Is bioethics consultation a profession? Withfew exceptions, the arguments andcounterarguments about whether healthcareethics consultation is a profession haveignored the historical and cultural developmentof professions in the United States, the wayssocial changes have altered the work andboundaries of all professions, and theprofessionalization theories that explain howmodern societies institutionalize expertise inprofessions. This interdisciplinary analysisbegins to fill this gap by framing the debatewithin a larger theoretical context heretoforemissing from the bioethics literature. Specifically, the question of whether ethicsconsultation is a profession is examined fromthe (...) perspectives of trait theory, Wilensky''sfive-stage process of professionalization,Abbott''s interdependent system of professions,and Haug''s deprofessionalization thesis. Whilehealthcare ethics consultation does not meetthe criteria to claim professional status,neither could most professions pass these idealtheoretical standards. Instead of a yes or nodichotomous response to the question, it ismore helpful to envision a professionalizationcontinuum with sales clerks or carpenters atone end and medicine or law at the other. During the past decade healthcare ethicsconsultation has been moving along thiscontinuum toward greater professional status. (shrink)

The American Society for Bioethics and the Humanities (ASBH) issued its Core Competencies for Health Care Ethics Consultation just as it is becoming ever clearer that secular ethics is intractably plural and without foundations in any reality that is not a social–historical construction (ASBH Core Competencies for Health Care Ethics Consultation , 2nd edn. American Society for Bioethics and Humanities, Glenview, IL, 2011 ). Core Competencies fails to recognize that the ethics of health care ethics consultants is not ethics in (...) the usual sense of a morally canonical ethics. Its ethics is the ethics established at law and in enforceable health care public policy in a particular jurisdiction. Its normativity is a legal normativity, so that the wrongness of violating this ethics is simply the legal penalties involved and the likelihood of their being imposed. That the ethics of ethics consultation is that ethics legally established accounts for the circumstance that the major role of hospital ethics consultants is as quasi-lawyers giving legal advice, aiding in risk management, and engaging in mediation. It also indicates why this collage of roles has succeeded so well. This article shows how moral philosophy as it was reborn in the 13th century West led to the ethics of modernity and then finally to the ethics of hospital ethics consultation. It provides a brief history of the emergence of an ethics that is after morality. Against this background, the significance of Core Competencies must be critically reconsidered. (shrink)

Using data from the 1979 to 1998 waves of the National Longitudinal Survey of Youth, the author explores how gender, family, and class alter the impact of self-employment on earnings. Fixed-effect regression results show that while self-employment positively influences men’s earnings, not all women similarly benefit. Professionals receive the same self-employment earnings premium, regardless of gender. However, self-employment in nonprofessional occupations negatively affects women’s earnings, with wives and mothers incurring the greatest penalties. The high concentration of nonprofessional self-employed women in (...) child care accounts for much of these penalties. Results are robust despite inclusion of controls for human capital and labor supply, job characteristics, occupational and industrial gender segregation, and demographic characteristics. The compensating differentials argument, that women with greater family responsibilities trade earnings for the family-friendly aspects of self-employment, is discussed in light of these findings. While this argument may explain women’s returns to nonprofessional self-employment, it is less persuasive for interpreting women’s returns to professional self-employment. (shrink)

Through a close analysis of various moments within two hours of video-taped interaction, we investigate properties of the setting that the participants cannot ignore even as they transform them in various ways. These properties are not under local control. What is under control is revealed in the participants' “play” with the properties, including dangerous, “deep” play. In this process, some properties of the participants are rarely mentioned (e.g., that the laboring woman is an MD), others are repeatedly emphasized (e.g. the (...) strength of contractions). And others appear in ways that have not been dealt with adequately in current theoretical frameworks. To deal with life-threatening lies, and jokes about lies, we must move away from theories of hegemonic particularity that rely on a habitus. Rather we must acknowledge the practical understandings revealed in the collective submergence of that which may be actively noted as potentially relevant and then set aside so that other tasks can be foregrounded and achieved. (shrink)

The paper reflects the situation and possible visions for the development of social work ethics in health care in Slovakia in the context of its current position in specific health care institutions within the confines of declared legal norms. It emphasizes examples of good philosophical and methodological practice from abroad, the activities of the professional NASW association, as well as empirical experience of social workers with reference to visualizing possible implantation of social workers into the health care system, especially (...) within managed care systems in Slovakia. (shrink)

