Organizational ethics—defined as the alignment of an institution’s practices with its mission, vision, and values—is a growing field in health care not well characterized in empirical literature. To capture the scope and context of organizational ethics work in United States healthcare institutions, we conducted a nationwide convenience survey of ethicists regarding the scope of organizational ethics work, common challenges faced, and the organizational context in which this work is done. In this article, we report substantial variability in the structure (...) of organizational ethics programs and the settings in which it is conducted. Notable findings included disagreement about the activities that comprise organizational ethics and a lack of common metrics used to assess organizational ethics activities. A frequently cited barrier to full engagement in these activities was poor institution-wide understanding about the role and function of organizational ethics resources. These data suggest a tension in the trajectory of organizational ethics’ professionalization: while some variability is appropriate to the field’s relative youth, inadequate attention to definitions of organizational ethics practice and metrics for success can impede discussions about appropriate institutional support, leadership context, and training for practitioners. (shrink)

After the COVID-19 outbreak, the health status of the general population has suffered a huge threat, and the health system has also encountered great challenges. As critical members of human capital in the health sector, medical students with specialized knowledge and skills have positively fought against the epidemic by providing volunteer services that boosted the resilience of the health system. Although volunteer behavior is associated with individual internal motivation, there is sparse evidence on this relationship among medical students, especially regarding (...) potential mechanisms. Therefore, this study had two main objectives: to examine the influence of prosocial motivation of medical students on their VB; and to verify the chain-mediating role of calling and vocation as well as social responsibility in the relationship between PM and VB. Study I: a total of 2454 Chinese full-time medical students were invited to complete an online survey. Data analysis was performed using descriptive statistics, Pearson’s correlation coefficient, and multiple linear regression analysis. The results demonstrated that PM significantly affected VB in medical students ; CV as well as SR chain-mediated the relationship between PM and VB. PM promoted the formation of SR by positively evoking CV of medical students, further resulting in increased VB. Study II: A 28 person qualitative interview was conducted. Qualitative data are added to reduce the limitations of online questionnaires. At the same time, we can also critically study the VB of Chinese medical students during COVID-19. The results showed that there were various reasons for medical students to volunteer in the process of fighting against COVID-19, and the experience of volunteer service and the impact on their future life were different. Lastly, the current findings suggest that fostering volunteerism among medical students requires the joint effort of the government, non-profit organizations, and medical colleges. (shrink)

ObjectiveThere is little literature on the validity of kurtosis-adjusted noise energy metrics in human studies. Therefore, this study aimed to validate the application of cumulative noise exposure adjusted by kurtosis in evaluating occupational hearing loss associated with non-Gaussian noise among manufacturing workers.MethodsA cross-sectional survey was conducted on 1,558 manufacturing workers exposed to noise from five industries to collect noise exposure and hearing loss data. Both CNE and kurtosis-adjusted CNE were collapsed into 2-dB∙year bins, and the mean noise-induced permanent threshold (...) shifts at 3, 4, and 6 kHz in each bin were calculated. The contributions of CNE and CNE′ to noise-induced hearing loss were compared using the multiple linear regression. The degree of overlap of two linear regression equations was used to evaluate the validity of the CNE′ using a stratified analysis based on age and sex.ResultsMultiple linear regression models showed that after kurtosis adjustment, the standardized regression coefficient of CNE increased from 0.230 to 0.255, and R2 increased from 0.147 to 0.153. The linear relationship between NIPTS346 and CNE′ or CNE showed that the regression line of non-Gaussian noise was closer to that of Gaussian noise when using CNE′ than using CNE. The mean difference in NIPTS346 between the equations of non-Gaussian noise and Gaussian noise was significantly reduced from 4.32 to 1.63 dB HL after kurtosis adjustment. Through a stratified analysis, these significant decreases were observed in male and female workers, and workers aged ≥30 years old.ConclusionAs a noise exposure metric combining noise energy and temporal characteristics, the kurtosis-adjusted-CNE metric was more effective than CNE alone in assessing occupational hearing loss among manufacturing workers in non-Gaussian noise environment. However, more studies are needed to verify the validity of the kurtosis-adjusted-CNE metric. (shrink)

