Within the context of service inquiries, and the specialized inferential logic associated with the particularized activities there is a gap in the orientations of customers and service representatives. Specifically, one problem that arises in customer service encounters is that customers and service representatives appear to arrive at different understandings of what constitutes a relevant response to a service inquiry. By examining one type of customer service context, calls to an electronic repair facility, this (...) article offers a conversation analytic account of how customers use formulations to collaboratively achieve a mutually agreed upon answer to their service inquiry and close the gap in the underlying logics that emerge in these calls. (shrink)

In highly routinised service encounter interactions, communication is often guided by service scripts that are the material embodiment of institutional expectations of how the service interaction is to be conducted. However, counter to common belief that scripted communication is well-controlled and homogeneous in its execution, observation of actual talk reveals interesting patterns and variations that reflect the ways in which participants make meaning of and perform their respective roles within the interaction towards achieving the overall goal of (...) the service communication. Applying the analysis of speech functions and sequential order of talk in audio-recorded verbal exchanges between servers and customers at the service counter of a fast-food restaurant, acts in the fast-food service interaction are interpreted and explained in relation to management-prescribed service script, servers’ script-in-use and customers’ script within an institutional discourse framework. Findings from the study have important implications for service management and training as it addresses the tension between the practices on the ground and those sanctioned by the organisation. (shrink)

ABSTRACTThe massive influx of refugees into Europe in the past few years has given rise to different kinds of challenges among which is the challenge to successfully communicate with newly arrived immigrants. In this article, we will focus on the public service provision sector where quality of service is to a large extent determined by the capability of a service provider and his or her “client” to understand one another. The article centres on a study involving public (...) organisations providing asylum services or healthcare services in the multilingual and multicultural city of Brussels. Several interviews were conducted to gain insight into the communication problems such organisations face, as well as their communication requirements and solutions when providing services to people of different linguistic and cultural backgrounds. We will focus on the types of bridging functions commonly deployed by these organisations in multilingual service encounters and on the motivations for using them. In a... (shrink)

Companies have a moral responsibility to treat customers fairly. One way for companies to do so is to allow their employees to exercise reasonableness in their interactions with customers. We define reasonableness as a latitude or space that exists around expectations in the delivery of service. In this paper, we explore the concept of reasonableness from a customer’s perspective (i.e., perceived reasonableness) and the role that the morals of service personnel play in customers’ perceptions of reasonableness. First, through (...) an open-ended survey on customers’ unreasonable service experiences, we identify themes of perceived reasonableness. We also discuss the role that the morals of service personnel play within these themes. Second, in order to identify the relationships between these themes, we create a cognitive map and discuss the implications of the identified relationships. Finally, we provide directions for future research on reasonableness. (shrink)

Dysfunctional customer behavior is common in service settings. For frontline employees, negative encounters can cause short-term despondency or have profound, long-term psychological effects that often result in both direct and indirect costs to service firms. Existing research has explored the influence of dysfunctional customer behavior on employee emotions, but it has not fully investigated the psychological mechanism through which customer misbehavior transforms into employee responses. To maintain service quality and employee well-being, it is important to understand (...) the impact of customer misconduct on employee emotions and its effect on subsequent service behavior. To assess the process through which dysfunctional customer behavior manifests as negative emotions in frontline service employees, and the influence of negative employee emotions on their prosocial service behavior, we surveyed 185 frontline banking service employees. We sought information on service employee experiences, attitudes, and feelings regarding dysfunctional customer behaviors, the perceived level of supervisor support, and employee prosocial service behavior intentions. Structural equation modeling and hierarchical linear modeling were used for statistical analysis and hypothesis verification. Results indicate that dysfunctional customer behavior has a positive relationship with bank service employee negative emotions and a negative influence on employee prosocial service behavior. The study found that negative emotions fully mediated the relationship between dysfunctional customer behavior and prosocial service behavior. The moderating role that perceived supervisor support plays on the relationships between dysfunctional customer behavior and negative emotion was also investigated. The results show that perceived supervisor support moderates the relationship between dysfunctional customer behavior and negative employee emotions. Finally, the study provides bank managers with effective strategies to assist frontline employees to manage and deter dysfunctional customer behavior, and presents employees with internal recovery strategies when encountering dysfunctional customer behavior. (shrink)

Ethical business practices have been widely prescribed, but why? Consumers views on unethical business practices have been studied, but possibly more important to marketers and researchers are consumer actions and reactions to unethical business practices and the businesses themselves. Do consumers react negatively, or in such a way as to "punish" the unethical business? If so, what is the nature and extent of the punishment? This research seeks answers to these questions by examining consumer reactions, such as complaining and switching, (...) to instances of unethical business practices. Using equity theory, this research proposes that consumers should be willing to tolerate some unethical behavior as long as they feel their investments and outcomes remain proportionately equal. Consumers who perceive that their outcome/investment ratio is proportionately unequal to their comparison other will respond by switching or complaining. In this research consumers were exposed to two types of service failures with different levels of service recovery in vignettes. Costs incurred by the consumer during the service transaction were also manipulated in the vignettes. Significant differences were found for complaint behavior in the failure recovery vignettes tested. Specifically, voice complaint was higher in the high cost service encounters in both types of services tested. The recovery attempt used (ethical, unethical, or none) led to significance differences in the variables of complaint, voice complaint, satisfaction, and quality. Higher satisfaction and quality ratings were found for the ethical recovery attempt and higher intentions to use complaint and voice complaint in the unethical recovery attempts. One significant interaction between cost and recovery attempt was found. Intentions to use voice complaint were higher in the high cost situations of ethical and unethical recovery, while approaching equality at the no recovery attempt. (shrink)