Should nurses have their own ethics to match specific problems met in their daily routines? How do nurses act in a society that is changing from a 'monocultural' to an 'intercultural' structure? What are the ethical consequences of these changes for their many tasks? How can the ethical aspects be taught to nurses? This article describes the current status of nursing ethics in the curriculum taught in schools of higher education for nurses in The Netherlands. Aspects of the debate (...) on nursing ethics are outlined and ideas about its future as a subject and discipline in nurse education are offered. Est-ce que le personnel infirmier doit avoir son éthique à soi pour faire face aux problèmes spécifiques dans la routine journalière? Et comment les infirmiers/ères se comportent-ils dans une société qui est en train de changer de la 'monoculture' en 'interculture'? Quels sont les conséquences éthiques de leur tâches? Comment peuvent ces aspets éthiques être enseignés aux infirmiers/ères? Cet article parle de l'état courant de l'éthique infirmier dans l'enseignement dans les écoles de l'education supérieure pour infirmiers/ères en Hollande. En plus, il donne une esquisse de la discussion sur l'éthique infirmier et donne quelques idées pour le futur de l'éthique infirmier comme sujet et discipline en soi dans l'éducation des infirmiers/ères. Sollte das Pflegepersonal seine eigene Ethik haben um den spezifischen Problemen seiner täglichen Routine gewachsen zu sein? Wie soll das Pflegepersonal in einer Gesellschaft handeln, die im Wechsel ist von einer 'Monokultur' zu einer 'Interkultur'? Was sind die ethischen Konsequenzen ihres handeln? Wie können diese ethischen Aspekte dem Pflegepersonal gelehrt werden? Dieser Artikel beschreibt den gegenwärtigen Zustand der Krankenpflege-Ethik im Lehrplan der Schulen für Höhere Ausbildung für Pflegepersonal in Holland. Er gibt auch einen Umriss über die Debatte über Krankenpflege-Ethik und formuliert einige Ideen für die Zukunft der Krankenpflege- Ethik als ein Thema und eine Disziplin in der Ausbildung des Pflegepersonals. (shrink)

This study examined whether holding a status-consistent or status-inconsistent position affected the work satisfaction of college-educated, white-collar employees. The status-consistent group contained 128 women and 118 men. The status-inconsistent group was composed of 89 women and 102 men. Our results indicated that workers in occupations in which the majority of workers are the same gender had significantly higher levels of work satisfaction than those in status-inconsistent occupations. However, subsequent analyses revealed that men and women employed (...) in occupations in which the majority of workers are men had higher levels of work satisfaction than those employed in women-dominated occupations. These findings held when controlling for other work-satisfaction factors, such as individual earnings, hours worked per week, and length of time employed. We suggest that the effect of status consistency on work satisfaction is mediated by the cultural value attached to the occupations men dominate. (shrink)

Although scholars have long acknowledged the importance of having effective networks in business, little is known about the role of women’s professional status in the effectiveness of their networks. Drawing on gender-status beliefs theory, we examine how a woman’s status affects levels of trust in the information that she shares with members of her professional network. We hypothesize that network members are likely to mistrust information from women because of a gender-status mismatch—a perceived mismatch (...) between a woman’s work-related high status and her low social status, due to widely held beliefs about women’s lack of competence. By measuring three types of status and analyzing trust levels in 3,842 dyads from communication networks in a UK railway construction project from 2014 through 2015, we find that network members trust information from women who are in supervisory positions and are connected with central contacts less than information from low-status women. Our study extends the literature on gender-status beliefs and effective networks, and discusses practical implications. (shrink)

The authors of the article with reference to the discussions about the status of knowledge in the postmodernism discourse and the "crisis of the intellectual" presented in the works by J.F. Lyotard and Z. Bauman, consider these issues in the context of other social challenges. Interpreting the conducted empirical research results, the research also focuses on the multidisciplinary theoretical analysis of philosophical, psychological and pedagogical literature. The authors note that in the absence of metanarratives, the phenomenon of intellectuals and (...) intellectual work is transformed: postmodern epistemology has changed the opportunities of mass education about how things should stand / what to have / how to act into the multiple / polyphonic / variable / fragmentary / collage dissemination of knowledge. As an argument in the "crisis of intellectuals" discussion, the authors analyze the educators` need and motivation sphere emphasizing constant knowledge enhancement to be a priority for them, which logically affects professional identity reconstruction carried out through self-reference. The paper presents an opinion that intellectuals lack self-perception as a reference social group. We conclude that in the information society, public interaction with the media affecting the reconsideration of the intellectual`s role and status serves as a basis for their legitimation. The results of the conducted survey enable us to conclude that raising educators` intellectual level affects their competences in professional practices. The status of the intellectual-educator is legitimized by their activity in training sessions, discussions, meet-ups and other events. The study presents an algorithm for constructing the intellectual-educator in the conditions of social reality challenges. The research substantiates demand for the intellectual-educator who is IT literate, capable of professional reflection, open to change, motivated for continuous self-development, ready for the reconstruction of professional identity from a knowledge transmitter to an erudite, a creative coach, a supervisor and a moderator. (shrink)

