Competitor intelligence gathering involves the aggregation of competitive information to facilitate strategic development and a competitive advantage. Unfortunately, companies are sometimes willing to carry out questionable gathering practices to collect such information. An ethical decision making framework for competitor intelligence gathering is presented in this paper that outlines the impact of several strengthening and weakening factors on individual ethical reasoning. Dialogue is provided about the management of intelligence gathering from various viewpoints, and the implications of (...) these managerial suggestions are discussed. (shrink)

Ethical decision-making in school administration has received considerable attention in educational leadership literature. However, most research has focused on principals working in secondary school settings while studies that explore ethical reasoning processes of academic deans have been significantly few. This qualitative study aims to describe the ethical decision-making processes employed by a select group of Filipino college deans in solving ethical dilemmas using the ethical paradigms proposed in the works of Starratt (...) (Educ Adm Q 27:185–202, 1991) and Shapiro and Stefkovich (Ethical leadership and decision-making in education: applying theoretical perspectives to complex dilemmas, 2005) as frameworks for the analysis. Data was gathered using semi-structured interviews and field text was analyzed using deductive thematic analysis. Findings of this study show that majority of the deans chose to share ethical dilemmas involving students and teachers. The findings also show the ethical frameworks of care, justice, and profession as the dominant paradigms utilized by Filipino deans and their preference for adopting multiple ethical frameworks when making their decisions. Most of the ethical dilemmas which the deans narrated relate to their tasks of academic administration such as monitoring student performance, faculty evaluation and maintaining school discipline. Interestingly, only a few dilemmas involving university administrators were expressed, and dilemmas that refer to broader societal issues usually associated with school administrators’ utilization of the ethic of critique were also significantly left out in the narratives of this study. This paper intends to contribute to current literature by expanding research to administrators working in the context of higher education in the Philippine setting. The findings of this study could serve as knowledge base in designing ethics courses to enhance educational leaders’ ethical decision-making skills. The study also provides useful insights of ethical decisions and reasoning processes employed by academic administrators in resolving real life ethical dilemmas that could be useful at the practical level for aspiring and practicing deans. (shrink)

The COVID-19 pandemic has strained healthcare resources the world over, requiring healthcare providers to make resource allocation decisions under extraordinary pressures. A year later, our understanding of COVID-19 has advanced, but our process for making ethical decisions surrounding resource allocation has not. During the first wave of the pandemic, our institution uniformly ramped-down clinical activity to accommodate the anticipated demands of COVID-19, resulting in resource waste and inefficiency. In preparation for the second wave, we sought to make such (...) ramp down decisions more prudently and ethically. We report the development of a tool that can be used to make fair and ethical decisions in times of resource scarcity. We formed an interprofessional team to develop and use this tool to ensure that a diverse range of stakeholder perspectives were represented in this development process. This team, called the clinical activity recovery team, established institutional objectives that were combined with well-established procedural values, substantive ethical principles and decision-making criteria by using a variation on the well-known accountability for reasonableness ethical framework. The result of this is a stepwise, semiquantitative, ethical decision tool that can be applied to resource allocation challenges in order to reach fair and ethically defensible decisions. This ethical decision tool can be applied in various contexts and may prove useful at both the institutional and the departmental level; indeed this is how it is applied at our centre. As the second wave of COVID-19 strains healthcare resources, this tool can help clinical leaders to make fair decisions. There are no data in this work. (shrink)

In this study, Canadian healthcare ethics consultants describe their use of ethics decision-making frameworks. Our research finds that ethics consultants in Canada use multi-purpose ethics decision-making frameworks, as well as targeted frameworks that focus on reaching an ethical resolution to a particular healthcare issue, such as adverse event reporting, or difficult triage scenarios. Several interviewees mention the influence that the accreditation process in Canadian healthcare organizations has on the adoption and use of such frameworks. Some (...) of the ethics consultants we interviewed also report on their reluctance to use these tools. Limited empirical work has been done previously on the use of ethics decision-making frameworks. This study begins to fill this gap in our understanding of the work of healthcare ethics consultants. (shrink)

In the aftermath of the accounting scandals of the early 2000s, the accounting profession experienced increased legislation and rules regulating ethical behavior of professional accountants and accounting firms. This paper considers ethics education for professional accountants (particularly Certified Public Accountants (CPAs)) and concludes that there is a need for a broader, principles-based approach to continuing professional ethics (CPE) in the United States. This conclusion is supported by the recent trend toward principles-based global ethics standards and a review of the (...) current professional standards and CPE requirements for ethics education for CPAs. We present tools, such as listing core values, creation of a personal mission statement, and the utilization of a comprehensive ethical decision-making framework, that can be incorporated into ethics CPE courses for CPAs, ethics education in academic programs, and ethical decisions in practice. We also present results from a survey about ethical dilemmas distributed to a sample of CPAs taking CPE ethics courses. Consistent with our expectations, we find that for ethical dilemmas in which professional standards more clearly apply and the facts were less ambiguous, the CPAs in the sample responded with higher average levels of ethicality and more agreement than for ethical dilemmas when professional standards were not as applicable and facts were more ambiguous. Finally, the paper demonstrates how a comprehensive ethical decision-making framework may be applied to ethical dilemmas, particularly those that cannot be satisfactorily resolved using a rulesbased approach and makes recommendations for future research. (shrink)