The ethics review of qualitative health research poses various challenges that are due to a mismatch between the current practice of ethics review and the nature of qualitative methodology. The process of obtaining ethics approval for a study by a research ethics committee before the start of a research study has been described as “procedural ethics” and the identification and handling of ethical issues by researchers during the research process as “ethics in practice.” While some authors dispute and other authors (...) defend the use of procedural ethics in relation to qualitative health research, there is general agreement that it needs to be supplemented with ethics in practice. This article aims to provide an illustration of research ethics in practice by reflecting on the ways in which we identified and addressed ethical and methodological issues that arose in the context of an interview study with mental health service users and relatives. We describe the challenges we faced and the solutions we found in relation to the potential vulnerability of research participants, the voluntariness of consent, the increase of participant access and the heterogeneity of the sample, the protection of privacy and internal confidentiality, and the consideration of personal and contextual factors. (shrink)

Our aim in this article is to define the difficulties that clinical ethics services encounter when they are asked to demonstrate the value a clinical ethics service (CES) could and should have for an institution and those it serves. The topic emerged out of numerous related presentations at the Un- Conference hosted by the Cleveland Clinic in August 2018 that identified challenges of articulating the value of clinical ethics work for hospital administrators. After a review these talks, it was (...) apparent that the field of clinical ethics may be at a crisis of sorts due to increased pressure to provide explicit measures to healthcare institutions to concretely demonstrate that CESs make a valuable difference in healthcare delivery. In this article, we grapple with how to satisfy the need for demonstrable value in a field in which metrics alone may not capture the scope of clinical ethics practice. We suggest that capturing the value of a CES has been difficult because the benefits of ethics consultation may be overt or attributable to the CES, but are often hidden due to the systems-level and process-oriented nature of clinical ethics work. Part of the difficulty in demonstrating the value of CESs is capturing and conveying all of the ways the integration of a CES throughout an institution positively affects patients, families, visitors, healthcare professionals, administrators, and the institution itself. Our aim is to (1) elucidate the multifaceted value added by a CES, including value that tends to be hidden and (2) suggest how to demonstrate value to others in a way that is not simplistic or reductionistic. (shrink)

It should not be a surprise in the near future to encounter either a personal or a professional service robot in our homes and/or our work places: according to the International Federation for Robots, there will be approx 35 million service robots at work by 2018. Given that individuals will interact and even cooperate with these service robots, their design and development demand ethical attention. With this in mind I suggest the use of an approach for incorporating (...) ethics into the design process of robots known as Care Centered Value Sensitive Design. Although this approach was originally and intentionally designed for the healthcare domain, the aim of this paper is to present a preliminary study of how personal and professional service robots might also be evaluated using the CCVSD approach. The normative foundations for CCVSD come from its reliance on the care ethics tradition and in particular the use of care practices for: structuring the analysis and, determining the values of ethical import. To apply CCVSD outside of healthcare one must show that the robot has been integrated into a care practice. Accordingly, the practice into which the robot is to be used must be assessed and shown to meet the conditions of a care practice. By investigating the foundations of the approach I hope to show why it may be applicable for service robots and further to give examples of current robot prototypes that can and cannot be evaluated using CCVSD. (shrink)

As pressures on the service economy from globalisation increase, new techniques may be appropriate for designing service systems. This paper examines the tradition of service quality and argues that its unique characteristics, such as the joint production of offerings by operators and customers, could benefit from the techniques of human factors. The interaction between human factors and quality is reviewed and four issues are extracted that should be directly applicable to service encounters. These are interface (...) design, the understanding of error causation, a design for operator well-being and human/automation function allocation. A framework is proposed for considering technology explicitly in the design of service systems. (shrink)

Conflicts of interest. None to report Healthcare is a context where individuals with disability confront important ethical and social challenges. Adolescents and young adults with cerebral palsy (CP) seem to face additional challenges but we have little insight into their perspectives. This qualitative study aimed to identify and better understand such challenges. We interviewed 14 participants with CP aged 18 to 25. Participants described a range of challenges experienced when using health services, including: lack of long-term follow-up, shortcomings in physical (...) access to infrastructures, and situations of injustice. Challenges specific to medical consultations were reported (e.g., rude attitudes, belittlement, inadequate communication, lack of consideration). We discuss and explain further that: (1) the ethical principle of respect for persons needs to be concretely specified to improve current practices; (2) respect for autonomy calls for further direct empowerment of individuals with CP and, (3) gaps in dedicated healthcare resources for CP and the long-term needs associated should be addressed. (shrink)

Ethnic minority patients face challenges concerning communication and are at higher risk of experiencing health problems and consuming fewer healthcare services. They are also exposed to disparaging societal discourses about migrants which might undermine healthcare institutions’ ambitions of equitable health care. Therefore, healthcare professionals need to critically reflect on their practices and processes related to ethnic minority patients. The aim of this article is to explore healthcare professionals’ experiences of working with ethnic minority patients by using the critical incident (CI) (...) technique. In two focus group sessions, participants discussed challenging events in their encounters with patients. The critical incidents show that healthcare professionals may experience unfamiliar situations related to their work performance, prejudice toward patients, and labeling by patients the professionals do not identify with. The professionals’ reflections are discussed in relation to social discourses on migration and their work conditions, and the possible influence on the professionals’ preconceptions and the patient–professional relationship in health care. Reflections about work experiences with ethnic minority patients and aligned societal discourses should be included in healthcare workers’ professional development. Critical incident reflections at work may contribute to better‐coping strategies for healthcare professionals and improved patient–professional relationships with ethnic minority patients. (shrink)

