Ethics support in primary health care has been sparser than in hospitals, the need for ethics support is probably no less. We have, however, limited knowledge about how to develop ethics support that responds to primary health-care workers’ needs. In this article, we present a survey with a mixture of closed- and open-ended questions concerning: How frequent and how distressed various types of ethical challenges make the primary health-care workers feel, how important they think it is to deal with these (...) challenges better and what kind of ethics support they want. Five primary health-care institutions participated. Ethical challenges seem to be prominent and common. Most frequently, the participants experienced ethical challenges related to scarce resources and lack of knowledge and skills. Furthermore, ethical challenges related to communication and decision making were common. The participants welcomed ethics support responding to their challenges and being integrated in their daily practices. (shrink)
Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health , - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project.
The Norwegian Parliament has decided to give priority to ethics in municipal health services. This priority is supposed to raise competence in ethics within municipal health services. As part of the national project, the participating municipalities were encouraged to develop and carry out local projects. In this article, we present a local ethics project in one of the participating municipalities in central eastern Norway. The local project for raising competence in ethics was carried out in cooperation with researchers at the (...) Centre for Medical Ethics (CME) at the University of Oslo. Most people agree that ethics are important in health services. However, there are many ways to increase competence in ethics and to stimulate ethical reflection. In this article we present a broad overview of this local ethics project, but special focus will be put on presenting the actions that have been used for increasing the level of ethical competence and stimulating ethical reflection among the participants. We describe our evaluation of the project and the research we carried out. Explanations will be given for the thought process behind the decisions that were made. (shrink)
Their nursing experience and/or training may lead students preparing for the nursing profession to have less moral distress and more favorable attitudes towards a hastened death compared with those preparing for other fields of study. To ascertain if this was true, 66 undergraduates (54 women, 9 men, 3 not stated) in southeastern USA completed measures of moral distress and attitudes towards hastening death. Unexpectedly, the results from nursing and non-nursing majors were not significantly different. All the present students reported moderate (...) moral distress and strong resistance to any efforts to hasten death but these factors were not significantly correlated. However, in the small sample of nurses in training, the results suggest that hastened death situations may not be a prime reason for moral distress. (shrink)
Climax is a compound rhetorical figure, consisting of the trope, Crementum, and the scheme, Gradatio, a combination that results in compelling semiotic effects. The component figures impact the conveyed meaning independently and collectively, which we chart by way of the PATH image schema and the Gestalt Figure-Ground relation. These layers of meaning function in a similar fashion to the dual figure visual phenomenon examined by Koffka and Rubin. Key elements of our project include knowledge representation of Climax and component figures, (...) a suite of ontologies that map the cognitive features supporting these complex structures and a base model of surface entities augmented with the related cognitive functions. Our ontologies are developed in the Web Ontology Language, validated for consistency and published online. (shrink)
As understanding of the human microbiome improves, novel therapeutic targets to improve human health with microbial therapeutics will continue to expand. We outline key considerations of balancing risks and benefits, optimising access, returning key results to research participants, and potential conflicts of interest.
Using samples from the U.S. and Puerto Rico, we examine cross-cultural differences in cultural value dimensions, and relate these to act and rule utilitarian orientations, and ethical decision making of business professionals. Although these places share the same legal environment, culturally they are distinct. In addition to tests of between-group differences, a model in which utilitarian orientation mediates the influence of cultural values on ethical decisions was evaluated at the individual level of analysis. Results indicated national culture differences on three (...) cultural values, but no between-group differences on utilitarian orientations and ethical decisions. Significant indirect effects were found; act utilitarian orientation mediated the effects of two values activity orientation and universalism on ethical decision making. Implications for international management practices and business ethics are discussed. (shrink)
The treatment of employees during downsizing and corporate restructuring raises many ethical issues. To provide a common framework for understanding ethical decisions facing organizations delivering the news of dismissal to affected employees, Integrative Social Contracts Theory and the research on social exchange was used to integrate existing research on employee dismissal. Of particular importance was determining the criteria necessary to manage the dismissal process within ethical boundaries. Three basic criteria, which together represent a variety of contractual and transactional obligations, are (...) proposed as necessary for an ethical approach to dismissal; 1) advance warning of the job loss, 2) open communication, and 3) institutionalized support services. The frequency with which organizations meet these criteria is examined using a geographically dispersed, cross-organizational sample of 770 involuntarily displaced professional employees. In addition, the effect of such an ethical approach to dismissal on individual psychological and financial outcomes is examined. Findings are discussed as they relate to the implicit contract between employee and employer and organizations' responsibility to employees during corporate restructuring. (shrink)
This study ascertained reports of assent (affirmative agreement) and permission (agreement by an adult fully capable of being informed) in 114 children's research articles in 1990 in Child Development (CD), Journal of Consulting and Clinical Psychology (JCCP), Journal of Pediatric Psychology, and Journal of Clinical Child Psychology. Of the research projects, 43% failed to specify permission, and 68.5% failed to specify assent. JCCP reported assent significantly more than CD. Assent was reported significantly more in research with older children than with (...) younger children. This lack of sensitivity to assent and permission suggests that many authors, reviewers, and editors consider reporting assent and permission unessential. We recommend specifying assent and permission in all manuscripts, highlighting children's research issues in graduate training, and using specific safeguards when conducting research with children. (shrink)
Inclusive, non-elitist art spaces are mounted by remarkably talented, creative individuals. Alfred Stieglitz and Donald Judd were two such individuals. Stieglitz's space was an intimate urban art gallery in Manhattan while Judd's space in Marfa, Texas was expansive, isolated, and rural. Aside from sharing the usual characteristics of the very creative, both were charismatic, physically attractive, intelligent men who held forceful visions about art. Unlike most of their peers, they had the capacity to write well and speak convincingly. Their resolute (...) confidence and aesthetic competencies enabled them to attract and hold astute colleagues. Last they had the necessary expertise and connections to obtain resources required to maintain their vision. (shrink)
In 1993, after an optimistic beginning followed by a half-decadeof conflict, the Superconducting Super Collider (SSC) project wasabandoned. In an era of `Big Science', a major scientificenterprise collapsed. Why? We employ the metaphor of the`frontier outpost' to analyse a critical moment in the history ofthis vastly expensive project, when the physicists who designedthe machine were forced to recognize that traditional post-warscientific values were no longer in harmony with governmentpriorities.
After presenting a brief history of the idea of a human right to an adequate environment as it has evolved in the United Nations documents, I assess this approach to our moral responsibility with regard to the environment. I argue that although this rights approach has some substantial weaknesses, these are outweighed by such clear advantages as its action-guiding nature and its political potency.