Journal articles on the topic 'Investments Moral and ethical aspects Decision making'
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Lin, Yu-Cheng, Chiung-Yao Huang, and Yu-Shan Wei. "Perfectionist decision-making style and ethical investment willingness." Management Decision 56, no. 3 (March 12, 2018): 534–49. http://dx.doi.org/10.1108/md-05-2017-0492.
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Purpose The purpose of this paper is to examine the ethical investment willingness decision-making process to understand how investors evaluate corporate social responsibility (CSR) actions. Design/methodology/approach Data were collected through a survey of 298 individual investors and analyzed using structural equation modeling. Findings Results reveal that perfectionist decision-making style is positively related to perceived moral intensity, substitutability of financial returns, and ethical investment willingness. In addition, perceived moral intensity and substitutability of financial returns are positively related to ethical investment willingness. Finally, perceived moral intensity is positively related to substitutability of financial returns, and a two-factor causal mediation model is supported. Research limitations/implications The limitation of this study was that the pre-tests and sampling methods required all participants to have investing experience; however, procurement of trading information for each investor was impossible; thus, actual investment behaviors were undetermined. This study shed light on the mediating roles of perceived moral intensity and the substitutability of financial returns. Future studies can further investigate the factors influencing perceived moral intensity and the substitutability of financial returns. Practical implications Future ethical investment education can focus on cultivate the ability to distinguish ethical investments and change ethical investment willingness into actual investment behavior. Originality/value Understanding the relationship between these variables can help understand why ethical investment willingness varies among investors and how the traditional financial theory investment decision model should be revised as, internationally, more people have begun to observe CSR and sustainable development.
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Bingham, Sarah-Louise. "Refusal of treatment and decision-making capacity." Nursing Ethics 19, no. 1 (January 2012): 167–72. http://dx.doi.org/10.1177/0969733011431925.
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This article explores refusal of medical treatment by adult patients from ethical and legal perspectives. Initially, consequentialist and deontological ethical theory are outlined. The concepts of autonomy, paternalism and competence are described and an overview of Beauchamp and Childress’s principle-based approach to moral reasoning is given. Relevant common law is discussed and the provisions of the Mental Capacity Act 2005 in assessing competence is evaluated. In order to demonstrate the consideration of moral issues in clinical practice, ethical theory is applied to two well-known incidents: the case of Re MB, where doubt over decision-making capacity led to a paternalistic act to override a patient’s choice; and the death of Emma Gough, a situation where respect for autonomy prevailed when healthcare staff acted lawfully in following a patient’s refusal of life-saving treatment. Finally, guidance from regulatory bodies on the roles and responsibilities of health professionals in relation to this topic are considered.
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Kucukkelepce, Gulhan Erkus, Leyla Dinc, and Melih Elcin. "Effects of using standardized patients on nursing students’ moral skills." Nursing Ethics 27, no. 7 (July 30, 2020): 1587–602. http://dx.doi.org/10.1177/0969733020935954.
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Background: Nurses and nursing students increasingly confront ethical problems in clinical practice. Moral sensitivity, moral reasoning, and ethical decision-making are therefore important skills throughout the nursing profession. Innovative teaching methods as part of the ethics training of nursing students help them acquire these fundamental skills. Aim: This study investigated the effects and potential benefits of using standardized patients in ethics education on nursing baccalaureate students’ moral sensitivity, moral reasoning, and ethical decision-making by comparing this method with in-class case analyses. Research design: This is a quasi-experimental study. Participants and research context: The sample comprised 89 students in Hacettepe University’s Faculty of Nursing. Following lectures describing the theoretical components of ethics, students were randomly assigned to two working groups, one using standardized patients and the other using in-class case analyses. Data were collected using the Moral Sensitivity Questionnaire, Rest’s Defining Issues Test, and the Nursing Dilemma Test. All data were analysed using IBM SPSS Statistics Version 23. Ethical considerations: Ethical approval and official permission were obtained. All participating students completed informed consent forms. Findings: According to the results, the moral sensitivity of students in the standardized patient group significantly improved over time compared to those in the case analysis group, while the mean scores of students in both groups for moral reasoning and ethical decision-making were not statistically significant. Conclusion: Based on our results, we recommend the use of both standardized patients and case analysis as appropriate teaching methods in ethics education.
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Fragouli, Evangelia. "The interaction of employee trust & ethical decision making." Business and Management Review 11, no. 02 (December 15, 2020): 161–68. http://dx.doi.org/10.24052/bmr/v11nu02/art-19.
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Trust is seen to include both emotional and cognitive dimensions and to function as a deep assumption underwriting social order. In the past three decades, the importance of trust in the workplace & its influence on organizational performance has been recognized by research scholars, and practitioners. This research paper aims to examine the impact of employee trust on leaders' ethical decision-making. This study applies literature review method to address the above subject showing that the impact of employee trust on leaders’ ethical decision-making relates to organizational aspects, as well as personal characteristics of leaders. Consideration of organizational aspects include performance, effective communication, and organizational culture. The personal aspects relate to leadership self-certification, guilt, rational attitude, leader learning, and moral model. Further, this study suggests that employee trust enhances e& & motivates leaders to make ethical decisions. However, organizational culture and leadership personal characteristics may have a negative impact on ethical decision-making. This study suggests that organizations could make collective decisions on major issues to reduce the impact of these negative factors on ethical decision-making.
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Perry, Joshua E., Ilene N. Moore, Bruce Barry, Ellen Wright Clayton, and Amanda R. Carrico. "The Ethical Health Lawyer: An Empirical Assessment of Moral Decision Making." Journal of Law, Medicine & Ethics 37, no. 3 (2009): 461–75. http://dx.doi.org/10.1111/j.1748-720x.2009.00407.x.
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The empirical literature exploring lawyers and their moral decision making is limited despite the “crisis” of unethical and unprofessional behavior in the bar that has been well documented for over a decade. In particular we are unaware of any empirical studies that investigate the moral landscape of the health lawyer’s practice. In an effort to address this gap in the literature, an interdisciplinary team of researchers at Vanderbilt University designed an empirical study to gather preliminary evidence regarding the moral reasoning of health care attorneys. The primary research question was how health lawyers respond when they encounter ethical or moral dilemmas in their practice for which the law fails to offer a bright-line solution. In exploring this question, we sought to understand better what motivations or influences guide action when health lawyers confront ethical quandaries, and whether there are specific differences, e.g., gender, experience, or religiosity, that are associated with specific responses to situations testing ethical or moral boundaries.
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Torabi, Mohammad, Fariba Borhani, Abbas Abbaszadeh, and Foroozan Atashzadeh-Shoorideh. "Barriers to ethical decision-making for pre-hospital care professionals." Nursing Ethics 27, no. 2 (June 11, 2019): 407–18. http://dx.doi.org/10.1177/0969733019848044.
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Background: Emergency care providers are frequently faces with situations in which they have to make decisions quickly in stressful situations. They face barriers to ethical decision-making and recognizing and finding solutions to these barriers helps them to make ethical decision. Objectives: The purpose of this study was to identify barriers of ethical decision-making in Iranian Emergency Medical Service personnel. Methods: In this qualitative research, the participants (n = 15) were selected using the purposive sampling method, and the data were collected by deep and semi-structured interviews. Finally, the data are analyzed using the content analysis approach. Ethical considerations: Permission to conduct the study was obtained from the Ethics Committee of the Shahid Beheshti University of Medical Sciences. The objectives of the study were explained to the participants and written consent was received from them. Also, participants were assured that necessary measures were taken to protect their anonymity and confidentiality. Findings: The results of the analysis are classified in five main categories. It encompasses the following areas: perception of situation, patient-related factors, input and output imbalance, uncoordinated health system, and paradoxes. Conclusion: Emergency Medical Service personnel make ethical decisions every day. It is important that prehospital personnel know how to manage those decisions properly so that clients’ moral rights are respected. Hence, by identifying the dimensions and obstacles of ethical decision-making in Emergency Medical Service personnel, it is possible to enhance the moral judgment and ethical accountability of the personnel and develop the strategies necessary for ethical decision-making in them.
