To determine the knowledge, attitude, and ethical concerns of medical students and graduates with regard to Embryonic Stem Cell (ESC) research. This questionnaire based descriptive study was conducted at the Civil Hospital Karachi (CHK), Pakistan from February to July 2008. A well structured questionnaire was administered to medical students and graduate doctors, which included their demographic profile as well as questions in line with the study objective. Informed consent was taken and full confidentiality was assured to the participants. Data (...) were entered in a Statistical Package for Social Sciences (SPSS version.12) and analyzed. A total of 204 male and 216 female medical students and doctors were administered questionnaires out of which 105 males (51.4%) and 108 females (50%) were aware of the embryonic stem cell research and its ethical implications. Forty percent males and 47% of females were of the opinion that life begins at conception. Forty-six percent males and 39% females were in favor of stem cell research while only 31% males and 28% females supported the ESC research. Less than 1/3 of students supported using frozen embryos for research purposes while more than 2/3 indicated that they were unlikely to support abortion for stem cell research purposes. The majority of the students were in favor of stem cell research with some reservations regarding ESC research. A sizeable number of students withheld their views, reflecting their poor understanding of medical ethics. The result of the study indicates a need for incorporating bioethics into the medical curriculum. (shrink)

Background Recently, palliative care is increasingly important, with an emphasis on the process of dying with dignity. However, nurses who care for such patients experience the associated ethical dilemmas. Objective To explore the meaning of nurses’ experiences in dealing with ethical dilemmas in relation to palliative sedation. Research design A qualitative research design was employed with a thematic analysis approach. Participants and research context Using purposive sampling, 15 nurses, working at palliative care units for at least 1 year, (...) were recruited as participants. Data were collected using unstructured in-depth interviews, and data collection and analysis was performed simultaneously. Ethical considerations Ethical approval was obtained from the authors’ institutional review board. All participants provided informed consent. For the face-to-face interview, the South Korean standard COVID-19 quarantine guidelines, such as mandatory masking and social distancing, were followed. Results Dilemmas raised by patients, were related to concerns about appropriate drug dose; dilemmas raised by nurses, were related to passive care, sense of guilt for failure to predict death, and colleague’s disrespectful attitudes toward patients; dilemmas from patients’ families were related to demands for palliative sedation and reversal of those demands. Care actions to deal with ethical dilemmas comprised evidence-based care, person-centered thinking, reflecting on the death situation, compassion, providing explanation and help to family members. Conclusion Nurses’ ethical dilemmas were pre-dominantly influenced by themselves, rather than by the patients or their families, especially if they felt they could not do their best for patients. The core concept of care actions to deal with the ethical dilemmas, was person-centered care and compassion. Then, how patients and their family members perceive person-centered care and compassion, should be further explored to improve palliative sedation. (shrink)

Ethical dilemmas are part of medicine, but the type of challenges, the frequency of their occurrence and the nuances in the difficulties have not been systematically studied in low-income settings. The objective of this paper was to map out the ethical dilemmas from the perspective of Ethiopian physicians working in public hospitals. A national survey of physicians from 49 public hospitals using stratified, multi-stage sampling was conducted in six of the 11 regions in Ethiopia. Descriptive statistics were used (...) and the responses to the open-ended question “If you have experienced any ethical dilemma, can you please describe a dilemma you have encountered in your own words?” were analyzed using a template analysis process. A total of 587 physicians responded, and 565 met the inclusion criteria. Twelve of 24 specified ethically challenging situations were reported to be experienced often or sometimes by more than 50% of the physicians. The most frequently reported challenge concerned resource distribution: 93% agreed that they often or sometimes had to make difficult choices due to resource limitation, and 83% often or sometimes encountered difficulties because patients were unable to pay for the preferred course of treatment. Other frequently reported difficulties were doubts about doing good or harming the patient, relating to conflicting views, concern for family welfare, disclosure issues and caring for patients not able to consent. Few reported dilemmas related to end-of-life issues. The 200 responses to the open-ended question mirrored the quantitative results. Ethiopian physicians report ethical challenges related more to bedside rationing and fairness concerns than futility discussions and conflicts about autonomy as described in studies from high-income countries. In addition to the high report of experienced challenges, gravity of the dilemmas that are present in their narratives are striking. Recognition of the everyday experiences of physicians in low-income settings should prompt the development of ethics teaching and support mechanisms, discussion of ethical guidelines as well as increase our focus on how to improve the grave resource scarcity they describe. (shrink)

