Numerous articles in the popular press together with an examination of websites associated with the medical, legal, engineering, financial, and other professions leave no doubt that the role of professions has been impacted by the Internet. While offering the promise of the democratization of expertise – expertise made available to the public at convenient times and locations and at an affordable cost – the Internet is also driving a reexamination of the concept of professional identity and related claims of expertise (...) and standards of integrity. This paper begins with a presentation of case studies illustrating the ease by which impostors infiltrate the ranks of professionals. Reports of individuals masquerading as professionals via the Internet often reveal that these imposters cause harm to the unwary victims who rely on assertions of professional expertise. Such reports motivated the authors to examine the origins and evolution of the traditional roles of professions and professionals in today’s society, as well as question how, or whether, the standards for professional practice have been adapted to the challenges posed by technology, i.e., do statements of professional ethics provide a ‘guiding light’ for practitioners and their clients in the cyber age? The authors challenge the professions to consider the notion that technology forces a confrontation between the guild-like aspects of a profession that have served, on the one hand, to protect a profession from encroachment and, on the other hand, have purportedly protected the public. (shrink)

The paradigm of work and the formal organizations within which people work are changing. Trends in organizations include less hierarchy, integrated structures, empowered employees, teams and teamwork, labor-management partnerships, and myriad other changes. Underlying all these changes is a new emphasis on values regarding how organizations function. Among the critical organizational functions to which the values framework applies is communication.Most models of internal organizational communication are adaptations of the existing model for communicating externally. These models fall short of what is (...) needed to impact today's employees. (shrink)

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

Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a (...) set of clearly defined procedures for these decisions. The procedures are based on the principle of nonmaleficence and typically include consultation with hospital ethics committees, reflecting the guidelines of relevant professional associations. Ethical debates about when CPR can and should be limited tend to rely more on discussions of theory, principles, and case studies than systematic empirical study of the situations in which such limitations are applied. Sociologists of bioethics call for empirical study, arguing that what ethicists and health professionals believe they are doing when they draft policies or invoke principles does not always mirror what is happening on the ground. In this article, we begin the task of modeling the empirical analyses sociologists call for, focusing on a cohort at Massachusetts General Hospital. We inductively analyzed ethics committee notes and medical records of nineteen patients whose surrogates did not accept the decision to withhold CPR. (shrink)

Recent ethical misconduct in American business has resulted in volumes of written commentary, various legislative responses, as well as litigation by those identified as victims. While legislators, judges, juries, and the Securities and Exchange Commission (SEC) pursue an increasing number of cases, there is little attention devoted to understanding what drives executives and other leaders to behave in ways that violate the ethical and legal standards of business in the United States. This understanding is a prerequisite to selecting leaders and (...) designing interventions that prevent future misconduct. Understanding leadership’s nature and functioning is one key to understanding the ethical behavior of an organization as a system and of the people who lead the organization. Two models or frameworks provide the foundation for this paper. The first is a model of leadership competencies. This model identifies five key areas of competence related to overall, long-term leadership success. The second model targets leadership effectiveness. This model has three components – motivational patterns, decision criteria, and competencies. Using the Leadership Effectiveness Model to frame the discussion, the authors describe the nature and importance of the models, with particular focus on motivational patterns. Research suggests these patterns often account for 40–60% of overall leadership effectiveness. This article defines motivational patterns and describes key patterns that may impact ethical behavior of leaders. The article concludes with a discussion of how to use data on motivational patterns in leadership selection, development, and evaluation processes. (shrink)

The remember/know procedure is the most widely used method to investigate recollection and familiarity. It uses trial-by-trial reports to determine how much recollection and familiarity contribute to different kinds of recognition. Few other methods provide information about individual memory judgements and no alternative allows such direct indications of recollection and familiarity influences. Here we review how the RK procedure has been and should be used to help resolve theoretical disagreements about the processing and neural bases of components of recognition memory. (...) Emphasis is placed on procedural weaknesses and a possible confound of recollection and familiarity with recognition memory strength. Recommendations are made about how to minimise these problems including using modified versions of the procedure. The proposals here are important for improving behavioural and lesion research, and vital for brain imaging work. (shrink)

An employer asked to provide a reference for a former or departing employee is confronted with a number of complex legal and ethical concerns. The issue of references is always controversial, involving a balance of employers' fears of legal liability, interests in providing relevant information to prospective employers, and concerns for fairness to former employees. Recently this topic has been the focus of new attention as the result of a court decision holding a former employer legally liable for wrongs committed (...) by a former employee in a new job. In that case, the former employer had provided a positive reference while neglecting to note certain negative aspects of the former employee'sperformance. This paper addresses legal and ethical aspects of the reference dilemma and incorporates responses of human resource professionals to the question of ethical reference policies and practices. (shrink)