Every day, thousands of polls, surveys, and rating scales are employed to elicit the attitudes of humankind. Given the ubiquitous use of these instruments, it seems we ought to have firm answers to what is measured by them, but unfortunately we do not. To help remedy this situation, we present a novel approach to investigate the nature of attitudes. We created a self-transforming paper survey of moral opinions, covering both foundational principles, and current dilemmas hotly debated in the media. (...) This survey used a magic trick to expose participants to a reversal of their previously stated attitudes, allowing us to record whether they were prepared to endorse and argue for the opposite view of what they had stated only moments ago. The result showed that the majority of the reversals remained undetected, and a full 69% of the participants failed to detect at least one of two changes. In addition, participants often constructed coherent and unequivocal arguments supporting the opposite of their original position. These results suggest a dramatic potential for flexibility in our moral attitudes, and indicates a clear role for self-attribution and post-hoc rationalization in attitude formation and change. (shrink)

This article examines the relevance of survey data of scientists’ attitudes about science and values to case studies in philosophy of science. We describe two methodological challenges confronting such case studies: 1) small samples, and 2) potential for bias in selection, emphasis, and interpretation. Examples are given to illustrate that these challenges can arise for case studies in the science and values literature. We propose that these challenges can be mitigated through an approach in which case studies and (...) class='Hi'>survey methods are viewed as complementary, and use data from the Toolbox Dialogue Initiative to illustrate this claim. (shrink)

This article reports on a survey of the moral problems that Dutch nurses experience during their everyday practice. A questionnaire was developed, based on published literature, panel discussions, in-depth interviews and participation observations. The instrument was tested in a pilot study and proved to be useful. A total of 2122 questionnaires were sent to 91 institutions in seven different health care settings. The results showed that nurses were not experiencing important societal issues such as abortion and euthanasia as morally (...) the most problematic, but rather situations such as verbally aggressive behaviour of colleagues towards patients, keeping silent about errors, and medical treatment given against the wishes of patients. Moral problems occurred especially when nurses experienced feelings of powerlessness with regard to the well-being of patients. Moreover, these moral problems proved to be related to institutional organization, leadership, and collaboration with colleagues and other disciplines. Nurses appeared to have a limited awareness of the moral dimensions of their practice. (shrink)

Purpose: Explore public attitudes towards the trade-offs between justice and medical outcome inherent in organ allocation decisions.Background: The US Task Force on Organ Transplantation recommended that considerations of justice, autonomy and medical outcome be part of all organ allocation decisions. Justice in this context may be modeled as a function of three types of need, related to age, clinical urgency, and quality of life.Methods: A web-based survey was conducted in which respondents were asked to choose between two hypothetical patients (...) who differed in clinical urgency , age, pretransplant and post-transplant quality of life, and life expectancy.Results: A pool of 1600 people were notified via email about the survey; 623 responded. Respondents preferred giving organs to younger people up to an age difference of <15.4 years and more clinically urgent people up to a difference in urgency of <2.54 months . Priority varied with the quality of life of the worst-off patient and the relative status of the patients. If both had worse than average quality of life, respondents preferred the better-off patient. When both had better than average quality of life, they preferred the worse-off patient. In analysis according to age versus clinical urgency, the older the patient, the more urgency needed to receive priority. In quality of life versus clinical urgency, the better the control’s quality of life, the more urgency the competing patient required. The worse the patient’s post-transplant outcome, the more urgency needed to receive priority.Conclusions: It appears that clinical urgency is only one of many factors influencing attitudes about allocation decisions and that respondents may invoke different principles of fairness depending the relative clinical status of patients. (shrink)

This article reports results of a survey about employment and compensation models for clinical ethics consultants working in the United States and discusses the relevance of these results for the professionalization of clinical ethics. This project uses self-reported data from healthcare ethics consultants to estimate compensation across different employment models. The average full-time annualized salary of respondents with a clinical doctorate is $188,310.08 (SD=$88,556.67), $146,134.85 (SD=$55,485.63) for those with a non-clinical doctorate, and $113,625.00 (SD=$35,872.96) for those with a masters (...) as their highest degree. Pay differences across degree level and type were statistically significant (F = 3.43; p. (shrink)