The authors led the development of a framework for ethical decision-making for an Academic Health Sciences Centre. They understood the existing mission, vision, and values statement (MVVs) of the centre as a foundational assertion that embodies an ethical commitment of the institution. Reflecting the Patient and Family Centred Model of Care the institution is living, the MVVs is a suitable base on which to construct an ethics framework. The resultant framework consists of a (...) set of questions for each of the MVVs. Users of the framework are expected to identify two or more possible decisions to address the issue at hand and then, by applying the provided sequence of questions to each, examine these options and determine the overall ethically preferable decision. The construction of such a framework requires the creative involvement of the institution’s staff. Thus the development of the framework can represent a training process in ethical decision-making as well as advance the ethical atmosphere of the institution. This novel approach has the advantage of placing the MVVs on active duty, at the centre of ethical decision-making, and lifts it from its otherwise relative obscurity in most institutions. (shrink)

Providing a vibrant four-color design, market-leading BUSINESS ETHICS: ETHICAL DECISION MAKING AND CASES, Ninth Edition, thoroughly covers the complex environment in which managers confront ethical decision making. Using a proven managerial framework, this accessible, applied text addresses the overall concepts, processes, and best practices associated with successful business ethics programs--helping readers see how ethics can be integrated into key strategic business decisions. Thoroughly revised, the new ninth edition incorporates coverage of new legislation affecting (...) business ethics, the most up-to-date examples, and the best practices of high-profile organizations. It also includes 20 all-new or updated original case studies. (shrink)

This paper contributes to the contemporary business ethics narrative by proposing an approach to corporate ethical decision making (EDM) which serves as an alternative to the imposition of codes and standards to address the ethical consequences of grand challenges, like COVID-19, which are impacting today’s society. Our alternative approach to EDM embraces the concept of reflexive thinking and ethical consciousness among the individual agents who collectively are the corporation and who make ethical decisions, often (...) in isolation, removed from the collocated corporate setting. We draw on the teachings of the Canadian philosopher and theologian, Fr. Bernard Lonergan, to conceptualize an approach to EDM which focuses on the ethics of the corporate agent by nurturing the universal and invariant structure that is operational in all human beings. Embracing Lonergan’s dynamic cognitive structure of human knowing, and the structure of the human good, we advance a paradigm of EDM in business which emboldens authentic ethical thought, decision making, and action commensurate with virtuous living and germane to human flourishing. Lonergan’s philosophy guides us away from the imposition of over-arching corporate codes of ethics and inspires us, as individual agents, to attend to the data of our own consciousness in our ethical decision making. Such cognitional endowment leads us out of the ethics of the ‘timeless present’ (Islam and Greenwood in Journal of Business Ethics 170: 1–4, 2021) towards ethical authenticity in business, leaving us better placed to reflect upon and address the ethical issues emanating from grand challenges like COVID-19. (shrink)

This paper reports on a survey of auditors in New Zealand which investigates the nature of the moral judgements they make on a series of problems with ethical dimensions. The framework adopted for this purpose is developed from earlier work which identifies a range of ethical principles which may be involved in business ethical decision‐making. Auditors responded to a questionnaire which posed, firstly, several questions about the context of their ethical decision‐making, (...) and secondly, a series of vignettes elaborating problematical dilemmas which required the selection of one of four possible responses. Data was analysed to determine whether or not it confirmed previous findings in suggesting a predominant ethical orientation for auditors. The results were correlated with demographic variables in order to determine whether or not age, gender, position in firm and size of employee firm were significantly correlated to ethical response. The survey results, on the whole, confirmed the ethical orientation suggested by previous findings, but there were some unexpected results in three out of the ten vignettes examined. Although some correlations were found between the demographic variables and subject responses, the evidence of this survey does not strongly suggest a consistent significant correlation. (shrink)

In order to strengthen RI in the private sector, it is imperative to understand how companies organise this process, where it takes place, and what considerations and motivations are central in the innovation process. In this chapter, the questions of whether and where normative considerations play a role in the innovation process, and whether dimensions of RI are present in the innovation process, are addressed. In order answer these research questions, a theoretical framework is developed based on Jones’s theory (...) of ethical decision making and Cooper’s stagegate model of innovation management. In order to answer the research questions, a specific case of innovations that contribute to public health is explored, namely, that of food companies that participate in a Front-of-Pack logo for healthier food. As the use of healthy food logos does not necessarily have a positive impact on sales and profits, it is expected that in the decision-making process, as part of their innovation process, companies make several trade-offs between economic, technical and moral factors. As the social-ethical values at stake in corporate innovation processes have remained to a large extent unexplored in research on innovation management, the aim of this chapter is to identify the motivations and barriers for companies embracing and continuing a FoP logo for healthier food, and to assess whether ethical considerations play a role in this innovation process. From the findings in this research, it will become clear that although the studied companies participated in a programme for healthy food and thus are responsive to the needs of society, and although the companies feel responsible for public health, ethical considerations do not play a central role in the operational innovation process. Instead, technical and economic considerations seem to prevail in the operational innovation process. Furthermore, none of the procedural dimensions of RI seems to be present at this level in the innovation trajectory. It is argued that this may be an indication that the ethical decision-making process for RI is not located at the level of the operational innovation process itself, but is something that might be located on a higher strategic level in the company. It is at this level that the moral decision is taken to adopt the FoP logo and to engage in the RI process. The findings cast a new light on the discourse on RI in general, and in the private sector in particular. (shrink)