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

The aim of this study was to describe specialist ambulance nurse students’ experiences of ethical conflicts and dilemmas in prehospital emergency care. In the autumn of 2015, after participating in a mandatory lecture on ethics, 24 specialist ambulance nurse students reported experiences and interpretations concerning conflicts and ethical dilemmas from prehospital emergency care. The text consisted of 24 written critical incidents which were interpreted using hermeneutic text interpretation. The text revealed three themes: Not safeguarding a patient’s body and (...) identity; Not agreeing on the care actions; and Not treating the patient with dignity. The SANs experiences ethical dilemmas and conflict of values when they witness how others violate a patient’s dignity. Discussion and reflection is based on ethical conflicts and dilemmas experienced when students see how caregivers do not safeguard the patient’s body or identity. When caregivers have a conflicting will, it results in patients not being treated in an ethical manner. Also, seeing how caregivers put themselves in a power position over patients is described as an ethical dilemma that students experience when they choose not to intervene. (shrink)

Undergraduate social work students are exposed to ethical and legal dilemmas during their fieldwork training. This article presents a study that examined these ethical dilemmas in an Israeli sample of undergraduate social work students. 117 students who participated in a course in ethics submitted 31 written presentations of ethical-dilemma analysis. Their oral presentations were recorded and transcribed. Using a qualitative analysis, three major themes emerged: 1. The tension between the duty to maintain client's confidentiality and its (...) violation under certain conditions; 2. The students’ conflict of loyalty toward the client vs. the organization; 3. The question of the clients’ right to self-determination when, in the student's view, this is against their best interests.Our findings point to the vital role of an ethics course in the social work undergraduate curriculum that can enhance students’ knowledge of specific laws relevant to the limits of confidentiality in social work and their ability to analyze ethical dilemmas as future professionals. Furthermore, it is essential to raise awareness in educators and supervisors concerning moral distress that may afflict students coping with ethical dilemmas at this early professional developmental phase. (shrink)

OBJECTIVES: To identify ethical dilemmas experienced by occupational and physical therapists working in the UK National Health Service (NHS). To compare ethical contexts, themes and principles across the two groups. DESIGN: A structured questionnaire was circulated to the managers of occupational and physical therapy services in England and Wales. SUBJECTS: The questionnaires were given to 238 occupational and 249 physical therapists who conformed to set criteria. RESULTS: Ethical dilemmas experienced during the previous six months were reported by (...) 118 occupational and 107 physical therapists. The two groups were similar in age, grade, and years of experience. Fifty of the occupational therapy dilemmas occurred in mental health settings but no equivalent setting emerged for physical therapy. Different ethical themes emerged between the two groups, with the most common in occupational therapy being difficult/dangerous behaviour in patients and unprofessional staff behaviour, and for physical therapists resource limitations and treatment effectiveness. No differences were found in the ethical principles used. CONCLUSION: The ethical dilemmas reported by the therapists were primarily concerned with health care ethics, rather than the more dramatic ethics reported in much of the biomedical ethics literature. Differences were found between the two professional groups when ethical contexts and themes were compared but not when ethical principles were compared. This suggests that educators and researchers need to be aware of work settings and the interdisciplinary nature of employment as well as ethical principles held by individual therapists. (shrink)

BackgroundMidwives frequently encounter ethical dilemmas in a critical unit such as a delivery room. Determining these ethical dilemmas is very important to prevent ethical problems and develop an ethical approach.AimThis study aims to identify the ethical dilemma experiences of midwives working in delivery rooms in Turkey.Research designThis study follows a qualitative phenomenological research design.Participants and research contextThe sample comprised 13 midwives with at least two years working experience in delivery rooms, having completed the midwifery (...) program of Manisa Celal Bayar University Health Sciences Institute in the 2017–2018 academic year. Data were collected through audio-recorded semi-structured interviews to reveal their experiences. Content analysis was done using the Nvivo software package program. All interviews were digitally recorded, transcribed verbatim, and transferred into NVivo for analysis.Ethical considerationsEthical approval was granted by Manisa Celal Bayar University University Health Sciences Ethics Committee (Date: 16.12.2016 No: 372). Participation in this study was voluntary. Written and verbal consent was gained. These consents include protecting midwives’ privacy, keeping information confidential, and/or allowing the participant to remain anonymous.FindingsFour themes were identified: differences of approach to the birth process, hospital management, communication, and differences in ethical approach. Several factors explained these ethical dilemmas while the midwives adopted different approaches to ethical decision making.DiscussionThese midwives experienced various dilemmas while working in the delivery room and are aware of most of them. They also took responsibility in the decision-making process and experienced many intense emotions that they had to cope with.ConclusionThe ethical dilemmas faced by these midwives while working in delivery rooms were mainly caused by hierarchy. Future studies could investigate clarifying job descriptions of midwives, who are authorized to manage normal births under their own responsibility, within the hospital management and the health care team. (shrink)

Ebola is a deadly disease with no cure; there is no vaccine developed yet. Many died during the 2014 outbreak in West Africa, and many healthcare professionals went to the virus infected area to treat the patients while placing their lives in danger. Not every medical professional placed in the field is a fully trained specialist, and sometimes one or two under-trained doctors are in charge of the entire clinic with some nurses and operating technicians. When unexpected outbreaks of the (...) virus occur in the places, the doctor(s) would encounter medical and ethical dilemmas. Should they leave or stay? In fact, this dilemma is not confined to the Ebola pandemic but relevant to all similar cases. In this paper, three authors, a medical resident, a clinical bioethicist, and a theoretical bioethicist respond to the dilemma. (shrink)