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Abou Hashish, Ebtsam Aly, and Nadia Hassan Ali Awad. "Relationship between ethical ideology and moral judgment: Academic nurse educators’ perception." Nursing Ethics 26, no. 3 (September 11, 2017): 845–58. http://dx.doi.org/10.1177/0969733017722825.
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Background: Ascertaining the relationship between ethical ideology, moral judgment, and ethical decision among academic nurse educators at work appears to be a challenge particularly in situations when they are faced with a need to solve an ethical problem and make a moral decision. Purpose: This study aims to investigate the relationship between ethical ideology, moral judgment, and ethical decision as perceived by academic nurse educators. Methods: A descriptive correlational research design was conducted at Faculty of Nursing, Alexandria University. All academic nurse educators were included in the study (N = 220). Ethical Position Questionnaire and Questionnaire of Moral Judgment and Ethical Decisions were proved reliable to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects’ informed consent. Findings: This study reveals a significant positive moderate correlation between idealism construct of ethical ideology and moral judgment in terms of recognition of the behavior as an ethical issue and the magnitude of emotional consequences of the ethical situation (p < 0.001; p = 0.031) respectively. Also, there is a positive significant moderate correlation between relativism construct of ethical ideology and overall moral judgment (p = 0.010). Approximately 3.5% of the explained variance of overall moral judgment is predicted by idealism together with relativism. Discussion: The findings suggest that variations in ethical position and ideology are associated with moral judgment and ethical decision. Conclusion: Organizations of academic nursing education should provide a supportive work environment to help their academic staff to develop their self-awareness and knowledge of their ethical position and promoting their ethical ideologies and, in turn, enhance their moral judgment as well as develop ethical reasoning and decision-making capability of nursing students. More emphasis in nursing curricula is needed on ethical concepts for developing nursing competencies.
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Monteverde, Settimio. "The Importance of Time in Ethical Decision Making." Nursing Ethics 16, no. 5 (August 11, 2009): 613–24. http://dx.doi.org/10.1177/0969733009106653.
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Departing from a contemporary novel about a boy who is going to die from leukaemia, this article shows how the dimension of time can be seen as a morally relevant category that bridges both ‘dramatic’ issues, which constitute the dominant focus of bioethical decision making, and ‘undramatic’ issues, which characterize the lived experience of patients, relatives and health care workers. The moral task of comparing the various time dimensions of a given situation is explained as an act of ‘synchronizing’ the clocks. Ethical sensitivity and competence are presented as core skills that allow a continuity of care in situations where dramatic issues seem to be resolved, but undramatic ones are still not addressed. A nine-step model of shared decision making is proposed as an approach to identifying critical junctures within an illness trajectory and synchronizing the clocks of the involved actors.
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Lee, Susan, Ellen M. Robinson, Pamela J. Grace, Angelika Zollfrank, and Martha Jurchak. "Developing a moral compass: Themes from the Clinical Ethics Residency for Nurses’ final essays." Nursing Ethics 27, no. 1 (April 28, 2019): 28–39. http://dx.doi.org/10.1177/0969733019833125.
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Background: The Clinical Ethics Residency for Nurses was offered selectively to nurses affiliated with two academic medical centers to increase confidence in ethical decision-making. Research Question/Aim: To discover how effective the participants perceived the program and if their goals of participation had been met. Research design: A total of 65 end-of-course essays (from three cohorts) were analyzed using modified directed content analysis. In-depth and recursive readings of the essays by faculty were guided by six questions that had been posed to graduates. Ethical considerations: Institutional review board approval was granted for the duration of the program and its reporting period. Confidentiality was maintained via the use of codes for all evaluations including the essays and potentially identifying content redacted. Findings: An umbrella theme emerged: participants had developed ethical knowledge and skills that provided a “moral compass to navigate the many gray areas of decision-making that confront them in daily practice.” Six major themes corresponding to questions posed to the participants included the ability to advocate for good patient care; to support and empower colleagues, patients, and families; they experienced personal and professional transformation; they valued the multimodal nature of the program; and were using their new knowledge and skills in practice. However, they also recognized that their development as moral agents was an ongoing process. Discussion: Findings support that enhancing nurse confidence in their moral agency with a multimodal educational approach that includes mentored practice in ethical decision-making, enhancing communication skills and role-play can mitigate moral distress. A majority found the program personally and professionally transformative. However, they recognized that ongoing ethics discussion involvement and supportive environments would be important in their continued development of ethical agency. Conclusion: Multimodal ethics education programs have potential to be transformative and enhance nurse confidence in their ethical decision-making.
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Woods, Martin. "Balancing Rights and Duties in ‘Life and Death’ Decision Making Involving Children: a role for nurses?" Nursing Ethics 8, no. 5 (September 2001): 397–408. http://dx.doi.org/10.1177/096973300100800504.
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In recent years, increasing pressures have been brought to bear upon nurses and others more closely to inform, involve and support the rights of parents or guardians when crucial ‘life and death’ ethical decisions are made on behalf of their seriously ill child. Such decisions can be very painful for all involved, and may easily become deadlocked when there is an apparent clash of moral ideals or values between the medical team and the parents or guardians. This article examines a growing number of such cases in New Zealand and analyses the moral parameters, processes, outcomes and ethical responses that must be considered when life and death ethical decisions involving children are made. The article concludes with a recommendation that nurses should be recognized as perhaps the most suitable of all health care personnel when careful mediation is needed to produce an acceptable moral outcome in difficult ethical situations.
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Alba, Barbara. "Factors that impact on emergency nurses’ ethical decision-making ability." Nursing Ethics 25, no. 7 (November 10, 2016): 855–66. http://dx.doi.org/10.1177/0969733016674769.
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Background: Reliance on moral principles and professional codes has given nurses direction for ethical decision-making. However, rational models do not capture the emotion and reality of human choice. Intuitive response must be considered. Research purpose: Supporting intuition as an important ethical decision-making tool for nurses, the aim of this study was to determine relationships between intuition, years of worked nursing experience, and perceived ethical decision-making ability. A secondary aim explored the relationships between rational thought to years of worked nursing experience and perceived ethical decision-making ability. Research design and context: A non-experimental, correlational research design was used. The Rational Experiential Inventory measured intuition and rational thought. The Clinical Decision Making in Nursing Scale measured perceived ethical decision-making ability. Pearson’s r was the statistical method used to analyze three primary and two secondary research questions. Participants: A sample of 182 emergency nurses was recruited electronically through the Emergency Nurses Association. Participants were self-selected. Ethical considerations: Approval to conduct this study was obtained by the Adelphi University Institutional Review Board. Findings: A relationship between intuition and perceived ethical decision-making ability ( r = .252, p = .001) was a significant finding in this study. Discussion: This study is one of the first of this nature to make a connection between intuition and nurses’ ethical decision-making ability. Conclusion: This investigation contributes to a broader understanding of the different thought processes used by emergency nurses to make ethical decisions.
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Barlow, Nichola Ann, Janet Hargreaves, and Warren P. Gillibrand. "Nurses’ contributions to the resolution of ethical dilemmas in practice." Nursing Ethics 25, no. 2 (May 3, 2017): 230–42. http://dx.doi.org/10.1177/0969733017703700.
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Background: Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. Aims: To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. Design: An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification. Participants and context: Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis. Ethical considerations: Ethical approval was obtained from the local National Research Ethics Committee. Findings: Four major themes emerged: ‘best for the patient’, ‘accountability’, ‘collaboration and conflict’ and ‘concern for others’. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas. Discussion: Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing ethical dilemmas and to engage with political and organisational macro- and micro-decision-making. Conclusion: Nurses’ professional relationships are central to nurses’ contributions to the resolution of ethical dilemmas.
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Evans, Katherine, Nelson de Moura, Stéphane Chauvier, Raja Chatila, and Ebru Dogan. "Ethical Decision Making in Autonomous Vehicles: The AV Ethics Project." Science and Engineering Ethics 26, no. 6 (October 13, 2020): 3285–312. http://dx.doi.org/10.1007/s11948-020-00272-8.