In this article we report findings from a qualitative study that explored how doctors and nurses in nursing homes describe professional collaboration around dying patients. The study also examined the consequences this can have for the life-prolonging treatment of patients and the care of them and their relatives. Nine doctors and 10 nurses from 10 Norwegian nursing homes were interviewed about their experience of decision-making processes on life-prolonging treatment and care. The findings reveal that the frameworks for the (...) professional collaboration and organization of physicians and nurses prevent patient treatment and care complying with ethical considerations and the law. These conditions have a challenging impact on the care of dying patients and their relatives. (shrink)

With the rise and public accessibility of AI-enabled decision-support systems, individuals outsource increasingly more of their decisions, even those that carry ethical dimensions. Considering this trend, scholars have highlighted that uncritical deference to these systems would be problematic and consequently called for investigations of the impact of pertinent technology on humans’ ethical decision-making. To this end, this article conducts a systematic review of existing scholarship and derives an integrated framework that demonstrates how intelligent (...) class='Hi'>decision-support systems (IDSSs) shape humans’ ethical decision-making. In particular, we identify resulting consequences on an individual level (i.e., deliberation enhancement, motivation enhancement, autonomy enhancement and action enhancement) and on a societal level (i.e., moral deskilling, restricted moral progress and moral responsibility gaps). We carve out two distinct methods/operation types (i.e., processoriented and outcome-oriented navigation) that decision-support systems can deploy and postulate that these determine to what extent the previously stated consequences materialize. Overall, this study holds important theoretical and practical implications by establishing clarity in the conceptions, underlying mechanisms and (directions of) influences that can be expected when using particular IDSSs for ethical decisions. (shrink)

The purpose of this study is to expand our understanding of the factors that influence ethical behavioral intentions of public accountants. Recent scandals have dominated the news and have caused legislators, regulators and the public to question the role of the accounting profession. Legislative changes have brought about major structural changes in the profession and continued scrutiny will surely lead to further changes. Thus, developing an understanding of the personal and contextual factors that influence ethical decisions is critical. (...) An extension of the theory of planned behavior [Ajzen, I.: 1985, Action Control-From Cognition to Behavior ], the model used in this study examined the influence of personal, social and organizational factors on ethical intentions. Specifically, the individual level model tested direct eects of attitudes, subjective norms, perceived behavioral control, moral sensitivity and ethical climate. Professionals from five accounting firms completed a survey that measured responses to ethical dilemmas related to the public accounting domain. To minimize the potential impact of common method bias, the survey instrument was administered in two phases. Hypotheses were evaluated using a structural modeling technique, partial least squares. Results show strong support for a direct relationship between attitudes and ethical intentions. The proposed direct eect of subjective norms was not supported. However, a significant relationship between subjective norms and attitudes was found. Professionals' attitudes towards ethical issues clearly influence intentions. Moreover, this study illustrates the potential influence of social factors in attitude formation. Future research should explore the factors in the public accounting domain that most strongly influence attitude formation. This study suggests that the theory of reasoned action oers a useful framework for exploring these issues. (shrink)

In the face of the business community’s widening concern about corporate ethical behavior, business schools are reexamining how they ensure that students appreciate the ethical implications of managerial decision making and have the analytical tools necessary to confront ethical dilemmas. The current approaches adopted by colleges vary from mere ‘lip service’ to embedding ethics at the core of the curriculum. This paper examines the experience of several US universities that have incorporated business ethics into their (...) curricula. In particular, the paper describes the issues facing Central Washington University as it seeks to integrate ethical decision making into its core undergraduate business curriculum. Issues addressed include the technical challenges of establishing a common element of curriculum across the various business disciplines, determining the major conceptual foundations of ‘ethical thinking’ while recognizing students’ existing value systems, and how to obtain ‘buy in’ by faculty to the initiative. (shrink)

Public health decisions made by the state involve considerable disagreements on the course of actions, uncertainties, and compromises that arise from moral tensions between the demands of civil liberties and the goals of public health. With such complex decisions, it can be extremely difficult to arrive at and justify the best option. In this article, we propose an ethical decision-making framework based on the philosophy of Ubuntu and argue that in sub-Saharan African settings, this approach provides (...) attractive alternative conventions of moral decision-making and a useful language for understanding moral reasoning and ethics. Through its emphasis on humanity, compassion, and social responsibility, Ubuntu (“I am because we are”) has the potential to facilitate solutions to and avert conflicts between individual rights and public health. The use of Ubuntu shifts the moral reasoning and ethics of decision-making from a field of philosophy shaped by the global north, to the everyday values, decision-making, and consequent practices of people in much of Africa. Using examples of Ebola, pandemic influenza, and tuberculosis, we illustrate how Ubuntu can be applied to tackle conflicting ethical problems in public health and medicine. (shrink)

This paper discusses the philosophical argument and the application of the Triple Font Theory for moral evaluation of human acts and attempts to integrate the conceptual components of major moral theories into a systematic internally consistent decision-making model that is theoretically driven. The paper incorporates concepts such as formal and material cooperation and the Principle of Double Effect into the theoretical framework. It also advances the thesis that virtue theory ought to be included in any adequate justification (...) of morality and the need to integrate or coordinate notions of virtue into various act-oriented or principles-based ethics. The TFT offers a comprehensive and practical approach to ethical decision-making and is a useful alternative embedded in traditional wisdom. This paper provides a more general framework of the TFT than traditionally presented. Practical judgment is shown to play a constitute role in providing a guide for right action and is the “glue” that integrates the various components of the TFT. (shrink)