The proportion of elderly in society is growing rapidly, leading to increasing health care costs. New remote monitoring technologies are expected to lower these costs by reducing the number of close encounters with health care professionals, for example the number of visits to health care centres. In this paper, I discuss issues of priority setting raised by this expectation. As a starting-point, I analyse the recent debate on principles for priority setting in Sweden. The Swedish debate illustrates that developing (...) an approach to priority setting is an ongoing process. On the basis of this analysis, I conclude that several different ethical principles, and specifications of these principles, can be appealed to for giving priority—over close encounters—to a large-scale introduction of remote monitoring technologies in health care services to elderly people, but also that many specifications can be appealed to against giving such priority. I propose that given the different views on principles, it is necessary to develop fair procedures of deliberation on these principles and their application, in particular in order to reach agreement on exactly how much resources should be allocated to remote monitoring and how much to close encounters. I also present a few points to consider in a large-scale introduction of remote monitoring. (shrink)

One of the most important problems of Muslim societies and humanity is the conflicts and troubles among spouses and between parents and their children in the family. problems. Research is carried out and answers are sought for the solution of these problems, but the dissolution in families cannot be prevented and the divorce rate increases day by day. Besides being a prophet, the Messenger of Allah (pbuh) is a servant of Allah and a human being. It is seen that there (...) were problems in the homes of the Prophet (pbuh), both between him and his wives, and among his wives. Since the creation of human beings has not changed, the Prophet's (pbuh) attitudes and solutions to these problems are important for the solution of family problems happening today. It is seen that the Messenger of Allah (pbuh) reacted to these problems and discussions far above his age and he treated his wives and solved the problems as modern researchers and scientists recommend in the recent world. The purpose of sending the Messenger of Allah (pbuh) is to convey the religion of Allah to people. For this reason, he was given orders regarding the most private matters of his private life when appropriate. Human's happiness in this world and in the hereafter can only be achieved by recognizing this perfect example. This can be achieved by learning about his personality as an individual and his family life as a family. The conflict of values among spouses in the family, life perspective, personality and priority differences are the basis of the problems. In addition, changes in personality especially after marriage, loss of love and respect for each other, and jealousy are the main situations that harm marriage. Many marriages end because of miscommunication. There are many people who try to solve problems by being cold towards their spouse and taking a stand towards him/her. If a man is married to many women, as in the example of the Prophet (pbuh), the main problem he encounters is jealousy and the resulting unrest. In a family, there are joyful and happy moments as well as unhappy moments and times. It is very natural for family members to quarrel with each other and to have disagreements among them. The Prophet's family is not far from it. The wives of the Messenger of Allah (pbuh) are not ordinary people, but women who are either at the forefront of their tribe with their ancestry, intelligence and beauty, or who are one step ahead with their conversion to Islam and their services. According to the laws of God, the same poles repel each other, while the opposite poles attract each other. They are all very precious and it is perfectly natural for a repulsion force to develop between them. It is necessary to think of the Prophet's (pbuh) houses as a school. The state of our mothers when they entered that house is not the same as the degree they reached when the Prophet (pbuh) passed away. Differences of opinion and conflicts between members of the family, deterioration of the balance in relations, and weakening of solidarity are among the events seen in every family. The Prophet (pbuh) was able to have controversies with his wives, even if it was a rarely example. However, in these discussions, it is seen that he does not allow violence and tries to solve the issues patiently and by talking to each other, and sometimes asks for help from his close circle or relatives of his spouses. ʿĀʾIs̲h̲a is the most prominent among the wives of the Messenger of Allah, except for Khadija. She himself knew this and was voicing this claim against the other wives of the Messenger of Allah (pbuh). When the Prophet (pbuh) married Umm Salama, people talked about his beauty. ʿĀʾIs̲h̲a, who heard these praises, was very upset about the new rival who came to her. With Zaynab bt. ḎJ̲aḥs̲h̲ stepping into the house of the prophet, the balances changed and a fierce rivalry began between her and ʿĀʾIs̲h̲a. Just as ʿĀʾIs̲h̲a was proud of her superiority, Zaynab began to brag about her superiority. ʿĀʾIs̲h̲a had a special place among the wives of the Prophet. This was evident from the fact that the Messenger of Allah (pbuh) said at every opportunity that he loved him very much. The Messenger of Allah (pbuh) did not hesitate to express this either. When the Prophet (pbuh) went on an expedition, he would treat his wives fairly and draw lots so that he would not cause hatred or envy among them. When the lottery went out to another wife besides ʿĀʾIs̲h̲a, the dissatisfaction on his face could be felt. Among his other wives, the Prophet tried to protect and watch over his wife, Safiyya, at every opportunity, which he felt was strange because he was later included among them and was of Jewish origin. Although Mariye was a slave, she became one of the envied women among the wives of the Prophet after she gave birth to her son Ibrahim to the Messenger of Allah (pbuh). Undoubtedly, it was ʿĀʾIs̲h̲a who envied him the most. (shrink)

This article presents an ethical analysis and critique of personalized service in the tradition of Catholic social teaching (CST) that is both Catholic and Personalist. It tackles the ethical issues involved when service delivery is personalized, issues that affect both the consumers and the service providers. It focuses on nonprofessional services that are offered by low-skilled blue-collar workers through corporations that are organized to produce efficient service to a high volume of consumers. Customer service involves (...) intersubjectivity, that is, interaction between two persons as subjects. Ethics in the service context is not only about treating consumers in a just manner; the threats to the personhood of the service providers are also significant, for their work cannot be separated from their very being. By focusing on the ethical issues of emotional labor and consumerism of human service, the study will argue that the human interaction in personalized service runs the risk of alienating us from our authentic selves and from each other. If the objective of personalized service is to create authentic human relationship in the service encounter, the latter can arise even in a nonpersonalized service. We do not have to personalize our actions in order to create genuine human interaction. Instead, what we must do is to treat each other as persons. (shrink)

This article examines patients’ calls to three different GP services in the United Kingdom. Using conversation analysis, combined with coding of 447 calls, we studied the role of thank you in closing sequences, focusing on their timing and order in relation to service outcome. We show first how patients withhold thank you in orientation to an absent summary or specification of service: patients are more likely to initiate thank you if the receptionist volunteers such a summary. Second, we (...) show there is variation in how appropriately participants project the termination of calls using thank you. Finally, while thank you serves a primary role in managing the termination of calls, the timing, order and design of thank you can also display patient satisfaction. We discuss our findings in terms of service encounters more generally, including implications for larger scale analysis. (shrink)