A needs assessment survey of ethics review committees (ERCs) across Africa was conducted in order to establish their major needs and areas of weaknesses in terms of ethical review capacity. The response rate was 84% (31 of 37 targeted committees), and committees surveyed were located in 18 African countries. The majority of the responding committees (61%) have been in existence between 5 and 10 years; approximately 74% of the respondents were institutional committees, with the remainder being either national (6/31) (...) or regional (2/31). In terms of the ethical review process, nine of the 31 committees that responded did not have standard operating procedures (SOPs), and seven of the 22 that did have SOPs had never revised them after their initial development (an average period of three years). Of the 31 committees, 10 operated without any ethical guidelines. Many of the committees (13/30) met once per month, and the number of proposals reviewed annually varied, ranging from five to over 100. All respondents relied on paper-based data management and archiving systems. Overall, the survey identified the major constraints on ERCs as lack of office equipment, outdated or lack of SOPs, lack of electronic data management systems, inadequate resources, lack of or insufficient expertise on the committees, and poor recognition of the importance of the role of the committees. Consequently, the authors are addressing the identified needs and weaknesses through the Bill and Melinda Gates Foundation-funded capacity building project. The impact of the intervention project will be assessed during and at the end of the four-year longitudinal project. (shrink)

The ArgumentA survey of 2901 genetics professionals in 36 nations suggests that eugenic thought underlies their perceptions of the goals of genetics and that directiveness in counseling after prenatal diagnosis leads to individual decisions based on pessimistically biaed information, especially in developing nations of Asia and Eastern Europe. The “non-directive counseling” found in English-speaking nations is an aberration from the rest of the world. Most geneticists, except in China, rejected government involvement in premarital testing or sterilization, but most also (...) held a pessimistic view of persons with genetic disabilities. Individual, but not state-coerced, eugenics survives in much modern genetic practice. (shrink)

To determine the knowledge, attitudes and practices regarding organ donation in a selected adult population in Pakistan.

BackgroundResuscitation and treatment of critically ill newborn infants is associated with relatively high mortality, morbidity and cost. Guidelines relating to resuscitation have traditionally focused on the best interests of infants. There are, however, limited resources available in the neonatal intensive care unit, meaning that difficult decisions sometimes need to be made. This study explores the intuitions of lay people regarding resource allocation decisions in the NICU.MethodsThe study design was a cross-sectional quantitative survey, consisting of 20 hypothetical rationing scenarios. There (...) were 119 respondents who entered the questionnaire, and 109 who completed it. The respondents were adult US and Indian participants of the online crowdsourcing platform Mechanical Turk. Respondents were asked to decide which of two infants to treat in a situation of scarce resources. Demographic characteristics, personality traits and political views were recorded. Respondents were also asked to respond to a widely cited thought experiment involving rationing.ResultsThe majority of respondents, in all except one scenario, chose the utilitarian option of directing treatment to the infant with the higher chance of survival, higher life expectancy, less severe disability, and less expensive treatment. As discrepancy between outcomes decreased, however, there was a statistically significant increase in egalitarian responses and decrease in utilitarian responses in scenarios involving chance of survival, life expectancy, and cost of treatment. In the classic ‘lifeboat’ scenario, all but two respondents were utilitarian.ConclusionsThis survey suggests that in situations of scarcity and equal clinical need, non-health professionals support rationing of life-saving treatment based on probability of survival, duration of survival, cost of treatment or quality of life. However, where the difference in prognosis or cost is very small, non-health professionals preferred to give infants an equal chance of receiving treatment. (shrink)

The prevalence and characteristics of research misconduct have mainly been studied in highly developed countries. In moderately or poorly developed countries such as Croatia, data on research misconduct are scarce. The primary aim of this study was to determine the rates at which scientists report committing or observing the most serious forms of research misconduct, such as falsification, fabrication, plagiarism, and violation of authorship rules in the Croatian scientific community. Additionally, we sought to determine the degree of development and the (...) extent of implementation of the system for defining and regulating research misconduct in a typical scientific community in Croatia. An anonymous questionnaire was distributed among 1232 Croatian scientists at the University of Rijeka in 2012/2013 and 237 returned the survey. Based on the respondents who admitted having committed research misconduct, 9 admitted to plagiarism, 22 to data falsification, 9 to data fabrication, and 60 respondents admitted to violation of authorship rules. Based on the respondents who admitted having observed research misconduct of fellow scientists, 72 observed plagiarism, 69 observed data falsification, 46 observed data fabrication, and 132 respondents admitted having observed violation of authorship rules. The results of our study indicate that the efficacy of the system for managing research misconduct in Croatia is poor. At the University of Rijeka there is no document dedicated exclusively to research integrity, describing the values that should be fostered by a scientist and clarifying the forms of research misconduct and what constitutes a questionable research practice. Scientists do not trust ethical bodies and the system for defining and regulating research misconduct; therefore the observed cases of research misconduct are rarely reported. Finally, Croatian scientists are not formally educated about responsible conduct of research at any level of their formal education. All mentioned indicate possible reasons for higher rates of research misconduct among Croatian scientists in comparison with scientists in highly developed countries. (shrink)