Organizational leaders face environmental challenges and pressures that put them under ethical risk. Navigating this ethical risk is demanding given the dynamics of contemporary organizations. Traditional models of ethical decision-making (EDM) are an inadequate framework for understanding how leaders respond to ethical dilemmas under conditions of uncertainty and equivocality. Sensemaking models more accurately illustrate leader EDM and account for individual, social, and environmental constraints. Using the sensemaking approach as a foundation, previous EDM models (...) are revised and extended to comprise a conceptual model of leader EDM. Moreover, the underlying factors in the model are highlighted—constraints and strategies. Four trainable, compensatory strategies (emotion regulation, self-reflection, forecasting, and information integration) are proposed and described that aid leaders in navigating ethical dilemmas in organizations. Empirical examinations demonstrate that tactical application of the strategies may aid leaders in making sense of complex and ambiguous ethical dilemmas and promote ethical behavior. Compensatory tactics such as these should be central to organizational ethics initiatives at the leader level. (shrink)

Currently, the number of patients diagnosed with impaired self-awareness of their own deficits after brain injury—anosognosia— is increasing. One reason is a growing understanding of this multifaceted phenomenon. Another is the development and accessibility of alternative measurements that allow more detailed diagnoses. Anosognosia can adversely affect successful rehabilitation, as often patients lack confidence in the need for treatment. Planning such treatment can become a complex process full of ethical dilemmas.To date, there is no systematic way to deal with different (...) aspects of anosognosia rehabilitation planning. This is the first article to present a framework for ethical decision making in establishing rehabilitation plans that are focused on increasing patients’ self-awareness of their own deficits after brain injury. It concentrates especially on addressing the ethical dilemmas that may arise, and describes stepwise procedures that can be applied to distinct theoretical approaches, as well as diagnostic and rehabilitation methods. To show the flexibility of the use of this framework, alternative approaches are discussed. (shrink)

Background Ethical decision-making confidence develops from clinical expertise and is a core competency for nurse leaders. No tool exists to measure confidence levels in nurse leaders based upon an ethical decision-making framework. Aims The objective of this research was to compare ethical decision-making among nurse leaders in the U.S. and three German-speaking countries in Europe by developing and testing a newly constructed Ethical Decision-Making Confidence (EDMC) scale. Methods (...) The cross-sectional survey included 18 theory-derived questions on ethical decision-making confidence which were used to develop the scale. Participants A convenience sample of nurse leaders from the U.S. and three German-speaking countries in Europe who self-identified as holding a leadership position. Ethical Considerations Ethical approval was given by the IRB Board of a U.S. university. Participation in the survey implied voluntary consent. Results The scale’s item structure dimensionality and subscale’s reliability were analyzed and compared between nurse leaders from all four countries. A principal component analysis (PCA) produced a 15-item bi-dimensional EDMC scale yielding a skill-related (9-item) and a behavior-related (6-item) confidence dimension. EDMC subscales showed good-to-excellent internal consistency. In both subscales, U.S. nurse leaders rated their mean EDMC score higher than their German-speaking counterparts in Europe. Discussion This exploratory study is the first of its kind to focus on nurse leaders’ confidence regarding ethical decision-making in an international context. An overarching factor structure was identified, which is shared by the two samples of nurse leaders and to examine (sub)scales’ psychometric properties. Conclusion This newly developed scale is an effective tool for measuring ethical decision-making confidence in nurse leaders. The promising results of this study should be replicated to ensure validity and reliability of the EDMC scale measuring skill-related and behavior-related concepts and include nurse leaders from various cultural, social, and demographic groups. (shrink)

We develop a model of ethical decision making that integrates the decision-making process and the content variables considered by individuals facing ethical dilemmas. The process described in the model is drawn from Janis and Mann’s [1977, Decision Making: A Psychological Analysis of Conflict Choice and Commitment (The Free Press, New York)] work describing the decision process in an environment of conflict, choice and commitment. The model is enhanced by the inclusion of (...) content variables derived from the ethics literature. The resulting integrated model aids in understanding the complexity of the decision process used by individuals facing ethical dilemmas and suggests variable interactions that could be field-tested. A better understanding of the process will help managers develop policies that enhance the likelihood of ethical behavior in their organizations. (shrink)

Background: Increasing interest in empirical ethics has enhanced understanding of healthcare professionals’ ethical problems and attendant decision-making. A four-stage decision-making model involving ethical attention, reasoning, intention and action offers further insights into how more than reasoning alone may contribute to decision-making.Aims: To explore how the four-stage model can increase understanding of decision-making in healthcare and describe the decision-making of an under-researched professional group.Methods: 23 purposively sampled UK community pharmacists (...) were asked, in semi-structured interviews, to describe ethical problems in their work and how they were resolved. Framework analysis of transcribed interviews utilised the four decision-making stages, together with constant comparative methods and deviant-case analysis.Results: Pharmacists were often inattentive and constructed problems in legal terms. Ethical reasoning was limited, but examples of appeals to consequences, the golden rule, religious faith and common-sense experience emerged. Ethical intention was compromised by frequent concern about legal prosecution. Ethical inaction was common, typified by pharmacists’ failure to report healthcare professionals’ bad practices, and ethical passivity emerged to describe these negative examples of the four decision-making stages. Pharmacists occasionally described more ethically active decision-making, but this often involved ethical uncertainty.Discussion: The four decision-making stages are a useful tool in considering how healthcare professionals try to resolve ethical problems in practice. They reveal processes often ignored in normative theories, and their recognition and the emergence of ethical passivity indicates the complexity of decision-making in practice. Ethical passivity may be deleterious to patients’ welfare, and concerns emerge about improving pharmacists’ ethical training and promoting ethical awareness and responsibility. (shrink)

