To date, few Norwegian clinical ethics committees (CECs) have included patients or next of kin in case discussions. In 2008, Rikshospitalet's (The National Hospital's) CEC began to routinely invite patients and relatives into case discussions. In this paper, we describe seven cases discussed by this committee in 2008. Six involved life and death decision-making in collaboration with the next of kin, while one related case did not include relatives. In our opinion, representing the patient's perspective was advantageous to the discussion (...) itself, to the conclusion made and to the next of kin's acceptance of the resolution. We believe that if the patient had been represented in the last case, the outcome might have been different. We conclude that successful patient involvement will rely on well-structured case discussions, an open atmosphere and good preparation and follow-up. (shrink)
Research on corporate social responsibility (CSR) has tended to focus on external stakeholders and outcomes, revealing little about internal effects that might also help explain CSR-firm performance linkages and the impact that corporate marketing strategies can have on internal stakeholders such as employees. The two studies ( N = 1,116 and N = 2,422) presented in this article draw on theory from both corporate marketing and organizational behavior (OB) disciplines to test the general proposition that employee trust partially mediates the (...) relationship between CSR and employee attitudinal and behavioral outcomes. Both studies provide evidence in support of these general relationships. Theoretical and practical implications of these findings are discussed in the context of CSR and corporate marketing research. (shrink)
Problem: Medical student mistreatment, as well as patient and staff mistreatment by all levels of medical trainees and faculty, is still prevalent in U.S. clinical training. Largely missing in interventions to reduce mistreatment is acknowledgement of the abuse of power produced by the hierarchical structure in which medicine is practiced. Approach: Beginning in 2001, Yale School of Medicine has held annual “Power Day” workshops for third year medical students and advanced practice nursing students, to define and analyse power dynamics within (...) the medical hierarchy and hidden curriculum using literature, guest speakers, and small groups. During rotations, medical students write narratives about the use of power witnessed in the wards. In response to student and small group leader feedback, workshop organizers have developed additional activities related to examining and changing the use of power in clinical teams. Outcome: Emerging narrative themes included the potential impact of small acts and students feeling “mute” and “complicit” in morally distressing situations. Small groups provided safe spaces for advice, support, and professional identity formation. By 2005, students recognized residents that used power positively with Power Day awards and alumni served as keynote speakers on the use of power in medicine. By 2010, departments including OB/GYN, surgery, psychiatry, and paediatrics, had added weekly team Power Hour discussions. Next Steps: The authors highlight barriers, benefits, and lessons learned. Barriers include the notion of clinical irrelevance and resistance to the word “power” due to perceived accusation of abuse. Benefits include promoting open dialogue about power, fostering inter-professional collaboration, rewarding positive role modelling by residents and faculty, and creating a network of trainee empowerment and leadership. Furthermore, faculty have started to ask that issues of power be addressed in a more transparent way at their level of the hierarchy as well. (shrink)
If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.
In recent years there has been an increased awareness with regards to ethics in business. More specifically, the abundance of well-publicized examples of cheating, greed, and hypocrisy has created some alarm about the general state of personal ethics. Recent examples include the Oliver North, Ivan Boesky, and Jimmy Swaggart cases. The tax practitioner probably has little direct concern for matters of misconduct and ethical improprieties as mentioned above. Adherence to a code of conduct appears to circumvent the ethical conflict typically (...) found in the business environment. The tax practitioner's ultimate goal is tax minimization for clients. This goal has the blessings of the courts and the writers of tax law.The present day dynamic global economic system includes organizations which have extensive international activity. In an effort to enhance the performance of these organizations, there is typically decentralization of operations. When decentralization exists it is necessary to evaluate the decentralized units. Profit centers are commonly used for this purpose. With profit centers comes the need for transfer pricing between profit centers. The transfer price should be determined in some objective fashion. However, tax minimization often is the driving force in the transfer price decision. (shrink)
The theoretical and empirical link between leadership and workplace bullying needs further elaboration. The aim of the study is to examine the relationship between quality of leadership and the occurrence of workplace bullying 2 years later. Furthermore, we aim to examine a possible mechanism from leadership to bullying using social community at work as mediator. Using survey data that were collected at two different points in time among 1664 workers from 60 Danish workplaces, we examined the total, direct and indirect (...) effects between quality of leadership and workplace bullying. Our results indicate that quality of leadership plays a role in establishing working conditions that lead to workplace bullying. Furthermore, social community at work fully mediates the effect of poor quality of leadership on workplace bullying. This longitudinal study adds to previous cross-sectional studies on the substantial role played by leaders in the bullying process. Within the leadership–bullying relationship, social community at work acts as a full mediator, adding a significant contribution to the discussion of mechanisms involved in the bullying process. Plausible explanations of this mechanism and practical implications are discussed. (shrink)
There is scarce research on the interaction between psychosocial working conditions and being a target of workplace bullying with individual characteristics as a moderator. We therefore examined 3,363 employees from 60 Danish workplaces to test whether sense of coherence moderates the relationship between the job demand-control model and bullying. This work is exploratory in nature, as no previous study to assess this moderation was found. Hierarchical linear regressions showed that demand-control model was significantly associated with bullying. Sense of coherence displayed (...) a significant though practically negligible moderating effect. This suggests that negative psychosocial working conditions are associated with bullying independently of personal characteristics, at least in terms of sense of coherence. (shrink)