One antidote to moral distress is stronger moral agency—that is, an enhanced ability to act to bring about change. The Clinical Ethics Residency for Nurses, an educational program developed and run in two large northeastern academic medical centers with funding from the Health Resources and Services Administration, intended to strengthen nurses’ moral agency. Drawing on Improving Competencies in Clinical Ethics Consultation: An Education Guide, by the American Society for Bioethics and Humanities, and on the goals of the nursing profession, CERN (...) sought to change attitudes, increase knowledge, and develop skills to act on one's knowledge. One of the key insights the faculty members brought to the design of this program is that knowledge of clinical ethics is not enough to develop moral agency. In addition to lecture‐style classes, CERN employed a variety of methods based in adult learning theory, such as active application of ethics knowledge to patient scenarios in classroom discussion, simulation, and the clinical practicum. Overwhelmingly, the feedback from the participants (sixty‐seven over three years of the program) indicated that CERN achieved transformative learning. (shrink)

Volume 20, Issue 4, May 2020, Page 108-110.

Background: The right of children to have their voice heard has been accepted by researchers, and there are increasing numbers of qualitative health studies involving children. The ethical and methodological issues of including children in research have caused worldwide concerns, and many researchers have published articles sharing their own experiences. Objectives: To systematically review and synthesise experts’ opinions and experiences about ethical and methodological issues of including children in research, as well as related solution strategies. Research design: The research design (...) was a systematic review of opinion-based evidence, based on the guidelines by Joanna Briggs Institute. Methods: A search of five computerised databases has been conducted in April 2014 and 2271 articles were found. After screening the titles, abstracts, full texts and appraising the quality, 30 articles were finally included in the review. A meta-aggregative approach was applied in the data analysis and synthesis process. Ethical considerations: Ethical approval is not needed as it is a systematic review of published literature. Results: Six themes were identified, including evaluating potential risks and benefits, gaining access, obtaining informed consent/assent, protecting confidentiality and privacy, building rapport and collecting rich data. The similarities and differences between research involving children and that involving adults were indicated. Conclusion: All potential incentives should be justified when designing the study. Further studies need to research how to evaluate individual capacity of children and how to balance protecting children’s right to participate and their interests in the research. Cultural differences related to researching children in different regions should also be studied. (shrink)

Demonstrating value is an ongoing process and requirement for institutional survival for ethics programs. Although our ethics program has significantly increased our ethics consultation volume and maintains a robust database that tracks ethics consultation data, these data regarding ethics consultations alone do not accurately represent the program’s overall activities and value to the institution. The roles and responsibilities of clinical ethicists extend beyond clinical ethics consultation, and there are many other ways that clinical ethicists contribute and add value to their (...) institutions. This article describes our ethics program’s early efforts to systematically track ethics program activities outside of ethics consultations as a way to demonstrate additional value to the institution that goes beyond ethics consultation. By systematically tracking activities such as internal ethics education sessions, conference presentations, publications, grants, committee/policy work, and other activities, our ethics program has been able to gather substantial quantitative data that highlight our program’s numerous activities and outreach, both within and outside the institution, that provide additional value to the institution beyond our ethical consultation activities. (shrink)

Understanding a patient’s story is integral to providing ethically supportable and practical recommendations that can improve patient care. Important skills include how to elicit an individual’s story, how to weave different narrative threads together, and how to assist the care team, patients, and caregivers to resolve difficult decisions or moral dilemmas. Narrative approaches to ethics consultation deepen dialogue and stakeholders’ engagement to reveal important values, preferences, and beliefs that may prove critical in resolving care challenges. Recognizing barriers to narrative inquiry, (...) such as patients who are unable or refuse to share their story, is also important. In this article we offer specific steps and guidelines that ethicists can follow to systematically elicit and construct patients’ stories. We provide a case example to illustrate how a narrative approach to ethics consultation illuminates salient ethical issues that may otherwise go unnoticed. We argue that this approach should be part of every consultant’s tool kit. (shrink)

This is a literary and philosophical study that links the idea of secularism to the form of the novel. It offers a groundbreaking critical foundation both for understanding the move toward a secular culture and for examining the role of the individual in modern ethical, political, and spiritual contexts.

This chapter examines the relationship between punishment and regulation as represented in Richard Price's 1992 novel, Clockers. In particular, it considers how obedience to regulation promises avoidance of punishment, even as regulation is often imposed as part and parcel of punishment. It explores how that variable relationship acts on individual subjects and considers how it is replicated and elucidated through narrative construction.

In December 1998, two groups of scientists announced that they had successfully isolated and cultured human pluripotent stem cells. This news was greeted with both tremendous enthusiasm and concern. Because these cells can develop into most types of cells or tissues in the human body, they hold great promise for scientific research and medical advances. For example, stem cells can potentially be used to:Generate cells and tissues for transplantation and therapy for conditions such as Parkinson’s disease, spinal cord injury, stroke, (...) burns, heart disease, diabetes, and arthritis;Improve scientists’ understanding of the complex events that occur during normal human development, as well as the abnormal events which cause conditions such as birth defects and cancer; andSubstantially change the development and testing of drugs. New medications could be tested initially on stem cells, and only drugs which were safe and effective on the cells would be tested further on laboratory animals and humans. (shrink)