There is no agreed minimum standard with regard to what is considered safe, competent nursing care. Limited resources and organizational constraints make it challenging to develop a minimum standard. As part of their everyday practice, nurses have to ration nursing care and prioritize what care to postpone, leave out, and/or omit. In developed countries where public healthcare is tax-funded, a minimum level of healthcare is a patient right; however, what this entails in a given patient’s actual situation is unclear. (...) Thus, both patients and nurses would benefit from the development of a minimum standard of nursing care. Clarity on this matter is also of ethical and legal concern. In this article, we explore the case for developing a minimum standard to ensure safe and competent nursing care services. Any such standard must encompass knowledge of basic principles of clinical nursing and preservation of moral values, as well as managerial issues, such as manpower planning, skill-mix, and time to care. In order for such standards to aid in providing safe and competent nursing care, they should be in compliance with accepted evidence-based nursing knowledge, based on patients’ needs and legal rights to healthcare and on nurses’ codes of ethics. That is, a minimum standard must uphold a satisfactory level of quality in terms of both professionalism and ethics. Rather than being fixed, the minimum standard should be adjusted according to patients’ needs in different settings and may thus be different in different contexts and countries. (shrink)

ABSTRACTCurrent discourse about higher education focuses on issues like government funding, student debt, and admissions diversity; however, increasing attention is being paid to issues of speech and politics in the university. Alongside a series of events at several institutions, calls for ‘safe space’ on campus have grown familiar. Yet the appropriateness of such spaces on campus is debated. In this article the notion of safety implied in calls for ‘safe space’ is clarified, and three reasons are suggested for (...) supporting such safety pedagogically. A public reason is proposed, which relies on a normative interpretation of publicness as conjoint action. This substantive version of ‘public’ could be considered when assessing the institution’s publicness, rather than typical elements of the university’s nominal publicness. By embracing and ensuring safe space, universities could become sites of public full participation, thus fostering a re-recognition of higher education as a public good. (shrink)

Digitalisation of health and the use of health data in artificial intelligence, and machine learning (ML), including for applications that will then in turn be used in healthcare are major themes permeating current UK and other countries’ healthcare systems and policies. Obtaining rich and representative data is key for robust ML development, and UK health data sets are particularly attractive sources for this. However, ensuring that such research and development is in the public interest, produces public benefit and preserves (...) privacy are key challenges. Trusted research environments (TREs) are positioned as a way of balancing the diverging interests in healthcare data research with privacy and public benefit. Using TRE data to train ML models presents various challenges to the balance previously struck between these societal interests, which have hitherto not been discussed in the literature. These challenges include the possibility of personal data being disclosed in ML models, the dynamic nature of ML models and how public benefit may be (re)conceived in this context. For ML research to be facilitated using UK health data, TREs and others involved in the UK health data policy ecosystem need to be aware of these issues and work to address them in order to continue to ensure a ‘safe’ health and care data environment that truly serves the public. (shrink)

__Creating Safe, Equitable, Engaging Schools_ brings together the collective wisdom of more than thirty experts from a variety of fields to show how school leaders can create communities that support the social, emotional, and academic needs of all students._ It offers an essential guide for making sense of the myriad evidence‐based frameworks, resources, and tools available to create a continuous improvement system. Chapters illustrate how leaders can leverage the power of school-based teams to assess the needs of students in (...) their school and select appropriate interventions across a wide variety of domains, including social and emotional learning, trauma, restorative practices, cultural responsiveness, and student and family engagement. Filled with recommendations gleaned from research and ongoing work in every US state and territory, _Creating Safe, Equitable, Engaging Schools_ is a critical resource for understanding and adopting evidence-based practices and making programmatic decisions to ensure the ideal conditions for learning, growth, and development. (shrink)

Since some AI algorithms with high predictive power have impacted human integrity, safety has become a crucial challenge in adopting and deploying AI. Although it is impossible to prevent an algorithm from failing in complex tasks, it is crucial to ensure that it fails safely, especially if it is a critical system. Moreover, due to AI’s unbridled development, it is imperative to minimize the methodological gaps in these systems’ engineering. This paper uses the well-known Box-Jenkins method for statistical modeling as (...) a framework to identify engineering pitfalls in the adjustment and validation of AI models. Step by step, we point out state-of-the-art strategies and good practices to tackle these engineering drawbacks. In the final step, we integrate an internal and external validation scheme that might support an iterative evaluation of the normative, perceived, substantive, social, and environmental safety of all AI systems. (shrink)

Within health care systems, negative perceptions of lesbian, gay, bisexual, and transgender persons have often translated into denial of services, denial of visitation rights to same‐sex partners, reluctance on the part of LGBT patients to share personal information, and failure of workers to assess and recognize the unique health care needs of these patients. Other bureaucratic forms of exclusion have included documents, forms, and policies that fail to acknowledge a patient's valued relationships because of, for example, a narrow definition of (...) “spouse,” “parent,” or “family.” Bureaucratic exclusion has taken a particularly prominent form in the U.S. military. Until its repeal and termination in 2011, the “Don't Ask, Don't Tell” policy had for eighteen years barred openly gay men and lesbians from serving in the military. Among the effects of DADT is a dearth of information about the number and needs of LGBT service members who transition to the Veterans Health Administration for health care at the end of their military service. The long‐standing social stigma against LGBT persons, the silence mandated by DADT, and the often unrecognized bias built into the fabric of bureaucratic systems make the task of creating a welcoming culture in the VHA urgent and challenging.The VHA has accepted a commitment to that task. Its Strategic Plan for fiscal years 2013 through 2018 stipulates that “[v]eterans will receive timely, high quality, personalized, safe, effective and equitable health care irrespective of geography, gender, race, age, culture or sexual orientation.” To achieve this goal, the VHA undertook a number of coordinated initiatives to create an environment and culture that is informed, welcoming, positive, and empowering for the LGBT veterans and families whom the agency serves. (shrink)

In a time of increasing polarization, how can we address sensitive topics and ensure that university classrooms remain places of healthy discussions and ethical deliberations? This paper addresses this important question by drawing on unique qualitative data from our students’ accounts of their experience in an organizational ethics course. We developed the course using a novel pedagogical strategy centered around the creation of an artistic portfolio. We find that student engagement in an alternative individual space, such as the artistic portfolio, (...) supports them in developing (inter)personal skills in preparation for constructive participation in sensitive discussions and ethical deliberation in the classroom. Additionally, engagement with the artistic portfolio provides them with an alternative means for alleviating tension that arises from these discussions and a space for expressing their opinions. Our findings highlight the role of the portfolio as an individual safe haven that supports teachers in facilitating a positive classroom atmosphere and guides students through challenging discussions and deliberations intrinsic to responsible management education. Considering these new insights, we advocate for a shift from a collective to an individual perspective on safety in academia. This transition liberates the classroom from the constraints and limitations often associated with the establishment of collective safe spaces. (shrink)