The particular dynamics of public health emergencies urge scientists and Ethics Committee (EC) members to change and adapt their operating procedures to function effectively. Despite having previous pandemic experiences, ethics committees were unprepared to adapt to COVID-19 pandemic challenges. This survey aims to learn and thoroughly discuss the most salient issues for ECs during the COVID-19 pandemic. The results indicate that the main problems faced by ECs were lack of/insufficient regulations, lack of data/experience/knowledge, sloppy review, poor research design, and (...) poor adaptation to quarantine measures. Coping with factors that threaten the autonomy and independence of ECs, the ethical dilemma regarding maximizing common good versus protecting the rights and well-being of study participants, comprehending the change in the context of vulnerable populations, and redefining the role of ECs to strengthen trust in science and vaccine confidence were outstanding issues. (shrink)

To explore social media use in New Zealand, a sample of 1001 adults aged 18 and over were surveyed in November 2021. Participants were asked about the frequency of their use of different social media platforms (text message included). This report describes how often each of the nine social media sites and apps covered in the survey are used individually on a daily basis. Differences based on key demographics, i.e., age and gender, are tested for statistical significance, and findings (...) summarised. (shrink)

This article reports on a survey of the moral problems that Dutch nurses experience during their everyday practice. A questionnaire was developed, based on published literature, panel discussions, in-depth interviews and participation observations. The instrument was tested in a pilot study and proved to be useful. A total of 2122 questionnaires were sent to 91 institutions in seven different health care settings. The results showed that nurses were not experiencing important societal issues such as abortion and euthanasia as morally (...) the most problematic, but rather situations such as verbally aggressive behaviour of colleagues towards patients, keeping silent about errors, and medical treatment given against the wishes of patients. Moral problems occurred especially when nurses experienced feelings of powerlessness with regard to the well-being of patients. Moreover, these moral problems proved to be related to institutional organization, leadership, and collaboration with colleagues and other disciplines. Nurses appeared to have a limited awareness of the moral dimensions of their practice. (shrink)

BackgroundConcerns about research misbehavior in academic science have sparked interest in the factors that may explain research misbehavior. Often three clusters of factors are distinguished: individual factors, climate factors and publication factors. Our research question was: to what extent can individual, climate and publication factors explain the variance in frequently perceived research misbehaviors?MethodsFrom May 2017 until July 2017, we conducted a survey study among academic researchers in Amsterdam. The survey included three measurement instruments that we previously reported individual (...) results of and here we integrate these findings.ResultsOne thousand two hundred ninety-eight researchers completed the survey. Results showed that individual, climate and publication factors combined explained 34% of variance in perceived frequency of research misbehavior. Individual factors explained 7%, climate factors explained 22% and publication factors 16%.ConclusionsOur results suggest that the perceptions of the research climate play a substantial role in explaining variance in research misbehavior. This suggests that efforts to improve departmental norms might have a salutary effect on behavior. (shrink)

Concerns that cash payments to people who inject drugs (PWID) to reimburse research participation will facilitate illicit drug purchases have led some ethical authorities to mandate department store/supermarket vouchers as research reimbursement. To examine the relative efficacy of the two forms of reimbursement in engaging PWID in research, clients of two public opioid substitution therapy clinics were invited to participate in a 20–30 min, anonymous and confidential interview about alcohol consumption on two separate occasions, 4 months apart. Under the crossover (...) design, at Time 1, clients of Clinic 1 were offered $A20 cash as reimbursement, while clients of Clinic 2 were offered an $A20 voucher; at Time 2, the form of reimbursement was reversed. Using clinic records to determine the denominator (number of clients dosed), we found that compared with clients offered a voucher, a significantly higher proportion of clients who were offered cash participated in the survey (58% (139/241) vs 74% (186/252); χ2=14.27; p=0.0002). At first participation, respondents most commonly reported planning to purchase food/drinks/groceries (68%), cigarettes (21%) and transport/fuel (11%) with their payments, with those reimbursed in cash more likely to report planning to fund transport/fuel (19% vs 1%; p<.01) and less likely to report planning to purchase food/drinks/groceries (62% vs 76%; p=0.02). Just three out of 155 cash participants reported planning to purchase illicit drugs with their payment. Results demonstrate that modest cash payments enhanced recruitment of this group, an important consideration given the challenges of delineating the parameters of a population defined by illegal activity, seemingly without promoting excessive additional drug use. (shrink)

