Islam and End-of-Life Practices in Organ Donation for Transplantation: New Questions and Serious Sociocultural Consequences Content Type Journal Article Pages 175-205 DOI 10.1007/s10730-009-9095-8 Authors Mohamed Y. Rady, Mayo Clinic Hospital in Phoenix 5777 East Mayo Boulevard Phoenix Arizona USA 85054 Joseph L. Verheijde, Mayo Clinic College of Medicine 5777 East Mayo Boulevard Phoenix Arizona USA 85054 Muna S. Ali, Arizona State University Phoenix Arizona USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal (...) Issue Volume 21, Number 2. (shrink)
The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy (...) raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder) from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1) direct participation of a multidisciplinary care team, including palliative care specialists, (2) a concise plan of care for anticipated device-related complications, (3) careful surveillance and counseling for caregiver burden, (4) advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5) a plan to address the long-term financial burden on patients, families, and caregivers. Short-term mechanical circulatory devices (e.g. percutaneous cardiopulmonary bypass, percutaneous ventricular assist devices, etc.) can be initiated in emergency situations as a bridge to permanent implantation of ventricular assist devices in chronic end-stage heart failure. In the absence of first-person (patient) consent, presumed consent or surrogate consent should be used cautiously for the initiation of short-term mechanical circulatory devices in emergency situations as a bridge to permanent implantation of left ventricular assist devices. Future clinical studies of destination therapy with left ventricular assist devices should include measures of recipients' quality of end-of-life care and caregivers' burden. (shrink)
BackgroundBioethics and law distinguish between the practices of "physician-assisted death" and "allowing the patient to die."DiscussionAdvances in biotechnology have allowed medical devices to be used as destination therapy that are designed for the permanent support of cardiac function and/or respiration after irreversible loss of these spontaneous vital functions. For permanent support of cardiac function, single ventricle or biventricular mechanical assist devices and total artificial hearts are implanted in the body. Mechanical ventilators extrinsic to the body are used for permanent support (...) of respiration. Clinical studies have shown that destination therapy with ventricular assist devices improves patient survival compared to medical management, but at the cost of a substantial alteration in end-of-life trajectories. The moral and legal assessment of the appropriateness and permissibility of complying with a patient's request to electively discontinue destination therapy in a life-terminating act in non-futile situations has generated controversy. Some argue that complying with this request is ethically justified because patients have the right to request withdrawal of unwanted treatment and be allowed to die of preexisting disease. Other commentators reject the argument that acceding to an elective request for death by discontinuing destination therapy is 'allowing a patient to die' because of serious flaws in interpreting the intention, causation, and moral responsibility of the ensuing death.SummaryDestination therapy with cardiac and/or ventilatory medical devices replaces native physiological functions and successfully treats a preexisting disease. We posit that discontinuing cardiac and/or ventilatory support at the request of a patient or surrogate can be viewed as allowing the patient to die if--and only if--concurrent lethal pathophysiological conditions are present that are unrelated to those functions already supported by medical devices in destination therapy. In all other cases, compliance with a patient's request constitutes physician-assisted death because of the pathophysiology induced by the turning off of these medical devices, as well as the intention, causation, and moral responsibility of the ensuing death. The distinction between allowing the patient to die and physician-assisted death is pivotal to the moral and legal status of elective requests for death by discontinuing destination cardiac and/or ventilatory medical devices in patients who are not imminently dying. This distinction also represents essential information that must be disclosed to patients and surrogates in advance of consent to this type of therapy. (shrink)
Mass media campaigns are widely and successfully used to change health decisions and behaviors for better or for worse in society. In the United States, media campaigns have been launched at local offices of the states’ department of motor vehicles to promote citizens’ willingness to organ donation and donor registration. We analyze interventional studies of multimedia communication campaigns to encourage organ-donor registration at local offices of states’ department of motor vehicles. The media campaigns include the use of multifaceted communication tools (...) and provide training to desk clerks in the use of scripted messages for the purpose of optimizing enrollment in organ-donor registries. Scripted messages are communicated to customers through mass audiovisual entertainment media, print materials and interpersonal interaction at the offices of departments