Employed professionals (e.g., accountants or engineers)-and those who study them-sometimes claim that their status as employeesdenies them the “autonomy” necessary to be “true professionals.” Is this a conceptual claim or an empirical claim? How might it be proved or disproved? This paper draws on recent work on autonomy to try to answer these questions. In the course of doing that, it identifies three literatures concerned with autonomy and suggests an approach bringing them together in a way likely to be (...) useful both to philosophers interested in the concept and to social scientists interested in studying autonomy in the workplace. (shrink)

Employed professionals (e.g., accountants or engineers)-and those who study them-sometimes claim that their status as employeesdenies them the “autonomy” necessary to be “true professionals.” Is this a conceptual claim or an empirical claim? How might it be proved or disproved? This paper draws on recent work on autonomy to try to answer these questions. In the course of doing that, it identifies three literatures concerned with autonomy and suggests an approach bringing them together in a way likely to be (...) useful both to philosophers interested in the concept and to social scientists interested in studying autonomy in the workplace. (shrink)

Mary Anne Warren investigates a theoretical question that is at the centre of practical and professional ethics: what are the criteria for having moral status? That is: what does it take to be an entity towards which people have moral considerations? Warren argues that no single property will do as a sole criterion, and puts forward seven basic principles which establish moral status. She then applies these principles to three controversial moral issues: voluntary euthanasia, abortion, and the (...) status of non-human animals. (shrink)

What purpose is served by renovation or redesign of professionalism, and how successful a process is it likely to be? This article addresses these questions by examining the effectiveness as a professional development mechanism of the imposition of changes to policy and/or practice that require modification or renovation of professionalism. The 'new' professionalisms purported to have been fashioned over the last two or three decades across the spectrum of UK education sectors and contexts have been the subject of extensive (...) analysis, and this article avoids going over old ground and revisiting issues that have already been much debated. Nevertheless, the example of UK government education policy during this period is used as a basis for considering the pitfalls associated with mechanisms for modifying professionalism through a reform and standards agenda. The article's analysis incorporates redefinition and examination of the concept and substance of professionalism and offers new perspectives in the form of three distinct conceptions: demanded, prescribed and enacted professionalism. Exploring the existentialist status of 'new' or 'modified' professionalisms and the relationship between professionality, professional culture and professionalism, it examines how professionalism may be interpreted and utilised for the development of education professionals. (shrink)

Background Professional values are important in promoting healthy work environments, patient satisfaction, and quality of care. Magnet® hospitals are recognized for excellence in nursing care and as such, understanding the relationship between nurses' values and Magnet status is essential as healthcare organizations seek to improve patient outcomes. Research question/aim/objectives The research question is: are there differences in individual values, professional values, and nursing care quality for nurses and nurse managers practicing in Magnet, Magnet journey, and non-Magnet direct (...) patient care settings? Research Design This descriptive cross-sectional study is guided and informed by the conceptual framework of the Professional Values Model including individual values, professional values, and nursing care quality. Participants and research context Convenience sampling of registered nurses and nurse managers, responsible for direct patient care, was utilized in a non-profit healthcare system in the Midwest region of the United States. Ethical Considerations Institutional review board approval was obtained. Participants were informed about the right to self-determine participation and assurance of anonymity. Findings 827 (n = 827) nurses and nurse managers responded to the survey. Significant differences were identified in individual values sub-scale: self-enhancement ( p = 0.38), professional values ( p = 0.037), practice environment: participation in hospital affairs ( p = 0.00), foundations for quality care ( p = 0.016), and resources adequacy ( p = 0.012) and in nurse sensitive HCAHPS questions: nurses explained things understandably ( p = 0.00), got help as soon as wanted ( p = 0.00), and treated with courtesy and respect ( p = 0.00). Discussion/Conclusions Findings indicate that fostering individual and professional values may impact nursing practice, regardless of Magnet designation. Promoting professional values may contribute to improved work environments, enhancing patient satisfaction. Study results offer valuable insights for organizations striving to enhance nursing values, impacting quality of care provided to patients. MeSH Terms Cross-Sectional Studies, Respect, Ethics Committees, Patient Satisfaction, Nurse Administrators, and Personal Satisfaction. (shrink)