Low levels of public trust in data practices have led to growing calls for changes to data-driven systems, and in the EU, the General Data Protection Regulation provides a legal motivation for such changes. Data management is a vital component of data-driven systems, but what constitutes ‘good’ data management is not straightforward. Academic attention is turning to the question of what ‘good data’ might look like more generally, but public views are absent from these debates. This paper addresses this gap, (...) reporting on a survey of the public on their views of data management approaches, undertaken by the authors and administered in the UK, where departure from the EU makes future data legislation uncertain. The survey found that respondents dislike the current approach in which commercial organizations control their personal data and prefer approaches that give them control over their data, that include oversight from regulatory bodies or that enable them to opt out of data gathering. Variations of data trusts – that is, structures that provide independent stewardship of data – were also preferable to the current approach, but not as widely preferred as control, oversight and opt out options. These features therefore constitute ‘good data management’ for survey respondents. These findings align only in part with principles of good data identified by policy experts and researchers. Our findings nuance understandings of good data as a concept and of good data management as a practice and point to where further research and policy action are needed. (shrink)

Based on the 2017 China General Social Survey data, with 5,439 observations as research objects, this paper empirically tests the impact of flexible employment on workers’ wellbeing and introduces labor income as mediator and social security as moderator to explore the mechanism of action. The empirical results show that: flexible employment has an inverted U-shaped relationship with workers’ wellbeing, which indicates that increasing employments’ flexibility will first rise and then reduce their perceived subjective wellbeing after reaching the peak; labor (...) income plays a mediating role in the relationship of flexible employment and wellbeing of workers; social security moderates the mediating effect of labor income whereas the moderating role in the relationship between flexible employment and workers’ wellbeing is not observed. Implications and future development of flexible employment are discussed. (shrink)

In Japan, discussion concerning advance directives (ADs) has been on the rise during the past decade. ADs are one method proposed to facilitate the process of communication among patients, families and health care providers regarding the plan of care of a patient who is no longer capable of communicating. In this paper, we report the results of the first in-depth survey on the general population concerning the preferences and use of ADs in Japan. A self-administered questionnaire was sent via (...) mail to a stratified random sampling of 560 residents listed in the residential registry of one district of Tokyo, Japan (n = 165,567). Association between correlating factors and specific preferences toward ADs was assessed using contingency table bivariate analysis and multivariate regression model to estimate independent contribution. Of the 560 questionnaires sent out, a total of 425 participants took part in the survey yielding a response rate of 75.9 %. The results of the present study indicate that: 1) the most important components to be addressed are the specifics of medical treatment at the end of life stage and disclosure of diagnosis and prognosis; 2) the majority of participants found it suitable to express their directives by word to family and/or physician and not by written documentation; 3) there is no strong need for legal measures in setting up an AD; 4) it is permissible for family and physician to loosely interpret one's directives; 5) the most suitable proxy is considered to be a family member, relative, or spouse. Multivariate analysis found the following five factors as significantly associated with preferences: 1) awareness regarding living wills, 2) experience with the use of ADs, 3) preferences for end-of-life treatment, 4) preferences for information disclosure, and 5) intentions of creating a will. Written ADs might be useful in the Japanese setting when the individual either wishes: 1) to not provide a lot of leeway to surrogates and/or caregivers, and/or 2) to ensure his or her directives in the cases of terminal illness, brain death, and pain treatment, as well as regarding information disclosure. (shrink)