of motor vehicles. These campaigns give rise to three serious concerns: (1) bias in communicating information with scripted messages without verification of the scientific accuracy of information, (2) the provision of misinformation to future donors that may result in them suffering unintended consequences from consenting to medical procedures before death (e.g, organ preservation and suitability for transplantation), and (3) the unmanaged conflict of interests for organizations charged with implementing these campaigns, (i.e, dual advocacy for transplant recipients and donors). We conclude the following: (1) media campaigns about healthcare should communicate accurate information to the general public and disclose factual materials with the least amount of bias; (2) conflicting interests in media campaigns should be managed with full public transparency; (3) media campaigns should disclose the practical implications of procurement as well as acknowledge the medical, legal, and religious controversies of determining death in organ donation; (4) organ-donor registration must satisfy the criteria of informed consent; (5) media campaigns should serve as a means of public education about organ donation and should not be a form of propaganda. (shrink)
Organ donation after cardiac or circulatory death (DCD) has been introduced to increase the supply of transplantable organs. In this paper, we argue that the recovery of viable organs useful for transplantation in DCD is not compatible with the dead donor rule and we explain the consequential ethical and legal ramifications. We also outline serious deficiencies in the current consent process for DCD with respect to disclosure of necessary elements for voluntary informed decision making and respect for the donor's autonomy. (...) We compare two alternative proposals for increasing organ donation consent in society: presumed consent and mandated choice. We conclude that proceeding with the recovery of transplantable organs from decedents requires a paradigm change in the ethics of organ donation. The paradigm change to ensure the legitimacy of DCD practice must include: (1) societal agreement on abandonment of the dead donor rule, (2) legislative revisions reflecting abandonment of the dead donor rule, and (3) requirement of mandated choice to facilitate individual participation in organ donation and to ensure that decisions to participate are made in compliance with the societal values of respect for autonomy and self-determination. (shrink)
Advance health care directives and informed consent remain the cornerstones of patients' right to self-determination regarding medical care and preferences at the end-of-life. However, the effectiveness and clinical applicability of advance health care directives to decision-making on the use of life support systems at the end-of-life is questionable. The Uniform Anatomical Gift Act (UAGA) has been revised in 2006 to permit the use of life support systems at or near death for the purpose of maximizing procurement opportunities of organs medically (...) suitable for transplantation. Some states have enacted the Revised UAGA (2006) and a few of those have included amendments while attempting to preserve the uniformity of the revised Act. Other states have introduced the Revised UAGA (2006) for legislation and remaining states are likely to follow soon. (shrink)
We respond to Morgan and Feeley’s critique on our article “Mass Media in Organ Donation: Managing Conflicting Messages and Interests.” We noted that Morgan and Feeley agree with the position that the primary aims of media campaigns are: “to educate the general public about organ donation process” and “help individuals make informed decisions” about organ donation. For those reasons, the educational messages in media campaigns should not be restricted to “information from pilot work or focus groups” but should include evidence-based (...) facts resulting from a comprehensive literature research. We consider the controversial aspects about organ donation to be relevant, if not necessary, educational materials that must be disclosed in media campaigns to comply with the legal and moral requirements of informed consent. With that perspective in mind, we address the validity of Morgan and Feeley’s claim that media campaigns have no need for informing the public about the controversial nature of death determination in organ donation. Scientific evidence has proven that the criteria for death determination are inconsistent with the Uniform Determination of Death Act and therefore potentially harmful to donors. The decision by campaign designers to use the statutory definition of death without disclosing the current controversies surrounding that definition does not contribute to improved informed decision making. We argue that if Morgan and Feeley accept the important role of media campaigns to enhance informed decision making, then critical controversies should be disclosed. In support of that premise, we will outline: (1) the wide-spread scientific challenges to brain death as a concept of death; (2) the influence of the donor registry and team-huddling on the medical care of potential donors; (3) the use of authorization rather than informed consent for donor registration; (4) the contemporary religious controversy; and (5) the effects of training desk clerks as organ requestors at the Department of Motor Vehicles offices. We conclude that organ donation is a medical procedure subject to all the ethical obligations that the medical profession must uphold including that of transparency and truthfulness. (shrink)