The purpose of this study is to expand our understanding of the factors that influence ethical behavioral intentions of public accountants. Recent scandals have dominated the news and have caused legislators, regulators and the public to question the role of the accounting profession. Legislative changes have brought about major structural changes in the profession and continued scrutiny will surely lead to further changes. Thus, developing an understanding of the personal and contextual factors that influence ethical decisions is critical. (...) An extension of the theory of planned behavior [Ajzen, I.: 1985, Action Control-From Cognition to Behavior (Springer, Heidelberg)], the model used in this study examined the influence of personal, social and organizational factors on ethical intentions. Specifically, the individual level model tested direct effects of attitudes, subjective norms, perceived behavioral control, moral sensitivity and ethical climate. Professionals from five accounting firms completed a survey that measured responses to ethical dilemmas related to the public accounting domain. To minimize the potential impact of common method bias, the survey instrument was administered in two phases. Hypotheses were evaluated using a structural modeling technique, partial least squares. Results show strong support for a direct relationship between attitudes and ethical intentions. The proposed direct effect of subjective norms was not supported. However, a significant relationship between subjective norms and attitudes was found. Professionals’ attitudes towards ethical issues clearly influence intentions. Moreover, this study illustrates the potential influence of social factors in attitude formation. Future research should explore the factors in the public accounting domain that most strongly influence attitude formation. This study suggests that the theory of reasoned action offers a useful framework for exploring these issues. (shrink)

Artificial intelligence is increasingly inputting into various human resource management functions, such as sourcing job applicants and selecting staff, allocating work, and offering personalized career coaching. While the use of AI for such tasks can offer many benefits, evidence suggests that without careful and deliberate implementation its use also has the potential to generate significant harms. This raises several ethical concerns regarding the appropriateness of AI deployment to domains such as HRM, which directly deal with managing sometimes sensitive aspects (...) of individuals’ employment lifecycles. However, research at the intersection of HRM and technology continues to largely center on examining what AI can be used for, rather than focusing on the salient factors relevant to its ethical use and examining how to effectively engage human workers in its use. Conversely, the ethical AI literature offers excellent guiding principles for AI implementation broadly, but there remains much scope to explore how these principles can be enacted in specific contexts-of-use. By drawing on ethical AI and task-technology fit literature, this paper constructs a decision-making framework to support the ethical deployment of AI for HRM and guide determinations of the optimal mix of human and machine involvement for different HRM tasks. Doing so supports the deployment of AI for the betterment of work and workers and generates both scholarly and practical outcomes. (shrink)

Recent theories on cognitive science have stressed the significance of moral intuition as a counter to and complementary part of moral reasoning in decision making. Thus, the aim of this paper is to create an integrated framework that can account for both intuitive and reflective cognitive processes, in order to explore the antecedents of ethical decision making. To do that, we build on Scholasticism, an important medieval school of thought from which descends the main (...) pillars of the modern Catholic social doctrine. Particularly, the focus will be on the scholastic concept of synderesis, which is an innate human faculty that constantly inclines decision makers toward universal moral principles. Managerial implications are discussed, stressing how a rediscovery of decision makers’ intuitive moral judgments could be relevant in the reflective thinking practice of managers’ ethical reasoning, thus saving them from rational insensitivity to ethical dilemmas. (shrink)

We are living in an unprecedented era of biomedical revolution. Medicine is remaking humans, and controversy surrounds such topics as abortion, artificial organs, brain circuitry, eugenics, euthanasia, and gene therapy. At the same time, medical advances are posing complex ethical problems for both patients and professionals. The most comprehensive and up-to-date collection of its kind, Case Studies in Biomedical Ethics: Decision-Making, Principles, and Cases explores fundamental ethical questions arising from real situations faced by health professionals, patients, (...) and others. Featuring a wide range of more than 100 case studies drawn from current events, court cases, and physicians' experiences, the book is divided into three parts. Part I presents a basic framework for ethical decision-making in healthcare, covering such issues as separating evaluative questions from questions of fact; distinguishing between ethical and nonethical evaluations; and identifying the source of ethical judgments. Expanding upon this framework, Part II explains the ethical principles: beneficence and nonmaleficence, justice, respect for autonomy, veracity, fidelity, and avoidance of killing. Parts I and II provide students with the background to analyze the ethical dilemmas presented in Part III, which features cases on a broad spectrum of issues including abortion, genetics, mental health, confidentiality, health insurance, experimentation on humans, the right to refuse treatment, and death and dying. Each case is accompanied by the authors' commentary, which guides students in considering the issues. Ideal for undergraduate and graduate courses in biomedical ethics, bioethics, and medical ethics, Case Studies in Biomedical Ethics incorporates opening text boxes in each chapter that cross-reference relevant cases in other chapters. It also includes an appendix of important ethical codes and a glossary of key terms. (shrink)