The Fibromyalgia Survey Questionnaire was self-administered by a sample of 207 Italian individuals with obesity to screen for fibromyalgia. We aimed to investigate the inter-rater reliability and the agreement in the detection of FM symptomatology between the self-administered FSQ and the clinical interview conducted by a rheumatologist. All the patients were divided randomly into two groups : a rheumatologist first interviewed patients of group A and after 48 h, the patients completed the self-report FSQ. Patients of group B first (...) completed the FSQ and 48 h later were interviewed by a rheumatologist. The agreement between the measurements was good with the Bland-Altman analysis showing low bias scores for the two subscales of the FSQ. Results showed that 33% of the sample satisfied the criteria for a diagnosis of fibromyalgia. The FSQ is a self-reporting measure that showed substantial reliability providing fast screening for FM symptomatology. (shrink)

The literature fails to reflect general agreement over the nature of the services and procedures provided by bioethicists, and the training and core competencies this work requires. If bioethicists are to define their activities in a consistent way, it makes sense to look for common ground in shared communities of practice. We report results of a survey of the services and procedures among bioethicists affiliated with the University of Toronto Joint Centre for Bioethics (JCB). This is the largest group (...) of bioethicists working in healthcare organizations in Canada. The results suggest there are many common services and procedures of JCB bioethicists. This survey can serve as a baseline for further exploration of the work of JCB bioethicists. Common practices exist with respect to the domains of practice, individual reporting relationships, service availability within business hours and the education and training of the bioethicist. (shrink)

This study examines the influence of some suspected sources of bias on perceptions of public sector corruption. These sources include dependence on two types of media as information sources about corruption: traditional and social media, positive perception of public employees, and social identification with public employees. Data were collected through a face-to-face survey of the general public in South Korea. The sample comprised 472 respondents evenly dispersed across the country. Through regression analysis, we found that dependence on traditional media—but (...) not social media—significantly increased the perceived level of corruption. However, positive perceptions of and social identification with public employees were negatively associated with it, showing that these factors may skew respondents' perceptions of corruption. The results have implications for practitioners and researchers who design, implement, or evaluate anti-corruption policies, suggesting the need for caution when making use of survey results. (shrink)

States began passing legislation mandating the collection of genetic material from certain convicted offenders in 1988. By 1998, all 50 states had passed laws allowing DNA databases for convicted sexual offenders, and some states collected DNA from all those convicted of a felony. A survey of 416 persons in Maryland revealed wide support for the inclusion of convicted violent offenders (89%) in DNA databases, in sync with most states’ policies. Between two thirds and three quarters of respondents also supported (...) expanding DNA databases to include those suspected of a violent offense, any convicted felon, as well as all convicted offenders, minor and major. Support for collecting the DNA of those suspected of any crime and for all newborns was considerably less (44% to 45%). Although a comprehensive database is most effective for solving and deterring crimes, vigorously enforced protections against abuse of this technology must be in place. (shrink)

This paper consists primarily of a survey of results of Harvey Friedman about some proof-theoretic aspects of various forms of Kruskal's tree theorem, and in particular the connection with the ordinal Γ0. We also include a fairly extensive treatment of normal functions on the countable ordinals, and we give a glimpse of Verlen hierarchies, some subsystems of second-order logic, slow-growing and fast-growing hierarchies including Girard's result, and Goodstein sequences. The central theme of this paper is a powerful theorem due (...) to Kruskal, the ‘tree theorem’, as well as a ‘finite miniaturization’ of Kruskal's theorem due to Harvey Friedman. These versions of Kruskal's theorem are remarkable from a proof-theoretic point of view because they are not provable in relatively strong logical systems. They are examples of so-called ‘natural independence phenomena’, which are considered by most logicians as more natural than the metamathematical incompleteness results first discovered by Gödel. Kruskal's tree theorem also plays a fundamental role in computer science, because it is one of the main tools for showing that certain orderings on trees are well founded. These orderings play a crucial role in proving the termination of systems of rewrite rules and the correctness of Knuth-Bendix completion procedures. There is also a close connection between a certain infinite countable ordinal called Γo and Kruskal's theorem. Previous definitions of the function involved in this connection are known to be incorrect, in that, the function is not monotonic. We offer a repaired definition of this function, and explore briefly the consequences of its existence. (shrink)

Background: Hospital nurses are frequently the first care givers to receive a patient’s request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses’ opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. Methods: A phone survey conducted among a random national sample of (...) 1502 French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Results: Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Conclusions: Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call “good” euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia. (shrink)