The moral status of professional boundaries and the ethical nature of dual and multiple overlapping human relationships in contemporary clinical practice remain enduring problems in all health care disciplines. In this paper I explore the ethics of dual or multiple overlapping relationship and apply a virtue ethics framework to the case of psychotherapy.After clarifying the context and meaning of commonly used terminology, and considering what some of the key Australian codes of ethics relevant to psychotherapy advise about dual (...) relationships, I identify some commonly occurring situations where overlapping relationships are unavoidable. A case study from a rural context where size, isolation, and community expectations profoundly impact on the capacity of a psychotherapist to maintain clearly defined professional therapeutic relationship boundaries is analysed. The rural example is pertinent. A virtue ethics approach goes some way toward alleviating perceptions about the nature of dual relationships that contribute to an enduring reticence amongst psychotherapists (and other professionals) to practice in rural settings.Clearly, if a dual relationship involves exploitation then that relationship is a boundary crossing that should rightly be categorised as a boundary violation. Boundary violations are exploitative and unethical. However, some dual relationships may involve boundary crossings that are not necessarily boundary violations. Despite their general prohibition by Australian (and many other countries’) codes of ethics relevant to psychotherapy, I argue that in certain situations, if a psychotherapist (who crosses a professional relationship boundary) acts with professional integrity from the distinct professional role-related virtues and/or regulative ideals that ensure the goals of psychotherapy (to increase autonomy and psychological wellbeing) are met, then a dual or multiple overlapping relationship in psychotherapy will be ethical. (shrink)

Professionalization of farmers and rural entrepreneurs is identified as a potential resource to advance transition to multifunctional landscapes and territorial development. Drawing on interactive conceptions of knowledge creation and technical change, I argue that collective structures that support pooling of experiential knowledge can complement public and private sector engagement in innovation systems. Through exercise of leadership in advancing integration of farming into regional development and in integrating ecological and social concerns into agriculture, farmers can forge a professional identity and (...) broker a new social contract entitling them to renewal of their political and economic status. (shrink)

Despite the undeniable ethical dimensions of paid occupations — trades and services — other than the traditional professions, it is still natural to associate courses of professional ethics with medicine, law, nursing or teaching, rather than auto‐repair, supermarket assistance or window‐cleaning. Indeed, it seems plausible to hold that if there is anything more to the traditional distinction of professions from trades or other services than considerations of social and economic status, it might well reside in the distinctive ethical (...) or moral character and implications of such occupations as medicine, law and education. This paper undertakes to explore, via examination of some of the commonly suggested criteria of professionalism, the nature of such implications and the extent to which they justify continued deployment of a distinctive occupational category of ‘profession’. On the assumption that they do, however, the paper is also concerned to examine critically the consequences for education in professional ethics of any such distinctive ethics of profession. (shrink)

Conflicts of interest in health and medicine have been the source of considerable public and professional debate. Much of this debate has focused on financial, rather than non-financial COI, which is a significant lacuna because non-financial COI can be just as influential as financial COI. In an effort to explore the nature and effects of non-financial, as well as financial COI, we conducted semi-structured interviews with eleven Australian medical professionals regarding their experiences of, and attitudes towards, COI. We found (...) that this group of medical professionals saw non-financial interests—most notably the pursuit of status and respect and the avoidance of stigma—as potentially conflicting with other important interests. (shrink)

Clinical psychologists' and nonpsychiatric physicians' attitudes and behaviors in sexual and confidentiality boundary violations were examined. The 171 participants' responses were analyzed by profession, sex, and status (student, resident, professional) on semantic differential, boundary violation vignettes, and a version of Pope, Tabachnick, and Keith-Spiegel's (1987) ethical scale. Psychologists rated sexual boundary violation as more unethical than did physicians (p<.001). Rationale (p<.01) and timing (p<.001) influenced ratings. Psychologists reported fewer sexualized behaviors than physicians (p<05). Professional experience (p<.01) and (...) sex (p<.05) were associated with confidence-violating behavior. Overall, 78% of the sample reported attitudes or behaviors associated with boundary violations. The behavior violations were correlated (r=.49). Actual violators rated vignette violators more leniently than did nonviolators (p<.01). (shrink)

Professionalism is initially understood as a historical process, through which certain commercial services sought to improve their social status by separating themselves from mere crafts or trades. This process may be traced clearly with the aspiration of British portrait painters, in the eighteenth century, to acquire a social status akin to that of already established professionals, such as clerics and doctors. This may be understood, to a significant degree, as a process of gentrification. The values of the (...) class='Hi'>professional thereby lie as much in the etiquette and other social skills with which they deal with their clients, than with any distinctive form of skill or value. Professionalisation as gentrification seemingly says little about the nature of modern professionalism. However, if this process is also construed as one in which the goals and achievements of the profession come to be subject to radical reflection, then something significant about professional values emerges. On this account, the profession is distinguished from craft or trade on the grounds that the goals of the profession, and the effectiveness of any attempt to realise them, are not transparent to the client. While a lay person will typically have the competence necessary to judge whether or not a craft worker has achieved their goal, that person will not necessarily be able to recognise the values that determine the success of a medical operation. It will be concluded that the values of a profession are articulated intrinsically to the profession, in terms of the contested understanding that the professionals themselves have of the meaning of the profession and the narratives within which its history is to be told. (shrink)