This study explores how therapists deal with ethical dilemmas in psychotherapy with older adults. Semi-structured interviews were conducted with 14 therapists and analyzed using grounded theory methodology. Findings clustered around three themes: (i) respecting autonomy when interacting with family of vulnerable and dependent older patients; (ii) prioritizing respecting autonomy in risk situations and in suspected financial abuse without impaired judgment; and (iii) prioritizing protecting the patient in risk situations of patients with dementia and of suspected physical abuse or neglect. (...) These findings highlight several important issues regarding the management of ethical dilemmas in psychotherapy with vulnerable and dependent older adults. (shrink)

The ethical dilemma of whether autonomous vehicles should protect the passengers or pedestrians when harm is unavoidable has been widely researched and debated. Several behavioral scientists have sought public opinion on this issue, based on the premise that EDs are critical to resolve for AV adoption. However, many scholars and industry participants have downplayed the importance of these edge cases. Policy makers also advocate a focus on higher level ethical principles rather than on a specific solution to (...) EDs. But conspicuously absent from this debate is the view of the consumers or potential adopters, who will be instrumental to the success of AVs. The current research investigated this issue both from a theoretical standpoint and through empirical research. The literature on innovation adoption and risk perception suggests that EDs will be heavily weighted by potential adopters of AVs. Two studies conducted with a broad sample of consumers verified this assertion. The results from these studies showed that people associated EDs with the highest risk and considered EDs as the most important issue to address as compared to the other technical, legal and ethical issues facing AVs. As such, EDs need to be addressed to ensure robustness in the design of AVs and to assure consumers of the safety of this promising technology. Some preliminary evidence is provided about interventions to resolve the social dilemma in EDs and about the ethical preferences of prospective early adopters of AVs. (shrink)

The objective of this survey was to assess the extent to which nurses encounter and identify dilemma-generating situations in the light of the publication and circulation of the Israeli code of ethics for nurses in 1994. The results are being used as a basis for a programme aimed at promoting nurses' decision-making skills in coping with ethical dilemmas. In this era of major advances in medicine, the nurse's role as the protector of patient rights may bring about conflicts (...) with physicians' orders, with institutional policies, or with patients' families. Nurses will then become confronted with ethical and moral dilemmas. A nationwide survey was carried out to identify and describe the ethical conflicts with which nurses in Israel are confronted in the course of their work. A third of the enumerated dilemmas were encountered by more than 50% of the nurses. The major determinant influencing encounters with dilemmas, as perceived by the participating nurses, was their work setting, namely, the hospital versus the community. It was shown that nurses seek support mainly among their peers, they are barely familiar with the Israeli Code, and they consider their own families as the predominant factor in shaping their ethical attitudes. (shrink)

One approach to the analysis of ethical dilemmas in medical practice uses the “four principles plus scope” approach. These principles are: respect for autonomy, beneficence, non-maleficence and justice, along with concern for their scope of application. However, conflicts between the different principles are commonplace in psychiatric practice, especially in forensic psychiatry, where duties to patients often conflict with duties to third parties such as the public. This article seeks to highlight some of the specific ethical dilemmas encountered in (...) forensic psychiatry: the excessive use of segregation for the protection of others, the ethics of using mechanical restraint when clinically beneficial and the use of physical treatment without consent. We argue that justice, as a principle, should be paramount in forensic psychiatry, and that there is a need for a more specific code of ethics to cover specialised areas of medicine like forensic psychiatry. This code should specify that in cases of conflict between different principles, justice should gain precedence over the other principles. (shrink)

Technological advances in veterinary medicine have produced considerable progress in the diagnosis and treatment of numerous diseases in animals. At the same time, veterinarians, veterinary technicians, and owners of animals face increasingly complex situations that raise questions about goals of care and correct or reasonable courses of action. These dilemmas are frequently controversial and can generate conflicts between clients and health care providers. In many ways they resemble the ethical challenges confronted by human medicine and that spawned the creation (...) of clinical ethics committees as a mechanism to analyze, discuss, and resolve disagreements. The staff of the North Carolina State University Veterinary Hospital, a specialty academic teaching institution, wanted to investigate whether similar success could be achieved in the tertiary care veterinary setting. We discuss the background and rationale for this method, as well as the approach that was taken to create a clinical ethics committee. (shrink)

This article uses Nigeria as a case study to examine the nature and consequences of the ethical dilemma African journalists face as a result of conflicting obligations to their profession and socio-politicaI environments. Professional skills and codes of conduct used by African journalists are adapted from Western libertarian news media philosophy that prescribes news media that are independent from the government. But African governments favor the development journalism philosophy that calls for a close working relationship between the news (...) media and government because of political instability and national development objectives. The conflicting expectations between the two philosophies create a clash of loyalties and ultimately an ethical dilemma for African journalists. (shrink)