Background There is considerable variation in the functionality of bioethical services in different institutions and countries for children in hospital, despite new challenges due to increasing technology supports for children with serious illness and medical complexity. We aimed to understand how bioethics services address bioethical concerns that are increasingly encountered in paediatric intensive care. Methods A qualitative descriptive design was used to describe clinician’s perspectives on the functionality of clinical bioethics services for paediatric intensive care units. Clinicians who were members (...) of formal or informal clinical bioethics groups, or who were closely involved with the process of working through ethically challenging decisions, were interviewed. Interviews took place online. Resulting transcripts were analysed using thematic analysis. Results From 33 interviews, we identified four themes that described the functionality of bioethics services when a child requires technology to sustain life: striving for consensus; the importance of guidelines; a structure that facilitates a time-sensitive and relevant response; and strong leadership and teamwork. Conclusions Clinical bioethics services have the potential to expand their role due to the challenges brought by advancing medical technology and the increasing options it brings for treatment. Further work is needed to identify where and how bioethics services can evolve and adapt to fully address the needs of the decision-makers in PICU. (shrink)

Although Emmanuel Levinas later expressed regret that he sided with Martin Heidegger rather than the more “ideal”-minded Ernst Cassirer in their 1929 Davos encounter, Cassirer’s philosophy of culture would never have been an apt framework for Levinas’s own project, which was always directed more to fundamental orientation than to formative activities or achievements. In “Meaning and Sense” (1964), Levinas conceived a totalizing cultural “meaning” as a foil to transcendent ethical “sense.” In a 1983 paper, however, he proposed an ethical conception (...) of culture. He could have developed this further using another element from “Meaning and Sense,” an ethical conception of work as service of the Other. The work-in-progress of culture combines pure ethics and implemented morality, pure command and consistent style, infinite vulnerability and actual power. (shrink)

This article analyzes a series of encounters between the Black Panther Party and the U.S. government’s War on Poverty, beginning with the Party’s foundation in a North Oakland anti-poverty office in 1966, and culminating with the resignation of six Party members from elected positions on a West Oakland anti-poverty board in 1973. The essay theorizes these encounters as moments in an antagonistic process whereby the Party sought to separate from and launch incursions into the state’s anti-poverty apparatus, which (...) had been established in the mid-1960s by a discrete stratum of state managers who sought to transform riotous energy into labor-power. This essay understands articles published in the Party’s newspaper, documents from its archive, and records of its community service practice as components of an ideological struggle which sought to reproduce anti-capitalist social relations on an extended scale. On the basis of this historical case study, the essay argues that the autonomy of radical social movement organizations from the state should be understood as a process rather than a status. It shows how social movements which view the state as an enemy can struggle in “close-quarters antagonism” within and against it. It situates this argument in relation to debates within the critical social sciences and state theory, and it considers the political and theoretical repercussions of this hypothesis for radical movements which confront the state apparatus of non-profit organizations today. (shrink)

Background Even though the traditional focus in emergency care is on life-threatening medical crisis, ambulance clinicians frequently encounter patients with mental illness, including suicidal ideation. A suicide is preceded by a complex process where most of the suicidal ideation is invisible to others. However, as most patients seek healthcare in the year before suicide, ambulance clinicians could have an important part to play in preventing suicide, as they encounter patients in different phases of the suicidal process. Aim The aim of (...) this study was to describe ambulance clinicians’ conceptions of responsibility when encountering patients in a suicidal process. Research design A qualitative inductive design using a phenomenographic approach was used. Participants and research context Twenty-seven ambulance clinicians from two regions in southern Sweden were interviewed. Ethical considerations The study was approved by the Swedish Ethical Review Authority. Findings Three categories of descriptions captured a movement from responding to a biological being to responding to a social being. Conventional responsibility was perceived as a primary responsibility for emergency care. In conditional responsibility, the patient’s mental illness was given only limited importance and only if certain conditions were met. Ethical responsibility was perceived to have its primary focus on the encounter with the patient and listening to the patient’s life story. Conclusions An ethical responsibility is favourable regarding suicide prevention in ambulance care, and competence development in mental illness and conversation skills could enable ambulance clinicians to have conversations with patients about suicidal ideation. (shrink)

In this article I claim that service-learning experiences, wherein students work directly with individuals in need—individuals from whom studentscan learn what they cannot learn elsewhere—are invaluable, and perhaps necessary, for any curriculum with an aim toward the development of ethical understanding, personal moral character and commitment, and/or conscientious citizenship, both local and global. My argument rests on Emmanuel Levinas’s philosophical ethical theory that re-envisions the ethical relation as arising out of revelation from the unique and precious Other, rather than (...) reason and the rational determinations and conceptions of the ethical agent. (shrink)