Recently, several articles in the scholarly literature on medical ethics proclaim the need for “responsible scholarship” in the debate over the proper criteria for death, in which “responsible scholarship” is defined in terms of support for current neurological criteria for death. In a recent article, James M. DuBois is concerned that academic critiques of current death criteria create unnecessary doubt about the moral acceptability of organ donation, which may affect the public’s willingness to donate. Thus he calls for a closing (...) of the debate on current death criteria and for journal editors to publish only critiques that “substantially engage and advance the debate.” We argue that such positions as DuBois’ are a threat to responsible scholarship in medical ethics, especially scholarship that opposes popular stances, because it erodes academic freedom and the necessity of debate on an issue that is literally a matter of life and death, no matter what side a person defends. (shrink)
The utilitarian construct of two alternative criteria of human death increases the supply of transplantable organs at the end of life. Neither the neurological criterion (heart-beating donation) nor the circulatory criterion (non-heart-beating donation) is grounded in scientific evidence but based on philosophical reasoning. A utilitarian death definition can have unintended consequences for dying Muslim patients: (1) the expedited process of determining death for retrieval of transplantable organs can lead to diagnostic errors, (2) the equivalence of brain death with human death (...) may be incorrect, and (3) end-of-life religious values and traditional rituals may be sacrificed. Therefore, it is imperative to reevaluate the two different types and criteria of death introduced by the Resolution (Fatwa) of the Council of Islamic Jurisprudence on Resuscitation Apparatus in 1986. Although we recognize that this Fatwa was based on best scientific evidence available at that time, more recent evidence shows that it rests on outdated knowledge and understanding of the phenomenon of human death. We recommend redefining death in Islam to reaffirm the singularity of this biological phenomenon as revealed in the Quran 14 centuries ago. (shrink)
In 1968, the Harvard criteria equated irreversible coma and apnea (i.e., brain death) with human death and later, the Uniform Determination of Death Act was enacted permitting organ procurement from heart-beating donors. Since then, clinical studies have defined a spectrum of states of impaired consciousness in human beings: coma, akinetic mutism (locked-in syndrome), minimally conscious state, vegetative state and brain death. In this article, we argue against the validity of the Harvard criteria for equating brain death with human death. (1) (...) Brain death does not disrupt somatic integrative unity and coordinated biological functioning of a living organism. (2) Neurological criteria of human death fail to determine the precise moment of an organism’s death when death is established by circulatory criterion in other states of impaired consciousness for organ procurement with non-heart-beating donation protocols. The criterion of circulatory arrest 75 s to 5 min is too short for irreversible cessation of whole brain functions and respiration controlled by the brain stem. (3) Brain-based criteria for determining death with a beating heart exclude relevant anthropologic, psychosocial, cultural, and religious aspects of death and dying in society. (4) Clinical guidelines for determining brain death are not consistently validated by the presence of irreversible brain stem ischemic injury or necrosis on autopsy; therefore, they do not completely exclude reversible loss of integrated neurological functions in donors. The questionable reliability and varying compliance with these guidelines among institutions amplify the risk of determining reversible states of impaired consciousness as irreversible brain death. (5) The scientific uncertainty of defining and determining states of impaired consciousness including brain death have been neither disclosed to the general public nor broadly debated by the medical community or by legal and religious scholars. Heart-beating or non-heart-beating organ procurement from patients with impaired consciousness is de facto a concealed practice of physician-assisted death, and therefore, violates both criminal law and the central tenet of medicine not to do harm to patients. Society must decide if physician-assisted death is permissible and desirable to resolve the conflict about procuring organs from patients with impaired consciousness within the context of the perceived need to enhance the supply of transplantable organs. (shrink)
Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the Institute of Medicine as a way to increase opportunities for organ procurement. Despite claims to the contrary, both forms of controlled and uncontrolled donation after cardiac death raise significant ethical and legal issues. Identified causes for concern include absence of agreement on criteria for the declaration of death, nonexistence of universal guidelines for duration before stopping resuscitation efforts and techniques, and assumption of presumed (...) intent to donate for the purpose of initiating temporary organ-preservation interventions when no expressed consent to donate is present. From a legal point of view, not having scientifically valid criteria of cessation of circulation and respiration for declaring death could lead to a conclusion that organ procurement itself is the proximate cause of death. Although the revised Uniform Anatomical Gift Act of 2006 provides broad immunity to those involved in organ-procurement activities, courts have yet to provide an opinion on whether persons can be held liable for injuries arising from the determination of death itself. Preserving organs in uncontrolled donation after cardiac death requires the administration of life-support systems such as extracorporeal membrane oxygenation. These life-support systems can lead to return of signs of life that, in turn, have to be deliberately suppressed by the administration of pharmacological agents. Finally, allowing temporary organ-preservation interventions without expressed consent is inherently a violation of the principle of respect for a person's autonomy. Proponents of organ donation from uncontrolled donation after cardiac death, on the other hand, claim that these nonconsensual interventions enhance respect for autonomy by allowing people, through surrogate decision making, to execute their right to donate organs. However, the lack of transparency and the absence of protection of individual autonomy, for the sake of maximizing procurement opportunities, have placed the current organ-donation system of opting-in in great jeopardy. Equally as important, current policies enabling and enhancing organ procurement practices, pose challenges to the constitutional rights of individuals in a pluralistic society as these policies are founded on flawed medical standards for declaring death. (shrink)
Ben Saunders claims that actual consent is not necessary for organ donation due to ‘normative consent’, a concept he borrows from David Estlund. Combining normative consent with Peter Singer's ‘greater moral evil principle’, Saunders argues that it is immoral for an individual to refuse consent to donate his or her organs. If a presumed consent policy were thus adopted, it would be morally legitimate to remove organs from individuals whose wishes concerning donation are not known. This paper disputes Saunders' arguments. (...) First, if death caused by the absence of organ transplant is the operational premise, then, there is nothing of comparable moral precedence under which a person is not obligated to donate. Saunders' use of Singer's principle produces a duty to donate in almost all circumstances. However, this premise is based on a flawed interpretation of cause and effect between organ availability and death. Second, given growing moral and scientific agreement that the organ donors in heart-beating and non-heart-beating procurement protocols are not dead when their organs are surgically removed, it is not at all clear that people have a duty to consent to their lives being taken for their organs. Third, Saunders' claim that there can be good reasons for refusing consent clashes with his claim that there is a moral obligation for everyone to donate their organs. Saunders' argument is more consistent with a conclusion of ‘mandatory consent’. Finally, it is argued that Saunders' policy, if put into place, would be totalitarian in scope and would therefore be inconsistent with the freedom required for a democratic society. (shrink)
In assisted dying, the end-of-life trajectory is shortened to relieve unbearable suffering. Unbearable suffering is defined broadly enough to include cognitive (early dementia), psychosocial or existential distress. It can include old-age afflictions that are neither life-threatening nor fatal in the “vulnerable elderly”. The voluntary refusal of food and fluids (VRFF) combined with continuous deep sedation (CDS) for assisted dying is legal. Scientific understanding of awareness of internal and external nociceptive stimuli under CDS is rudimentary. CDS may blunt the wakefulness component (...) of human consciousness without eradicating internal affective awareness of thirst and hunger. Patients may suffer because of the slow dying process following dehydration and starvation. The difficulty to adequately control distress, without bringing the dying process to a rapid conclusion by lethal pharmacological interventions, can cause feelings of guilt among hospice and medical staff. Furthermore, the double-effect principle is not applicable in these situations because the primary objective of VRFF is to hasten death. Legal and societal debate should focus on sharpening the boundaries between assisted dying and palliative care. This separation is necessary to: 1) uphold trust in the patient-phyician relationship, and 2) preserve integrity and ethics of the medical profession. (shrink)
En la historia del pensamiento político musulmán ŷihād e iŷtihād siempre van unidos. Pero es en el pensamiento combativo donde más se manifiesta esa unión de un modo transcendente. El objetivo del presente trabajo es plantear el aspecto transhistórico del iŷtihād y del ŷihād, y con ello, exponer de manifiesto el siempre fracasado proceso de emancipación histórica y teológica del proyecto ŷihadístico basado sobre la mistificación de lo sustancialmente humano.