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AbstractThe ethics of autonomous vehicles (AV) has received a great amount of attention in recent years, specifically in regard to their decisional policies in accident situations in which human harm is a likely consequence. Starting from the assumption that human harm is unavoidable, many authors have developed differing accounts of what morality requires in these situations. In this article, a strategy for AV decision-making is proposed, the Ethical Valence Theory, which paints AV decision-making as a type of claim mitigation: different road users hold different moral claims on the vehicle’s behavior, and the vehicle must mitigate these claims as it makes decisions about its environment. Using the context of autonomous vehicles, the harm produced by an action and the uncertainties connected to it are quantified and accounted for through deliberation, resulting in an ethical implementation coherent with reality. The goal of this approach is not to define how moral theory requires vehicles to behave, but rather to provide a computational approach that is flexible enough to accommodate a number of ‘moral positions’ concerning what morality demands and what road users may expect, offering an evaluation tool for the social acceptability of an autonomous vehicle’s ethical decision making.
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Cervantes, José-Antonio, Luis-Felipe Rodríguez, Sonia López, Félix Ramos, and Francisco Robles. "Cognitive Process of Moral Decision-Making for Autonomous Agents." International Journal of Software Science and Computational Intelligence 5, no. 4 (October 2013): 61–76. http://dx.doi.org/10.4018/ijssci.2013100105.
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There are a great variety of theoretical models of cognition whose main purpose is to explain the inner workings of the human brain. Researchers from areas such as neuroscience, psychology, and physiology have proposed these models. Nevertheless, most of these models are based on empirical studies and on experiments with humans, primates, and rodents. In fields such as cognitive informatics and artificial intelligence, these cognitive models may be translated into computational implementations and incorporated into the architectures of intelligent autonomous agents (AAs). Thus, the main assumption in this work is that knowledge in those fields can be used as a design approach contributing to the development of intelligent systems capable of displaying very believable and human-like behaviors. Decision-Making (DM) is one of the most investigated and computationally implemented functions. The literature reports several computational models that enable AAs to make decisions that help achieve their personal goals and needs. However, most models disregard crucial aspects of human decision-making such as other agents' needs, ethical values, and social norms. In this paper, the authors present a set of criteria and mechanisms proposed to develop a biologically inspired computational model of Moral Decision-Making (MDM). To achieve a process of moral decision-making believable, the authors propose a cognitive function to determine the importance of each criterion based on the mood and emotional state of AAs, the main objective the model is to enable AAs to make decisions based on ethical and moral judgment.
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Repenshek, Mark. "Moral Distress: Inability to Act or Discomfort with Moral Subjectivity?" Nursing Ethics 16, no. 6 (November 2009): 734–42. http://dx.doi.org/10.1177/0969733009342138.
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Amidst the wealth of literature on the topic of moral distress in nursing, a single citation is ubiquitous, Andrew Jameton’s 1984 book Nursing practice. The definition Jameton formulated reads ‘... moral distress arises when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. Unfortunately, it appears that, despite the frequent use of Jameton’s definition of moral distress, the definition itself remains uncritically examined. It seems as if the context of how moral distress arises (i.e. anger, frustration etc.) has been co-opted as its definition. This current work suggests that the current definition is not moral distress as defined by Jameton, but rather, in large part, nursing’s discomfort with moral subjectivity in end-of-life decision making. A critical examination of how the Catholic tradition’s normative ethical framework accounts for moral subjectivity in end-of-life decision making serves to aid nursing’s discomfort and as a starting point to recontextualize moral distress.
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Pinch, W. J. Ellenchild, and Mary E. Parsons. "Moral Orientation of Elderly Persons: considering ethical dilemmas in health care." Nursing Ethics 4, no. 5 (September 1997): 380–93. http://dx.doi.org/10.1177/096973309700400504.
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Knowledge about moral development and elderly persons is very limited. A hermeneutical interpretative study was conducted with healthy elderly persons ( n = 20) in order to explore and describe their moral orientation based on the paradigms of justice (Kohlberg) and care (Gilligan). The types of moral reasoning, dominance, alignment and orientation were determined. All but one participant included both types of reasoning when discussing an ethical conflict. None of the men’s moral reasoning was dominated by caring, but justice dominated the reasoning of four women. The implications for ethical decision-making and future research are discussed.
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Molloy, Jennifer, Marilyn Evans, and Kevin Coughlin. "Moral distress in the resuscitation of extremely premature infants." Nursing Ethics 22, no. 1 (April 8, 2014): 52–63. http://dx.doi.org/10.1177/0969733014523169.
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Objective: To increase our understanding of moral distress experienced by neonatal registered nurses when directly or indirectly involved in the decision-making process of resuscitating infants who are born extremely premature. Design: A secondary qualitative analysis was conducted on a portion of the data collected from an earlier study which explored the ethical decision-making process among health professionals and parents concerning resuscitation of extremely premature infants. Setting: A regional, tertiary academic referral hospital in Ontario offering a perinatal program. Participants: A total of 15 registered nurses were directly or indirectly involved in the resuscitation of extremely premature infants. Methods: Interview transcripts of nurses from the original study were purposefully selected from the original 42 transcripts of health professionals. Inductive content analysis was conducted to identify themes describing factors and situations contributing to moral distress experienced by nurses regarding resuscitation of extremely premature infants. Ethical considerations: Ethical approval was obtained from the research ethics review board for both the initial study and this secondary data analysis. Results: Five themes, uncertainty, questioning of informed consent, differing perspectives, perceptions of harm and suffering, and being with the family, contribute to the moral distress felt by nurses when exposed to neonatal resuscitation of extremely premature infants. An interesting finding was the nurses’ perceived lack of power and influence in the neonatal resuscitation decision-making process. Conclusion: Moral distress continues to be a significant issue for nursing practice, particularly among neonatal nurses. Strategies are needed to help mediate the moral distress experienced by nurses, such as debriefing sessions, effective communication, role clarification, and interprofessional education and collaboration.
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Han, Sung-Suk, and Sung-Hee Ahn. "An Analysis and Evaluation of Student Nurses’ Participation in Ethical Decision Making." Nursing Ethics 7, no. 2 (March 2000): 113–23. http://dx.doi.org/10.1177/096973300000700204.
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This study analyses the types and frequencies of ethical dilemmas and the rationale of ethical decision making in student nurses; it also evaluates their decision making. One hundred senior student nurses who were enrolled in a two-credit course in nursing ethics were asked to provide an informal description of a dilemma that they had experienced during their clinical practice. The results were as follows. The ethical dilemmas identified fell into four categories and were of 27 types. Those most frequently experienced were ‘family giving up on a patient because he or she could not be cured’, and ‘not telling the truth to the patient’. The Korean Nurses’ Code of Ethics was applied, in particular the preamble, and the third, fourth, seventh and tenth clauses. The most common rule of ethics and principle applied in these nurses’ ethical decision making were veracity and nonmaleficence. With regard to the moral reasoning process, the primary concern was the welfare of the patients. These students were equipped with the ability to exercise critical and reflective thought when they experienced ethical dilemmas.
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Ølholm, Anne Mette, Kristian Kidholm, Mette Birk-Olsen, and Janne Buck Christensen. "HOSPITAL MANAGERS’ NEED FOR INFORMATION ON HEALTH TECHNOLOGY INVESTMENTS." International Journal of Technology Assessment in Health Care 31, no. 6 (2015): 414–25. http://dx.doi.org/10.1017/s0266462315000665.