This study investigated the relationship between hospital nurses’ professional care obligation, their attitudes towards SARS infection control measures, whether they had ever cared for SARS patients, their current health status, selected demographic characteristics, and the time frame of the data collection (from May 6 to May 12 2003 during the SARS epidemic, and from June 17 to June 24 2003 after the SARS epidemic). The study defines 172 nurses’ willingness to provide care for SARS patients as a (...) class='Hi'>professional obligation regardless of the nature of the disease. A conceptual model was developed and tested using ordinal logistic regression modelling. The findings showed that nurses’ levels of agreement with general SARS infection control measures and the lack of necessity for quarantining health care workers who provided care for SARS patients were statistically significant predicators of the nurses’ fulfilling of their professional care obligation. Suggestions and study limitations are discussed. (shrink)

In Belgium, a service voucher scheme – known as Titres Services – was launched in 2004 in order to create employment and regularize the labor conditions of domestic workers. The extent to which this scheme has represented an improvement in domestic workers’ labor conditions, however, is still a matter of debate. This article explores the workers’ experience of the changes introduced by this scheme. It focuses on Latin American migrants that are currently working under this scheme in Brussels, situating them (...) in relation to their previous experiences and the experience of other migrants who currently work in the informal market. The authors distinguish two tropes in their informants’ discourse, which describe their ambivalence regarding these changes. Using the Titres Services scheme’s rhetoric, the first one seeks to increase the social status of this occupation by presenting it as a ‘profession’. Contrarily, the second trope highlights the limits to professionalization. (shrink)

Clinical Ethics Consultation (CEC) has grown significantly in the last decade, and efforts are being made to professionalize the practice. The American Society for Bioethics and Humanities (ASBH) has been instrumental in this process, having published the _Code of Ethics and Professional Responsibilities for Healthcare Ethics Consultants_ and founded and endorsed the creation of the _Healthcare Ethics Consultant Certified (HCEC) Certification Commission._ The ASBH also published “core competencies” for healthcare ethics consultants and has delineated a clear identity and role (...) of such consultants distinct from that other healthcare professionals. In addition, more enter the field armed with advanced degrees (MA and PhD) or certification in clinical ethics consultation. While some have questioned the trend toward professionalization, the momentum is clearly in its favor. This paper explores three questions: Does the professionalization of healthcare ethics consultation expose those engaged in the field to the types of liability claims faced by professionals in other fields? What specific liabilities could affect a healthcare ethics consultant? And finally, what should healthcare ethics consultants do to protect themselves against liability claims? We conclude that while the risk of liability remains low, those engaged in the field should accept that risk just as part of their status as professionals and, like those in allied professions, seek appropriate protection in the form of liability insurance. (shrink)

ABSTRACT We examine the influence of neo-liberalism in re-shaping the accountability of five professional groups (accountants, solicitors, social workers, nurses and doctors) and its consequence for their CPD policies. Documentary analysis and Quarterly Labour Force Survey data (n=31,260) from the 1990s to the present are integrated in a comparative method which examines whether changes are specific to a profession or represent more general patterns. Using complementary theories from neo-liberal economics and the sociology of professionalism, we show how regulatory oversight (...) has altered accountabilities. Its consequences for the autonomy of professions and individuals in determining CPD requirements differ amongst the five groups, mediated by status, public concern, regulator activism and, possibly, alignment with the financial sector. Efficiency and equity are analysed using theories of professional learning and human capital. Wider economic conditions influence the incidence of CPD with recent years showing declining participation; we also show changes in ?what counts? as CPD and its greater integration with performance management. Findings on selected equity criteria are also reported. Some regulators are becoming more specific about the content of CPD, while others are defining what constitutes good practice and requiring its use in planning CPD. Greater attention is being given to issues of ethics and probity. (shrink)

The rapid expansion of competence‐based education through the work of the National Council for Vocational Qualifications has now, thanks to generous public funding and official endorsement by the Department for Education, penetrated the theory and practice of professional studies in teacher education at both school and post‐school levels. The NCVQ model of CBE is criticised and alternatives described. The current NCVQ approach is neither the only nor necessarily the most appropriate model of occupational development on offer. Models of professionalism (...) based on the concept of ‘expertise’ are recommended as the ones most likely to produce the reflective practitioners required to enhance the status and quality of teaching in schools and colleges. (shrink)