This research seeks an answer to the question of why spirituality is needed in social service. Providing spiritual support resources to the client in overcoming the problems that people face, coping with these problems, making sense of them, and reaching spiritual peace is called spiritually sensitive social service. It can be said that the history of social work is equivalent to the history of humanity. Therefore, especially in the West, the problems experienced in the modernization process, or the (...) dominant paradigm of the period (science-church conflict, rationalization and positivist approach to knowledge) brought a social service discipline and intervention, which was far from spirituality. It can be said that, in the last quarter of the 20th century, the lack of this approach was felt in the West and the studies on this field are accumulating today. In Turkey, there is an obvious gap in this literature. The problem of the present study is why there is a need for spiritually sensitive social service. The gap in the literature on this subject in Turkey indicates the importance of the study. The present study is of a descriptive method based on literature review. Social service is a career that aims to increase the functionality of individuals, families, groups, and societies at micro, mezzo, and macro levels and to strengthen them in overcoming their problems. Therefore, social service helps individuals to overcome problems arising from the individual issues and external factors and to meet resources with opportunities. It is obvious that it is difficult for a social service approach, which is distant from spiritual values, to find satisfactory answers to some of the questions and problems faced by individuals. It is clear that the understanding and practices of social service sensitive to spirituality will play an important role in helping clients overcome problems, make sense of them, and strengthen the individual. This study addresses the necessity of spiritually sensitive social service in four items: First, modern societies are under more threat and fear in comparison with the ones in the past. Therefore, they experience more anxiety, stress, and distrust. While the developments in technology and science offer great opportunities and conveniences to people, they have also manifested some problems that have not been experienced until today. Social service sensitive to spirituality will contribute to the separation of individuals, groups, and communities from the climate of fear they have experienced by activating their current cultural structure and world of belief. Second, modern lifestyle and individualization have isolated people by weakening people's social support systems. Modern lifestyle makes people to experience loneliness. The individualistic and self-centered lifestyle has alienated the individual from social ties and created a perception that one does not need anyone else. Social service that is sensitive to spirituality will increase the quality of life and joy of the individual by eliminating one’s loneliness and will help one to look to the future with hope and to overcome one’s loneliness. Third, human beings want to make sense of the events and problems they encounter. It would not be wrong to call the modern age "the age of the crisis of meaning". Today's people are experiencing serious crises in terms of making sense of the problems they face. Especially when faced with existential life-threatening factors such as severe illnesses, disability, and death, spirituality has a great impact on overcoming these problems and making sense of life. The efforts of individuals to rebuild the meaning they have lost can only be possible with the provision of social services sensitive to spirituality. Fourth, since the modern social service understanding is human-centered, holistic, and rights-based, the idea that people should be evaluated holistically highlights the necessity of spiritually sensitive social service. Experiencing a dizzying, diverse and, rapid change, today's people live in a complex network of relationships. The inaccuracy of the one-dimensional evaluation of human behavior is better understood today. The individual differences of the clients and their approaches to the problems make it necessary to evaluate the applications for these with a holistic and encompassing perspective. Therefore, the holistic evaluation of human also reveals the necessity of evaluating the spiritual social service within the framework of the rights arising from being human, not as a treat offered to individuals. (shrink)

This text aims to rethink educational activity inspired by the thought of the philosopher Ignacio Ellacuría, in what we have synthesised as a pedagogy of poverty. This should be understood as a pedagogy that, in the neoliberal context of Western societies, takes poverty as its motor—its efficient cause—and as its essence or fundamental structure—its formal cause –, in the duality of dimensions of its genitive. It is concretised in what is presented as Problem-Based Service-Learning (PB-SL). Through specific pedagogical guidelines (...) for implementing this methodology, this study indicates how the teaching action can show the learner what is immediate, what is not constructed, what consciousness does not establish but rather encounters: reality—weak, limited, imperfect, needy; in short, poor—as a problem and, in its deficiency and insufficiency, as a task towards which the subject has a responsibility. This reveals the fundamental anthropological structure to the learner: its intrinsic relational character—its reality as a being-in-a-suffering-world, who lives-with and lives-to save the needy who share its humanity. It is then possible to perceive the scale of the ultimate aim of PB-SL: the need to create the social conditions for a praxis that enables a dignification of reality. (shrink)

There is a pressing need to think the Heidegger affair. There are several states of urgency, and thus the affair is not the exclusive province of the political or politics. There is an urgency of thought.1A union of state and philosophy can make sense only if philosophy promises to be unconditionally useful to the state, that is to say, to set usefulness to the state higher than the truth. It would be splendid of course for the state if it also (...) had truth in its pay and service; but the state itself well knows that it is part of the essence of truth that it never accepts pay or stands in anyone's service. 2. (shrink)

In this article I claim that service-learning experiences, wherein students work directly with individuals in need—individuals from whom studentscan learn what they cannot learn elsewhere—are invaluable, and perhaps necessary, for any curriculum with an aim toward the development of ethical understanding, personal moral character and commitment, and/or conscientious citizenship, both local and global. My argument rests on Emmanuel Levinas’s philosophical ethical theory that re-envisions the ethical relation as arising out of revelation from the unique and precious Other, rather than (...) reason and the rational determinations and conceptions of the ethical agent. (shrink)

The topic of Ron Paterson’s book which was recently reviewed by Deborah Oyer only scratches the surface of a disturbing problem that is not confined to medicine, as health care delivery is a multidisciplinary experience for patients. I hear stories from patients about bullying dieticians, callous nurses, and institutions that espouse patient-centred care yet fail to deliver it to individuals who are unwell, worried, and vulnerable in an unfamiliar environment into which they have come for help. Maybe being conversant with (...) standard guidelines and care pathways for specific health conditions makes it too easy forget that, for individual patients, ill health is a unique experience within their life-world. It could and should be our default approach as clinicians (and ancillary personnel) to acknowledge the fundamental competence that patients bring to health service encounters and to help them comprehend their options and the ramifications of their preferences within their life-world. Unl. (shrink)

Academic dishonesty presents in different forms, including fabrication of data, falsifying references, multiple submissions, collusion, and sabotage, with two forms haunting academia, namely plagiarism and contract cheating or ghost writing. These latter forms have received considerable attention and have been subjects for research. This interview-based study provides some further insight into the problem of ghost writing through presenting the attitudes, justifications and networking practices of some hired ‘ghost-writers’ from a developing country and discusses the depth of this emerging threat to (...) the academic community.Initially, through simple internet searches using specific keywords, an array of professional advertisements selling contract writing services were identified. Some of these promotional advertisements were found in Facebook® posts, and/or Twitter® feeds. The second part of this study presents a summary of findings from interviews of a group of ghost-writers including their background, attitude and justifications for setting up this new business. The study identifies several high calibre post-graduates who have come to understand the Western (European/north American/australian) ways of scientific writing and have produced a network of ‘consultancy’ services. Although the birth of their business was ad-hoc, they have established a good network and are now able to share projects and practices. Many of them offer services to home and foreign students with varied levels of customer focus. Some of them are even using Turnitin© software to identify text matching issues. This study suggests that these paper mills have widely been subscribed to by students. The article finally discusses wider issues arising from these interviews and proposes some ways of tackling this new threat to academia. (shrink)