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Objectives: There is growing interest in implementing hospital-based health technology assessment (HB-HTA) as a tool to facilitate decision making based on a systematic and multidisciplinary assessment of evidence. However, the decision-making process, including the informational needs of hospital decision makers, is not well described. The objective was to review empirical studies analysing the information that hospital decision makers need when deciding about health technology (HT) investments.Methods: A systematic review of empirical studies published in English or Danish from 2000 to 2012 was carried out. The literature was assessed by two reviewers working independently. The identified informational needs were assessed with regard to their agreement with the nine domains of EUnetHTA's Core Model.Results: A total of 2,689 articles were identified and assessed. The review process resulted in 14 relevant studies containing 74 types of information that hospital decision makers found relevant. In addition to information covered by the Core Model, other types of information dealing with political and strategic aspects were identified. The most frequently mentioned types of information in the literature related to clinical, economic and political/strategic aspects. Legal, social, and ethical aspects were seldom considered most important.Conclusions: Hospital decision makers are able to describe their information needs when deciding on HT investments. The different types of information were not of equal importance to hospital decision makers, however, and full agreement between EUnetHTA's Core Model and the hospital decision-makers’ informational needs was not observed. They also need information on political and strategic aspects not covered by the Core Model.
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Jamshidian, Fatemeh, Mohsen Shahriari, and Mohsen Rezaei Aderyani. "Effects of an ethical empowerment program on critical care nurses’ ethical decision-making." Nursing Ethics 26, no. 4 (March 7, 2018): 1256–64. http://dx.doi.org/10.1177/0969733018759830.
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Background: Nurses require empowerment if they are to make ethical decisions. Ethical empowerment has always been one of the main concerns in nurse training programs. Research aim: The present study was conducted to determine the effect of an ethical empowerment program on critical care nurses’ ethical decision-making. Research design: This is a clinical trial study with two groups and pre and post design. Participants and research context: In this study, 60 nurses working in Intensive Care Unit were selected through random sampling and then divided into a control and an experimental group after filling out the Moral Sensitivity Questionnaire. Both groups completed the questionnaire again immediately and 2 months after the ethical empowerment workshop had been held for the experimental group. The collected data were analyzed in SPSS-16 using descriptive and inferential statistics. Ethical considerations: The goals of the study were explained to the participants and then a written informed consent was received from them. Findings: The results showed no significant differences between the two groups in terms of their ethical sensitivity scores at the beginning of the study; however, immediately and 2 months after the intervention, the mean score increased significantly in the experimental group. Moreover, the scores obtained 2 months after the workshop increased compared to the pre-intervention scores but showed a drop compared to the scores reported immediately after the workshop. Discussion: The ethical empowerment program, given to the critical care nurses in this study, improved their ethical sensitivity in making decisions significantly over time. Despite the extensive methods, available for teaching nursing ethics, the ethical empowerment program, adopted in this study, had long-lasting effects in terms of ameliorating the process of ethical decision-making in clinical situations. Conclusion: The ethical empowerment of nurses requires the adoption and application of proper methods and patterns of complying with nursing ethics.
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Lewis, Alan, and Craig Mackenzie. "Morals, money, ethical investing and economic psychology." Human Relations 53, no. 2 (February 1, 2000): 179–91. http://dx.doi.org/10.1177/a010699.
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This paper reports on a questionnaire survey of 1146 ethical investors in the UK. Ethical investing usually means that certain companies are excluded from one's portfolio on non-economic grounds, e.g. because they manufacture armaments, test chemicals on live animals, or have poor pollution records. Is this an example where moral commitment rather than economics is driving economic decision making? Ethical investors were found to be neither cranks nor saints holding both ethical and not so ethical investments at the same time. A case is made that people are prepared to put their money where their morals are although there is no straightforward trade-off between principles and money. A broader analysis than that based on rational economic man is recommended: an economic psychology.
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Kucher, D. E., and S. G. Kharchenko. "The Precautionary Principle as a Decision-Making Criterion." Ecology and Industry of Russia 26, no. 1 (January 18, 2022): 66–71. http://dx.doi.org/10.18412/1816-0395-2022-1-66-71.
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A comprehensive analysis of the precautionary principle is carried out in the article. The essence of the "precautionary principle" concept and its main elements are analyzed, the concept of "morally unacceptable harm"is interpreted. A retrospective analysis of the emergence of the "precautionary principle" concept is carried out, the place and role of the precautionary principle in various international treaties is investigated. It is emphasized that scientific uncertainty is not an excuse for inaction when there is convincing evidence of potentially serious damage. The moral and ethical basis of the precautionary principle is noted. The place of the precautionary principle in the theory and practice of decisionmaking is investigated in the article. It is emphasized that the precautionary principle must be applied in conditions of uncertainty, when the boundaries of possible results are unknown and there are no reliable grounds for quantifying probabilities, and the ethical aspects of equality between and within generations are at stake, other decision-making principles cannot satisfactorily solve these problems.
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Bagrationi, Irma. "On the Risks of Ethical Decision-Making from the History of the Political Thought." Cybernetics and Computer Technologies, no. 4 (December 30, 2021): 89–94. http://dx.doi.org/10.34229/2707-451x.21.4.9.
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Introduction: We are interested in the theoretical considerations of the actual pragmatic questions about ethical worldview meaning of understanding of the innovation dealings world, the nature of its conceptual risk dilemmas and problems and sententious thinking in the sphere of political business industry. Our viewpoint is dedicated to the most important aspects of the essence and peculiarities of the social moral standards of innovation approaches in the context of a political solution through methodology of modern mental technology - especially: cognitive methods with gnostic wisdom research and utilitarian creative knowledge and axiological methodology with overestimation ethical values and demonstrating intellectual concepts. Into the framework of the main goal of the research are reviewed the basic theoretical paradigms on the background of ethical worldview analysis (through comparative historical technique of thinking) of the leading-edge conceptual theories of the famous contemporary Russian, American and European thinkers. The purpose of the article is to prove, substantiate and confirm the following thesis. In order for the ethical of timely paroemiac responsibility and political freedom to be able to fulfill its axiological tasks, it is necessary to reach some worldview ideas: ??to create an universal model of moral consciousness and high valuable behavior; overcome mental and sociocultural biases regarding the debatable assessment of the convincingness of events and determine the relevant logical reaction of society not only to a certain risk of eatable technical thinking, but also to uncertainty regarding their intellectual decision in relation to approved ethical, operational, empirical and principled notions, proposals, expression views and suggestions. The results. Scientific conceptual alternatives of optimization of practical and urgent ethical valuable dilemmas are given. The issues of the possibility of formation of a worldview system through practical ethical requirements that standard regulates the reactionary politics of intellectual reality to probabilistic hazards are discussed. The ethical standards of universal prohibitions, the moral responsibility of human nature and the ethics of virtue make a conflict of social and political interests through insurmountable cognitive, discussible, reviewable and discursive difficulties are demonstratively shown. Conclusions. Taking into dominant the essence of the main backgrounds of the existential specific theoretical approaches for worldview methods solving moral political problems is integrated some innovation decisions through valuable considerations. The fundamental ethical concepts of utilitarian thought of historical reminiscences synthesize the possibility problematic circumstances into the logical model of making morally important and useful decisions much easier are analyzed, but through in the valuating pragmatic context needs a main transformation in mental formation of ideological metric and social-political structure. Keywords: ethical worldview decision, political industry, innovation approaches, moral values, mental technologies, risk decision methods, conceptual risk dilemmas.
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Howells, Amy J. "Are we creating ethical dilemmas where there are none?" Clinical Ethics 13, no. 4 (September 30, 2018): 220–24. http://dx.doi.org/10.1177/1477750918802424.
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This case study focuses on decision-making for minors who are permanently unconscious and dependent on life-sustaining therapies. Cases of this type often cause anguish and angst for health care providers and caregivers and can lead to mistrust, moral distress, and communication problems. After presenting a particular case, an ethical analysis is applied to determine whether there is an apparent course of action or an ethical dilemma. The ethical analysis focuses on the currently accepted guidance principle for surrogate decision-making for minors and applies them to the case. The conclusion drawn shows that the case was not, in fact, an ethical dilemma by definition and that there is a reasonable course of action to be taken.
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Doane, Gweneth, Bernadette Pauly, Helen Brown, and Gladys McPherson. "Exploring The Heart Ofethical Nursing Practice: implications for ethics education." Nursing Ethics 11, no. 3 (May 2004): 240–53. http://dx.doi.org/10.1191/0969733004ne692oa.