In the APA Newsletter on Feminism and Philosophy, Lauren Freeman (2014) advocates that faculty turn their classrooms into “safe spaces” as a method for increasing the diversity of philosophy majors. The creation of safe spaces is meant to make women and minority students “feel sufficiently comfortable” and thereby increase the likelihood that they pursue philosophy as a major or career. Although I agree with Freeman’s goal, I argue that philosophers, and faculty in general, should reject the call for (...) turning classrooms into “safe spaces.” I begin by distinguishing extra-curricular safe spaces from the classroom as a safe space. I then argue that although faculty should not object to extra-curricular safe spaces, they should reject curricular ones. I argue that the classroom as a safe space is currently an impractical and inappropriate goal given the nature of academic philosophy, and that encouraging students to think of classrooms as safe/unsafe does not facilitate learning. Nonetheless, I agree with Freeman that faculty should take steps to ensure that students from all backgrounds have the tools they need to be successful in the classroom. I further argue that faculty calls for safe spaces creates confusion concerning the educative environment one should expect to find at the majority of America universities. (shrink)

In a time of increasing polarization, how can we address sensitive topics and ensure that university classrooms remain places of healthy discussions and ethical deliberations? This paper addresses this important question by drawing on unique qualitative data from our students’ accounts of their experience in an organizational ethics course. We developed the course using a novel pedagogical strategy centered around the creation of an artistic portfolio. We find that student engagement in an alternative individual space, such as the artistic portfolio, (...) supports them in developing (inter)personal skills in preparation for constructive participation in sensitive discussions and ethical deliberation in the classroom. Additionally, engagement with the artistic portfolio provides them with an alternative means for alleviating tension that arises from these discussions and a space for expressing their opinions. Our findings highlight the role of the portfolio as an individual safe haven that supports teachers in facilitating a positive classroom atmosphere and guides students through challenging discussions and deliberations intrinsic to responsible management education. Considering these new insights, we advocate for a shift from a collective to an individual perspective on safety in academia. This transition liberates the classroom from the constraints and limitations often associated with the establishment of collective safe spaces. (shrink)

Education has always occupied a contradictory position in society, expected to ensure compliance and continuity and yet to encourage critique and renewal. Since the early 1980s, however, successive UK governments have directly mobilised education, and higher education in particular, as an ideological tool in the task of embedding neo-liberalism as ‘common sense’. Modularisation has been in the vanguard, first in the universities, more latterly at secondary level. The effect has been disastrous: here as elsewhere, choice has become depressingly fetishised; knowledge, (...) and with it learning, have been fragmented and commodified; academics, like others, have been de-professionalised; and students, like the rest of us, have been transformed into clients or customers. The details of the history and impact of all this are too close to readers’ experience to require elaboration here: its significance, however, has been too little considered. In particular, the question of how we allowed it to come about is one worth asking – if only so that we can learn from our complicity. Since, however, that judgement depends on the negative view of modularisation just outlined, I start by giving a summary argument for such an evaluation (section 1). I then offer some remarks about the specifically ideological character of modularisation (section 2) as an introduction to some initial reflections on our complicity in this aspect of the neo-liberals’ efforts to make universities safe in their attempt to ensure that the future belongs to them (section 3). Finally I offer a brief suggestion about what we might yet do to overcome the disaster (section 4). (shrink)

When lethal injection was first legalized in the late 1970s, many people viewed it as safe, reliable, and humane. Today, however, lethal injection does not always perform as promised. Due to difficulties with sourcing lethal injection drugs, states are utilizing untested lethal injection protocols, with little knowledge or experience to guide them. This article argues that lethal injection reform requires regulation similar to that for human subject research, and that the practice of utilizing untested lethal injection methods comes very (...) close to falling under the federal statutory definition of “human subject research“ formulated in the Common Rule. This article argues further that even if one decides that it does not, the practice of lethal injection today is the type of conduct that the human subject research regulations were designed to correct. Moreover, society has an interest in ensuring that executions are conducted in a way that reduces pain and suffering to the lowest extent possible. As such, lethal injection ought to receive further review and oversight to ensure that it comports with reasonable notions of humanity. (shrink)

AI systems that demonstrate significant bias or lower than claimed accuracy, and resulting in individual and societal harms, continue to be reported. Such reports beg the question as to why such systems continue to be funded, developed and deployed despite the many published ethical AI principles. This paper focusses on the funding processes for AI research grants which we have identified as a gap in the current range of ethical AI solutions such as AI procurement guidelines, AI impact assessments and (...) AI audit frameworks. We highlight the responsibilities of funding bodies to ensure investment is channelled towards trustworthy and safe AI systems and provides case studies as to how other ethical funding principles are managed. We offer a first sight of two proposals for funding bodies to consider regarding procedures they can employ. The first proposal is for the inclusion of a Trustworthy AI Statement’ section in the grant application form and offers an example of the associated guidance. The second proposal outlines the wider management requirements of a funding body for the ethical review and monitoring of funded projects to ensure adherence to the proposed ethical strategies in the applicants Trustworthy AI Statement. The anticipated outcome for such proposals being employed would be to create a ‘stop and think’ section during the project planning and application procedure requiring applicants to implement the methods for the ethically aligned design of AI. In essence it asks funders to send the message “if you want the money, then build trustworthy AI!”. (shrink)

New genomic techniques (NGTs) are powerful technologies with the potential to change how we relate to our food, food producers, and natural environment. Their use may affect the practices and values our societies are built on. Like many countries, the EU is currently revisiting its GMO legislation to accommodate the emergence of NGTs. We argue that assessing such technologies according to whether they are ‘safe enough’ will not create the public trust necessary for societal acceptance. To avoid past mistakes (...) of under- or miscommunication about possible impacts, we need open, transparent, and inclusive societal debate on the nature of the science of gene (editing) technologies, on how to use them, and whether they contribute to sustainable solutions to societal and environmental challenges. To be trustworthy, GMO regulation must demonstrate the authorities’ ability to manage the scientific, socio-economic, environmental, and ethical complexities and uncertainties associated with NGTs. Regulators and authorities should give equal attention to the reflexive and the emotional aspects of trust and make room for honest public and stakeholder inclusion processes. The European Group of Ethics in Science and Technology’s recent report on the Ethics of Genome Editing (2021) is important in calling attention to a series of fundamental issues that ought to be included in debates on the regulation and use of NGTs to ensure public trust in these technologies and in regulating authorities. With the great power of NGTs comes great responsibility, and the way forward must be grounded in responsible research, innovation, and regulation. (shrink)

The article discusses the theoretical issues of designing a safe professional and educational environment. The environmental approach is substantiated as a methodology for this process. The environmental conditions that provide the teacher with safety and security in the implementation of professional activities are indicated. An attempt was made to determine the ratio of the structural components of the vocational and educational environment and the environmental conditions that ensure its safety. The stages and levels of designing a safe professional (...) and educational environment have been substantiated. (shrink)