This article examines the ethical dilemmas faced by professional and academic researchers in the health field who undertake nonclinical or social research among patients or staff. The experiences of health researchers and health professionals in the UK are directly relevant to those undertaking similar health-related research in other parts of the world at a time when nonclinical research in health care is becoming widespread in all countries and cultures. This article addresses ethical dilemmas as they relate to researchers’ (...) ability to maintain confidentiality, their commitment to the welfare of respondents, and the tensions that arise from undertaking research for an employer. In addition, the danger of conducting covert research inadvertently may present unexpected ethical problems, which are discussed. Although it is impossible to provide a policy document to address all ethical dilemmas, this article does attempt to address the question of how best to approach health-related research in order to minimize the possibility of running into ethical problems at a later stage. (shrink)

Médecins Sans Frontières (MSF) is an independent medical humanitarian organisation working in over 70 countries. It has provided medical assistance for over 35 years to populations vulnerable through conflict, disease and inadequate health systems. Medical ethics define the starting point of the relationship between medical staff and patients. The ethics of humanitarian interventions and of research in conflict settings are much debated. However, less is known about the ethical dilemmas faced by medical humanitarian staff in their daily work. (...) class='Hi'>Ethical dilemmas can be intensified in humanitarian contexts by insecure environments, lack of optimum care, language barriers, potentially heightened power discrepancies between care providers and patients, differing cultural values and perceptions of patients, communities and medical staff. Time constraints, stressful conditions and lack of familiarity with ethical frameworks can prevent reflection on these dilemmas, as can frustration that such reflection does not necessarily provide instant solutions. Lack of reflection, however, can be distressing for medical practitioners and can reduce the quality of care. Ethical reflection has a central role in MSF, and the organisation uses ethical frameworks to help with clinical and programmatic decisions as well as in deliberations over operational research. We illustrate and discuss some real ethical dilemmas facing MSF teams. Only by sharing and seeking guidance can MSF and similar actors make more thoughtful and appropriate decisions. Our aim in sharing these cases is to invite discussion and dialogue in the wider medical community working in crisis, conflict or with severe resource limitations. (shrink)

In this article we discuss the ethical dilemmas facing performance evaluators and the "evaluatees" whose performances are measured in a business context. The concepts of role morality and common morality are used to develop a framework of behaviors that are normally seen as the moral responsibilities of these actors. This framework is used to analyze, based on four empirical situations, why the implementation of a performance measurement system has not been as effective as expected. It was concluded that, in (...) these four cases, unethical behavior (i.e. deviations from the ethical behaviors identified in the framework) provided, at least to some extent, an explanation for the lower than expected effectiveness of the performance measurement procedures. At the end of the paper we present an agenda for further research through which the framework could be further developed and systematically applied to a broader set of cases. (shrink)

Highlights of this edition include: / Important new material addressing federal privacy regulations, disclosure of medical errors, limits on residents'...

There is a tension between our need for associative control and our need for social connections. This tension creates ethical dilemmas that we can call each-we dilemmas of sociability. To resolve these dilemmas, we must prioritize either negative moral rights to dissociate or positive moral rights to social inclusion. This article shows that we must prioritize positive social rights. This has implications both for personal morality and for political theory. As persons, we must attend to each other's basic social (...) needs. As a society, we must adopt a sufficientarian approach to the regulation of social resources. (shrink)

The accidents at Three Mile Island and Chemobyl have slowed the development of commercial nuclear fission in most industrialized countries, although nuclear proponents are trying to develop smaller, allegedly “fail-safe” reactors. Regardless of whether or not they succeed, we will face the problem of radioactive wastes for the next million years. After a brief, “revisionist” history of the radwaste problem, Isurvey some of the major epistemological and ethical difficulties with storing nuclear wastes and outline four ethical dilemmas common (...) to many technological and environmental controversies. I suggest two solutions to these ethical dilemmas and show why they are also economical and realistic proposals. (shrink)

This book discusses the ethical dilemmas of migration in the era of globalization. Centered on the recent influx of large numbers of migrants and refugees to the United States and Europe and viewed through the lens of the 2016 World Humanitarian Summit and the United Nations Summit on Refugees and Migrants, this book focuses on the problems posed by globalized migration and analyzes proposed responses. Using prominent ethical theories and moral principles, such as Utilitarianism, duty, justice, and integrity, (...) the book proposes a framework for analyzing decision-making by migrants and policymakers and formulating equitable policies to address the migration crisis. Drawing attention to the ethical dilemmas that migrants and policymakers experience, this book fills a gap in the literature and enriches it, adding to the economic, political, and human rights issues that are traditionally part of the migration discussion. Appropriate for students and scholars of ethics, policy, and political science, this book is also meant to be of use to practitioners and decision-makers faced with similar decisions. (shrink)