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The limitations of rational models of ethical decision making and the importance of nurses’ human involvement as moral agents is increasingly being emphasized in the nursing literature. However, little is known about how nurses involve themselves in ethical decision making and action or about educational processes that support such practice. A recent study that examined the meaning and enactment of ethical nursing practice for three groups of nurses (nurses in direct care positions, student nurses, and nurses in advanced practice positions) highlighted that humanly involved ethical nursing practice is also simultaneously a personal process and a socially mediated one. Of particular significance was the way in which differing role expectations and contexts shaped the nurses’ ethical practice. The study findings pointed to types of educative experiences that may help nurses to develop the knowledge and ability to live in and navigate their way through the complex, ambiguous and shifting terrain of ethical nursing practice.
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Skott, Carola. "Storied Ethics: conversations in nursing care." Nursing Ethics 10, no. 4 (July 2003): 368–76. http://dx.doi.org/10.1191/0969733003ne619oa.
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The purpose of this article is to discuss narration of ethical themes in nursing care. The text represents part of the findings of an ethnographic study aimed at description of everyday work on an oncology ward. Nurses on this ward are constantly involved in ethical care issues and narratives are told to share experiences. Of vital importance in ethical decision making is the perpetual creation of a mediating moral world constituted by daily experience. The need for making space in nursing for a continual learning conversation is expressed and in this I include writings of nursing theorists.
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Linder, G. Fletcher, Allison J. Ames, William J. Hawk, Lori K. Pyle, Keston H. Fulcher, and Christian E. Early. "Teaching Ethical Reasoning." Teaching Ethics 19, no. 2 (2019): 147–70. http://dx.doi.org/10.5840/tej202081174.
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This article presents evidence supporting the claim that ethical reasoning is a skill that can be taught and assessed. We propose a working definition of ethical reasoning as 1) the ability to identify, analyze, and weigh moral aspects of a particular situation, and 2) to make decisions that are informed and warranted by the moral investigation. The evidence consists of a description of an ethical reasoning education program—Ethical Reasoning in Action (ERiA)—designed to increase ethical reasoning skills in a variety of situations and areas of life. ERiA is housed at a public, major comprehensive U.S. university—James Madison University—and assessment of the program focuses on interventions delivered prior to and during orientation for incoming first-year students. Findings indicate that the interventions measurably enhance the ability of undergraduate students to reason ethically. ERiA’s competency-targeted program and positive student learning outcomes offers a promising model for higher education ethics programs seeking to connect classroom learning in ethics to decision-making in everyday life.
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Hasanlo, Masoumeh, Arezo Azarm, Parvaneh Asadi, Kourosh Amini, Hossein Ebrahimi, and Mohammad Asghari Jafarabadi. "Analytical study of care quality and moral distress in clinical situations and patient care." Frontiers of Nursing 6, no. 4 (December 31, 2019): 327–34. http://dx.doi.org/10.2478/fon-2019-0037.
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Abstract Objective Nursing profession conventionally meets a high standard of ethical behavior and action. One of the ethical challenges in nursing profession is moral distress. Nurses frequently expose to this phenomenon which leads to different consequences such as being bored by delivering patient care that decline care quality and make it challenging to achieve health purposes. This study was conducted to investigate the association between the aspects of moral distress and care quality. Methods In this descriptive–analytical study, 545 nurses of intensive and cardiac care units and dialysis and psychiatric wards were recruited by census sampling. Three questionnaires, Sociodemographics, Moral Distress Scale, and Quality Patient Care Scale, were distributed among the participants and collected within 9 months. Data analysis was conducted by descriptive statistics, analysis of variance, and the least significant difference in SPSS 13. Results Investigating moral distress domains (ignoring patient, decision-making power, and professional competence) and care quality domains (psychosocial, physical, and communicational) demonstrated that in being exposed to moral distress, ignoring patient had no effect on psychosocial domain (P=0.056), but decision-making and professional competence of moral distress had positive effect on psychosocial, physical (bodily), and communication domains of care quality. Conclusions Because moral distress domains are effective on patient care quality, it is recommended to enhance the knowledge of nurses, especially beginners, about moral distress, increase their strength alongside standardizing nursing services in decision-making domains, improve the professional competence, and pay attention to patients.
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Khatiban, Mahnaz, Seyede Nayereh Falahan, Roya Amini, Afshin Farahanchi, and Alireza Soltanian. "Lecture-based versus problem-based learning in ethics education among nursing students." Nursing Ethics 26, no. 6 (May 1, 2018): 1753–64. http://dx.doi.org/10.1177/0969733018767246.
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Background: Moral reasoning is a vital skill in the nursing profession. Teaching moral reasoning to students is necessary toward promoting nursing ethics. Objectives: The aim of this study was to compare the effectiveness of problem-based learning and lecture-based methods in ethics education in improving (1) moral decision-making, (2) moral reasoning, (3) moral development, and (4) practical reasoning among nursing students. Research design: This is a repeated measurement quasi-experimental study. Participants and research context: The participants were nursing students in a University of Medical Sciences in west of Iran who were randomly assigned to the lecture-based (n = 33) or the problem-based learning (n = 33) groups. The subjects were provided nursing ethics education in four 2-h sessions. The educational content was similar, but the training methods were different. The subjects completed the Nursing Dilemma Test before, immediately after, and 1 month after the training. The data were analyzed and compared using the SPSS-16 software. Ethical considerations: The program was explained to the students, all of whom signed an informed consent form at the baseline. Findings: The two groups were similar in personal characteristics (p > 0.05). A significant improvement was observed in the mean scores on moral development in the problem-based learning compared with the lecture-based group (p < 0.05). Although the mean scores on moral reasoning improved in both the problem-based learning and the lecture-based groups immediately after the training and 1 month later, the change was significant only in the problem-based learning group (p < 0.05). The mean scores on moral decision-making, practical considerations, and familiarity with dilemmas were relatively similar for the two groups. Conclusion: The use of the problem-based learning method in ethics education enhances moral development among nursing students. However, further studies are needed to determine whether such method improves moral decision-making, moral reasoning, practical considerations, and familiarity with the ethical issues among nursing students.
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Krawczyk, Rosemary M. "Teaching Ethics: Effect on Moral Development." Nursing Ethics 4, no. 1 (January 1997): 57–65. http://dx.doi.org/10.1177/096973309700400107.
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The purpose of this study was to determine the development of moral judgement in first-year and senior baccalaureate nursing students. These students were enrolled in three separate nursing programmes, each of which differed significantly in ethical content. The sample totalled 180 students enrolled in three New England programmes. Programme A included an ethics course taught by a professor of ethics. Programme B integrated ethical issues into all nursing theory courses. Programme C did not include ethical content in theory courses. The design was of a developmental cross-sectional study. The dependent variable was the development of moral judgement, as measured by Rest’s Defining Issues Test. The independent variable was the amount of ethics taught in the nursing programmes and the level of academic education. The senior nursing students from programme A scored significantly higher than the other senior groups on the Defining Issues Test. The conclusion is that an ethics course with group participation and a decision-making element significantly facilitated nursing students’ development of moral judgement.
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Pramana, I. Kadek Adhi, I. Gusti Ayu Nyoman Budiasih Budiasih, Anak Agung Ngurah Bagus Dwirandra, and I. Gusti Ayu Made Asri Dwija Putri. "Insightfully Explore the Ethical Decision Making of Tax Consultants During COVID-19 Pandemic." Jurnal Ilmiah Akuntansi dan Bisnis 17, no. 1 (January 8, 2022): 159. http://dx.doi.org/10.24843/jiab.2022.v17.i01.p11.
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Weakening economic performance during COVID-19 pandemic has an impact on state revenues in the tax sector caused dilemma for a tax consultant. This study aims to explore various ethical decisions making by tax consultants. Transcendental phenomenology Husserl's is used to obtain pure consciousness from informants. Data was collected by interview and based on the interpretation, the dilemma caused by non-optimal income and client's internal policies. In addition, several clients experience tax audits during the pandemic. Ethical assessment of decision making is considered into several aspects, such as: moral considerations, commitment to providing optimal services, and awareness that the role of tax consultants is helping the government to gain state revenue in tax sector. This study provides the relevance use of ethical theory and the theory of planned behaviour. For practitioners, this research can be used as advice in making decisions both in pandemic situations and other unexpected events.