En la historia del pensamiento politico musulman .ih.d e i.tih.d siempre van unidos. Pero es en el pensamiento combativo donde mas se manifiesta esa union de un modo transcendente. El objetivo del presente trabajo es plantear el aspecto transhistorico del i.tih.d y del .ih.d, y con ello, exponer de manifiesto el siempre fracasado proceso de emancipacion historica y teologica del proyecto .ihadistico basado sobre la mistificacion de lo sustancialmente humano.
This paper investigates the debris generation mechanism for polymers due to the actions of the micro-asperities of a hard counterface. Nanoscratching tests were conducted on the surface of five commercially available polymers using a diamond conical tip indenter with three different scratching sequences namely unidirectional multipass, orthogonal multipass and orthogonal omnipass. The scratch damage surface was analysed using an atomic force microscope and a scanning electron microscope to investigate the material removal phenomenon for the selected polymers. The results show that (...) debris generation in polymers is largely a phenomenon of low-cycle fatigue when asperities contribute to the localized plastic deformation of the surface. Hence the rate of material removal is reduced for a polymer which has higher toughness and a higher percentage of elongation before failure. The hardness of the polymer has a counter effect on wear as higher hardness tends to reduce the toughness property in polymers which leads to microcracking and further wear debris generation. (shrink)
Creep experiments were conducted on Zn-22%?Al in which SiC particulates were introduced by variable co-deposition of multi-phase materials (VCM). The objective of the investigation is to determine the effect of SiC particulates on the creep behaviour in region I (the low-stress region) and region II (the intermediate-stress or superplastic region) of the sigmoidal plot between stress and strain rate, which was previously reported for the reinforcement-free Zn-22%?Al. The creep data show that the presence of SiC particulates has no effect on (...) the sigmoidal trend between stress and strain rate; and that in region II, the stress exponent, n, and the activation energy for creep, Q, agree well with those reported for SiC-free grades of Zn-22%?Al; n?=?2.5 and Q???Q gb, where Q gb is energy for grain boundary diffusion in the alloy. However, the data indicate that the presence of the particulates results in narrowing region II and reducing maximum ductility. An analysis of the creep data reveals the presence of a threshold stress that depends strongly on temperature. The microstructural data inferred from an examination of the crept specimens by the means of transmission electron microscopy (TEM) suggest that the origin of τ 0 may be related to the interaction between moving dislocations and dispersion particles. These particles are introduced in the material as a result of processing the material by thermal spray and deposition. (shrink)
La presente seleccion de textos, contiene los principales aspectos de la tesis del pensador egipcio Ali Sami Nash.r destacado miembro de la escuela "fundamentalista" defensora de la "originalidad de la filosofia islamica" en la historia del pensamiento arabe moderno. En estos textos, se llega a afirmar que la filosofia islamica tuvo su propia y especial estructura y por consiguiente, su peculiar personalidad, y que los filosofos dichos "islamicos" no eran nada mas que filosofos peripateticos seguidores de Aristoteles mientras que los (...) verdaderos filosofos del Islam eran los mutakallim.n, autenticos representantes del espiritu musulman. Con esta seleccion de textos traducidos directamente del arabe, se pretende realizar una reflexion sobre el destino que tomo una de las aproximaciones mas especificas sobre la filosofia peripatetica en el mundo islamico, que, por razones desconocidos, permanecio desconocida en Occidente y parte del mundo islamico. (shrink)
Con la publicación de al-�Aqida al-burhaniyya al-as,ariyya, una joya más del legado as,ari marroquí ha visto la luz. El objetivo de este trabajo es analizar la importancia de esa edición científica y aportar algunas reflexiones acerca de su contenido y forma.