Each country may face some distinctive ethical problems. Little is known about what kind of ethical problems exist and how often physicians are faced with them in clinical settings in Japan. The authors conducted both retrospective and prospective studies to identify ethical dilemmas at a general medical ward of a university hospital in Japan. In the first phase of the study, retrospective chart reviews were conducted for 61 patients who had been admitted to our general medical ward. (...) It revealed that ethical dilemmas were recorded in 17 cases. In the subsequent period, as the second phase of the study, 6-month prospective case findings were conducted, showing that 22 of 47 patients had ethical dilemmas that attending physicians were concerned about. Ethical dilemmas frequently identified included refusal of or unnecessary requests for diagnostic procedures or treatment by patients, issues concerning truth-telling to patients with a serious illness, and disagreement regarding plans for patient care between patients' family and physicians in charge. The prospective case findings identified a significantly higher frequency of ethical dilemmas than did retrospective chart reviews . Demographics were not significantly different for the two patient groups. The data suggests that ethical dilemmas are not uncommon in general medical wards in Japan. The patients' family played a significant role in clinical decision making, leading on some occasions to complicated ethical dilemmas. (shrink)

Ethics and business -- Culture, business and ethics in a globalising world -- Moral development, moral positioning and decision-making -- Ethical dilemmas and decision-making (models) -- Professional ethics -- Organisational ethics -- Corporate social responsibility -- Sustainability and business -- Business and human rights -- Responsible entrepreneurship and innovation -- Information technology and business.

Background: In 2019, an outbreak of COVID-19 broke out in Hubei, China. Medical workers from all over the country rushed to Hubei and participated in the treatment and care of COVID-19 patients. These nurses, dedicated to their professional practice, volunteered to provide compassion and expert clinical care during the pandemic. As with other acts of heroism, the ethical dilemmas associated with working on the front line must be considered for future practice. Purpose: To explore the ethical dilemmas of (...) frontline nurses of Jiangsu Province in China during deployment to Wuhan to fight the novel coronavirus pneumonia, and to provide a basis for developing strategies to help nursing staff address personal and practice concerns in order to work more effectively during this pandemic and other disasters in the future. Research design and method: Using the phenomenological research method and the purpose sampling method, semi-structured interviews were conducted with 10 nurses, post-deployment to Wuhan, who had worked on the front line to fight the novel coronavirus. Ethical considerations: The research proposal was approved by the Research Ethic Committee of Yangzhou University, China. Findings: From the analysis of the interviews of the 10 participants, three main themes were identified: ethical dilemmas in clinical nursing, ethical dilemmas in interpersonal relationships, and ethical dilemmas in nursing management. Conclusion: During a quick response to public health emergencies, where nurses are deployed immediately as a call to action, the issues surrounding ethical dilemmas from several perspectives must be considered. This research suggests that a team approach to proactive planning and open communication during the emergency is an efficient and productive strategy to improve the nurses’ experience and sense of well-being. (shrink)

Gaining ethical approval for qualitative health research and implementing all the planned research processes in a proposed study are not straightforward endeavours. The situation becomes more complex when qualitative research is conducted in a cross-national healthcare and academic context. Also, it is even exhausting when the study is student-based, as student researchers may be considered novices and inexperienced researchers, especially for field-based research. Our aim in this reflective paper is to present, reflect, and discuss the experiences of a doctoral (...) researcher in dealing with two independent institutional review boards in Canada and Ghana during an interdisciplinary Ph.D. project and the ethical dilemmas encountered while collecting data in Ghana. Based on the researcher’s experiences, it became apparent that consent and its documentation can have cultural implications in different settings; hence, institutional review boards must exercise reflexivity in their protocol review practice. Also, sharing research data with participants and institutional leaders while maintaining participant confidentiality and privacy in institutional ethnographic research requires sensitivity to bi-lateral ethical values. With the experiences shared in this paper, we advocate for a dialogic ethical review process in qualitative research where researchers and research ethics boards engage in ongoing dialogue rather than the usual prescriptive format research ethics reviews often assume. (shrink)

This article examines the ethical dilemmas faced by professional and academic researchers in the health field who undertake nonclinical or social research among patients or staff. The experiences of health researchers and health professionals in the UK are directly relevant to those undertaking similar health-related research in other parts of the world at a time when nonclinical research in health care is becoming widespread in all countries and cultures. This article addresses ethical dilemmas as they relate to researchers’ (...) ability to maintain confidentiality, their commitment to the welfare of respondents, and the tensions that arise from undertaking research for an employer. In addition, the danger of conducting covert research inadvertently may present unexpected ethical problems, which are discussed. Although it is impossible to provide a policy document to address all ethical dilemmas, this article does attempt to address the question of how best to approach health-related research in order to minimize the possibility of running into ethical problems at a later stage. (shrink)