BackgroundDepressive disorders are a common form of psychiatric illness and cause significant disability. Regulation authorities, the medical profession and the public require high safety standards for antidepressants to protect vulnerable psychiatric patients. Ketamine is a dissociative anaesthetic and a derivative of a hallucinogen. Its abuse is a major worldwide public health problem. Ketamine is a scheduled drug and its usage is restricted due to its abuse liability. Recent clinical trials have reported that ketamine use led to rapid antidepressant effects in (...) patients suffering from treatment-resistant depression. However, various flaws in study designs, and possible biased reporting of results, may have influenced those findings. Further analyses of ketamine use are needed to ensure patient safety.DiscussionThe use of ketamine in research and treatment of depressive disorders is controversial. Recently, mental health professionals raised ethical concerns about an ongoing ketamine trial in the UK. Also, a Canadian agency reviewed the existing evidence and did not recommend prescribing ketamine to treat depressive disorders. Findings obtained from tightly controlled research settings cannot be easily translated to clinical practice as substance abuse is commonly comorbid with depressive disorders. An effective antidepressant should reduce severity of depressive symptoms without liability problems. Although the US FDA has not approved the use of ketamine to treat depressive disorders, some psychiatrists offer off-label repeat prescription of ketamine. Prescribing ketamine for treating depressive disorders requires substantial empirical evidence. Clinicians should also consider research findings on ketamine abuse. Depressive disorders can be chronic conditions and the current evidence does not rule out the risk of substance abuse after repeat prescription of ketamine. Off-label ketamine use in treating depressive disorders may breach ethical and moral standards, especially in countries seriously affected by ketamine abuse. This article presents two real-world clinical vignettes which highlight ethical principles and theories, including autonomy, nonmaleficience, fidelity and consequentialism, as related to off-label ketamine use.ConclusionWe urge clinicians to minimise the risk of harming patients by considering the empirical evidence on ketamine properties and attempting all standard antidepressant therapies before considering the off-label use of ketamine. (shrink)

Sociability is essential for modern robots to increase their acceptability in human environments. Traditional techniques use manually engineered utility functions inspired by observing pedestrian behaviors to achieve social navigation. However, social aspects of navigation are diverse, changing across different types of environments, societies, and population densities, making it unrealistic to use hand-crafted techniques in each domain. This paper presents a data-driven navigation architecture that uses state-of-the-art neural architectures, namely Conditional Neural Processes, to learn global and local controllers of the mobile (...) robot from observations. Additionally, we leverage a state-of-the-art, deep prediction mechanism to detect situations not similar to the trained ones, where reactive controllers step in to ensure safe navigation. Our results demonstrate that the proposed framework can successfully carry out navigation tasks regarding social norms in the data. Further, we showed that our system produces fewer personal-zone violations, causing less discomfort. (shrink)

Following an initial study of the needs of healthcare providers (HCP) regarding the introduction of Medical Assistance in Dying (MAiD), and the subsequent development of an assisted dying program, this study sought to determine the efficacy and impact of MAiD services following the first two years of implementation. The first of three aims of this research was to understand if the needs, concerns and hopes of stakeholders related to patient requests for MAiD were addressed appropriately. Assessing how HCPs and families (...) perceived the quality of MAiD services, and determining if the program successfully accommodated the diverse needs and perspectives of HCPs, rounded out this quality evaluation. This research implemented a mixed-methods design incorporative of an online survey with Likert scale and open-ended questions, as well as focus groups and interviews with staff and physicians, and interviews with MAiD-involved family members. There were 356 online surveys, as well as 39 participants in six focus groups with HCP, as well as fourteen interviews with MAiD-involved family members. Participants indicated that high-quality MAiD care could only be provided with enabling resources such as policies and guidelines to ensure safe, evidence-based, standardized care, as well as a specialized, trained MAiD team. Both focus group and survey data from HCPs suggest the infrastructure developed by the hospital was effective in delivering high-quality MAiD care that supports the diverse needs of various stakeholders. This study may serve as a model for evaluating the impact and quality of services when novel and ethically-contentious clinical practices are introduced to healthcare organizations. (shrink)

The Millennium Development Goal (MDG) 5 A states that the maternal mortality ratio has to be reduced to three-quarters between 1990 and 2015. The target for India is a maternal mortality ratio of 109/100,000 live births. The Janani Suraksha Yojna (JSY) (Maternal Protection Scheme) is a centrally sponsored conditional cash transfer scheme to promote institutional deliveries and thus ensure safe delivery and reduce maternal mortality. The JSY scheme and its various evaluations were reviewed. The Tannahill’s ethical framework was applied (...) to the JSY and analyzed. Evaluations have shown that the JSY has significantly increased institutional deliveries. The public health system is not fully geared up for delivering good quality maternal health services. Thus encouraging women to go to them violates the principle of doing good. There are several barriers for availing the scheme. Procuring the certificates to meet eligibility can be difficult. The women do not have power over the cash incentive. There are large inequities in access to the JSY scheme based on socioeconomic status, caste and education. The accountability mechanisms for the scheme are weak at the grassroots level. Without an overall improvement in health system and awareness among women, the JSY cannot be said to empower the women in a sustainable way. In order, that the increases in institutional deliveries due to JSY are more than just a Hawthorne effect, which is a change in behavior just due to the fact that the population is being closely observed and intervened, there is a need to bridge the ethical gaps in the program to make it an empowering, sustainable, accountable and just one. (shrink)

Medical care of critically ill and injured infants and children globally should be based on best research evidence to ensure safe, efficacious treatment. In South Africa and other low and middle-income countries, research is needed to optimise care and ensure rational, equitable allocation of scare paediatric critical care resources.

Background The early phase of the COVID-19 pandemic affected nursing homes and their residents heavily. Guidelines on how to mitigate the virus’s spread and ensuring safe healthcare delivery were continually evolving. Concurrently, nursing homes faced intense media scrutiny. This challenging environment severely impacted registered nurses and physicians employed within these facilities. Aim To understand the ethical challenges experienced by registered nurses and physicians working in nursing homes during the COVID-19 pandemic. Research design Qualitative descriptive research using thematic analysis. (...) Participants and research context Individual online interviews with four registered nurses and eight physicians clinically active at nursing homes in Sweden. Ethical considerations The study was approved by the Swedish Ethical Review Authority. All participants provided written consent. Results Registered nurses and physicians working in nursing homes perceived ethical challenges stemming from early COVID-19 pandemic guidelines and media coverage. The main theme generated was ‘Struggling to maintain professional and ethical standards under pressure’ incorporating two subthemes: ‘Guidelines developed without the profession put pressure on staff’ and ‘Media’s biased reporting was perceived as unethical and undermined care’. Guidelines from the authorities were considered as developed without professional involvement. It made them difficult to adhere to without deviating from professional and ethical compasses. Media coverage adversely influenced relatives’ perceptions, resulting in mistrust towards physicians’ and registered nurses’ in delivering optimal care for the residents. Conclusions Resilient care in nursing homes necessitates the collaborative development of guidelines involving registered nurses and physicians, particularly amidst crises. Moreover, it is vital to provide support to registered nurses navigating ethical dilemmas, especially during pandemics. Guidelines and principles for care during a crisis should be development with professional involvement, be transparent, and be available to the public, to promote neutral media coverage. Future research is crucial to enhance ethical standards and tackle challenges in this context. (shrink)

Background: Psychedelics are known for their powerful mental effects due to the activation of 5HT-2A receptors in the brain. During the 1950s and 1960s, research was conducted on these molecules until their criminalization. However, their clinical investigation as therapeutic tools for psychiatric disorders has revived the deontological ethics surrounding this subject. Questions arise as research on their therapeutic outcome becomes a reality. We aim to explore deontological ethics to understand the implications of psychedelics for the clinician, patient, and society. Results: (...) A total of 42 articles were considered for this review. Methods: A methodological search of psychedelic studies from 2017 to 2022 was conducted in PubMed, Scopus, EBSCOhost, and ScienceDirect to address the deontological ethics of clinical psychedelic use. Conclusion: Psychedelics need to be culturally contextualized, epistemic harm minimized and represented to ensure informed consent. Open data and commissions are needed to ensure safe and equal distribution. (shrink)