Background: International developments suggest that providing clinical ethics services to help clinicians negotiate ethical issues that arise in clinical practice is beneficial and reflects best practice in promoting high ethical standards and patient-centered care. The aim of this study was to explore the needs and experiences of clinical staff members to inform the development of future clinical ethics support. Methods: Health professionals at a large regional health service completed an online survey containing questions about the frequency of ethical and (...) legal issues encountered in clinical practice, the type of situations that gave rise to the ethical and/or legal uncertainty or concern, how clinicians currently address these issues, and what support would be welcome. Results: The survey was completed by 369 staff members, including 61% with more than 10 years in the profession and 51% in nursing/midwifery. Two-thirds (66%) indicated they often considered ethical implications of their clinical decisions, and half (49%) often considered the legal implications. More than half (58%) were often/occasionally concerned about the ethically right thing to do. Patient requests for borderline treatment (47%), staff disagreements about patient care (48%), and patients declining recommended treatment (54%) were the most frequent reasons given for ethical or legal uncertainty. Sixty-nine percent of respondents indicated that the way their department addressed ethical issues could be improved and 85% agreed that there is a need for more discussion on ethical issues. The majority (82%) of respondents had encountered ethically challenging clinical situations where additional support would have helped. Common approaches to issues were discussion with colleagues/supervisor (91.1%), discussion at handover/group forums (50.8%), and consultation with guidelines/protocols (60.9%). Conclusions: A majority of clinical staff members surveyed have encountered ethically/legally challenging cases daily for which they have often sought additional advice. This study indicates that many clinical staff members would welcome some form of additional clinical ethics support including advice and education. (shrink)

While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in (...) implementing system-wide ethics consultation services. Specifically, we identify four models for organizing, developing, and enhancing ethics consultation activities within a system created through acquisitions: train-the-trainer, local capacity-building, circuit-riding, and consolidated accountability. We note each model’s benefits and challenges. To our knowledge, this is the first paper to consider the broader landscape of issues affected by consolidation. We anticipate that clinical ethicists, volunteer consultants, and hospital administrators will benefit from our recommendations. (shrink)

Contemporary Christian ethics encounters the challenge to communicate genuinely Christian normative orientations within the scientific debate in such a way as to render these orientations comprehensible, and to maintain or enhance their plausibility even for non-Christians. This essay, therefore, proceeds from a biblical motif, takes up certain themes from the Christian tradition (in particular the idea of social justice), and connects both with a compelling contemporary approach to ethics by secular moral philosophy, i.e. with Axel Honneth's reception of Hegel, (...) as based on Hegel's theory of recognition. As a first step, elements of an ethics of recognition are developed on the basis of an anthropological recourse to the conditions of intersubjective encounters. These conditions are then brought to bear on the idea of social justice, as developed in the social-Catholic tradition, and as systematically explored in the Pastoral Letter of the United States Conference of Catholic Bishops, Economic Justice For All (1986). Proceeding from this basis, aspects of a Christian ethics of community service with regard to long-term care can be defined. (shrink)

While available to a multitude, routine health precautions and basic, nonspecialized medical services are lacking in many societies. This may in part be the outcome of attitudinal distortions, not only at the national and global levels, but fundamentally within the patient-physician encounter. Demands for a disturbance-free subsistence clash with values of power and control within health-care sub-systems resulting in an overall neglect of primary needs and a distribution of medical services that benefits select groups. True needs are misrepresented and an (...) intensification of particular services does not fulfill one''s duties toward those who realize little or no services at all. The entire institutional system of medicine requires a rebalancing of rights, intentions and outcomes, beginning with the correlative experiences of patient and physician. (shrink)

This paper's first goal is to evaluate the evolution and state of scholarship in public administration. It begins with a question: How far have public administration theory and research advanced since 1940, when the self-aware study of public administration, as a field if not a discipline, took root in the United States? This paper argues that scholars of public administration in the U.S. and abroad continuously advance the scientific rigor of research and are cognizant of the real-world challenges faced by (...) policymakers and public servants of all sorts. Nonetheless, it is further argued, there remains room for improving our scientific understanding of the public service in the twenty-first century. Turning to practice, the second section identifies how we might better link our scientific findings to the lessons we provide in the classroom. Finally, the paper concludes with a discussion on preparing the public service of the twenty-first century and beyond to manage some of the considerable challenges it will encounter. (shrink)

Although Emmanuel Levinas later expressed regret that he sided with Martin Heidegger rather than the more “ideal”-minded Ernst Cassirer in their 1929 Davos encounter, Cassirer’s philosophy of culture would never have been an apt framework for Levinas’s own project, which was always directed more to fundamental orientation than to formative activities or achievements. In “Meaning and Sense” (1964), Levinas conceived a totalizing cultural “meaning” as a foil to transcendent ethical “sense.” In a 1983 paper, however, he proposed an ethical conception (...) of culture. He could have developed this further using another element from “Meaning and Sense,” an ethical conception of work as service of the Other. The work-in-progress of culture combines pure ethics and implemented morality, pure command and consistent style, infinite vulnerability and actual power. (shrink)