Moral Seduction Theory suggests that auditors are morally compromised by the perceived consequences of their opinions. The root of the auditing problem appears to result in an unintentional bias rather than in dishonesty. Although important accounting reforms have been taken to deal with auditors' trustworthiness, their lack of independence has not been adequately addressed. The new regulation (Sarbanes-Oxley Act) is a consequence of an incorrect understanding of the main true source of auditor's biases. We have developed a cognitive approach by (...) connecting the Throughput Model (TM) to the Moral Seduction Theory. This approach allows a better understanding of how conflicts of interest lead auditors to avoid the issuance of warning signals to stakeholders. We have tested our model by conducting a hypothetical scenario with eighty experienced auditors from international accounting firms. Our results confirm auditors' unintentional reluctance to issue qualified audit opinions alerting investors due to their fear of precipitating clients' final bankruptcy. The main implication is that, more than a regulation, effort should be made in monitoring those conflicts of interest to reduce unintentional bias. (shrink)

Although a modus operandi throughout history, the passing down of beliefs and values from parent to child is a practice that must now be challenged. Drawing a connection between fundamentalist religious beliefs and inter-generational violence, this paper examines an ethical dilemma that lies at its crux: on the one hand, the peaceful intentions of fundamentalist believers, and on the other a number of violent consequences for individuals, society, and the world. Applying interdisciplinary religious and peace theory scholarship to (...) the case of Christian fundamentalism in Australia, a number of intertwining issues surrounding religion and education are explored. Should religion be taught to children? What is the difference between indoctrination and education? Is some enculturation desirable? Who decides? Do children have a right to choose their own religion? Do parents have a right to teach them theirs? Is indoctrination avoidable? Is neutrality of the teacher attainable? Does a liberal society have a right not to tolerate the intolerant? How might these complex paradoxes be addressed from a philosophical and peace education perspective? (shrink)

This paper discusses ethical dilemmas related to social work practice with young adults with autism. It does so via the use of a case study taken from real life practice. The different viewpoints and ethical frameworks of the young person, the young person's parents and the Local Authority (or the Local Authority social worker) are considered and discussed. The competing rights of the 2006 United Nations Convention on the Rights of Persons with Disabilities (and the Optional Protocol) are (...) also considered. (shrink)

This article examines the ethical dilemmas that can occur due to university and industry cooperative arrangements. The values that Conant (1952) and Merton (1942) ascribed to university science are used as a measure of the evolving university-industry relations in the 1980s. Examples of the types of relations being forged are discussed and possible conflicts of interest are explored. The author argues that the goals of the university are and must remain different from those of industry for the good of (...) the entire society. The transformation of the university into a research institution for industry could result in the university not adequately training the scientists of tomorrow, and simultaneously, not discharging its duty to do basic research as it focuses on the more applied research that industry desires and funds. (shrink)

Ethical dilemmas in community mental health care is the focus of this article. The dilemmas are derived from a discussion of the results of a qualitative research project that took place in five countries of the European Union. The different stakeholders are confronted with the following dilemmas: community care versus hospital care ; a life with care versus a life without care ; stimulation of the client toward greater responsibility versus protection against such responsibility ; budgetary control versus financial (...) incentives , and respect for the client versus particular private needs . These dilemmas are interpreted against the background of a value based ethical model. This model offers an integral approach to the dilemmas and can be used to determine policy. The dilemmas are discussed here as the result of conflicting values—namely autonomy and privacy, support and safety, justice and participation, and trust and solidarity. (shrink)

Results of surveys in which pharmacy students and pharmacists responded to ethical dilemmas are discussed. Respondents indicated a high level of concern about patient welfare and patient rights in dilemmas involving conflicts with socio-economic issues, and with peers and physicians. Conflicts that might arise as the roles of pharmacists change and the health-care systems evolve are also discussed.

This article presents the complicated ethical dilemmas that arise in the procedures and proceedings of the Nursing Disciplinary Committee, which deals with matters of life and death (e.g. patients' rights to quality. and safe care, professional integrity and account ability, and the nurse's future). The article also describes the composition and function of the Committee, the type of case it deliberates, its limitations, and the dilemmas its members may encounter.