The integration of artificial intelligence (AI) into healthcare and research introduces sophisticated diagnostic and treatment capabilities but also raises significant ethical challenges from development to deployment and evaluation, requiring comprehensive ethical training and interdisciplinary collaboration to ensure the responsible use of AI technologies. The “CONNECT with AI”- Collaborative Opportunity to Navigate and Negotiate Ethical Challenges and Trials with Artificial Intelligence) workshop was a three-day event, engaging multi-institutional interdisciplinary and interprofessional participants (both industry professionals and academicians) from diverse fields such as (...) Medicine, Dentistry, Nursing, Engineering, Law, and Allied Health Sciences from India. There was equal distribution of participants from diverse fields. A mixed-method approach utilizing pre- and post-workshop assessments, confidence level surveys and thematic analyses of small group discussions and open-ended questions to evaluate the impact of the workshop on participants’ ethical understanding and decision-making skills regarding AI. Post-workshop evaluations indicated a significant improvement in both theoretical knowledge and practical application of AI ethics, with assessment scores rising markedly from pre-workshop levels (p < 0.0001). Confidence in handling ethical dilemmas related to AI saw substantial increases across all domains, particularly in ensuring patient privacy and data security (p < 0.0001). Qualitative feedback highlighted diverse perceptions and sector-specific concerns about AI, emphasizing the importance of customized ethical guidelines and the integration of AI into healthcare practices. The workshop effectively enhanced participants’ competence and confidence in addressing AI-related ethical issues, demonstrating the critical role of interprofessional education in fostering an ethical AI implementation framework. Continuous, interdisciplinary and interprofessional training is essential to navigate the evolving ethical landscape of AI in healthcare, ensuring safe, effective, and responsible technology use. (shrink)

Modern health care relies extensively on the use of technologies for assessing and treating patients, so it is important to be certain that health care technologies perform their professed functions in an effective and safe manner. Philosophers of technology have developed methods to assign and evaluate the functions of technological products, the major elements of which are described in the ICE theory. This paper questions whether the standard of evidence advocated by the ICE theory is adequate for ascribing and (...) assessing technologies employed in health care. The paper proposes that the general problem with the standard of evidence embodied in the ICE theory is too permissive for assessing medical technologies, in that it does not take into account the relative benefit and harm of medical technologies in ensuring safe functional performance in patients. The paper illustrates how evidence-based medicine has demonstrated the value of clinical research methods, including observational studies, randomized and non-randomized clinical trials, and formal techniques, such as meta-analysis, to measure therapeutic effectiveness. I argue, therefore, that evidence from clinical research studies should take precedence over the testimonial evidence and other types of non-clinical evidence, in providing justification for health technologies. (shrink)

– Pharmacy sales of over‐the‐counter medicines in the UK represent an economically significant and important mechanism by which customers self‐medicate. Sales are supervised in pharmacies, but this paper seeks to question whether patients' electronic health records – due to be introduced nationally – could be used, ethically, by pharmacists to ensure safe medicines sales., – Using theoretical arguments, three areas of ethical concern are identified and explored in relation to pharmacists' access to EHRs‐consequentialsim, analogies and confidentiality/privacy., – Consequentialist arguments (...) include positive benefits to customer's welfare and control of medicine of abuse, but negative economic healthcare burdens and consequences due to potentially increased or paradoxically, decreased presentation of patients to doctors. Socially accepted analogous practices – credit checks, existing pharmacy access to information and hospital treatment – are then argued to be ethically relevant and supportive of access. Privacy and confidentiality are then considered as reasons not to allow EHR access. A contrasting view is that pharmacy access to EHRs is another form of surveillance and hence the question of pharmacists' assess to EHRs may be answered negatively by empirical research that locates pharmacy customers as expert users and identifies confidentiality and privacy concerns about information technology in healthcare more generally., – This paper offers a unique and valuable contribution to the debate about healthcare professionals' role‐based access to patients' medical records and offers a reflection on the ethical concerns surrounding patient information and the rival concerns of patient qua customer autonomy and safety. (shrink)

"The Ethics of Medical Testing: Modern Medical Testing Is Shaped by a Troubled Legacy; Strict Guidelines Ensure Safe and Ethical Medical testing on Humans; Medical Testing on Humans Can Be Dangerous and Corrupt; Review Boards Are Inadequate to Ensure Ethical Medical Testing; Medical Testing on Prisoners Is Unethical and Should Be Outlawed; Medical Testing on Prisoners Can Be Done Ethically; Medical Testing on Children Involves Unique Considerations; Special Rules Help Ensure Medical Testing in Vulnerable Populations Remains Ethical; Using Animals (...) for Medical Testing Is Unethical and Unnecessary; Using Animals for Medical Testing Is Both Ethical and Essential; Genetic Testing Ushers in a New Era of Ethical Considerations; Prenatal Genetic Testing Creates Ethical Dilemmas for Parents; International Standards for Medical Testing Are Essential to Prevent Ethical Abuses; Medical Testing In Developing Countries Is Conducted Ethically; Ethicists Disagree About Medical Testing Without Consent During Crises"--. (shrink)

Food safety and food quality are two closely related aspects of the food management system. The difference between the two is that one keeps consumers safe while the other keeps consumers satisfied. This study examined the differences in how consumers value food safety and food quality with a focus on the influence of loss aversion on one’s psychological level and of income effect on one’s socio-demographic level. Our findings indicate that loss aversion and income effect significantly influence the way (...) consumers value food safety vs. quality labels when considering potential health risks and food price. High risk-averse and low-income consumers with strong loss aversion and a weak income effect show a higher demand for food safety labels as a way to ensure easy access to safety indications. Low risk-averse and high-income consumers with weak loss aversion and a strong income effect show a higher demand for food quality labels because they hope to gain more health benefits from high-quality food at good prices. This study provides insights that will assist public authorities and food industry in balancing food safety control and food quality improvement in order to meet the heterogeneous market demand changing alongside the transition of China’s food consumption and production. (shrink)

Background Professional misconduct undermines safe and quality care; however, little is known about its nature and influential factors. Aim This study aimed to explain the factors influencing professional misconduct in nurses. Research Design This qualitative study was conducted using the conventional content analysis method. Participants and Research Context Data were collected using semi-structured interviews with 19 nurses working in the hospital selected through a purposeful method and analyzed by Graneheim and Lundman approach. Ethical Considerations The ethics committee of Tehran (...) University of Medical Sciences approved this study with the ethics code IR.TUMS.FNM.REC.1400.187. Informed consent was obtained from all participants. Participants were assured of confidentiality. Findings Factors influencing professional misconduct by nurses were categorized into three main categories: human factors (nurses’ professional characteristics, personal characteristics of nurses and patient/companion, patient’s clinical condition), procedural factors (procedural conditions, possibility of proving misconduct), and organizational factors (recruitment process, conditions of resources, managing misconduct, bureaucracy, and ward characteristics). Conclusion This study assists in explaining the factors influencing professional misconduct by nurses. Therefore this study’s results can help managers and planners develop interventions to prevent and correct factors that contribute to misconduct and strengthen factors that prevent misconduct in order to ensure quality and safe patient care. (shrink)