Averroes, según el autor, argumenta en defensa de la unidad de la verdad y de la razón, tanto en la filosofía como en la religión. Para probarla, primero traslada una de las dos verdades y razones a la otra por medio de la interpretación demostrativa. En segundo lugar, aleja la filosofía de las desviaciones teológica, el llamado Kalam, y sufí. Finalmente, liberada la filosofía del sufismo y del Kalam, Averroes persigue el objetivo del la filosofía como ser en sus tres (...) niveles (sustancia, movimiento, relación), y como causalidad. (shrink)
The dream of the conversion in Ramon Llull is related with the own author’s vital vicissitudes. Therefore, the Islamic influence in the lulian system is obvious, besides the knowledge of Arab sources on the part of the author. On the other hand, Mohammed’s vision and the Islam that Ramon Llull presents is intimately related with its apologetic plans, inserting it in the Christian tradition of rebuttal, being in to traditional way a topic like the Antichrist.
Business and especially marketing ethics have come to the forefront in recent years. While consumers have been surveyed regarding their perceptions of ethical business and marketing practices, research has been minimal with regard to their perceptions of ethical consumer practices. In addition, few studies have examined the ethical beliefs of elderly consumers even though they are an important and rapidly growing segment. This research investigates the relationship between Machiavellianism, ethical ideology and ethical beliefs for elderly consumers. The results indicate that (...) elderly consumers, while generally being more ethical than younger consumers, are diverse in their eithical beliefs. (shrink)
This study explores the ethical ideol-ogies and ethical beliefs of African American consumers using the Forsyth ethical position questionnaire (EPQ) and the Muncy-Vitell consumer ethics questionnaire (MVQ). The two dimensions of the EPQ (i.e., idealism and relativism) were the independent constructs and the four dimensions of the MVQ (i.e., illegal, active, passive and no harm) were the dependent variables. In addition, this paper explores the consumer ethics of African Americans across four demographic factors (i.e., age, education, gender, and marital status). (...) A sample of 315 African American consumers was used to explore these relationships. Results confirmed that consumers who score high on the idealism scale are more likely to reject questionable consumer activities, but there was no relationship between relativism and consumers'' rejection of questionable activities. Older, more educated and married consumers rejected questionable activities more than younger, less educated and single consumers. Gender did not have any significant relationship to consumers'' ethical orientation. (shrink)
Business and Marketing ethics have come to the forefront in recent years. While consumers have been surveyed regarding their perceptions of ethical business and marketing practices, research has been minimal with regard to their ethical beliefs and ideologies. In addition, no study has examined the ethical beliefs of Austrian consumers even though Austria maintains a unique status of political neutrality, nonalignment, stability, economic prosperity and geographical proximity to the East- and West-European countries. This research investigates the relationship between Machiavellianism, ethical (...) ideology and ethical beliefs of Austrian consumers. The results indicate that Austrian consumers are mostly situationists who, while rejecting moral rules, judge the ethics of a behavior by the consequences and outcomes of the situation. (shrink)
The ethical climate in Turkey is beset by ethical problems. Bribery, environmental pollution, tax frauds, deceptive advertising, production of unsafe products, and the ethical violations that involved politicians and business professionals are just a few examples. The purpose of this study is to compare and contrast the ethical beliefs of American and Turkish consumers using the Ethical Position Questionnaire (EPQ) of Forsyth (1980), the Machiavellianism scale, and the Consumer Ethical Practices of Muncy and Vitell questionnaire (MVQ). A sample of 376 (...) subjects that consists of American consumers (n = 188) and Turkish consumers (n = 199) was used to compare the ethical beliefs and practices of the two samples. The MANOVA results for the two nationality groups found that five out of six criterion variables differed between the two groups. The implications of this study are intended to assist marketers to develop strategies that suit a particular market and lessen their risk of entry. (shrink)
Research investigating the consumer's ethical beliefs, ideologies and orientation has been limited. Additionally, despite the repeated call in the literature for cross cultural research, virtually no studies have examined the ethical beliefs and ideologies of consumers from cultures other than those in North America. This study partially fills this gap in the literature by investigating the ethical beliefs, preferred ethical ideology, and degree of Machiavellianism of consumers from Egypt and Lebanon. The results indicate that consumers in Lebanon, which has been (...) torn by civil unrest and terrorism, tend to be more Machiavellian, less idealistic, and more relativistic than their Egyptian counterparts. Additionally, the Lebanese consumers tend to be more accepting of questionable consumer practices. (shrink)
Past research has examined the ethical judgments of consumers in the U.S., but few studies have investigated such attitudes in foreign-market settings. The current study compares ethical attitudes of consumers in two countries (Ireland and Lebanon) which share a cultural similarity of ongoing war and terrorism. The findings reveal that both cultures exhibit low sensitivity to ethical issues. Furthermore, the findings show that the Irish consumers are less sensitive to consumer ethical practices, less idealistic, more relativistic, and more Machiavellian than (...) Lebanese consumers. The authors recommend that other researchers need to further investigate this perplexing issue because ethics is a research topic which often discourages survey respondents to be candid. (shrink)
This paper represents the responses of 377 pharmacists to a mail survey examining their views concerning ethical conflicts and practices. Besides identifying the sources of ethical conflicts, pharmacists were asked how ethical standards have changed over the last 10 years as well as the factors influencing these changes. Conclusions and implications are outlined and future research needs are examined.