This study examined how different components of working memory are involved in the acquisition of egocentric and allocentric survey knowledge by people with a good and poor sense of direction (SOD). We employed a dual-task method and asked participants to learn routes from videos with verbal, visual, and spatial interference tasks and without any interference. Results showed that people with a good SOD encoded and integrated knowledge about landmarks and routes into egocentric survey knowledge in verbal and spatial (...) working memory, which is then transformed into allocentric survey knowledge with the support of all three components, distances being processed in verbal and spatial working memory and directions in visual and spatial working memory. In contrast, people with a poor SOD relied on verbal working memory and lacked spatial processing, thus failing to acquire accurate survey knowledge. Based on the results, a possible model for explaining individual differences in spatial knowledge acquisition is proposed. (shrink)

In recent decades, the general public has become increasingly receptive toward a legislation that allows active voluntary euthanasia. The purpose of this study was to survey the current attitude towards AVE within the Austrian population and to identify explanatory factors in the areas of socio-demographics, personal experiences with care, and ideological orientation. A further objective was to examine differences depending on the type of problem formulation for the purpose of measuring attitude.

Since 2010, the European Journal of Anaesthesiology has required the reporting of five items concerning ethical approval in articles describing human research: ethics committee’s name and address, chairperson’s name, study’s protocol number and approval date. We aimed to assess whether this requirement has helped to identify and to contact the referenced ethics committees. In this cross-sectional study, we analysed articles requiring ethical approval, according to the Swiss federal law for human research and published in the European Journal of Anaesthesiology in (...) 2011. Ethics committees were searched through our institutional Internet access based on information provided in the articles. The last search was performed in November 2015. Numbers of items reported, of ethics committees identified, and of those that confirmed having provided ethical approval are reported. Of 76 articles requiring ethical approval, 74 declared it. Ethics committees’ names and addresses were mentioned in 63/74, protocol numbers in 51/74, approval dates in 48/74, and chairpersons’ names in 45/74. We could identify 44/74 committees; 36/74 answered our inquiry and 24/74 confirmed their role. Thirty-four of 74 articles reported all five items; in 25/34, we were able to identify an ethics committee, 18/34 answered our inquiry, and 15/34 confirmed their role. Forty of 74 articles reported ≤4 items; in 19/40, we were able to identify an ethics committee, 18/40 answered our inquiry, and 9/40 confirmed their role. Reporting five items significantly increased identification of ethics committees and their confirmation of ethical approval. Twelve of 74 ethics committees were unable to confirm their role in approving the study. Even when details concerning ethical approval were reported in these studies of human research, we were unable to identify almost half of the ethics committees concerned. The reporting of five items, compared with reporting ≤4, was associated with facilitated identification of ethics committees, and increased the likelihood that they would be able to confirm the study’s approval. Future research should identify which information facilitates identification of, and contact with, ethics committees. (shrink)

This first-of-its-kind national survey of 485 psychiatrists in nine states and the District of Columbia finds substantial evidence of clinicians being uninformed, misinformed, and misinforming patients of their gun rights regarding involuntary commitments and voluntary inpatient admissions. A significant percentage of psychiatrists did not understand that an involuntary civil commitment triggered the loss of gun rights, and the majority of psychiatrists in states with prohibitors on voluntary admissions and emergency holds were unaware that patients would lose gun rights upon (...) voluntary admission or temporary commitment. Moreover, the survey found evidence that psychiatrists may use gun rights to negotiate “voluntary” commitments with patients: 15.9% of respondents reported telling patients they could preserve their gun rights by permitting themselves to be voluntarily admitted for treatment, in lieu of being involuntarily committed. The results raise questions of whether psychiatrists obtained full informed consent for voluntary patient admissions, and suggest that some medical providers in states with voluntary admission prohibitor laws may unwittingly deprive their patients of a constitutional right. The study calls into question the fairness of state prohibitor laws as policy, and — at minimum — indicates an urgent need for psychiatrist training on their state gun laws. (shrink)