Background: There are intriguing and challenging ethical dilemmas in the practice of palliative care in a traditional developing society.Objective: To review the different ethical issues involved in cancer and palliative care in developing countries, with special reference to India.Methods: Published literature on pain relief and palliative care in the developing countries was reviewed to identify ethical issues and dilemmas related to these, and ways in which ethical principles could be observed in delivery of palliative care in (...) such countries are discussed.Results: The literature review revealed a number of ethical dilemmas and challenges that professionals, cancer patients and their families encountered during palliative care. It was noted that patients’ preferences and decisions are influenced by family members. Dilemmas leave the professionals and families confused about how ethical their actions have been. Specific ethical issues were noted in relation to the availability and use of oral morphine for pain relief, spiritual care, lack of adequate palliative care services, and palliative care education.Conclusions: The four principles of ethics posed difficulties in understanding the complex ethical issues in a developing country with a traditional background. Ethical issues need to be handled delicately and sensitively in palliative care settings, within the framework of the traditions and culture of the society and financial constraints. The possible role of ethics committees in palliative care settings to help decision-making needs to be studied and discussed. (shrink)

Purpose This article aims to describe the personal experience and ethical dilemmas that the author encountered when conducting qualitative research on a highly sensitive topic, i.e. interviews with offenders convicted of child pornography. Design/methodology/approach This study uses an autoethnographic approach to describe and reflect on my personal experience, emotions and ethical dilemmas when undertaking sensitive research that examines illegal acts. Findings Ethical dilemmas and emotional challenges highlighted refer to the issue of access to useful empirical material, conducting (...) interviews with convicted offenders in prison environments, the complexity surrounding confidentiality when interviewing offenders about their criminal activities, vulnerability and insecurity for the researcher and emotional challenges for the researcher when listening to the offenders’ stories describing serious crimes against children. Originality/value This article contributes with insights and reflections on conducting qualitative research with a marginalized and stigmatized group in prison environments. (shrink)

Unethical practices in education come at too great a cost when our future generation is at stake. Educators are role models for students in their future careers and so must believe in and use ethical practices. In politics, in big and small business, and in legal and medical practice the question of ethical practices surrounds us. Have people become desensitized to ethics? Are we condoning unethical practice? Our educational profession must stand up for honesty and integrity. We, as (...) educators, have the obligation of setting the standards for ethics. Ethical Dilemmas in Education addresses the dilemmas teachers face every day throughout all aspects of education in a comprehensive manner. The book outlines standards of professionalism and presents information teachers can use for the challenges teachers face. With the policies of today's educational system, teachers need to stand up for honesty and integrity, providing role models for students in their future careers. This book guides teachers towards developing ethical habits and a professional demeanor. (shrink)

Multinational corporations' international staffing policies have been evaluated in terms of cost and efficiency arguments. Research has not addressed, however, the ethical impact of these policies on diverse stakeholder groups. This paper presents a conceptual framework by which ethnocentric, polycentric and geocentric staffing policies are theoretically linked to underlying decision-making modes of instrumentality, bounded rationality and economic rationality, respectively. It goes on to describe the ethical rationales associated with each policy type, namely, distributive justice, moral rights of man, (...) and utilitarianism. An investigation of resulting ethical dilemmas affecting relevant MNC stakeholder groups is incorporated and offered as a tool for analyzing the true and full costs of trade-offs when choosing one policy over another. The paper concludes with a discussion of the implications of the conceptual framework for theory and practice and directions for future research. (shrink)

People frequently make ethical choices they later regret. Causal Loop Archetypes offer a basic systems framework for analyzing the unintended consequences of personal and professional ethical decisions. Pressure or enticement or defensiveness can stymie individuals’ rational sensemaking. Causal Loop Thinking, and in particular the “Fixes That Fail” Archetype, draw on the familiar decision model of identifying the problem, specifying the alternative courses of action andtheir consequences, to guide our final choice. As students grapple with their own conflicts and (...) business school faculty look for tools to anticipate professional ethical dilemmas, Causal Loop Thinking can expand our awareness of the context of choices and actions, thus leading to a more fully assessed decision. (shrink)

Background Previous studies have shown that the rapid transition to emergency remote teaching due to the COVID-19 pandemic was challenging for healthcare teachers in many ways. This sudden change made them face ethical dilemmas that challenged their values and ethical competence. Research aim This study aimed to explore and gain a deeper understanding of the ethical dilemmas healthcare teachers faced during the COVID-19 pandemic. Research design This was an inductive qualitative study using a hermeneutic approach. Semi-structured interviews (...) were conducted and analysed thematically. Participants and research context Healthcare teachers ( n = 20) from eight universities and universities of applied sciences in the Nordic and Baltic countries participated. Ethical considerations This study was based on the research ethics of the Norwegian National Research Ethics Committee for Medicine and Health Sciences and approved by the Norwegian Agency for Shared Services in Education and Research. Findings Healthcare teachers faced several ethical dilemmas due to restrictions during the COVID-19 pandemic. The analysis revealed three main themes: How should I deal with students’ ill-being, and what can I as a teacher do?; What can I demand from myself and my students, what is good teaching?; How do I manage the heavy workload and everyone’s needs, and who gets my time? Conclusions This study highlights the importance of healthcare teachers’ continuous need for pedagogic and didactic education, especially considering new technology and ethical issues. During the pandemic, the ethical consequences of remote teaching became evident. Ethical values and ethical dilemmas should be addressed in healthcare education programmes at different levels, especially in teacher education programmes. In the coming years, remote teaching will grow. Therefore, we need more research on this issue from an ethical perspective on its possible consequences for students and healthcare teachers. (shrink)