Keywords: phenomenology, dilemma, tax consultant, explore, ethical decision
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Macpherson, Ignacio, María Victoria Roqué, and Ignacio Segarra. "Moral dilemmas involving anthropological and ethical dimensions in healthcare curriculum." Nursing Ethics 27, no. 5 (April 29, 2020): 1238–49. http://dx.doi.org/10.1177/0969733020914382.
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Background Currently a variety of novel scenarios have appeared within nursing practice such as confidentiality of a patient victim of abuse, justice in insolvent patients, poorly informed consent delivery, non-satisfactory medicine outputs, or the possibility to reject a recommended treatment. These scenarios presuppose skills that are not usually acquired during the degree. Thus, the implementation of teaching approaches that promote the acquisition of these skills in the nursing curriculum is increasingly relevant. Objective The article analyzes an academic model which integrates in the curriculum a series of specific theoretical concepts together with practical skills to acquire the basic ethic assessment competency. Research design The project includes designing two subjects, General Anthropology and Ethics-Bioethics, with an applied approach in the nursing curriculum. The sequential structure of the curriculum in both subjects is constituted by three learning domains (theoretical, practical, and communicative) with different educational strategies. Ethical considerations No significant ethical considerations as this is a discussion paper. Findings The model was structured from the anthropology’s concepts and decision-making process, applied to real situations. The structure of the three domains theoretical–practical–communicative is present in each session. Discussion It is observed that theoretical domain fosters the capacity for critical analysis and subsequent ability to judge diverse situations. The practical domain reflected two significant difficulties: students’ resistance to internalizing moral problems and the tendency to superficial criticism. The communicative domain has frequently shown that the conflicting points are in the principles to be applied. Conclusion We conclude that this design achieves its objectives and may provide future nursing professionals with ethical competences especially useful in healthcare practice. The three domains of the presented scheme are associated with the same process used in decision making at individual levels, where the exercise of clinical prudence acquires particular relevance.
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Joyner, LoraKim. "Ethical considerations in wildlife medicine." Wildlife Rehabilitation Bulletin 39, no. 1 (May 31, 2022): 36–46. http://dx.doi.org/10.53607/wrb.v39.248.
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Component wildlife ethics includes two aspects: an understanding of ethical principles and skills in ethical deliberation. Ethical principles reviewed here include utilitarianism, deontological ethics, environmentalism or respect for nature, virtue ethics, relational ethics, care ethics and reverence for life ethics. Other processes and tools that take into account human sociology, behaviour and subconscious functioning in moral decision-making include conservation psychology, narrative ethics, socioscience, listening and communication skills, and needs-based ethics. We also take into account non-human functioning such as welfare science, conservation behaviour and cognitive ethology. Incorporating these tools and instituting ethical practices and programs within our wildlife and conservation management plans and organizations improve our ability to care for ourselves, other humans, wildlife and ecosystems.
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Oberle, Kathleen. "Measuring Nurses' Moral Reasoning." Nursing Ethics 2, no. 4 (December 1995): 303–13. http://dx.doi.org/10.1177/096973309500200405.
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The purpose of this exploratory study was to examine the possibility of designing a satisfactory method, using written responses to hypotheical scenarios, for evaluating the quality of moral reasoning in student nurses. Scenarios were developed from interviews with practising nurses. Nurses and student nurses provided written responses to the scenarios, and nursing faculty members from six institutions sorted the responses according to their perceptions of quality (i.e. 'best', 'next best', 'worst' etc.). There was very little agreement among faculty members on the quality of the responses. Consequently, it was impossible to develop a 'best' response on which the faculty members could agree. Analysis revealed a framework used by the participants for ethical decision-making. The results of this study have important implications for the way in which we think about the teaching and the evaluation of nursing ethics.
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Sellman, Derek. "The Virtues in the Moral Education of Nurses: Florence Nightingale Revisited." Nursing Ethics 4, no. 1 (January 1997): 3–11. http://dx.doi.org/10.1177/096973309700400102.
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The virtues have been a neglected aspect of morality; only recently has reference been made to their place in professional ethics. Unfashionable as Florence Nightingale is, it is nonetheless worth noting that she was instrumental in continuing the Aristotelian tradition of being concerned with the moral character of persons. Nurses who came under Nightingale’s sphere of influence were expected to develop certain exemplary habits of behaviour. A corollary can be drawn with the current UK professional body: nurses are expected to behave in certain ways and to display particular kinds of disposition. The difference lies in the fact that, while Nightingale was clear about the need for moral education, current emphasis is placed on ethical theory and ethical decision-making.
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Wright, David, and Susan Brajtman. "Relational and embodied knowing: Nursing ethics within the interprofessional team." Nursing Ethics 18, no. 1 (January 2011): 20–30. http://dx.doi.org/10.1177/0969733010386165.
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In this article we attempt to situate nursing within the interprofessional care team with respect to processes of ethical practice and ethical decision making. After briefly reviewing the concept of interprofessionalism, the idea of a nursing ethic as ‘unique’ within the context of an interprofessional team will be explored. We suggest that nursing’s distinct perspective on the moral matters of health care stem not from any privileged vantage point but rather from knowledge developed through the daily activities of nursing practice. Because of their position vis-à-vis patients and families in everyday clinical care, nurses cultivate ethical knowledge of at least two forms: (1) relational knowledge; and (2) embodied knowledge. Through the integration of these forms of knowledge, nurses develop a unique moral perspective and can make a meaningful contribution to the realm of ethics in interprofessional care.
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Tuvesson, Hanna, and Kim Lützén. "Demographic factors associated with moral sensitivity among nursing students." Nursing Ethics 24, no. 7 (January 28, 2016): 847–55. http://dx.doi.org/10.1177/0969733015626602.
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Background: Today’s healthcare environment is often characterized by an ethically demanding work situation, and nursing students need to prepare to meet ethical challenges in their future role. Moral sensitivity is an important aspect of the ethical decision-making process, but little is known regarding nursing students’ moral sensitivity and its possible development during nursing education. Objectives: The aims of this study were to investigate moral sensitivity among nursing students, differences in moral sensitivity according to sample sub-group, and the relation between demographic characteristics of nursing students and moral sensitivity. Research design: A convenience sample of 299 nursing students from one university completed a questionnaire comprising questions about demographic information and the revised Moral Sensitivity Questionnaire. With the use of SPSS, non-parametric statistics, including logistic regression models, were used to investigate the relationship between demographic characteristics and moral sensitivity. Ethical considerations: The study followed the regulations according to the Swedish Ethical Review Act and was reviewed by the Ethics Committee of South-East Sweden. Findings: The findings showed that mean scores of nursing students’ moral sensitivity were found in the middle to upper segment of the rating scale. Multivariate analysis showed that gender (odds ratio = 3.32), age (odds ratio = 2.09; 1.73), and parental status (odds ratio = 0.31) were of relevance to nursing students’ moral sensitivity. Academic year was found to be unrelated to moral sensitivity. Discussion and conclusion: These demographic aspects should be considered when designing ethics education for nursing students. Future studies should continue to investigate moral sensitivity in nursing students, such as if and how various pedagogical strategies in ethics may contribute to moral sensitivity in nursing students.
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Bjorklund, Pamela, and Denise M. Lund. "Informed consent and the aftermath of cardiopulmonary resuscitation: Ethical considerations." Nursing Ethics 26, no. 1 (April 26, 2017): 84–95. http://dx.doi.org/10.1177/0969733017700234.