Background: The concept of digital twins has great potential for transforming the existing health care system by making it more personalized. As a convergence of health care, artificial intelligence, and information and communication technologies, personalized health care services that are developed under the concept of digital twins raise a myriad of ethical issues. Although some of the ethical issues are known to researchers working on digital health and personalized medicine, currently, there is no comprehensive review that maps the major ethical (...) risks of digital twins for personalized health care services. Objective: This study aims to fill the research gap by identifying the major ethical risks of digital twins for personalized health care services. We first propose a working definition for digital twins for personalized health care services to facilitate future discussions on the ethical issues related to these emerging digital health services. We then develop a process-oriented ethical map to identify the major ethical risks in each of the different data processing phases. Methods: We resorted to the literature on eHealth, personalized medicine, precision medicine, and information engineering to identify potential issues and developed a process-oriented ethical map to structure the inquiry in a more systematic way. The ethical map allows us to see how each of the major ethical concerns emerges during the process of transforming raw data into valuable information. Developers of a digital twin for personalized health care service may use this map to identify ethical risks during the development stage in a more systematic way and can proactively address them. Results: This paper provides a working definition of digital twins for personalized health care services by identifying 3 features that distinguish the new application from other eHealth services. On the basis of the working definition, this paper further layouts 10 major operational problems and the corresponding ethical risks. Conclusions: It is challenging to address all the major ethical risks that a digital twin for a personalized health care service might encounter proactively without a conceptual map at hand. The process-oriented ethical map we propose here can assist the developers of digital twins for personalized health care services in analyzing ethical risks in a more systematic manner. (shrink)

Based on ethnographic fieldwork with panhandlers who provide services while asking for money, informal interviews with pedestrians who have interacted with them, and formal interviews with twenty people who regularly interact with panhandlers, this article unpacks the relationship between temporality and ambiguity of meaning in exchange. In line with previous research, I find that providing a service while asking for money allows panhandlers to manage stigma by recasting their relationship with pedestrians who give as a market exchange. More surprisingly, (...) I find that this kind of recasting makes giving less compelling for the pedestrians in fleeting encounters with panhandlers: they resist service provision in fleeting encounters with panhandlers on the grounds that the exchange is experienced as a coldly rational quid pro quo. In contrast, pedestrians who have long-term relationships with panhandlers experience the interaction as a gift exchange and the service as an expression of gratitude and subservience. The development of an open-ended temporal horizon and of a cycle of exchange, I argue, allows the service and the money given to operate as boundary objects, enabling panhandlers and pedestrians to attach different meanings to the exchange of money for services. This emergent ambiguity allows them to carry out interaction and exchange successfully. Contrary to models of interaction and everyday economic transactions that frame shared definitions of the situation as necessary for successful and repeated interactions, I find that ambiguity and polysemy may be productive and sustaining in interactions between participants from distinct social worlds. (shrink)

Transformative learning is a compelling approach to learning that is becoming increasingly popular in a diverse range of educational settings and encounters. This book reconceptualises transformative learning through an investigation of the learning process and outcomes of International Service-Learning, a pedagogical approach that blends student learning with community engagement overseas and the development of a more just society. Drawing upon key philosophers and theorists, Bamber offers an integrated, multi-dimensional approach, linking transformative learning to the development of the authentic (...) self, and analysing the aesthetic, moral and relational dimensions of ISL in an increasingly globalized world. Chapters explore rich empirical data to provide a timely framework and ethical ecology of transformative learning, detailing the challenges facing the approach, and how it can be embedded at the levels of practice, institutional ethos and partnership. Transformative Learning through International Service-Learning will appeal to academics, researchers, teachers, instructors and leaders in the fields of service-learning, international education, character education and in adult learning and education. It will also be of interest to practitioners working in international education, development education, volunteering, service-learning and community engagement. (shrink)

The purpose of this study is to investigate the incidence of service failure in rendering service process during COVID-19. It further explores the outcomes of service recovery offered to customers in case of service failure. Like other businesses, webstores have also faced the challenges in their efforts to satisfy their customers during COVID-19. Service failure has increased due to unexpected circumstances produced by this pandemic. It has become necessary for the webstores to retain their dissatisfied (...) customers by reconsidering their service strategies. Relevant data for the purpose of this study were collected through questionnaires from 383 respondents by using online channels. The online channels were exclusively employed for maintaining the safety of respondents during COVID-19. Respondents for this study were online shoppers who encountered service failure during COVID-19. The results indicated that the incidence of service failure has increased due to an increase in online shopping during COVID-19. Some customers tend to repurchase from the same webstore. On the other hand, some customers do not want to purchase again from the same seller and decided to switch to the alternative webstore. Based on the findings, new strategy for online shopping service providers was introduced. This strategy will be helpful for the online service providers to increase their profitability by retaining their dissatisfied customers. Service providers can minimize the number of customers switching to other webstores by reducing the events of service failure. Customer’s assistive intent can also be helpful for service providers to increase the efficiency of service recovery. Conducting a proper follow-up after providing service recovery can also reduce the switching of customer. It will be helpful for service providers to understand the customers’ expectations before recovery process and their feeling after getting service recovery. (shrink)

International medical travel occurs when patients cross national borders to purchase medical goods and services. On occasion, physicians in home countries will be the last point of domestic contact for patients seeking healthcare information before they travel abroad for care. When this is the case, physicians have a unique opportunity to inform patients about their options and help guide them towards ethical practices. This opportunity brings to the fore an important question: What role should physicians in more-developed home countries play (...) in promoting or constraining international medical travel towards less-developed destination countries? In our view, critical attention to the decision spaces of patients—defined by the personal circumstances, socio-cultural cues, and legal constraints that inform decision-making—is a useful starting point for evaluating the proper response of physicians to various forms of international medical travel. (shrink)