Despite existing federal and state law and regulation, new human subjects research scandals involving “vulnerable” populations continue to surface. Although existing oversight mechanisms were enacted to ensure voluntary informed consent for participants and institutional review board oversight of HSR, these laws and regulations do not provide any special oversight mechanisms or protections to ensure the ethical and safe inclusion of cognitively impaired adults. The absence of rules to ensure consistently ethical conduct of research involving adults who lack consent capacity (...) may either lead to exploitation of this vulnerable population or the dearth of important research into the broad range of diseases that impair cognition. In other words, while some institutions and investigators are conducting research with this group without guidance, others are taking an extremely conservative approach and are excluding these individuals from research. Without safeguards that are adequate and robust but not overly burdensome, conducting research involving this population is ethically and legally challenging. (shrink)

There is an inextricable link between cultural and clinical safety. In Australia high‐profile Aboriginal deaths in custody, publicised institutional racism in health services and the international Black Lives Matter movement have cemented momentum to ensure culturally safe care. However, racism within health professionals and health professional students remains a barrier to increasing the number of Aboriginal and Torres Strait Islander Health professionals. The Australian Health Practitioner Regulation Agency's Aboriginal and Torres Strait Islander Health Strategy's objective to ‘eliminate racism from (...) the health system’, and the recent adoption of the Aboriginal and Torres Strait Islander peoples led cultural safety definition, has instigated systems level reflections on decolonising practice. This article explores cultural safety as the conceptual antithesis to racism, examining its origins, and contemporary evolution led by Aboriginal and Torres Strait Islander peoples in Australia, including its development in curriculum innovation. The application of cultural safety is explored using in‐depth reflection, and the crucial development of integrating critical consciousness theory, as a precursor to culturally safe practice, is discussed. Novel approaches to university curriculum development are needed to facilitate culturally safe and decolonised learning and working environments, including the key considerations of non‐Indigenous allyship and collaborative curriculum innovations and initiatives. (shrink)

Complex frameworks for defining programming languages aim to generate various tools (e.g. interpreters, symbolic execution engines, deductive verifiers, etc.) using only the formal definition of a language. When used at an industrial scale, these tools are constantly updated, and at the same time, it is required to be trustworthy. Ensuring the correctness of such a framework is practically impossible. A solution is to generate proof objects as correctness artefacts that can be checked by an external trusted checker. A logic (...) suitable for developing such frameworks is matching logic. K framework is a canonical example having matching logic-based foundation. Since the (symbolic) configurations of the programs are represented by matching logic patterns, the algorithms computing the dynamics of these configurations can be seen as pattern transformers and a proof object should be generated for the relationship between these patterns. In this paper, we show that conjunctions and disjunctions of patterns, produced by semantics or analysis rules, can be safely normalized using unification and antiunification algorithms. We also provide a prototype implementation of our proof object generation technique and a checker for certifying the generated objects. (shrink)

Nursing staff plays a key role in the public health response to the COVID-19 pandemic, being in the front line of care. This study sought to synthesise the qualitative literature on care experiences of frontline nurses during the COVID-19 pandemic. A search was conducted on five databases in January 2021. Fifteen qualitative studies met the inclusion criteria and were included in the research, being submitted to interpretive meta-synthesis according to the eMERGe guide. The final synthesis included a line of argument (...) that shows the experiences of frontline nurses during the COVID-19 pandemic, divided into three major themes: ‘Instability on the edge of a cliff: unpredictable and unknown context,’ ‘The price of walking the tightrope: the uncertainty surrounding care,’ and ‘Finding the balance to reach the other side: dealing with the emotional demands of care.’ Although essential in the health response to the COVID-19 pandemic, nurses experienced an emotional impact arising from the hampered care provision. Our results point to need for strengthening the training of nurses and future nurses, creating and promoting measures that contribute to their psycho-emotional well-being, ensuring a safe environment for their clinical practice, and promoting their participation in decision-making processes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Is Literature Self-Referential?Eric MillerIIs literary language necessarily self-referential? And does this put paradox at the heart of literature? For at least two decades now, affirmative answers to both questions have been articles of faith among critics in the structuralist and poststructuralist mainstream. Literature’s ineluctable paradoxicality attracts us so because a paradox suggests that there are limits to human rationality, and thus strikes a blow for literature and against science. (...) Paradox ensures literature its own special realm, safe from the culturally imperialistic inroads of science’s orderly, rational-empirical constructions. Literature thus gets to be seen as “bigger” than reason, because only literature can live with paradox, and thus only literature reveals those “deeper” truths of contradiction-ridden human existence, whereas science can never penetrate beyond rational manipulations of phenomenal surfaces. Indeed, for anyone who holds all human existence to be fundamentally paradoxical, this special capacity makes literature the only genuine, demystified species of human knowledge. In the war between C. P. Snow’s Two Cultures, a war humanists are now losing badly, we like to regard paradox as our ultimate weapon.Belief in the paradoxicality of literature may also be found among the New Critics, 1 and in fact goes back at least to the Romantics, 2 but they did not derive this belief from a necessary self-referentiality of literary language. This newer way of deriving paradox appears to offer several competitive advantages. Self-reference seems to be the ultimate version of “art for art’s sake”: if all literary language is necessarily self-referential, then literature must be something totally self-contained, and is thus legitimized solely in and through itself. In addition, deriving [End Page 475] literature’s paradoxicality from self-reference seems to ground it in the same conceptual realm as mathematical logic, and thus tempts us to claim for literature a “rigor” normally conceded only to logic, mathematics, and theoretical physics. Self-referentiality would thus seem both to protect literature’s autonomy and to raise its cultural status into the company of mathematics and science.But it is a trap. For behind this new strategy lurks a capitulation to the underlying conceptual scheme of natural science, and literature thus comes to be conceived, in effect, as a science. Self-reference is, after all, still a kind of reference; paradox is still a kind of truth-relational construction;—and truth-relations built around reference constitute the correspondence theory of truth. From such a foundational commitment to reference and correspondence-truth, flows the rest of the scientific worldview: the dualism of referring expression and referent, word and object, sentence and fact, theory and data, language and world, culture and nature. The presentation of literature as a quasi-negation of this ontology changes nothing. The dualism of reference still functions as literature’s conceptual starting point, as its arche. We only appear to be defining a peculiar and radically distinct sphere for literature when we insist on its self-referentiality, on the (recursive) identity, for it, of referring expression and referent. For, this is still to treat the conceptual distinction between the two as foundational, and literature thereby tacitly assimilates science’s fundamental categorial division: the referential language-world duality of correspondence truth. Indeed, literature thus comes to live even more completely in the margins of science: it will have no essence of its own; it will differ at most in being a photo-negative image of science’s positiv(istic) project. In Snow’s war, self-reference is a Trojan horse.With self-reference as the essence of literature, we are thus staking our reputations on literature’s being a special field of formalizable “knowledge about...,” rather than, say, a quality or kind or realm of possible experience—which is to adopt science’s understanding of what is important. Matters are only made worse by that other attempt to define literary studies as a negation of the theory-data dualism of natural science: the poststructuralist denial of the distinction between criticism and literature. For the institutional need professional critics have to be seen as a discipline with a method and a subject, as a form of “knowledge about,” hardly disappears with... (shrink)