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Background: Patients often are confronted with the choice to allow cardiopulmonary resuscitation (CPR) should cardiac arrest occur. Typically, informed consent for CPR does not also include detailed discussion about survival rates, possible consequences of survival, and/or potential impacts on functionality post-CPR. Objective: A lack of communication about these issues between providers and patients/families complicates CPR decision-making and highlights the ethical imperative of practice changes that educate patients and families in those deeper and more detailed ways. Design: This review integrates disparate literature on the aftermath of CPR and the ethics implications of CPR decision-making as it relates to and is affected by informed consent and subsequent choices for code status by seriously ill patients and their surrogates/proxies within the hospital setting. Margaret Urban Walker’s moral philosophy provides a framework to view informed consent as a practice of responsibility. Ethical considerations: Given nurses’ communicative skills, ethos of care and advocacy, and expertise in therapeutic relationships, communication around DNAR decision-making might look quite different if institutional norms in education, healthcare, law, and public policy held nurses overtly responsible for informed consent in some greater measure. Findings: Analysis from this perspective shows where changes in informed consent practices are needed and where leverage might be exerted to create change in the direction of deeper and more detailed discussions about CPR survival rates and possible consequences of survival.
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Rickard, Maurice, Helga Kuhse, and Peter Singer. "Caring and Justice: A Study of two Approaches to Health Care Ethics." Nursing Ethics 3, no. 3 (September 1996): 212–23. http://dx.doi.org/10.1177/096973309600300304.
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This article presents an empirical study of approaches to ethical decision-making among nurses and doctors. It takes as its starting point the distinction between the perspectives of care and of justice in ethical thinking, and the view that nurses' thinking will be aligned with the former and doctors' with the latter. It goes on to argue that the differences in these approaches are best understood in terms of the distinction between partialist and impartialist modes of moral thinking. The study seeks to determine the distribution of these modes of thinking between nurses and doctors, and finds that there are no signif icant differences between them. A 'two-level' philosophical view of the nature of moral thinking is appealed to in order to explain the study findings.
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Settle, Peggy Doyle. "Nurse Activism in the newborn intensive care unit." Nursing Ethics 21, no. 2 (March 1, 2013): 198–209. http://dx.doi.org/10.1177/0969733012475254.
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Nurses working in a newborn intensive care unit report that treatment decision disagreements for infants in their care may lead to ethical dilemmas involving all health-care providers. Applying Rest’s Four-Component Model of Moral Action as the theoretical framework, this study examined the responses of 224 newborn intensive care unit nurses to the Nurses Ethical Involvement Survey. The three most frequent actions selected were as follows: talking with other nurses, talking with doctors, and requesting a team meeting. The multiple regression analysis indicates that newborn intensive care unit nurses with greater concern for the ethical aspects of clinical practice (p = .001) and an increased perception of their ability to influence ethical decision making (p = .018) were more likely to display Nurse Activism. Future research is necessary to identify other factors leading to and inhibiting Nurse Activism as these findings explained just 8.5% of the variance.
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Malloy, D. C., J. Williams, T. Hadjistavropoulos, B. Krishnan, M. Jeyaraj, E. F. McCarthy, M. Murakami, S. Paholpak, J. Mafukidze, and B. Hillis. "Ethical decision-making about older adults and moral intensity: an international study of physicians." Journal of Medical Ethics 34, no. 4 (April 1, 2008): 285–96. http://dx.doi.org/10.1136/jme.2006.019273.
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Grote, Thomas, and Philipp Berens. "On the ethics of algorithmic decision-making in healthcare." Journal of Medical Ethics 46, no. 3 (November 20, 2019): 205–11. http://dx.doi.org/10.1136/medethics-2019-105586.
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In recent years, a plethora of high-profile scientific publications has been reporting about machine learning algorithms outperforming clinicians in medical diagnosis or treatment recommendations. This has spiked interest in deploying relevant algorithms with the aim of enhancing decision-making in healthcare. In this paper, we argue that instead of straightforwardly enhancing the decision-making capabilities of clinicians and healthcare institutions, deploying machines learning algorithms entails trade-offs at the epistemic and the normative level. Whereas involving machine learning might improve the accuracy of medical diagnosis, it comes at the expense of opacity when trying to assess the reliability of given diagnosis. Drawing on literature in social epistemology and moral responsibility, we argue that the uncertainty in question potentially undermines the epistemic authority of clinicians. Furthermore, we elucidate potential pitfalls of involving machine learning in healthcare with respect to paternalism, moral responsibility and fairness. At last, we discuss how the deployment of machine learning algorithms might shift the evidentiary norms of medical diagnosis. In this regard, we hope to lay the grounds for further ethical reflection of the opportunities and pitfalls of machine learning for enhancing decision-making in healthcare.
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Mackenzie, Robin. "Sexbots: Customizing Them to Suit Us versus an Ethical Duty to Created Sentient Beings to Minimize Suffering." Robotics 7, no. 4 (November 11, 2018): 70. http://dx.doi.org/10.3390/robotics7040070.
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Sex robot scholarship typically focuses on customizable simulacra, lacking sentience and self-awareness but able to simulate and stimulate human affection. This paper argues that future humans will want more: sex robots customized to possess sentience and self-awareness [henceforth, sexbots], capable of mutuality in sexual and intimate relationships. Adopting a transdisciplinary critical methodology focused on the legal, ethical and design implications of sexbots, it assesses implications of sexbots’ non-mammalian subjectivity, balancing designed-in autonomy and control, decision-making capacity and consent, sexual preferences and desire, legal and moral status, vulnerability and contrasts between mammalian and non-mammalian moral decision-making. It explores theoretical, ethical, and pragmatic aspects of the tensions involved in creating sentient beings for utilitarian purposes, concluding that sexbots, customized manufactured humanlike entities with the capacity for thought and suffering, have a consequent claim to be considered moral and legal persons, and may become the first conscious robots. Customizing sexbots thus exemplifies many profound ethical, legal and design issues. The contradictions inherent in their inconsistent ethical and legal status as both manufactured things and sentient, self-aware entities who are customized to be our intimate partners augments existing human/animal scholars’ call for a new theoretical framework which supersedes current person/thing dichotomies governing human responsibilities to other sentient beings. The paper concludes that the ethical limits and legal implications of customizable humanlike robots must be addressed urgently, proposing a duty on humans as creators to safeguard the interests and minimize the suffering of created sentient beings before technological advances pre-empt this possibility.
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Scott, P. Anne. "Aristotle, Nursing and Health Care Ethics." Nursing Ethics 2, no. 4 (December 1995): 279–85. http://dx.doi.org/10.1177/096973309500200402.
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Even a brief consideration of the nature of nursing will indicate that an ethical dimension underlies much, if not all, of nursing practice. It is therefore important that students and practitioners are facilitated in developing an ethical awareness and sensitivity from early in their professional development. This paper argues that Aristotelian virtue theory provides a practice-based focus for health care ethics for a number of reasons. Also, because of his emphasis on the character of the moral agent, and on the importance of perception and emotion in moral decision-making, Aristotelian virtue theory provides a useful supplement to the traditional duty-based approaches to health care ethics analysis, which are increasingly being identified in the literature as having limits to their application within the health care context.
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Ramos, Flávia Regina Souza, Laura Cavalcanti de Farias Brehmer, Mara Ambrosina Vargas, Ana Paula Trombetta, Luciana Ramos Silveira, and Laila Drago. "Ethical conflicts and the process of reflection in undergraduate nursing students in Brazil." Nursing Ethics 22, no. 4 (August 4, 2014): 428–39. http://dx.doi.org/10.1177/0969733014538890.
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Background: Nursing students on clinical placements as part of their professional training are routinely faced with situations involving ethical conflicts. The initial act of perceiving a situation as causing an ethical dilemma is the result of both the students’ personal values, drawn from their culture and families, and of the professional knowledge and values that they have acquired through training and experience. Objectives: Nursing students’ experiences on clinical placements in primary care settings were investigated in order to identify situations that they perceived as involving ethical conflict and describe the elements they took into consideration during their decision-making processes in these situations. Methods: The research design was qualitative descriptive case study. Around 50 students from three different intakes to a nursing degree answered a questionnaire and discussed it in focus groups. Ethical considerations: The study was designed in accordance with the principles guiding research with human beings and was approved by the Human Research Ethics Committee. Results: Synthesised into two principal axes: (a) ethical conflicts in primary care, linked with the domains of working processes, professional nursing ethics and human and social rights and (b) students’ decision-making processes – realisation, reflection and intervention. Conclusion: The student nurses saw themselves both as actors and spectators in situations involving ethical problems and demanding moral deliberation, demonstrating the ability to base their arguments soundly. They tended to emphasise the possibilities offered by dialogue and that different ethical values must be respected to find fair solutions to ethical problems.