The accidents at Three Mile Island and Chemobyl have slowed the development of commercial nuclear fission in most industrialized countries, although nuclear proponents are trying to develop smaller, allegedly “fail-safe” reactors. Regardless of whether or not they succeed, we will face the problem of radioactive wastes for the next million years. After a brief, “revisionist” history of the radwaste problem, Isurvey some of the major epistemological and ethical difficulties with storing nuclear wastes and outline four ethical dilemmas common (...) to many technological and environmental controversies. I suggest two solutions to these ethical dilemmas and show why they are also economical and realistic proposals. (shrink)

Each case study defines:The dilemma in questionThe context of the organizational/management settingThe conditions that create the dilemmaThe courses of action ...

Weapons of war are inevitably used to kill human beings, destroy property, and change political landscapes. Their production and use immediately raise complex ethical questions concerning the creat...

Physicians in rural settings confront many of the same ethical dilemmas as their urban counterparts: confidentiality, quality‐of‐life decisions, resource allocation, and their moral responsibility for bettering the life of the community. However, the courses of action they choose as morally justifiable are influenced by distance from other professional facilities, the interrelationship of private and professional roles in a small community, and the non‐specialized orientation of their practices.

The necessity of having effective and socially sound networks is trivial. It is clear that information technology is now a necessary tool that has well understood advantages. The same technology carries negative side-effects. It is our social and ethical duty to examine the possibly negative side effects of IT, especially as IT becomes prevalent in a conservative society such as Kuwait. In our research Kuwait forms a case study as we try to understand what ethical theories underlie the (...) attitude toward one problematic aspect of IT, online pornography, in Muslim/Arab societies. In this paper we review several ethical theories and then present the results of experimental research aimed at determining the concepts that underlie the Kuwaiti response to pornography online. (shrink)

New and experienced psychotherapists alike can find themselves overwhelmed by an ethical quandary where there doesn't seem to be an easy solution. This book presents positive ethics as a means to overcome such ethical challenges. The positive approach focuses on not just avoiding negative consequences, but reaching the best possible outcomes for both the psychotherapist and the client. The authors outline a clear decision-making process that is based on three practical strategies: the ethics acculturation model to help therapists (...) incorporate personal ethics into their professional roles, the quality enhancement model for dealing with high-risk patients who are potentially harmful, and ethical choice-making strategies to make the most ethical decision in a situation where two ethical principles conflict. Throughout the decision-making process, psychotherapists are encouraged to follow four basic guidelines: Focus on overarching ethical principles Consider intuitive, emotional, and other nonrational factors Accept that some problems have elusive solutions Solicit input from colleagues and consultation groups Numerous vignettes illustrate how to apply positive ethics to many different ethical challenges that psychotherapists will likely encounter in practice. (shrink)

Therapists treating adolescent gang members face unique ethical dilemmas. These dilemmas arise directly from clinical issues that inevitably emerge in the treatment of this population. Clinical issues related to the adolescent gang member having great difficulty trusting, having experienced and observed much violence, and usually having participated in criminal activities are central to the treatment process. In this article I discuss the ethical problems that subsequently emerge: maintaining confidentiality, discharging one's duty to warn or protect, and imposing one's (...) personal values. Suggestions for future research are offered. (shrink)

Background: Not all patients are considered equal. For patients who are considered to be “very important persons,” care can be different from that of other patients with advantages of greater access to resources, special attention from staff, and options for luxurious hospital amenities. While very important person care is common and widely accepted by healthcare administration, it has negative implications for both very important person and non-very important person patients, supports care disparities and inequities, and can create serious ethical (...) dilemmas for healthcare professionals. Very important person care can also result in negative care outcomes for its recipients. Objective: This article sought to explore the implications and ethical considerations of very important person care within the context of United States healthcare system, and integrate bioethical principles and American Nurses Association Code of Ethics for Nurses to influence recommendations for managing ethical dilemmas associated with very important person care. Method: A synthesis of the literature on very important person care was undertaken for this article. Ethical considerations: Ethical conduct was considered and respected when performing the literature review, referencing sources, and establishing authorship. Findings: According to the published literature, very important person care bares both positive and negative implications for patients, and negative implications for nurses. Nurses are the most affected by the demands from their administrators to provide special care and attention to patients in the “very important person” category and their families. Very important person care can be disruptive, disorienting, challenging, and stressful to nurses. Conclusion: While physicians and other healthcare professionals have commented on very important person care, limited work has been done in nursing. There have not been any empirical studies on very important person care. Therefore, in order to minimize the negative implications of very important person care, studies of this phenomenon are warranted. Exposing very important person care is important in the development of an ethical healthcare system. Moreover, understanding the ethical principles surrounding the concept of very important person care will empower nurses to effectively manage conflicts and ethical dilemmas that arise with very important person care. (shrink)