Professionalism is initially understood as a historical process, through which certain commercial services sought to improve their social status by separating themselves from mere crafts or trades. This process may be traced clearly with the aspiration of British portrait painters, in the eighteenth century, to acquire a social status akin to that of already established professionals, such as clerics and doctors. This may be understood, to a significant degree, as a process of gentrification. The values of the (...) class='Hi'>professional thereby lie as much in the etiquette and other social skills with which they deal with their clients, than with any distinctive form of skill or value. Professionalisation as gentrification seemingly says little about the nature of modern professionalism. However, if this process is also construed as one in which the goals and achievements of the profession come to be subject to radical reflection, then something significant about professional values emerges. On this account, the profession is distinguished from craft or trade on the grounds that the goals of the profession, and the effectiveness of any attempt to realise them, are not transparent to the client. While a lay person will typically have the competence necessary to judge whether or not a craft worker has achieved their goal, that person will not necessarily be able to recognise the values that determine the success of a medical operation. It will be concluded that the values of a profession are articulated intrinsically to the profession, in terms of the contested understanding that the professionals themselves have of the meaning of the profession and the narratives within which its history is to be told. (shrink)

This article discusses the triage response to the COVID-19 delta variant surge of 2021. One issue that distinguishes the delta wave from earlier surges is that by the time it became the predominant strain in the USA in July 2021, safe and effective vaccines against COVID-19 had been available for all US adults for several months. We consider whether healthcare professionals and triage committees would have been justified in prioritising patients with COVID-19 who are vaccinated above those who are unvaccinated (...) in first-order or second-order triage. Given that lack of evidence for a correlation between short-term survival and vaccination, we argue that using vaccination status during first-order triage would be inconsistent with accepted triage standards. We then turn to notions of procedural fairness, equity and desert to argue that that there is also a lack of justification for using vaccination status in second-order triage. In planning for future surges, we recommend that medical institutions base their triage decisions on principles meant to save the most lives, minimise inequity and protect the public’s trust, which for the time being would not be served by the inclusion of vaccination status. (shrink)

Many debates about the moral status of things—for example, debates about the natural rights of human fetuses or nonhuman animals—eventually migrate towards a discussion of the capacities of the things in question—for example, their capacities to feel pain, think, or love. Yet the move towards capacities is often controversial: if a human’s capacities are the basis of its moral status, how could a human having lesser capacities than you and I have the same "serious" moral status as (...) you and I? This book answers this question by arguing that if something is human, it has a set of typical human capacities; that if something has a set of typical human capacities, it has serious moral status; and thus all human beings have the same sort of serious moral status as you and I. Beginning from what our common intuitions tell us about situations involving "temporary incapacitation"—where a human organism has, then loses, then regains a certain capacity—this book argues for substantive conclusions regarding human fetuses and embryos, humans in a permanent vegetative state, humans suffering from brain diseases, and humans born with genetic disorders. Since these conclusions must have some impact on our ongoing moral and political debates about the proper treatment of such humans, this book will be useful to professionals and students in philosophy, bioethics, law, medicine, and public policy. (shrink)

BackgroundIn the last 2 weeks of January 2021, Portugal was the worst country in the world in incidence of infections and deaths due to COVID-19. As a result, the pressure on the healthcare system increased exponentially, exceeding its capacities and leaving hospitals in near collapse. This scenario caused multiple constraints, particularly for hospital medical staff. Previous studies conducted at different moments during the pandemic reported that COVID-19 has had significant negative impacts on healthcare workers’ psychological health, including stress, anxiety, depression, (...) burnout, post-traumatic stress symptoms, and sleep disturbances. However, there are many uncertainties regarding the professional quality of life of hospital nurses and physicians. To address gaps in previous research on secondary traumatic stress, we focused on healthcare workers working in hospitals affected by a major traumatic event: the third wave of COVID-19.ObjectivesThe aim of the present study was to identify the contribution of personal and work-related contextual variables on professional quality of life of healthcare workers.MethodsCross-sectional study with a web-based questionnaire given to physicians and nurses working in a hospital setting. A total of 853 healthcare professionals participated in the survey assessing professional quality of life compassion satisfaction, secondary traumatic stress, and burnout. Factors of professional quality of life were assessed using regression analysis.ResultsMost of the participants showed moderate or high levels of compassion satisfaction, whereas the majority of them experienced moderate levels of burnout and secondary traumatic stress. The analyzed variables demonstrated no differences between professionals who were directly or not involved in the care of COVID-19 patients. Parental status was found to be a significant factor in compassion satisfaction. Female gender was significantly associated with more susceptibility to secondary traumatization. Factors that may potentially contribute to burnout include years of professional experience and the number of work hours per week.ConclusionThe COVID-19 pandemic has created a new challenge for the healthcare system. Burnout and secondary traumatic stress can lead to medical errors and impact standards of patient care, particularly compromising compassionate care. It is therefore recommended that hospitals develop psychoeducational initiatives to support professionals in dealing with barriers to compassion. (shrink)