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Juujärvi, Soile, Kirsi Ronkainen, and Piia Silvennoinen. "The ethics of care and justice in primary nursing of older patients." Clinical Ethics 14, no. 4 (September 19, 2019): 187–94. http://dx.doi.org/10.1177/1477750919876250.
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While the ethic of care has generally been regarded as an appropriate attitude for nurses, it has not received equal attention as a mode of ethical problem solving. The primary nursing model is expected to be aligned with the ethic of care because it emphases the nurse–patient relationship and enables more independent role for nurses in decision-making. The aim of this study was to examine nurses’ ethical decision-making in the context of primary nursing. Participants were seven nurses, and one physiotherapist from a geriatric rehabilitation unit of a public hospital in Finland. Data were collected through focus group interviews and qualitatively analyzed through Lyons’ coding scheme for moral orientations. The results showed that primary nurses employ empathic understanding and particularistic thinking when building relationships with patients and their families, and when assessing their needs for coping at home after discharge. Most ethical conflicts were related to discharge and were solved through balancing the ethics of care and justice considerations. It is concluded that care and justice are integrated in nurses’ everyday ethical decision-making. The ethic of care nurtures good patient–nurse relationships, while the ethic of justice is needed to address the fair delivery of care in the context of an aging population and diminishing public resources. Both ethics should be acknowledged in clinical practices and included in ethics education.
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Axelsson, Lena, Eva Benzein, Jenny Lindberg, and Carina Persson. "Processes toward the end of life and dialysis withdrawal Physicians’ and nurses’ perspectives." Nursing Ethics 27, no. 2 (June 11, 2019): 419–32. http://dx.doi.org/10.1177/0969733019848050.
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Background: Nurses and physicians in nephrology settings provide care for patients with end-stage kidney disease receiving hemodialysis treatment along a complex illness trajectory. Aim: The aim was to explore physicians’ and nurses’ perspectives on the trajectories toward the end of life involving decisions regarding hemodialysis withdrawal for patients with end-stage kidney disease. Research design and participants: A qualitative research approach was used. Four mixed focus group interviews were conducted with renal physicians (5) and nurses (17) in Sweden. Qualitative content analysis was used to analyse data. Ethical considerations: Ethical approval was obtained (Dnr 2014/304-31). Findings and discussion: Findings illuminated multi-faceted, intertwined processes encompassing healthcare professionals, patients, and family members. The analysis resulted in four themes: Complexities of initiating end-of-life conversations, Genuine attentiveness to the patient’s decision-making process, The challenge awaiting the family members’ processes, and Negotiating different professional responsibilities. Findings showed complexities and challenges when striving to provide good, ethical care which are related to beneficence, nonmaleficence, and self-determination, and which can give rise to moral distress. Conclusion: There are ethical challenges and strains in the dialysis context that healthcare professionals may not always be prepared for. Supporting healthcare professionals in not allowing complexities to hinder the patient’s possibilities for shared decision-making seems important. An open and continual communication, including family meetings, from dialysis initiation could serve to make conversations involving decisions about hemodialysis withdrawal a more natural routine, as well as build up a relationship of trust necessary for the advance care planning about the end of life. Healthcare professionals should also receive support in ethical reasoning to meet these challenges and handle potential moral distress in the dialysis context.
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Bjorklund, Pamela. "Invisibility, Moral Knowledge and Nursing Work in the Writings of Joan Liaschenko and Patricia Rodney." Nursing Ethics 11, no. 2 (March 2004): 110–21. http://dx.doi.org/10.1191/0969733004ne677oa.
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The ethical ‘eye’ of nursing, that is, the particular moral vision and values inherent in nursing work, is constrained by the preoccupations and practices of the superordinate biomedical structure in which nursing as a practice discipline is embedded. The intimate, situated knowledge of particular persons who construct and attach meaning to their health experience in the presence of and with the active participation of the nurse, is the knowledge that provides the evidence for nurses’ ethical decision making. It is largely invisible to all but other nurses. Two nurse researchers, Joan Liaschenko of the University of Minnesota and Patricia Rodney of the University of Victoria, have investigated the ethical concerns of practising nurses and noted in their separate enquiries the invisible nature of critical aspects of nursing work. Noting the similarities in their respective observations, and with the feminist ethics of Margaret Urban Walker as a theoretical framework, this article examines the concept of ‘invisibility’ as it relates to nursing work and nursing ethics.
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Santos, Laís Silveira, and Mauricio Custódio Serafim. "Phronesis , Moral Judgment, and Ethical Decision Making: Experiences of Public Managers in the Area of Emergency Management." Organizações & Sociedade 29, no. 101 (June 2022): 414–42. http://dx.doi.org/10.1590/1984-92302022v29n0017en.
Full textAbstract:
Abstract The purpose of this article is to investigate how phronesis manifests itself in moral judgment based on the experience of public managers in situations of ethical decisions in the area of emergency management (risk and disaster management). We conducted a literature review on phronesis as a virtue of “acting well.” As methodological procedures guided by a phenomenological epistemology and qualitative approach, an in-depth interview, non-participant observation, and document analysis were conducted. The discussion of data was organized into three sections: context and circumstances in the area of emergency management, experience and tacit knowledge of managers, and cognitive, affective, and reflexive composition of phronesis . Some elements of phronesis are perceptible and contribute to the ethical decision-making process in view of the possibilities of limiting moral judgment, such as the context and contingency circumstances of emergencies, the affective dimension such as empathy, the need for mediation between instrumental aspects and the will to act with compassion, counseling as a reflective element, and memory and learning from past experiences. The conclusion is that, when conditions for moral judgment are not favorable and/or there are limiting factors - such as excess of technical and/or bureaucratic issues, a context of insecurity, and a purpose of protecting human life -, phronesis may help to develop an enlightened knowledge for the individual exposed to reviews, education and clarification about the social, political, and organizational context to which she or he belongs.
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Papanikolaou, Vaia, Yiannis Roussakis, and Panagiotis Tzionas. "Ethical Decision Making in Emergent Emergencies under a Veil of Ignorance." HAPSc Policy Briefs Series 1, no. 1 (June 30, 2020): 46. http://dx.doi.org/10.12681/hapscpbs.24947.
Full textAbstract:
In this paper we initially propose a scheme for the determination of threats due to the Covid19 pandemic, followed by appropriate response measures. In order to devise successful response actions, one should pay extreme care in identifying the actual threats posed and, as a matter of fact, prioritize them with respect to their severity on human life, societal risks, democratic operation of the institutions and the state and irreversible environmental impact.But would everyone be benefited the same by these response measures? There lies the danger to be unfair of even ignoring socially disadvantaged groups and, thus, increasing social inequality gaps. And the new equilibrium attained runs the danger of being less stable than the old one, exhibiting degraded emergent behavior and capabilities for self-organization. In this case we would have achieved exactly the opposite of what we wished for, a system of lower resilience to perturbations.Thus, we argue that the ethical element is the predominant factor that should determine all types of feedback responses and actions taken by decision-makers in all political, social, economic and environmental aspects during the process of returning to normality.Towards this purpose, a method of determining the morality of response measures is required. A variation of the ‘Veil of Ignorance’ provides such a method, as introduced in this paper. It asks the decision-makers to make choices about social or moral issues related to the feedback responses to the pandemic and assumes that they have enough information to know the consequences of their possible decisions for everyone but would not know which person they will be themselves, in the new equilibrium. We believe that the proposed ethical framework will result to just and fair to all response measures.