of ethics.