A wide range of decision-making models have been offered to assist in making ethical decisions in the workplace. Those that are based on normative moral frameworks typically include elements of traditional moral philosophy such as consequentialist and/or deontological␣ethics. This paper suggests an alternative model drawing on Jean-Paul Sartre’s existentialism. Accordingly, the model focuses on making decisions in full awareness of one’s freedom and responsibility. The steps of the model are intended to encourage reflection of one’s (...) projects and one’s situation and the possibility of refusing the expectations of others. A case study involving affirmative action in South Africa is used to demonstrate the workings of the model and a number of strengths and weaknesses are identified. Despite several weaknesses that can be raised regarding existential ethics, the model’s success lies in the way that it reframes ethical dilemmas in terms of individual freedom and responsibility, and in its acceptance and analysis of subjective experiences and personal situations. (shrink)

This paper reports on a survey of auditors in New Zealand which investigates the nature of the moral judgements they make on a series of problems with ethical dimensions. The framework adopted for this purpose is developed from earlier work which identifies a range of ethical principles which may be involved in business ethical decision‐making. Auditors responded to a questionnaire which posed, firstly, several questions about the context of their ethical decision‐making, (...) and secondly, a series of vignettes elaborating problematical dilemmas which required the selection of one of four possible responses. Data was analysed to determine whether or not it confirmed previous findings in suggesting a predominant ethical orientation for auditors. The results were correlated with demographic variables in order to determine whether or not age, gender, position in firm and size of employee firm were significantly correlated to ethical response. The survey results, on the whole, confirmed the ethical orientation suggested by previous findings, but there were some unexpected results in three out of the ten vignettes examined. Although some correlations were found between the demographic variables and subject responses, the evidence of this survey does not strongly suggest a consistent significant correlation. (shrink)

Focusing on millennials, individuals born between 1980 and 2000 and representing the largest generational population in our history, this research seeks to understand their ethical decision-making processes by exploring the distinctive, yet interconnected, theories of personal values and cognitive moral reasoning. Utilizing a decision-making framework introduced in the 1990s, we discover that there is a statistically supported relationship between a millennial’s personal value orientation and stage of cognitive moral reasoning. Moreover, we discover a strong (...) relationship between three of the four value orientations and a corresponding stage of cognitive moral reasoning. The theoretical and practical research implications of our discovery about millennials’ decision making are discussed. (shrink)

Operational psychology is an emerging subdiscipline that has enhanced the U.S. military's combat capabilities during the Global War on Terrorism. What makes this subdiscipline unique is its use of psychological principles and skills to improve a commander's decision making as it pertains to conducting combat (or related operations). Due to psychology's expanding role in combat support, psychologists are being confronted with challenges that require the application of their professional ethics in areas in which little if any guidance has (...) been provided. Operational psychologists are at the forefront of this expansion. Accordingly, they need a decision model to assist them in this complex dynamic environment. To this end, this article reviews various decision models and ethical frameworks, selects the most appropriate, and then applies it to the challenges faced by operational psychologists. A naturalistic decision model that integrates rational and intuitive elements is recommended. (shrink)

The case method approach to introducing ethical issues is a traditional tool for applying critical thinking skills to a specific dilemma (Beauchamp & Childress, 2001). It allows for personal reflection and clarification of an individual's conceptual framework for deciding what is and is not ethical behavior. However, it also affords the student distance from the story line and may, through providing a retrospective critique, prevent sufficient challenge to the student to articulate and defend personal value assessments in (...) addressing the ethical dynamics reflected in the case. Providing teaching exercises that encourage the creation of language to form that conceptual framework and a comfort in using that language allows the student to not only identify ethical issues but also recognize and more effectively communicate the struggles with molding a personal values portrait to apply to such cases. (shrink)

Ethical decision-making research has centered on Rest’s framework that represents a rational, nonaffective model for ethical decision making. However, research in human cognition suggesting a “dual-processing” framework, composed of both rational and affective components, has been relatively ignored in the ethical decision-making literature. Examining dual-processing literature, it seems affect might be an important factor in decision making when a person’s mood is congruent with the task or situational (...) context frame. Given that ethical decisions are serious and complex tasks, it is proposed here that inducing a negative affective state might produce mood congruence, reinforce the salience of emotion for ethical decision makers, and lead to differences in decision processing. Evidence is presented documenting differences in the decisions made by ethical decision makers in a negative affective state as compared to those in either a positive or neutral affective state. (shrink)

Integrated approaches in the ethical decision-making (EDM) and practically wise decision-making literature are emerging as alternative perspectives to management theories that conceptualize decision-making in a rationalist and value-free manner. However, more dialogue between both perspectives and qualitative research that applies them is required. In addition, there is a need for empirical analysis on business engagement in the face of grand challenges in developing countries. This paper proposes an integrated practically wise EDM framework (...) to study how Colombian councilors who, in 2013, voted for or against the merger between the Colombian state-owned company UNE and the Swedish multinational Millicom interpret this decision and its public impact. Qualitative semi-structured interviews were conducted with a voluntary sample of 18 of 21 councilors. Supporters of the UNE-Millicom merger expressed open-mindedness, seeing the merger as a means to achieve justice. On the contrary, the merger’s opponents expressed circumspection, doubting that Millicom’s intentions really leaned toward justice. We conclude that practical wisdom—embodied by both supporters and detractors—fosters an understanding of EDM beyond what leaders should not do. It also includes a democratic and balanced deliberation on what leaders think they should do to promote the common good. (shrink)

The authors present a comprehensive synthesis and evaluation of the published scales measuring the components of the decision making process in ethical situations using the Hunt-Vitell (1993) theory of ethics as a framework to guide the research. Suggestions for future scale development are also provided.