Revolutions in semiconductor device miniaturization, bioelectronics, and applied neural control technologies are enabling scientists to create machine-assisted minds, science fiction's “cyborgs.” In a paper published in 1999, we sought to draw attention to the advances in prosthetic devices, to the myriad of artificial implants, and to the early developments of this technology in cochlear and retinal implants. Our concern, then and now, was to draw attention to the ethical issues arising from these innovations. Since that time, breakthroughs have occurred at (...) a breathtaking pace. Scientists, researchers, and engineers using differing methodologies are pursuing the possibilities of direct interfaces between brains and machines. Technological innovations as such are neither good nor evil; it is the uses devised for them that create moral implications. As there can be ethical problems inherent in the proper human uses of technologies and because brain chips are a very likely future technology, it is prudent to formulate policies and regulations that will mitigate their ill effects before the technologies are widespread. Unlike genetic technologies, which have received widespread scrutiny within the scientific community, national governments, and international forums, brain–machine interfaces have received little social or ethical scrutiny. However, the potential of this technology to change and significantly affect humans is potentially far greater than that of genetic enhancements, because genetic enhancements are inherently limited by biology and the single location of an individual, whereas hybrids of human and machine are not so restricted. Today, intense interest is focused on the development of drugs to enhance memory; yet, these drugs merely promise an improvement of normal memory, not the encyclopedic recall of a computer-enhanced mind combined with the ability to share information at a distance. The potential of brain chips for transforming humanity are astounding. This paper describes advances in hybrid brain–machine interfaces, offers some likely hypotheses concerning future developments, reflects on the implications of combining cloning and transplanted brain chips, and suggests some potential methods of regulating these technologies. (shrink)

Documentary filmmakers have ethical responsibilities to the subjects of their films. Specifically, they have an ethical responsibility to prevent harm to their subjects if they are in a position to do so, even harm not directly related to being in the film. Justification for this comes from documentary's status as a practice of a social institution and can be supported by Utilitarian and Kantian considerations, as well as the Aristotelian discussion of practices. Three films, The Thin Blue Line, Dope Sick (...) Love , and Born Into Brothels , are used as examples for the requirement to prevent harm to subjects. These examples cover several different possibilities of how documentary filmmakers behave concerning the welfare of their subjects and are evaluated in light of ethical considerations offered. (shrink)

There are many strains in Heidegger’s thought to which he often refers, but one that he never mentions, Taoism. Otto Pöggeler has noted that Heidegger’s engagement with Chinese philosophy, and in particular with the Tao Te Ching of Lao-tzu, exerted a decisive effect on the form and direction of his later thinking. With Reinhard May’s careful comparisons of passages from Heidegger’s major texts with translations of the Tao Te Ching and various Zen Buddhist texts, there is now general agreement on (...) Heidegger’s indebtedness to Chinese philosophy. The recurrent themes of his later lectures can all be found in Taoist texts. Often these are points on which he is labeled a mystic or an irrationalist and taken to task by his Western critics. This essay examines some key facets of his thought and compares his position to that of the Tao Te Ching so as to determine the extent to which Heidegger has departed from the Western tradition to become a Taoist. (shrink)

The present organ procurement system in the United States has failed to alleviate the chronic shortage of organs. Neither policies that require request for organ donation, nor increased educational...

In online lectures, unlike in face-to-face lectures, teachers lack access to (nonverbal) cues to check if their students are still “with them” and comprehend the lecture. The increasing availability of low-cost eye-trackers provides a promising solution. These devices measure unobtrusively where students look and can visualize these data to teachers. These visualizations might inform teachers about students’ level of “with-me-ness” (i.e., do students look at the information that the teacher is currently talking about) and comprehension of the lecture, provided that (...) (1) gaze measures of “with-me-ness” are related to comprehension, (2) people not trained in eye-tracking can predict students’ comprehension from gaze visualizations, (3) we understand how different visualization techniques impact this prediction. We addressed these issues in two studies. In Study 1, 36 students watched a video lecture while being eye-tracked. The extent to which students looked at relevant information and the extent to which they looked at the same location as the teacher both correlated with students’ comprehension (score on an open question) of the lecture. In Study 2, 50 participants watched visualizations of students’ gaze (from Study 1), using six visualization techniques (dynamic and static versions of scanpaths, heatmaps, and focus maps) and were asked to predict students’ posttest performance and to rate their ease of prediction. We found that people can use gaze visualizations to predict learners’ comprehension above chance level, with minor differences between visualization techniques. Further research should investigate if teachers can act on the information provided by gaze visualizations and thereby improve students’ learning. (shrink)