Background Little is known about the attitudes and practices of intensivists working in Lebanon regarding withholding and withdrawing life-sustaining treatments. The objectives of the study were to assess the points of view and practices of intensivists in Lebanon along with the opinions of medical, legal and religious leaders regarding withholding withdrawal of life-sustaining treatments in Lebanese intensive care units. Methods A web-based survey was conducted among intensivists working in Lebanese adult ICUs. Interviews were also done with Lebanese medical, legal (...) and religious leaders. Results Of the 229 survey recipients, 83 intensivists completed it, i.e. a response rate of. Most respondents were between 30 and 49 years old, Catholic Christians, anesthesiologists, working in Beirut. Ninety-two percent of them were familiar with the withholding and withdrawal concepts and 80% applied them. Poor prognosis of the acute and chronic disease and futile therapy were the main reasons to consider withholding and withdrawal of treatments. Ninety-five percent of intensivists agreed with the “Principle of Double Effect”. The main withheld therapies were vasopressors, respiratory assistance and CPR. Most of the respondents reported the decision was often to always multidisciplinary, involving the family, and the patient, or his advance directives or his surrogate and the nurses. The interviewees agreed there was a law governing withholding and withdrawal decisions/practices in Lebanon. Christians and Muslim Sunni leaders declared accepting those practices. Conclusion Withholding and withdrawal of LSTs in the ICU are known concepts among intensivists working in Lebanon and are being practiced. Our results could be used to inform and optimize therapeutic limitation in ICUs in the country. (shrink)

Summary This paper reports on the perspectives of elite athletes on anti-doping work in general and on the whereabouts system in particular, and uses a figurational perspective to explore the unintended consequences of the planned introduction of the whereabouts system. A cross-sectional survey of all the athletes in the Norwegian registered testing pool was carried out in 2006, using a structured questionnaire. Overall, 70.6% of the athletes agreed that doping was a problem in elite sport in general, but paradoxically (...) only 17.5% agreed that doping was a problem in their own sport. However, more than four in ten of the athletes agreed that the whereabouts information system made a contribution to a “cleaner” sport. Some athletes thought the system was unfair. The whereabouts information system had, despite all good intentions, outcomes other than those planned and intended by the WADA. Thus, athletes’ views might fruitfully be integrated with other perspectives when anti-doping work is developed further. (shrink)

Objectives: To examine the perspectives of journal editors and authors on overlapping and redundant publications in clinical research.Design: Pretested cross-sectional survey, containing both forced choice and open ended questions, administered by mail to the senior editors and one randomly selected author from all journals in the Abridged Index Medicus that published clinical research.Main measurements: The views of editors and authors about the extent of redundant publications, why they occur, how to prevent and respond to cases, and when the publication (...) of overlapping manuscripts is justified.Results: Seventy two per cent of editors and 65% of authors completed the survey. There was consensus between both groups that redundant publications occur because authors feel the pressure to publish and journals do not do enough to publicise, criticise, and punish cases, and that the publication of most types of overlapping articles is unacceptable. Sixty seven per cent of authors but only 31% of editors felt, however, that it was justified to publish an overlapping article in a non-peer reviewed symposium supplement, and 68% of editors but 39% of authors supported imposing restrictions on guilty authors’ future submissions. In written comments, 15% to 30% of both groups emphasised that it was justified to publish overlapping articles when there were different or non-English-speaking audiences, new data, strengthened methods, or disputed findings.Conclusions: Editors, authors, and other academic leaders should together develop explicit guidelines that clarify points of contention and ambiguity regarding overlapping manuscripts. (shrink)

This paper examines the planning, execution, and closure of the US–Korea Cooperative Ecological Survey project in the Korean Demilitarized Zone in the 1960s. In this period, the U.S. National Academy of Sciences initiated bilateral scientific cooperation between the NAS and similar organizations in developing countries along the line of the developmental turn of U.S. foreign assistance. Working closely with the NAS, U.S. conservationists used this scheme to introduce nature conservation practices and the discipline of ecosystem ecology to developing countries. (...) In this context, by way of the NAS’s Pacific Science Board, two countries’ biologists initiated the preliminary cooperative project in the DMZ in 1966. Korean and U.S. scientists soon began to realize that their collaboration was marked by dissonance. The U.S. side attributed the cooperation failure to Korean culture while the Korean side criticized the unequal structure of their cooperation. Joining the global historiography of Cold War scientific collaboration, this paper pays particular attention to the intermediaries of the collaborative project and their rivalry. It argues that political struggles revolving around the position of go-betweens – as what I call knowledge brokers – on the recipient side provoked contestation between American and Korean scientists. The contention between the two sides played out in the collaboration coming to an end, albeit partially. Throughout this analysis, this study suggests paying more serious attention to the politics of scientific exchange among actors on the recipient side as an outset from which to analyze the heterogeneity of the Korean side without losing sight of their active role in the building process of American hegemony. (shrink)