Institutional Review Board decisions hinge on the availability and interpretation of information. This is demonstrated by the following well-known historical example. In 2001, 24-year-old Ellen Roche died from respiratory distress and organ failure as a result of her participation in a study at Johns Hopkins Asthma and Allergy Center. The non-therapeutic physiological study, “Mechanisms of Deep Inspiration-Induced Airway Relaxation,” was designed to examine airway hyperresponsiveness in healthy individuals in order to better understand the pathophysiology of asthma. Participants inhaled hexamethonium, a (...) chemical ganglionic blocker that was not FDA-approved for use as specified in the experimental protocol. Risks of inhaling hexamethonium, including lung damage, had been reported in the 1950s and ‘60s. An investigation conducted after Roche's death determined that the study's principal investigator had failed to adequately search the medical literature; the protocol submitted for IRB review cited articles indexed in online literature databases that went back only as far as the 1970s. (shrink)

BackgroundHealthcare providers have to make ethically complex clinical decisions which may be a source of stress. Researchers have recently introduced Artificial Intelligence (AI)-based applications to assist in clinical ethical decision-making. However, the use of such tools is controversial. This review aims to provide a comprehensive overview of the reasons given in the academic literature for and against their use.MethodsPubMed, Web of Science, Philpapers.org and Google Scholar were searched for all relevant publications. The resulting set of publications was (...) title and abstract screened according to defined inclusion and exclusion criteria, resulting in 44 papers whose full texts were analysed using the Kuckartz method of qualitative text analysis.ResultsArtificial Intelligence might increase patient autonomy by improving the accuracy of predictions and allowing patients to receive their preferred treatment. It is thought to increase beneficence by providing reliable information, thereby, supporting surrogate decision-making. Some authors fear that reducing ethical decision-making to statistical correlations may limit autonomy. Others argue that AI may not be able to replicate the process of ethical deliberation because it lacks human characteristics. Concerns have been raised about issues of justice, as AI may replicate existing biases in the decision-making process.ConclusionsThe prospective benefits of using AI in clinical ethical decision-making are manifold, but its development and use should be undertaken carefully to avoid ethical pitfalls. Several issues that are central to the discussion of Clinical Decision Support Systems, such as justice, explicability or human–machine interaction, have been neglected in the debate on AI for clinical ethics so far.Trial registrationThis review is registered at Open Science Framework (https://osf.io/wvcs9). (shrink)

Decisions about long-term ventilation in children can be clinically contentious and ethically challenging. In this article, the relevant legal, professional and moral principles inherent in such cases are explored. We commend the central importance of deliberation in the assessment of best interests, and propose a practical framework to assist the parent–clinical team to reach decisions in as transparent and equitable a manner as possible.

Artificial intelligence is set to transform healthcare. Key ethical issues to emerge with this transformation encompass the accountability and transparency of the decisions made by AI-based systems, the potential for group harms arising from algorithmic bias and the professional roles and integrity of clinicians. These concerns must be balanced against the imperatives of generating public benefit with more efficient healthcare systems from the vastly higher and accurate computational power of AI. In weighing up these issues, this paper applies the (...) deliberative balancing approach of the Ethics Framework for Big Data in Health and Research. The analysis applies relevant values identified from the framework to demonstrate how decision-makers can draw on them to develop and implement AI-assisted support systems into healthcare and clinical practice ethically and responsibly. Please refer to Xafis et al. in this special issue of the Asian Bioethics Review for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end of this paper. (shrink)

This article reports on the development of the managerial ethical profile (MEP) scale. The MEP scale is a multilevel, self-reporting scale measuring the perceived influence that different dimensions of common ethical frameworks have on managerial decision making. The MEP scale measures on eight subscales: economic egoism, reputational egoism, act utilitarianism, rule utilitarianism, self-virtue of self, virtue of others, act deontology, and rule deontology. Confirmatory factor analysis (CFA) was used to provide evidence of scale validity. Future research (...) needs and the value of this measure for business ethics are discussed. (shrink)

We present a comprehensive model that integrates virtues, values, character strengths and ethical decision making (EDM). We describe how a largely consequentialist ethical framework has dominated most EDM scholarship to date. We suggest that reintroducing a virtue ethical perspective to existing EDM theories can help to illustrate deficiencies in existing decision-making models, and suggest that character strengths and motivational values can serve as natural bridges that link a virtue framework to EDM (...) in organizations. In conjunction with the more fully formulated extant research on situational determinants, we present and discuss our model that introduces a virtue based orientation to EDM. (shrink)

BackgroundThe expectation of pandemic-induced severe resource shortages has prompted authorities to draft and update frameworks to guide clinical decision-making and patient triage. While these documents differ in scope, they share a utilitarian focus on the maximization of benefit. This utilitarian view necessarily marginalizes certain groups, in particular individuals with increased medical needs.Main bodyHere, we posit that engagement with the disability critique demands that we broaden our understandings of justice and fairness in clinical decision-making and patient triage. (...) We propose the capabilities theory, which recognizes that justice requires a range of positive capabilities/freedoms conducive to the achievement of meaningful life goals, as a means to do so. Informed by a disability rights critique of the clinical response to the pandemic, we offer direction for the construction of future clinical triage protocols which will avoid ableist biases by incorporating a broader apprehension of what it means to be human.ConclusionThe clinical pandemic response, codified across triage protocols, should embrace a form of justice which incorporates a vision of pluralistic human capabilities and a valuing of positive freedoms. (shrink)