This study was designed to examine the determinants of and differences between the ethical beliefs of two groups of Japanese students in religious and secular universities. Multiple regression analysis revealed that students of the Japanese religious university perceived that young, male, relativistic, and opportunistic students tended to behave less ethically than did older, female, and idealistic students. Students of the Japanese secular university perceived that male, achievement-oriented, and opportunistic students tended to behave less ethically than did female and experience-oriented students. (...) Opportunism was found to be one of the most important determinants in explaining misconduct. Multivariate analysis of variance (MANOVA) and multiple discriminant analysis (MDA) revealed that students of the Japanese secular university tended to score higher on achievement and humanism, and lower on theism and positivism than did students of the Japanese religious university. In addition, students of the Japanese secular university were somewhat more sensitive to academic dishonesty practices than were students of the Japanese religious university. (shrink)
This paper reports the responses of 251 mental health care practitioners to a mail survey examining their views concerning ethical conflicts and practices within their work environments. Besides identifying the sources and types of conflicts they experience, respondents were asked how ethical standards have changed over the last 10 years as well as the factors influencing these changes. Conclusions and implications are outlined and future research needs are described.
Relationships with one's employees, co-workers, or superiors create ethical dilemmas. Employees' judgments and ethical perceptions have been extensively studied in Western cultures, but not in developing countries. The purpose of this investigation is to examine employees' self-reported work-related ethics and compare them to their perceptions of co-workers' and top managements' along various morally challenging situations in three developing countries' organizations. Saudi Arabia, Kuwait, and Oman, known as the Gulf countries, were selected as the research setting - and provided the sampling (...) frame - for this study. The results suggest that respondents perceived all ethically challenging situations as unethical and had significant differences among themselves regarding the ethical perceptions of self, as compared to perceptions of peers', and top managements'. Discussion of the results and implications are provided. (shrink)
A vast majority of marketing theory and research has focused on relativism and idealism in order to understand ethical behavior. However, making ethical assessments that in turn influence behavior is much more complicated than it appears. One of the most important developments in contemporary philosophy has been the renewed interest in epistemic virtue. Epistemologists contend that belief is an ethical process that is susceptible to the intellectual virtue or vice of one’s own life and personal experiences. Open-mindedness, curiosity, careful thinking, (...) creativity, and intellectual courage are the foundations of epistemic virtues. Closed-mindedness, intellectual overconfidence, unimaginativeness, intellectual conformity, and wishful thinking are among epistemic vices. The purpose of this investigation is to introduce epistemology to marketing ethics by linking it to personal moral philosophies (idealism and relativism) and optimism to explain various ethically challenging organizational behaviors. The items of epistemology were developed and pretested by the lead author of this study. Structural equations (LISREL) analyses found that epistemic virtues and vices are better predictors of ethical behavior than were personal moral philosophies (idealism and relativism), and their influence on mild and severe levels of unethical behaviors was enhanced by the moderator variable, optimism. Implications are designed to develop suggestions for improving ethical behavior in the workplace. (shrink)