This qualitative study explored how 10 first-year peer educators understood and utilized their own socilal identities (e.g., their race, gender, sexual orientation, etc.) in their diversity education efforts. All participants saw their identities as having a profound impact on their teaching, although they identified many different, and sometimes contradictory influences. Their identities influenced their credibility as educators, use of emotion, and relationships with dominant and target group member students. Educators sometimes chose to discuss their own experiences with oppression and privilege, (...) and sometimes kept their identities hidden. Participants noted, in conclusion, the importance of considering the influence of their own identity, as awareness influenced how they approached their qork as diversity educators. (shrink)

Regarding Equality offers an innovative and controversial analysis of the relationship between equality and pluralism. Tackling an issue central to modern political thought, Freeberg highlights the struggle to characterize citizens as equals while respecting their moral, religious, and cultural diversity. The work ably contrasts and critiques the prevailing models for balancing equality with pluralism from thinkers Amartya Sen, Martha Nussbaum, John Rawls, Amy Gutmann, Dennis Thompson, Michael Oakeshott, and Drucilla Cornell. From these liberal, democratic, and conservative approaches to equality and (...) pluralism, Freeberg builds a theory of responsive regard: reciprocal civility between citizens that forms a chastened conception of what we share as free and equal persons. This work will greatly add to political theorists' and philosophers' arsenals of concepts for egalitarian and democratic theory. (shrink)

A current issue in environmental ethics concerns the role of scientists as advocates for environmental policy. Some have argued that scientists should not be permitted to be policy advocates. I will argue that it is morally permissible for scientists to be advocates for environmental policies for four reasons. First, since scientists are also citizens it is improper to deny them the opportunity to advocate for certain policies. Second, scientists possess some expertise in these areas should be sought out to advocate (...) for these positions precisely because they are the ones with the knowledge, understanding and access to objective studies relating to policy issues. Third, I will argue that while objectivity is required for research, advocacy for policy issues does not entail the failure of objectivity. Last, scientists advocating for environmental policy meets the ethical requirements for advocacy generally offered by Robert Audi. These give us good reason to think it is morally permissible for scientists to act as advocates for environmental policy. (shrink)

In Epistemology of the Closet, Eve Kosofsky Sedgwick explores the connection between the binaries of heterosexuality/homosexuality and the utopian/apocalyptic. In doing so, she exposes the commonplace of a “fantasy trajectory toward a life after the homosexual.”1 In this narrative model, once the queer has completed its function of purging the symbolic of its sins, the character is eliminated from the text as part of the emergence of a postnarrative hetero-normative utopia. In a similar vein, Lee Edelman’s “Against Survival: Queerness in (...) a Time That’s Out of Joint,” an essay on the quintessential revenge tragedy, Hamlet, notes that the revenger’s death ensures a return of society’s idealized vision of the future.2... (shrink)

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. (shrink)

The idea of a role in nursing that includes expertise in ethics has been around for more than 30 years. Whether or not one subscribes to the idea that nursing ethics is separate and distinct from bioethics, nursing practice has much to contribute to the ethical practice of healthcare, and with the strong grounding in ethics and aspiration for social justice considerations in nursing, there is no wonder that the specific role of the nurse ethicist has emerged. Nurse ethicists, expert (...) in nursing practice and the application of ethical theories and concepts, are well positioned to guide nurses through complex ethical challenges. However, there is limited discussion within the field regarding the specific job responsibilities that the nurse ethicist ought to have. The recent appearance of job postings with the title “nurse ethicist” suggest that some healthcare institutions have identified the value of a nurse in the practice of ethics and are actively recruiting. Discomfort about the possibility of others defining the role of the nurse ethicist inspired this paper (and special issue). If the nurse ethicist is to be seen as an integral part of addressing ethical dilemmas and ethical conflicts that arise in healthcare, then nurse ethicists ought to be at the forefront of defining this role. In this paper, we draw upon our own experiences as nurse ethicists in large academic healthcare systems to describe the essential elements that ought to be addressed in a job description for a nurse ethicist practicing in a clinical setting linked to academic programs. Drawing upon our experience and the literature, we describe how we perceive the nurse ethicist adds value to healthcare organizations and teams of professional ethicists. (shrink)

We have long used mechanical devices to compensate for physical disability. Soon, however, it may be possible to augment mental capacity—to add memory or upgrade processing power. We should ponder the enormous moral implications of the machine‐assisted mind now, before it is accomplished.