Although various models of ethical decision making have implicitly called upon constructs governed by working memory capacity , a study examining this relationship specifically has not been conducted. Using a sense making framework of EDM, we examined the relationship between WMC and various sensemaking processes contributing to EDM. Participants completed an online assessment comprised of a demographic survey, intelligence test, various EDM measures, and the Automated Operation Span task to determine WMC. Results indicated that WMC (...) accounted for unique variance above and beyond ethics education, exposure to ethical issues, and intelligence in several sensemaking processes. Additionally, a marginally significant effect of WMC was also found with reference to EDM. Individual differences in WMC appear likely to play an important role in the ethical decision-making process, and future researchers may wish to consider their potential influences. (shrink)

This Korean study replicated a previously published American study. The conceptual framework and method combined ethical enquiry and phenomenology. The research questions were: (1) What is nursing students’ experience of ethical problems involving nursing practice? and, (2) What is nursing students’ experience of using an ethical decision-making model? The participants were 97 senior baccalaureate nursing students, each of whom described one ethical problem and chose to use one of five ethical decision- (...) class='Hi'>making models. From 97 ethical problems, five content categories emerged, the largest being health professionals (69%). The basic nature of the ethical problems was the students’ experience of conflict, resolution and rationale. Using an ethical decision-making model helped 94% of the students. A comparison of the Korean and American results yields important implications for nursing ethics education, practice and research. (shrink)

In recent years, autonomous systems have become an important research area and application domain, with a significant impact on modern society. Such systems are characterized by different levels of autonomy and complex communication infrastructures that allow for collective decision-making strategies. There exist several publications that tackle ethical aspects in such systems, but mostly from the perspective of a single agent. In this paper we go one step further and discuss these ethical challenges from the perspective of (...) an aggregate of autonomous systems capable of collective decision-making. In particular, in this paper, we propose the Caesar approach through which we model the collective ethical decision-making process of a group of actors—agents and humans, as well as define the building blocks for the agents participating in such a process, namely Caesar agents. Factors such as trust, security, safety, and privacy, which affect the degree to which a collective decision is ethical, are explicitly captured in Caesar. Finally, we argue that modeling the collective decision-making in Caesar provides support for accountability. (shrink)

Background: Research involving adults lacking mental capacity relies on the involvement of a proxy or surrogate, although this raises a number of ethical concerns. Empirical studies have examined attitudes towards proxy decision-making, proxies’ authority as decision-makers, decision accuracy, and other relevant factors. However, a comprehensive evidence-based account of proxy decision-making is lacking. This systematic review provides a synthesis of the empirical data reporting the ethical issues surrounding decisions made by research proxies, and (...) the development of a conceptual framework of proxy decision-making for research. Methods: A systematic review was conducted according to PRISMA guidelines. Databases including MEDLINE, EMBASE, and CINAHL were searched using a combination of search terms, and empirical data from eligible studies were retrieved. The review followed the framework synthesis approach to refine and develop a conceptual framework. Results: Thirty-four studies were included in the review. Two dimensions of proxy decision-making emerged. The ethical framing criteria of decision-making used by proxies: use of a substituted judgement, use of a best interests approach, combination of substituted judgement and best interests, and ‘something else’, and the active elements of proxy decision-making: ‘knowing the person’, patient-proxy relationship, accuracy of the decision, and balancing risks, benefits and burdens, and attitudes towards proxy decision-making. Interactions between the framing criteria and the elements of decision-making are complex and contextually-situated. Conclusions: The findings from this systematic review challenge the accepted reductionist account of proxy decision-making. Decision-making by research proxies is highly contextualized and multifactorial in nature. The choice of proxy and the relational features of decision-making play a fundamental role: both in providing the proxy’s authority as decision-maker, and guiding the decision-making process. The conceptual framework describes the relationship between the framing criteria used by the proxy, and the active elements of decision-making. Further work to develop, and empirically test the proposed framework is needed. (shrink)

A number of ethical frameworks have been proposed to support decision-making in public health and the evaluation of public health policy and practice. This is encouraging, since ethical considerations are of paramount importance in health policy. However, these frameworks have various deficiencies, in part because they incorporate substantial ethical positions. In this article, we discuss and criticise a framework developed by James Childress and Ruth Bernheim, which we consider to be the state of the (...) art in the field. Their framework distinguishes aims, such as the promotion of public health, from constraints on the pursuit of those aims, such as the requirement to avoid limitations to liberty, or the requirement to be impartial. We show how this structure creates both theoretical and practical problems. We then go on to present and defend a more practical framework, one that is neutral in avoiding precommitment to particular values and how they ought to be weighted. We believe ethics is at the very heart of such weightings and our framework is developed to reflect this belief. It is therefore both pluralist and value-based. We compare our new framework to Childress and Bernheim’s and outline its advantages. It is justified by its impetus to consider a wide range of alternatives and its tendency to direct decisions towards the best alternatives, as well as by the information provided by the ranking of alternatives and transparent explication of the judgements that motivate this ranking. The new framework presented should be useful to decision-makers in public health, as well as being a means to stimulate further reflection on the role of ethics in public health. (shrink)