It could be argued that there is now a crisis of confidence in the professions. Although many professionals individually undertake their roles with care and diligence, there have been so many systematic failures involving professionals across a range of sectors, both in the UK and globally, that the special status enjoyed by the professions is being widely questioned. In this article, I argue that recent cases are symptomatic of a lack of ethical reasoning in professional practice, yet professions (...) enjoy an elevated status based on claims that ethics, typically communicated in codes of conduct, are central to their purpose. I argue that to help solve this crisis, philosophical literacy needs to be promoted in school, initial professional education and continuing professional development. Passing tests to superficially demonstrate an understanding of a code is quite different from reasoning through practical dilemmas in the professional workplace with judgements informed by philosophical ideas. (shrink)

Over the past twenty years there has been a shift in medical law and practise to increasingly distrust the judgement of health professionals. An increasing number of codes of conduct, disciplinary bodies, ethics committees and bureaucratic policies now prescribe how health professional and health researchers should act and relate to their patients. The result of this, Mark Henaghan argues, has been to undermine trust and professional judgement in health professionals, while simultaneously failing to trust the patient to make (...) decisions about their care. This book will look at the issue of health professionals and trust comparatively in a number of countries including the USA, Canada, Australia, New Zealand and the UK. The book will show by historical analysis of legislation, case law, disciplinary proceedings reports, articles in medical and law journals and protocols produced by management teams in hospitals, how the shift from trust to lack of trust has happened. Drawing comparisons between situations where trust is respected such as in emergency situations, and where it is not for example routine decisions such as obtaining consent for an anaesthetic procedure, the book shows how this erosion of trust has the potential to dehumanise the special nature of the relationship between healthcare professionals and patients. The effect of this is that the practice of health care is turned into a mechanistic enterprise controlled by "management processes" rather than governed by trust and individual care and judgement. This book will be an invaluable resource for students and scholars of medical law and medical sociology, public policy-makers and a range of associated professionals, from health service managers to medical science and clinical researchers. (shrink)

Public relations (PR) is trying to gain professional status by stressing specialized education for the field. Results are mixed, at best. Most practitioners have had educations in some aspects of communication, but so far only a small (though growing) number acknowledge it as being in public relations per se. Furthermore, when certain key attributes of professionalism are measured, practitioners with formal educations in public relations differ little from those without such educations.

In this paper I examine the relation of social justice and professional sports. I discuss two interrelated key ideas of social justice: equality of opportunity, and the just distribution of income and social status according to the principle of desert. I sketch what they both could mean in the context of professional sports and conclude that social justice should be implemented accordingly. This includes measures to equal the chances of becoming a professional athlete, the regulation of (...) their incomes—especially those which are exceptionally high—and that they—again especially those who are superstars—are viewed and treated as equals among equals. Professional athletes might show exceptional talent and effort, but they nonetheless fall under the jurisdiction of social justice. (shrink)

In vitro fertilization is now a well-established practice in the field of assisted reproduction. In 1995, over 41,000 IVF cycles were done in the United States, at a cost of more than $300 million. The overall success rate has risen to 22.8 deliveries per 100 egg-retrieval procedures. As the field has matured, the attention of policy-makers has shifted from questions about the ethical and legal status of human embryos to concerns about providing access and protecting consumers.Three such concerns have (...) emerged. One is the danger that IVF programs will disseminate misleading information about their success rates in order to attract patients. This problem, however, may be alleviated by the publication in late 1997 of the first of annual national and clinic specific reports, based on randomly audited data, by the Centers for Disease Control and Prevention, the American Society of Reproductive Medicine, the Society for Assisted Reproductive Technology, and RESOLVE, pursuant to the federal 1992 Fertility Clinic Success Rate and Laboratory Certification Act. (shrink)

In vitro fertilization is now a well-established practice in the field of assisted reproduction. In 1995, over 41,000 IVF cycles were done in the United States, at a cost of more than $300 million. The overall success rate has risen to 22.8 deliveries per 100 egg-retrieval procedures. As the field has matured, the attention of policy-makers has shifted from questions about the ethical and legal status of human embryos to concerns about providing access and protecting consumers.Three such concerns have (...) emerged. One is the danger that IVF programs will disseminate misleading information about their success rates in order to attract patients. This problem, however, may be alleviated by the publication in late 1997 of the first of annual national and clinic specific reports, based on randomly audited data, by the Centers for Disease Control and Prevention, the American Society of Reproductive Medicine, the Society for Assisted Reproductive Technology, and RESOLVE, pursuant to the federal 1992 Fertility Clinic Success Rate and Laboratory Certification Act. (shrink)