In this manuscript I explore an example of an over-privileged white woman who encounters two young Black men in a parking garage stairwell. Two related axioms are central to the oppressive script that lies before these subjects: the hetero-patriarchal axiom that women are not safe alone at night and the racist axiom that Black men, especially young ones, are dangerous. These axioms are intended to ensure a practical conclusion—white women and Black men are supposed to avoid each other—thereby conferring (...) legitimacy on the white male, hetero-patriarchal order. If this is a performance of oppression, we must ask, what is the performance of freedom? Freedom, I argue, is the practice of allowing and encouraging a subject's multiple selves to interact so that one may devise and pursue courses of action that have been strategically hidden by systems of domination designed to cultivate pliant agency. My project augments accounts of multiplicitous subjectivity wherein our multiple social worlds socially constitute persons as both oppressor and oppressed, empowered and pliant. The practice of freedom conceived here acknowledges multiplicity while positioning us to seek feminist and antiracist futures that are not configured by oppression. (shrink)

Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)

With the technological evolutionary advent, a vision-based approach presents the remote measuring approach for the analysis of vibration. The structure vibration test and model parameter identification in the detection of the structure of the bridge evaluation occupies the important position. The bridge structure to operate safely and reliably is ensured, according to the geological data of qixiashan lead-zinc mine and engineering actual situation, with the aid of international mining software Surpac. To build the 3D visualization model of the application of (...) visualization in mine production are discussed. The results show that the final solid model of -425 stope can accurately display the spatial form of each layer of stope through rotation, amplification and movement. The proposed system is effectually able to perform cutting, volume calculation and roaming in any direction, which has certain guiding significance for mine production management. An accuracy value of 98.75%, the sensitivity of 99%, specificity of 99.64% and PPV of 99.89% are achieved using the proposed 3D modelling and visualization algorithm for vibration signal processing and management. (shrink)

This paper critically examines the implications of state efforts to expand prescriptive authority of pharmacists, which will allow them to prescribe various types of hormonal contraceptives. With this expansion, women no longer need to see a physician before being prescribed such contraceptives, but instead, they must answer self-assessment questionnaires at the pharmacy to ensure that their chosen method is safe and appropriate. This paper argues that while these measures to expand pharmacists’ prescriptive authority will surely meet the stated goal (...) to increase access to hormonal contraceptives, the measures may have detrimental consequences that have largely been downplayed. Studies consistently show that the OB-GYN is a significant primary care provider identified by young female patients, and some of the main reasons provided by these young women for going to the OB-GYN is to discuss, or obtain a prescription for, contraceptives. Through the expansion of pharmacists’ prescriptive authority, a likely consequence is that some women will relinquish going to the OB-GYN. However, the OB-GYN provides important services beyond contraceptives, such as preventive screenings for hypertension, cardiovascular diseases, alcohol abuse, mental health, etc., and there is evidence supporting both the effectiveness and cost–benefits of these interventions. By increasing access to contraceptives, the likely result is that many women will have less interaction with a physician and will receive fewer preventive screenings. I do not wish to suggest that these bills should not pass, nor that OB-GYNs should hold contraceptives hostage, only that there are consequences to expanded prescriptive authority that must be anticipated. Further, expanding prescriptive authority obscures the real problem: some individuals have trouble accessing the health care system, not merely trouble accessing hormonal contraceptives. The expansion of prescriptive authority to include contraceptives applies a Band-Aid to treat one aspect of this problem. What is needed is not merely expanded access to hormonal contraceptives, but better access to health care in general. (shrink)

The United Nation’s (UN) 3rd Annual Multi-stakeholder Forum on ‘Science, Technology and Innovation for the Sustainable Development Goals (STI Forum) - Transformation Towards Sustainable and Resilient Societies’ was held at the UN Headquarters in New York on 5th and 6th of June, 2018. This STI Forum set out to discuss a suit of the sustainable development goals, namely sustainable management of water and sanitation for all (SDG 6), sustainable consumption and production patterns (SDG 12), and sustainable terrestrial ecosystems (SDG 15). (...) It also discussed how to ensure access to affordable, reliable, sustainable and modern energy for all (SDG 7) and how to make cities and human settlements inclusive, safe, resilient and sustainable (SDG 11). I participated in the panel debate on ‘Science, Technology and Innovation for Sustainable Terrestrial Ecosystems (SDG 15)’ – emphasizing the importance of food systems in the context of SDG 15. My statement is summarized below. The panel debate aimed at helping to identify good practices and policy recommendations, as well as challenges and needs, especially as they relate to international cooperation, innovation and capacity-building, with a view to facilitate the development, scaling up adoption and dissemination of relevant technologies for SDG 15. A food system can be described as a system that embraces all the elements (environment, people, inputs, processes, institutions, infrastructure, markets and trade) and activities that relate to the production, processing, distribution and marketing, preparation and consumption of food and the outputs of these activities, including socio-economic and environmental outcomes. A sustainable food system delivers food and nutrition security for all in such a way that the economic, social and environmental bases to generate food security and nutrition for future generations are not compromised. (shrink)

BackgroundPatients have the right to equal, respectful treatment. Nowadays, one third of patient complaints concern health care staff’s behavior towards patients. Ethically safe care requires ethical competence, which has been addressed as a core competence in physiotherapy. It has been defined in terms of character strength, ethical awareness, moral judgment skills in decision-making, and willingness to do good. The purpose of this study was to analyze the ethical competence of practicing physiotherapists.MethodA self-evaluation instrument (Physiotherapist’s Ethical Competence Evaluation Tool) based (...) on an analysis of a concept “ethical competence” was constructed in 2016 and physiotherapists (n = 839), working in public health services or private practice responded to the questionnaire.ResultsBased on the results, most of the physiotherapists evaluated themselves highly ethically competent in all areas of ethical competence, subscales being Strength, Awareness, Skills and Will. Willingness to do good was evaluated as highest, while character strength, including the strength to support ethical processes and speak on behalf of the patient, was evaluated the lowest. Physiotherapists most commonly consult a colleague when encountering an ethical problem. Other methods for problem solving are not very familiar, neither are the international or national ethical codes of conduct.ConclusionsThis was the first attempt to assess all aspects of ethical competence empirically in a clinical environment in physiotherapy, using a novel self-evaluation instrument. Even if physiotherapists evaluate themselves as competent in ethics, further exploration is needed for ethical awareness. Also the patients’ viewpoints about ethically competent care should be considered, to better ensure ethical safety of the patient. (shrink)

