This article critically questions the commercialization of hospice care and the ethical concerns associated with the industry's movement toward “market-driven medicine” at the end of life. For example, the article examines issues raised by an influx of for-profit hospice providers whose business model appears at its core to have an ethical conflict of interest between shareholders doing well and terminal patients dying well. Yet, empirical data analyzing the experience of patients across the hospice industry are limited, and general claims that (...) end-of-life patient care is inferior among for-profit providers or even that their business practices are somehow unseemly when compared to nonprofit providers cannot be substantiated. In fact, non-profit providers are not immune to potentially conflicting concerns regarding financial viability (i.e., “no margin, no mission”). Given the limitations of existing empirical data and contrasting ideological commitments of for-profit versus non-profit providers, the questions raised by this article highlight important areas for reflection and further study. Policymakers and regulators are cautioned to keep ethical concerns in the fore as an increasingly commercialized hospice industry continues to emerge as a dominant component of the U.S. health care system. Both practitioners and researchers are encouraged to expand their efforts to better understand how business practices and commercial interests may compromise the death process of the patient and patient's family — a process premised upon a philosophy and ethical tradition that earlier generations of hospice providers and proponents established as a trusted, end-of-life alternative. (shrink)
Bringing together some of the most eminent thinkers in the field, this book celebrates the seminal contribution of Ted Benton to such pressing themes as: realism, naturalism and the philosophy of the social sciences, the continuing relevance of Marxism, philosophical anthropology and human needs, and ecology, society and natural limits.
A model of information technology (IT) ethical work climates is presented. Using these ethical work climates and data collected from a national mail survey of Association for Computing Machinery (ACM) members, empirical measures were developed and evaluated. A mailing of 2446 questionnaires was sent to ACM members and 136 usable responses were returned (5.6%). Using these data, an exploratory factor analysis was performed using principle components analysis to identify the IT ethical work climates from the data. Six of these work (...) climates were identified as predicted by the model. Two ethical work climates that were combinations of the proposed climates were also identified.From the results of the exploratory factor analysis, a confirmatory factor analysis was performed using Calis in PC SAS version 8. The purpose of this analysis was to evaluate the overall fit of these measures to the data and evaluate the psychometric properties of the measures. The fit of the IT ethical work climates model was acceptable. The psychometric properties of these measures were good. Based on these results, conclusions, limitations of the study, and directions for future research are proposed. (shrink)