It is with no feigned modesty that I acknowledge, as a limited and superficial student of philosophy, the honour you have done me by your invitation to deliver the Manson Lecture. But if the honour is undeserved, it is by fortuitous circumstance the more appreciated. Dr. Manson was a family doctor in Warrington, Lancs., with whom I was privileged to have close professional associations. He was a man of many parts who regarded the isolation of medicine from philosophy as (...) an unintelligible and lamentable phenomenon of our time. He wished to see philosophy restored to its earlier and rightful basic rôle in medical education. He recognized that medicine and, indeed, the cognate basic sciences were occupying themselves almost exclusively with so rapidly accelerating an accumulation of facts, that little time remained for reflection and interpretation, and for pondering on the place of medicine in, and its contribution to, the general corpus of knowledge. And he was especially interested in the topic which I have chosen for this commemorative lecture, for he recognized, and translated into practice, the dictum that “No disease is wholly physical, and none wholly mental.” He saw in his patient the “whole” man, not a summation of such isolates as body, mind, environment, and family. (shrink)

This paper provides information on different training models within clinical neuropsychology in Finland. Systematic specialization training program began in Finland in 1983. It was first organized mainly by the Finnish Neuropsychological Society and since 1997 by the Finnish universities. At present, close to 400 clinical neuropsychologists have completed the training. The number of professionals still does not cover the needs of the country, and geographical disparities are a constant concern. The training models in Finland have changed over the years and (...) will continue to evolve. Specialization training can be organized by national societies or by universities. It can lead to an academic degree or a diploma. It can be linked to doctoral studies or form a parallel track. Financial model can involve student fees or be governed by ministries. This paper describes and compares different strategies in education that have impact on the output of professionals. One model does not fit all, or even one country at all times. The strategies of the stakeholder ministries can change over time. The experiences from Finland can be useful for other countries that are developing their models. The estimated need of practitioners and the educational resources including the available financial models for training differ between countries. The guiding principles in specialist training should focus on the advanced competencies expected from the neuropsychologist when entering the profession. (shrink)

While most research in public relations and strategic communication concentrates on textual elements, this contribution shifts the focus to the growing importance of visual elements. The theoretical background is based on visual theory and the concept of strategic mediatization. By using a large-scale quantitative survey among 3,387 European communication professionals, this study is the first empirical evidence of communication professionals’ perspectives concerning visual communication. Therefore, the paper empirically demonstrates a visual turn in strategic communication. Although practitioners have been using visual (...) elements since the very beginnings of their trade, only a minority guide these activities through a sound management process. This calls for a deeper consideration of visual communication management in practice and visual public relations research in academia. (shrink)

Los avances científico-tecnológicos han abierto una brecha en cuanto a los tratamientos médicos y los valores morales que deben sustentar la atención de salud. El profesional de enfermería no está exento de estos peligros, por lo que se ha generado un nuevo modelo ético que se integre al proceso de atención de enfermería. Con el objetivo de determinar los conocimientos y opiniones de estos profesionales, del área de cirugía de mínimo acceso, acerca de la aplicación del modelo en el contexto (...) de estos servicios, se diseñó una investigación de tipo observacional descriptiva con empleo de metodología cualitativa. Como técnica de exploración se usó la entrevista en profundidad, así como un panel de expertos para la construcción de la guía de entrevista. Se entrevistó a 34 enfermeras que laboraban en el Centro Nacional de Cirugía de Mínimo Acceso durante el período del estudio. Se concluye que la práctica de la cirugía de mínimo acceso es propicia para que médicos y enfermeras hagan una mayor observancia del derecho de autonomía de los pacientes. Se reconoce la capacidad de este personal para tomar decisiones independientes de los médicos en cuanto a las acciones de cuidado, lo que implica una mayor responsabilidad. Scientific and technological advances have opened a gap between medical treatments and the moral values that should support health care. The nurse is not exempt from these dangers. As such, a new ethical model that integrates to the process of nursing care has emerged. In order to determine the knowledge and opinions of the professionals who work in minimal access surgery services on the implementation of this model, a descriptive, observational study was designed utilizing qualitative methodology. In-depth interviewing was used as the primary testing technique. A panel of experts from the National Center of Minimal Access Surgery was consulted to develop the interview guide. Thirty-four nurses from the National Center for Minimal Access Surgery were interviewed over the course of the study period. Results suggest that the setting of minimal access surgery is conducive to medical professionals making greater observance of the right to patient autonomy. The ability of this staff to make independent decisions regarding medical care action is recognized, which implies greater responsibility. (shrink)

Preview: Where should we look for an answer to the question whether a psychiatrist is an expert? In analyses of the concept of “expert”? In sociological studies? Or perhaps in opinions formulated by psychiatrists themselves? The subject is not as simple as it might first seem and the answer cannot be obvious. Certainly, psychiatrists are considered to be experts when they are called in by the court to act as expert witnesses. They are also deemed experts when they make a (...) diagnosis, prescribe medication, or write out a sick note – similarly to other doctors. We typically trust that, just like other healthcare professionals, they will help us to recover or at least that they can alleviate our suffering. (shrink)