Background: Responsibility is an important component of the professional values and core competencies for bachelor degree nursing students and has relationships with nursing education and professionalization. It is important for providing safe and high-quality care to the clients for the present and future performance of student. But there is no clear and operational definition of this concept for bachelor degree nursing students; however, there are extensive contents and debates about the definitions, attributes, domains and boundaries of responsibility in nursing (...) and non-nursing literature. Objective: To examine the concept of responsibility among bachelor degree nursing students using the evolutionary approach to concept analysis. Methods: A total of 75 articles published between 1990 and 2016 and related to the concept of responsibility were selected from seven databases and considered for concept analysis based on Rogers’ evolutionary approach. Ethical considerations: Throughout all stages of data collection, analysis and reporting, accuracy and bailment were respected. Findings: Responsibility is a procedural, spectral, dynamic and complex concept. The attributes of the concept are smart thinking, appropriate managerial behaviours, appropriate communicational behaviours, situational self-mandatory and task-orientation behaviours. Personal, educational and professional factors lead to the emergence of the responsible behaviours among bachelor degree nursing students. The emergence of such behaviours facilitates the learning and education process, ensures nursing profession life and promotes clients and community health level. Responsibility has some effects on nursing students. Discussion: This concept had been changed over time since 1990–2016. There are similarities and differences in the elements of this concept in disciplines of nursing and other educational disciplines. Conclusion: The analysis of this concept can help to develop educational or managerial theories, design instruments for better identification and evaluation of responsible behaviours among bachelor degree nursing students, develop strategies for enhancing the responsibility and improve the safety and quality of nursing care in the community and healthcare system. (shrink)

This article shows how state guardianship law can provide a mechanism for courts to reduce gun violence by removing the right to possess firearms from individuals found, after hearing and due process, to be incapable of safely possessing them. It explores how this often overlooked body of law not only complements extreme risk protection orders where they exist, but can also be used to accomplish a portion of what such orders are designed to do in states that have not authorized (...) them. It concludes by suggesting some modest adjustments to guardianship law and practice that would help ensure that guardianship systems interventions in this arena are fair and effective. (shrink)

This practical guide explores professional values in nursing, helping you to develop safe, compassionate, person-centred and evidence-based practice. The fundamental values of equality, anti-discriminatory practice and caring are discussed throughout. Chapters explore person-centred and holistic nursing care. They discuss working in partnership with people and families and working in partnership within the interprofessional team. The book explores vulnerability and safeguarding, challenging poor practice and promoting best practice. Chapters are mapped to NMC Standards for Pre-registration Nursing Education. Strong evidence base (...) to ensure best practice. Accessible style with features including learning outcomes, key points, summary boxes, case studies, reflection points and questions. Relevant to all fields of nursing, with case studies representing patients across the lifespan and with different healthcare needs. Free online resources include PowerPoints, additional scenarios and questions. Professional Values in Nursing is a valuable resource for all nursing students, helping to embed professional values in your everyday practice. (shrink)

The article examines the Scandinavian model of public administration, which is characterized by a corporate decision-making system (state – trade unions – employers), in which the role of coordinator in this structure is assigned to the authorities. It was determined that the state assumes responsibility for providing the population with social benefits and exercises control over the economy, promoting fair competition, safe working conditions and employment of the population. Characteristic features are a high level of trust of citizens in (...) public authorities and their participation in decision-making (through a referendum, consultations with the public, trade unions), openness and accountability of public authorities to the population. It is highlighted that the studied Scandinavian countries, Sweden and Norway, are leaders in the world in terms of the standard of living of the population, economic development, ensuring social standards and political stability, which is a guarantee of the high competitiveness of the Scandinavian countries. It is noted that different levels of government (state, regional, local) work together on favorable conditions for the country’s development and on ensuring quality living conditions for its citizens. A reliable basis for ensuring the high competitiveness of the countries under study is the balanced and effective functioning of all subsystems within the nation. Scandinavian countries are able to maximally combine progressive political and economic development and a high level of social security in modern conditions, which is a necessary condition for achieving high competitiveness in the world.Thus, the comparative study conducted in the mentioned Scandinavian countries using the method of binary longitudinal temporal comparison made it possible to single out a model of public policy of liberal democratic states, in which effective interaction between the government and society regarding the development and implementation of political decisions is established.Constructive factors that affect the relationship between the government and society and contribute to the functioning of this model of public policy are: clear legislative regulation of the legal status of all participants in the socio-political process; high level of political and legal culture and consciousness; stable economy; the activity of expert groups, the presence of independent institutes of control over the activities of the authorities, and others. The number of constructive factors of influence in these states significantly exceeds the level of destructive ones. An important condition for the functioning of public policy in liberal democracies is the presence of feedback between the government and society. (shrink)

After the US Supreme Court’s reversal of Roe v. Wade, a number of states have immediately banned abortion. Pro-choice activists are responding by promoting medication abortions – a do-it-yourself form of abortion. Women can take pills at home to induce an abortion in the first few weeks of pregnancy. -/- The Biden Administration [1] has backed the abortion pill, too. Attorney-General Merrick B. Garland and Health and Human Services Secretary Xavier Becerra both issued statements endorsing it. -/- “We stand ready (...) to work with other arms of the federal government that seek to use their lawful authorities to protect and preserve access to reproductive care,” said the Attorney-General. “In particular, the F.D.A. has approved the use of the medication mifepristone. States may not ban mifepristone based on disagreement with the F.D.A.’s expert judgment about its safety and efficacy.” -/- As the New York Times [1] has noted, this sets the scene for legal battles. The obvious one is: will anti-abortion states prosecute medication abortions? -/- But – based on experience in the United Kingdom - the use of the abortion pill could give pro-life doctors headaches as well. -/- In the past year, UK has witnessed the saga of two Catholic doctors who have been brought in front of the professional regulator, the General Medical Council, after accusations of professional misconduct. Their crime? They had supplied abortion pill reversal (APR) treatment to women. Accusations of this misconduct have been brought forward by pro-choice organisations [2]. -/- The problem is that some women might panic when they discover that they are pregnant or are pressured to make a rash decision. They obtain abortion pills, often without seeing a doctor faceto- face, and soon after taking the first pill, they regret their decision. -/- Is it too late for them to save their pregnancy? Not necessarily. -/- A treatment developed in the US works about half the time. It involves the woman taking progesterone after the first abortion pill to counteract the abortifacient action of the drug. -/- Seventy-three women in the UK are reported to have taken a full APR course, of whom, 38 – more than half — successfully remained pregnant. Admittedly, the procedure is controversial [3], with pro-choice writers denouncing it as unproven, unscientific, and unethical. This has triggered some healthcare practitioners and scholars to analyse the commitments of the pro-choice movement to APR. In a recently published paper in The New Bioethics [4], two colleagues, Dominic Whitehouse and Steven Bow, and I argue that those espousing a pro-choice worldview should actually support abortion pill reversal and that the current evidence indicates that they should actually be doing it. -/- While some pro-choice activists might be happy simply to expand women’s reproductive choices, some might also want to ensure that these choices are safe and effective at achieving the desired outcome, which in principle includes maintaining a pregnancy. -/- We then review the scientific evidence with respect to the ability of APR to halt an abortion, look at the potential impact of APR on mental health, as well as its procedural safety. While highlighting that gold-standard evidence is lacking, we note that APR is associated with about two times higher rate of embryo survival compared to not completing the full early medical abortion course, that there is large agreement in the literature that women who are ambiguous about abortion are at risk of poorer mental health outcomes after abortion (and argue that women who request APR fall into this category), and highlight that there is no evidence that APR is more dangerous than abandoning an initiated early medical abortion. -/- The latter fact is important, as the results of the only randomised-controlled trial of APR have been at times misrepresented in the media [5.6], creating the impression that APR is not safe while most of the adverse effects occurred in the study group that did not receive APR. As our paper argues, with respect to APR the two UK doctors were “champions of women’s choice and should be congratulated, not condemned, by pro-choice advocates”. -/- While the cases against the two doctors have now been dropped (and there have even been accusations against a member of one of these pro-choice organisations that they pressurised a patient into complaining about one of the doctors and twisted the patient’s experience of the treatment [7]), we argue that it is important to set-up systems to facilitate the future provision of APR to protect both patients and healthcare staff. -/- Our conclusion is that, while being open to any change in evidence, those espousing a pro-choice outlook should “support calls for an APR framework that will protect women and the healthcare professionals caring for them” “and certainly not oppose” APR. -/- The debate over abortion pill reversal will be heading to the United States soon. It is quite possible that it will be denounced as dangerous misinformation. It’s not. But pro-life defenders should be prepared to defend their ground. -/- This article was first published by Mercatornet. (shrink)