While available to a multitude, routine health precautions and basic, nonspecialized medical services are lacking in many societies. This may in part be the outcome of attitudinal distortions, not only at the national and global levels, but fundamentally within the patient-physician encounter. Demands for a disturbance-free subsistence clash with values of power and control within health-care sub-systems resulting in an overall neglect of primary needs and a distribution of medical services that benefits select groups. True needs are misrepresented and an (...) intensification of particular services does not fulfill one's duties toward those who realize little or no services at all. The entire institutional system of medicine requires a rebalancing of rights, intentions and outcomes, beginning with the correlative experiences of patient and physician. (shrink)

Background Ethical reasoning and sensitivity are always important in public health, but it is especially important in the sensitive and complex area of public health emergency preparedness. Here, we explored the ethical challenges, and dilemmas encountered by frontline health workers amid the coronavirus disease-19 (COVID-19) pandemic in Ethiopia. Methods A nationwide survey was conducted amongst the frontline health workers from nineteen public hospitals. Health workers were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive statistics. (...) Results Of the 285 frontline health workers to whom questionnaires were distributed, 217 of them gave their responses (response rate 76.1%). Respondents frequently reported encountering rationing dilemmas on health commodities directly used for the prevention and treatment of COVID-19. Most (83.9%) of the health workers agreed that they encountered ethical challenges very frequently or frequently. Almost all [215(99.1%)] claimed that the limitation of resources was directly used for the treatment and prevention of COVID-19. The frequency of difficulty in the provision of essential clinical services varied between 77% and 98.7% for different services. More than half of the study participants reported that they had encountered difficulty in the provision of clinical care on a daily or weekly basis. Regarding rationing strategies, isolating COVID-19 treatment units and limiting admission were the most frequent rationing strategies used by two-thirds of health workers on a daily or weekly basis. Conclusion Front-line health workers encountered numerous ethically challenging situations during COVID-19. More than half of health workers reported that they encountered ethical challenges in rationing the resources and delivery of different clinical services such as family planning services, maternal and childcare, immunization, and chronic care. With limited resources such as ventilators and hospital beds, healthcare providers have been faced with the difficult task of deciding who gets access to these resources and who doesn't. Overall, the COVID-19 pandemic has presented numerous ethical challenges for healthcare providers, highlighting the importance of ethical considerations in healthcare delivery. By being aware of these dilemmas and having policies in place to address them, healthcare providers can ensure that they are providing the best possible care to their patients while upholding ethical standards. (shrink)

Service failure is almost inevitable with the intensifying competition in the service market and expectation of heterogeneous customers. The customer–firm relationship can significantly influence customers’ subsequent attitudes and behaviors to the service provider when they encounter service failure. This study proposes a theoretical model to examine how customer-perceived dependence affects their forgiveness toward a service failure in attribution logic. According to an experiment with 138 and a survey with 428 commercial bank customers, we used a (...) multivariate approach to validate our model. The results show that relationship-valued dependence leads to external attribution, which is positively related to customer forgiveness. In contrast, switching-cost dependence leads to internal attribution, which is negatively related to customer forgiveness. The relationship length is a relevant contextual factor that acts as a negative moderating factor. Our study contributes to the service recovery literature by elucidating the underlying process of forgiveness with the presence of the customer–firm dependence relationship. (shrink)

Since the early 1980s, service management representatives have made an effort to distinguish service from manufacturing industries and highlight specific traits that characterize service industries. However, others have claimed that there is no need for such a distinction, and service would benefit from a clear technocratic thinking and standardization in order to improve quality, productivity and profitability. Service businesses are though personnel-intense and many encounters occur between managers, employees and customers. Using standards is not (...) enough for this endeavour and managers are important as role models. Instead, it is argued that managers need ‘proper’ education to be able to meet that which does not follow patterns of rational reasoning and action. Humanism is introduced as an important aspect of future management education. Humanism can prepare managers to meet with those unique conditions and demands characterizing the personnel- and encounter-intense service sector. (shrink)

A mobile service robot performing a task for its user might not be able to accomplish its mission without help from other people present in the shared environment. In previous research, collaborative control has been studied as an interactive mode of operation with a robot, compensating for its limitations in autonomy. However, few studies of robots requesting assistance by detecting potential collaborators, directing its attention to them, addressing them, and finally obtaining help from them, have previously been performed in (...) real-world use contexts. This study focuses on a fetch-and-carry robot, Cero, which has been designed to operate in an office environment as an aid for motion-impaired users. During its missions, the robot sometimes needs help with loading or unloading an object. The main question for the study was: under what conditions are people willing to help when requested to do so by the robot? We were particularly interested in bystanders, i.e. people who happened to be in the environment but who did not “have any official business” with the robot. To answer these questions and to provide a better understanding of human–robot help-seeking situations, we conducted an experimental study in which subjects who had not encountered our service robot before were requested to assist it with a task. The results of the study confirm that bystanders can to some degree be expected to help in robot missions, but that their willingness to help the robot depends on the situation and state of occupation that people are in when requested to interact with and assist the robot. (shrink)

A mobile service robot performing a task for its user might not be able to accomplish its mission without help from other people present in the shared environment. In previous research, collaborative control has been studied as an interactive mode of operation with a robot, compensating for its limitations in autonomy. However, few studies of robots requesting assistance by detecting potential collaborators, directing its attention to them, addressing them, and finally obtaining help from them, have previously been performed in (...) real-world use contexts. This study focuses on a fetch-and-carry robot, Cero, which has been designed to operate in an office environment as an aid for motion-impaired users. During its missions, the robot sometimes needs help with loading or unloading an object. The main question for the study was: under what conditions are people willing to help when requested to do so by the robot? We were particularly interested in bystanders, i.e. people who happened to be in the environment but who did not “have any official business” with the robot. To answer these questions and to provide a better understanding of human–robot help-seeking situations, we conducted an experimental study in which subjects who had not encountered our service robot before were requested to assist it with a task. The results of the study confirm that bystanders can to some degree be expected to help in robot missions, but that their willingness to help the robot depends on the situation and state of occupation that people are in when requested to interact with and assist the robot. (shrink)