As the world has turned into a global village, it has created many challenges for human resource departments regarding the management of a diverse workforce in satisfying the employees and creating a diverse yet safe environment for them that does not make them uncomfortable. The current study has investigated the effect of human resource practices on the diversity climate with the mediation of job satisfaction. The data has been collected from human resource personnel of multinationals in China with the (...) help of 316 participants. The study deployed SEM analysis to analyze and measure the effect of training and development along with performance appraisal on the diversity climate. The findings of the study revealed that training and growth or development do not have an impact on the diversity climate, however, performance appraisal has a strong positive impact. Similarly, the mediating role of job satisfaction has been found to ensure the relationship of training and development and performance appraisal with the diversity climate. This study has provided certain implications for the HR managers of multinationals to ensure a secure diversity climate for a diverse workforce. (shrink)

Background: Nurse managers are expected to continuously ensure that ethical standards are met and to support healthcare workers’ ethical competence. Several studies have concluded that nurses across various healthcare settings lack the support needed to provide safe, compassionate and competent ethical care. Objective: The aim of this study was to explore and understand how nurse managers perceive their role in supporting their staff in conducting ethically sound care in nursing homes and home nursing care. Design and participants: Qualitative individual (...) interviews were performed with 10 nurse managers with human resources responsibilities for healthcare workers in four nursing home wards and six home nursing care districts. Content analysis was used to analyse the data. Ethical considerations: The Norwegian Centre for Research Data granted permission for this study. Findings: The analysis resulted in seven subcategories that were grouped into three main categories: managers’ perception of the importance of the role, managers’ experiences of exercising the role and managers’ opportunities to fulfil the role. Challenges with conceptualizing ethics were highlighted, as well as lack of applicable tools or time and varying motivation among employees. Discussion: The leaders tended to perceive ethics as a ‘personal matter’ and that the need for and benefit of ethical support (e.g., ethics reflection) depended on individuals’ vulnerability, attitudes, commitment and previous experiences. The managers did not seem to distinguish between their own responsibility to support ethical competence and the responsibility of the individual employee to provide ethical care. Conclusions: Our findings suggest that nurse managers need support themselves, both to understand and to carry out their responsibilities to foster their staffs’ ethical conduct. Supporting staff in conducting ethically sound care requires more than organizing meeting places for ethical reflection; it also requires greater awareness and understanding of what ethical leadership means. (shrink)

This article address the issue of employee safety and the social responsibility of multinational apparel retailers who contract with Bangladesh manufacturers in their global supply chain. Both the Alliance for Bangladesh Worker Safety and the Accord on Fire and Building Safety in Bangladesh have been identified as the two primary facilitators for global apparel industry efforts to actively address this serious human rights issue; thus, they have the potential to help drive the success of the industry's corporate citizenship efforts to (...) successfully manage the issue of fire and building safety in Bangladesh. The article further explores these relationships within the context of the “global corporate citizenship” concept, and develops a rationale for the limits of a socially responsible supply chain. In the context of global corporate citizenship, the article describes the existing state of these two industry organizations remediation efforts to ensure a stable supply chain in Bangladesh, and offers an analysis of existing industry nonmarket strategy approaches to improving contractor's factory fire and building safety environments for their employees. Lastly, a comprehensive set of nonmarket strategies for multinational apparel retailers is recommended when addressing their global corporate citizenship commitments to a safe working environment for Bangladesh garment manufacturing employees. (shrink)

ABSTRACTComparative effectiveness studies, referred to here as “usual-care” trials, seek to compare current medical practices for the same medical condition. Such studies are presumed to be safe and involve only minimal risks. However, that presumption may be flawed if the trial design contains “unusual” care, resulting in potential risks to subjects and inaccurately informed consent. Three case studies described here did not rely on clinical evidence to ascertain contemporaneous practice. As a result, the investigators drew inaccurate conclusions, misinformed research (...) participants, and subjects’ safety was compromised. Before approving usual-care protocols, IRBs and scientific review committees should evaluate the quality and completeness of information documenting usual-care practices. Guidance from governmental oversight agencies regarding evidence-based documentation of current clinical practice could prevent similar occurrences in future usual-care trials. Accurate information is necessary to ensure that trials comply with government regulations that require minimizing research risks to subjects and accurate informed consent documents. (shrink)

The concept of faith is a word that comes from the root e-m-n, meaning to believe, to trust, to be attached, to obey, to obey and to follow. It is a concept that is used with different conjunctions/letters in Arabic language grammar and semantics and gains different meanings according to the conjunction/letter used together, also differs and diversifies depending on the starting points and approaches, and has special field uses as well as meaning contractions and expansions. Investigative faith includes a (...) meaning that provides the heart with a boost in regard to all the orders/reverses conveyed by the Messenger of Allah, inspires confidence, gives certainty, makes it safe enough to bring peace and tranquility, and ensures that it is accepted on the axis of reason and transmission.. On the other hand, imitation faith means acting on the suggestion and word of another, believing and trusting, trusting and following without feeling the need to search for evidence, question and research. These two concepts also reveal the type, degree and severity of commitment to what is believed, depending on the inner world of people. In this context, imitative faith, which expresses people's shallow ties and superficial faith, has less effect on influencing people and adding meaning to life, whereas, on the other hand, intangible faith, which is questioned, wondered and researched, established and internalized in the context of evidence and knowledge, affects the states and actions of people. It gives direction, becomes more effective, meets the search for meaning in life, and raises the person to the level of a more confident, happy and peaceful individual. (shrink)

The aim of the present study was to describe how registered nurses in nursing homes ensure legal security, good and safe nursing care and uphold the dignity of nursing home residents with severe dementia without violating residents’ integrity. Semi-structured interviews were conducted with 10 charge nurses in a county in central Sweden. The transcribed interviews were examined using manifest and latent content analyses. The manifest analysis identified actual local routines involving coercive treatment and registered nurses’ descriptions of complications and (...) alternative measures. The latent analysis resulted in three themes describing nursing strategies: one with coercive treatment, one with coercive treatment under specific circumstances and one to prevent coercive treatment. Interpretations of legal terms regarding coercive treatment and inadequate gerontological nursing training and understaffing seem to preserve the use of coercive treatment. (shrink)